In patients with typical symptoms and diagnostic laboratory tests, CT or MR imaging is not required to confirm the diagnosis of acute pancreatitis. CT or MR imaging are primarily used to detect complications of acute pancreatitis...
In adults, by far and away the most common foreign body ingestion is a meat bolus impacting a preexisting anatomic structure. In children, the most common foreign body ingestion are coins.
Serious ingestions can immediately result in perforation, shock, and even death. Intentional ingestions in adults tend to have more serious consequences. Long-term complications can lead to strictures and an increased risk of esophageal cancer.
Boerhaave syndrome is a spontaneous rupture of the esophagus. It usually results from barotrauma related to retching or any sudden increase in intraabdominal pressure against a closed glottis.
In the ED patient with syncope, the ECG should be scrutinized for signs of ischemia, bradydysrhythmias, tachydysrhythmias, and conduction delays. Critical diagnoses to consider that can be detected with the ECG include: Brugada syndrome, Long or short QT syndromes ...
Shortness of breath (dyspnea) is the subjective sensation of breathlessness which is excessive for any given level of activity. It is important to remember that any component of the respiratory system can cause dyspnea.
Diuretics may not be the preferred initial therapy, however, for those patients with vascular failure, who are often euvolemic, or those with cardiogenic shock, who are often hypovolemic. In these patients, the emergency provider should first optimize preload and afterload reduction with the use of noninvasive positive pressure ventilation (NPPV), nitrates, or inotropes as indicated.
In recent years, there are increasing data that support the use of high-dose vasodilator therapy as the initial treatment for patients with acute decompensated heart failure (ADHF)
Approximately 1% to 2% of patients with hypertension will present with a hypertensive emergency, defined as organ dysfunction due to an elevated blood pressure. Importantly, there is no specific blood pressure threshold that identifies a patient with a hypertensive emergency.
VAD (Ventricular assist device) patients are a special challenge for the EP. Through a careful assessment of the VAD, physical exam, MAP, ECG, and echo, the EP can resuscitate the good VAD that has gone bad.