Diagnosing the Patient with Loss of Consciousness (Syncope and Coma)
Diagnosis Algorithm for Syncope
Loss of consciousness may be transient (syncope) or ongoing (coma). Many patients are admitted to hospital with "collapse".
Abdominal Pain in the Emergency Department
Abdominal Pain - Causes
Work-up for abdominal pain begins with resuscitation and exclusion of critical diagnoses. Then, through a detailed history and physical, consider all the causes of abdominal pain...
Imaging of Acute Pancreatitis: to Image or Not to Image
Acute Pancreatitis - Causes, Pathology, Symptoms and Signs, Investigations, Management and Complications
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...
Ingested Foreign Body: When to Intervene ?
Foreign Body Aspiration - Pathogenesis and Clinical Findings
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.
Caustic Ingestions: Don’t Make it Worse
Alkaline and Acidic Caustic Ingestions
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: Not all Life-threatening Chest Pain Involves the Heart and Lungs
Boerhaave Syndrome - Causes, Symptoms, Diagnosis, Treatment
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.
Pearls in Syncope ECG Interpretation
Abnormal Ecg Findings of Cardiac Syncope
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): Differential Diagnosis, Examination and Investigations
The Causes of Shortness of Breath (Dyspnea)
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.
Beyond Diuresis – Treatment Adjuncts in Cardiogenic Pulmonary Edema
The emergency management of patients with cardiogenic shock, acute pulmonary edema, or both
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.
Aggressive Nitroglycerin Usage in Acute Decompensated Heart Failure (ADHF)
Phenotypes of Acute Decompensated Heart Failure (ADHF), their Presentations, and Suggested Therapy
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)
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