The influence of coronavirus disease 2019 on emergency department visits in Nanjing, China: A multicentre cross-sectional study
Influenza has been linked to the crowding in emergency departments (ED) across the world. The impact of the Coronavirus Disease 2019 (COVID-19) pandemic on China EDs has been quite different from those during past influenza outbreaks. Our objective was to determine if COVID-19 changed ED visit disease severity during the pandemic. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 9, 2020 Category: Emergency Medicine Authors: Hao Sun, Keqin Liu, Meng Li, Shaowen Tang, Andrew A. Monte, Jun Wang, Shinan Nie, Qinglin Rui, Wenge Liu, Haidong Qin, Xiao Tan, Haibin Ni, Wenxin Yang, Congjian Zhu, Runhua Yang, Tianhao Yu, Shengwei Wang, Hao Jiang, Xiaofeng Chen, Wei Zhang, Yi Zhu, Hua Source Type: research

Geriatric assistive devices improve older patient engagement and clinical care in an emergency department
In 2014, national emergency medicine and geriatrics societies released joint, standardized guidelines for Geriatric Emergency Department (GEDs) [1] One guideline recommendation is for assistive devices, which included cognitive engagement tools, walking aids/devices, and hearing amplifiers, to be incorporated in GEDs [1]. This recommendation for assistive devices was based on expert consensus and data from non-ED settings, and the effects of providing these types of equipment on ED patients and staff have not been explored. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 8, 2020 Category: Emergency Medicine Authors: Naleef Fareed, Lauren T. Southerland, Brian M. Rao, Cynthia J. Sieck Tags: Correspondence Source Type: research

Transtracheal ultrasonographic confirmation of endotracheal intubation using I-gel and an endotracheal tube introducer
This study aimed to investigate the efficacy of transtracheal ultrasonography in confirming the placement of an endotracheal tube introducer during endotracheal intubation using the I-gel supraglottic airway as a guide. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 8, 2020 Category: Emergency Medicine Authors: Sin-Youl Park, Jong Kun Kim Source Type: research

Desmopressin with four-factor prothrombin complex concentrate for life-threatening bleeding: A case series
There are multiple disease states that warrant the use of anticoagulation with one or more antiplatelet agents. Additionally, direct oral anticoagulants (DOACs) are gradually replacing warfarin as the anticoagulants of choice [1]. A major complication of anticoagulant and antiplatelet therapy may be life-threatening bleeding, resulting in a debilitating state or death. Current guidelines recommend the use of four-factor prothrombin complex concentrate (4F-PCC) for anticoagulation reversal in patients experiencing major bleeding or necessitating urgent surgical intervention due to warfarin use [1,2]. (Source: The American J...
Source: The American Journal of Emergency Medicine - August 7, 2020 Category: Emergency Medicine Authors: Dalila Masic, Ochan Kwon, Megan A. Rech Source Type: research

COVID-19 respiratory support in the emergency department setting
Severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2), which causes the coronavirus disease 2019 (COVID-19), may result in severe complications, multiorgan dysfunction, acute respiratory failure, and death. SARS-CoV-2 is highly contagious and places healthcare workers at significant risk, especially during aerosol-generating procedures, including airway management. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 7, 2020 Category: Emergency Medicine Authors: Tim Montrief, Mark Ramzy, Brit Long, Michael Gottlieb, Dan Hercz Source Type: research

The authors respond: Evaluating and analyzing outcomes accurately
Thanks for the interest from the readers and we appreciate this opportunity to further clarify some of the content of our research. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 7, 2020 Category: Emergency Medicine Authors: Yongxue Zhang Source Type: research

Comparison the accuracy of early warning scores with qSOFA and SIRS for predicting sepsis in the emergency department
The aims of this study were to evaluate the accuracy of early warnings scores including National Early Warning Score (NEWS), Modified Early Warning Score (MEWS), Mortality in Emergency Department Sepsis score (MEDS), Search Out Severity score (SOS) and compare them with quick Sequential Organ Failure Assessment (qSOFA) and Systemic Inflammatory Response Syndrome (SIRS) for detecting sepsis among infected patients at the emergency department (ED). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 6, 2020 Category: Emergency Medicine Authors: Prangsai Wattanasit, Bodin Khwannimit Source Type: research

A pilot study examining the use of ultrasound to measure sarcopenia, frailty and fall in older patients
The importance of this study is to devise an efficient tool for assessing frailty in the ED. The goals of this study are 1) to correlate ultrasonographic (US) measurements of muscle thickness in older ED patients with frailty and 2) to correlate US-measured sarcopenia with falls, subsequent hospitalizations and ED revisits. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 6, 2020 Category: Emergency Medicine Authors: Emily Benton, Andrew S. Liteplo, Hamid Shokoohi, Michael A. Loesche, Sarah Yacoub, Phraewa Thatphet, Thiti Wongtangman, Shan W. Liu Source Type: research

Clinical characteristics and outcomes of bone marrow transplantation patients presenting to the ED of a tertiary care center
Bone marrow transplantation is a breakthrough in the world of hematology and oncology. In our region, there is scarce literature studying emergency department visits among BMT patients, as well as their predictors of mortality. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 5, 2020 Category: Emergency Medicine Authors: Imad El Majzoub, Rola A. Cheaito, Mohamad Ali Cheaito, Ali Bazarbachi, Kinda Sweidan, Aseel Sarieddine, Farouk Al Chami, Hani Tamim, Jean El Cheikh Source Type: research

EMS dispatch center activity during the COVID-19 containment
To the Editor: (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 4, 2020 Category: Emergency Medicine Authors: Yann Penverne, Joel Jenvrin, Emmanuel Montassier Tags: Correspondance Source Type: research

Prediction of emergency department volume and severity during a novel virus pandemic: Experience from the COVID-19 pandemic
During a novel virus pandemic, predicting emergency department (ED) volume is crucial for arranging the limited medical resources of hospitals for balancing the daily patient- and epidemic-related tasks in EDs. The goal of the current study was to detect specific patterns of change in ED volume and severity during a pandemic which would help to arrange medical staff and utilize facilities and resources in EDs in advance in the event of a future pandemic. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 4, 2020 Category: Emergency Medicine Authors: Hsiang-Yun Lo, Chung-Hsien Chaou, Yu-Che Chang, Chip-Jin Ng, Shou-Yen Chen Source Type: research

Inaccurate outcome evaluation and conflict in odds ratio in multivariable analysis
⁎Corresponding author. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 4, 2020 Category: Emergency Medicine Authors: Mehmet Ali Aslaner, Nurettin Özgür Doğan Source Type: research

Guillain-Barr é syndrome in a patient previously diagnosed with COVID-19
As the COVID-19 pandemic continues to progress, the medical community is rapidly trying to identify complications and patterns of disease to improve patient outcomes. In a recent systematic review, it has been reported that isolated cases of Guillain-Barre Syndrome (GBS) have occurred secondary to COVID-19 infection. GBS is defined as a rare, but potentially fatal, immune mediated disease of peripheral nerves and nerve roots that is usually triggered by infections. The incidence of GBS can therefore increase during outbreaks of infectious diseases, as was seen during the Zika virus epidemics in 2013 in French Polynesia and...
Source: The American Journal of Emergency Medicine - August 4, 2020 Category: Emergency Medicine Authors: Alexandria C. Defabio, Thomas R. Scott, Robert T. Stenberg, Erin L. Simon Source Type: research

High-flow oxygen and pro-serotonin agents for non-interventional treatment of post-dural-puncture headache
Post dural puncture headache (PDPH) is a common complication in patients following diagnostic or therapeutic lumbar puncture, procedures requiring epidural access, and spinal surgery. Epidural blood patch (EBP), the gold standard for the treatment of this pathology requires training not provided to emergency physicians. In addition, the presence of concomitant pathology and abnormal laboratory values are contraindications to perform EBP. In presence of these limitations, we sought for a non-interventional management of PDPH utilizing high-flow oxygen and pro-serotonin agents. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 3, 2020 Category: Emergency Medicine Authors: Carlos J. Roldan, Matthew Chung, Correa MC, J. Cata, Huh B Source Type: research

The association between neuromuscular blockade use during target temperature management and neurological outcomes
To date, no study has comprehensively analyzed the association between neuromuscular blockade (NMB) during target temperature management (TTM) and the neurological outcomes after out-of-hospital cardiac arrest (OHCA) using a multicenter dataset. We aimed to examine the association between NMB during TTM after cardiac arrest and neurological outcomes after OHCA. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 3, 2020 Category: Emergency Medicine Authors: Toru Hifumi, Akihiko Inoue, Hideki Arimoto, Naohiro Yonemoto, Yasuhiro Kuroda, Yoshio Tahara, Kenya Kawakita, Hiroyuki Yokoyama, Ken Nagao, Hiroshi Nonogi, the J-PULSE-Hypo Investigators Source Type: research

Sunitinib-associated hyperammonemic encephalopathy
has not been previously reported in the emergency medicine literature. As newer treatments for cancer become more widespread and patients live longer, the emergence of previously unreported or rare adverse effects is expected to increase. Here we report the case of a 71-year-old woman with infiltrating ductal carcinoma of the breast with metastasis to the liver who developed hyperammonemic encephalopathy after taking sunitinib for 12  days. She presented to the emergency department (ED) with confusion and the initial workup revealed an elevated ammonia level (202 μmol/L; reference range, 11–51 μmol/L) wi...
Source: The American Journal of Emergency Medicine - August 3, 2020 Category: Emergency Medicine Authors: Demis N. Lipe, Besim Hoxha, Sunil K. Sahai Source Type: research

Exhaled end-tidal carbon dioxide as a predictor of lactate and pediatric sepsis
The objective of this study was to investigate the relationship between exhaled end-tidal carbon dioxide (ETCO2) and serum lactate via nasal capnography and to assess the ability of ETCO2 to predict disease severity in children with suspected sepsis in a pediatric emergency department. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 1, 2020 Category: Emergency Medicine Authors: Matthew Cully, Michael Treut, Amy D. Thompson, Andrew D. DePiero Source Type: research

End-of-life care provided in emergency medical system in Japan.
Japan has been experiencing population aging to an unprecedented degree, with a rapid increase in the number of people aged 75  years and above. It reached 14.2% of the total population in 2018 and is estimated to reach 20% (about 22 million) by 2040 [1,2]. This aging of the population has burdened the healthcare system by increasing the overall medical costs. In response to this issue, the Japanese government has initiat ed a policy reform to shift from a facility- to a community-based integrated care system [3]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 31, 2020 Category: Emergency Medicine Authors: Takahiro Onuki, Shinji Nakahara, Takashi Fujita, Yasuhiro Miyake, Tetsuya Sakamoto Source Type: research

A visually striking case of primary acrocyanosis: A rare cause of the blue digit
We present a case of a 24-year-old female who presented to the Emergency Department with peripheral cyanosis after cold exposure and was eventually diagnosed with primary acrocyanosis by Rheumatology. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 31, 2020 Category: Emergency Medicine Authors: Jessica T. Kent, David Carr Source Type: research

Thrombolysis in severe COVID-19 pneumonia with massive pulmonary embolism
We present a COVID-19 patient with refractory acute respiratory syndrome (ARDS), and life-threatening PE who underwent successful thrombolysis. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 30, 2020 Category: Emergency Medicine Authors: Abdulrahman Alharthy, Fahad Faqihi, John Papanikolaou, Abdullah Balhamar, Mike Blaivas, Ziad A. Memish, Dimitrios Karakitsos Source Type: research

Effect of Chinese medicine for promoting blood circulation on microvascular angina: A systematic review and meta-analysis
This study aims to summarize relevant evidence from randomized controlled trials (RCTs) to assess the efficacy and safety of BADs in the treatment of microvascular angina. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 29, 2020 Category: Emergency Medicine Authors: Li Zhong, Jieqin Zhuang, Zilin Jin, Yanhong Chen, Bojun Chen Source Type: research

Vertical nystagmus as isolated presentation in a patient with new diagnosis of multiple sclerosis
We present a healthy young woman who came to the Emergency Department with two days of isolated vertical nystagmus and was subsequently diagnosed with MS on imaging. Although bilateral vertical nystagmus is not a common presentation of MS, its presence should prompt inclusion of this disease process in the differential diagnosis. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 29, 2020 Category: Emergency Medicine Authors: Daniel M. Imas, Ellen L. Duncan, Ee Tein Tay Source Type: research

A novel approach: Point-of-care ultrasound for the diagnosis of retropharyngeal abscess
Deep space neck infections in children, specifically retropharyngeal abscesses (RPA), are uncommon. Retropharyngeal abscesses are generally a disease of young children, peaking between 2 and 4  years of age, although can be seen at any age [1]. They are most commonly seen secondary to a preceding infection, though can result from trauma [2]. Failure to recognize and appropriately treat can have potentially serious sequelae. Complications range from airway obstruction, sepsis, and spread to other deep neck spaces or structures such as the internal jugular vein, carotid artery, or mediastinum [3]. (Source: The American Jou...
Source: The American Journal of Emergency Medicine - July 29, 2020 Category: Emergency Medicine Authors: Laurie Malia, Adam Sivitz, Henry Chicaiza Source Type: research

Erythema nodosum-like rash in a COVID-19 patient: A case report
We describe a case of a female patient who presented with an Erythema Nodosum-like exanthema likely secondary to COVID-19. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 29, 2020 Category: Emergency Medicine Authors: Nicole SipfleDO, Rachel E. BridwellMD, Jamie RoperDO Source Type: research

Spontaneous hemopneumothorax in a patient with COVID-19: A case report
Coronavirus disease 2019 (COVID-19) is primarily a febrile respiratory illness that was first documented in China in December 2019 and shortly after declared a pandemic on March 11, 2020. The pathophysiology of the virus is still not completely understood and remains under investigation. Consequently, new symptomatic manifestations and complications of the disease continue to be discovered. Here we present the case of a spontaneous hemopneumothorax resulting in hemorrhagic shock in an adult male with PCR confirmed COVID-19. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 29, 2020 Category: Emergency Medicine Authors: Ann Long, Felipe Grimaldo Source Type: research

Spontaneous pneumomediastinum in a male adult with COVID-19 pneumonia
Spontaneous pneumomediastinum is a rare complication of viral pneumonia. Here we report a case of a 52  year old male who presented with a spontaneous pneumomediastinum in COVID-19 pneumonia, followed by a severe course of disease. We discuss the pathophysiological mechanisms underlying this association as well as its possible clinical implications as a marker of disease severity in COVID-19. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 29, 2020 Category: Emergency Medicine Authors: Joris Janssen, Marlijn J.A. Kamps, Tamara M.B. Joosten, Dennis G. Barten Source Type: research

Concerns with use of drape/patient covering during potentially aerosolizing procedures
I read with great interest an article by Bryant Allen et al. [1] where they provide recommendations for use of drape/patient covering during potentially aerosolizing procedures. After going through the article few things remain unaddressed. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 29, 2020 Category: Emergency Medicine Authors: Bharat Paliwal, Anamika Purohit Source Type: research

Use of high-flow nasal cannula and noninvasive ventilation in patients with COVID-19: A multicenter observational study
The use of high-flow nasal cannula (HFNC) and noninvasive ventilation (NIV) in patients with COVID-19 is debated. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 29, 2020 Category: Emergency Medicine Authors: Jun Duan, Baixu Chen, Xiaoyi Liu, Weiwei Shu, Wei Zhao, Ji Li, Yishi Li, Yueling Hong, Longfang Pan, Ke Wang Source Type: research

Emergency physicians' active patient queues over the course of a shift
When emergency physicians see new patients in an ad libitum system, they see fewer patients as the shift progresses. However, it is unclear if this reflects a decreasing workload, as patient assessments often span many hours. We sought to investigate whether the size of a physician's queue of active patients similarly declines over a shift. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 28, 2020 Category: Emergency Medicine Authors: Joshua W. Joseph, Samuel Davis, Elissa H. Wilker, Benjamin A. White, Ori Litvak, Larry A. Nathanson, Leon D. Sanchez Source Type: research

Toxic leukoencephalopathy –When a Boxer's fracture requires an MRI and LP
This case report describes a young patient presenting to the ED with altered mental status several days after being diagnosed with a Boxer's fracture and ultimately discovered to have toxic leukoencephalopathy. We review the clinical features in his presentation leading to his diagnosis, as well as MRI imaging findings frequently found in his condition. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 28, 2020 Category: Emergency Medicine Authors: Jeffrey Mayer, Lucy Willis Source Type: research

Emergency department providers knowledge, attitudes, and beliefs towards firearm ownership and reporting
Recent mass shootings sparked debate about early flagging of individuals who exhibit violent behavior to reduce firearm injuries using “red flag” laws. At-risk individuals may be reported to third parties and become temporarily or permanently ineligible to possess firearms under existing “red-flag” laws in 19 states. Emergency Department (ED) physicians are in a unique position to combat firearm violence as first-line repor ters of red flag situations. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 27, 2020 Category: Emergency Medicine Authors: Aidan L. Neustadtl, Alicia Kaneb, Alan D. Neustadtl, David Milzman Source Type: research

Assessing the impact of CKD on outcomes in septic shock patients receiving standard Vs reduced initial fluid volume
To determine if following fluid resuscitation recommendations in the Surviving Sepsis Campaign guidelines affects hospital length of stay (LOS) in chronic kidney disease (CKD) patients who present to the emergency department with sepsis-induced hypotension or septic shock. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 27, 2020 Category: Emergency Medicine Authors: DevinM. Rice, Patrick D. Ratliff, W. Russ Judd, Samer A. Kseibi, Kip A. Eberwein Source Type: research

Unenhanced computed tomography (CT) utility for triage at the emergency department during COVID-19 pandemic
Unenhanced chest computed tomography (CT) can assist in the diagnosis and classification of coronavirus disease 2019 (COVID-19), complementing to the reverse-transcription polymerase chain reaction (RT-PCR) tests; the performance of which has yet to be validated in emergency department (ED) setting. The study sought to evaluate the diagnostic performance of chest CT in the diagnosis and management of COVID-19 in ED. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 27, 2020 Category: Emergency Medicine Authors: Ioannis Skalidis, Vinh Kim Nguyen, Hugo Bothorel, Lauriane Poli, Rui Ribeiro Da Costa, Alain Bigin Younossian, Nicole Petriccioli, Omar Kherad Source Type: research

Editorial Board
(Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 25, 2020 Category: Emergency Medicine Source Type: research

Toc
(Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 25, 2020 Category: Emergency Medicine Source Type: research

Info for authors
(Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 25, 2020 Category: Emergency Medicine Source Type: research

Quick cuts: A comparative study of two tools for ring tourniquet removal
Ring tourniquet occurs when a ring becomes entrapped due to swelling or trauma. As the finger expands the blood flow restriction causes additional swelling, which can lead to nerve damage and other complications. Ring tourniquet can be an emergency that requires rapid ring removal. Standard devices for ring removal have been described but rarely tested. We conducted a randomized study to compare removal time, user and participant satisfaction and complications between a motorized diamond disc ring cutter (MDDRC) and a ring cutter attached to trauma shears (TS). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 25, 2020 Category: Emergency Medicine Authors: Joseph Walter, Michael DeBoer, Jenny Koops, Lydia L. Hamel, Paula E. Rupp, Bjorn C. Westgard Source Type: research

Micropuncture kits for difficult vascular access
We would like to propose a technique using a 5-Fr micropuncture kit to obtain vascular access in critically ill patients who are at high risk for immediate procedural complications. The ability to obtain rapid vascular access, both arterial and venous, is a critical skill in emergency medicine [1]. Emergent vascular access may be challenging because of the patient's body habitus, anatomical deformities, agitation or altered mental status, intravascular volume loss, and hemodynamic status. These unpredictable factors turn an otherwise routine procedure into a lengthy and complicated one that exposes the patient to multiple ...
Source: The American Journal of Emergency Medicine - July 25, 2020 Category: Emergency Medicine Authors: Tim Montrief, Mark Ramzy, Brit Long Source Type: research

Incidence of prescription errors in patients discharged from the emergency department
The Emergency Department (ED) is known for its high rates of medication errors secondary to many characteristics such as unfamiliar patients, lack of continuity of care, increasing patient volumes, reliance on verbal orders, and fewer safety mechanisms. The purpose of this study was to quantify and characterize the medication errors that occur in patients discharged from the ED. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 25, 2020 Category: Emergency Medicine Authors: Haili Gregory, Morgan Cantley, Chara Calhoun, Gregory A. Hall, Andrew J. Matuskowitz, Kyle A. Weant Source Type: research

Signs of early cardiac tamponade induced by Minoxidil
Minoxidil is an antihypertensive that works by directly dilating peripheral vessels. This medication is typically reserved for patients with resistant hypertension, whose blood pressure remains above goal despite being on multiple agents. A rare but potentially dangerous side effect of Minoxidil is drug-induced pericardial effusion. Here we report a case of a patient who was taking Minoxidil and subsequently developed a large pericardial effusion, with concerns for impending cardiac tamponade. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 24, 2020 Category: Emergency Medicine Authors: Monique Oye, Melissa Oye, Aleem Ali Source Type: research

Optimizing emergency department care transitions to outpatient settings: A systematic review and meta-analysis
Suboptimal transitions from the emergency department (ED) to outpatient settings can result in poor care continuity, and subsequently higher costs to the healthcare system. We aimed to systematically review care transition interventions (CTIs) for adult patients to understand how effective ED-based CTIs are in reducing return visits to the ED and increasing follow-up visits with primary care physicians. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 23, 2020 Category: Emergency Medicine Authors: Fariba Aghajafari, Sayeeda Sayed, Nader Emami, Eddy Lang, Joanna Abraham Source Type: research

Medication shortages during the COVID-19 pandemic: Saving more than COVID lives
In the United States (US) alone, 3,302,194 cases and 135,171 deaths due to COVID-19 have been confirmed as of July 12th, 2020 [1]. To put this in perspective, from 2018 –2019, the CDC estimated there were approximately 35,500,000 cases and 34,200 deaths due to influenza [2]. These statistics correspond to a case-fatality ratio (CFR), the number of deaths divided by the total number of confirmed cases, that is nearly 40 times that of influenza in the case of COVID -19 (CFR 0.1% and 4.0%, respectively). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 23, 2020 Category: Emergency Medicine Authors: Brendon Sen-Crowe, Mark McKenney, Adel Elkbuli Source Type: research

Temporal trends in out-of-hospital cardiac arrest during the COVID-19 outbreak
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), responsible for the coronavirus disease 2019 (COVID-19), overwhelmed worldwide healthcare systems requiring abrupt changes in hospitals reorganization and human resources allocation. Recent literature data demonstrated a global reduction of hospitalizations for acute myocardial infarction [1] and urgent pacemaker implantations [2], mainly related to the fear of COVID-19 infection, with consequent development of life-threating complications due to delayed treatment. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 23, 2020 Category: Emergency Medicine Authors: Antonio Landi, Stefano De Servi Source Type: research

Flank pain and hematuria is not always a kidney stone
We present a case of a patient with hematuria and flank pain typical of nephrolithiasis who was diagnosed with a Page kidney causing secondary hypertension.A 50  year-old male with no significant past medical history presented to the Emergency Department with severe left-sided flank pain, vomiting, and blood-tinged urine. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 23, 2020 Category: Emergency Medicine Authors: Lisa Feit, Delna John, Nayla Delgado Torres, Richard Sinert Source Type: research

Systemic thrombolysis for refractory cardiac arrest due to presumed myocardial infarction
We report a case of successful resuscitation after protracted OHCA with suspected non-PE cardiac etiology, with favorable neurological outcome after empiric administration of systemic thrombolysis.A 47-year-old male presented to the emergency department (ED) after a witnessed OHCA with no bystander cardiopulmonary resuscitation (CPR). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 23, 2020 Category: Emergency Medicine Authors: Joseph A. Hamera, Noah B. Bryant, Mark S. Shievitz, David A. Berger Source Type: research

Pulmonary embolism in COVID-19: Clinical characteristics and cardiac implications
The thrombogenic potential of Covid-19 is increasingly recognised. We aim to assess the characteristics of COVID-19 patients diagnosed with pulmonary embolism (PE). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 23, 2020 Category: Emergency Medicine Authors: Jason Kho, Adam Ioannou, Koenraad Van den Abbeele, Amit K.J. Mandal, Constantinos G. Missouris Source Type: research

Strategies to prevent COVID-19 transmission in the emergency department of a regional base hospital in Korea: From index patient until pandemic declaration
This study aimed to describe the timely strategies used to prevent the spread of the emerging coronavirus disease 2019 (COVID-19) and present the activities performed in a regional base hospital in South Korea, from the identification of the index patient until the pandemic declaration. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 23, 2020 Category: Emergency Medicine Authors: Jong-Hak Park, Seong-Geun Lee, Sejoong Ahn, Joo Yeong Kim, Juhyun Song, Sungwoo Moon, Hanjin Cho Source Type: research

Early initiation of extracorporeal membrane oxygenation (ECMO) in emergency department to rescue severe diffuse alveolar hemorrhage —A case report
This article reports successful early initiation of veno-venous extracorporeal membrane oxygenation (V-V ECMO) in an emergency department to rescue an adult patient with diffuse alveolar hemorrhage caused by viral pneumonia. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 23, 2020 Category: Emergency Medicine Authors: Lei Zhang, Caiwei Lin, Lina Liu, Xudong Wang Source Type: research

The efficacy of tranexamic acid for brain injury
I have read the article titled “The efficacy of tranexamic acid for brain injury: A meta-analysis of randomized controlled trials” published by Chen et al. [1] with great interest. The authors conducted a meta-analysis to investigate the efficacy of tranexamic acid for traumatic brain injury. They collected six randomized con trolled trials (RCTs) and pooled risk ratios (RRs) (95% confidence intervals [CIs]) of tranexamic acid for mortality and growth of hemorrhagic mass were 0.91 (0.85 to 0.97) and 0.78 (0.61 to 0.99), respectively. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 23, 2020 Category: Emergency Medicine Authors: Tomoyuki Kawada Source Type: research

Dead in the air? Case report highlighting need to adapt to CoVID adaptations
During the recent CoVID-19 pandemic, airway management recommendations have been provided to decrease aerosolization and risk of viral spread to healthcare providers. High efficiency particulate air (HEPA) viral filters and adaptors are one way to decrease the risk of aerosolization during intubation. When placed proximal to the ventilator circuit, these viral filters and adaptors can create a significant amount of dead space, which in our smallest patients can significantly impact effective ventilation. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 23, 2020 Category: Emergency Medicine Authors: Nicholas A. Kuehnel, R.T. Rhonda Yngsdal-Krenz, Joshua M. Glazer Source Type: research