The number of critically ill patients that present to emergency departments across the world continues to rise. In fact, the proportion of critically ill patients in emergency departments is now higher than pre-COVID-19 pandemic levels. [1] The emergency physician (EP) is typically the first physician to evaluate and resuscitate the critically ill patient.
View Article and Find Full Text PDFThe number of critically ill patients that present to emergency departments across the world has risen steadily for nearly two decades. Despite a decrease in initial emergency department (ED) volumes early in the COVID-19 pandemic, the proportion of critically ill patients is now higher than pre-pandemic levels [1]. The emergency physician (EP) is often the first physician to evaluate and resuscitate a critically ill patient.
View Article and Find Full Text PDFAn emergency physician (EP) is often the first provider to evaluate, resuscitate, and manage a critically ill patient. Over the past two decades, the annual hours of critical care delivered in emergency departments across the United States has dramatically increased. During the period from 2006 to 2014, the extent of critical care provided in the emergency department (ED) to critically ill patients increased approximately 80%.
View Article and Find Full Text PDFGiven the dramatic increase in critically ill patients who present to the emergency department for care, along with the persistence of boarding of critically ill patients, it is imperative for the emergency physician to be knowledgeable about recent developments in resuscitation and critical care medicine. This review summarizes important articles published in 2020 that pertain to the resuscitation and care of select critically ill patients. These articles have been selected based on the authors annual review of key critical care, emergency medicine and medicine journals and their opinion of the importance of study findings as it pertains to the care of critically ill ED patients.
View Article and Find Full Text PDFAn emergency physician (EP) is often the first health care provider to evaluate, resuscitate, and manage a critically ill patient. In recent years, the annual hours of critical care delivered in emergency departments across the United States has steadily increased. From 2006 to 2014, emergency department (ED) visits for critically ill patients increased approximately 80%.
View Article and Find Full Text PDFAn emergency physician (EP) is often the first health care provider to evaluate, resuscitate, and manage a critically ill patient. In recent years, the annual hours of critical care delivered in emergency departments (EDs) across the United States increased more than 200% (Herring et al., 2013).
View Article and Find Full Text PDFThere are currently 5 combined residencies in emergency medicine (EM), namely EM/pediatrics, EM/internal medicine, EM/internal medicine/critical care, EM/family medicine and EM/anesthesiology. These combined programs vary from 5-6 years in length. Like categorical programs, the decision to enter a 5- or 6-year program should be an informed and comprehensive decision.
View Article and Find Full Text PDFAn emergency physician (EP) is often the first health care provider to evaluate, resuscitate, and manage a critically ill patient. Between 2001 and 2009, the annual hours of critical care delivered in emergency departments (EDs) across the United States increased >200% [1]! This trend has persisted since then. In addition to seeing more critically ill patients, EPs are often tasked with providing critical care long beyond the initial resuscitation period.
View Article and Find Full Text PDFAn emergency physician (EP) is often the first health care provider to evaluate, resuscitate, and manage a critically ill patient. Between 2001 and 2009, the annual hours of critical care delivered in emergency departments (EDs) across the United States increased >200%! (Herring et al., 2013).
View Article and Find Full Text PDFIntroduction: Many patients presenting to urban emergency departments (EDs) have chief complaints directly related to the use of illicit drugs. Given the reluctance of patients to admit to their use of cocaine, it is important for the emergency medicine provider (EMP) to recognize key epidemiologic principles as well as features of the history, physical examination, and diagnostic studies that suggest the sequelae of cocaine abuse.
Case Presentation: We describe our assessment of an otherwise healthy 47-year-old man with the acute onset of pleuritic chest pain accompanied by hypoxia, radiographic evidence of diffuse alveolar hemorrhage (DAH), and an elevated creatine phosphokinase (CPK) level.
With an aging population, emergency department clinicians can expect an increase in geriatric patients presenting with abdominal pain. Compared with younger patients, this patient population is less likely to present with classic symptoms, physical examination findings, and laboratory values of abdominal disease. However, the morbidity and mortality associated with elderly patients presenting with abdominal pathologic conditions are significant.
View Article and Find Full Text PDFAbdominal vascular catastrophes are among the most challenging and time sensitive for emergency practitioners to recognize. Mesenteric ischemia remains a highly lethal entity for which the history and physical examination can be misleading. Laboratory tests are often unhelpful, and appropriate imaging must be quickly obtained.
View Article and Find Full Text PDFEvery year, thousands of articles are published in numerous medical journals that relate to the clinical practice of medicine. However, it is impossible for a single clinician to stay abreast of the literature, let alone to determine which articles should change daily practice. Physicians in our department have searched the emergency medicine and the specialty literature of 2014 to determine which articles are most relevant to the clinical practice of emergency medicine, summarized them, and listed key take-home points from these 'need-to-know' articles.
View Article and Find Full Text PDFTransition metal dichalcogenides (TMDs) have emerged as a new class of two-dimensional materials that are promising for electronics and photonics. To date, optoelectronic measurements in these materials have shown the conventional behavior expected from photoconductors such as a linear or sublinear dependence of the photocurrent on light intensity. Here, we report the observation of a new regime of operation where the photocurrent depends superlinearly on light intensity.
View Article and Find Full Text PDFAbdominal pain is one of the most frequent reasons that elderly people visit the emergency department (ED). In this article, we review the deadliest causes of abdominal pain in this population, including mesenteric ischemia, abdominal aortic aneurysm, and appendicitis and potentially lethal non-abdominal causes. We also highlight the pitfalls in diagnosing, or rather misdiagnosing, these clinical entities.
View Article and Find Full Text PDFThe expanding use of bedside ultrasonography in the practice of emergency medicine and other specialties is accompanied by the need to train medical students in its applications and interpretation of its results. In this article, the authors describe their successful design, launch, and management of the ultrasound elective at the University of Maryland School of Medicine. Because the course has been so well received, the authors are now exploring ways of presenting its content and skills-building opportunities in more venues, including the Introduction to Clinical Medicine course.
View Article and Find Full Text PDFEmerg Med Clin North Am
November 2013
Drugs and natural compounds that affect the thermoregulatory system can induce or contribute to hyperthermia when used in excess. Hyperthermia associated with drug overdose is dangerous and potentially lethal. This article reviews the body's process of maintaining thermodynamic equilibrium, and describes the mechanisms by which it is influenced by sympathomimetic and anticholinergic drugs, salicylates, and thyroid replacement medications.
View Article and Find Full Text PDFThe QT interval measures the time from the start of the QRS complex to the end of the T wave. Prolongation of the QT interval may lead to malignant ventricular tachydysrhythmias, including torsades de pointes. Causes of QT prolongation include congenital abnormalities of the sodium or potassium channel, electrolyte abnormalities, and medications; idiopathic causes have also been identified.
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