Skin and soft tissue infections (SSTI), specifically skin abscesses, are an increasingly common cause for emergency department (ED) visits. Many of these are uncomplicated and are treated in the ED with incision and drainage (I&D) and then discharged. In an era of increasing rates of methicillin-resistant staph aureus (MRSA), there may be a role for adjunct therapy with oral antibiotics to improve cure rates.
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Patients with end of life care needs frequently present to emergency departments (EDs) throughout the world, whether for life sustaining treatments, symptomatic relief or social needs.Previous research has demonstrated that these patients and their families often do not have their expectations of care met by the ED, and furthermore, may even experience greater suffering. Emergency medicine (EM) physicians and nurses may not be adequately trained to deal with this specific patient population,
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Anaphylaxis is an acute, potentially life-threatening emergency. In patients with compromise of their airway, breathing or circulation, epinephrine (epi) should be rapidly administered. There is little data describing the differences in epi administration and cardiac complications among older and younger patients with anaphylaxis. Older patients have been identified as a vulnerable group for severe or fatal anaphylaxis.
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Recent years have seen a paradigm shift in cardiac arrest from the traditional mantra of airway, breathing circulation (ABC’s) to circulation, airway, breathing (CAB). This change represents the understanding that circulation is of paramount importance and thus, advanced airway management has been de-emphasized. This change is rational as the only interventions that have been shown to be beneficial in cardiac arrest are high-quality CPR and defibrillation.
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Angiotensin Converting Enzyme Inhibitors (ACE-I) are prescribed to millions of patients in the US. Though they are relatively safe, upper airway angioedema is one of the life-threatening adverse effects that we see frequently in the Emergency Department. Though this disorder is routinely treated with medications for anaphylaxis (i.e. epinephrine, histamine blockers, corticosteroids) the underlying mechanism of action predicts that these medications will fail.
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In the US, vast differences in pricing exist for the same medical services across the country, with no correlation shown between price and quality (Sinaiko 2017). Previous studies on price transparency in medicine have shown that many patients would like to know “the price of medical services in advance and are willing to look for ‘better-value care’” (Sinaiko 2017).
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Cellulitis is a common emergency department (ED) presentation. Despite the fact that diagnosis remains relatively straight forward, complexity remains in management in terms of the causative agent and appropriate antibiotic regimen. Though beta-hemolytic Streptococci are the most common causative agents there is increasing prevalence of community acquired methicillin-resistant Staphylococcus aureus (MRSA). Cephalexin has long been used to treat uncomplicated cellulitis because of it’s activity against streptococci and methicillin-sensitive S.
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In 2002, the New England Journal of Medicine published two studies that changed the management of post-cardiac arrest patients by showing improved outcomes in patients treated with therapeutic hypothermia (32°C-34°C) for at least 24 hours. (Bernard 2002, Hypothermia 2002) The landscape changed again in 2013 with the publication of the Targeted Temperature Management (TTM) trial in the New England Journal,
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