ABSTRACT
An estimated 60,000 patients with severe head injury reach the Emergency Department alive each year; 50% of these patients have significant elevations in intracranial pressure at or shortly after arrival. Aggressive emergency department management with particular attention to airway management, control of intracranial pressure, and proper use of radiographic studies is crucial to successful neurologic recovery.
Subject(s)
Brain Injuries/therapy , Craniocerebral Trauma/diagnosis , Craniocerebral Trauma/therapy , Brain Injuries/diagnosis , Cerebral Hemorrhage/diagnosis , Craniocerebral Trauma/physiopathology , Emergency Medical Services , Humans , Intracranial Pressure , Magnetic Resonance Imaging , Physical Examination , Resuscitation , Tomography, X-Ray ComputedABSTRACT
An annual report, by summarizing the emergency department's accomplishments, is an effective means of highlighting the vital role of the emergency department within the hospital system and the community. The report should begin with an Executive Summary and proceed to detail the clinical, educational, research, administrative, financial, and other essential aspects of the status and development of the department.
Subject(s)
Emergency Service, Hospital/organization & administration , Annual Reports as TopicABSTRACT
The electrocardiographic manifestations of pulmonary embolism include rhythm and condition disturbances and changes in the P wave, QRS complex, or T wave. Since these abnormalities are highly variable and frequently transient, they lack the sensitivity necessary to establish the diagnosis of pulmonary embolism. The electrocardiogram may rise the suspicion of pulmonary embolism, but other diagnostic tests are necessary to confirm the diagnosis.
Subject(s)
Electrocardiography , Pulmonary Embolism/diagnosis , Blood Pressure , Humans , Pulmonary Artery/physiopathology , Pulmonary Embolism/physiopathologyABSTRACT
Pericardial tamponade persists as a diagnostic challenge to the clinician. The immediate diagnosis is particularly difficult when the patient is well compensated hemodynamically. In contrast to the deceptively stable appearance, the patient is at increased risk due to delayed onset, recognition, and therapy. A case of penetrating thoracic trauma is presented in which the concern about pericardial tamponade was considerable. However, the elements of clinical assessment were inconclusive. Two-dimensional echocardiography was employed in the emergency department to detect a pericardial effusion and thus avoid delayed management. Pericardial tamponade and associated vascular injuries were confirmed at surgery.
Subject(s)
Aorta/injuries , Cardiac Tamponade/diagnosis , Echocardiography , Pericardial Effusion/diagnosis , Wounds, Stab/diagnosis , Acute Disease , Cardiac Tamponade/etiology , Emergencies , Humans , Male , Middle Aged , Pericardial Effusion/therapy , Wounds, Stab/surgeryABSTRACT
The clinical diagnosis of lithium intoxication can be elusive because of the slow onset and diversity of toxic manifestations. Mental status and neurologic symptoms often predominate. After the diagnosis is made, management depends on the clinical presentation and serum lithium level. Hemodialysis is the treatment of choice for severe lithium intoxication. Two cases of lithium intoxication are presented that demonstrate that predisposing factors and drug interactions play major roles. A review is given of the pathophysiology, presenting signs, symptoms, and approaches to treatment of lithium intoxication.
Subject(s)
Lithium/adverse effects , Adult , Bipolar Disorder/drug therapy , Emergencies , Female , Humans , Intestinal Absorption , Lithium/blood , Male , Middle Aged , Potassium/blood , Renal Dialysis , Schizophrenia/drug therapyABSTRACT
Coronary artery spasm can occur in several settings, often combined with coronary artery disease and thrombosis. Calcium channel blockers and beta-blockers are primary treatment modalities. The role of alpha-blocking agents remains unconfirmed.
