Lessons learned from COVID-19 and 3D printing
The use of 3D printing in medicine is not new, with consolidated and growing applications in surgical procedure planning, the creation of both personalized implants or prostheses, developing of medical devices or improvement and personalization of existing ones and anatomical models for improving medical training and education [1]. Moreover, nowadays is not uncommon to find 3D printing units or labs at radiology departments and hospitals approaching medical imaging to personalized medicine. The new COVID-19 pandemic has pushed healthcare resources to the limit. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 14, 2020 Category: Emergency Medicine Authors: Teodoro Mart ín Noguerol, Félix Paulano Godino, Christine O. Menias, Antonio Luna Source Type: research

Clinical outcome of new-onset atrial fibrillation after emergency percutaneous coronary intervention for myocardial infarction
Atrial fibrillation (AF), the most frequently sustained arrhythmia with an increasing incidence due to the ageing population [1], is common in the setting of acute myocardial infarction (AMI) with a reported incidence of 6% to 21% [2]. Compared with ventricular tachyarrhythmias, severe heart failure, or sudden cardiac arrest, AF has been regarded as a benign, transient, and self-limited and not a critical event during AMI. However, AF, in particular new-onset AF (NOAF), which is defined as AF rhythm without previous history before AMI occurrence, has been associated with higher rates of adverse events and mortality [3-6]. ...
Source: The American Journal of Emergency Medicine - August 14, 2020 Category: Emergency Medicine Authors: Changzuan Zhou, Lingfang Yu, Qianli Zhu, Guangze Xiang, Pengfei Xv, Chen Chen, Menxing Cai, Weijian Huang, Peiren Shan Source Type: research

A unique presentation of Colovesical fistula
A colovesical fistula (CVF) is a pathological connection between the colon and the urinary bladder. Although they are uncommon, consequences can severely affect quality of life and mortality. Diverticula are the most common cause of CVF. This case details a patient's CVF diagnosis in the emergency department with unremitting gastrointestinal and urinary symptoms.A 78-year-old male patient with recent hospitalization for stroke and left carotid endarterectomy complicated by urinary retention treated with a Foley catheter presented to the Emergency Department with a chief complaint of hematuria and unremitting diarrhea. (Sou...
Source: The American Journal of Emergency Medicine - August 14, 2020 Category: Emergency Medicine Authors: Michael Li, Jennifer Sadowski, Elizabeth M. Evans, Marna Greenberg Source Type: research

An unusual presentation of portal vein thrombosis in a 2-year-old girl
Portal vein thrombosis (PVT) is the most common cause of extrahepatic portal vein obstruction in children. Upper gastrointestinal (GI) bleeding and splenomegaly are the most common presenting features. PVT diagnosis is usually delayed in the absence of upper GI bleeding and many children undergo a hematologic work-up due to splenomegaly and signs of hypersplenism. Here, we present a case of a 2-year-old girl who had pancytopenia and splenomegaly. The hematologic work-up including a bone marrow aspirate was unrevealing and she was thought to have viral-induced bone marrow suppression and severe iron deficiency anemia. (Sour...
Source: The American Journal of Emergency Medicine - August 14, 2020 Category: Emergency Medicine Authors: Shafee Salloum, Kidist Alemu, Rand Abedalweli Source Type: research

Electronic cigarette explosion/burn and poisoning related emergency department visits, 2018 –2019
This study updates national estimates of ECIG-related emergency department (ED) visits and describes the context of these injuries. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 14, 2020 Category: Emergency Medicine Authors: Matthew E. Rossheim, Kayla K. McDonald, Eric K. Soule, Gilbert W. Gimm, Melvin D. Livingston, Tracey E. Barnett, David H. Jernigan, Dennis L. Thombs Source Type: research

Melkersson-Rosenthal syndrome induced by COVID-19: A case report COVID-19 with Melkersson-Rosenthal syndrome
We present a case of a female patient presenting with edema. We present a case of a female patient presenting with edema. Her examination revealed edema in the right lower lip, right facial paralysis, and fissured tongue. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 14, 2020 Category: Emergency Medicine Authors: Bahad ır Taşlıdere, Liljana Mehmetaj, Ayşe Büşra Özcan, Bedia Gülen, Nazan Taşlıdere Source Type: research

Small bowel obstruction caused by massive fibroids
A 44-year-old woman presented to the Emergency Department with abdominal pain. She had a history of fibroids and no prior surgeries. Ultrasonography and CT imaging revealed a small bowel obstruction and massive uterine fibroids. The patient required laparotomy to relieve the intestinal obstruction after conservative therapy failed. Massive uterine fibroids is a rare cause of small bowel obstruction which requires the vigilance of Emergency Medicine physicians. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 14, 2020 Category: Emergency Medicine Authors: Daniel Sas, Jim Fan Yang, Nestor Agbayani, Siu Fai Li Source Type: research

Can non-contrast head CT and stroke severity be used for stroke triage? A population-based study
Acute ischemic stroke (AIS) patients may benefit from endovascular thrombectomy (EVT) up to 24  h since last known normal (LKN). Advanced imaging is required for patient selection. Small or rural hospitals may not have sufficient CT technician and radiology support to rapidly acquire and interpret images. We estimated transfer rates using non-contrast head CT and stroke severity to select p atients to be transferred to larger centers for evaluation. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 14, 2020 Category: Emergency Medicine Authors: Charles Kircher, Amanda Humphries, Dawn Kleindorfer, Kathleen Alwell, Heidi Sucharew, Charles J. Moomaw, Jason Mackey, Felipe De Los Rios La Rosa, Brett Kissela, Opeolu Adeoye Source Type: research

Improving the prediction of streptococcal pharyngitis; time to move past exudate alone
Palatal petechiae are predictive of Group A streptococcal (GAS) pharyngitis. We sought to (a) quantify the value of considering petechiae in addition to exudate, and (b) assess provider incorporation of petechiae's predictive nature for GAS into clinical decision making. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 14, 2020 Category: Emergency Medicine Authors: Nicole L. Nadeau, Andrew M. Fine, Amir Kimia Source Type: research

Traumatic pedestrian and bicyclist injuries associated with intoxication
We describe the prevalence of drug and alcohol use and clinical consequences in a cohort of pedestrians and bicyclists with trauma. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 14, 2020 Category: Emergency Medicine Authors: D.J. Tonellato, J.R. Ransohoff, C. Nash, S.E.F. Melanson, A.K. Petrides, N.V. Tolan, S.A. Goldberg, E.W. Boyer, P.R. Chai, T.B. Erickson Source Type: research

Other aspects of Heyde's syndrome
The patient in the vignette [1] was at a diagnostic advantage because she had the “classic murmur of aortic stenosis”, namely, grade 4/6 intensity, maximal at the second right intercostal space, and radiating to the neck [2]. Atypically, however, the murmur may, in some cases “be most easily audible in the mitral area” [2], thereby simulating the systolic murmur which is sometimes attributable solely to anemia [3], the so-called “hemic” murmur [4]. Conversely, in a few patients with hemic murmurs the murmur may be audible in the aortic area [4], thereby simulating the murmur of aortic st...
Source: The American Journal of Emergency Medicine - August 14, 2020 Category: Emergency Medicine Authors: Oscar M.P. Jolobe Source Type: research

Pyogenic liver abscess and endogenous endophthalmitis secondary to Klebsiella pneumoniae
This article reports the identification of a pyogenic liver abscess and associated endogenous endophthalmitis in a patient presenting to the emergency department. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 14, 2020 Category: Emergency Medicine Authors: Genevieve S. Pentecost, Jacob Kesterson Source Type: research

Regional anesthesia for rib fractures: A decision making guide
We thank A. Houghton for his input on this important topic [1]. The aim of our exploratory study was to confirm the efficacy and safety of the erector spinae plane block (ESP) and serratus anterior block (SAB) in an effort to guide future research [2]. We agree that currently there is very little evidence to support the efficacy of one regional anesthesia technique over another for the management of rib fractures. In response to the risks associated with the ESP and SAB, both can result in damage to deeper structures [1,3]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 14, 2020 Category: Emergency Medicine Authors: L. White, B. Riley, U. Malla, N. Snels, A. Mitchell, C. Abi-Fares, W. Basson, C. Anstey Source Type: research

Thin-walled introducer needle vs catheter-over-needle technique for central venous catheterisation: A brief meta-analysis
Central venous catheterisation is a technically challenging procedure with numerous indications, including fluid resuscitation, total parenteral nutrition, chemotherapy or central venous pressure monitoring. There has been recent debate regarding the optimal technique for guidewire placement; a thin-walled introducer needle (TWN) or a catheter-over-needle (CON) technique, with the latter being suggested by the American Society of Anaesthesiologists as providing more stable access if manometry is used for venous confirmation [1]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 14, 2020 Category: Emergency Medicine Authors: Lachlan Fairley Source Type: research

A review of pre-hospital case series among those with time to double external defibrillation and neurologic outcomes
Double external defibrillation (DED) has been used as a final effort to terminate refractory ventricular fibrillation/pulseless ventricular tachycardiac (rVF/pVT). Data surrounding time to DED and patient-centered outcomes remains limited. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 14, 2020 Category: Emergency Medicine Authors: Dennis Miraglia, Wilfredo Alonso Tags: Reviews Source Type: research

Weather and temporal models for emergency medical services: An assessment of generalizability
Emergency medical services (EMS) response volume has been linked to weather and temporal factors in a regional EMS system. We aimed to identify if models of EMS utilization incorporating these data are generalizable through geographically disparate areas in the United States. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 14, 2020 Category: Emergency Medicine Authors: Sriram Ramgopal, Nalyn Siripong, David D. Salcido, Christian Martin-Gill Source Type: research

Survival after left ventricular free wall rupture following acute myocardial infarction by conservative treatment
Left ventricular free wall rupture (LVFWR) is a rare and fatal mechanical complication following an acute myocardial infarction (AMI). Cases of survival after LVFWR due to ST-segment elevation myocardial infarction (STEMI) treated with a conservative treatment strategy are extremely rare. In this case, a 55-year-old male patient with several cardiovascular risk factors presented to the emergency department with symptoms of ongoing chest pain and syncope. The patient's electrocardiogram was in sinus rhythm with ST-elevation on I, aVL, and V4 –6 leads. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 14, 2020 Category: Emergency Medicine Authors: Liyuan Yan, Haipeng Wang, Bo Su, Jiali Fan, Minghan Wang, Xin Zhao Source Type: research

The disutility of stress testing in low-risk HEART Pathway patients
The objective of this study is to determine the frequency and diagnostic yield of stress testing among low-risk patients. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - August 13, 2020 Category: Emergency Medicine Authors: Nicklaus P. Ashburn, Zachary P. Smith, Kale J. Hunter, Nella W. Hendley, Simon A. Mahler, Brian C. Hiestand, Jason P. Stopyra Source Type: research

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 8, 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 7, 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 7, 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 6, 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 6, 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 6, 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 5, 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 5, 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 4, 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 3, 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 3, 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 3, 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 3, 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 2, 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 2, 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 2, 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 - July 31, 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 30, 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 30, 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 29, 2020 Category: Emergency Medicine Authors: Abdulrahman Alharthy, Fahad Faqihi, John Papanikolaou, Abdullah Balhamar, Mike Blaivas, Ziad A. Memish, Dimitrios Karakitsos Source Type: research

Spontaneous hemopneumothorax in a patient with COVID-19
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

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 28, 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 28, 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 28, 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 28, 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 28, 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 28, 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 28, 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 28, 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 27, 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 27, 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 26, 2020 Category: Emergency Medicine Authors: Aidan L. Neustadtl, Alicia Kaneb, Alan D. Neustadtl, David Milzman Source Type: research