Acute aortic syndromes—aortic dissection, intramural hematoma, and penetrating atherosclerotic ulcer—are life-threatening conditions that demand swift recognition and treatment in the ED. This issue presents the latest evidence on managing AAS. Includes 4 AMA PRA Category 1 Credits™. CME expires on 12/01/2024

When rib fractures are suspected following blunt thoracic trauma, initiating multimodal pain control and choosing imaging based on patient risk factors is critical. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME credits. CME expires on 11/01/2024

This summary and analysis of the international literature on vaccine effectiveness, breakthrough infection, waning immunity, and emergence of variants will help inform the decisions of physicians and institutions regarding vaccination boosters and nonpharmaceutical interventions. Two personal views of the controversies are also included.

Cervical spine injuries can have devastating consequences, and initial ED management is critical in determining the type of injury or fracture and choosing immobilization, imaging, and referral. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME credits. CME expires on 10/01/2024

High-altitude illness is a spectrum of respiratory and neurologic effects resulting from hypobaric hypoxia. Swift intervention can manage these life-threatening disorders, and pretravel planning and counseling can prevent them. Includes 4 AMA PRA Category 1 Credits™. CME expires on 08/01/2024

Abnormal uterine bleeding can be a sign of serious and life-threatening conditions as well as being distressing and inconvenient. There are now effective diagnostic and management strategies that emergency clinicians can offer. Includes 4 AMA PRA Category 1 Credits™. CME expires on 08/01/2024

ED management of HIV patients now includes management of age-related concerns, side effects of antiretroviral therapies, and PEP and PrEP regimens. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Infectious Disease CME, 4 Pharmacology CME and 4 HIV CME credits. CME expires on 07/01/2024

This Stroke EXTRA CME supplement (free to Emergency Medicine Practice subscribers) reviews the evaluation and management of patients with stroke who present to the ED after 3 hours. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Stroke CME and 1 Pharmacology CME credits. CME expires on 06/15/2024.

Identifying the cause of syncope can be difficult, but a structured ED approach can help separate life-threatening causes from benign ones, reducing hospitalizations and improving care. Includes 4 AMA PRA Category 1 Credits™. CME expires on 06/01/2024

In order to prevent stroke in ED patients with atrial fibrillation, pharmacologic and/or electrical control of rate and/or rhythm are essential, along with risk stratification to determine the need for anticoagulation. Includes 4 AMA PRA Category 1 Credits™. CME expires on 05/01/2024

Sepsis and septic shock guidelines, requirements, criteria, and treatments have changed substantially in the last few years. This issue reviews the latest evidence and discusses the changes and current controversies in sepsis diagnosis and management. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 2 Pharmacology CME credits. CME expires on 10/1/2023

This Trauma EXTRA CME supplement (free to Emergency Medicine Practice subscribers) reviews the evaluation and management of patients with neck trauma. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME credits. CME expires on 04/15/2024.

This white paper outlines essential elements of planning and preparedness for emergency department pandemic surge response, based on lessons learned from the 2020 COVID-19 pandemic experience in New York City

Before or after mammalian bites or exposures, rabies is completely preventable, but ED management must be timely and administered correctly. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Infectious Disease CME credits. CME expires on 04/01/2024

This Pharmacology EXTRA CME supplement (free to Emergency Medicine Practice subscribers) reviews the management of alcohol withdrawal syndrome. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Pharmacology CME credits. CME expires on 02/15/2024.

While men, women, and children who present with urinary retention require fast, effective, and comfortable relief, it is essential to investigate the cause - structural, toxicologic, neurologic, or infectious - to prevent life-threatening sequelae. Includes 4 AMA PRA Category 1 Credits™. CME expires on 03/01/2024

Interdisciplinary teams at Mount Sinai Health Systems in New York developed protocols for management of COVID-19 patients. This February 2021 update of the protocols is based on the latest published literature and current practice.

Recommendations on risk stratification, imaging, testing, and drug therapies for CAP are evolving continuously. This issue reviews the latest evidence on managing CAP in the ED. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Infectious Disease CME credits. CME expires on 02/01/2024

When a patient presents to the ED with symptoms of STEMI, emergency clinicians must be prepared to initiate coordinated, time-sensitive, and effective diagnostic and treatment strategies, with the ultimate goal of initiation of reperfusion. Includes 4 AMA PRA Category 1 Credits™. CME expires on 01/01/2024

This Stroke EXTRA CME supplement (free to Emergency Medicine Practice subscribers) provides an evidence-based overview of the recognition and management in the emergency department management of blunt cerebrovascular injuries, and focuses on the appropriate diagnostic studies and stroke prevention. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Stroke CME credits. CME expires on 12/15/2023.

Rhabdomyolysis is a complex pathological process that requires prompt treatment to prevent potentially life-threatening sequelae. This issue reviews the broad differential and presents evidence-based recommendations for the management of rhabdomyolysis. Includes 4 AMA PRA Category 1 Credits™. CME expires on 12/01/2023

Managing ED patients with hemorrhagic shock requires swift coordination of ED resources and protocols. This issue reviews the latest evidence on hemostatic devices and medications, testing, and massive transfusion. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME credits. CME expires on 11/01/2023

This Trauma EXTRA CME supplement (free to Emergency Medicine Practice subscribers) reviews emergency department management of the pregnant trauma patient. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME credits. CME expires on 10/15/2023.

Diagnosis of deep vein thrombosis in the ED requires risk stratification and targeted diagnostic testing. For patients who have a diagnosed DVT, newer strategies for outpatient management of anticoagulation can reduce costs and improve outcomes. Includes 4 AMA PRA Category 1 Credits™. CME expires on 10/01/2023

This Pharmacology EXTRA CME supplement (free to Emergency Medicine Practice subscribers) provides an evidence-based overview of emergency department management of calcium-channel blocker overdose, beta blocker overdose, and digoxin toxicity, and focuses on the caveats of treatment for each. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Pharmacology CME. CME expires on 09/15/2023.

Infective endocarditis can be difficult to diagnose, given its often subtle presentation and multisystem involvement. This issue presents an evidence-based approach to testing, imaging, and empiric antibiotic therapies. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 2 Infectious Disease CME credits. CME expires on 09/01/2023

This Trauma EXTRA CME supplement (free to Emergency Medicine Practice subscribers) provides an evidence-based overview of considerations for radiation exposure in trauma imaging as well as strategies for resuscitation in trauma. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME. CME expires on 08/15/2023.

Heart palpitations is a common chief complaint in the ED, and emergency clinicians need to be able to quickly and accurately identify serious tachydysrhythmias to determine treatment that is safe, effective, and comfortable for patients. Includes 4 AMA PRA Category 1 Credits™. CME expires on 08/01/2023

This Stroke EXTRA CME supplement (free to Emergency Medicine Practice subscribers) provides an evidence-based overview of imaging modalities for acute stroke in the emergency department as well as identification and management strategies for central retinal artery occlusion. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Stroke CME. CME expires on 07/15/2023.

When a patient must be placed on a ventilator in the ED, clinicians choose the mode and initial settings based on institutional protocols and presentation, but the patient’s clinical scenario and respiratory response will dictate strategies for further management. Includes 4 AMA PRA Category 1 Credits™. CME expires on 07/01/2023

Summary and review of the results of a survey of 65 pediatric emergency department leaders in the U.S. and Canada.

Quickly differentiate benign from deadly causes of dizziness with the timing-and-triggers approach to evaluation. This on-demand course includes a 1-hour lecture, an evidence-based article, and 1 stroke CME credit. CME expires on 06/17/2023

This Pediatric EXTRA supplement describes the epidemiology, reviews presenting features, and offers management recommendations for COVID-19 in pediatric patients. It includes a discussion of multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19, as well as other aspects of the COVID-19 pandemic that are affecting children and families. (No CME)

Life-threatening secondary headache can be due to vascular disorders or trauma, and they can present with sudden, severe onset. This course presents the red flag signs for the most dangerous causes of life-threatening headaches, with recommendations on swift imaging and treatment. It also includes up to 5 stroke CME credits. CME expires on 06/04/2023.

Acid-base disturbances signal many disorders and diseases, and interpretation of testing results can be difficult. Using descriptive methodologies, comparing various approaches, and following a diagnostic algorithm will improve diagnosis and treatment. Includes 4 AMA PRA Category 1 Credits™. CME expires on 06/01/2023

The novel coronavirus, COVID-19, has raised serious concerns worldwide, particularly for emergency clinicians. This overview reviews and links the most authoritative early research and provides all the contacts and resources that can keep you continuously updated on this outbreak. This article and related resources are free for everyone. CME credit is available for subscribers.

Three modules on high-risk cardiovascular presentations encountered by emergency clinicians: non–ST-segment elevation myocardial infarction, patients taking direct oral anticoagulant agents, and blunt cardiac injury. Also included are two video recordings from the 2019 ResusEM conference. Emergency Medicine Practice and Pediatric Emergency Medicine Practice subscribers receive this content & CME Credit absolutely free! Log in to your subscription or subscribe now to gain instant access.

Abnormal vision in ED patients can be caused by abnormalities in visual structures (cornea, lens, vitreous, and retina) as well as neurologic, toxicologic, and psychogenic etiologies. High-value history, physical examination, and imaging can provide important clues for management. Includes 4 AMA PRA Category 1 Credits™. CME expires on 04/01/2023

Acute gastroenteritis is common in the ED, but what is the evidence on whether testing, antibiotics, and antiemetics are useful and necessary? Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 2 Pharmacology CME credits. CME expires on 03/01/2023

Influenza can present with a wide range of nonspecific clinical signs and symptoms, making ED management challenging. This issue reviews the latest evidence on recognizing influenza in the ED, performing rapid testing and initiating antiviral treatment, and how to manage complications in high-risk patient groups. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 2 Pharmacology CME credits. CME expires on 03/01/2023

Follow a systematic approach for managing patients with DKA and HHS in the ED: volume repletion, correction of hyperglycemia, and electrolyte replacement. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Pharmacology CME credits. CME expires on 02/01/2023

When patients present to the ED with suspected myocardial infarction, it is critical to differentiate NSTEMI from other cardiac causes and initiate swift, evidence-based management. Review the latest evidence on diagnosis and treatment of NSTEMI. Includes 4 AMA PRA Category 1 Credits™. CME expires on 01/01/2023

This EXTRA Stroke CME supplement (free to Emergency Medicine Practice subscribers) provides evidence-based recommendations for common causes of ischemic stroke and hemorrhagic stroke in children, offers guidance for differentiating stroke from its mimics, discusses indications for diagnostic studies, and provides recommendations for treatment of pediatric stroke in the emergency department. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Stroke CME and 0.25 Pharmacology CME credits. CME expires on 12/01/2022.

Acute dizziness is a common presentation in the ED. Quickly differentiate the benign from the deadly with the timing-and-triggers approach to evaluation. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 2 Stroke CME credits. CME expires on 12/01/2022

Many options exist to effectively manage pain without opioids. This issue provides the latest evidence what to use and when. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Pharmacology CME and 4 Pain Management CME credits. CME expires on 11/01/2022

Altered mental status is a common presentation in the ED, and time is of the essence in diagnosing NCSE and halting seizure activity. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 3 Pharmacology CME credits. CME expires on 10/01/2022

This EXTRA Trauma CME supplement (free to Emergency Medicine Practice subscribers) provides evidence-based recommendations for concussion management in the ED and reviews consensus-based guidelines for the evaluation and management of sport-related concussion and mTBI. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME credits. CME expires on 09/15/2022.

When a medical emergency occurs onboard a commercial aircraft and you raise your hand to help, what are the resources and risks in volunteering? Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 1 Ethics CME credit. CME expires on 09/01/2022

Direct oral anticoagulant agents do not require INR monitoring like warfarin, but managing bleeding complications or reversal requires different strategies. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Pharmacology CME credits. CME expires on 08/01/2022.

As bariatric surgery for weight loss becomes increasingly common, more patients are presenting to the ED with complications. This issue reviews the most common types of surgery, their early and late complications, and diagnostic and management options. Includes 4 AMA PRA Category 1 Credits™. CME expires on 07/01/2022.

This EXTRA Stroke CME supplement (free to Emergency Medicine Practice subscribers) reviews the latest evidence and recommendations for two essential treatments for patients with acute ischemic stroke: IV thrombolysis with rt-PA and endovascular thrombectomy with stentriever. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Stroke CME and 2 Pharmacology CME credits. CME expires on 06/15/2022.

Improve ED assessment of patients with abdominal pain by using strategies that emphasize safe disposition over diagnosis. Recognize high-risk patients and dangerous mimics and choose testing, imaging, and consultation that will improve outcomes. Includes 4 AMA PRA Category 1 Credits™. CME expires on 06/01/2022.

The ED is a critical intervention point for patients in mental health crisis. Emerging evidence shows it is possible and feasible to screen all ED patients for depression and suicidal ideation. Novel tools and strategies can help reduce the risk of suicide. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Behavioral Health CME credits. CME expires on 05/01/2022.

Sexually transmitted diseases are a significant and growing public health threat that can cause lasting danger to the health of men, women, and unborn babies. Swift diagnosis and effective treatment strategies can lessen the public health consequences. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 1 Pharmacology CME and 4 Infectious Disease CME credits. CME expires on 04/01/2022.

The spectrum of blunt cardiac injury can range from minor soreness to dysrhythmia, free wall rupture, hemorrhage, and sudden death. This issue reviews the latest evidence on the swift diagnosis of cardiac injury and best strategies for treatment. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME credits. CME expires on 03/01/2022.

Life-threatening secondary headache can be due to vascular disorders or trauma, and can present with sudden, severe onset. This issue presents the red flag signs for the most dangerous causes, with recommendations on swift imaging and treatment. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Stroke CME and 1 Pharmacology CME credits. CME expires on 02/01/2022

Common first-trimester ED presentations include miscarriage, ectopic pregnancy, nausea and vomiting, urinary tract infections, and potential appendicitis. This issue reviews the evidence on these common conditions to ensure swift and safe management. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 2 Pharmacology CME credits. CME expires on 01/01/2022.

Patients with electrical injuries in the ED can suffer trauma, external burns, and occult injuries to deep tissues, affecting all body systems. Fluids, cardiac monitoring, and disposition of low-voltage, high-voltage, and lightning strike injuries can vary. CME expired on 11/01/2021. (No CME for this activity).

Venomous North American snakes include pit vipers (copperheads, water moccasins/cottonmouths, and rattlesnakes) and coral snakes. The diagnostic studies, antivenom treatment, and follow-up required depend on the type of snake and the bite severity. The latest evidence on managing snake bites in the ED is reviewed. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME and 1 Pharmacology CME credits. CME expired on 9/1/2021 - No CME for this activity

This issue reviews the pathophysiology and clinical findings associated with cannabinoid use, including acute intoxication, the recent emergence of cannabinoid hyperemesis syndrome, and novel treatments for its symptoms. CME expired on 8/1/2021 - No CME for this activity

Dyspnea is a distressing symptom in the dying process, but it can be managed in the ED to keep patients comfortable, alleviate patient and family anxieties, and honor the patient's goals of care. CME expired 07/01/2021 - No CME for this activity

Determining the source of shoulder pain - fracture, dislocation, or overuse - is an essential part of management. This issue offers information about effective strategies in diagnostic techniques, pain management, and indications for surgical referral for patients presenting to the ED with shoulder injuries and pain. CME expires on 06/01/2021 - No CME for this activity

For ED patients with signs and symptoms of infectious disease - including fever, rash, joint pain, and headache - obtaining a travel history is essential in order to quickly identify emerging (or re-emerging) infections. This issue reviews diagnostic and management best practices for three infections: Middle East respiratory syndrome, chikungunya virus infection, and Zika virus infection. CME expired on 05/01/2021 - No CME for this activity

This issue reviews the critical steps that should be taken to manage a patient who presents with jaundice, including the history and physical examination, necessary laboratory testing, imaging, and treatment. Management of neonates, pregnant patients, and transplant patients are also reviewed. (No CME for this activity).

This issue reviews the diagnosis and management of airway compromise that can result from fire, smoke, and heat injury, as well as carbon monoxide and cyanide toxicity. Although a standardized diagnostic protocol is lacking, the evidence on best-practice diagnostic tools, airway management, and medical adjuncts are presented. (No CME for this activity).

Optimal management of a burn patient begins with accurately classifying and measuring the extent of the burns. Every treatment decision that follows - from IV fluid management, wound care, escharotomy, and criteria for referral - depends on it. This issue reviews the best evidence on managing patients with burns, from prehospital management to disposition. (No CME for this activity).

This issue reviews 3 of the more common presentations of oncology patients to the emergency department: metastatic spinal cord compression, tumor lysis syndrome, and febrile neutropenia. (No CME for this activity).

This review presents an algorithmic approach to management that ensures that pain relief, imaging, reduction, vascular monitoring, and emergent orthopedic consultation are carried out in a timely fashion. (No CME for this activity).

This issue reviews the literature on management of IBD flares in the emergency department, including laboratory testing, imaging, and identification of surgical emergencies, emphasizing the importance of coordination of care with specialists on treatment plans and offering patients resources for ongoing support. (No CME for this activity).

This issue presents strategies and algorithms for the early use of evidence-based interventions, including appropriate use of antibiotics, bronchodilators, and corticosteroids, along with noninvasive ventilation with capnography, to minimize morbidity and mortality associated with this disease. (No CME for this activity).

This issue provides recommendations on effective management of patients presenting with adrenal insufficiency, with particular attention to the management of critically ill and septic patients, pregnant patients, and children. (No CME for this activity).

This review provides a best-practice approach to the diagnosis and management of renal and genitourinary injuries, with an emphasis on the systematic approach needed to identify subtle injuries and avoid long-term urinary sequelae such as hypertension, incontinence, erectile dysfunction, chronic kidney disease, and nephrectomy. (No CME for this activity).

From the prehospital care setting to disposition and follow-up, this systematic review addresses the fundamentals of the emergency department evaluation of patients determined to be at low risk for acute coronary syndromes or adverse outcomes. (No CME for this activity).

This issue provides a systematic review of the literature on common acute traumatic and atraumatic dental emergencies with a focus on the historical and physical examination findings that must be understood to identify life-threatening infections, relieve pain, salvage natural teeth, and communicate with specialists in the further management of patients after emergency treatment. (No CME for this activity).

Emergency room management of ADHF including critical decision-making points in resuscitation for both hypertensive and hypotensive patients and a review of newer medications. (No CME for this activity).

A detailed reference on how to identify and treat injuries to the face by physical examination and imaging, including assessing complications of maxillofacial trauma. (No CME for this activity).

A review of the pathophysiology, diagnostic decision-making tools, and pharmaceutical treatment options to create a patient-tailored approach to sedative-hypnotic withdrawal.

When noninvasive ventilation is indicated over endotracheal intubation and rapid sequence intubation for patients in respiratory distress. Key contraindications for NIV and signs that positive pressure ventilation has failed. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 0.5 Pharmacotherapy credits. CME expires on 02/01/2020.

Current evidence for immediate emergency room treatment of ischemic priapism, using a stepwise approach starting with aspiration of cavernosal blood, cold saline irrigation, and penile injection with sympathomimetic agents. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 0.25 Pharmacology CME credits. CME expires on 1/1/2020

Diagnosing PID through medical history and examination, including evaluation for alternate diagnoses, and initiating appropriate antibiotic therapy. Early diagnosis and treatment of PID by the emergency room physician prevents complications such as chronic pain, ectopic pregnancy, infertility. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 2 Pharmacology CME credits. CME expires on 12/1/2019

This review examines the most current evidence with regard to the pathophysiology, diagnosis, and management of potassium disorders: hypokalemia and hyperkalemia. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 2 Pharmacology CME credits. CME expires on 11/1/2019

Systematic review of the basic life support factors for cardiac arrest, including chest compression technique during CPR and rapid defibrillation of shockable rhythms (ventricular tachycardia, ventricular fibrillation), and common underlying causes of cardiac arrest. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 0.5 Pharmacology CME credits. CME expires on 10/1/2019

Reviews common sources of alcohol ingestion, basic mechanisms of toxicity, physical examination and laboratory findings that may guide rapid assessment and management, and indications for treatment. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 0.5 Pharmacology CME credits. CME expires on 9/1/2019

A detailed framework for the emergency physician to distinguish transient global amnesia (the acute onset of profound anterograde amnesia lasting up to 24 hours) from its most common mimics. Includes 4 AMA PRA Category 1 Credits™. CME expires on 08/01/2019.

Focuses on the diagnosis and treatment of patients with blunt injuries to the chest, ribs and lung. Decision rules for chest x-ray, CT and bedside lung ultrasonography; treatment controversies including the limitations of needle thoracostomy using standard needle, chest tube placement, and chest tube size. Also airway and ventilation management. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME credits. CME expires on 06/01/2019.

Diagnosis and treatment of caustic ingestions and exposures, including staging, pathophysiology, and surgical consult. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 0.25 Pharmacology CME credits. CME expires on 05/01/2019.

In-depth look at the treatment of human and animal bites, including the timing of wound closure, the use of prophylactic antibiotics, and the latest recommendations for rabies postexposure prophylaxis (PEP). Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME and 0.5 Pharmacology CME credits. CME expires on 4/1/2019

The use and limitations of the FAST examination in patients with blunt pelvic trauma, including the when to perform the exam during the trauma survey and how FAST can be used for abdominal trauma with pelvic injuries. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME credits. CME expires on 03/01/2019.

2016 review of long-term HIV infection complications seen in the emergency room, especially noninfectious conditions, complications common in the HAART-adherent HIV patient, and side effects from antiretroviral drugs, as well as recognition of life-threatening and rare opportunistic infections. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 3 Pharmacology CME credits. CME expires on 2/1/2019

2016 review of the pathophysiology, differential diagnosis, and emergency room rewarming and treatment of patients with mild, moderate, and severe hypothermia with or without hemodynamic instability. Includes 4 AMA PRA Category 1 Credits™. CME expires on 01/01/2019.

Spontaneous intracerebral hemorrhage is a neurological emergency,made more complicated when patients are anticoagulated. Reversal of anticoagulation must be initiated simultaneously with diagnosis, treatment, and disposition. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Stroke CME credits and 2 Pharmacology CME credits. CME expires on 12/01/2018.

Evidence-based recommendations for diagnosis and treatment of ocular trauma: ocular burn, corneal abrasion, retrobulbar hemorrhage, open glob injury, traumatic hyphema, retinal detachment, vitreous hemorrhage, lens dislocation. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME credits and 0.5 Pharmacology CME credits. CME expires on 11/01/2018.

Evaluating for delirium using the Confusion Assessment Method (CAM), targeting underlying etiology, and treatment guidelines including nonpharmacological and means and when to use antipsychotics or benzodiazepines. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 0.5 Pharmacology CME credits. CME expires on 10/01/2018.

This issue reviews the various international guidelines for pharyngitis and notes controversies in diagnostic and treatment strategies, specifically for management of suspected bacterial, viral, and fungal etiology.

Review of clinical criteria to diagnose anaphylaxis, and treatment guidelines involving the intramuscular administration and dosing of epinephrine, both in and out of the hospital setting. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 0.5 Pharmacology CME credits. CME expires on 08/01/2018.

Reviews the differential diagnosis and identification of different types of cardiac dysrhythmias and discusses preferred treatment options for various wide-complex tachycardias. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 0.25 Pharmacology CME credits. CME expires on 07/01/2018.

Resuscitating and treating adult drowning patients in the emergency department, including pathophysiology of drowning and concerns such as hypothermia, mechanical ventilation, and trauma. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME credits. CME expires on 05/01/2018.

This issue of Emergency Medicine Practice will focus on the management of patients with upper gastrointestinal bleeding.

This review examines the most current evidence regarding emergency department treatment of asymptomatic hypertension.

This issue of Emergency Medicine Practice provides an evidence-based review of the diagnosis and management of adult patients presenting to the emergency department (ED) with seizure and SE, with a focus on the clinical situations most commonly encountered in daily practice.

This review discusses the clinical evaluation and management of high-morbidity hand injuries in the context of the current evidence.

This review evaluates the literature and current evidence, including controversies and recent American Heart Association guidelines, to support a best-practice approach to the diagnosis and treatment of patients with spontaneous subarachnoid hemorrhage.

This review summarizes current indications for permanent pacing, reviews epidemiologic data relevant to implant complications, and describes a clinical approach to the patient with potential pacing malfunction.

This review examines the physiology, diagnosis, and treatment of exertional, classic, and drug-induced hyperthermia.

A working knowledge of local or at least national susceptibil - ity patterns of the most likely pathogens is essential. A variety of special populations exist that require special management, including pregnant females, patients with anatomic abnormalities, and instrumented patients.

This review evaluates the current strategies for management of diabetic emergencies and offers new information regarding effective diagnostic strategies, selection of fluids for rehydration, correction of potassium, the use of subcutaneous insulin for mild hyperglycemia, and management of metformin-induced lactic acidosis.

This review discusses the diagnosis and treatment of the 3 most common mosquito-borne illnesses seen in the United States: Plasmodium falciparum malaria, dengue, and West Nile virus.

This issue reviews the 4 primary categories of shock as well as special categories, including shock in pregnancy, traumatic shock, septic shock, and cardiogenic shock in myocardial infarction. Adherence to evidence-based care of the specific causes of shock can optimize a patient's chances of surviving this life-threatening condition.

The focus of this issue of Emergency Medicine Practice is the ED evaluation of anemia and, more importantly, its management based on the best available evidence in the literature.

This review presents the electrocardiographic findings seen in common bradydysrhythmias and emphasizes prompt recognition of these patterns. Underlying etiologies that may accompany these conduction abnormalities are discussed, including bradydysrhythmias that are reflex mediated (including trauma induced) and those with metabolic, environmental, infectious, and toxicologic causes. Evidence regarding the management of bradydysrhythmias in the emergency department is limited; however, there are data to guide the approach to the unstable bradycardic patient. When decreased end-organ perfusion is present, the use of atropine, beta agonists, and transcutaneous or transvenous pacing may be required.

This review explores an evidence-based rationale for the evaluation of the patient with low back pain, and it provides guidance on risk stratification pertaining to laboratory assessment and radiologic imaging in the emergency department. Published guidelines from the American College of Physicians and American Pain Society are reviewed, with emphasis on best evidence for pharmacologic treatments, self-care interventions, and more invasive procedures and surgery in management of low back pain. Utilizing effective and proven strategies will avoid medical errors, provide better care for pa- tients, and help manage healthcare resources and costs.

This issue of Emergency Medicine Practice provides an evidence-based review of asthma as it relates to emergency department (ED) care and establishes best-practice approaches to management.

Traumatic brain injury is the most common cause of death and disability in young people, with an annual financial burden of over $50 billion per year in the United States.

Since the 2008 issue of Emergency Medicine Practice on TIA was published, there have been numerous studies focusing on improving risk stratification and early management strategies in TIA. This update will provide the best available evidence on diagnosing and managing TIAs.

This issue presents a review of the current evidence guiding the emergency medicine approach to the diagnosis and treatment of pulmonary embolism.

This review assesses the evidence on the causes and treatments of angioedema in the emergency department and reviews the new therapeutic options available for treatment of angioedema based on their effectiveness, price, and availability.

Manifestations of hyponatremia, which is one of the more common electrolyte abnormalities in clinical medicine, depend on multiple factors, including the chronicity of the symptoms, the absolute level of sodium, and the patient's overall health.

This review assesses the burgeoning research in the field and reviews current clinical guidelines and decision rules on mild traumatic brain injury, addressing the concept of serial examinations to identify clinically significant intracranial injury, the approach to pediatric and elderly patients, and the management of patients who are on anticoagulants or antiplatelet agents or have bleeding disorders.

This evidence-based review summarizes the pathophysiology, historical factors, diagnostic strategies, and demographics that influence the experience of pain and provides recommendations for a variety of treatment options.

This issue outlines and reviews the literature on 4 evolving strategies reflecting developing advancements in the care of acute ischemic stroke and their potential to impact patients in the emergency department setting: (1) the expanding window for intravenous rt-PA, (2) the use of multimodal computed tomographic scanning in emergent diagnostic imaging, (3) endovascular therapies for stroke, and (4) stroke systems of care.

This issue of Emergency Medicine Practice discusses the initial workup and management of patients with primary headache disorders, with special detail to classification and medication options.

This review examines the diagnosis and treatment of monoarticular arthritis, with a focus on recent evidence in the diagnosis of septic arthritis and new research on gout therapies.

This issue of Emergency Medicine Practice reviews the available evidence and consensus guidelines for the management of common infectious diseases presenting to the ED and presents recommendations for treatment.

This issue reviews the physics of ballistics as it relates to the tracts and patterns of tissue injury caused by different types of firearms and missiles, and it takes a regional approach to reviewing the current evidence for managing gunshot wounds to the head, neck, thorax, abdomen, genitourinary (GU) system, extremities, and soft tissues. Current guidelines as well as new research and evidence regarding fluid resuscitation, airway management, evaluation strategies, drug therapies, and documentation are discussed.

This issue of Emergency Medicine Practice focuses on advances in knowledge that should fundamentally change how we treat trauma patients in hemorrhagic shock. The best available evidence from the literature suggests that we must shift away from the paradigms that have guided emergency clinicians in the past.

In this issue of Emergency Medicine Practice, the most current findings in regard to the diagnosis of appendicitis in the emergency department (ED) will be discussed, with particular attention towards elucidating the elements of history, physical examination, and laboratory testing that will most benefit the emergency clinician faced with the dilemma of diagnosing possible appendicitis.

This issue of Emergency Medicine Practice presents a synopsis of the latest evidence regarding the pathophysiology, diagnosis, and treatment of emergent complications of SCD.

In this issue of Emergency Medicine Practice, the current understanding of flank pain associated with urinary stone disease is discussed.

Cardiac arrest is one of the most intense clinical scenarios faced by the emergency clinician. The challenges are twofold: restarting spontaneous circulation and simultaneously attempting to find;and then reverse;the cause of the cardiac arrest.

This issue of Emergency Medicine Practice expands on this review and summarizes the existing and best available literature concerning these EUS applications.

The goal of this review is to provide an analysis of the current literature and recommendations regarding the diagnosis and management of CA-MRSA in the ED based on the best available evidence.

This issue of Emergency Medicine Practice focuses on the most commonly encountered postpartum emergencies: headache, LPPE, hypertension, and cardiomyopathy.

This review will cover 4 common complaints involving the ear: pain (otalgia), hearing loss, tinnitus, and trauma.

This issue of Emergency Medicine Practice focuses on the management of ALF and the acutely symptomatic cirrhotic patient.

This issue of Emergency Medicine Practice focuses on determining which patients will benefit from regional anesthesia and how to perform the most common facial anesthesia procedures.

This issue of Emergency Medicine Practice reviews the fundamental principles of the management of thyroid emergencies using a focused, evidenced-based approach to the literature.

This issue of Emergency Medicine Practice focuses on hypertensive disorders of pregnancy and vaginal bleeding. More information about complications in early pregnancy, specifically ectopic pregnancies, can be found in the June 2007 issue of Emergency Medicine Practice.

This issue of Emergency Medicine Practice addresses cervical spine injuries by providing a systematic approach that optimizes resource utilization and minimizes identification failure.

In this issue of Emergency Medicine Practice, an overview of the technical features of MRI will be presented in order to provide a framework for understanding its limits and potential benefits.

The goal of this issue of Emergency Medicine Practice is to provide a risk management tool and to provide an evidence-based best practice approach to the male complaining of acute scrotal or penile pain.

The goal of this Emergency Medicine Practice issue is to provide an overview of mechanical ventilation in the acute care setting. Basic ventilator technology will be discussed and placed in the context of various disease pathophysiologies with a focus on asthma, emphysema, and acute pulmonary edema.

This issue of Emergency Medicine Practice will provide a review of SVTs with a focus on the ECG analysis and the evidence behind the most recent ACLS guidelines.

This issue of Emergency Medicine Practice discusses the general management of cocaine-associated emergencies. Additionally, it will make evidence-based recommendations for the treatment and disposition of these patients.

Emergency physicians are frequently confronted with patients with neurological complaints requiring emergent imaging for diagnosis and treatment. The diversity and variations of imaging modalities may appear confusing, resulting in physician uncertainty about the most appropriate modality to evaluate the presenting complaint. An evidence-based approach, with the modality and technique selected based on patient characteristics and differential diagnosis, is essential. In this review, the evidence supporting the use of computed tomography (CT) and magnetic resonance imaging (MRI) for the diagnosis and treatment of emergency brain disorders will be reviewed. Adjunctive imaging techniques will also be considered, including conventional angiography, plain films, and ultrasound. Clinical decision rules intended to target imaging utilization to high-risk patients will also be discussed.

This issue of Emergency Medicine Practice is designed to provide an evidencebased, algorithmic approach to the management and diagnosis of conditions causing hypotension. Specific attention will be given to the role of ultrasound in the clinical decision making involved in caring for these patients.

This issue of Emergency Medicine Practice provides an overview of the current evidence regarding the benefit of respiratory, hemodynamic, and neurologic monitoring of the critically ill patient.

Toxic exposures present a unique set of issues to clinicians caring for children. Children commonly ingest household products and sometimes are exposed to medications that are taken by others living in the household. The clinician must be quick to recognize potentially dangerous exposures in order to intervene and prevent or mitigate adverse outcomes. Fortunately, the majority of pediatric ingestions involve unintentional exposure to small doses of nontoxic or minimally toxic substances. However, it is those few truly toxic exposures that demonstrate the invaluable role played by a skilled emergency physician. This review will primarily focus on pediatric poison exposures in children ages six years and under.

This issue of Emergency Medicine Practice provides a comprehensive overview of the spectrum of altitude illness with a focus on prevention strategies and life saving interventions in the eventuality for severe disease.

Anyone who works in an emergency department (ED) knows that abdominal pain (or some variation of it) is one of the most frequent presenting complaints evaluated. Although it is difficult to truly quantify, it is estimated that abdominal pain accounts for 5 - 10% of all ED visits and that emergency physicians care for nearly eight million patients with abdominal pain each year.1-3 The sheer volume of potential diagnoses coupled with the lack of evidenced-based standards create a dilemma when determining a diagnostic study choice. The question of which radiological modality and when to utilize it is further complicated by the rapid advances in radiolographic technology. The goal of this Emergency Medicine Practice article is to provide a functional framework for the diagnostic evaluation of the patient with nontraumatic abdominal pain.

This issue of Emergency Medicine Practice provides an overview of thoracic imaging modalities and guidance on the indications for each test in emergency practice.

This issue of Emergency Medicine Practice provides a systematic review of the diseases that present with a chief complaint of "swollen extremity" and provides a costeffective approach to guide in the selection of diagnostic tests to aid in clinical decision-making.

Acute spinal cord injuries (ASCIs) remain a devastating consequence of traumatic injuries around the globe. These injuries cause permanent, profound disabilities and lead to changes in lifestyle ranging from employment to marital status.

This issue of Emergency Medicine Practice will review the current literature, including the potential mechanisms of injury. early signs of these injuries, and the natural course of the problems caused by explosive blasts.

This month's issue of Emergency Medicine Practice is the second in a 2-part review of aortic emergencies. The first part focused on the thoracic aorta and emphasized the pivotal role the emergency physician plays in diagnosing and directing care for these patients. This month's issue reviews abdominal aortic aneurysms and aortic trauma. While aortic emergencies are relatively unusual in the total scope of emergency practice, their associated morbidity and mortality is high, making recognition and management a mandatory competency for the emergency physician.

This review covers the historical and physical exam features in evaluating a laceration and determining the most prudent course of treatment.

This issue of Emergency Medicine Practice discusses what is currently known about herbal toxicology.

This issue of Emergency Medicine Practice reviews the epidemiology, dynamics, and characteristic presentations of intimate partner violence (IPV), with the goal of bridging the gap between assumption and evidence and providing a practical approach to patients in the ED. It also discusses some of the legal issues inherent in the evaluation and treatment of victims of IPV.

Clinical judgment based on the current evidence can help guide a cost-effective work-up of patients with diarrhea that will identify patients with more severe etiologies or at risk for complications.

This review highlights the advances in our understanding of ACS: its pathophysiology, clinical diagnosis, risk stratification, and therapeutics. There is a particular focus on the subgroup of unstable angina (UA) and non-STsegment elevation myocardial infarction (NSTEMI).

This issue of Emergency Medicine Practice describes management strategies for common orthopedic sports injuries. Prior issues of Emergency Medicine Practice, such as the January 2000 issue on mild head trauma, the February 2000 issue on back pain, the October 2001 issue on cervical spine injuries, the November 2001 issue on wrist injuries, and the May 2002 issue on ankle injuries, also provide pertinent information.

Emergency physicians are the primary source of care for most victims of sexual assault. The emergency physician is often called upon to treat patients who present with the statement "I was raped" and attend to their medical, legal, and psychosocial needs.

The crashing infant is a challenge in any setting. From the largest specialty children's center to the smallest rural ED, a dying baby creates havoc. Even when you think you're prepared, things appear chaotic. Procedures go wrong; rarely used equipment seems to disappear. IV access becomes impossible for even the most experienced hands; your mind freezes when trying to calculate drug doses. The right decisions must come quickly or a baby will die.

This issue of Emergency Medicine Practice provides answers to these and other pressing questions.

This article addresses three basic complaints: the red eye, visual problems, and periorbital swelling. It addresses both common and unusual causes of eye disorders as well as the approach to specific populations (neonates, children, and the immunocompromised).

This issue of Emergency Medicine Practice aims to fill this void by describing the state of the art ED management of wrist injuries.

This issue of Emergency Medicine Practice reviews the diagnostic and management challenges associated with caring for children with abdominal pain, placing emphasis on the best available evidence from the literature.

Because airway management is such a key component of the care of the critically ill or injured patient, emergency physicians must possess unique expertise in this area.

This issue of Emergency Medicine Practice will address the unique issues involved in assessment and treatment of the febrile senior. Special attention is given to differences in presentation between the infected elderly and younger adults.

This issue of Emergency Medicine Practice will decrease your trepidation in dealing with this common complaint.