Key Concepts Neurologic complaints, such as imbalance, dysarthria, or numbness in patients with dizziness/vertigo raise the likelihood of transient ischemic attack (TIA) or stroke as the cause. Benign paroxysmal positional vertigo (BPPV) requires head movement to elicit symptoms. Consequently, the…
Key Concepts Lifetime seizure incidence reaches up to 10% in the US population and depends upon multiple factors including age, history of epilepsy, structural brain or neurodegenerative disease, genetic predisposition, acuity and severity of metabolic derangements. Seizures are the result…
Key Concepts Confusion and delirium are symptoms, not a diagnosis. Focal cortical dysfunction, such as from tumor or stroke, typically does not cause confusion. Any underlying clinical process that disrupts optimal central nervous system (CNS) functioning can result in confusion.…
Key Concepts Coma is a state of depressed consciousness in which a patient is not aware, is not awake, and does not respond to vigorous stimulation. Consciousness consists of arousal (subcortical) and awareness (cortical). Damage to the dorsal brainstem, thalamus,…
Foundations Epidemiology Syncope is a common clinical entity with a lifetime prevalence between 20% and 40%, and is slightly more common in women than in men. Key Concepts Syncope is defined as a sudden, spontaneous loss of consciousness and postural…
Key Concepts Cyanosis occurs due to an absolute amount of desaturated hemoglobin (∼5 g/dL) rather than a percentage; anemic patients exhibit cyanosis at a lower Pa o 2 than those with normal hemoglobin levels. Cyanosis is an insensitive indicator of…
Key Concepts Weakness is a common complaint among emergency department (ED) patients, with a preponderance in elders and those with chronic disease, and therefore may require a broad approach to investigating underlying causes. Patients may use the term weakness to…
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…