ABSTRACT
Although injuries of the hand are infrequently life-threatening, they are common in the emergency department and are associated with significant patient morbidity and medicolegal risk for physicians. Care of patients with acute hand injury begins with a focused history and physical examination. In most clinical scenarios, a diagnosis is achieved clinically or with plain radiographs. While most patients require straightforward treatment, the emergency clinician must rapidly identify limb-threatening injuries, obtain critical clinical information, navigate diagnostic uncertainty, and facilitate specialist consultation, when required. This review discusses the clinical evaluation and management of high-morbidity hand injuries in the context of the current evidence.
Subject(s)
Emergency Service, Hospital , Hand Injuries/diagnosis , Hand Injuries/therapy , Hand Injuries/etiology , HumansABSTRACT
Emergency medicine clinicians frequently diagnose and treat patients with pneumonia. The recent recognition of healthcare-associated pneumonia (HCAP) mandates that emergency medicine clinicians remain current and able to distinguish this from community-acquired pneumonia. This article reviews the diagnosis and management of HCAP from the perspective of the emergency medicine clinician.
Subject(s)
Community-Acquired Infections/diagnosis , Cross Infection/diagnosis , Emergency Medicine/methods , Emergency Service, Hospital , Pneumonia/diagnosis , Anti-Bacterial Agents/therapeutic use , Community-Acquired Infections/microbiology , Cross Infection/drug therapy , Cross Infection/microbiology , Diagnosis, Differential , Drug Resistance, Multiple, Bacterial , Emergency Medicine/standards , Humans , Methicillin-Resistant Staphylococcus aureus , Microbial Sensitivity Tests , Pneumonia/drug therapy , Pneumonia/microbiology , Practice Guidelines as Topic , Risk Factors , Staphylococcal Infections/diagnosis , Staphylococcal Infections/drug therapy , Staphylococcal Infections/microbiologyABSTRACT
As the prevalence of HIV infection continues to increase, EPs will be called upon to evaluate increasing numbers of AIDS patients who have abdominal pain, some of whom will require emergent surgical intervention. In addition to the myriad causes of abdominal pain in the nonimmunocompromised patient, the differential diagnosis in the AIDS patient includes a wide variety of opportunistic infections and neoplasms (Table 5). Evaluation frequently requires extensive laboratory studies and cultures and advanced imaging (CT, ultrasound, and so forth). A low threshold for surgical and other subspecialty consultation should be in place because of the often subtle presentation of surgical emergencies in AIDS patients.
