Essentials Emergency physicians and nurses should all be trained to provide effective procedural sedation in the emergency department (ED). Plan and prepare yourself, and assess the risk-benefit of each individual procedure. Assess the timing and nature of recent oral intake,…
Essentials 1 Local anaesthetic infiltration and nerve blocks may be used as a supplement to oral, inhaled or parenteral analgesia. 2 Also, they may be the primary method of achieving analgesia, particularly where pain is localized to a digit or…
Essentials 1 Acute pain is the most common symptom in the emergency setting. 2 Pain is a complex, multidimensional, subjective phenomenon. 3 Effective pain management involves both accurate assessment and timely treatment. 4 Patient self-reporting is the most reliable indicator…
Essentials 1 Organ donation should be considered for all patients where death is expected. Suitability for donation should be discussed with an organ donation specialist. 2 A substantial numbers of missed potential organ and tissue donors can be identified in…
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…