There are more than 450,000 Emergency Department presentations each year for children with blunt head trauma. 25% of visits for blunt head trauma are in children less than 24 months of age. Scalp hematomas in this age group maybe the only sign of traumatic brain injury (TBI). An astute clinician must clinically assess those with possible TBI,
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Abdominal pain is the most frequent presenting symptom in US emergency departments. The current standard care in the ED for upper abdominal pain involves ruling out severe causes (i.e. biliary disease, perforated viscous etc) and consideration of empiric gastric disease treatment with histamine blockers, antacids, or proton-pump inhibitors.
H. pylori is a bacterium that infects the stomach causing dyspepsia.
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Background: Patients with fluid refractory septic shock should be treated with vasoactive medications to improve perfusion. It has become widely accepted in recent years to use norepinephrine as the first-line vasopressor in adults with septic shock. In children, however, there is little research to guide our choice of agent. Dopamine has been used as the first-line agent in children though it has fallen out of favor in adults.
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Background
Acute pulmonary embolism (PE) is a common disease associated with high degrees of morbidity and mortality. The D-dimer assay has the potential to be a valuable test in the workup of PE as it is sensitive for thrombus formation. Unfortunately, specificity is low and indiscriminate use can lead to increased advanced imaging.
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Sudden cardiac arrest has very poor outcomes; less than 11% of patients in cardiac arrest in the Emergency Department survive to discharge from the hospital. The management of cardiac arrest is algorithmic because providers have limited tools at their disposal and limited knowledge of the patient’s past medical history. EKG is limited in its evaluation of cardiac function.
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Acute Aortic Dissection (AD) is an uncommon, but potentially fatal cardiovascular disorder with a mortality of 1-2% per hour. This requires rapid identification and diagnosis, however, there are a limited number of screening tools available. Currently three diagnostic studies are employed: CT, MRI and TEE. Unfortunately, these modalities are time consuming, carry the risk of radiation and contrast reactions (in the case of CT) and are not always accessible (i.e.
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Diabetic ketoacidosis (DKA) is a diagnosis commonly encountered in the emergency department (ED), with the numbers of patients presenting in DKA rising. The increasing number of DKA patients has led to a concomitant rise in cost, with a substantial part of the cost related to intensive care unit (ICU) stay. Treatment of DKA involves correcting acidosis/electrolyte derangements,
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“The Golden Hour”, a widely accepted concept that transport of the trauma patient within the initial 60 minutes after injury purports better outcomes has little empiric evidence directly supporting this relationship between time and outcome. While there have been many studies that suggest a survival benefit to shorter on-scene time and shorter transit time; most studies fail to substantiate a relationship.
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