Emergency Department (ED) patients frequently present with injuries and disease requiring procedural sedation and analgesia (PSA). PSA is a core skill for Emergency Physicians (EP) and acts to relieve pain and anxiety for patients. The procedure involves providing sedative and analgesic agents in order to allow EPs to effectively perform critical procedures from joint reduction to incision and drainage of abscesses to laceration repairs to preoxygenation.
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Annual emergency department visits for skin and soft tissue infections (SSTI) are on the rise nationwide, and an increased incidence of abscesses is the likely culprit. MRSA is quickly emerging as the most common cause of purulent SSTIs, and Trimethoprim-Sulfamethoxazole (TMP-SMX) remains a cost-effective first line enteral antimicrobial to treat it. The primary treatment for a cutaneous abscess is incision and drainage (I&D),
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Warfarin and clopidogrel are two commonly prescribed anticoagulant medications, and based on previous studies, patients taking either of these medications who suffer blunt head trauma are at an increased risk for traumatic intracranial hemorrhage (ICH). Additionally, there is concern that patients on these agents can have delayed traumatic ICH (traumatic ICH occurring within 2 weeks after an initially normal CT scan result in the absence of recurrent head trauma).
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Corneal abrasions account for approximately 10% of eye-related visits to the Emergency Department (ED). The cornea is a highly innervated structure and, thus, remarkably sensitive, making this condition a notoriously painful one. We have all witnessed the almost magical analgesia achieved with application of topical anesthetics when evaluating these patients. Unfortunately, we limit the use of this effective pain management modality to the ED because of the seemingly prohibitive dangers of prolonged use of these agents.
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In cardiopulmonary resuscitation (CPR), chest compressions are frequently interrupted to provide rescue breathing. It has been documented in several pig models that these pauses are associated with a decrease in coronary perfusion pressure. Furthermore, it may take several minutes of chest compressions to restore perfusion pressures to adequate values. Other studies have found interruptions to be associated with decreased survival in animals with cardiac arrest.
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Peripheral venous cannulation is the most frequently performed procedure in the Emergency Department (ED). The vast majority of patients admitted to the hospital will leave the ED with an intravenous catheter (IV). While these devices typically have a “life-span” of 72 hours from placement, they often fail prematurely as a result of infection, phlebitis, occlusion or dislodgement.
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Despite several expert panel recommendations and cellulitis treatment guidelines, there are currently no clinical decision rules to assist clinicians in decideding which Emergency Department (ED) patients should be treated with oral antibiotics and which patients require IV therapy at first presentation of cellulitis amenable to outpatient treatment.
Cellulitis is an acute or subacute infection of the dermis and subcutaneous tissue of presumed bacterial etiology charactrerized by warmth,
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