[Abuse: emergency department management].

Abuse has many forms. Its societal impact is substantial. Abused patients are insufficiently identified as such.

Opioid-related adverse drug reactions in patients visiting the emergency division of a tertiary hospital.

Opioid use and associated morbidity and mortality have increased in several countries during the past 20 years. We performed a study whose objective was to assess the frequency and causes of opioid-related emergency division (ED) visits in an adult tertiary Swiss University Hospital over 9 weeks in 2018. We primarily assessed opioid-related adverse drug reactions (ADR), secondary overdose, misuse, abuse, and insufficient pain relief.

[Interdisciplinarity and critical care in emergency medicine].

Cardiorespiratory arrest, stroke and severe trauma have serious consequences if untreated with strict procedures in a timely manner. This temporal imperative implies the implementation of a succession of actions coordinated by healthcare providers with diverse expertise, and operating according to known, mastered and trained standards of care. Simple and clear communication principles ensure the consistency and fluidity of these actions.

A new screening tool for SARS-CoV-2 infection based on self-reported patient clinical characteristics: the COV-ID score.

Background: While several studies aimed to identify risk factors for severe COVID-19 cases to better anticipate intensive care unit admissions, very few have been conducted on self-reported patient symptoms and characteristics, predictive of RT-PCR test positivity. We therefore aimed to identify those predictive factors and construct a predictive score for the screening of patients at admission.

Methods: This was a monocentric retrospective analysis of clinical data from 9081 patients tested for SARS-CoV-2 infection from August 1 to November 30 2020.

[The toxicological testing in the emergency room in the era of ].

The emergency physician is frequently called upon to take care of intoxicated patients. The identification of the culprit is a diagnostic challenge when the clinical picture is discordant, or the poisoning uncertain. Toxicological screening is of limited usefulness to the ED physician.

[The diagnostic approach of stable coronary heart disease : What risk can you trust ?].

We present the case of a 72-year-old patient, with multiple cardiovascular risk factors, investigated for exertional dyspnea. The diagnostic workup led to a percutaneous coronary intervention. During the procedure, catheter-induced iatrogenic coronary artery dissection (CICAD) resulted in cardiorespiratory arrest.

Impact of a patient-flow physician coordinator on waiting times and length of stay in an emergency department: A before-after cohort study.

Objective: Overcrowding is common in most emergency departments (ED). Despite the use of validated triage systems, some patients are at risk of delayed medical evaluation. The objective of this study was to assess the impact of a patient-flow physician coordinator (PFPC) on the proportion of patients offered medical evaluation within time limits imposed by the Swiss Emergency Triage Scale (SETS) and on patient flow within the emergency department of a teaching urban hospital.

[Analgesia and sedation in the pregnant patient].

Nonobstetric emergencies are frequent during pregnancy. The emergency physician must be knowledgeable regarding the physiological changes related to pregnancy, and must evaluate the benefit/risk ratio of any medication given to the mother. Though maternal side-effects are easy to predict, the fetal risk remains difficult to evaluate as medications are numerous and clinical evidence scarce.

[Emergency medicine : update 2017].

Emergency medicine is part of the current stream of efficient and qualitative medicine : 1) the modified Valsava maneuver results in the resolution of almost 50% of supra-ventricular tachycardia without any drug; 2) lung echography performed by emergency physicians is a very sensitive and specific diagnostic tool for most thoracic emergencies; 3) cardiopulmonary resuscitation initiated by lay-rescuers improves short and long-term outcome; 4) no anticoagulant treatment is warranted in distal deep vein thrombosis and 5) systematic unenhanced abdominal CT might improve evaluation of elderly patients with acute abdominal pain.

Brugada Pattern Caused by a Flecainide Overdose.

Background: Brugada pattern can be found on the electrocardiogram (ECG) of patients with altered mental status, usually with fever or drug intoxication. Diagnosis remains challenging, because the ECG changes are dynamic and variable. In addition, triggers are not always clearly identified.

[Acute dyspnea in the emergency room: from pathophysiology to ultrasonography].

Acute dyspnea is one of the leading clinical symptoms encountered in the emergency room. Its differential diagnosis is wide, ranging from noisy panic attacks to threatening acute heart failure. History taking and physical examination, even when exhaustive are of limited diagnostic value.

[Acute analgesia: implementation of a dedicated protocol in an emergency department].

Acute pain relief is an ongoing challenge for both nurses and emergency physicians. Its management remains suboptimal or delayed, despite the existence of valid recommendations. The complexity of the emergency department and the diversity of encountered situations justify a tailored approach, taking into account the patient's clinical characteristics and needs.

[Shock: diagnostic evaluation in the emergency department].

The identification of shock may be sometimes easy or on the other hand difficult due to the lack of accuracy of ancillary tests. The use of ultrasound has modified the initial emergency assessment of patients presenting with shock, in that it can now be used to differentiate between different types of shock (cardiogenic versus hypovolemic). The use, performance, and clinical benefits of ultrasound protocols applied by emergency physicians, still remain to be validated before to be implemented.