11,143 results match your criteria The American journal of emergency medicine[Journal]


A case of purulent pneumococcal pericarditis.

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

Department of Emergency Medicine, Shaare Zedek Medical Center, Jerusalem, Israel.

Background: Purulent bacterial pericarditis is a rare and potentially fatal disease. The course may be fulminant, and the presentation may pose a diagnostic challenge.

Case Report: An otherwise healthy 75-year-old male was brought to the emergency department in a state of general deterioration, confusion, and shock. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.02.013DOI Listing
February 2019

Aspartate-aminotransferase to platelet ratio index score for predicting HELLP syndrome.

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

Department of Emergency Medicine, Kanuni Sultan Suleyman Education and Research Hospital University of Health Science, İstanbul, Turkey.

Introduction: HELLP (hemolysis, elevated liver enzyme levels, low platelet counts)-syndrome is a rare but dramatic pregnancy-related illness. The difficult part of this syndrome is the lack of standardised diagnostic criterias and tests to be used to predict it. The aim of this study is determining the role of APRI score in the diagnosis of HELLP syndrome. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.02.014DOI Listing
February 2019

Acute coronary syndrome after cannabis use: Correlation with quantitative toxicology testing.

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

Department of Internal Medicine, Division of Cardiovascular Medicine, University of California Davis Medical Center, Sacramento, CA, United States of America.

Excluding ethanol, cannabis is the most commonly used drug in the United States and worldwide. Several published case series and reports have demonstrated an association between cannabis use and acute coronary syndrome (ACS). We report the first ever published case of ACS precipitated by cannabis use that was confirmed with concomitant rising quantitative plasma levels of 11-nor-9-carboxy-Δ9-tetrahydrocannabinol, a secondary metabolite of cannabis. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.02.017DOI Listing
February 2019

Implications of culture collection after the first antimicrobial dose in septic emergency department patients.

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

The University of Kansas Health System, Department of Critical Care and Emergency Medicine, 4000 Cambridge Street, Kansas City, KS 66160, Mailstop 4040, United States of America.

Background: Previous research has illustrated the importance of collection of microbiologic cultures prior to first antimicrobial dose (FAD) in septic patients to avoid sterilization of pathogens and thus allowing confirmation of infection, identification of pathogen(s), and de-escalation of antimicrobial therapy. There is currently a lack of literature characterizing the implications and clinical courses of patients who have cultures collected after FAD.

Methods: In this single-center, retrospective chart review of 163 sepsis cases in the emergency department, the primary outcome was positive-cultures from appropriate sources. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.02.016DOI Listing
February 2019

Nursing driven approaches to improving emergency department discharge.

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

University of Pennsylvania, Department of Emergency Medicine, Penn Presbyterian Medical Center, Philadelphia, PA, United States of America.

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https://linkinghub.elsevier.com/retrieve/pii/S07356757193009
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http://dx.doi.org/10.1016/j.ajem.2019.02.015DOI Listing
February 2019
2 Reads

Usefulness of RBC distribution width and C-reactive protein to predict mortality in pediatric non-cardiac critical illness.

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

Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou, Sichuan, China. Electronic address:

Introduction: We aimed to assess the performance of red blood cell distribution width (RDW), C-reactive protein (CRP) or the combination of both to predict clinical outcomes in pediatric non-cardiovascular critical illness.

Materials And Methods: We analyzed 404 pediatric non-cardiovascular critically ill patients admitted to pediatric intensive care unit (PICU). Potential predictors were identified using multivariable logistic regression. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.041DOI Listing
January 2019
1 Read

Flexible nasotracheal intubation compared to blind nasotracheal intubation in the setting of simulated angioedema.

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

Department of Emergency Medicine, Saint Vincent Hospital, Erie, PA, United States of America. Electronic address:

Background: Nasotracheal intubation is rarely performed in the emergency department (ED) but may be required in specific situations such as angioedema. Both blind and flexible nasal intubation (FNI) may be utilized; however, the preferred technique is unknown.

Methods: We performed a randomized, crossover manikin study using a convenience sample of emergency physicians and medical students from a local community teaching hospital. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.02.012DOI Listing
February 2019
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Comparison of intravenous lidocaine/ketorolac combination to either analgesic alone for suspected renal colic pain in the ED.

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

Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, NY, USA.

Study Objective: To compare analgesic efficacy and safety of intravenous lidocaine and ketorolac combination to each analgesic alone for ED patients with suspected renal colic.

Methods: We conducted a randomized, double-blind trial comparing analgesic efficacy of a combination of intravenous lidocaine (1.5 mg/kg) and ketorolac (30 mg), to ketorolac (30 mg), and to lidocaine (1. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.048DOI Listing
January 2019

Ultrasound guided supra-inguinal Fascia Iliaca Compartment Blocks in hip fracture patients: An alternative technique.

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

Department of Anesthesiology, Academic Medical Center, Amsterdam, the Netherlands.

Introduction: In the Emergency Department, regional anesthesia is increasingly used in elderly patients with hip fractures. An example is a Fascia Iliaca Compartment Block (FICB). Traditionally, this block is administered below the inguinal ligament. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.02.011DOI Listing
February 2019

Digoxin-specific Fab and therapeutic plasma exchange for digitalis intoxication and renal failure: A case report.

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

Dipartimento di Biotecnologie Mediche e Medicina Traslazionale, Università degli Studi di Milano, Via Manzoni 56, Rozzano, MI, Italy.

Treatment of chronic digitalis intoxication includes suspension of drug intake, which may be sufficient in case of mild manifestations, and supportive measures. Severe bradycardia requires the administration of atropine or isoproterenol; placement of a temporary pacemaker may be required in case of absent response to pharmacological therapy. Severe and life-threatening manifestations should be treated with digoxin-specific fragment antigen binding antibodies (Fab). Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.038DOI Listing
January 2019

Asking the correct questions of push dose vasopressors.

Authors:
Nicholas Farina

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

Department of Pharmacy, Michigan Medicine, Ann Arbor, MI, United States of America. Electronic address:

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http://dx.doi.org/10.1016/j.ajem.2019.02.008DOI Listing
February 2019

Lactate and NEWS-L are fair predictors of mortality in critically ill geriatric emergency department patients.

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

Emergency Medicine Department, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey.

Introduction: In this study, we aimed to investigate the prognostic power of the first lactate level measured in the emergency department (ED), National Early Warning Score (NEWS), and NEWS-lactate (NEWS-L) on ED admission in critically ill geriatric patients.

Methods: This retrospective observational study was conducted in the ED of a university hospital. Consecutive patients ≥65 years of age admitted to our ED between July 1, 2017, and December 31, 2017, and transferred to the intensive care unit after the ED follow-up period were included in the study. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.02.006DOI Listing
February 2019

The Ottawa subarachnoid hemorrhage clinical decision rule for classifying emergency department headache patients.

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

Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong Township, Kaohsiung County 833, Taiwan. Electronic address:

Background: Subarachnoid hemorrhage (SAH) is a serious cause of headaches. The Ottawa subarachnoid hemorrhage (OSAH) rule helps identify SAH in patients with acute nontraumatic headache with high sensitivity, but provides limited information for identifying other intracranial pathology (ICP).

Objectives: To assess the performance of the OSAH rule in emergency department (ED) headache patients and evaluate its impact on the diagnosis of intracranial hemorrhage (ICH) and other ICP. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.02.003DOI Listing
February 2019

Diagnostic considerations in detecting apical hypertrophic cardiomyopathy while utilizing point-of-care ultrasound.

Am J Emerg Med 2019 Feb 1. Epub 2019 Feb 1.

Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America. Electronic address:

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http://dx.doi.org/10.1016/j.ajem.2019.01.057DOI Listing
February 2019

Heart rate variability in patients presenting with neurally mediated syncope in an emergency department.

Am J Emerg Med 2019 Feb 6. Epub 2019 Feb 6.

Department of Emergency and Disaster Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.

Background: Neurally mediated syncope (NMS) is a disorder of autonomic nervous system (ANS) regulation. Orthostatic stress is one of the most common causative factors seen in clinical practice. Analysis of heart rate variability (HRV) is a non-invasive method that is used to assess ANS regulation. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07356757193008
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http://dx.doi.org/10.1016/j.ajem.2019.02.005DOI Listing
February 2019
1 Read

Emergency department sepsis huddles: Achieving excellence for sepsis benchmarks in New York State.

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

Emergency Department, Good Samaritan Hospital Medical Center, United States of America.

The sepsis order set at our institution was created with the intent to facilitate the prompt initiation of appropriate sepsis care. Once clinical features meeting criteria for systemic inflammatory response syndrome (SIRS) are identified and an infectious source is considered, a "sepsis huddle" is concomitantly initiated. The sepsis huddle was implemented in March of 2016 in order to increase compliance with the sepsis bundles. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07356757193008
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http://dx.doi.org/10.1016/j.ajem.2019.02.007DOI Listing
February 2019
6 Reads

The impact of an emergency care access point on pediatric attendances at the emergency department: An observational study.

Am J Emerg Med 2019 Feb 6. Epub 2019 Feb 6.

Department of Emergency Medicine, VieCuri Medical Center, Venlo, the Netherlands. Electronic address:

Objective: Crowding is a growing concern in general and pediatric Emergency Departments (EDs). The Emergency Care Access Point (ECAP) - a collaboration between general practitioners and the ED - has been established to reduce the number of self-referrals and non-urgent ED visits. The aim of this study was to determine the impact of an ECAP on pediatric attendances in the ED. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.02.002DOI Listing
February 2019

Intravenous dexketoprofen versus paracetamol in non-traumatic musculoskeletal pain in the emergency department: A randomized clinical trial.

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

Urla State Hospital, Emergency Service, Izmir, Turkey.

Introduction: Although acute musculoskeletal pain has a wide range of causes from tendinitis, muscle spasm, to bone and joint injuries, it is a frequent occurrence in emergency services. Paracetamol and non-steroidal anti-inflammatory analgesics (NSAID) are common used in the treatment of musculoskeletal pain. This study sets out to compare the effectiveness of intravenous dexketoprofen and paracetamol in musculoskeletal pain relief. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.040DOI Listing
February 2019

Single dose phenobarbital in addition to symptom-triggered lorazepam in alcohol withdrawal.

Authors:
Francisco Ibarra

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

Community Regional Medical Center, P.O. Box 1232, Fresno, CA 93715, United States of America. Electronic address:

Objective: The purpose of this study was to evaluate the safety and efficacy of a single parenteral dose of phenobarbital in addition to symptom-triggered lorazepam for the acute management of alcohol withdrawal syndrome (AWS).

Methods: This was a retrospective chart review of adult patients who presented to the Emergency Department with moderate or severe symptoms of alcohol withdrawal. Patients were included if they received at least 4 mg of lorazepam through the hospital's Alcohol Withdrawal Order Set on hospital day one. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.053DOI Listing
January 2019
3 Reads

Ultrasound and optic neuritis.

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

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

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http://dx.doi.org/10.1016/j.ajem.2019.02.001DOI Listing
February 2019

Pre-hospital modified shock index for prediction of massive transfusion and mortality in trauma patients.

Am J Emerg Med 2019 Feb 1. Epub 2019 Feb 1.

Department of Orthopedic Surgery, Pusan National University Hospital, 179, Gudeok-ro, Seo-gu, Busan 602-739, South Korea.

Background: Modified shock index (MSI) is a useful predictor in trauma patients. However, the value of prehospital MSI (preMSI) in trauma patients is unknown. The aim of this study was to investigate the accuracy of preMSI in predicting massive transfusion (MT) and hospital mortality among trauma patients. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.056DOI Listing
February 2019
2 Reads

Sensitivity of a bedside reagent strip for the detection of spontaneous bacterial peritonitis in ED patients with ascites.

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

Department of Emergency Medicine, Loma Linda University Medical Center, Loma Linda, CA, United States of America.

Study Objective: To determine the sensitivity of a highly sensitive bedside leukocyte esterase reagent strip (RS) for detection of spontaneous bacterial peritonitis (SBP) in emergency department (ED) ascites patients undergoing paracentesis.

Methods: We conducted a prospective, observational cohort study of ED ascites patients undergoing paracentesis at two academic facilities. Two practitioners, blinded to each other's results, did a bedside RS analysis of the peritoneal fluid in each patient and documented the RS reading at 3-min according to manufacturer-specified colorimetric strip reading as either "negative", "trace", "small", or "large". Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.044DOI Listing
January 2019
1 Read

Traumatic cerebrovascular injury: Prevalence and risk factors.

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

Neurosurgery Unit, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand.

Background: Traumatic cerebrovascular injury (TCVI) is uncommon in traumatic brain injury (TBI). Although TCVI is a rare condition, this complication is serious. A missed or delayed diagnosis may lead to an unexpected life-threatening hemorrhagic event or persistent neurological deficit. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.055DOI Listing
January 2019
1 Read
1.152 Impact Factor

Presentation and management of traumatic occipital spur fracture.

Am J Emerg Med 2019 Jan 24. Epub 2019 Jan 24.

Department of Neurosurgery, Medical University of South Carolina, Charleston, SC 29425, USA.

Occipital spur is an abnormal bony outgrowth of the external occipital protuberance (EOP). We describe an interesting and previously unreported case of fracture of an occipital spur following trauma. Our 20-year-old male patient was treated in the emergency department (ED) and discharged home without complication. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.043DOI Listing
January 2019

Nurse practitioners and physician assistants in emergency medical services who billed independently, 2012-2016.

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

The Johns Hopkins Bloomberg School of Public Health, United States of America.

Objective: As nurse practitioners (NPs) and physician assistants (PAs) become an integral part of delivering emergency medical services, we examined the involvement of NPs and PAs who billed independently in emergency departments (EDs).

Methods: We used Medicare provider utilization and payment data from 2012 to 2016 to conduct a retrospective analysis. We examined the changes in the number of each clinician type who billed independently for four common emergency services (CPT codes: 99282-5), the change in their service volume, and the change in their average number of services billed. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.052DOI Listing
January 2019

Lev's Syndrome: A rare case of progressive cardiac conduction disorder presenting to the emergency department.

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

Emergency Medicine Department, Brooke Army Medical Center, Fort Sam Houston, TX, USA.

Lev's Syndrome is a rare, progressive cardiac conduction defect (PCCD) due to myocardial fibrosis first described by Maurice Lev in 1964. This condition, proposed to start in the fourth decade of life, involves a sclerotic fibro-fatty degeneration of the Bundle of His and Purkinje fibers, which Lev proposed caused increasing AV delay with age. With the prevalence of electrocardiogram (ECG) use in the emergency department (ED) for cardiac- and non-cardiac complaints, dysrhythmias can be incidentally found and confuse diagnosis and disposition. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.054DOI Listing
January 2019
1 Read

Approach to cardiopulmonary resuscitation induced consciousness, an emergency medicine perspective.

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

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

Background: Cardiopulmonary resuscitation (CPR) remains the key intervention following cardiac arrest because of its ability to continue circulation. Recent focus on high quality compressions during CPR has coincided with more frequent encounters of CPR Induced Consciousness (CPRIC). CPRIC represents a poorly understood patient experience during CPR and defined as signs of consciousness and pain perception during CPR. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.051DOI Listing
January 2019
2 Reads

The intensity of pain in the prehospital setting is most strongly reflected in the respiratory rate among physiological parameters.

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

University of Borås, Prehospen-Centre for Prehospital Research, Faculty of Caring Science, Work, Life and Social Welfare, Sweden. Electronic address:

Background: In order to treat pain optimally, the Emergency Medical Service (EMS) clinician needs to be able to make a reasonable estimation of the severity of the pain. It is hypothesised that various physiological parameters will change as a response to pain.

Aim: In a cohort of patients who were seen by EMS clinicians, to relate the patients' estimated intensity of pain to various physiological parameters. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.032DOI Listing
January 2019

Effect of insonation angle on peak systolic velocity variation.

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

Olive View-UCLA Medical Center, United States of America. Electronic address:

Objectives: As point of care ultrasound (POCUS) has become more integrated into emergency and critical care medicine, there has been increased interest in utilizing ultrasound to assess volume status. However, recent studies of carotid POCUS on volume status and fluid responsiveness fail to recognize the effect insonation angle has on their results. To address this, we studied the effect of insonation angle on peak systolic velocity (PSV) change associated with respiratory variation (RV) and passive leg raise (PLR). Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.050DOI Listing
January 2019

Ultrasound-guided transverse abdominis plane block for ED appendicitis pain control.

Am J Emerg Med 2019 Jan 26. Epub 2019 Jan 26.

Department of Emergency Medicine/Alameda County Medical Center, Highland General Hospital, Oakland, CA 94602-1018, USA.

The ultrasound-guided transversus abdominis plane (TAP) block or TAP block is a well-established regional anesthetic block used by anesthesiologists for peri-operative pain control of the anterior abdominal wall. Multiple studies have demonstrated its utility to control pain for a range of procedures from inguinal hernia repair, laparoscopic cholecystectomies to cesarean sections [1-3]. There are no cases describing the efficacy of the ultrasound-guided TAP block in the emergency department as a part of a multimodal pain pathway for patients diagnosed with acute appendicitis. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.024DOI Listing
January 2019
3 Reads

Emergency physician care of family members, friends, colleagues and self.

Am J Emerg Med 2019 Jan 26. Epub 2019 Jan 26.

Department of Emergency Medicine, University of Arizona, Tucson, AZ, United States of America.

Emergency Physicians are frequently called upon to treat family members, friends, colleagues, subordinates or others with whom they have a personal relationship; or they may elect to treat themselves. This may occur in the Emergency Department (ED), outside of the ED, as an informal, or "curbside" consultation, long distance by telecommunication or even at home at any hour. In surveys, the vast majority of physicians report that they have provided some level of care to family members, friends, colleagues or themselves, sometime during their professional career. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.046DOI Listing
January 2019

Factors associated with the provision of targeted temperature management: A balanced factorial experiment.

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

Department of Emergency Medicine, Myongji Hospital, Hanyang University, College of Medicine, Goyang-si, Republic of Korea.

Aim: This study examined the influence of patient attributes and provider or organizational factors on the decision to apply targeted temperature management (TTM) to resuscitated out-of-hospital cardiac arrest (OHCA) patients.

Methods: A balanced factorial experiment was conducted among emergency medicine physicians (EMPs). Sixteen OHCA patient scenarios with balanced factors were presented. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07356757193001
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http://dx.doi.org/10.1016/j.ajem.2019.01.013DOI Listing
January 2019
5 Reads

Risk factors for seizure recurrence in a pediatric observation unit.

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

Hacettepe University Medical Faculty, Department of Pediatrics, Division of Pediatric Neurology, Ankara, Turkey.

Background: Most patients present with seizures to pediatric emergency department (PED) are observed for extended periods for the risk of possible acute recurrence.

Objective: The aim of this study is to determine the risk factors of acute recurrence within first 24 h.

Methods: Patients who presented to PED with seizure during past 24 h were enrolled. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.042DOI Listing
January 2019

Financial relationships with industry among guideline authors for the management of acute ischemic stroke.

Am J Emerg Med 2019 Jan 24. Epub 2019 Jan 24.

Department of Emergency Medicine, Crozer-Keystone Health System, Upland, PA, United States of America. Electronic address:

Objective: To characterize the prevalence of industry relationships among authors of acute ischemic stroke (AIS) guidelines and its association with graded evidence.

Methods: A cross-sectional study of five policy papers on AIS published by the American Heart Association (AHA)/American Stroke Association (ASA), American Academy of Emergency Physicians (AAEM), and American College of Emergency Physicians (ACEP). Financial conflicts of interest (FCOI) data were obtained using the Open Payments Database for the years 2013 through 2017. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.037DOI Listing
January 2019

A comparison of call volumes before, during, and after Hurricane Harvey.

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

University of Texas Medical Branch, Galveston, TX, United States of America.

Background: There is currently minimal data regarding the demand placed on Emergency Medical Services in the wake of hurricanes and other natural disasters. This retrospective review provides an opportunity to analyze call volumes to EMS and their distribution before, during, and after Hurricane Harvey in one area on the Texas Gulf Coast.

Objectives: Call volumes from Galveston Area Ambulance Authority were reviewed to provide insights for allocation of resources during natural disasters, identifying weaknesses in the current EMS system, and recommending proactive changes for future disasters. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.007DOI Listing
January 2019

A case with an unusual cause of syncope: Thyrotoxicosis.

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

Department of Emergency Medicine, Kaiser Permanente Emergency Medicine Residency, San Diego, CA, USA. Electronic address:

Syncope is a common emergency department (ED) chief complaint, with many known but also unknown causes. Here we present a novel ED presentation of a young woman with new-onset hyperthyroidism that masqueraded as a syncopal event with head trauma. A 21-year-old woman arrived in the ED with head trauma as the result of seemingly unprovoked syncope, due to her history as well as the nature of her trauma. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.018DOI Listing
January 2019
1 Read

Successful Distal Urethral Stone Removal in the Emergency Department.

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

Medical University of South Carolina, Department of Emergency Medicine, United States of America.

Nephrolithiasis is a common pathology encountered in the primary care and emergency department (ED) setting. In 2009 alone, there were over one million ED visits related to nephrolithiasis Higa et al. (2017) [1]. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.045DOI Listing
January 2019
1 Read

Interexaminer reliability of pharyngeal injection and palatine tonsillar hypertrophy in a pediatric emergency department.

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

Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-Ro Jongno-Gu, Seoul 03080, Republic of Korea.

Objectives: To evaluate the interrater reliability of throat examinations in children according to the major and training stage.

Study Design: We performed a prospective observational study of interrater reliability. The participants included physicians with various amounts of experience and majors who were working in an urban, tertiary hospital. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.016DOI Listing
January 2019

The diagnostic efficacy of cardiac CTA combined with D-dimer assay for the detection of left atrial thrombus in patients with atrial fibrillation.

Authors:
Xin Du Yutang Wang

Am J Emerg Med 2019 Jan 14. Epub 2019 Jan 14.

Fu Xing road No. 28, Beijing 100853, China. Electronic address:

Purpose: We aimed to evaluate a combination diagnostic method of single-phased, single-contrast injection cardiac computed tomography angiography CTA combined with age-adjusted D-dimer assay for diagnosis of left atrial/left atrial appendage (LA/LAA) thrombus in comparison to transesophageal echocardiography (TEE) in patients with atrial fibrillation. The addition of D-dimer to the CTA is to increase specificity, since CTA is part of the combined method.

Materials And Methods: Between October 2016 and December 2017, 113consective patients with non-valvular or valvular AF (male: 72. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.014DOI Listing
January 2019
1 Read

Extracorporeal cardiopulmonary resuscitation for massive pulmonary embolism in a "hybrid emergency room".

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

Trauma and Critical Care Center, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.

Aim: Patients with massive pulmonary embolism (PE) have poor outcomes and their management remains challenging. An interventional radiology (IVR)-computed tomography (CT) system available in our emergency room (ER) allows immediate access to CT and extracorporeal membrane oxygenation (ECMO) with safe cannulation under fluoroscopy. We aimed to determine if initial treatment in this "hybrid ER" is helpful in patients with PE requiring extracorporeal cardiopulmonary resuscitation (ECPR). Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.039DOI Listing
January 2019
1 Read

Massage-induced spinal epidural hematoma presenting with delayed paraplegia.

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

Truman Medical Center, Department of Emergency Medicine, University of Missouri-Kansas City (UMKC) School of Medicine, Kansas City, Mo, USA. Electronic address:

Background: Spinal epidural hematoma (SEH) is an uncommon but serious emergency condition rare cases of spontaneously or following a minor traumatic event without bony injury.

Objective: We report the rare case of SEH associated with traditional massage initially presenting with delayed lower paraplegia.

Case Report: A 20-year-old man presented with bilateral lower extremity weakness and numbness 3 h prior to presentation. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.017DOI Listing
January 2019
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Agreement between arterial and peripheral venous lactate levels in the emergency department: A systematic review.

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

Departments of Internal Medicine, OLVG, Amsterdam, the Netherlands.

Background: In the Emergency Department, lactate measurement is a useful tool to risk-stratify critically ill patients. However, it is unclear whether arterial or peripheral venous lactate levels can be used interchangeably for this purpose. In this systematic review, we provide an overview of studies investigating the agreement between arterial and peripheral venous lactate levels in the Emergency Department. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.034DOI Listing
January 2019

Which one is more important in traumatic brain injury: Hypotension or hypoxia?

Authors:
Arsal Acarbaş

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

Muğla University, Faculty of Medicine, Department of Neurosurgery, Turkey. Electronic address:

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http://dx.doi.org/10.1016/j.ajem.2019.01.036DOI Listing
January 2019

Perceived vs. actual distractions in the emergency department.

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

Temple University Hospital, Department of Emergency Medicine, Philadelphia, PA 19140, United States of America. Electronic address:

Introduction: The emergency department (ED) has been shown to be an interrupt-driven workplace fraught with potential for distractions and interruptions that increase the potential for medical error. Accuracy of provider perception of these distractions and interruptions has yet to be investigated.

Methods: An observational two-phase study was conducted over a 9-week period in the highest acuity zone of the ED at an urban, academic medical center with about 90,000 visits/year. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.005DOI Listing
January 2019

Management and outcome of obstructive ureteral stones in the emergency department: Emphasis on urine tests and antibiotics usage.

Am J Emerg Med 2018 Dec 24. Epub 2018 Dec 24.

NYMC, Metropolitan Hospital Center, Department of Emergency Medicine, New York, NY, United States of America. Electronic address:

Background: Kidney stone related complaints in the Emergency Department (ED) are common. Current guidelines recommend antibiotic therapy for infected obstructive stones and stone removal in a timely fashion, but there is no clear recommendation for prophylactic antibiotic use for bacteriuria or pyuria in the setting of obstructive ureteral stones.

Objectives: The aim of this study is to evaluate the current management of patients with obstructive ureteral stones in a single ED with emphasis on urine tests and antibiotics use. Read More

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http://dx.doi.org/10.1016/j.ajem.2018.12.046DOI Listing
December 2018

Validating the LUCAS® mechanical chest compression fit specifications.

Am J Emerg Med 2019 Feb 30;37(2):371-373. Epub 2018 Jun 30.

University of North Dakota, Center for Rural Health, United States of America.

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http://dx.doi.org/10.1016/j.ajem.2018.06.069DOI Listing
February 2019
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Penile fracture: Surgical vs. conservative treatment.

Am J Emerg Med 2019 Feb 22;37(2):366-367. Epub 2018 Jun 22.

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

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http://dx.doi.org/10.1016/j.ajem.2018.06.051DOI Listing
February 2019

Aortic dissection and aneurysm are hypertensive target organ damages and should be listed in the guidelines.

Am J Emerg Med 2019 Feb 23;37(2):365-366. Epub 2018 Jun 23.

Department of Cardiology, Clinical Centre and Medical Faculty, University of Nis, Nis, Serbia. Electronic address:

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http://dx.doi.org/10.1016/j.ajem.2018.06.047DOI Listing
February 2019
1 Read