Emergency Medicine Reports saves you time keeping up with all the latest advances in a variety of clinical problems and gives you important time-saving techniques that can actually save lives in the ED!
Emergency Medicine Reports Latest Issue
End-of-Life and Futile Medical Care in the Emergency Department Oct. 14, 2014
- Futile care is treatment with no realistic benefit as would be perceived by the patient.
- Palliative care is treatment that improves the patient's quality of life by addressing physical and psychological symptoms.
- Hospice care is comprehensive treatment provided to terminally ill patients, focusing on symptom management rather than disease cure.
- Advance directives appoint a legal health care representative and provide instructions for future life-sustaining treatments, but importantly, do not guide EMS personnel.
- Physician Orders for Life-Sustaining Treatment (POLST) provide medical orders for current treatment and, when available, guide actions by EMS personnel.
Trauma Reports Latest Issue
Read the latest issue of this bimonthly, 12-page clinical monograph focusing on emergency care of adult and pediatric patients with moderate and severe traumatic injuries. Each issue gives you a practical, problem-solving, comprehensive review of a common clinical entity, packed with updated techniques you can apply immediately.
Blunt Pelvic Trauma Nov. 1, 2014
- Schulman et al found that patients presenting with pelvic ring fractures are at increased risk of death regardless of other associated injuries. Additionally, they were able to demonstrate that patients with pelvic fractures presenting with age greater than 65 years, injury severity index greater than 18, respiratory rate greater than 30 bpm, SBP less than 90 mmHg, and GCS score less than 8 had an even further increased risk of mortality.
- The structures at greatest risk for injury due to their location adjacent to the pelvic bones and ligaments are: the sciatic, femoral, and obturator nerves, as well as the bladder, urethra, and extraperitoneal rectum.
- Higher-energy forces are required to cause APC3 injuries, and the posterior sacroiliac ligaments are completely disrupted, resulting in a severely unstable pelvic ring in which the highest clinical suspicion for hemorrhage should be considered.
- The correct way to test for pelvic stability is to grab the iliac crests and push inward in a gentle motion. Also, the symphysis pubis can be palpated to assess for widening.
- In the setting of pelvic fracture and hematuria, the CT cystogram with distended bladder and post-emptying views has replaced the retrograde cystourethrogram for the diagnosis of bladder injury.