Emergency Tips

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.

The initial objectives in treating an asthma or chronic obstructive pulmonary disease (COPD) exacerbation are to relieve significant hypoxemia (oxygen), reverse airflow obstruction (b-agonists 1 ipratropium), and to reduce of the likelihood of recurrence (corticosteroids).

Consider Kawasaki’s disease in children presenting with 5 days of fever

In patients with a high suspicion for bacterial meningitis, administer antibiotics promptly before the lumber puncture is performed and after blood cultures are obtained

Documenting adherence to evidence-based guidelines is helpful in defending against a malpractice claim.

When a mandible fracture is suspected, a panoramic radiograph of the mandible is the least expensive and most accurate film to assess the patient.

Perilimbic flush suggests iritis or glaucoma, not conjunctivitis

An afferent pupillary defect points to a defect of the retina or optic nerve

Spinal epidural abscess should be suspected as the cause of back pain in immunocompromised patients and IV drug users who present with localized spinal tenderness and fever

The diagnosis of gastroenteritis cannot be made without the presence of both vomiting and diarrhea.

A foreign body in the airway should be suspected in a child with sudden onset of respiratory symptoms and lack of response to appropriate treatment.

In febrile patients, a white blood cell or band count is rarely useful in differentiating between bacterial and viral illnesses.

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