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Putting Clinical Gestalt to Work in the Emergency Department

ACEP Now

On a busy day shift in the emergency department, our seasoned triage nurse comes to me after I finish caring for a hallway patient, “Hey, can you come see this guy in the triage room? This is the essence of emergency medicine. The post Putting Clinical Gestalt to Work in the Emergency Department appeared first on ACEP Now.

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Large bowel obstruction: ED presentation, evaluation, and management

EMDocs

Bowel perforation demonstrated by CT, hard signs of peritonitis, or an overall toxic appearance warrant emergent surgical consultation. Measures to optimize the patient for surgical intervention and treat shock, including antibiotics and fluid resuscitation, are associated with improved outcomes in these patients.

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Something she ate?

Intensive Blog

Labs and Lytes 040 Author: Dr Nasreen Bahemia Peer reviewers: Dr Craig Johnston, A/Prof Chris Nickson A 56-year-old female presented to the Emergency Department (ED) with 2 days of severe nausea, vomiting and diarrhoea. 2007, Mar). She was also getting progressively drowsier while waiting in ED. Bellomo, R. 2014, Jan).

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EM@3AM: Hyperthermia

EMDocs

An 18-month-old boy presents to the emergency department with loss of consciousness. Evaporative cooling is the preferred method to actively reduce body temperature in the emergency department , as it can be performed with ongoing resuscitation efforts. The Journal of Emergency Medicine. , 50 (4), 607–616.

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IV fluids in the ED: When do we really need them?

EMDocs

Much of our understanding of the clinical signs of hypovolemia comes from studies performed on phlebotomy volunteers 1,2 while our understanding of fluid overload comes from heart failure patients. For patients without frank signs of shock, it is reasonable to trial oral hydration prior to moving on to IV fluids. Ann Emerg Med.