RESUMO
Bleeding in late-term pregnancy can present as an innocuous start to parturition or a catastrophic maternal-fetal hemorrhage masked by the physiologic adaptations of pregnancy. The emergency management of late-term bleeding can be challenging, especially when providing stabilizing care in a limited-resource environment. Early recognition of life-threatening vaginal bleeding, potential causes, and emergency management of maternal-fetal distress is reviewed. Maternal resuscitation with balanced versus targeted blood products replacement is presented for low-resource versus high-resource environments. Emergency department readiness for such a patient, in combination with appropriate consultation or transfer, is essential to the effective management of late-term vaginal bleeding.
Assuntos
Complicações na Gravidez/diagnóstico , Terceiro Trimestre da Gravidez , Hemorragia Uterina/complicações , Serviço Hospitalar de Emergência , Feminino , Humanos , Gravidez , Complicações na Gravidez/terapia , Hemorragia Uterina/diagnóstico , Hemorragia Uterina/terapiaRESUMO
Patients with complications of chemotherapy, either acute or chronic, are frequently encountered in the emergency department (ED). Some patients present with complaints immediately after chemotherapy administration, whereas others may show subtle, secondary signs or may have no signs or symptoms of chemotoxicity. An increased index of suspicion prompts early recognition, diagnosis, and prevention of further iatrogenic injury. This article reviews characteristic hypersensitivity reactions, typical organ system dysfunction, and treatment strategies for adult patients who present to the ED with complications after chemotherapy.
Assuntos
Hipersensibilidade a Drogas/diagnóstico , Hipersensibilidade a Drogas/terapia , Serviços Médicos de Emergência/métodos , Adulto , Serviço Hospitalar de Emergência , HumanosRESUMO
Patients with complications of chemotherapy, either acute or chronic, are frequently encountered in the emergency department (ED). Some patients present with complaints immediately after chemotherapy administration, whereas others may show subtle, secondary signs or may have no signs or symptoms of chemotoxicity. An increased index of suspicion prompts early recognition, diagnosis, and prevention of further iatrogenic injury. This article reviews characteristic hypersensitivity reactions, typical organ system dysfunction, and treatment strategies for adult patients who present to the ED with complications after chemotherapy.
