Tamingthesru
Swelling out of the Blue - Angioedema in the ED
Angioedema is like urticaria in that both are transient swelling of well-demarcated areas. However, angioedema involves swelling of deeper tissues, producing nonpitting edema of the dermis and subcutaneous layers. It is most often seen in the eyelids and lips, and sometimes in the mouth and throat. While it is not pruritic it may be painful. In the US, angioedema accounts for approximately 100,000 ER visits annually (1). Across the world, 35% of prescriptions written for hypertension are for ACE-inhibitors (>40 million people). With a reported incidence of angioedema in 0.1–0.7% of those patients on ACEI, there are approximately 40,000 cases of ACEI-associated angioedema worldwide annually (2).
Diagnostics: Elevated Intraocular Pressure
Elevated intraocular pressure (IOP) is a common finding among eye complaints in the ED. Dr. Melanie Yates reviews what we can do in the emergent setting to reduce the IOP with topical and systemic medications and potentially save vision.
A Test of Limitations - Urine Drug Screens
The urine drug screen (UDS) is a relatively inexpensive and quick test to obtain in the emergency department, but how useful is it?. You may be tempted to order it for a patient who comes in altered or intoxicated. Before ordering, it is important to understand how the UDS works and its limitations.