The American journal of emergency medicine
-
Procalcitonin is a useful biomarker for infection. Over the past two decades, there has been much research on the clinical applications of procalcitonin, yet the majority of these studies have been conducted in the intensive care setting. Despite the extensive use of procalcitonin in emergency departments, there have been no guidelines focusing specifically on these clinical settings. ⋯ Recommendations will be formulated based on explicit consideration of established criteria. This structured approach ensures that guideline recommendations are founded on robust evidence and transparently assessed for strength and potential caveats. This is the first guideline on the use of procalcitonin to be applied in emergency departments that adopts the principles of evidence-based medicine and encompasses the up-to-date literatures, and it marks an advancement in providing guidance on the utilization of procalcitonin in emergency departments.
-
Each year millions of children seek care in emergency departments, many of whom are from marginalized and minoritized groups who lack access to primary and preventive care. Law enforcement personnel are also commonly present in pediatric and adult emergency departments serving in a range of roles. Therefore, pediatric emergency departments sit at the nexus of the health system and the legal system for many vulnerable youth and families. ⋯ Pediatric clinicians, highly trained professionals in the medical and social care of youth and children, are often unaware of legal rules and procedures that guide law enforcement interaction with youth. This lack of knowledge may result in unknowing and unwitting violations of patients' rights while also compromising the quality of health care provided. Therefore, it is imperative that clinicians are educated on their roles and their institutions' roles in safeguarding patients' privacy and autonomy while still promoting effective collaboration with law enforcement.
-
Acute pain management is a critical component of prehospital and emergency medical care. Opioids are effective; however, the risks and side-effects of opioids have led providers to use low-dose ketamine (LDK) for safe and effective treatment of acute pain. ⋯ LDK is a safe and effective option for acute pain treatment. It can be used as an alternative therapy to opioids or used in conjunction with them to reduce opioid exposure through its opioid-sparing effect. Importantly, LDK is available in a variety of formulations including intramuscular, intravenous, and intranasal, making it an effective acute pain treatment option in both the prehospital and ED settings. LDK holds promise as an emergency treatment in the evolving landscape of acute pain management.
-
Traumatic brain injury (TBI) afflicts 69 million individuals annually, resulting in numerous neuropsychiatric sequelae. Here, we investigate the possible relation between TBI and depression. ⋯ Individuals suffering from TBI are almost twice as likely to develop depressive symptomology compared to non-TBI individuals.
-
Airway management including endotracheal intubation (ETI) is a key skill for emergency clinicians. Therefore, it is important for emergency clinicians to be aware of the current evidence regarding the identification and management of patients requiring ETI. ⋯ An understanding of literature updates can improve the ED care of patients requiring emergent intubation.