Emergency Tips

A febrile patient returning from the tropics has malaria until proved otherwise

Doxycycline is the drug of choice for most severe tick-borne infections, and it should be used empirically and early in the febrile, severely ill patient with a possible tick exposure.

In a young woman presenting with rash, fever, and diarrhea, consider toxic shock syndrome and examine for a retained tampon

When a patient with end-stage renal disease presents with shortness of breath, volume overload is by far the most common cause, even when physical examination and chest X-ray are not diagnostic

The indications for emergency dialysis are acute pulmonary edema, life-threatening hyperkalemia, and life-threatening intoxication or overdose by agents normally excreted by the kidneys

It is not necessary to gradually empty the bladder when treating an episode of acute urinary retention

Do not acutely lower the mean arterial pressure (MAP) more than 20% to 25% in patients with hypertensive encephalopathy

Every ED should have an interdisciplinary evidence-based guideline for the management of acute stroke

The diagnosis of atrial fibrillation (AF) can be made clinically by palpating a peripheral pulse and simultaneously auscultating the heart or visualizing the cardiac rhythm; AF is the only dysrhythmia that results in a pulse deficit (fewer beats palpated than observed or auscultated)

An external pacemaker can be used if a permanent pacemaker malfunctions

It is not always necessary to identify a dysrhythmia prior to treating it. Assume all wide complex tachycardia with hemodynamic instability is ventricular tachycardia (VT)

Serum lactate is a useful marker to assess the extent of systemic hypoperfusion and response to resuscitation

The most important tool in assessing patients in whom you suspect ischemic heart disease is the history. The second most important tool is the history. The third most important tool is, well, you get the picture.

Continuous positive airway pressure (CPAP) or bi-level positive airway pressure (BiPAP) may well reduce the need for endotracheal intubation in both the ED and prehospital arenas.

There is no increased risk for a serious bacterial illness in a child with a simple febrile seizure.

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