What should emergency medical services (EMS) pay special attention to in terms of rheumatologic emergencies?
Bhaskar Dasgupta, MD: I think that is an excellent question. The important answer that I give to that question is that whenever an emergency physician or a general physician sees a patient who is acutely unwell, there are common causes of their being unwell, for example, infection, cancer. But we should always, always remember rheumatologic causes for these, particularly in patients who have got multisystem involvement. So patients who have, for example, kidney involvement and lung involvement, and patients who have got skin involvement, neuropathy, joint involvement, and other organ system involvement. Particularly patients who have got vascular involvement in different vascular territories, so you are thinking of vasculitis that will explain all that.
I think the emergency physician needs to look for multisystem involvement in all patients who present to them acutely unwell.