Key Concepts Younger adults with fever usually have benign self-limited disease with low mortality. The challenge in this group is to identify rare causes of fever such as meningitis or septic condition when confronted with a predominance of self-limited viral…
Key Concepts Safe, effective procedural sedation and analgesia requires high-level experience and sound protocols for patient selection and patient monitoring. After procedural sedation, patients should be discharged with and remain in the company of a responsible adult for 4 to…
Key Concepts Acute pain is an urgent condition for the patient. Pain should be rapidly assessed, treated, and frequently reassessed in tandem with diagnostic evaluations. Therapy for acute pain is different than for chronic pain. Chronic pain treatment should be…
Key Concepts Cardiopulmonary resuscitation (CPR) quality is critical to successful resuscitation from cardiac arrest. Important benchmarks of quality CPR include compression rate 100–120 compressions/min, compression depth 5–6 cm, compression fraction at least 80%, full chest recoil between compressions, and a…
Key Concepts Neuronal injury is a dynamic process that continues for hours or days after an ischemic insult to the brain. Avoid hypotension and hypoperfusion by maintaining a mean arterial pressure greater than 65 mm Hg and a cerebral perfusion…
Key Concepts Shock can occur with normal arterial blood pressure and not all patients with arterial hypotension have shock. A base deficit more negative than −4 mEq/L or a serum lactate level greater than 4.0 mmol/L warrants a presumptive diagnosis…
Key Concepts Noninvasive positive-pressure ventilation (NPPV) is often adequate for reversal of impending respiratory failure due to a rapidly reversible cause, and should be considered as the first-line therapy for patients with exacerbations of chronic obstructive pulmonary disease (COPD) and…
Key Concepts Anticipating the clinical course of the patient’s condition and assessing the likelihood of deterioration are crucial to the decision to intubate, especially if the patient is to leave the emergency department (ED) for a period of time (e.g.,…