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.,…
Introduction This appendix presents a list of calculations commonly used by emergency physicians. It is not all-inclusive and purposely does not include decision tools or scales that do not require algebraic calculations. Many of these equations can be found in…
Introduction Performing an invasive procedure on an anticoagulated emergency department (ED) patient can be challenging for the emergency provider (EP). Regardless of the procedure, some anticoagulated patients are at potential significant risk of hemorrhage from the procedure. However, emergency reversal…
The annual, population-wide exposure to ionizing radiation from medical sources increased a staggering 750% from 1980 to 2009, and medical imaging now comprises nearly one-half of Americans' radiation exposure. The World Health Organization classifies x-rays officially as carcinogens, and indeed…
In addition to cardiac pacemakers and defibrillators, a number of noncardiac devices have been developed for electronic neuromodulation and drug delivery. Although these devices are placed by a variety of subspecialists for the treatment of chronic illnesses, if the devices…
Emergency clinicians often face the challenge of caring for agitated, uncooperative, combative, and violent patients who are unable to participate in their care, make rational health care decisions, and/or are a danger to themselves and others. Psychiatric illness, acute chemical…