Emerg Med Clin North Am
· 2024 Nov · PMID 39326988
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This article reviews the use of point-of-care ultrasound (POCUS) for evaluating the aorta from anatomy and image acquisition to the diagnosis of aortic pathology, including aneurysms and dissection. Ruptured aortic aneur...This article reviews the use of point-of-care ultrasound (POCUS) for evaluating the aorta from anatomy and image acquisition to the diagnosis of aortic pathology, including aneurysms and dissection. Ruptured aortic aneurysm and aortic dissection are associated with high mortality and often experience a delay in time to diagnosis. Traditionally diagnosis was made through computed tomography which takes time and removes the patient from the emergency department. Incorporating POCUS into the evaluation of patients with suspected aortic pathology allows for rapid, accurate diagnosis and earlier definitive treatment.
Emerg Med Clin North Am
· 2024 Nov · PMID 39326987
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Point-of-care ultrasound has been shown to have excellent diagnostic accuracy for a variety of gastrointestinal and biliary pathologies. This review explores the evidence and scanning techniques for hypertrophic pyloric...Point-of-care ultrasound has been shown to have excellent diagnostic accuracy for a variety of gastrointestinal and biliary pathologies. This review explores the evidence and scanning techniques for hypertrophic pyloric stenosis, intussusception, appendicitis, small bowel obstruction, diverticulitis, hernias, pneumoperitoneum, and biliary pathology.
Emerg Med Clin North Am
· 2024 Nov · PMID 39326986
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Airway and thoracic ultrasound applications can provide critical information to improve patient safety for procedures and management of pulmonary conditions. Emergency physicians should utilize airway ultrasound in the p...Airway and thoracic ultrasound applications can provide critical information to improve patient safety for procedures and management of pulmonary conditions. Emergency physicians should utilize airway ultrasound in the preparation for an anatomically and/or physiologically difficult airway, which may include site demarcation for surgical airway planning. Thoracic ultrasound is useful in the prompt evaluation of a dyspneic patient. This article underscores the crucial role of airway and thoracic ultrasound in emergency medicine, emphasizing its utility for assessing difficult airways, planning surgical airways, and promptly evaluating dyspneic patients.
Emerg Med Clin North Am
· 2024 Nov · PMID 39326985
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Cardiac point-of-care ultrasound (POCUS) can make critical diagnoses and monitor the response to interventions. In contrast with consultative echocardiography, cardiac POCUS serves to answer a specific clinical question....Cardiac point-of-care ultrasound (POCUS) can make critical diagnoses and monitor the response to interventions. In contrast with consultative echocardiography, cardiac POCUS serves to answer a specific clinical question. This imaging modality can be used to evaluate for left ventricular systolic and diastolic dysfunction, pericardial effusion and tamponade, acute and chronic right ventricular dysfunction, valvular dysfunction, and cardiac activity in cardiac arrest.
Emerg Med Clin North Am
· 2024 Nov · PMID 39326984
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With the growing use of point-of-care ultrasound (POCUS) in various clinical settings, it is essential for users of ultrasound to have a thorough understanding of the basics of ultrasound physics, including sound wave pr...With the growing use of point-of-care ultrasound (POCUS) in various clinical settings, it is essential for users of ultrasound to have a thorough understanding of the basics of ultrasound physics, including sound wave properties, its interaction with various tissues, common artifacts, and knobology. The authors introduce and discuss these concepts in this article, with a focus on clinical implications.
Emerg Med Clin North Am
· 2024 Aug · PMID 38925783
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The safety and health of individuals who may be exposed to the spaceflight environment are first and foremost cared for through prevention. This environment, which encompasses microgravity, radiation, and alternobaric fa...The safety and health of individuals who may be exposed to the spaceflight environment are first and foremost cared for through prevention. This environment, which encompasses microgravity, radiation, and alternobaric factors, can have physiologic impacts on every human system. Available medical care and resources in the spaceflight environment are currently limited by mass and volume constraints, with available medical resources thereby focusing on a patient's stabilization and evacuation. An understanding of the spaceflight environment and its possible effects is crucial for the treatment of individuals prior to, during, and after spaceflight.
Emerg Med Clin North Am
· 2024 Aug · PMID 38925782
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As human-induced climate change warms the planet, its health impacts will affect all populations, but certain groups will be more vulnerable to its impacts. Given its role as a health care safety net, emergency medicine...As human-induced climate change warms the planet, its health impacts will affect all populations, but certain groups will be more vulnerable to its impacts. Given its role as a health care safety net, emergency medicine will play a crucial role in addressing these health conditions. Additionally, with its expertise in disaster medicine, interdisciplinary collaboration, and health care systems knowledge, emergency medicine has the potential to lead the health care sector's response to climate change.
Emerg Med Clin North Am
· 2024 Aug · PMID 38925781
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Lightning is a common environmental hazard, and is a significant cause of global injury and death. Care and evaluation should follow general trauma guidelines, but several unique aspects of lightning injuries necessitate...Lightning is a common environmental hazard, and is a significant cause of global injury and death. Care and evaluation should follow general trauma guidelines, but several unique aspects of lightning injuries necessitate deviations from standard care that can improve survival and overall outcomes. When evaluating lightning strike patients, some common injury patterns are pathognomonic for lightning strikes and easy to recognize, while others are subtle and require heightened awareness. While most lightning-related injuries resolve spontaneously, some may have significant long-term symptoms. Anticipatory guidance and specialty referral may be needed for appropriate follow-up, evaluation, and treatment.
Emerg Med Clin North Am
· 2024 Aug · PMID 38925780
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Envenomations are the 23rd most common reason for calls to US poison control centers, with over 35,000 incidents reported annually. Snake bites account for over 20% of those calls, while marine envenomations are likely u...Envenomations are the 23rd most common reason for calls to US poison control centers, with over 35,000 incidents reported annually. Snake bites account for over 20% of those calls, while marine envenomations are likely underreported at 3% to 4%. While these types of envenomations may not be encountered on a daily basis for many physicians, the different types of envenomations warrant unique management strategies based on the offending creature and symptom presentation. This text serves as a review of the epidemiology, clinical presentations, and management of endemic North American species of snakes and marine vertebrate and invertebrate envenomations.
Emerg Med Clin North Am
· 2024 Aug · PMID 38925779
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This text serves to familiarize readers with animal bites and attacks. Topics include appropriate management of animal bite wounds, postexposure prophylaxis for possible rabies exposures, and unique infectious diseases t...This text serves to familiarize readers with animal bites and attacks. Topics include appropriate management of animal bite wounds, postexposure prophylaxis for possible rabies exposures, and unique infectious diseases transmitted through animal vectors. Large mammal attacks are discussed, in addition to the management of smaller animal attacks and exposures.
Emerg Med Clin North Am
· 2024 Aug · PMID 38925778
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Plant dermatitis is a common pathology that plagues those who work and recreate in the North American outdoors. The most common plant family to cause dermatitis is the Toxicodendron genus, which includes the plants known...Plant dermatitis is a common pathology that plagues those who work and recreate in the North American outdoors. The most common plant family to cause dermatitis is the Toxicodendron genus, which includes the plants known by the common names of poison ivy, poison oak, and poison sumac. While mortality is usually quite low for this pathology, the incidence and prevalence of the disease leads to substantial healthcare burden and financial implications across the population. The mainstays of treatment have focused on prevention, corticosteroids, and antihistamines.
Emerg Med Clin North Am
· 2024 Aug · PMID 38925777
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This review highlights the causative organisms, clinical features, diagnosis, and treatment of the most common tick-borne illnesses in the United States, including Lyme disease, Rocky Mountain spotted fever, anaplasmosis...This review highlights the causative organisms, clinical features, diagnosis, and treatment of the most common tick-borne illnesses in the United States, including Lyme disease, Rocky Mountain spotted fever, anaplasmosis, ehrlichiosis, tularemia, Powassan virus, and alpha-gal syndrome. Tick bite prevention strategies and some basic tick removal recommendations are also provided.
Emerg Med Clin North Am
· 2024 Aug · PMID 38925776
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Endurance sports encompass a broad range of events from marathons and triathlons to ultramarathons, long-distance cycling, skiing, and swimming. As these events have experienced a surge in popularity, we have a greater n...Endurance sports encompass a broad range of events from marathons and triathlons to ultramarathons, long-distance cycling, skiing, and swimming. As these events have experienced a surge in popularity, we have a greater need to understand the associated medical risks. This article reviews the history of endurance races, reviews the most critical and common causes of cardiovascular, heat, electrolyte, and musculoskeletal injuries/illnesses, and discusses considerations for medical directors/personnel associated with such events.
Emerg Med Clin North Am
· 2024 Aug · PMID 38925775
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Deserts are defined by their arid nature, characterized by little rainfall, and often featuring vast stretches of sandy terrain with sparse vegetation. The resulting variations in temperature, humidity, and topography pr...Deserts are defined by their arid nature, characterized by little rainfall, and often featuring vast stretches of sandy terrain with sparse vegetation. The resulting variations in temperature, humidity, and topography predispose patients to medical conditions that practitioners in both rural and urban deserts must recognize and manage. This article will equip medical practitioners with the essential knowledge and tools to navigate these complexities, including a description of specific environmental considerations and challenges encountered while providing care in these desert locations, common conditions associated with extreme heat and solar radiation, and animal encounters.
Emerg Med Clin North Am
· 2024 Aug · PMID 38925774
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The evaluation and care of an injured scuba diver requires an understanding of the different types of underwater activities that may be deemed scuba diving. Such activities may range from the complex (eg, commercial or t...The evaluation and care of an injured scuba diver requires an understanding of the different types of underwater activities that may be deemed scuba diving. Such activities may range from the complex (eg, commercial or technical diving) all the way up to basic recreational scuba or snorkeling. A thorough physical examination should be completed as early as possible with a focus on specific areas at risk for injury and etiology, such as a detailed cardiopulmonary, skin, and neurologic examination. Serial reassessments and supportive care are as equally important as consultation with a dive medicine expert, especially one with hyperbaric capabilities.
Emerg Med Clin North Am
· 2024 Aug · PMID 38925773
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Drowning is responsible for considerable morbidity and mortality worldwide, and it is estimated that 90% of drownings are preventable. Drowning is defined as "the process of experiencing respiratory impairment from subme...Drowning is responsible for considerable morbidity and mortality worldwide, and it is estimated that 90% of drownings are preventable. Drowning is defined as "the process of experiencing respiratory impairment from submersion/immersion in liquid." Emergency providers should focus on airway management and rapid delivery of oxygen to interrupt the drowning process and improve patient outcomes. Patients with minimal or no symptoms do not require any specific diagnostic workup, aside from physical examination and 4 to 6 hours of observation prior to discharge. Patients with more severe symptoms may present with rales and foamy secretions, and should be managed with high-concentration oxygen and positive airway pressure.
Emerg Med Clin North Am
· 2024 Aug · PMID 38925772
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Altitude-related illness occurs as a result of inadequate acclimatization. The mainstay of prevention is a slow, graded ascent profile which gives the body time to respond to a low-oxygen environment. The diagnosis of th...Altitude-related illness occurs as a result of inadequate acclimatization. The mainstay of prevention is a slow, graded ascent profile which gives the body time to respond to a low-oxygen environment. The diagnosis of these conditions is often difficult in resource-limited environments, so history and a physical exam are key in identifying patients who will require descent and evacuation. Treatment modalities such as supplemental oxygen, portable hyperbaric chambers, and medications, are all temporizing measures until the patient can be safely evacuated to a lower elevation.
Emerg Med Clin North Am
· 2024 Aug · PMID 38925771
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Cold injury has been documented for centuries and remains a concern for military personnel, winter recreationalists, and urban homeless populations. Treatment advances in the last decades have included thrombolytic and p...Cold injury has been documented for centuries and remains a concern for military personnel, winter recreationalists, and urban homeless populations. Treatment advances in the last decades have included thrombolytic and prostaglandin therapies however the mainstay remains early recognition and rapid rewarming. This chapter focuses on frostbite, with a brief overview of other cold related conditions.