Abstract：
:Diseases do not always show the usual or "classic" signs and symptoms in the elderly. Physiologic changes over the years of a long life seem to be responsible for impairment of regulation or function of many organ systems. Since function often is measured in clinical medicine by laboratory testing, physicians frequently face difficult clinical decisions as to the need for further evaluation of a patient based upon a laboratory test result received. For the most part, the laboratory values obtained in elderly persons seem to fall into our traditional or so-called normal ranges, and little evidence supports the need for separate sets of reference ranges for the elderly. A few patients do show abnormalities on specific tests, and a few test values can be expected more frequently than others to be out of line in healthy elderly individuals, specifically: serum alkaline phosphatase (elevations to about 2.5 times the normal) fasting blood glucose (up to 135 to 150 mg/dl) postprandial blood glucose or oral glucose tolerance test (increased above normal to 10 mg/dl per decade of age) normal serum creatinine with the existence of markedly decreased creatinine clearance higher erythrocyte sedimentation rates (up to 40 mm/hr) hemoglobin (lowest acceptable level is 11.0 gm/dl in women; 11.5 gm/dl in men) BUN (up to 28 to 35 mg/dl) The presence of multiple diseases in elderly patients, as well as the many medications often taken, will no doubt be more of a source of confusion and consternation in the clinical correlation of laboratory test results than the lack of adequate reference ranges specifically compiled for the elderly. The question "What test result is significant and raises suspicion of disease?" will remain a part of that all-important integration and correlation of the information available to the physician for the diagnosis and treatment of the patient.
journal_name
Emerg Med Clin North Amjournal_title
Emergency medicine clinics of North Americaauthors
Kelso Tsubject
Has Abstractpub_date
1990-05-01 00:00:00pages
241-54issue
2eissn
0733-8627issn
1558-0539journal_volume
8pub_type
杂志文章,评审abstract：:Gynecologic malignancies are the third most common cancer among women in the United States. Because of often subtle early findings, the diagnosis may not be made before the widespread dissemination of the disease. The Emergency Department physician will commonly encounter a woman with vaginal bleeding, pelvic pain, or...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1987-08-01 00:00:00
abstract：:The elderly patient is likely to suffer severer immediate effects and more long-term complications from equivalent forces of injury. However, with an aggressive approach to evaluation, monitoring, and treatment, there is hope for successful recovery in the majority of cases. ...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1990-05-01 00:00:00
abstract：:Many systemic diseases have associated oral symptoms. Occasionally, patients with these diseases present with lesions that occur primarily in the mouth. Although few systemic diseases have strictly pathognomonic lesions of the oral mucosa, a careful examination of the oral cavity can often lend important clues to maki...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0733-8627(05)70144-9
更新日期：2000-08-01 00:00:00
abstract：:Although emergency departments (ED's) vary in shape, size, and technology, similarities in responsibilities exist. The primary responsibility is to provide quality health care to the communities served. The (ED) constitutes a substantial business in any hospital. Because of changing acuity levels, patient volume, and ...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/S0733-8627(03)00099-3
更新日期：2004-02-01 00:00:00
abstract：:Rapid response systems (RRS) are both intuitive and supported by data, but the institution of an RRS is not a panacea for in-hospital cardiac arrest or unexpected deaths. RRS implementation should be one component of an institution-wide effort to improve patient safety that includes adequate nursing education and staf...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2011.09.012
更新日期：2012-02-01 00:00:00
abstract：:Pain measurement and relief is complex and should be a priority for prehospital providers and supervisors. The literature continues to prove that we are poor pain relievers, despite the high prevalence of pain in the out-of-hospital patient population. Lack of education and research, along with agent availability, con...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2004.12.009
更新日期：2005-05-01 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：:Ventilation-perfusion scintigraphy remains an important diagnostic tool in the evaluation of patients suspected of having PE. It is important for the emergency physician to be able to use the information from a lung scan appropriately in the diagnostic management of this elusive and life-threatening disorder. This req...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1991-11-01 00:00:00
abstract：:The widely recognized benefits of early diagnosis and treatment of acute myocardial infarction (AMI) have only emphasized the importance of emergency physician (EP) competence in electrocardiographic interpretation. As such, the EP must be an expert in the interpretation of the electrocardiogram (ECG) in the emergency...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0733-8627(05)70185-1
更新日期：2001-05-01 00:00:00
abstract：:Patients with complications of chemotherapy, either acute or chronic, are frequently encountered in the emergency department (ED). Some patients present with complaints immediately after chemotherapy administration, whereas others may show subtle, secondary signs or may have no signs or symptoms of chemotoxicity. An i...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2014.04.006
更新日期：2014-08-01 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：:Pulmonary edema is differentiated into two categories--cardiogenic and noncardiogenic. Noncardiogenic pulmonary edema is due to changes in permeability of the pulmonary capillary membrane as a result of either a direct or an indirect pathologic process. It is a spectrum of illness ranging from the less severe form of ...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0733-8627(03)00020-8
更新日期：2003-05-01 00:00:00
abstract：:Patient satisfaction is an integral component of the measurement of health care quality. Proper attention to patient complaints is one part of a patient satisfaction management strategy aimed at revealing and alleviating the causes of patient dissatisfaction. ...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1992-08-01 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：:Pediatric mechanical ventilation is first initiated by emergency physicians when performing active airway management in a critically ill or injured child. When initiating and adjusting mechanical ventilation, the child has unique anatomy and physiology to consider. The EP is the first to respond to ventilator alarm tr...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2017.12.008
更新日期：2018-05-01 00:00:00
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
更新日期：1998-08-01 00:00:00
abstract：:Although useful to emergency physicians in determining and following up treatment, the microbiology department can be a source of frustration and erroneous results due to improper or inconsistent methodology, ordering, and interpretation. This article will review the principles of microbiologic specimen collection, ha...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1986-05-01 00:00:00
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
更新日期：2015-11-01 00:00:00
abstract：:Blunt abdominal trauma results in potentially life-threatening injuries that require organized rapid evaluation and treatment. Resuscitation of hemodynamically unstable patients should be completed in the operating room if retroperitoneal hemorrhage is not strongly suspected. DPL and abdominal CT scans are methods of ...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1989-08-01 00:00:00
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
更新日期：2016-05-01 00:00:00
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：
更新日期：1985-08-01 00:00:00
abstract：:In recent years, health care providers have sounded the call that the US mental health system is in crisis. With decreases in funding and eroding access to care, the availability of psychiatric services has become increasingly limited, failing to meet growing needs. This article provides a brief history of mental heal...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2015.07.013
更新日期：2015-11-01 00:00:00
abstract：:Adverse cardiovascular events comprise a large portion of the morbidity and mortality in drug overdose emergencies. Adverse cardiovascular events encountered by emergency physicians treating poisoned patients include myocardial injury, hemodynamic compromise with shock, tachydysrhythmias, and cardiac arrest. Early sig...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2013.10.003
更新日期：2014-02-01 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：:Critically ill patients with pulmonary hypertension (PH) often seem well, but they can decompensate dramatically in a short time. PH has several causes, classes, and complications; but the natural progression eventually leads to right ventricular failure, which can be extraordinarily difficult to manage. The purpose o...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2015.04.012
更新日期：2015-08-01 00:00:00
abstract：:Pediatric asthma is a disease that is managed across outpatient physicians, hospitalists, critical care physicians, and emergency department (ED) physicians. Scoring systems may facilitate a rapid assessment of the child with asthma in the ED. Short-acting beta agonists are still the mainstay of therapy for acute exac...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2013.05.001
更新日期：2013-08-01 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：:Acute stroke care is a multidisciplinary effort. It crosses the boundaries of traditional hospital-based medicine, relying heavily on prehospital providers to obtain a significant amount of clinical information. Currently, modifications of existing EMS systems are underway to support the idea that "time is brain." Dis...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0733-8627(02)00011-1
更新日期：2002-08-01 00:00:00
abstract：:This article provides a review of the evaluation and treatment of common injuries to the shoulder, humerus, and clavicle in the emergency department (ED) setting. In addition to a focused review of the shoulder's physical examination, topics include common emergent injuries such as glenohumeral dislocations, proximal ...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.emc.2010.06.006
更新日期：2010-11-01 00:00:00
abstract：:Heat stroke is reviewed in detail. Particular attention is paid to diagnosis and current emergency department treatment, and a brief overview of pathophysiology is included. Early complications, with recommendations for prevention and management, are described. Minor heat related syndromes are also mentioned. ...
journal_title：Emergency medicine clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1992-05-01 00:00:00
