Clinical reviews of how to approach and take care of patients with the most serious and common ED and Urgent care complaints.
C3 - Stroke
In this episode of C3, we review the management of the patient with acute stroke. Although cerebrovascular disease is a leading cause of death worldwide, advances in acute stroke care have been overshadowed to some degree by advances in cardiovascular care. After years of slow and difficult progress, the battle against stroke is picking up steam. Advances in imaging allow us to more precisely define the various stroke syndromes and new interventional techniques now the hold promise of more effective targeted treatments.
C3 - Painful Red Eye
In this episode of C3, we examine the approach to the patient with a painful red eye(s). The causes of a painful red eye range from benign and self-limited to very serious and sight threatening. We will emphasize a methodical approach and discuss the skills and procedures that we need to be familiar with in the acute care setting.
C3 - HIV and AIDS
In this month’s C3, we discuss one of the most important and fascinating infectious diseases of our time - HIV/AIDS. The rapid spread of this global pandemic and its evolution from a universally fatal disease to one that can be controlled and prevented, is one of the most compelling stories in modern medicine.
C3 - Atrial Fibrillation
Atrial fibrillation (AF) is the most common tachyarrhythmia. As such, AF is bread and butter for the emergency provider. We need to really understand and be comfortable with this rhythm.
C3 - Seizures in Pediatric Patients
How should we approach seizures in pediatric patients? How different is this from adults with seizures? We will discuss.
C3 - Seizures
Seizures frighten everybody. They can be distressing not only for patients but also for their families, public bystanders and even emergency providers. Because the convulsions associated with seizures can be so dramatic, we tend to lose our ability to think in a logical manner when a patient is actively seizing. In this episode of C3, we cover the initial approach to the seizing patient, how to manage status epilepticus and how to disposition these patients from the emergency department.
C3 - Bradycardia
In last month’s C3, we discussed the concept of primacy of rate. Simply stated, the more abnormal the heart rate, the more likely that it is responsible for the patient’s symptoms. In most cases (but not all - e.g. not in hypothermia and myxedema coma) intervening to correct the rate is a high priority in the resuscitation.
C3 - Tachyarrhythmias
Managing patients with tachycardia is as central to emergency medicine as airway, breathing, and circulation. In many cases, a rapid heart rate is the most prominent and obvious part of a patient’s presentation – and in some cases it demands immediate action from the treatment team. In this episode of C3, we have attempted to make the approach to patients with tachyarrhythmias simple “but not too simple”, as a great man (Albert Einstein!) once said.
C3 - Epistaxis
Epistaxis, or nosebleed, is among the commonest presentations to the emergency department. Although epistaxis occurs in the majority of people at some point during their lives, most are minor and self-limited. Those patients who arrive to the ED represent a specific subset of nosebleeds - ones that won’t stop. These patients may be quite anxious and fearful. In some cases there are underlying reasons why the bleeding won’t stop. Fortunately, we have a wealth of tools, tips, and procedures to stop the bleeding.
C3 - Dizziness
Dizziness is a poorly defined symptom that plagues both patients and clinicians. It is one of the most common chief complaints in both emergency and outpatient settings, accounting for millions of visits to each annually in the U.S. alone. There is often uncertainty surrounding the clinical approach to the dizzy patient and the wide variation in practices is what makes it particularly difficult for new and seasoned practitioners alike.
C3 - Chest Pain
Chest pain is the second most common chief complaint in the ED, with over 8 million visits annually in the U.S. alone. Chest pain evaluation is challenging but very manageable with the current systems and protocols in place in many hospitals
C3 - Pediatric Abdominal Pain
As with the elderly, children with abdominal pain are special and require a different diagnostic approach. In this episode of C3, we will consider the general approach to abdominal pain in children.
C3 - Elderly Abdominal Pain
Elderly patients with abdominal pain represent a special population that is much more likely to have a serious life-threatening cause than almost any other presenting complaint.