Sedation and Analgesia for Mechanically Ventilated Patients in the Emergency Department.

Abstract:

:Mechanically ventilated patients can experience significant pain and anxiety associated with their care. These symptoms should be aggressively treated, but can be challenging to manage without a systematic approach. This article reviews recent literature, current guidelines, and best practices in managing pain, agitation, and anxiety in mechanically ventilated patients in the emergency department.

authors

Noel C,Mallemat H

doi

10.1016/j.emc.2019.04.004

subject

Has Abstract

pub_date

2019-08-01 00:00:00

pages

545-556

issue

3

eissn

0733-8627

issn

1558-0539

pii

S0733-8627(19)30046-X

journal_volume

37

pub_type

杂志文章,评审
  • Optimal trauma outcome: trauma system design and the trauma team.

    abstract::Trauma is the number one killer of Americans under age 34; optimal trauma care is provided when there is a well-functioning, comprehensive system. This article reviews the development of trauma centers in the United States, recommending that the number of trauma centers be optimized so that resources and expense be ke...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章

    doi:10.1016/j.emc.2007.07.002

    authors: Markovchick VJ,Moore EE

    更新日期:2007-08-01 00:00:00

  • Pulmonary emergencies in the elderly.

    abstract::The aging process results in changes in pulmonary physiology that make the elderly population more susceptible to pulmonary disease. These physiologic changes also alter the clinical presentation of such diseases, making the diagnosis and treatment of pulmonary disorders particularly challenging for the clinician. It ...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/j.emc.2006.01.002

    authors: Imperato J,Sanchez LD

    更新日期:2006-05-01 00:00:00

  • Emergency thoracotomy.

    abstract::Emergency thoracotomy is a valuable therapeutic modality for the moribund patient when trauma is the cause of the shock state. It is a procedure that requires an understanding of the technique and indications and should be instituted based on the indications listed above. There is probably no reason to do this procedu...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章,评审

    doi:

    authors: Krome RL,Dalbec DL

    更新日期:1986-08-01 00:00:00

  • Mass casualty management of a large-scale bioterrorist event: an epidemiological approach that shapes triage decisions.

    abstract::The threat of a BT event has catalyzed serious reflection on the troublesome issues that come with event management and triage. Such reflection has had the effect of multiplying the efforts to find solutions to what could become a catastrophic public health disaster. Management options are becoming more robust, as are...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/s0733-8627(01)00008-6

    authors: Burkle FM Jr

    更新日期:2002-05-01 00:00:00

  • Rapid Fire: Central Nervous System Emergencies.

    abstract::Neurologic complications are unfortunately common in oncology patients, with many presenting to the emergency department for diagnosis and management. This case-based review provides a brief overview of the key points in pathophysiology, diagnosis, and management of 2 oncologic central nervous system emergencies: mali...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/j.emc.2018.04.010

    authors: Dubbs SB,Honasoge AP

    更新日期:2018-08-01 00:00:00

  • Overview of seizures.

    abstract::Epilepsy is a chronic disorder characterized by recurrent unprovoked epileptic seizures. Not all epileptic seizures indicate the existence of an epileptic disorder; many represent a natural response of the normal brain to transient noxious insults that are not likely to be repeated (reactive seizures). Not only is it ...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章,评审

    doi:

    authors: Engel J Jr,Starkman S

    更新日期:1994-11-01 00:00:00

  • Critical care aspects in the management of patients with acute coronary syndromes.

    abstract::The spectrum of acute coronary syndromes (ACS) includes several clinical complexes that frequently cause critical instability in affected patients. This article focuses on several critical care aspects of these unstable ACS patients. The management of cardiogenic shock can be particularly challenging because the mecha...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/j.emc.2008.04.002

    authors: Naples RM,Harris JW,Ghaemmaghami CA

    更新日期:2008-08-01 00:00:00

  • Ultrasound-guided procedures in the emergency department-needle guidance and localization.

    abstract::Ultrasound has rapidly become an essential tool in the emergency department, specifically in procedural guidance. Its use has been demonstrated to improve the success rate of procedures, while decreasing complications. In this article, we explore some of these specific procedures involving needle guidance and structur...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章

    doi:10.1016/j.emc.2012.09.008

    authors: Tirado A,Nagdev A,Henningsen C,Breckon P,Chiles K

    更新日期:2013-02-01 00:00:00

  • Factors Affecting Emergency Department Crowding.

    abstract::Emergency department crowding is a multifactorial issue with causes intrinsic to the emergency department and to the health care system. Understanding that the causes of emergency department crowding span this continuum allows for a more accurate analysis of its effects and a more global consideration of potential sol...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/j.emc.2020.04.001

    authors: Kenny JF,Chang BC,Hemmert KC

    更新日期:2020-08-01 00:00:00

  • Chemical, thermal, and biological ocular exposures.

    abstract::Chemical or radiant energy injuries to the eyes are considered ocular burns. The majority of these injuries are occupation-related. Chemical burns are by far more common and represent a true emergency. Thermal and UV injuries are associated with severe pain, but often result in less long-term sequelae than chemical in...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/j.emc.2007.11.002

    authors: Spector J,Fernandez WG

    更新日期:2008-02-01 00:00:00

  • Quality assurance in emergency medical service systems.

    abstract::EMS quality assurance programs can help guarantee that the provision of prehospital care is medically accountable. The establishment and management of such a program, although time consuming, are critically important. It is essential that the medical director or a designee responsible for quality assurance activities ...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章

    doi:

    authors: Polsky SS,Weigand JV

    更新日期:1990-02-01 00:00:00

  • Soft tissue wounds and principles of healing.

    abstract::Wound healing is a complex interchange, orchestrated between cellular components that play their respective parts signaled by and mediated by different cellular instruments of healing. When healing is performed well, the final product is a thing of beauty. When healing is delayed, interrupted, or excessive, then unsig...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/j.emc.2006.12.002

    authors: Strecker-McGraw MK,Jones TR,Baer DG

    更新日期:2007-02-01 00:00:00

  • Sepsis and septic shock.

    abstract::Sepsis and septic shock remain all too frequent syndromes in modern medicine with unacceptably high mortality rates. Physicians must be aware of the many ways in which sepsis and septic shock may present and the multiple differential diagnoses. Early recognition and prompt institution of empiric therapy are of utmost ...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章,评审

    doi:

    authors: Ellrodt AG

    更新日期:1986-11-01 00:00:00

  • Defibrillation.

    abstract::Defibrillation has emerged as the single most effective intervention for resuscitation of patients from cardiac arrest. This article reviews the electrophysiologic basis of defibrillation, and ways to increase the effectiveness of counter-shocks, particularly for refractory ventricular fibrillation. Automatic implanta...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章,评审

    doi:

    authors: Cummins RO

    更新日期:1988-05-01 00:00:00

  • Cardiopulmonary resuscitation in the elderly. Beneficial or an exercise in futility?

    abstract::Sudden cardiac death is one of the leading causes of death and a major public health problem that particularly affects the elderly. Sudden cardiac death may be a terminal event after a prolonged debilitating and painful illness, or it may occur following many years of symptoms related to a cardiac disorder; however, i...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/s0733-8627(05)70023-7

    authors: Tresch DD,Thakur RK

    更新日期:1998-08-01 00:00:00

  • Urinary Retention.

    abstract::Urinary retention is a common problem encountered in the emergency department. Acute urinary retention (AUR) presents as a sudden inability to voluntarily void, and is typically associated with lower abdominal pain. Its etiology can be varied and multifactorial. Treatment of AUR aims to relieve the obstruction and mit...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/j.emc.2019.07.005

    authors: Billet M,Windsor TA

    更新日期:2019-11-01 00:00:00

  • Neuroimaging.

    abstract::Nonenhanced CT scan remains the most valuable and available neuroimaging study available in the ED. Nonenhanced CT scans are excellent for identifying acute hemorrhage, mass lesions, hydrocephalus, and cerebral edema. It is of limited value in identifying old blood, small abscesses and tumors, arteriovenous malformati...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/s0733-8627(05)70315-1

    authors: Araiza J,Araiza B

    更新日期:1997-08-01 00:00:00

  • End Points of Sepsis Resuscitation.

    abstract::Resuscitation goals for the patient with sepsis and septic shock are to return the patient to a physiologic state that promotes adequate end-organ perfusion along with matching metabolic supply and demand. Ideal resuscitation end points should assess the adequacy of tissue oxygen delivery and oxygen consumption, and b...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/j.emc.2016.09.001

    authors: Greenwood JC,Orloski CJ

    更新日期:2017-02-01 00:00:00

  • Developing and implementing emergency medicine programs globally.

    abstract::International EM development requires a comprehensive assessment of the current system and careful planning to ensure that the most important needs are addressed. Modeling a country's EM system after an existing foreign system underestimates the complex needs for instituting appropriate system interventions. Planning ...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/j.emc.2004.09.005

    authors: Thomas TL

    更新日期:2005-02-01 00:00:00

  • Abdominal Pain in the Immunocompromised Patient-Human Immunodeficiency Virus, Transplant, Cancer.

    abstract::Patients with human immunodeficiency virus, those who are posttransplant, and those undergoing chemotherapy are populations who are immunocompromised and present to the emergency department with abdominal pain related to their disease processes, opportunistic infections, and complications of treatment. Emergency depar...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/j.emc.2015.12.002

    authors: McKean J,Ronan-Bentle S

    更新日期:2016-05-01 00:00:00

  • Vaginal bleeding.

    abstract::Vaginal bleeding is one of the most common gynecologic symptoms for which the patient will come to the Emergency Department. It is usually associated with psychologic distress and can be frightening to the patient. Vaginal bleeding can be the first sign of life-threatening medical disorders such as carcinoma, bleeding...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章

    doi:

    authors: Hochbaum SR

    更新日期:1987-08-01 00:00:00

  • Basic neuroanatomy and stroke syndromes.

    abstract::Stroke should not solely be considered a disease of the elderly, and racial disparities are most evident among young adults. Acute stroke can present at any age and it is important to be familiar with the evaluation and treatment of stroke to provide timely care. The National Institute of Health Stroke Scale helps phy...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/j.emc.2012.05.004

    authors: Pare JR,Kahn JH

    更新日期:2012-08-01 00:00:00

  • The porphyrias.

    abstract::The porphyrias are a group of disorders involving enzymatic defects in heme synthesis. The porphyrias classically manifest neuro-visceral or photocutaneous symptoms based on which enzyme in the heme metabolic pathway is deficient. Although rare, the porphyrias would most likely be encountered in the emergency departme...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/j.emc.2005.03.014

    authors: Dombeck TA,Satonik RC

    更新日期:2005-08-01 00:00:00

  • Abdominal trauma.

    abstract::Abdominal injuries are an important cause of morbidity and mortality. In the face of more obvious traumatic lesions, life-threatening intra-abdominal injuries may be initially overlooked. Plain abdominal and chest radiographs may prove diagnostic for specific injuries. However, normal or equivocal studies should not e...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章,评审

    doi:

    authors: Evers K,DeGaeta LR

    更新日期:1985-08-01 00:00:00

  • Triage and initial evaluation of the oral facial emergency.

    abstract::Essentially, emergency medicine encompasses the efficient application of limited resources to provide timely care to patients in health crisis. The appropriate triage, management, and disposition of patients with orofacial complaints requires systematic evaluation with attention to the ABCs. The first priority is to s...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/s0733-8627(05)70134-6

    authors: Howes DS,Dowling PJ

    更新日期:2000-08-01 00:00:00

  • Management of unique clinical entities in disaster medicine.

    abstract::This article discusses the management of clinical problems encountered particularly in disasters. These include the principles of multiple-casualty triage, and field and hospital management of blast injury, crush syndrome, compartment syndrome, particulate inhalation, and traumatic asphyxiation. The indications for ex...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/s0733-8627(05)70253-4

    authors: Gans L,Kennedy T

    更新日期:1996-05-01 00:00:00

  • Acute HIV infection: diagnosis and management in the emergency department.

    abstract::Acute human immunodeficiency virus (HIV) infection, also known as primary HIV infection, is the initial phase of infection, spanning from inoculation to the establishment of CD4 count and viral load set points. This phase is marked by dynamic changes in viral replication and host immune responses and contains 2 import...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章

    doi:10.1016/j.emc.2010.01.002

    authors: Self WH

    更新日期:2010-05-01 00:00:00

  • Consent and refusal of treatment.

    abstract::Clearly, a multitude of potential consent problems can exist for the emergency physician. It is difficult at times to balance the concepts of patient autonomy with the desire to provide optimal medical care. Experienced emergency physicians should be able to individualize the type of consent needed in a particular sit...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章,评审

    doi:

    authors: Siegel DM

    更新日期:1993-11-01 00:00:00

  • Stabilization and Management of the Acutely Agitated or Psychotic Patient.

    abstract::Acutely agitated or psychotic patients are particularly challenging to manage in the emergency department. Often these patients present with little or no history, and an adequate assessment may initially be difficult because of the condition of the patient. This article discusses basic concepts regarding agitation, an...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/j.emc.2015.07.003

    authors: Deal N,Hong M,Matorin A,Shah AA

    更新日期:2015-11-01 00:00:00

  • Evaluation of the patient with blunt chest trauma: an evidence based approach.

    abstract::The patient who has sustained blunt trauma to the chest can present a diagnostic challenge to the emergency physician. There are several diagnostic modalities available for treating life-threatening injuries to these patients. The authors review published studies to support the use of these tests in diagnosing injurie...

    journal_title:Emergency medicine clinics of North America

    pub_type: 杂志文章,评审

    doi:10.1016/s0733-8627(05)70046-8

    authors: Greenberg MD,Rosen CL

    更新日期:1999-02-01 00:00:00