OBJECTIVE Substance use disorders are prevalent in emergency departments in medical and psychiatric services, reaching rates of 28% of cases in medical emergency departments. However, professionals in the emergency department identify less than 50% of cases of alcohol-related problems. This article aims to provide evidence-based interventions for the specific treatment to patients who meet diag...

Dr. Vianello and colleagues understand very well that it is usually because of an inability to cough out airway secretions during chest colds, rather than because of chronic hypoventi¬ lation, that patients with neuromuscular disease develop acute respiratory failure (ARF). They deserve commendation for directing their attention to these patients' primary impedi¬ ment to extended survival. They...

more physiological action profile. Apart from the practical problems of assessing the depth of subcutaneous tissue in a large number of patients-and the provision of a range of needle lengths-longer term studies are needed on blood glucose control, the relative rate of hypoglycaemia, effects of exercise, and patient acceptability. Until such data are available it may perhaps be wise to recommen...

Background Acute migraine headaches can last from 4 hours to 3 days if untreated. Migraines often require bed rest, pain medications, and time off from work and other activities, thus reducing an individual’s productivity and quality of life. Seven percent of U.S. migraine patients reported using an ED or urgent care center for treatment within the previous 12 months. Of patients who use an ED ...

"Limp" is a common complaint of children presenting to the emergency department or physician's office. For most patients presenting with limp, the diagnosis and management can be completed in the physician's office or emergency department by gathering a detailed history, performing a careful physical examination, and requesting a few laboratory and imaging studies. This article reviews common c...

intrOdUctiOn Emergency physicians must be comfortable and confident in providing safe and effective procedural sedation and analgesia (PSA). Goals of PSA include providing an adequate level of sedation while minimizing pain and anxiety, maximizing amnesia, minimizing the potential for adverse drug-related events, controlling behavior, and maintaining a stable cardiovascular and respiratory stat...

OBJECTIVE To identify common weaknesses in senior house officer-patient consultation skills, and evaluate direct observation with feedback and negotiation of educational contracts, as a teaching tool in an emergency department setting. METHOD Common weaknesses were identified through review of feedback charts by three trained observers. Alteration in clinical and learning behaviour, as well a...

PURPOSE Management strategy in acute appendicitis patients initially presenting with abscess or mass is surrounded with controversy. This study was performed to identify the outcomes of management for this condition. METHODS We retrospectively analyzed prospectively registered 76 patients (male:female = 39:37; mean age, 50.8 years) with appendicitis presenting with abscess or mass over a 9-ye...

Morel-Lavallée lesions are uncommon injuries that can be associated with significant comorbidities if not detected early. Rapid diagnosis in the Emergency Department could significantly improve patient outcomes. We describe the diagnosis of such a lesion through the use of ultrasound imaging in the Emergency Department to utilize a fast, cost-effective imaging technique that does not subject th...