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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Atrial fibrillation (AF) is one of the most common dysrhythmias encountered in the ED. Patients with chronic AF often present with increased heart rates, chest pain and weakness among other presentations. However, it’s the patients with new onset AF that really peak our interest. Why? Well, the management of these patients is potentially exciting, filled with procedures and clearly debatable.
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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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ATLS teaches inexperienced providers a systemic approach to trauma, with focus on stabilization and appropriate transfer of care. It is designed for providers who do not have much trauma exposure, not necessarily for providers who work in major trauma centers. This article reviews the scope of ATLS training and asks whether it is important or relevant for providers in major trauma centers.
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Sepsis and meningitis are rare but feared diagnoses in children, especially when they are unable to provide any meaningful history. Based upon available evidence, it can be assumed that delayed diagnosis in a dangerous condition would lead to worse outcomes. Children under the age of one month are almost universally treated as if they are immunosuppressed for this reason,
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