Fasciculating toxicity
We describe here a case of 19-year old girl who presented to the Emergency Department with atypical features of OP poisoning. She had perioral, tongue and lower limb fasciculations along with generalized muscle weakness with no or minimal muscarinic effects. OP poisoning with isolated nicotinic receptor mediated effect is often reported in children but in adult it is extremely rare. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 21, 2019 Category: Emergency Medicine Authors: Anupam Ranjan, Nayer Jamshed, Praveen Aggarwal, Vibhor Upadhyay Tags: Case Report Source Type: research

Agreement between arterial and peripheral venous lactate levels in the ED: A systematic review
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. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 21, 2019 Category: Emergency Medicine Authors: A.J. van Tienhoven, C.A.J. van Beers, C.E.H. Siegert Tags: Review Source Type: research

Factors associated with the provision of targeted temperature management: A balanced factorial experiment
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. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 19, 2019 Category: Emergency Medicine Authors: DongHyun Lee, Ki Ok Ahn, Joohyun Suh, Si Young Jung Source Type: research

Adult emergency department referrals from urgent care centers
Although urgent care centers (UCCs) can often evaluate and treat minor injuries/illnesses, patients may present with life threatening conditions that require immediate recognition, stabilization, and transfer to a higher level of care, beyond the capabilities of most UCCs. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 17, 2019 Category: Emergency Medicine Authors: Isaac Siegfried, Jennifer Jacobs, Robert P. Olympia Source Type: research

Prevalence of attention deficit hyperactivity disorder (ADHD) in children presenting with foreign body ingestion
Foreign body ingestion is a common condition in children. We aimed to compare the incidence of attention deficit hyperactivity disorder (ADHD) symptoms in children that ingested foreign bodies with healthy children. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 17, 2019 Category: Emergency Medicine Authors: Kas ım Turgut, Mehmet Kaan Poyraz, Ebru Sekmen, İrfan Aydın, Abdullah Algın, Erdal Yavuz Source Type: research

The author responds: MS 19440
I sincerely appreciate your interest in our work, and I thank you for the questions about our paper. In our study we retrospectively reviewed clinical data of 1156 patients presented to our ED for several clinical condition non-related to trauma, and build a score for positive cranial CT scan prediction in the ED setting. We furtherly validated our score on a prospective population of 508 patients. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 16, 2019 Category: Emergency Medicine Authors: Marcello Covino, Emanuele Gilardi, Benedetta Simeoni Source Type: research

Perceived vs. actual distractions in the emergency department
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. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 16, 2019 Category: Emergency Medicine Authors: Michelle Shiao-Bin Eng, Kyle Fierro, Shauna Abdouche, Daohai Yu, Kraftin E. Schreyer Source Type: research

Moderate brain hypothermia started before resuscitation improves survival and neurobehavioral outcomes after CA/CPR in mice
We examined the effects of moderate brain hypothermia before resuscitation on survival and histopathological and neurobehavioral outcomes in a mouse model. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 16, 2019 Category: Emergency Medicine Authors: Mun-Sun Jang, Se Kwang Oh, Suk Woo Lee, Seong-Hae Jeong, Hoon Kim Source Type: research

Attitudes of firefighters towards the use of supraglottic airways devices
In the article “Advanced airway management in out of hospital cardiac arrest: A systematic review and meta-analysis” by White et al. published in The American Journal of Emergency Medicine, the authors indicate that the overall heterogeneous benefit in survival with ETT was not replicated in the low risk rando mized controlled trials, with no significant difference in survival or neurological outcome [1]. It is worth noting that endotracheal intubation is a highly specialized procedure, requiring from the person performing it a lot of knowledge and skills in its use. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 16, 2019 Category: Emergency Medicine Authors: Kurt Ruetzler, Agnieszka Madziala, Marcin Madziala, Michal Pruc, Dominika Dunder Tags: Correspondence Source Type: research

The author responds: The need for prospective studies of cranial CT for ED head trauma patients
I sincerely appreciate your interest in our work, and I thank you for the questions about our paper. In our study we retrospectively reviewed clinical data of 1156 patients presented to our ED for several clinical condition non-related to trauma, and build a score for positive cranial CT scan prediction in the ED setting. We furtherly validated our score on a prospective population of 508 patients. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 16, 2019 Category: Emergency Medicine Authors: Marcello Covino, Emanuele Gilardi, Benedetta Simeoni Source Type: research

The Emergency Medical Treatment and Active Labor Act (EMTALA): Assisting physicians to honor medical oaths
Oath-taking in medical education is an integral part of becoming a physician. One hundred percent of medical schools confirm the practice of oath-taking amongst their medical students [1]. Central to these medical oaths is the principle of non-discrimination [2]. The value that all patients should be treated equally is fundamental to the practice of a physician. Emergency medicine is unique due to the passage of the Emergency Medical Treatment and Active Labor Act (EMTALA), that while protecting patients, can also assist physicians in upholding their non-discriminatory oath. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 15, 2019 Category: Emergency Medicine Authors: Kimberly Gressick, Jennifer S. Jackson Source Type: research

Antibiotic stewardship: The treatment of uncomplicated lower limb cellulitis
Cellulitis commonly causes patient emergency department visits and hospital admits in the United States. Since the emergence of Methicillin-resistant Staphylococcus aureus (MRSA) infections, many practitioners are reluctant to take a conservative approach to treating cellulitis. Some studies have shown an incidence as high as 204 cases per 100,000 people for emergency department cellulitis visits [1,2]. The expense of these visits is vast and places avoidable strain on health care dollars. The average hospital stay (5  days) for patients treated for cellulitis costs roughly $7341 [1,3]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 15, 2019 Category: Emergency Medicine Authors: William David Boothe, Dayna Diven Source Type: research

What pediatric intubation technique is most optimal for direct laryngoscopy? Pilot data
Endotracheal intubation has for many years been recognized as the gold standard for airway management [1]. However, as with any procedure, it requires appropriate training [2]. The average learning curve for direct laryngoscopy as shown by studies of Buis et al. is about 50 endotracheal intubations [3]. Studies by Aghamohammadi et al. have shown that the learning curve for videolaryngoscopy is much shorter than for direct laryngoscopy [4]. However, due to the high cost of a videolaryngoscope, standard laryngoscopes with Miller or Macintosh blades are the main type of devices used for endotracheal intubation in the operatin...
Source: The American Journal of Emergency Medicine - January 15, 2019 Category: Emergency Medicine Authors: Kurt Ruetzler, Damian Gorczyca, Tadeusz Plusa, Dominika Dunder, Kacper Kranc Source Type: research

Respiratory adjusted shock index for identifying occult shock and level of Care in Sepsis Patients
Early identification of shock allows for timely resuscitation. Previous studies note the utility of bedside calculations such as the shock index (SI) and quick sepsis-related organ failure assessment (qSOFA) to detect occult shock. Respiratory rate may also be an important marker of occult shock. The goal of our study was to evaluate whether using a modified SI with respiratory rate would improve identification of emergency department sepsis patients admitted to an ICU or stepdown unit. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 15, 2019 Category: Emergency Medicine Authors: Lynn Jiang, Nicholas D. Caputo, Bernard P. Chang Source Type: research

Diagnostic accuracy of presepsin for sepsis by the new Sepsis-3 definitions
Early diagnosis of sepsis in the Emergency Department and intensive care unit (ICU) is important when treating septic patients. Novel biomarkers of sepsis have been developed and are being widely adopted in clinical settings. Among them, procalcitonin (PCT) has been widely used as biomarker in septic patients but has limited specificity. It increases transiently in patients with non-septic conditions and systemic inflammatory response syndromes (SIRS) (e.g., trauma, surgery, and heatstroke) [1]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 15, 2019 Category: Emergency Medicine Authors: Tomonori Yamamoto, Tetsuro Nishimura, Shinichiro Kaga, Kenichiro Uchida, Yosuke Tachibana, Maiko Esaki, Wakaba Fukushima, Kyoko Kondo, Yasumitsu Mizobata Source Type: research

Food dependent exercise induced anaphylaxis triggered by inhaled antigen
SS, a 23-year-old male professional bike racer, was competing in bicycle race in Southern California. He had been in his usual state of health, on his normal diet and is not on any medications. Medical history is significant only for an allergy to peanuts. He has been previously tested by his allergist and has no other allergies. In the final 20  km of a 180 km race, he rode through an almond orchard in full bloom. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 14, 2019 Category: Emergency Medicine Authors: Mark Greve Source Type: research

The diagnostic efficacy of cardiac CTA combined with D-dimer assay for the detection of left atrial thrombus in patients with atrial fibrillation
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. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 14, 2019 Category: Emergency Medicine Authors: Xin Du, Yutang Wang Source Type: research

Comparison of intravenous NSAIDs and trigger point injection for low back pain in ED: A prospective randomized study
Low back pain (LBP) is a common complaint originating from muscles.Myofascial pain syndrome (MPS) is mainly associated with trigger points (TrP) in the muscle tissue. We compared the intravenously administered non-steroidal anti-inflammatory drug (NSAID) and trigger point injection (TPI) in the treatment of LBP patients admitted to the emergency department due to pain caused by TrPs. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 14, 2019 Category: Emergency Medicine Authors: Abdullah Osman Kocak, Ali Ah ıskalıoglu, Emre Sengun, Sultan Tuna Akgol Gur, Ilker Akbas Source Type: research

Comparison of Quick Track ™ and Melker™ for emergent invasive airway management in Simulated Obese Model
Emergent cricothyrotomy is the final step in managing difficult airways [1,2]. The Quick Trach II ™ (QT; VBM Medizintechnik GmbH, Sulz am Neckar, Germany) was developed for direct placement in the trachea using the catheter-over-needle technique. In contrast, the Melker Set™ (Melker; Cook Group Incorporated, Bloomington, IN) uses a guide-wire for placing the cannula with the Seldinger method . It remains controversial which of direct placement or the Seldinger method is optimal for invasive airway management. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 14, 2019 Category: Emergency Medicine Authors: Mamiko Higashida, Nobuyasu Komasawa, Haruki Kido, Toshiaki Minami Tags: Correspondence Source Type: research

Consent for emergency treatment: Emergency department patient recall and understanding
This study was undertaken to identify patient recall and understanding of the emergency department (ED) Consent for Treatment document. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 14, 2019 Category: Emergency Medicine Authors: Catherine A. Marco, Ashley LaFountain, Ashwatha Thenappan, Daniel E. Ross Source Type: research

A case with an unusual cause of syncope: Thyrotoxicosis
Syncope is a common emergency department chief complaint, with many known but also unknown causes. Here we present a novel emergency department (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. Persistent tachycardia during her ED course after an unremarkable full trauma evaluation prompted ordering of additional lab testing, which revealed evidence of thyrotoxicosis. (Source: The American Journal ...
Source: The American Journal of Emergency Medicine - January 14, 2019 Category: Emergency Medicine Authors: Andrew Kaddis, Thomas Tellez Source Type: research

Massage-induced spinal epidural hematoma presenting with delayed paraplegia
Spinal epidural hematoma (SEH) is an uncommon but serious emergency condition rare cases of spontaneously or following a minor traumatic event without bony injury. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 14, 2019 Category: Emergency Medicine Authors: Alissara Vanichkulbodee, Pholaphat Charles Inboriboon, Suwara Issaragrisil Source Type: research

Thyrotoxicosis: an unusual cause of syncope
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. Persistent tachycardia during her ED course after an unremarkable full trauma evaluation prompted ordering of additional lab testing, which revealed evidence of thyrotoxicosis. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 14, 2019 Category: Emergency Medicine Authors: Andrew Kaddis, Thomas Tellez Tags: Case Report Source Type: research

Standard dose epinephrine versus placebo in out of hospital cardiac arrest: A systematic review and meta-analysis
Out of hospital cardiac arrest (OHCA) is a time critical and heterogeneous presentation. The most appropriate management strategies remain an issue for debate. The aim of this systematic review and meta-analysis was to determine the association of epinephrine versus placebo with return of spontaneous circulation, survival to hospital admission, survival to hospital discharge and neurological outcomes in out of hospital cardiac arrest. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 11, 2019 Category: Emergency Medicine Authors: Hannah Kempton, Ruan Vlok, Christopher Thang, Thomas Melhuish, Leigh White Tags: Reviews Source Type: research

Traumatic cervical fusion hardware displacement presenting with dysphagia and dysphonia
We report the case of a woman with new dysphagia and hoarseness secondary to traumatic screw dislodgement into her pre-vertebral space 5  months after cervical discectomy. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 11, 2019 Category: Emergency Medicine Authors: Valerian Peterson, Rebecca Jeanmonod Source Type: research

Pentraxin-3: A strong novel biochemical marker for appendicitis in children
Appendicitis is the most common surgical disease evaluated by pediatric surgeons in the emergency department. Despite the history, physical examination, laboratory tests and imaging methods, the misdiagnosis may be observed often in children. Pentraxin-3 (PTX-3) is an acute phase protein which is produced directly in the inflammatory tissue. Our aim was to investigate the diagnostic value of PTX-3 levels in appendicitis in pediatric patients and compare it with the other serum parameters. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 11, 2019 Category: Emergency Medicine Authors: Mustafa Onur Oztan, Aysegul Aksoy Gokmen, Tunc Ozdemir, Tuba M üderris, Selcuk Kaya, Gokhan Koyluoglu Source Type: research

Priapism following erector spinae plane block for the treatment of a complex regional pain syndrome
We report the case of a patient treated with ESPB for a complex regional pain syndrome, complicated by the development of a priapism. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 11, 2019 Category: Emergency Medicine Authors: Abdelghafour Elkoundi, Zakarya Eloukkal, Mustapha Bensghir, Lahcen Belyamani Source Type: research

Four-factor prothrombin complex concentrate for the reversal of factor Xa inhibitors for traumatic intracranial hemorrhage
The objective of this study was to determine the effectiveness and safety of four-factor prothrombin complex concentrate (4F-PCC) for the reversal of factor Xa inhibitors in patients with traumatic intracranial hemorrhage (ICH). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 9, 2019 Category: Emergency Medicine Authors: Daniel Dybdahl, Grant Walliser, M. Chance Spalding, Michelle Pershing, Michelle Kincaid Source Type: research

A comparison of call volumes before, during, and after Hurricane Harvey
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. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 9, 2019 Category: Emergency Medicine Authors: Andrew S. Crutchfield, Kent Alan Harkey Source Type: research

Pre-hospital mechanical ventilation in septic shock patients
Mechanical ventilation can cause deleterious effects on the lung and thus alter patient's prognosis.The aim of this study was to describe the characteristics of prehospital mechanical ventilation in patients with septic shock requiring mechanical ventilation in the prehospital setting. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 7, 2019 Category: Emergency Medicine Authors: Romain Jouffroy, Anastasia Saade, Antoine Pegat-Toquet, Pascal Philippe, Pierre Carli, Beno ît Vivien Source Type: research

Protective effects of minocycline, doxycycline and tetracycline on seizure and lethality in a mice cocaine toxicity model
Acute cocaine intoxication is one of the important causes of admission to emergency department, especially in western countries. We aimed to compare the efficacies of tetracycline, minocycline, doxycycline in the prevention of seizures and deaths in mice due to cocaine intoxication. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 7, 2019 Category: Emergency Medicine Authors: Tar ık Bektas, Bulent Erdur, Atakan Yilmaz, Aykut Yuksel, Hasan Avci, Mert Ozen, Aykut Uyanik Source Type: research

Antipsychotics for the treatment of sympathomimetic toxicity: A systematic review
Benzodiazepines are often recommended first-line for management of cocaine and amphetamine toxicity while antipsychotic treatment is discouraged due to the potential for lowering seizure threshold, prolonging the QT interval, and decreasing heat dissipation. We performed a systematic review including animal and human studies to elucidate the efficacy and safety of antipsychotics in managing sympathomimetic toxicity specifically evaluating the effect of treatment on mortality, seizures, hyperthermia, and cardiovascular effects. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 6, 2019 Category: Emergency Medicine Authors: Nicholas J. Connors, Ahmed Alsakha, Alexandre Larocque, Robert S. Hoffman, Tara Landry, Sophie Gosselin Source Type: research

Aggressive imaging protocol for hanging patients yields no significant findings
Despite rising rates of hanging injuries, few high-quality data and no national trauma guidelines are available to standardize the evaluation of these patients. We sought to identify the yield of imaging hanging patients at our institution. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 4, 2019 Category: Emergency Medicine Authors: Samuel Schuberg, Nachiketa Gupta, Kaushal Shah Source Type: research

Benzodiazepines vs barbiturates for alcohol withdrawal: Analysis of 3 different treatment protocols
The objective of this study is to describe the effectiveness and safety of our institutional protocols during three time periods utilizing benzodiazepines and barbiturates for the acute treatment of alcohol withdrawal in the emergency department. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 3, 2019 Category: Emergency Medicine Authors: Amelia C. Nelson, Joy Kehoe, Jeffrey Sankoff, David Mintzer, Julie Taub, Kevin A. Kaucher Source Type: research

Nighttime is associated with decreased survival for out of hospital cardiac arrests: A meta-analysis of observational studies
The relationship between time of day and the clinical outcomes of patients with out-of-hospital cardiac arrest (OHCA) remains inconclusive. We undertook a meta-analysis to assess the available evidence on the relationship between nighttime and prognosis for patients with OHCA. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 3, 2019 Category: Emergency Medicine Authors: Ping Lin, Fangyu Shi, Lei Wang, Zongan Liang Source Type: research

An evidence-based narrative review of the emergency department evaluation and management of rhabdomyolysis
Rhabdomyolysis is a medical condition caused by muscle breakdown leading to potential renal damage. This can lead to significant morbidity and mortality if not rapidly identified and treated. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 2, 2019 Category: Emergency Medicine Authors: Brit Long, Alex Koyfman, Michael Gottlieb Tags: Reviews Source Type: research

Optimal treatment modality for coexisting acute myocardial infarction and ischemic stroke
We present a rare case of coexisting thrombosis of the coronary artery and mid cerebral artery that was managed successfully with tissue plasminogen activator thrombolytic therapy. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 31, 2018 Category: Emergency Medicine Authors: Fatih Gungoren, Feyzullah Besli, Zulkif Tanriverdi, Ozcan Kocaturk Source Type: research

Preference for opioids in emergency department patients with acute musculoskeletal pain
Public awareness of the opioid epidemic is increasing nationally, emphasizing the need to develop methods to reduce opioid use. We determined patient preference for analgesics before and after a brief educational intervention informing them of the risks and benefits of opioids versus non-steroidal anti-inflammatory drugs (NSAID's). We hypothesized 50% of patients would prefer opioids pre-intervention and that this would be reduced by the intervention by at least 15%. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 29, 2018 Category: Emergency Medicine Authors: Cooper Swenson, Nishant Prashar, Alyssa Mangino, Henry C. Thode, Adam J. Singer Source Type: research

Cranial CT of nontrauma emergency department patients
I have greatly enjoyed reading the recently published article by Covino et al. [1]. In this retrospective study, the authors evaluated 1156 patients presenting to the ED for neurological deficit, postural instability, acute headache, altered mental status, seizures, confusion, dizziness, vertigo, syncope, and pre-syncope. The authors built a score for positive cranial computed tomography prediction by using a logistic regression model on clinical factors significant at univariate analysis. I congratulate the authors for their successful article. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 29, 2018 Category: Emergency Medicine Authors: Arsal Acarba ş Tags: Correspondence Source Type: research

Association of optic nerve sheath diameter measurement withhyponatremia in emergency department
Investigation of association of ONSD with hyponatremia in symptomatic patients. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 28, 2018 Category: Emergency Medicine Authors: Tayfun An ıl Demir, Fevzi Yılmaz, Bedriye Müge Sönmez, Mehmet Akif Karadaş, Resmiye Nur Okudan, Olgun Keskin Source Type: research

Choosing wisely in the ED: The diagnostic cascade of needless medical testing in a two-level study
The diagnostic cascade in the emergency department (ED) has not been fully elucidated.AimTo inspect whether the usage of consulting medicine and imaging contributes to hospital outcomes. We also propose a theoretical model for better understanding the diagnostic cascade of needless medical testing. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 28, 2018 Category: Emergency Medicine Authors: Mor Saban, Barniv Hava, Patito Heli, Shachar Tal, Haber Reuben, Salama Rabia, Darawsha Aziz Source Type: research

Analysis of current financial relationships between emergency physicians and industry
Characterize the frequency and magnitude of all categories of publicly reported financial payments made to emergency physicians (EPs) in the United States (U.S.) in 2017. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 28, 2018 Category: Emergency Medicine Authors: Joshua D. Niforatos, Samuel Boas, Samuel Hertz, Ahmed Ozgur, Ali S. Raja Source Type: research

Predictive and prognostic value of optic nerve sheath diameter measurement associated with hyponatremia in emergency department
Investigation of association of ONSD with hyponatremia in symptomatic patients. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 28, 2018 Category: Emergency Medicine Authors: Tayfun An ıl Demir, Fevzi Yılmaz, Bedriye Müge Sönmez, Mehmet Akif Karadaş, Resmiye Nur Okudan, Olgun Keskin Source Type: research

Prophylactic systemic antibiotics for anterior epistaxis treated with nasal packing in the emergency department
Emergency Department (ED) patients presenting with spontaneous epistaxis who have anterior nasal packing are routinely prescribed systemic prophylactic antibiotics in spite of the lack of supporting evidence-based literature. Although there is literature that discusses infection rates with nasal packing for epistaxis and prophylactic antibiotics prescribing practices of otolaryngologists, this is the first study to our knowledge that examines the practices of emergency physicians. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 28, 2018 Category: Emergency Medicine Authors: Tiffany Murano, Debbie Brucato-Duncan, Christine Ramdin, Steven Keller Source Type: research

Prophylactic systemic antibiotics for anterior epistaxis treated with nasal packing in the ED
Emergency Department (ED) patients presenting with spontaneous epistaxis who have anterior nasal packing are routinely prescribed systemic prophylactic antibiotics in spite of the lack of supporting evidence-based literature. Although there is literature that discusses infection rates with nasal packing for epistaxis and prophylactic antibiotics prescribing practices of otolaryngologists, this is the first study to our knowledge that examines the practices of emergency physicians. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 28, 2018 Category: Emergency Medicine Authors: Tiffany Murano, Debbie Brucato-Duncan, Christine Ramdin, Steven Keller Tags: Brief Report Source Type: research

Quantifying the burden of pre-existing conditions in older trauma patients: A novel metric based on mortality risk
Pre-existing medical conditions (PEC) represent a unique domain of risk among older trauma patients. The study objective was to develop a metric to quantify PEC burden for trauma patients. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 27, 2018 Category: Emergency Medicine Authors: Richard Y. Calvo, C. Beth Sise, Michael J. Sise, Vishal Bansal Source Type: research

Optic nerve sheath diameter ultrasonography in differentiation of ischemic and hemorrhagic strokes
Dear Editor, (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 27, 2018 Category: Emergency Medicine Authors: Maddalena De Bernardo, Livio Vitiello, Nicola Rosa Source Type: research

Beyond observation: Protocols and capabilities of an Emergency Department Observation Unit
Emergency Department Observation Units (Obs Units) provide a setting and a mechanism for further care of Emergency Department (ED) patients. Our hospital has a protocol-driven, type 1, complex 20 bed Obs Unit with 36 different protocols. We wanted to understand how the different protocols performed and what types of care were provided. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 27, 2018 Category: Emergency Medicine Authors: Lauren T. Southerland, Steffen R. Simerlink, Anthony J. Vargas, Margaret Krebs, Lalitha Nagaraj, Krystin N. Miller, Eric J. Adkins, Michael G. Barrie Source Type: research

Acute ascites and abdominal pain from ovarian hyperstimulation syndrome (OHSS)
A healthy 30  year old female G1P1 presented to the ED with a chief complaint of abdominal pain, shortness of breath and bloating 72 h after an egg retrieval out of state. She states she had two injections of an unknown hormone therapy and that the retrieval was uncomplicated. On arrival, heart rate is 130– 140 s and her blood pressure is soft (99/76). Her abdomen is distended and non-focally tender but not peritoneal. Point-of-care FAST exam was immediately performed showing free fluid (Fig. 1) and enlarged, cystic appearing ovaries (Fig. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 27, 2018 Category: Emergency Medicine Authors: John Kiel Source Type: research

Seizure in code stroke: Stroke mimic and initial manifestation of stroke
The objective of this study was to analyze the frequency, characteristics and results of neuroimaging including CT perfusion in patients with seizures manifesting initially as stroke-like symptoms. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 27, 2018 Category: Emergency Medicine Authors: Soo Jeong Kim, Dong Wook Kim, Hahn Young Kim, Hong Gee Roh, Jeong-Jin Park Source Type: research