Essentials 1 An emergency department attendance represents an opportunity to set goals for care during the attendance and beyond. 2 End-of-life discussions and advance care planning assist early decision making about treatment goals and end-of-life care. 3 Knowledge of the…
Essentials 1 Many patients characterized as ‘challenging’ share common characteristics, including complex and chronic medical disease, mental illness, marginalization, poverty, high levels of drug and alcohol use and lack of social supports, safety and security. 2 An understanding of the…
Essentials 1 Acute alcohol intoxication and withdrawal are responsible for many emergency department attendances and carry significant morbidity and mortality. 2 Chronic gastrointestinal and hepatic disease, mental illness, central nervous system disease and immunosuppression are common in alcohol-dependent persons, with…
Essentials 1 Family violence encompasses physical, sexual, financial and psychological abuse. 2 All forms of family violence are inter-related in a complex way. Victims of violence may suffer many forms of abuse over their lives. 3 Between 30% and 50%…
Essentials 1 Sexual assault is defined as an act of a sexual nature carried out against a person’s will. 2 There is widespread under-reporting of this criminal offence. 3 The complex medical, legal and psychological sequelae mandate a team-based approach…
Essentials 1 Death and management of the dying process is core business for emergency medicine. 2 Death in the emergency department can be either sudden and unexpected or the natural and expected evolution of a disease process. 3 Emergency physicians…
Essentials 1 Benzodiazepines and antipsychotics, often used most effectively in combination, are the first-line drugs for sedation of the aroused patient. 2 As much information as possible should be collected before the patient is sedated. 3 The risks involved in…
Essentials 1 In the age of community mental health treatment, emergency departments have become major sites for the assessment of patients with psychosis. 2 An important responsibility of the emergency department clinician is to exclude delirium and ‘organic’ causes of…
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Essentials 1 Deliberate self-harm is a frequent presentation to emergency departments and is a symptom of diverse underlying problems, be they biological, social or psychological. 2 Patients with deliberate self-harm form a heterogeneous group, most of whom do not have…