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Journals American Journal of Emergency ...

American Journal of Emergency Medicine

https://read.qxmd.com/read/34325216/the-physical-examination-is-unreliable-in-determining-the-location-of-the-distal-fibular-physis
#1
Véronique Dion, Vikram Sabhaney, Justin S Ahn, Shannon Erdelyi, Daniel J Kim
OBJECTIVES: Salter-Harris type 1 (SH1) fractures of the distal fibula are acute orthopedic injuries with tenderness over the physis without radiographic evidence of fracture. Our primary objective was to establish the accuracy of the physical examination performed by pediatric emergency medicine (PEM) physicians in determining the location of the distal fibular physis compared to a criterion standard of ultrasound. METHODS: This was a prospective, observational study at an urban academic pediatric emergency department of a convenience sample of children aged 4 to 10 years old between March 2019 and March 2020...
July 22, 2021: American Journal of Emergency Medicine
https://read.qxmd.com/read/34325215/scientific-publication-trends-of-emergency-department-of-international-federation-for-emergency-medicine-members-2009-to-2018
#2
Hsin-Hui Chou, Chien-Wei Cheng, Ching-Hsing Lee
BACKGROUND: Emergency medicine (EM) is a rapidly developing specialty worldwide. The scientific publications trend is one of the parameters to evaluate national EM developmental milestones. This study was performed to analyze the publication trends from emergency departments (EDs) of International Federation for Emergency Medicine (IFEM) full member countries from 2009 to 2018. METHODS: All data were retrieved from the SciVerse Scopus database. IFEM full member countries where EM was recognized as a specialty before 2009 and annual publication numbers exceeded 12 in 2018 were included...
July 21, 2021: American Journal of Emergency Medicine
https://read.qxmd.com/read/34325179/efast-exam-errors-at-a-level-1-trauma-center-a-retrospective-cohort-study
#3
Kiana Khosravian, Keith Boniface, Elizabeth Dearing, Aaran Drake, Kathleen Ogle, Matthew Pyle, Sarah E Frasure
OBJECTIVES: Extended Focused Assessment with Sonography for Trauma (eFAST) ultrasound exams are central to the care of the unstable trauma patient. We examined six years of eFAST quality assurance data to identify the most common reasons for false positive and false negative eFAST exams. METHODS: This was an observational, retrospective cohort study of trauma activation patients evaluated in an urban, academic Level 1 trauma center. All eFAST exams that were identified as false positive or false negative exams compared with computed tomography (CT) imaging were included...
July 21, 2021: American Journal of Emergency Medicine
https://read.qxmd.com/read/34312038/silence-is-deafening-acute-bilateral-hearing-loss-as-a-rare-presentation-of-acute-stroke
#4
Alex S Vaughn, Megan A Rech, Shannon Lovett
Acute bilateral hearing loss is an uncommon presentation in the Emergency Department (ED), with a variety of potential causes. It is important to consider neurologic vascular etiologies as a cause for acute sensorineural hearing loss. We report a case of acute hemorrhagic stroke presenting as acute bilateral hearing loss. A 60-year-old male with a history of atrial fibrillation presented to the ED with the acute onset of bilateral hearing loss with otherwise intact neurologic testing. He was found to have an acute left temporal hemorrhagic stroke, and magnetic resonance imaging demonstrated multifocal ischemia including an acute right temporal ischemic stroke...
July 21, 2021: American Journal of Emergency Medicine
https://read.qxmd.com/read/34312037/changes-in-poisoning-during-the-covid-19-pandemic-worldwide
#5
LETTER
Sheng-Teck Tan, Tse-Hao Chen, Hsiu-Wu Yang, Yu-Jang Su
No abstract text is available yet for this article.
July 21, 2021: American Journal of Emergency Medicine
https://read.qxmd.com/read/34303186/efficacy-of-bolus-dose-epinephrine-to-manage-hypotension-in-the-prehospital-setting
#6
Kyle A Weant, David M French
PURPOSE: Hypotension in the Emergency Department (ED) and the prehospital setting has been associated with significant morbidity and mortality. Limited literature exists exploring the utilization of intravenous (IV) bolus-dose epinephrine (BDE) by Emergency Medical Services (EMS). METHODS: A retrospective review evaluated patients transported to an academic medical center who had received IV BDE by a single urban EMS system from 2016 to 2020. The primary outcome was to assess the influence IV BDE had on systolic blood pressure (SBP)...
July 18, 2021: American Journal of Emergency Medicine
https://read.qxmd.com/read/34274878/cardiotoxicity-associated-with-immune-checkpoint-inhibitors-and-car-t-cell-therapy
#7
REVIEW
Demis N Lipe, Eva Rajha, Adriana H Wechsler, Susan Gaeta, Nicolas L Palaskas, Zahra Alhajji, Jayne Viets-Upchurch, Patrick Chaftari
INTRODUCTION: The expanding use of immunotherapy and the growing population of patients with cancer has led to an increase in the reporting of immune related adverse events (irAEs). The emergency clinician should be aware of these emerging toxicities, some of which can be fatal. In this review we discuss the cardiotoxic side effects of immune checkpoint inhibitors (ICIs) and chimeric antigen receptor T-cell (CAR T-cell) therapy. DISCUSSION: Recognizing the possible presentations of cardiotoxic irAEs is of utmost important as the diagnosis of cardiotoxicity associated with ICI and CAR T-cell can be difficult to make in the emergency department...
July 13, 2021: American Journal of Emergency Medicine
https://read.qxmd.com/read/34294501/bamlanivimab-infusion-experience-at-one-academic-emergency-department
#8
LETTER
Michael J Yoo, Brit J Long, Steven G Schauer
No abstract text is available yet for this article.
July 12, 2021: American Journal of Emergency Medicine
https://read.qxmd.com/read/34304920/hyperacute-hyponatremia-mimicking-acute-ischemic-stroke-a-case-report
#9
Alanna Balbi, Jennifer A Sadowski, Daniel Torrens, Jeanne L Jacoby, Hussam A Yacoub, Jessica K Eygnor
We present a case of hyperacute hyponatremia with stroke like symptoms on presentation. Symptoms included confusion, left-sided facial droop, right-sided hemiparesis, dysarthria and aphasia, with an NIH stroke score of 5. Sodium level at the time of presentation was 119 mmol/L which dropped acutely from 138 mmol/L seven hours prior. Symptoms improved after treatment with 3% saline and no evidence of stroke, intracranial hemorrhage or space-occupying lesion was seen on imaging. The most likely cause of the hyponatremia was increased free water consumption and ADH surge...
July 10, 2021: American Journal of Emergency Medicine
https://read.qxmd.com/read/34304094/effect-of-focused-protocol-on-reducing-radiation-dose-for-children-who-require-computed-tomography-for-suspected-appendicitis
#10
Suzanne Roberts, Bernard Goldwasser, Abigail F Nixon, Deeksha Borkar, Max Brookman, Carolyn E Fox, Cyril Rosenfeld, James A Meltzer
BACKGROUND: Despite efforts to incorporate ultrasound into the evaluation of children for appendicitis, computed tomography (CT) is often used to aid in its diagnosis. CT scans, however, expose children to a considerable amount of radiation. In 2017, our institution began using a height-based Focused CT protocol for children with suspected appendicitis in need of CT. OBJECTIVE: To compare the radiation dose received by children with suspected appendicitis who underwent a Standard CT of the abdomen and pelvis (CTAP) with that of a Focused CT...
July 10, 2021: American Journal of Emergency Medicine
https://read.qxmd.com/read/34314941/effect-of-synchronous-online-vs-face-to-face-cardiopulmonary-resuscitation-training-on-chest-compression-quality-a-pilot-randomized-manikin-study
#11
Lian Lin, Shaozhou Ni, Jin Cheng, Zhongxiang Zhang, Rong Zeng, Xiaoqing Jin, Yan Zhao
OBJECTIVES: The aim of the study was to compare the effect of synchronous online and face-to-face cardiopulmonary resuscitation (CPR) training on chest compressions quality in a manikin model. METHODS: A total of 118 fourth-year medical students participated in this study. The participants were divided into two groups: the online synchronous teaching group and the face-to-face group. Then, the participants were further randomly distributed to 1 of 2 feedback groups: online synchronous teaching and training with feedback devices (TF, n = 30) or without feedback devices (TN, n = 29) and face-to-face teaching and training with feedback devices (FF, n = 30) or without feedback devices (FN, n = 29)...
July 9, 2021: American Journal of Emergency Medicine
https://read.qxmd.com/read/34273866/prognostic-accuracy-of-qsofa-at-triage-in-patients-with-suspected-infection-in-a-brazilian-emergency-department
#12
Ian Ward A Maia, Lucas Oliveira J E Silva, Henrique Herpich, Luciano Diogo, João Carlos Batista Santana, Daniel Pedrollo, Mario Castro Alvarez Perez, Rafael Nicolaidis
OBJECTIVE: To evaluate the prognostic accuracy of qSOFA for predicting in-hospital mortality among patients with suspected infection presenting to the ED of a public tertiary hospital in Brazil. METHODS: We performed a retrospective cohort study of consecutive adult patients (age ≥ 18 years) with suspected infection who presented to an academic tertiary ED in Porto Alegre (Southern Brazil) during an 18-month period. The qSOFA was calculated by using information collected at triage and patients were followed throughout hospitalization for the primary outcome of in-hospital mortality...
July 9, 2021: American Journal of Emergency Medicine
https://read.qxmd.com/read/34271232/development-of-a-prediction-model-for-clinically-important-outcomes-of-acute-diverticulitis
#13
Stephen Gyung Won Lee, Sang Do Shin, Hui Jai Lee, Gil Joon Suh, Do Joong Park
OBJECTIVE: Acute diverticulitis (AD) is a common disease with various outcomes. When AD is diagnosed in the emergency department (ED), the ED clinician must determine the patient's treatment strategy whether the patient can be discharged, needs to be admitted to the general ward, ICU, or needs surgical consultation. This study aimed to identify potential risk factors for clinically important outcomes (CIOs) and to develop a prediction model for CIOs in AD to aid clinical decision making in the ED...
July 9, 2021: American Journal of Emergency Medicine
https://read.qxmd.com/read/34271231/patterns-of-emergency-department-visits-for-acute-and-chronic-diseases-during-the-two-pandemic-waves-in-italy
#14
Davide Golinelli, Francesca Campinoti, Francesco Sanmarchi, Simona Rosa, Michelle Beleffi, Gabriele Farina, Andrea Tampieri, Maria Pia Fantini, Fabrizio Giostra, Luca Santi
BACKGROUND: Evidence is lacking about the impact of subsequent COVID-19 pandemic waves on Emergency Departments (ED). We analyzed the differences in patterns of ED visits in Italy during the two pandemic waves, focusing on changes in accesses for acute and chronic diseases. METHODS: We conducted a retrospective study using data from a metropolitan area in northern Italy that includes twelve ED. We analyzed weekly trends in non-COVID-19 ED visits during the first (FW) and second wave (SW) of the pandemic...
July 9, 2021: American Journal of Emergency Medicine
https://read.qxmd.com/read/34271230/prevelence-of-imaging-findings-of-acute-pancreatitis-in-emergency-department-patients-with-elevated-serum-lipase
#15
Daniel I Glazer, Lailah R Cochon, Ali S Raja, David X Jin, Peter A Banks, Aaron D Sodickson, Ramin Khorasani
PURPOSE: To assess the association of imaging features of acute pancreatitis (AP) with the magnitude of lipase elevation in Emergency Department (ED) patients. METHODS: This Institutional Review Board-approved retrospective study included 509 consecutive patients presenting from 9/1/13-8/31/15 to a large academic ED with serum lipase levels ≥3× the upper limit of normal (ULN) (≥180 U/L). Patients were excluded if they did not have imaging (n = 131) or had a history of trauma, abdominal metastases, altered mental status, or transfer from an outside hospital (n = 190); the final study population was 188 patients...
July 9, 2021: American Journal of Emergency Medicine
https://read.qxmd.com/read/34265732/emergency-department-management-of-chemotherapy-related-febrile-neutropenia-an-opportunity-to-improve-care
#16
Nicholas Pettit, Daniel Boadu, Jason J Bischof
BACKGROUND: Febrile neutropenia (FN) is an important oncological emergency seen in the emergency department (ED), and the American Society of Clinical Oncology recommends risk stratification of patients with febrile neutropenia using the Multinational Association for Supportive Care in Cancer (MASCC) Index, with ED discharge on oral antibiotics recommended for low-risk patients. OBJECTIVES: To determine the prevalence of FN neutropenia and medical system wide ED treatment guideline adherence...
July 9, 2021: American Journal of Emergency Medicine
https://read.qxmd.com/read/34265731/stress-hormones-kinetics-in-ventricular-fibrillation-cardiac-arrest-and-resuscitation-translational-and-therapeutic-implications
#17
Ioannis Pantazopoulos, Ioannis Boutsikos, Georgios Mavrovounis, Themis Graikou, Gavino Faa, Dimitrios Barouxis, Evangelia Kesidou, Theodoros Mavridis, Athanasios Chalkias, Theodoros Xanthos
BACKGROUND: Knowing the kinetics of endogenous stress hormones during cardiac arrest and cardiopulmonary resuscitation (CRP) will help to optimize personalized physiology-guided treatment. The aim of this study was to examine the dynamic changes in stress hormones in a swine model of ventricular fibrillation (VF) cardiac arrest. METHODS: Ventricular fibrillation was induced in 10 healthy Landrace/Large White piglets, which were subsequently left untreated for 8 min...
July 9, 2021: American Journal of Emergency Medicine
https://read.qxmd.com/read/34303568/bystander-cardiopulmonary-resuscitation-in-public-locations-before-and-after-the-coronavirus-disease-2019-pandemic-in-the-republic-of-korea
#18
LETTER
Kyu Tae Lim, Ki Ok Ahn, Jeong Ho Park, Chi Ho Park, Jangsun Lim, Kyeongjae Lee
No abstract text is available yet for this article.
July 8, 2021: American Journal of Emergency Medicine
https://read.qxmd.com/read/34301446/can-metrics-give-physicians-insight
#19
LETTER
Erin Bright, Jean Scofi, Rohit B Sangal, Craig Rothenberg, Jeremiah Kinsman, Amitkumar Patel, Vivek Parwani, John Sather, Andrew Pickens, Andrew Ulrich, Arjun K Venkatesh
No abstract text is available yet for this article.
July 8, 2021: American Journal of Emergency Medicine
https://read.qxmd.com/read/34293624/effect-of-guo-qing-yi-tang-combined-with-western-medicine-cluster-therapy-on-acute-pancreatitis
#20
Ying-Jie Chen, Ming-Zhi Chen, Hong-Wei Zhang, Gui-Song Wu, Sen-Ren Guo
BACKGROUND: This study evaluated the effect of Guo Qing Yi Tang (GQYT) combined with Western medicine cluster therapy on acute pancreatitis (AP). METHODS: A total of 138 AP patients were recruited and divided into the observation group (68 patients) and control group (70 patients). The control group was treated with cluster therapy alone, while the observation group was treated with trans-jejunum feeding of GQYT combined with cluster therapy. Blood samples were taken before the treatment and 24 h, 72 h, and 1 week after the treatment...
July 8, 2021: American Journal of Emergency Medicine
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