• Ultrasonography: The widespread use of this imaging modality has improved urgent evaluation of clinical conditions and diagnostic/treatment accuracy, potentially avoiding unnecessary tests and procedures.
• NEXUS and Canadian C-spine rules: These rules, taken together or separately, have significantly decreased unnecessary C-spine radiography, limiting use to only those cases in which it is truly beneficial. Estimates point to a 12.6% reduction in unnecessary imaging in these patients.
• Ottawa knee and ankle rules: Both rules have decreased the amount of unnecessary radiography and serve as examples of properly developed clinical decision rules.
• PERC rule: This unidirectional test helps to rule out the need for further testing in certain patients. The result has been a decrease in unnecessary CT for pulmonary embolism.
• tPA for stroke: tPA is the only treatment for ischemic stroke that is approved by the US Food and Drug Administration (FDA). This treatment signaled a new era of cooperation between the neurology and emergency departments.
Top emergency medicine advances selected by Richard H. Sinert, DO, Professor of Emergency Medicine; Clinical Assistant Professor of Medicine; Research Director, State University of New York College of Medicine; Consulting Staff; Vice-Chair in Charge of Research, Department of Emergency Medicine, Kings County Hospital Center, Brooklyn, New York.
For more on ultrasonography in emergency medicine, read here.
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Cite this: What Do You Consider to Be the Top Medical Advances of the Past 20 Years? - Medscape - May 27, 2015.
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