Emergency medicine clinics of North America
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Emerg. Med. Clin. North Am. · May 2015
ReviewEvaluation and Treatment of Acute Back Pain in the Emergency Department.
Back pain is a common presenting complaint to the emergency department. The key to proper evaluation is a history and physical examination focused on determining if any red flags for serious disease are present. ⋯ No diagnostic testing is required. For patients with red flags, a focused history and examination in conjunction with diagnostic laboratory tests and imaging determine whether the patient has an emergent condition such as herniated disc, epidural compression, or spinal infection.
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Emerg. Med. Clin. North Am. · May 2015
ReviewEmergency Department Evaluation and Treatment of Acute Hip and Thigh Pain.
Although the incidence of hip fractures is decreasing, the overall prevalence continues to increase because of an aging population. People older than 65 suffer fractures at a rate of 0.6% per year--2% per year for persons older than 85. ⋯ Additionally, the emergency physician must consider entities such as avascular necrosis, compartment syndrome, and muscular disruption. This article reviews patterns and complications of acute hip and thigh injuries and clinically relevant diagnostic, anesthetic, and treatment options that facilitate timely, appropriate, and effective emergency department management.
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Emerg. Med. Clin. North Am. · May 2015
ReviewEnterovirus D68: acute respiratory illness and the 2014 outbreak.
Enteroviruses cause illnesses ranging from benign upper respiratory infections to severe meningitis and encephalitis. A recent uptick in the number of patients, many of them children, with respiratory infections caused by enterovirus 68 (EV-D68) has captured the attention of health care providers and public health administrators. In the United States, this type of infection was confirmed in 1152 people during 2014. This article examines recent trends in EV-D68 infections, reviewing past outbreaks and the 2014 outbreak, and describes the increasing cases of acute flaccid myelitis and their possible connection with EV-D68.
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Emerg. Med. Clin. North Am. · May 2015
ReviewEvaluation and Management of Traumatic Knee Injuries in the Emergency Department.
Posttraumatic knee pain is a common presentation in the emergency department (ED). The use of clinical decision rules can rule out reliably fractures of the knee and reduce the unnecessary cost and radiation exposure associated with plain radiographs. ⋯ Patients presenting after high-energy mechanisms are at risk for occult fracture and vascular injuries. ED providers must consider these injuries in the proper clinical setting.
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Emerg. Med. Clin. North Am. · May 2015
ReviewThe Emergent Evaluation and Treatment of Hand Injuries.
The hand is especially prone to traumatic injury. Some sources indicate that injuries to the hand account for somewhere between 10% and 30% of patients treated in emergency care settings. ⋯ Because the mechanism of injury often results in damage to multiple tissue structures, a detailed history and evaluation are vital to properly identifying and managing these injuries. This article provides the emergency physician with tools to identify and manage orthopedic injuries to the hand.