Emergency medicine clinics of North America
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Emerg. Med. Clin. North Am. · May 2024
ReviewThe Diagnosis and Treatment of Adult Urinary Tract Infections in the Emergency Department.
Emergency medicine has been called the art of "making complicated clinical decisions with limited information." This description is particularly relevant in the case of diagnosis and treatment of urinary tract infections (UTIs). Although common, UTIs are often challenging to diagnose given the presence of non-specific signs and symptoms and over-reliance on laboratory findings. This review provides an interdisciplinary interpretation of the primary literature and practice guidelines, with a focus on diagnostic and antimicrobial stewardship in the emergency department.
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Emerg. Med. Clin. North Am. · May 2024
ReviewThe Intersection of Substance Use Disorders and Infectious Diseases in the Emergency Department.
Substance use disorders (SUDs) intersect clinically with many infectious diseases, leading to significant morbidity and mortality if either condition is inadequately treated. In this article, we will describe commonly seen SUDs in the emergency department (ED) as well as their associated infectious diseases, discuss social drivers of patient outcomes, and introduce novel ED-based interventions for co-occurring conditions. Clinicians should come away from this article with prescriptions for both antimicrobial medications and pharmacotherapy for SUDs, as well as an appreciation for social barriers, to care for these patients.
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A quality clinical interview helps establish a good collaborative relationship with the patient. This is especially important when emergency physicians conduct a psychiatric interview. Familiarity with interview techniques, empathic listening, and observation of nonverbal cues, behavior, and appearance enhance diagnostic excellence.
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Affective disorders affect the way that people think and feel and are classified into unipolar disorders and bipolar disorders. Bipolar disorders represent a spectrum of these chronic mental health illnesses. Patients with bipolar disorder have high recurrence of acute symptoms, and on average spend 20% of their life in exacerbations characterized by mania, depression, or psychosis. Given the increased morbidity and mortality associated with bipolar disorders, it is imperative that the emergency physician remain vigilant when these patients seek emergency care.