RESUMO
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.
Assuntos
Serviço Hospitalar de Emergência , Traumatismos da Mão/diagnóstico , Traumatismos da Mão/terapia , Traumatismos da Mão/etiologia , HumanosRESUMO
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.
Assuntos
Infecções Comunitárias Adquiridas/diagnóstico , Infecção Hospitalar/diagnóstico , Medicina de Emergência/métodos , Serviço Hospitalar de Emergência , Pneumonia/diagnóstico , Antibacterianos/uso terapêutico , Infecções Comunitárias Adquiridas/microbiologia , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/microbiologia , Diagnóstico Diferencial , Farmacorresistência Bacteriana Múltipla , Medicina de Emergência/normas , Humanos , Staphylococcus aureus Resistente à Meticilina , Testes de Sensibilidade Microbiana , Pneumonia/tratamento farmacológico , Pneumonia/microbiologia , Guias de Prática Clínica como Assunto , Fatores de Risco , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/microbiologiaRESUMO
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.
