Manejo general del intoxicado / General management of intoxicated

Intoxications have become a relevant complaint in the emergency room since the second half of the last century. Toxidromes have been replaced by a more practical combined analysis of vital signs, directed physical examination and selected laboratory tests. Most of the mortality can be prevented by the correct and opportune implementation of general management strategies, including supportive care, prevention of absortion, enhancement of elimination and extracorporeal removal of toxins. Through the following pages we will review many of different diagnostic and therapeutic alternatives...

Dolor torácico en el Servicio de Urgencia / Chest pain in urgency service

According to the literature, chest pain corresponds to an estimate of 5 to 9 percent of presenting complaints in Emergency Departments (ED) in the United States. In spite of the high rate of admission, there is still a 0,4 to 4 percent of patients who are discharged from an ED with a missed Acute Myocardial Infarction. Diagnostic etiologies range from benign to life-threatening conditions, so there is the need for a clinical approach that is both safe and cost-effective. The diagnostic strategies are based on three elements: anamnesis and physical examination, Electrocardiography and chest X-ray. This article presents an Emergency Medicine-oriented perspective in the hopes of offering to the physician a strategie focused in ruling out life-threatening conditions in the first place and then define patient disposition in an efficient and safe manner...