Endocrine and Metabolic Emergencies
Preface Endocrine and Metabolic Emergencies
George C. Willis, MD
M. Tyson Pillow, MD, MEd Editors
Hello everyone and welcome to this issue of the Emergency Medicine Clinics of North America. We are excited to have the opportunity to revisit key topics in endocrinology and metabolism. Often the mention of endocrine and metabolism is met with eye-rolling and sighs, but this continues to be at least a consideration in every patient (you are screening the patient every time you order a basic metabolic panel, for example). As we examined this area of emergency medicine, we tried to incorporate several key themes into the articles. First, endocrine emergencies are a critical part of emergency medicine practice. Although infrequent, endocrine emergencies may present with life-threatening illness as well. This relates to the second point: endocrine emergencies can be easily missed. Many of the disease processes overlap in symptomatology and few have pathognomonic features that can exclude any other diagnosis without confirmatory testing. Third, endocrine and metabolic emergencies are difficult in that even when identified, mismanagement can lead to life-threatening complications. When these emergencies do occur, especially at night, most of our endocrinologist colleagues do not take calls and are unavailable to us. So, for the practicing emergency physician, we sought to address the topics in a way that highlighted the difficulties in diagnosis and management. We extracted key points from each area and emphasized the approach to diagnosis as well. Treatment options can vary, but we have included evidence-based and guideline-based recommendations (wherever applicable) combining both the best information and our collective years of experience. Finally, we offer a fresh perspective on diabetes in the United States. While more common than the other diseases discussed in this issue, our understanding of how to treat this condition continues to evolve in response to its impact on our patients. We would like to thank all of the authors and colleagues who contributed to this issue of Emergency Medicine Clinics of North America. We would also like to thank Amal Emerg Med Clin N Am 32 (2014) xvii–xviii http://dx.doi.org/10.1016/j.emc.2014.03.001 0733-8627/14/$ – see front matter Ó 2014 Published by Elsevier Inc.
emed.theclinics.com
xviii
Preface
Mattu, for providing us this wonderful opportunity, and Patrick Manley, for his overwhelming support throughout this endeavor. We hope that all of our readers find the information useful to their practice and that it enhances the care delivered to our patients. George C. Willis, MD Department of Emergency Medicine University of Maryland School of Medicine Baltimore, MD, USA 1304 Teacher Lane Severn, MD 21144, USA M. Tyson Pillow, MD, MEd Section of Emergency Medicine Undergraduate Medical Education Baylor College of Medicine 1504 Taub Loop Road Houston, TX 77030, USA San Antonio Military Medical Center 3551 Roger Brooke Drive Fort Sam Houston, TX 78234, USA E-mail addresses: [email protected] (G.C. Willis) [email protected] (M.T. Pillow)
Preface Endocrine and Metabolic Emergencies
George C. Willis, MD
M. Tyson Pillow, MD, MEd Editors
Hello everyone and welcome to this issue of the Emergency Medicine Clinics of North America. We are excited to have the opportunity to revisit key topics in endocrinology and metabolism. Often the mention of endocrine and metabolism is met with eye-rolling and sighs, but this continues to be at least a consideration in every patient (you are screening the patient every time you order a basic metabolic panel, for example). As we examined this area of emergency medicine, we tried to incorporate several key themes into the articles. First, endocrine emergencies are a critical part of emergency medicine practice. Although infrequent, endocrine emergencies may present with life-threatening illness as well. This relates to the second point: endocrine emergencies can be easily missed. Many of the disease processes overlap in symptomatology and few have pathognomonic features that can exclude any other diagnosis without confirmatory testing. Third, endocrine and metabolic emergencies are difficult in that even when identified, mismanagement can lead to life-threatening complications. When these emergencies do occur, especially at night, most of our endocrinologist colleagues do not take calls and are unavailable to us. So, for the practicing emergency physician, we sought to address the topics in a way that highlighted the difficulties in diagnosis and management. We extracted key points from each area and emphasized the approach to diagnosis as well. Treatment options can vary, but we have included evidence-based and guideline-based recommendations (wherever applicable) combining both the best information and our collective years of experience. Finally, we offer a fresh perspective on diabetes in the United States. While more common than the other diseases discussed in this issue, our understanding of how to treat this condition continues to evolve in response to its impact on our patients. We would like to thank all of the authors and colleagues who contributed to this issue of Emergency Medicine Clinics of North America. We would also like to thank Amal Emerg Med Clin N Am 32 (2014) xvii–xviii http://dx.doi.org/10.1016/j.emc.2014.03.001 0733-8627/14/$ – see front matter Ó 2014 Published by Elsevier Inc.
emed.theclinics.com
xviii
Preface
Mattu, for providing us this wonderful opportunity, and Patrick Manley, for his overwhelming support throughout this endeavor. We hope that all of our readers find the information useful to their practice and that it enhances the care delivered to our patients. George C. Willis, MD Department of Emergency Medicine University of Maryland School of Medicine Baltimore, MD, USA 1304 Teacher Lane Severn, MD 21144, USA M. Tyson Pillow, MD, MEd Section of Emergency Medicine Undergraduate Medical Education Baylor College of Medicine 1504 Taub Loop Road Houston, TX 77030, USA San Antonio Military Medical Center 3551 Roger Brooke Drive Fort Sam Houston, TX 78234, USA E-mail addresses: [email protected] (G.C. Willis) [email protected] (M.T. Pillow)
