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American Journal of Emergency Medicine

Michael Gottlieb, Dallas Holladay, Katharine Burns, Stephen R Gore, Collin Wulff, Shital Shah, John Bailitz
INTRODUCTION: Ultrasound has been increasingly utilized for the identification of endotracheal tube (ETT) location after an intubation attempt, particularly among patients in cardiac arrest. However, prior studies have varied with respect to the choice of transducer and no studies have directly compared the accuracy between transducer types. Our study is the first to directly compare the accuracy of ETT confirmation between the linear and curvilinear transducer. METHODS: This study was performed in a cadaver lab using three different cadavers chosen to represent varying neck circumferences...
March 12, 2019: American Journal of Emergency Medicine
Zhengcai Lou
No abstract text is available yet for this article.
March 11, 2019: American Journal of Emergency Medicine
Michael E Winters, Kami Hu, Joseph P Martinez, Haney Mallemat, William J Brady
An emergency physician (EP) is often the first health care provider to evaluate, resuscitate, and manage a critically ill patient. Between 2001 and 2009, the annual hours of critical care delivered in emergency departments (EDs) across the United States increased >200% [1]! This trend has persisted since then. In addition to seeing more critically ill patients, EPs are often tasked with providing critical care long beyond the initial resuscitation period. In fact, >33% of critically ill patients who are brought to an ED remain there for >6 h [1]...
March 10, 2019: American Journal of Emergency Medicine
Alexandros Doukas, Harald Barth, K Athanasios Petridis, Maximilian Mehdorn, Christian von der Brelie
OBJECTIVE: Patients suffering from aneurysmatic Subarachnoid Hemorrhage (SAH) may present with a variety of symptoms. The aim of this study is to evaluate the spectrum of misdiagnoses and to analyze the significance of delay of correct diagnosis on the clinical outcome. METHODS: The data was collected prospectively from 2003 to 2013. Patients diagnosed with disease different from aneurysmal SAH by the initially treating physician, and admitted to our department with a delay of at least 24 h after the beginning of the symptoms, were included in this study...
March 10, 2019: American Journal of Emergency Medicine
Yutaka Igarashi, Tatsuya Norii, Kim Sung-Ho, Shimpei Nagata, Takashi Tagami, Jon Femling, Yasuaki Mizushima, Hiroyuki Yokota
INTRODUCTION: Foreign body airway obstruction (FBAO) is a common medical emergency; however, few studies of life-threatening FBAO have been reported and no standard classification system is available. METHODS: We retrospectively evaluated patients who presented to the emergency departments of two hospitals and were diagnosed with FBAO. The primary outcome was cerebral performance category (CPC) score at discharge. To establish a new classification system for FBAO, FBAO was classified into three types based on the anatomical and physiological characteristics of the obstructed airway...
March 9, 2019: American Journal of Emergency Medicine
Daniel McCabe, Stacey Bangh, Ann Arens, Jon Cole
BACKGROUND: Phenibut is a synthetically produced central nervous system (CNS) depressant that is structurally similar to the inhibitory neurotransmitter γ-aminobutyric acid (GABA). Phenibut has been identified as a drug of abuse with numerous clinical effects in overdose and a withdrawal syndrome with chronic use. The purpose of this study is to report the incidence of exposure calls regarding phenibut to a poison center, describe the reasons for its use and clinical effects. METHODS: Study subjects were identified using Toxicall®, the electronic medical record utilized by the Minnesota Poison Control System...
March 9, 2019: American Journal of Emergency Medicine
Jeffrey G Klein, Scott M Alter, Richard J Paley, Patrick G Hughes, Lisa M Clayton, William Benda, Richard D Shih, Joshua J Solano
No abstract text is available yet for this article.
March 8, 2019: American Journal of Emergency Medicine
Jin Hee Lee, Jae Yun Jung, Hyun Jung Lee, Do Kyun Kim, Young Ho Kwak, Ikwan Chang, Hyuksool Kwon, Yoo Jin Choi, Joong Wan Park, So Hyun Paek, Jun Hwi Cho
OBJECTIVE: Croup treatment usually involves a single dose of systemic dexamethasone combined with nebulized epinephrine. However, the optimal dose of l-epinephrine remains unclear. We examined whether a low dose (0.1 mg/kg) was inferior to the conventional dose (0.5 mg/kg) of 1:1000 nebulized l-epinephrine in patients with moderate to severe croup. METHODS: This randomized double-blind clinical non-inferiority trial was conducted in three pediatric emergency departments from May 2015 to October 2017...
March 8, 2019: American Journal of Emergency Medicine
Kyohei Miyamoto, Naoaki Shibata, Atsuhiro Ogawa, Tsuyoshi Nakashima, Seiya Kato
OBJECTIVE: The quick sequential organ failure assessment (qSOFA) score is calculated from three variables measured at the scene of trauma-systolic blood pressure, respiratory rate and consciousness. This study aimed to evaluate the discriminative ability of the prehospital qSOFA score for in-hospital mortality in patients with trauma. METHODS: This retrospective multicenter study used data from 42,722 patients with trauma included in a Japanese nationwide trauma registry...
March 8, 2019: American Journal of Emergency Medicine
La Vonne A Downey, Amanda Hong, Karina Herrera
No abstract text is available yet for this article.
March 8, 2019: American Journal of Emergency Medicine
Jungyeon Kim, Esther Israel, Sandhya Rao, Emily Aaronson, Jeffrey Weilburg, Haytham Kaafarani, Jarone Lee
No abstract text is available yet for this article.
March 8, 2019: American Journal of Emergency Medicine
Akira Kuriyama, Toshie Kaihara, Tetsunori Ikegami
BACKGROUND: In developed nations, the age of patients in emergency departments (ED) continues to increase. Many emergency triage systems, such as the Canadian Triage and Acuity Scale (CTAS), triage patients as a homogenous group, regardless of age. However, older adults have multiple comorbidities and a higher risk of undertriage. The Japan Acuity and Triage Scale (JTAS) was developed based on the CTAS and has been validated for overall adults. We assessed the validity of the JTAS for use in elderly ED patients...
March 8, 2019: American Journal of Emergency Medicine
Tomohiro Yoshizawa, Yoshito Kamijo, Tomoki Hanazawa, Yoshiki Suzuki, Yuji Fujita, Kiyotaka Usui, Sumio Hirata, Tohru Kishino
No abstract text is available yet for this article.
March 8, 2019: American Journal of Emergency Medicine
Hakan Hakkoymaz, Selçuk Nazik, Muhammed Seyithanoğlu, Özlem Güler, Ahmet Rıza Şahin, Emrah Cengiz, Fatih Mehmet Yazar
INTRODUCTION: The present study evaluates the predictive value of such markers as ischemia-modified albumin (IMA), malondialdehyde (MDA) and glutathione peroxide (GSH-Px), in addition to parameters associated with inflammation, oxidative stress and ischemia, playing roles in the pathology of acute appendicitis (AA), including c-reactive protein (CRP), procalcitonin (PCT) and complete blood count (CBC) parameters and their ratios, for the diagnosis of AA in adults. MATERIAL AND METHODS: The study included 51 patients with histologically confirmed appendicitis and 45 healthy controls who referred to the emergency care unit between January and June 2018...
March 7, 2019: American Journal of Emergency Medicine
Lindsey Ouellette, Allison Cook, Keegan Michel, Leah Harvey, Chad Sutliffe, Todd Chassee, Jeffrey Jones
No abstract text is available yet for this article.
March 6, 2019: American Journal of Emergency Medicine
Peter S Pang, Megan Litzau, Mark Liao, Jennifer Herron, Elizabeth Weinstein, Christopher Weaver, Dan Daniel, Charles Miramonti
BACKGROUND: Community paramedicine (CP) leverages trained emergency medical services personnel outside of emergency response as an innovative model of health care delivery. Often used to bridge local gaps in healthcare delivery, the CP model has existed for decades. Recently, the number of programs has increased. However, the level of robust data to support this model is less well known. OBJECTIVE: To describe the evidence supporting community paramedicine practice...
March 5, 2019: American Journal of Emergency Medicine
Jean Macé, Nicolas Marjanovic, Farnam Faranpour, Olivier Mimoz, Marc Frerebeau, Mathieu Violeau, Pierre-Alexis Bourry, Jérémy Guénézan, Arnaud W Thille, Jean-Pierre Frat
OBJECTIVES: To compare clinical impact after early initiation of high-flow nasal cannula oxygen therapy (HFNC) versus standard oxygen in patients admitted to an emergency department (ED) for acute hypoxemic respiratory failure. METHODS: We performed a prospective before-after study at EDs in two centers including patients with acute hypoxemic respiratory failure defined by a respiratory rate above 25 breaths/min or signs of increased breathing effort under additional oxygen for a pulse oximetry above 92%...
March 5, 2019: American Journal of Emergency Medicine
Steven T Haywood, Jessica S Whittle, Leonithas I Volakis, George Dungan, Michael Bublewicz, Joseph Kearney, Terrell Ashe, Thomas L Miller, Pratik Doshi
BACKGROUND AND OBJECTIVE: Managing respiratory failure (RF) secondary to acute decompensated heart failure (ADHF) with non-invasive positive-pressure ventilation (NIPPV) has been shown to significantly improve morbidity and mortality in patients presenting to the emergency department (ED). This subgroup analysis compares high-velocity nasal insufflation (HVNI), a form of high-flow nasal cannula, with NIPPV in the treatment of RF secondary to ADHF with respect to therapy failure, as indicated by the requirement for intubation or all-cause arm failure including subjective crossover to the alternate therapy...
March 3, 2019: American Journal of Emergency Medicine
Chao Liu, Guangming Lu, Dong Wang, Yi Lei, Zhi Mao, Pan Hu, Jie Hu, Rui Liu, Dong Han, Feihu Zhou
INTRODUCTION: Fluid resuscitation is a fundamental component of the management of critically ill patients, but whether choice of crystalloid affects patient outcomes remains controversial. Therefore, we performed this meta-analysis to compare the efficacy and safety of balanced crystalloids with normal saline. METHODS: We searched the MEDLINE, Cochrane Central and EMBASE up to October 2018 to identify randomized controlled trials (RCTs) that compared balanced crystalloids versus normal saline in critically ill patients...
March 1, 2019: American Journal of Emergency Medicine
Jeremy S Boyd, Charles M LoPresti, Megan Core, Christopher Schott, Michael J Mader, Brian P Lucas, Elizabeth K Haro, Erin P Finley, Marcos I Restrepo, Chad Kessler, Angel Colon-Molero, Jacqueline Pugh, Ilam J Soni
No abstract text is available yet for this article.
February 28, 2019: American Journal of Emergency Medicine
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