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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. 4 However, emergency physicians rely on gestalt to predict outcomes well. Gigerenzer, G.

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Glasgow Coma Scale in Children

Pediatric EM Morsels

Motor Fingernail bed pressure with a pencil first If flexion outcome, then apply painful stimulus to neck or head (trapezius or supraorbital notch) to look for localization Spinal reflex can result in a falsely elevated score if lower extremity pain induced Verbal Orientated- Able to answer all questions. A practical scale. PMID: 4136544.

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Low Risk Intra-Abdominal Trauma: Rebaked Morsel

Pediatric EM Morsels

2007 Nov 22;357:2277-2284. Ann Emerg Med. Ann Emerg Med. PECARN prediction rules for CT imaging of children presenting to the emergency department with blunt abdominal or minor head trauma: a multicentre prospective validation study. 2014;165:1230-1235. doi:10.1016/j.jpeds.2014.08.014. 2014.08.014. N Engl J Med.

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Improving Care for Patients with a Non-English Language Preference (NELP)

EMDocs

12 How do we address these disparities in the emergency department? Certified interpreter use can improve communication and patient outcomes. An implementation science approach improves language access in the emergency department. One cohort study in a public ED found that 84.5% 45:446-458. Taira B, et al.

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Diagnostics and Therapeutics: Ear Emergencies in the Department

Taming the SRU

Chief complaints involving the ear are a common occurrence in Emergency Departments across the US and include presenting symptoms such as ear pain or fullness, hearing loss, redness, trauma, vertigo, and foreign bodies. A retrospective analysis of the Nationwide Emergency Department Sample (NEDS) from 2009 through 2011 identified 8.6

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Blood Pressure Management in Neurologic Emergencies: What Does the Evidence Say?

EMDocs

Introduction: Neurologic emergencies are common in the Emergency Department (ED), and blood pressure management is critical to immediate management. Poor blood pressure management can worsen the outcome of hemorrhagic stroke by increasing the risk of hematoma expansion, cerebral edema, and ischemia [8-14]. PMID: 11988609.

Stroke 101
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SGEM #397: Give a Little Bit…of Oseltamivir to Pediatric Patients Admitted with Influenza

The Skeptics' Guide to EM

Association of early oseltamivir with improved outcomes in hospitalized children with influenza, 2007-2020. She is also the […] The post SGEM #397: Give a Little Bit…of Oseltamivir to Pediatric Patients Admitted with Influenza first appeared on The Skeptics Guide to Emergency Medicine. JAMA Pediatr. JAMA Pediatr. JAMA Pediatr.