11,255 results match your criteria Am J Emerg Med[Journal]


Anomalous left anterior descending artery diagnosed on pulmonary artery computed tomography.

Am J Emerg Med 2019 Apr 12. Epub 2019 Apr 12.

Department of Emergency Medicine, Baylor Scott and White Health, 2401 S 31(st) Street, Temple, TX 76508, United States of America.

Typically, the left anterior descending artery (LAD) and left circumflex artery (LCX) arise from the left main coronary artery. However, uncommon coronary anomalies may be found in clinical practice. This case presents with a rare finding where the LAD originates from the right coronary artery (RCA) separately from the LCX and takes an interarterial pathway to reach its perfusion territory. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.04.028DOI Listing

Factors associated with serious bacterial infections in infants ≤60 days with hypothermia in the emergency department.

Am J Emerg Med 2019 Apr 11. Epub 2019 Apr 11.

Division of Infectious Disease, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States of America.

Background: We sought to investigate risk factors for serious bacterial infection (SBI: bacterial meningitis, bacteremia, and urinary tract infection [UTI]) among infants ≤60 days of age presenting to the emergency department (ED) with hypothermia (temperature < 36 °C).

Methods: We performed a single center study over a 12-year period including all patients ≤60 days old with hypothermia, excluding patients who did not receive a blood culture and patients who received antibiotics prior to culture acquisition. The primary outcome was SBI. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.04.015DOI Listing

Hiccups as the only symptom of acute myocardial infarction.

Am J Emerg Med 2019 Apr 12. Epub 2019 Apr 12.

Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan. Electronic address:

Hiccups are usually benign, while myocardial infarction (MI) has the potential for morbidity and mortality. Here, we report 3 cases of MI, with hiccups being the only symptom on presentation to the emergency department. Attention should be given to patients who present with hiccups and multiple risk factors for acute coronary syndrome, especially those with factors predisposing them to atypical presentations, such as diabetes mellitus, and old age. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.04.023DOI Listing

Pyogenic sacroiliitis: A rare complication of inflammatory bowel disease.

Am J Emerg Med 2019 Apr 13. Epub 2019 Apr 13.

Department of Emergency Medicine, Spectrum Health Hospitals, Grand Rapids, MI, United States of America. Electronic address:

Although sacroiliitis is not uncommon in patients with inflammatory bowel diseases (IBD), bacterial infection of the sacroiliac joint is rare. The diagnosis is often delayed because of low clinical suspicion, a vague clinical picture and poorly defined localization of symptoms. We report a case of pyogenic sacroiliitis in a patient with Crohn's disease caused by Clostridia spp. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.04.017DOI Listing

Bug off! Severe toxicity following inhalational exposure to N, N-diethyl-meta-toluamide (DEET).

Am J Emerg Med 2019 Apr 12. Epub 2019 Apr 12.

Spectrum Health - Michigan State University Emergency Medicine Residency Program, Grand Rapids, MI, United States of America. Electronic address:

N, N-diethyl-meta-toluamide (DEET) is an insect repellent currently used by millions of people since 1956. DEET has an excellent safety profile and has remarkable protection against mosquitoes, ticks and various other arthropods. Toxicity is unusual, and is generally associated with incorrect, or overuse of the product. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.04.019DOI Listing

The difference of subcutaneous digital nerve block method efficacy according to injection location.

Am J Emerg Med 2019 Apr 15. Epub 2019 Apr 15.

Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, Republic of Korea. Electronic address:

Introduction: Finger injuries are commonly attended to in the emergency department, and digital nerve block is a frequently performed procedure for such injuries. This study compared the efficacy levels of the subcutaneous method according to the different injection sites.

Method: This was a simulation study for medical students who rendered medical service at the emergency department. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.04.031DOI Listing

Comparing the effects of 3 oxygen delivery methods plus intravenous ketorolac on primary headaches: A randomized clinical trial.

Am J Emerg Med 2019 Apr 13. Epub 2019 Apr 13.

Tehran University of Medical Sciences, Department of Emergency Medicine, Dr. Shariati Hospital, Kargar Ave, P.O Box 14117-13137, Tehran, Iran. Electronic address:

Objective: To compare three different oxygen therapy methods in primary headaches.

Methods: Design: A randomized placebo-controlled clinical trial was conducted between January 2016 and October 2017.

Setting: The emergency department of a university-affiliated urban hospital in Tehran, Iran. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.04.018DOI Listing

Safety and effectiveness of intravenous prochlorperazine for intractable vomiting in children with gastroenteritis.

Am J Emerg Med 2019 Apr 12. Epub 2019 Apr 12.

Michigan State University College of Human Medicine, Department of Emergency Medicine, Grand Rapids, MI, United States; Spectrum Health - Michigan State University Emergency Medicine Residency Program, Grand Rapids, MI, United States. Electronic address:

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http://dx.doi.org/10.1016/j.ajem.2019.04.020DOI Listing

Accuracy of patient self-administered medication history forms in the emergency department.

Am J Emerg Med 2019 Apr 13. Epub 2019 Apr 13.

Department of Pharmacy, Royal Prince Alfred Hospital, Level 5, Building 65, Missenden Road, Camperdown, 2050, Australia; School of Pharmacy, University of Sydney, Pharmacy and Bank Building (A15), Camperdown Campus, Sydney, New South Wales 2006, Australia. Electronic address:

Objectives: The primary objective of this study was to determine the proportion of patients with medication discrepancies when using a self-administered medication history form in the emergency department (ED). The secondary objectives were to identify predictors of medication discrepancies and determine the proportion of patients with a high-risk medication discrepancy.

Methods: This was a cross-sectional study conducted in an urban ED in Australia. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07356757193023
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http://dx.doi.org/10.1016/j.ajem.2019.04.016DOI Listing
April 2019
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Narrowing performance gap between rural and urban hospitals for acute myocardial infarction care.

Am J Emerg Med 2019 Apr 16. Epub 2019 Apr 16.

College of Medicine, Central Michigan University, Mount Pleasant, MI, USA. Electronic address:

Background: Rural communities experience significant barriers to quality healthcare, including disparities in medical care following acute myocardial infarctions (AMI). This study sought to determine if the population density of the county where Medicare patients were hospitalized following AMI predicted short-term outcomes and to quantify longitudinal changes in hospital performance on quality of care metrics.

Methods: Hospital-level data was queried from the 2012 and 2018 Centers for Medicare & Medicaid Services archives. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.04.030DOI Listing

Quality retention of chest compression after repetitive practices with or without feedback devices: A randomized manikin study.

Am J Emerg Med 2019 Apr 12. Epub 2019 Apr 12.

Emergency Center, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, Hubei 430071, China.

Objectives: This study was designed to investigate whether an audiovisual feedback (AVF) device is beneficial for quality retention of chest compression (CC) after repetitive practices (RP).

Methods: After completion of a 45-min CC-only cardiopulmonary resuscitation (CPR) training, participants performed 3 sessions of practices on days 1, 3, and 7 under the guidance of an instructor with (RP + AVF) or without (RP) the AVF device. CC quality was determined after each session and was retested at 3 and 12 months. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07356757193024
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http://dx.doi.org/10.1016/j.ajem.2019.04.025DOI Listing
April 2019
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Effect of infarct site on the clinical endpoints of thrombolytic-treated ST-elevation myocardial infarction.

Am J Emerg Med 2019 Apr 12. Epub 2019 Apr 12.

Division of Cardiovascular Medicine, University of Missouri Health Care, Columbia, MO, USA. Electronic address:

Introduction: Some studies suggest better outcomes after the use of thrombolytics in inferior ST-elevation myocardial infarction (STEMI) compared to other locations. The goal of this study is to compare the clinical endpoints of thrombolytic-treated STEMI based on coronary artery distribution.

Methods: The study population was extracted from the 2014 Nationwide Readmissions Data using the International Classification of Diseases, Ninth Revision, Clinical Modifications codes for STEMI, thrombolytic infusion, and complications of STEMI. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.04.026DOI Listing

Kasabach-Merritt syndrome arising from a vascular fistula.

Am J Emerg Med 2019 Apr 10. Epub 2019 Apr 10.

Internal Medicine, San Camillo Hospital, Rome, Italy.

A 58-year-old woman presented with gum bleeding, hematuria, and cutaneous ecchymoses. Left hip replacement had been performed five years prior. The overall findings of our work-up were consistent with ongoing DIC triggered by the presence of an arterio-venous left femoral fistula. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07356757193023
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http://dx.doi.org/10.1016/j.ajem.2019.04.013DOI Listing
April 2019
2 Reads

Iatrogenic pediatric hydroxocobalamin overdose.

Am J Emerg Med 2019 Apr 10. Epub 2019 Apr 10.

University of Washington, Department of Emergency Medicine, United States of America.

Introduction: Hydroxocobalamin, a precursor molecule to vitamin B12, has emerged as the preferred empiric treatment for patients rescued from enclosed-space fires with concern for inhalational injury and potential concomitant cyanide toxicity. Limited data exist on the effects of hydroxocobalamin toxicity, particularly in pediatric patients.

Case Report: We report a case of a healthy three-year old girl who was rescued from an apartment fire and electively intubated by prehospital providers. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07356757193023
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http://dx.doi.org/10.1016/j.ajem.2019.04.012DOI Listing
April 2019
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A systematic review of foam dressings for partial thickness burns.

Am J Emerg Med 2019 Apr 11. Epub 2019 Apr 11.

Department of Emergency Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY, USA. Electronic address:

Background: Partial thickness burns are the most common form of thermal burns. Traditionally, dressing for these burns is simple gauze with silver sulfadiazine (SSD) changed on a daily basis. Foam dressings have been proposed to offer the advantage of requiring less frequent dressing change and better absorption of exudates. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07356757193023
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http://dx.doi.org/10.1016/j.ajem.2019.04.014DOI Listing
April 2019
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A-scan ultrasonography to detect intracranial hypertension in patients with hyponatremia.

Am J Emerg Med 2019 Apr 10. Epub 2019 Apr 10.

Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Salerno, Italy.

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http://dx.doi.org/10.1016/j.ajem.2019.04.009DOI Listing

Throwing it in reverse: An update on reversal of oral factor Xa inhibitors.

Am J Emerg Med 2019 Apr 8. Epub 2019 Apr 8.

Fetter Health Care Network, 51 Nassau St, Charleston, SC, United States of America.

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https://linkinghub.elsevier.com/retrieve/pii/S07356757193022
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http://dx.doi.org/10.1016/j.ajem.2019.04.007DOI Listing
April 2019
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WAMAMI: emergency physicians can accurately identify wall motion abnormalities in acute myocardial infarction.

Am J Emerg Med 2019 Apr 3. Epub 2019 Apr 3.

Department of Emergency Medicine, Maine Medical Center, Portland, ME, United States of America; Tufts University School of Medicine, Boston, MA, United States of America.

Objective: The ability to identify wall motion abnormalities may be useful for emergency clinicians, but is not typically evaluated in point-of-care echocardiograms. We sought to determine if emergency physicians with basic training in emergency echocardiography could identify regional wall motion abnormalities (RWMA) in patients admitted with ST-elevation myocardial infarction (STEMI).

Methods: We prospectively enrolled patients with admitted with STEMI. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07356757193018
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http://dx.doi.org/10.1016/j.ajem.2019.03.037DOI Listing
April 2019
2 Reads

Mechanical, inflammatory, and embolic complications of myocardial infarction: An emergency medicine review.

Am J Emerg Med 2019 Apr 8. Epub 2019 Apr 8.

Brooke Army Medical Center, Department of Emergency Medicine, 3841 Roger Brooke Dr, Fort Sam Houston, TX 78234, United States. Electronic address:

Introduction: Despite the declining incidence of coronary heart disease (CHD) in the United States, acute myocardial infarction (AMI) remains an important clinical entity, with many patients requiring emergency department (ED) management for mechanical, inflammatory, and embolic complications.

Objective: This narrative review provides an evidence-based summary of the current data for the emergency medicine evaluation and management of post myocardial infarction mechanical, inflammatory, and embolic complications.

Discussion: While 30-day mortality rate after AMI has decreased in the past two decades, it remains significantly elevated at 7. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.04.003DOI Listing
April 2019
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Developing neural network models for early detection of cardiac arrest in emergency department.

Am J Emerg Med 2019 Apr 7. Epub 2019 Apr 7.

Department of Emergency Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, Republic of Korea.

Background: Automated surveillance for cardiac arrests would be useful in overcrowded emergency departments. The purpose of this study is to develop and test artificial neural network (ANN) classifiers for early detection of patients at risk of cardiac arrest in emergency departments.

Methods: This is a single-center electronic health record (EHR)-based study. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07356757193022
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http://dx.doi.org/10.1016/j.ajem.2019.04.006DOI Listing
April 2019
2 Reads

Efficacy and safety of Shenfu injection for septic shock: A systematic review and meta-analysis of randomized controlled trials.

Am J Emerg Med 2019 Apr 5. Epub 2019 Apr 5.

Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China; Capital Medical University, Beijing 100010, China; Beijing institute of Traditional Chinese Medicine, Beijing 100010, China; Beijing Key Laboratory of Basic Research with Traditional Chinese Medicine on Infectious Diseases, Beijing 100010, China. Electronic address:

Objective: To evaluate the efficacy and safety of Shenfu injection (SFI) combined with standard therapy versus standard therapy for septic shock, three groups of patients with septic shock were analyzed based on the level of mean arterial lactate. They were mean arterial lactate level < 4.5 mmol/L, 4. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.03.032DOI Listing
April 2019
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A new marker identification of high risk stroke patients: Jugular saturation.

Am J Emerg Med 2019 Mar 27. Epub 2019 Mar 27.

Department of Emergency Medicine, University of Health Sciences, Konya Education and Research Hospital, Konya, Turkey.

Objectives: The aim of this prospective study; to investigate in emergency patients with stroke the relationship between jugular saturation and National Institutes of Health Stroke Scale (NIHSS), lesion volume and mortality score.

Materials And Methods: In this prospective study, 82 patients who fulfilling the criteria for inclusion in diagnosed with were enrolled in the study. Patients' demographic data, comorbid conditions and stroke type were recorded. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.03.040DOI Listing
March 2019
5 Reads

Berberine inhibits the ischemia-reperfusion induced testicular injury through decreasing oxidative stress.

Am J Emerg Med 2019 Apr 2. Epub 2019 Apr 2.

Department of Emergency Medicine, Faculty of Medicine, Karadeniz Technical University, 61080 Trabzon, Turkey.

Purpose: The aim of this study was to investigate the effect of berberine (BBR) on oxidative stress in an experimental testicular I/R injury model.

Methods: Eighteen rats were divided into three groups: control group, torsion-detorsion (T/D) group, and BBR + T/D group. In the pre-treatment of the BBR group, 200 mg/kg BBR was given intraperitoneally 30 min before detorsion. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07356757193022
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http://dx.doi.org/10.1016/j.ajem.2019.04.001DOI Listing
April 2019
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A physician's (and private citizen's) right to privacy against internet data brokers: Maintaining safety in an unsafe profession.

Authors:
Kevin M Takakuwa

Am J Emerg Med 2019 Mar 27. Epub 2019 Mar 27.

PO Box 27574, San Francisco, CA 94127, United States of America. Electronic address:

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http://dx.doi.org/10.1016/j.ajem.2019.03.042DOI Listing

Intravenous fluid bolus rates and pediatric diabetic ketoacidosis resolution.

Am J Emerg Med 2019 Mar 27. Epub 2019 Mar 27.

Kendall Regional Medical Center, Department of Emergency Medicine, 11750 SW 40th St., Miami, FL 33175, United States of America; Nova Southeastern University College of Allopathic Medicine, Davie, FL 33328, United States of America. Electronic address:

Background: Recent data have challenged the notion that rapid intravenous fluid administration results in adverse neurologic outcomes in children with diabetic ketoacidosis (DKA). While many physicians still administer a cautious 10 cc/kg bolus of intravenous fluids for pediatric DKA patients, there may be benefits to using a larger bolus.

Methods: This was a retrospective chart review of all pediatric patients with DKA presenting to a single emergency department (ED) between 2013 and 2015. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.03.039DOI Listing
March 2019
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Epidemiology of opioid-related visits to US Emergency Departments, 1999-2013: A retrospective study from the NHAMCS (National Hospital Ambulatory Medical Care Survey).

Am J Emerg Med 2019 Mar 31. Epub 2019 Mar 31.

Cooper Medical School of Rowan University, Department of Emergency Medicine, One Cooper Plaza, Camden, NJ, United States of America.

Goals: To characterize the epidemiology of opioid-related visits to United States (US) emergency departments (EDs) and describe trends in opioid-related visits over time.

Design: Retrospective cohort study CASES: The National Hospital Ambulatory Care Survey (NHAMCS) was used to identify opioid-related ED visits between 1999 and 2013.

Measurements: The NHAMCS is an annual, weighted, multi-stage survey which allows for the study of ambulatory care services within a nationally representative sample of US hospitals. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.03.052DOI Listing
March 2019
4 Reads

Incidence and risk factors for hyperlactatemia in ED patients with acute metformin overdose.

Am J Emerg Med 2019 Mar 23. Epub 2019 Mar 23.

Division of Medical Toxicology, Department of Emergency Medicine, The Icahn School of Medicine at Mount Sinai, Elmhurst Hospital Center, NY, New York, USA. Electronic address:

Introduction: The goals of this study are to describe clinical characteristics and risk factors for metabolic acidosis with hyperlactatemia in emergency department (ED) patients with acute metformin overdose.

Methods: This was a secondary analysis of data from a retrospective observational cohort of adult ED patients presenting with acute drug overdose at two tertiary care hospitals over 5 years. The primary outcomes were: (1) hyperlactatemia, defined as a lactate concentration ≥ 2 mmol/L at any point during hospital admission and, (2) metformin associated lactic acidosis (MALA), defined as a lactate concentration ≥ 5 mmol/L and pH <7. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.03.033DOI Listing
March 2019
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Dextrose dilution for pediatric hypoglycemia.

Am J Emerg Med 2019 Mar 31. Epub 2019 Mar 31.

Loma Linda University Medical Simulation Center, Loma Linda, CA, USA; Department of Emergency Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA.

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http://dx.doi.org/10.1016/j.ajem.2019.03.054DOI Listing
March 2019
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Physical findings in sexual assault cases when victims delay reporting.

Am J Emerg Med 2019 Apr 4. Epub 2019 Apr 4.

Department of Emergency Medicine, Spectrum Health Hospitals, Grand Rapids, MI, United States. Electronic address:

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http://dx.doi.org/10.1016/j.ajem.2019.04.005DOI Listing

Effects of videolaryngoscopes on cognitive workload during tracheal intubation performed by emergency residents.

Am J Emerg Med 2019 Apr 2. Epub 2019 Apr 2.

Emergency Department and Prehospital Care, University Hospital of Poitiers, Poitiers, France.

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http://dx.doi.org/10.1016/j.ajem.2019.04.002DOI Listing

Pentraxin 3 level in acute migraine attack with aura: Patient management in the emergency department.

Am J Emerg Med 2019 Apr 4. Epub 2019 Apr 4.

Dicle University, School of Medicine, Department of Physiology, Diyarbakır, Turkey.

Objectives: We investigated the state of inflammation, PTX3 level and other routine inflammatory markers (high sensitivity C-reactive protein [hsCRP], and white blood cells [WBC]), in patients who presented to the emergency department (ED) with migraine. We also investigated the relationship between the clinical presentation, PTX3 level, and other routine inflammatory markers in the emergency management of these patients.

Methods: The study included 44 patients (group 1) who presented to the ED due to a migraine attack with aura and 44 controls (group 2) with similar demographic characteristics. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.04.004DOI Listing

"Bandemia" without leukocytosis: A potential Emergency Department diagnostic pitfall.

Am J Emerg Med 2019 Mar 29. Epub 2019 Mar 29.

Emergency Medicine Department, George Washington University School of Medicine and Health Sciences, Washington, DC, United States. Electronic address:

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http://dx.doi.org/10.1016/j.ajem.2019.03.050DOI Listing

N95 filtering facepiece respirators do not reliably afford respiratory protection during chest compression: A simulation study.

Am J Emerg Med 2019 Mar 27. Epub 2019 Mar 27.

Statistics and Data Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Background: N95 filtering facepiece respirators (N95 respirators) may not provide adequate protection against respiratory infections during chest compression due to inappropriate fitting.

Methods: This was a single-center simulation study performed from December 1, 2016, to December 31, 2016. Each participant underwent quantitative fit test (QNFT) of N95 respirators according to the Occupational Safety and Health Administration protocol. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.03.041DOI Listing
March 2019
2 Reads
1.152 Impact Factor

Is my baby normal? A review of seemingly worrisome but normal newborn signs, symptoms and behaviors.

Am J Emerg Med 2019 Mar 20. Epub 2019 Mar 20.

Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Utah, Salt Lake City, UT, USA.

Infant patients are a unique challenge to emergency department (ED) physicians as the spectrum of normal infant signs, symptoms and behaviors are often difficult to differentiate from abnormal and potentially life-threatening conditions. In this article, we address some common chief complaints of neonates and young infants presenting to the ED, and contrast reassuring neonatal and young infant signs and symptoms against those that need further workup and intervention. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.03.028DOI Listing

Angiotensin converting enzyme inhibitor intoxication: Naloxone to the rescue? Naloxone for ACE inhibitor intoxication.

Am J Emerg Med 2019 Mar 28. Epub 2019 Mar 28.

Intensive Care Department, Hôpitaux IRIS-Sud, Brussels, Belgium.

We report here the case of a patient with perindopril intoxication inducing severe bradycardia together with a profound hypotension. Initiation of a naloxone infusion completely resolved those symptoms. As a consequence, we could recommend as a first step the use of naloxone in order to prevent the use of more invasive therapeutic tools. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.03.046DOI Listing

Motorized scooter injuries in the era of scooter-shares: A review of the national electronic surveillance system.

Am J Emerg Med 2019 Mar 30. Epub 2019 Mar 30.

Emory University School of Medicine, Department of Orthopaedics, Atlanta, GA, United States of America. Electronic address:

Introduction: There has been a spike in recent news regarding motorized scooter injuries due to the expansion of scooter sharing companies. Given the paucity of literature on this topic, the purpose of our study was to describe and quantify emergency department encounters associated with motorized scooter related injuries.

Methods: The National Electronic Injury Surveillance System (NEISS) was queried for motorized scooter related injuries from 2013 to 2017. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.03.049DOI Listing
March 2019
2 Reads

A checklist manifesto: Can a checklist of common diagnoses improve accuracy in ECG interpretation?

Am J Emerg Med 2019 Mar 29. Epub 2019 Mar 29.

Mount Sinai School of Medicine, Department of Emergency Medicine, New York University, United States of America.

Objective: To determine whether a checklist of possible etiologies for syncope provided alongside ECGs helps Emergency Medicine (EM) residents identify ECG patterns more accurately than with ECGs alone.

Methods: We developed a test of ten ECGs with syncope-related pathology from ECG Wave-Maven. We reviewed the literature and used expert consensus to develop a checklist of syncope-related pathologies commonly seen and diagnosed on ECGs. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.03.048DOI Listing
March 2019
4 Reads

Slime product injuries managed at emergency departments.

Am J Emerg Med 2019 Mar 30. Epub 2019 Mar 30.

4600 Monterey Oaks Boulevard #F2335, Austin, TX 78749, USA. Electronic address:

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http://dx.doi.org/10.1016/j.ajem.2019.03.051DOI Listing

Role of dantrolene in dinitrophenol (DNP) overdose: A continuing question?

Am J Emerg Med 2019 Mar 23. Epub 2019 Mar 23.

Department of Emergency Medicine, Division of Medical Toxicology, Indiana University, Indianapolis, IN, United States of America. Electronic address:

Background: 2,4-Dinitrophenol (DNP) is a known uncoupler of oxidative phosphorylation that clinically results in hyperthermia, tachycardia, tachypnea, and metabolic acidosis. Overdoses of DNP are often fatal and there is no specific reversal therapy. Dantrolene interferes with calcium release in skeletal muscle and is traditionally used to treat malignant hyperthermia. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.03.035DOI Listing
March 2019
1 Read

Point of care ultrasound is associated with decreased emergency department length of stay for symptomatic early pregnancy.

Am J Emerg Med 2019 Mar 21. Epub 2019 Mar 21.

Beth Israel Deaconess Medical Center, Department of Emergency Medicine, 1 Deaconess Rd, Rosenberg 2, Boston, MA 0215, USA. Electronic address:

Introduction: Emergency physicians (EP) can accurately rule out ectopic pregnancy with pelvic point of care ultrasound (PPOCUS). Multiple studies have suggested that PPOCUS may decrease length of stay (LOS) for emergency department (ED) patients presenting with early symptomatic pregnancy compared to comprehensive ultrasound (CUS). This systematic review and meta-analysis examines the association between the use of PPOCUS vs CUS and ED LOS. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.03.025DOI Listing
March 2019
2 Reads

Pharmacologic anisocoria due to nebulized ipratropium bromide: A diagnostic challenge.

Am J Emerg Med 2019 Mar 28. Epub 2019 Mar 28.

Department of Emergency Medicine, Ümraniye Training and Research Hospital, University of Health Sciences, İstanbul, Turkey.

Anisocoria may be physiological or seen in fatal conditions, such as intracranial hemorrhage. Newly developing anisocoria may cause confusion and diagnostic difficulty in the emergency department (ED). A 35-year-old female was admitted to the ED with an asthma attack and dyspnea. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.03.047DOI Listing
March 2019
2 Reads

Effect of two tourniquet techniques on peripheral intravenous cannulation success: A randomized controlled trial.

Am J Emerg Med 2019 Mar 23. Epub 2019 Mar 23.

Department of Emergency Medicine, Mayo Clinic, Rochester, MN, United States of America. Electronic address:

Objectives: Peripheral intravenous (IV) cannulation is the most common procedure performed in the emergency department (ED). Elastic tourniquets (ETs) and blood pressure cuffs (BPCs) are frequently used for venodilation. Although BPCs lead to increased venodilation and decreased compressibility, it is unclear whether this translates into a meaningful patient-centered outcome. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.03.034DOI Listing
March 2019
1 Read

Principles of safety for ultrasound-guided single injection blocks in the emergency department.

Am J Emerg Med 2019 Mar 27. Epub 2019 Mar 27.

Alameda Health System/Highland General Hospital, Department of Emergency Medicine, United States of America.

Ultrasound-guided nerve blocks (UGNBs) allow emergency physicians an opportunity to provide optimal pain management for acute traumatic conditions. Over the past decade, a growing body of literature has detailed the novel ways clinicians have incorporated UGNBs for analgesia and an alternative to procedural sedation. UGNBs are considered a relatively safe procedure, and have been shown to increase rates of success and reduce complications (as compared to older techniques). Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07356757193019
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http://dx.doi.org/10.1016/j.ajem.2019.03.045DOI Listing
March 2019
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Electronic health record triggered hepatitis C screening in the ED.

Am J Emerg Med 2019 Mar 27. Epub 2019 Mar 27.

Department of Emergency Medicine, Rutgers New Jersey Medical School, Newark, NJ, United States of America.

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http://dx.doi.org/10.1016/j.ajem.2019.03.043DOI Listing
March 2019
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Thrombolysis for atlantoaxial dislocation mimicking acute ischemic stroke: Case report and review.

Am J Emerg Med 2019 Mar 27. Epub 2019 Mar 27.

Stroke Center and Department of Neurology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan. Electronic address:

The frequency of stroke mimics among stroke patients has been reported to be up to 30%, and that in patients who receive thrombolytic therapy ranges between 1% and 16%. Atlantoaxial dislocation with myelopathy mimicking stroke is extremely rare. An 83-year-old man with a history of old cerebellar infarction presented to the emergency department with acute left hemiplegia after a chiropractic manipulation of the neck and back several hours before symptom onset. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.03.044DOI Listing
March 2019
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An analysis of randomized controlled trials underpinning ST-elevation myocardial infarction management guidelines.

Am J Emerg Med 2019 Mar 28. Epub 2019 Mar 28.

Oklahoma State University Center for Health Sciences, Dept. of Institutional Research, United States of America.

Background: The fragility index (FI) is calculated by iteratively changing one outcome "event" to a "non-event" within a trial until the associated p-value exceeds 0.05.

Purpose: To investigate the FI and fragility quotient (FQ) of trial endpoints referenced in the ACCF/AHA/SCAI guidelines in the management of ST-elevation myocardial infarctions. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.03.038DOI Listing
March 2019
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Angiotensin II in septic shock.

Am J Emerg Med 2019 Mar 19. Epub 2019 Mar 19.

Clinical Associate Professor, Critical care/Neurocritical care, Mercy Hospital St.Louis, St. Louis University School of Medicine Program, United States of America.

Septic shock is a life threatening condition and a medical emergency. It is associated with organ dysfunction and hypotension despite optimal volume resuscitation. Refractory septic shock carries a very high rate of mortality and is associated with ischemic and arrhythmogenic complications from high dose vasopressors. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07356757193017
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http://dx.doi.org/10.1016/j.ajem.2019.03.026DOI Listing
March 2019
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A novel method of palpating the pancreas in children: Three cases of pediatric acute pancreatitis.

Am J Emerg Med 2019 Mar 22. Epub 2019 Mar 22.

Division of Pediatric Emergency Medicine, Department of Pediatric Emergency and Critical Care Medicine, Tokyo Metropolitan Children's Medical Center, Japan.

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http://dx.doi.org/10.1016/j.ajem.2019.03.031DOI Listing
March 2019
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Orthostatic vital signs do not predict 30 day serious outcomes in older emergency department patients with syncope: A multicenter observational study.

Am J Emerg Med 2019 Mar 25. Epub 2019 Mar 25.

Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Heath & Science University, Portland, OR, United States of America.

Background: Syncope is a common chief complaint among older adults in the Emergency Department (ED), and orthostatic vital signs are often a part of their evaluation. We assessed whether abnormal orthostatic vital signs in the ED are associated with composite 30-day serious outcomes in older adults presenting with syncope.

Methods: We performed a secondary analysis of a prospective, observational study at 11 EDs in adults ≥ 60 years who presented with syncope or near syncope. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.03.036DOI Listing
March 2019
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Comments on GEDI vs. CVP goal-directed fluid resuscitation for chronic obstructive pulmonary disease patients with septic shock: A randomized controlled trial.

Am J Emerg Med 2019 Mar 11. Epub 2019 Mar 11.

The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China; Department of Emergency, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, Guangdong Province, China.. Electronic address:

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http://dx.doi.org/10.1016/j.ajem.2019.03.019DOI Listing
March 2019
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