Emergency medicine clinics of North America
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Emerg. Med. Clin. North Am. · Nov 2016
ReviewDiagnosis of Acute Neurologic Emergencies in Pregnant and Postpartum Women.
Acute neurologic symptoms in pregnant and postpartum women may be caused by exacerbation of a preexisting neurologic condition, the initial presentation of a non-pregnancy-related problem, or a new neurologic problem. Pregnant and postpartum patients with headache and neurologic symptoms are often diagnosed with preeclampsia or eclampsia; however, other etiologies must also be considered. A team approach with close communication between emergency physicians, neurologists, maternal-fetal medicine specialists, and radiologists is the key to obtaining best outcomes. This article reviews the clinical features and differential diagnosis of acute serious neurologic conditions in pregnancy and the puerperium, focusing on diagnosis.
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Emerg. Med. Clin. North Am. · Nov 2016
ReviewA New Approach to the Diagnosis of Acute Dizziness in Adult Patients.
Dizziness is a common chief complaint in emergency medicine. The differential diagnosis is broad and includes serious conditions, such as stroke, cardiac arrhythmia, hypovolemic states, and acute toxic and metabolic disturbances. ⋯ The traditional approach does not distinguish benign from dangerous causes and is not consistent with best current evidence. This article presents a new approach to the diagnosis of acutely dizzy patients that highly leverages the history and the physical examination.
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Coma represents a true medical emergency. Drug intoxications are a leading cause of coma; however, other metabolic disturbances and traumatic brain injury are also common causes. ⋯ Definitive treatment is ultimately disease-specific. This article presents an overview of the pathophysiology, causes, examination, and treatment of coma.
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Acute ischemic stroke is a challenging and time-sensitive diagnosis. Diagnosis begins with rapid detection of acute stroke symptoms by the patient, their family or caregivers, or bystanders. ⋯ EMS providers will utilize prehospital stroke tools to diagnose and determine potential stroke severity. Once at the hospital, the stroke team works rapidly to solidify the patient history, perform a focused neurologic examination and obtain necessary laboratory tests and brain imaging to accurately diagnose acute ischemic stroke and properly treat the patient.