Abstract：
:Neurologic and myopathic complications of alcoholism are multiple and diverse, affecting both the central and peripheral nervous systems. In the ED, initial concern is for diagnosing readily reversible causes and ruling out possible life- or limb-threatening etiologies. A rapid assessment of the ABCs, a fingerstick blood glucose determination, and, in cases of AMS, the administration of intravenous naloxone is indicated. In almost every instance of a potential neurologic complication, intravenous thiamine replacement is indicated initially, along with the parenteral administration of folic acid and the other B vitamins, including nicotinic acid and pyridoxine. Metabolic screening with electrolytes, glucose, blood urea nitrogen, creatinine, calcium, magnesium, liver enzymes (AST, alkaline phosphatase), bilirubin, arterial blood gases with carboxyhemoglobin determination, and a complete blood count are often warranted. Special tests such as CT scan, CK, ammonia, or toxicologic screens are indicated in specific instances. In terms of physical examination, attention to the presence of focal neurologic findings is paramount because of the possibility of a subdural or epidural hematoma. It is important not to miss meningitis and a low threshold for treatment or lumbar puncture should be maintained. Specialized consultation and referral are needed only after stabilization and appropriate tests are performed. If an organized approach to the evaluation of an alcoholic with neurologic symptoms is undertaken, occult disease will not be missed and outcomes will be improved.
journal_name
Emerg Med Clin North Amjournal_title
Emergency medicine clinics of North Americaauthors
Wrenn KD,Slovis CMsubject
Has Abstractpub_date
1990-11-01 00:00:00pages
835-58issue
4eissn
0733-8627issn
1558-0539journal_volume
8pub_type
杂志文章,评审abstract：:As more Americans venture into the wilderness, physicians will be called upon to provide care in the backcountry or austere setting. Additionally, more isolated regions of the world are becoming accessible for trekking and mountaineering. These facts imply a higher rate of injuries and medical problems within a distin...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章
doi：10.1016/j.emc.2004.01.012
更新日期：2004-05-01 00:00:00
abstract：:This article updates research concerning the resuscitation of a pediatric patient. The topics discussed include the state of pediatric life support, the current guidelines, the management of those guidelines, and coping with death. ...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0733-8627(03)00049-x
更新日期：2002-02-01 00:00:00
abstract：:Rapid sequence intubation is the process involving administration of a sedative (eg, induction agent) followed almost immediately by a neuromuscular blocking agent to facilitate endotracheal intubation The purpose of emergency RSI is to make emergent intubation easier and safer, thereby increasing the success rate of ...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2008.10.002
更新日期：2008-11-01 00:00:00
abstract：:Health care professionals often encounter patients who refuse a recommended treatment plan. Overriding a patient's right to autonomy has ethical, legal, and moral consequences. Incapacity is the determination by a physician that a patient lacks the ability to make informed decisions about his or her health care. The f...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0733-8627(05)70120-6
更新日期：2000-05-01 00:00:00
abstract：:Despite recent advances, care of the post-cardiac arrest patient remains a challenge. In this article, the authors discuss an approach to the initial care of post-cardiac arrest patients with particular focus on targeted temperature management (TTM). The article starts with history, physiologic rationale, and the majo...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2019.03.002
更新日期：2019-08-01 00:00:00
abstract：:Pulmonary embolism (PE) remains one of the most challenging medical diseases in the emergency department. PE is a potentially life threatening diagnosis that is seen in patients with chest pain and/or dyspnea but can span the clinical spectrum of medical presentations. In addition, it does not have any particular clin...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2011.12.004
更新日期：2012-05-01 00:00:00
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
更新日期：2012-08-01 00:00:00
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：
更新日期：1994-11-01 00:00:00
abstract：:This article focuses on the use of hyperbaric oxygen therapy (HBOt) in the treatment of open fractures and crush injuries. Based on the clinical evidence and cost analysis, medical institutions that treat open fracture and crush injuries are justified in incorporating HBOt as a standard of care. Both Medicare and Unde...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2007.01.008
更新日期：2007-02-01 00:00:00
abstract：:Toxic overdose can present with various clinical signs and symptoms. These may be the only clues to diagnosis when the cause of toxicity is unknown at the time of initial assessment. The prognosis and clinical course of recovery of a patient poisoned by a specific agent depends largely on the quality of care delivered...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2007.02.004
更新日期：2007-05-01 00:00:00
abstract：:Bradydysrhythimas include sinus bradycardia, junctional brady-cardia, and idioventricular rhythm, which can be distinguished by examining the tracing for the presence or absence of P waves,noting the morphology of these P waves, and determining the width of the QRS complex. Sinoatrial blocks may occur in either first,...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2005.08.006
更新日期：2006-02-01 00:00:00
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
更新日期：2007-02-01 00:00:00
abstract：:A thorough working knowledge of the diagnosis and treatment of life-threatening electrolyte abnormalities in cancer patients, especially hyponatremia, hypoglycemia, and hypercalcemia, is essential to the successful practice of emergency medicine. Although most minor abnormalities have no specific treatment, severe cli...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2009.01.007
更新日期：2009-05-01 00:00:00
abstract：:Because of the altered physiology of the elderly population, either as a result of aging or as a result of other disease processes, many illnesses may present with features that are either atypical or nonspecific in nature. Difficult and nonspecific complaints such as weakness in an elderly patient must be handled in ...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0733-8627(05)70056-0
更新日期：1999-02-01 00:00:00
abstract：:Sexually transmitted diseases comprise one of the most common medical complications of pregnancy. Prompt treatment is essential to minimize the risk of fetal and neonatal adverse consequences. At this time, however, no pharmacologic therapy is routinely employed for the viral STDs during pregnancy, including HIV, HSV,...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1994-02-01 00:00:00
abstract：:Avoiding legal pitfalls of orthopedic injuries in the emergency department (ED) requires an understanding of certain high-risk injuries, their presentation, evaluation, and disposition. Various pitfalls pertaining to both upper and lower extremity injuries are discussed in detail, with recommendations regarding the hi...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2010.06.002
更新日期：2010-11-01 00:00:00
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
更新日期：2005-08-01 00:00:00
abstract：:The scope of gynecologic infections presenting to the emergency department is quite diverse. This article presents an update on the current literature for vaginitis, cervicitis, pelvic inflammatory disease, tubo-ovarian abscesses, the Fitz-Hugh-Curtis syndrome, herpes, and syphilis. Inadequate identification or treatm...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0733-8627(03)00039-7
更新日期：2003-08-01 00:00:00
abstract：:The diagnosis of malignancy in childhood is challenging. Signs and symptoms are generally nonspecific, and children with an underlying malignancy rarely are seriously ill at the time of initial presentation. A thorough history and physical examination are the most important components of the emergency physician's asse...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1993-05-01 00:00:00
abstract：:Pneumonia remains one of the most common reasons for admission of emergency department (ED) patients to the hospital. Pneumonia also remains one of the most common causes of death in our patients. As with many emergent conditions, the ED management of these patients initiated by ED physicians contributes greatly to th...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2008.02.005
更新日期：2008-05-01 00:00:00
abstract：:This article reviews some common illnesses and conditions that prompt traveling patients to seek medical care in the emergency department in the United States. It also presents an emergency department approach to the initial diagnosis and treatment of travelers who are experiencing adverse side effects from pretravel ...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0733-8627(05)70295-9
更新日期：1997-02-01 00:00:00
abstract：:The aging population of the United States creates pharmaceutical challenges for the practicing emergency physician. Polypharmacy, drug-drug and drug-disease interactions, and other pharmaceutical complications from the pathophysiologic changes associated with aging need to be recognized in order to optimize outcomes i...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2016.04.003
更新日期：2016-08-01 00:00:00
abstract：:US is the imaging modality of choice in many situations encountered in the Emergency Department. It is particularly useful in evaluating renal colic, pain or vaginal bleeding in the pregnant patient, and pelvic pain in the nonpregnant woman; and in diagnosing gallbladder disease, appendicitis, proximal lower extremity...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1992-02-01 00:00:00
abstract：:Orthopedic injuries in children are unique when compared to those of adults because of the physiologic differences, especially the growth plates, stronger periosteum, and dynamic state of growth. The approach to the orthopedically injured child requires a gentle yet thorough focus with consideration of the growth plat...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2014.12.012
更新日期：2015-05-01 00:00:00
abstract：:Epigastric pain is an extremely common complaint in the emergency department and has an associated broad differential diagnosis. In the differential it is important to consider cardiac causes that may be mistaken for gastrointestinal disorders as well as various serious intra-abdominal causes. This article highlights ...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2015.12.012
更新日期：2016-05-01 00:00:00
abstract：:The history, effectiveness, and services of regional poison control centers are reviewed. In addition, the American Association of Poison Control Centers criteria for designation as a regional poison control center are presented. ...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章
doi：
更新日期：1984-02-01 00:00:00
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
更新日期：2008-02-01 00:00:00
abstract：:Medical planning requires the expedition physician to draw from many aspects of the knowledge base of wilderness and environmental medicine and to learn and use lessons from those that have gone before. The medical plan is dependent on parameters of the expedition objective, scope, and resources and is developed coope...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章
doi：
更新日期：1992-05-01 00:00:00
abstract：:Newer drugs of abuse, such as MDMA, GHB, GBL, 1,4-BD and ketamine, are frequently used in the settings of raves and are often promoted on the internet. The popularity of these agents is increasing; therefore, emergency physicians should become familiar with the clinical presentations and management of the toxicity ind...
journal_title：Emergency medicine clinics of North America
pub_type： 历史文章,杂志文章
doi：10.1016/s0733-8627(05)70150-4
更新日期：2000-11-01 00:00:00
abstract：:This article is designed to review proper procedure by an emergency or primary care physician when evaluating a patient with decreased hearing. It will cover the anatomy and physiology of hearing, as well as the evaluation and initial management of conductive and sensorineural hearing loss. ...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1987-05-01 00:00:00
