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

This issue reviews the most recent literature on mTBI and concussion and provides recommendations for the evaluation, diagnosis, and treatment of mTBI and concussion in the acute setting. Clinical decision rules and their utility in clinical practice will also be discussed. 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 06/01/2024

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

This issue reviews 3 pediatric syndromes - spina bifida, Down syndrome, and Marfan syndrome - each of which are associated with unique emergent conditions. The issue discusses the pitfalls in interpreting routine testing and reviews diagnostic and therapeutic approaches helpful in evaluating children with these syndromes.Includes 4 AMA PRA Category 1 Credits™. CME expires on 04/01/2024.

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 issue reviews the common presentations of Guillain-Barré syndrome and acute transverse myelitis and provides evidence-based recommendations for the workup, treatment, and disposition of patients with these syndromes. Includes 4 AMA PRA Category 1 Credits™. CME expires on 03/01/2024.

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

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.

This course combines video and digital components to review the evaluation and management of stroke in the setting of life-threatening headaches and dizziness, as well as stroke in pediatric patients. 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.

Review the evaluation and management of seizures in adult and pediatric patients, including neonates, for whom seizures can be difficult to diagnose. Presentations, diagnostic studies, and treatment options are discussed for different types of seizures, with particular emphasis on nonconvulsive status epilepticus. 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.

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

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.

This issue reviews common presentations and causes of neonatal seizures, provides recommendations for management in the ED, and evaluates the evidence regarding antiepileptic medications for neonates. 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 06/01/2023

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

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 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.

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

This issue provides guidance on how to determine whether a patient has bacterial meningitis versus viral meningitis, when a lumbar puncture is indicated, which antibiotics are recommended, and when they should be started. It also reviews evidence on the use of biomarkers such as procalcitonin to detect serious bacterial infections. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Infectious Disease CME and 2 Pharmacology CME credits. CME expires on 11/1/2021

This study guide, delivered in print, online, and audio digital formats, is designed to prepare emergency medicine physicians to pass the ABEM exams, as required to maintain board certification. It includes our "pass-or-it's-free" guarantee, as well as 35 AMA PRA Category 1 Credits™ (Specialty CME credits also included: 3 Critical Care credits, 3 Ethics credits, 6 Neurology credits, 6 Obstetrics/Gynecology credits, 4 Pharmacology credits, and 3 Trauma credits) (CME expires 12/1/22).

This study guide, delivered in print and online digital formats, is designed to prepare emergency medicine physicians to pass the ABEM exams, as required to maintain board certification. It includes our "pass-or-it's-free" guarantee, as well as 35 AMA PRA Category 1 CME Credits™ (Specialty CME credits also included: 3 hours elder abuse credit, 9 hours ethics credit, 3 hours behavioral health credit, 3 hours end-of-life care credit, 6 hours stroke credit, and 3 hours preventing medical errors credit) (CME expires 12/1/21).

Differential diagnosis and treatment of pediatric syncope in the emergency department, including spotting red flags for cardiac syncope. (No CME for this activity).

Altered level of consciousness in a child can have many causes, some life-threatening. 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 1/1/2020

This issue discusses methods to maintain adequate oxygenation, maximize management of intracranial hypertension, and optimize blood pressure in the emergency department to improve neurologic outcomes following pediatric severe traumatic brain injury. 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 expires on 10/1/2019

This review discusses the limitations of routine pulse oximetry and carboxyhemoglobin measurement in determining carbon monoxide exposure, and notes effects of co-ingestions and comorbidities.

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.

This study guide, delivered in print and online digital formats, is designed to prepare emergency medicine physicians to pass the ABEM exams, as required to maintain board certification. It includes our "pass-or-it's-free" guarantee, as well as 35 AMA PRA Category 1 CME Credits™ (Specialty CME credits also included: 3 hours trauma credit, and 6 hours ethics credit) (CME expires 11/30/2023).

This issue reviews current approaches to prehospital immobilization, identification of low-risk patients who may be clinically cleared from immobilization, a rational approach to the use of radiologic imaging, and the existing evidence for medical management of spinal cord injuries.

This review summarizes the literature on complications of ventriculoperitoneal shunts, examines the literature regarding the workup and management of patients with ventriculoperitoneal shunts, and makes recommendations for the management of these patients in the emergency department.

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.

Best approaches to managing common problems with enteral feeding tubes, tracheostomies, and ventricular shunts, and in sedating a pediatric patient with autism or developmental delays. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 0.75 Pharmacology CME credits. CME expires on 06/01/2018.

This issue of Pediatric Emergency Medicine Practice will focus on the emergency department management of seizures in pediatric patients.

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 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.

A critical appraisal of the existing guidelines for the management of motor vehicle trauma and for the use of appropriate child-safety restraints is presented.

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 reviews the broad differential of primary and secondary headaches in the pediatric emergency department, summarizes effective strategies for diagnosis, and evaluates the current evidence supporting safe, appropriate treatment.

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 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.

An evidence-based evaluation of various agents of procedural sedation is presented in this review.

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 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.

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 Pediatric Emergency Medicine Practice focuses on the challenge of evaluating and treating the pediatric patient who presents with a fever and neutropenia. A discussion of chemotherapy- induced neutropenia is included in the Special Circumstances section at the end of the article.

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.