ABSTRACT
Patients with respiratory distress present a frequent and challenging dilemma for emergency physicians (EPs). The accurate diagnosis and treatment of the underlying pathology is vitally important in these sick patients to ensure the best outcome and minimise harm from unnecessary treatments. Within the last decade, studies have shown lung ultrasonography (LU) to be valuable in the accurate diagnosis of a variety of lung pathologies, including cardiogenic pulmonary oedema, pleural effusion, pneumothorax, haemothorax and pneumonia. However, despite advances in techniques and the evidence for the use of LU in the diagnosis of respiratory pathology, it remains poorly understood and rarely used by EPs. This clinical review article provides an overview of LU and its relevance as a diagnostic aid to the detection of respiratory pathology in the Emergency Department (ED).
Subject(s)
Dyspnea/diagnosis , Lung/abnormalities , Point-of-Care Systems/standards , Ultrasonography/methods , Dyspnea/etiology , Emergency Service, Hospital/organization & administration , Humans , Lung/physiopathology , Pleural Effusion/diagnosis , Pneumonia/diagnosis , Pneumothorax/diagnosis , Point-of-Care Systems/trends , Pulmonary Edema/diagnosis , Ultrasonography/standardsABSTRACT
Acute respiratory failure (ARF) is a frequent emergency department (ED) presentation. The definition and common causes of ARF are discussed in this article and ED management of the condition is discussed, using an illustrative case report. The paper considers the role of B-type natriuretic peptide in diagnosis and non-invasive ventilation (NIV) in treatment. Intensive care unit admission denial is common in ARF, although the evidence base is lacking. Finally, the decision-making process is described when a patient with ARF fails to improve with NIV.
Subject(s)
Critical Care , Emergency Service, Hospital , Pulmonary Disease, Chronic Obstructive/therapy , Respiration, Artificial , Respiratory Insufficiency/therapy , Aged , Female , Humans , Pulmonary Disease, Chronic Obstructive/complications , Respiratory Insufficiency/diagnosis , Respiratory Insufficiency/etiologyABSTRACT
Two patients with severe palmar burns sustained from hot playground equipment during a heatwave are presented here, with a review of the management of palmar burn injuries.
