Key Concepts The population is aging, with 10,000 Americans turning 65 every day, resulting in an increasing proportion of ED patients that are elderly. Older ED patients have the greatest resource use, longest lengths of stay, and highest admission rates…
Key Concepts Female trauma patients of reproductive potential should be screened for pregnancy and assumed to be pregnant until proven otherwise. Management of life- and limb-threatening injury in the mother comes first. Saving the mother provides the best chance of…
Key Concept Most ED deliveries require only basic equipment to cut and clamp the umbilical cord and dry and suction the infant. However, the ED should have additional equipment and trained staff should be available to care for a newborn…
Key Concepts Chemically induced birth defects are responsible for approximately 1% to 3% of anomalous births. Gestational age is crucial in determination of the impact of any given exposure, especially during organogenesis (days 21–56 of fetal life), when major body…
Key Concepts Asthma The treatment goal for a pregnant woman with an acute asthma exacerbation is to prevent fetal hypoxia by keeping maternal oxygen saturation above 95%. Inhaled beta-agonists and corticosteroids are first-line emergency department treatment and are considered safe…
Acknowledgment We thank Dr. Sidhant Nagrani and Dr. Bisan Salhi for their contributions to previous editions of this chapter. Key Concepts Miscarriage is defined as the spontaneous termination of pregnancy before 20 weeks of gestational age. Approximately 25% of women…
Physical Abuse Key Concepts The ultimate determination of whether abuse has occurred can take days or weeks. Emergency clinicians should focus on recognizing possible abuse, treating medical injuries, and establishing a safe disposition for the child. Completely undress infants and…
Key Concepts Awareness of differences in pediatric pharmacokinetics and specific drug toxicities is of critical significance for the safe and effective use of medications in children. Avoid prescription and over-the-counter (OTC) cough and cold medications in children because these agents…
Key Concepts The pediatric physis is the weakest part of the bone and more likely to separate before adjacent tendon or ligament tears, occurring more frequently during periods of rapid growth. Displaced supracondylar fractures are at greater risk for neurovascular…
Key Concepts Altered mental status in children has a varied spectrum of clinical presentations, and may include any of the following: altered level of consciousness, excessive sleepiness, irritability, lethargy, and abnormal behavior. A careful and detailed history is instrumental in…