MedWorm: Emergency Medicine Top 20

Non Operative Management of liver and spleen traumatic injuries: a giant with clay feet

World Journal of Emergency Surgery — Mon, 23 Jan 2012 05:00:00 +0100

After years of initial aggressive surgical treatment and a subsequent shift to Damage Control Surgery, NOM has be shown to be safe and effective and in the 90's it became the gold standard for liver injuries in hemodynamically stable patients, regardless of injury grade and degree of hemoperitoneum, allowing better outcomes with fewer complications and lesser transfusions. Nevertheless concerns have been raised regarding continuous monitoring need, safety in higher grades and general applicability of NOM to all hemodynamically stable patients. Similarly, in the same period and following promising results obtained with splenic salvage by using several surgical techniques such as splenorraphy, high intensity ultrasound, hemostatic wraps and staplers, NOM became the treatment of choice for bl...

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Theme: Suicide and suicidal behaviours

Emergency Medicine Journal — Wed, 11 Jan 2012 05:00:00 +0100

Question 1 Which of the following are true regarding suicidal intent and suicide? A previous suicide attempt is the best predictor of a future suicide attempt. 10–15% of those attempting suicide succeed, but 60–70% of successful suicides have no prior history of attempts. Patients who attempt suicide have low CSF serotonin levels. Borderline personality disorder is the Axis II diagnosis most closely associated with suicide. Question 2 Which of the following are true regarding assessment of potentially suicidal patients? A ‘SAD PERSONS’ score of <6 has a negative predictive value (NPV) of >95%. No single psychological test can accurately predict suicidal attempts. Scoring systems might help in determining the need for hospitalisation. Suicide is often provoked ...

Social Media May Be Useful in Predicting EpidemicsSocial Media May Be Useful in Predicting Epidemics

Medscape Emergency Medicine Headlines — Tue, 17 Jan 2012 17:32:14 +0100

Twitter and other informal media provided reliable estimates of initial trends in the 2010 Haitian cholera epidemic up to 2 weeks earlier than official reports. Medscape Medical News (Source: Medscape Emergency Medicine Headlines)

One-Week and 3-Month Outcomes After an Emergency Department Visit for Undifferentiated Musculoskeletal Low Back Pain

Annals of Emergency Medicine — Fri, 20 Jan 2012 19:16:32 +0100

Conclusion: There is substantial short- and longer-term morbidity and ongoing analgesic use among patients who present to an ED with undifferentiated musculoskeletal low back pain. (Source: Annals of Emergency Medicine)

The Evaluation And Management Of Constipation In The Pediatric Emergency Department

Pediatric Emergency Medicine Practice — Mon, 23 Jan 2012 19:19:09 +0100

This issue examines existing literature on constipation, though few randomized double-blind, controlled clinical trials of good quality existed in the literature until recently. (Source: Pediatric Emergency Medicine Practice)

Advances In Diagnosis And Management Of Hypokalemic And Hyperkalemic Emergencies

Emergency Medicine Practice — Mon, 23 Jan 2012 19:19:09 +0100

This issue of Emergency Medicine Practice presents a systematic review of the latest evidence regarding the pathophysiology, diagnosis, and treatment of potassium-related emergencies. (Source: Emergency Medicine Practice)

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Man With Blurred Vision

Annals of Emergency Medicine — Fri, 20 Jan 2012 19:16:32 +0100

A 34-year-old man with diabetes presented to the emergency department with a 1-week history of fever, general malaise, and bilateral blurred vision. He had no history of ocular surgery. On ophthalmologic consultation, his visual acuity was 20/50 in the right eye and counting fingers in the left eye. Slit-lamp biomicroscopic and fundus examination was performed. Slit-lamp biomicroscopic examination showed 3+ cells without a hypopyon in the anterior chamber of each eye. Fundus examination revealed multiple subretinal/choroidal infiltrations and vitreous opacities, especially in the left eye (). Blood, urine, and vitreous cultures were obtained. (Source: Annals of Emergency Medicine)

Emergency

Academic Emergency Medicine — Tue, 24 Jan 2012 05:00:00 +0100

(Source: Academic Emergency Medicine)

Review article: Part one: Goal‐directed resuscitation – Which goals? Haemodynamic targets

Emergency Medicine Australasia — Tue, 17 Jan 2012 05:00:00 +0100

Part 2: Goal Directed Resuscitation – Which Goals? Perfusion Targets will follow in the next issue.AbstractThe use of appropriate resuscitation targets or end‐points may facilitate early detection and appropriate management of shock. There is a fine balance between oxygen delivery and consumption, and when this is perturbed, an oxygen debt is generated. In this narrative review, we explore the value of global haemodynamic resuscitation end‐points, including pulse rate, blood pressure, central venous pressure and mixed/central venous oxygen saturations. The evidence supporting the reliability of these parameters as end‐points for guiding resuscitation and their potential limitations are evaluated. (Source: Emergency Medicine Australasia)

Young Man With Fever and Eye Pain

Annals of Emergency Medicine — Fri, 20 Jan 2012 19:16:32 +0100

A 21-year-old man presented with several days of fever, sinus pain, decreased vision, and pain with eye movement. Examination revealed proptosis and periorbital edema/erythema, with an afferent pupillary defect and a visual acuity of hand-motion in the right eye (). A computed tomography (CT) scan showed opacification of the frontal, ethmoid, and maxillary sinuses bilaterally, with right-sided orbital inflammatory changes and a subperiosteal abscess in the superomedial orbit (). The patient began receiving vancomycin, ceftazidime, and metronidazole. He underwent an orbitotomy with subperiosteal abscess drainage and right-sided ethmoidectomy that same day. Abscess cultures grew Staphylococcus aureus and Streptococcus sanguis. Although the external examination showed apparent improvement, th...

Social and Medical Vulnerability Factors of Emergency Department Frequent Users in a Universal Health Insurance System

Academic Emergency Medicine — Thu, 05 Jan 2012 05:00:00 +0100

Conclusions: Frequent users accounted for a moderate proportion of visits at the Lausanne ED. Social and medical vulnerability factors were associated with frequent ED use. In addition, frequent users were more likely to have both social and medical vulnerabilities than were other patients. Case management strategies might address the vulnerability factors of frequent users to prevent inequities in health care and related costs. (Source: Academic Emergency Medicine)

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The Relationship Between Shift Work, Sleep, and Cognition in Career Emergency Physicians

Academic Emergency Medicine — Thu, 05 Jan 2012 05:00:00 +0100

Conclusions: These data indicate that short‐term memory appears to decline after day and overnight shifts and confirms the high incidence of disturbed sleep in this population. (Source: Academic Emergency Medicine)

Prehospital trauma care reduces mortality. Ten-year results from a time-cohort and trauma audit study in Iraq

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine — Fri, 03 Feb 2012 05:00:00 +0100

Conclusion: In case of long prehospital transit times simple life support measures by paramedics and lay first responders reduce trauma mortality in major injuries. Delegating life-saving skills to paramedics and lay people is a key factor for efficient prehospital trauma systems in low-resource communities.. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)

Gratitude

Academic Emergency Medicine — Tue, 24 Jan 2012 05:00:00 +0100

(Source: Academic Emergency Medicine)

Doctoring 1.0

Academic Emergency Medicine — Tue, 24 Jan 2012 05:00:00 +0100

(Source: Academic Emergency Medicine)

Annals of Emergency Medicine — Fri, 20 Jan 2012 19:16:32 +0100

(Source: Annals of Emergency Medicine)

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Professional Societies and Commercial Conflicts of Interest: Critics Blast Circuslike Atmosphere, Barker Marketing at Conferences

Annals of Emergency Medicine — Fri, 20 Jan 2012 19:16:32 +0100

Practicing a learned profession within a commercial culture has never been simple. The overlapping status of medicine in the United States as both a vocation and a business means that the borderlines of ethics and self-interest are constantly being drawn and redrawn. Medical professional organizations, like physicians, need to balance their healing mission and their cash flow. To an increasingly visible community of observers, many of these groups have lost this balance, even to the point of forfeiting the credibility as an independent professional authority. (Source: Annals of Emergency Medicine)

Classified

Annals of Emergency Medicine — Fri, 20 Jan 2012 19:16:32 +0100

TEXAS, Austin: RARE MEDICAL DIRECTOR OPPORTUNITY IN AUSTIN! Ideal candidate will be board-certified in Emergency Medicine with previous medical director experience. EXCEPTIONAL LOCATION: Live the good life in highly sought-after Austin, Texas. EXCEPTIONAL FACILITY: Work in 35,000-volume ED at award-winning flagship hospital. EXCEPTIONAL GROUP: Emergency Service Partners, LP is a stable, physician-owned and operated partnership with 20+ hospitals and 300+ providers, dedicated to quality care and patient satisfaction. Enjoy competitive productivity-based compensation, excellent work environment, two-year partnership track, equitable scheduling, and paid malpractice/tail coverage—all with tort reform and no state income tax. Strong medical director leadership is the key to our success! Cont...

Calendar

Annals of Emergency Medicine — Fri, 20 Jan 2012 19:16:32 +0100

2012 Midwest Winter Symposium. February 2-5, 2012. Boyne Falls, MI. Sponsor: MI Colg of Emer Phys. Fee: $50.00 – $495.00. Contact: Christy Snitgen, 6647 West St. Joseph Hwy., Lansing, MI, 48917. Email: mcep@mcep.org. 5173275700. (14) (Source: Annals of Emergency Medicine)

What's Coming in Annals ● March 2012

Annals of Emergency Medicine — Fri, 20 Jan 2012 19:16:32 +0100

(Source: Annals of Emergency Medicine)

MedWorm: Emergency Medicine Top 20

Non Operative Management of liver and spleen traumatic injuries: a giant with clay feet

Theme: Suicide and suicidal behaviours

Social Media May Be Useful in Predicting EpidemicsSocial Media May Be Useful in Predicting Epidemics

One-Week and 3-Month Outcomes After an Emergency Department Visit for Undifferentiated Musculoskeletal Low Back Pain

The Evaluation And Management Of Constipation In The Pediatric Emergency Department

Advances In Diagnosis And Management Of Hypokalemic And Hyperkalemic Emergencies

Man With Blurred Vision

Emergency

Review article: Part one: Goal‐directed resuscitation – Which goals? Haemodynamic targets

Young Man With Fever and Eye Pain

Social and Medical Vulnerability Factors of Emergency Department Frequent Users in a Universal Health Insurance System

The Relationship Between Shift Work, Sleep, and Cognition in Career Emergency Physicians

Prehospital trauma care reduces mortality. Ten-year results from a time-cohort and trauma audit study in Iraq

Gratitude

Doctoring 1.0

Table of Contents

Professional Societies and Commercial Conflicts of Interest: Critics Blast Circuslike Atmosphere, Barker Marketing at Conferences

Classified

Calendar

What's Coming in Annals ● March 2012