Management of the mild traumatic brain injured patient using a multidisciplinary observation unit protocol
We describe the cohort of patients who were placed in the ED OU and we evaluated if changes to our inclusion and exclusion criteria should be made. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 12, 2020 Category: Emergency Medicine Authors: Katherine Rhame, Diana Le, Amanda Ventura, Amy Horner, Norberto Andaluz, Christopher Miller, Uwe Stolz, Laura B. Ngwenya, Opeolu Adeoye, Natalie Kreitzer Source Type: research

Xuebijing combined with Ulinastatin for treating septic patients
The meta-analysis conducted by Zheng et al. that compared the efficacy of Xuebijing combined with Ulinastatin to that of the single administration of Ulinastatin for sepsis treatment is an interesting study [1]. However, after carefully reading the paper, we have some questions regarding the study. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 10, 2020 Category: Emergency Medicine Authors: Yuqiong Xu, Haiyan Zhong, Wei Liu, Jingfeng Du, Wei Han Source Type: research

Multicenter retrospective analysis of the risk factors for delayed neurological sequelae after acute carbon monoxide poisoning
This study aims at exploring the independent predictors of DNS in patients with CO exposure. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 10, 2020 Category: Emergency Medicine Authors: Yongxue Zhang, Qingsheng Lu, Jing Jia, Dekun Xiang, Yanan Xi Source Type: research

Bilateral spontaneous pneumothorax in SARS-CoV-2 infection: A very rare, life-threatening complication
In the coronavirus disease 2019 (COVID-19) era, the presence of acute respiratory failure is generally associated with acute respiratory distress syndrome; however, it is essential to consider other differential diagnoses that require different, and urgent, therapeutic approaches. Herein we describe a COVID-19 case complicated with bilateral spontaneous pneumothorax. A previously healthy 45-year-old man was admitted to our emergency department with sudden-onset chest pain and progressive shortness of breath 17  days after diagnosis with uncomplicated COVID-19 infection. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 10, 2020 Category: Emergency Medicine Authors: H éctor González-Pacheco, Rodrigo Gopar-Nieto, Gian-Manuel Jiménez-Rodríguez, Daniel Manzur-Sandoval, Julio Sandoval, Alexandra Arias-Mendoza Source Type: research

Transversus abdominis plane block: A new method in renal colic pain management
In recent decades, regional plane blocks via ultrasonography have become very popular in regional anesthesia and are more commonly used in pain management. The transversus abdominis plane (TAP) block is a procedure where local anesthetics are applied to block the anterior divisions of the tenth thoracic intercostal through the first lumbar nerves (T10 –L1) into the anatomic space formed amidst the internal oblique and transversus abdominis muscles located in the antero-lateral part of the abdomen wall. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 10, 2020 Category: Emergency Medicine Authors: Emine Kadioglu, Murtaza Kaya, Harun Yildirim Source Type: research

Some questions on the use of Xuebijing combined with Ulinastatin in treating patients with sepsis
The meta-analysis conducted by Zheng et al. that compared the efficacy of Xuebijing combined with Ulinastatin to that of the single administration of Ulinastatin for sepsis treatment is an interesting study [1]. However, after carefully reading the paper, we have some questions regarding the study. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 10, 2020 Category: Emergency Medicine Authors: Yuqiong Xu, Haiyan Zhong, Wei Liu, Jingfeng Du, Wei Han Source Type: research

Consistency and reliability of COVID-19 projection models as a means to save lives
In January 2020, the COVID-19 pandemic took the United States (US) by surprise. Projections were needed to estimate the magnitude and plan responses at national and local levels. In turn, the projections influenced decisions regarding social distancing, resource distribution, and lockdowns like the mandatory closing of businesses and schools [1]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 10, 2020 Category: Emergency Medicine Authors: Brendon Sen-Crowe, Mark McKenney, Adel Elkbuli Source Type: research

Predictive performance of SOFA and qSOFA for in-hospital mortality in severe novel coronavirus disease
This study was conducted to evaluate the effectiveness of the Sequential Organ Failure Assessment (SOFA) and Quick Sequential Organ Failure Assessment (qSOFA) scoring systems at admission for the prediction of mortality risk in COVID-19 patients. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 10, 2020 Category: Emergency Medicine Authors: Sijia Liu, Ni Yao, Yanru Qiu, Chengqi He Source Type: research

Retrospective analysis of the hemodynamic consequences of prehospital supplemental oxygen in acute stroke
This study examines the hemodynamic consequences of prehospital sO2 in stroke. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 9, 2020 Category: Emergency Medicine Authors: Layne Dylla, Jeremy T. Cushman, Beau Abar, Curtis Benesch, Courtney M.C. Jones, M. Kerry O'Banion, David H. Adler Source Type: research

A novel inline PEEP valve design for differential multi-ventilation
Ventilator sharing is one option to emergently increase ventilator capacity during a crisis but has been criticized for its inability to adjust for individual patient needs. Newer ventilator sharing designs use valves and restrictors to control pressures for each patient. A key component of these designs is an inline Positive End Expiratory Pressure (PEEP) Valve but these are not readily available. Creating an inline PEEP valve by converting a standard bag-valve-mask PEEP valve is possible with the addition of a 3D printer collar. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 9, 2020 Category: Emergency Medicine Authors: Leonard Bunting, Steven Roy, Hannah Pinson, Tobin Greensweig, International Differential Multi-Ventilation Working Group Source Type: research

Dilemnas raised by implementation of an unqualified STEMI algorithm
The authors of the study of the impact of patient delay in a modern real world STEMI network have rightly focussed on the adverse impact of delay in implementation of percutaneous coronary intervention [1]. The dilemna which faces clinicians who are aware of the existence of the entity of the mimicry of ST segment elevation myocardial infarction(STEMI) by dissecting aortic aneurysm(DAA), and the mimicry of STEMI by pulmonary embolism(PE) is that strategies such as point-of-care transthoracic echocardiography(TTE), which might mitigate the risk of misdiagnosis, also incur the risk of compounding the delay in achieving timel...
Source: The American Journal of Emergency Medicine - July 8, 2020 Category: Emergency Medicine Authors: Oscar M.P. Jolobe Source Type: research

Indications and preference considerations for using medical Cannabis in an emergency department: A National Survey
Due to its Schedule I drug designation, medical cannabis continues to remain a controversial topic [1] despite an increasing number of US states legalizing it2 and the growing acceptance of it socially [3] and even within some physicians in the medical community [4]. Because of federal laws, studying cannabis in randomized controlled trials remains a monumental challenge [5]. Meanwhile cannabis use, much by patients seeking symptomatic relief of their symptoms, is widespread. This has led to the acknowledgement and subsequent policy statement by the American College of Emergency Physicians (ACEP) to recommend rescheduling ...
Source: The American Journal of Emergency Medicine - July 8, 2020 Category: Emergency Medicine Authors: Kevin M. Takakuwa, Raquel M. Schears Source Type: research

Including syncope when assessing risk scores for atrial fibrillation in the ED
According to the authors of the recent study, one of their aims was to assess the potential to further improve the tools, namely, the RED AF score, AFTER score and the CHA2DS2-Vasc score, with the incorporation of new variables [1]. With that aim in mind I propose that syncope should be incorporated as a variable because the association of syncope and atrial fibrillation can be a predictor of sudden death. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 8, 2020 Category: Emergency Medicine Authors: Oscar M.P. Jolobe Source Type: research

Variation in opioid analgesia administration and discharge prescribing for emergency department patients with suspected urolithiasis
We examined opioid analgesic usage in ED patients with suspected urolithiasis across fifteen participating hospitals. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 8, 2020 Category: Emergency Medicine Authors: Anna E. Wentz, Ralph R.C. Wang, Brandon D.L. Marshall, Theresa I. Shireman, Tao Liu, Roland C. Merchant Source Type: research

Think about acute shisha carbon monoxide intoxication: that's one small step for the patient, one giant leap for our society
We report in this series 3 cases of acute carbon monoxide poisoning following active or passive consumption of chicha. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 8, 2020 Category: Emergency Medicine Authors: Nicolas Cazes, Caroline Duchier, S ébastien Beaume, Pascal Menot, Aurélien Renard, Frank Peduzzi Source Type: research

The authors' response: Propofol in COVID 19: From basic science to clinical impact
We thank you for your valuable comments on our manuscript. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 8, 2020 Category: Emergency Medicine Authors: Mitsuhito Soh, Toru Hifumi, Shutaro Isokawa, Masato Shimizu, Norio Otani, Shinichi Ishimatsu Source Type: research

An important caveat for all cases of suspected supraventricular tachycardia
The recruitment criteria in the recently reported randomised controlled trial specified that the participants should have narrow complex tachycardia with QRS duration (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 8, 2020 Category: Emergency Medicine Authors: Oscar M.P. Jolobe Source Type: research

The financial strain placed on America's hospitals in the wake of the COVID-19 pandemic
The current pandemic caused by the acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has profoundly impacted nearly every aspect of society. While mitigation strategies have curbed the spread of the disease caused by SARS-CoV-2, COVID-19, these policies have had deleterious effects on the United States (US) economy, leading to a large contraction in the Gross Domestic Product (GDP). Spending on healthcare services comprises a sizable portion of the GDP, reductions in GDP, driven by the current pandemic milieu, could potentially harm patients who still need timely, high-quality care. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 8, 2020 Category: Emergency Medicine Authors: Brad Boserup, Mark McKenney, Adel Elkbuli Source Type: research

Effect of heart failure on the outcome of COVID-19 — A meta analysis and systematic review
Several comorbidities have been associated with an increased risk of severity and mortality in coronavirus disease 2019 (COVID-19), including hypertension, diabetes, cerebrovascular disease, chronic kidney disease, and chronic obstructive pulmonary disease. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 8, 2020 Category: Emergency Medicine Authors: Emir Yonas, Idrus Alwi, Raymond Pranata, Ian Huang, Michael Anthonius Lim, Eddy Jose Gutierrez, Muhammad Yamin, Bambang Budi Siswanto, Salim S. Virani Source Type: research

Propofol in COVID 19 — From basic science to clinical impact
We read the case report by Soh et al. [1] and the comments of Sohn [2] with great interest. However, we would like to highlight some of the important actions of propofol and its current application to COVID-19 cases. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 8, 2020 Category: Emergency Medicine Authors: Subramanian Senthilkumaran, Koushik Murugan, Patne Sanjay, Ponniah Thirumalaikolundusubramanian Source Type: research

Characteristics of very elderly patients in the emergency department – A retrospective analysis
Elderly people, defined by age 65  years and older, made up 18.45% of the Swiss Population in 2018 and their number is projected to rise continuously. Data investigating specific characteristics of this patient subgroup, especially in the emergency setting, is scarce. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 8, 2020 Category: Emergency Medicine Authors: Bertram K. Woitok, Svenja Ravioli, Georg-Christian Funk, Gregor Lindner Source Type: research

Intramuscular medication for treatment of agitation in the emergency department: A systematic review of controlled trials
Severely agitated patients in the emergency department (ED) are often sedated with intramuscularly-administered medications. The evidence base underlying particular medication choices is surprisingly sparse, as existing reviews either have methodological limitations or have included data collected outside of emergent settings. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 8, 2020 Category: Emergency Medicine Authors: Allison Schneider, Samuel Mullinax, Nathanael Hall, Ashley Acheson, Alison H. Oliveto, Michael P. Wilson Source Type: research

A randomized cohort study of the efficacy of PO magnesium in the treatment of acute concussions in adolescents
Concussions are becoming a growing concern in society today with one out of every five adolescents being affected. This accounts for 1.6 to 3.8 million emergency department visits annually. The current standard of care involves an initial period of mental rest with symptomatic care and symptom-based return to daily activities/sports. High dose IV magnesium has been proven to be neuroprotective in severe TBI. We hypothesized that oral magnesium replacement following a concussion will decrease the overall symptomatic period allowing a quicker return to functional baseline. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 7, 2020 Category: Emergency Medicine Authors: Louis Standiford, Michael O'Daniel, Christopher Trigger, Matthew Hysell, Sam Wisniewski Source Type: research

The role of Chinese medicine in COVID-19 pneumonia: A systematic review and meta-analysis
Chinese medicine (CM) has been used to treat Novel Coronavirus 2019 (COVID-19) pneumonia in China. This meta-analysis was conducted to evaluate the clinical efficacy and safety of CM in the treatment of COVID-19 pneumonia. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 7, 2020 Category: Emergency Medicine Authors: Chun-Yang Sun, Ya-Lei Sun, Xin-Min Li Source Type: research

Cobra snakebite mimicking brain death treated with a novel combination of polyvalent snake antivenom and anticholinesterase: Case report
In toxicology literature, snake bites were the second toxicology-relevant cause mimicking brain death. A 57-year-old woman with history of cobra snake bite. On examination, the brain stem reflexes were absent with Glasgow coma score of 3. The patient accomplished full neurological recovery after using a novel combination of Polyvalent Snake Antivenom (PSA) and anticholinesterases. This case highlights a unique presentation of cobra bite induced brain death mimicking. Thus, intensivist should exclude neuroparalytic effect of snakebite before considering withdrawal of ventilatory support or organ donation. (Source: The Ameri...
Source: The American Journal of Emergency Medicine - July 5, 2020 Category: Emergency Medicine Authors: Musa S. ALfaifi, Atheer E. ALOtaibi, Ohood A. ALShahrani, Khalid M. ALSharani, Ali O. ALbshabshi, Hasan M. ALZahrani, Hadi E. ALAli Source Type: research

Amiodarone and/or lidocaine for cardiac arrest: A Bayesian network meta-analysis
Although available studies have not demonstrated that antiarrhythmic drugs could increase long-term survival or survival with favorable neurological outcome, some studies have shown that the rate of hospital admission is higher with amiodarone or lidocaine than with placebo. To study the effects of antiarrhythmic drugs during cardiac arrest, a meta-analysis was conducted to assess the efficacy of amiodarone and/or lidocaine. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 4, 2020 Category: Emergency Medicine Authors: Hongli Zhao, Kai Fan, Guilong Feng Source Type: research

Palliative care in the emergency department during a COVID-19 pandemic
The COVID-19 pandemic is challenging the healthcare system [1]. It is crucial for physicians to provide an opportunity for shared decision making and ascertain, without prejudice, a patient's goals of treatment and advanced directives [2]. Palliative care support at the point of initial care has the potential to play a vital role in assisting in ascertaining the patient's wishes for treatment, especially in the setting of a busy emergency department (ED). Palliative care specialists provide individualized, compassionate care including symptom control for those choosing to forgo aggressive interventions like ventilator supp...
Source: The American Journal of Emergency Medicine - July 4, 2020 Category: Emergency Medicine Authors: Jessica K. Eygnor, Alexander M. Rosenau, David B. Burmeister, David M. Richardson, Amy M. DePuy, Allison N. Kayne, Marna Rayl Greenberg Tags: Correspondence Source Type: research

Is novel coronavirus 2019 reinfection possible? Interpreting dynamic SARS-CoV-2 test results
Since December 2019, COVID-19, the clinical syndrome associated with SARS-CoV-2 infection, has infected more than 6.2 million people and brought the function of the global community to a halt. As the number of patients recovered from COVID-19 rises and the world transitions toward reopening, the question of acquired immunity versus the possibility of reinfection are critical to anticipating future viral spread. Here, we present a case of a patient previously recovered from COVID-19 who re-presents with new respiratory, radiographical, laboratory, and real-time reverse transcriptase-polymerase chain reaction (RT-PCR) findin...
Source: The American Journal of Emergency Medicine - July 4, 2020 Category: Emergency Medicine Authors: Nicole M. Duggan, Stephanie M. Ludy, Bryant C. Shannon, Andrew T. Reisner, Susan R. Wilcox Tags: Case Report Source Type: research

Guanfacine toxic ingestion with subsequent cardiogenic pulmonary edema
Guanfacine is a central alpha-2 agonist often prescribed for Attention-deficit hyperactive disorder as well as tic disorder, with a usual dose of 1 –4 mg per day. Due to its sympatholytic mechanism of action, Guanfacine can cause autonomic instability and hypotension. It can additionally cause cardiac dysfunction to include symptomatic bradycardias and contractility suppression. The authors present a case of a 17 year-old male with an inges tion of 80 mg of extended release Guanfacine with delayed onset cardiogenic pulmonary edema requiring mechanical ventilation. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 4, 2020 Category: Emergency Medicine Authors: Rachel E. Bridwell, Neil P. Larson, Jennifer B. Rosenthal, Jesse Wray, Zachary Baker, Amber Cibrario, Joshua J. Oliver Tags: Case Report Source Type: research

Is novel coronavirus 2019 reinfection possible? Interpreting dynamic SARS-CoV-2 test results through a case report
Since December 2019, COVID-19, the clinical syndrome associated with SARS-CoV-2 infection, has infected more than 6.2 million people and brought the function of the global community to a halt. As the number of patients recovered from COVID-19 rises and the world transitions toward reopening, the question of acquired immunity versus the possibility of reinfection are critical to anticipating future viral spread. Here, we present a case of a patient previously recovered from COVID-19 who re-presents with new respiratory, radiographical, laboratory, and real-time reverse transcriptase-polymerase chain reaction (RT-PCR) findin...
Source: The American Journal of Emergency Medicine - July 3, 2020 Category: Emergency Medicine Authors: Nicole M. Duggan, Stephanie M. Ludy, Bryant C. Shannon, Andrew T. Reisner, Susan R. Wilcox Source Type: research

Guanfacine toxic ingestion with subsequent cardiogenic pulmonary edema: A case report
Guanfacine is a central alpha-2 agonist often prescribed for Attention-deficit hyperactive disorder as well as tic disorder, with a usual dose of 1 –4 mg per day. Due to its sympatholytic mechanism of action, Guanfacine can cause autonomic instability and hypotension. It can additionally cause cardiac dysfunction to include symptomatic bradycardias and contractility suppression. The authors present a case of a 17 year-old male with an ing estion of 80 mg of extended release Guanfacine with delayed onset cardiogenic pulmonary edema requiring mechanical ventilation. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 3, 2020 Category: Emergency Medicine Authors: Rachel E. Bridwell, Neil P. Larson, Jennifer B. Rosenthal, Jesse Wray, Zachary Baker, Amber Cibrario, Joshua J. Oliver Source Type: research

Prognostic performance of peripheral perfusion index and shock index combined with ESI to predict hospital outcome
Peripheral perfusion index (PPI) and shock index (SI) are considered valuable predictors of hospital outcome and mortality in various operative and intensive care settings. In the present study, we evaluated the prognostic capabilities of these parameters for performing emergency department (ED) triage, as represented by the emergency severity index (ESI). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 3, 2020 Category: Emergency Medicine Authors: Murat Da ş, Okan Bardakci, Duygu Siddikoğlu, Gökhan Akdur, Musa Caner Yilmaz, Okhan Akdur, Yavuz Beyazit Source Type: research

Influence of procedural factors on patient procedural pain in relation to diagnostic lumbar puncture
The aim of this study is to investigate the influence of local anesthetic (LA), operator experience level and needle type on patient procedural pain in relation to diagnostic lumbar puncture (LP). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 3, 2020 Category: Emergency Medicine Authors: R.B.A. S ørensen, M.J.V. Henriksen, T. Wienecke Source Type: research

The conundrum of rising Covid19 infection among health care workers: An emerging paradigm
Most of the countries over the world are still struggling with the ongoing battle against covid19 pandemic. Months have passed since the first appearance of covid19 but many of its nature and behaviors still remain a mystery to the world. In spite of taking all the precautions and protection measures, distressing number of health care workers (HCWs) are getting infected with covid19 which is indeed worrisome. This is the reason why the articles by Sahu et al. [1] and Smereka et al. [2] in your esteemed journal have drawn our attention and we read it very keenly. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 3, 2020 Category: Emergency Medicine Authors: Jitendra Kumar, P.S. Khatana, Rajni Raina Source Type: research

The verbal numeric pain scale: Emergency Department patients' understanding and perspectives
Acute and chronic pain related conditions are common chief complaints among ED patients [1]. Self-reported pain can be influenced by multiple factors, including, age, race, gender, Medicaid insurance, lower educational status, higher number of previous visits to the ED and psychological stress [2-8]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 3, 2020 Category: Emergency Medicine Authors: Catherine A. Marco, Brian Patrick Murray, Mitchell McMurray, Blake Nelson, Declan Feery, Bricey, Jacob Butman, Sabina Bashir Source Type: research

Prothrombin Time ratio can predict mortality in severe pediatric trauma: Study in a French trauma center level 1
Injury results in more deaths in children than all other causes combined, but there is little data regarding the association of early coagulopathy on outcomes in pediatric patients with traumatic injuries. The aim of this study was to determine the optimal cut-off value for the Prothrombin Time ratio (PTr) and to show the diagnostic characteristics of the PTr to predict mortality. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 3, 2020 Category: Emergency Medicine Authors: Audrey Hochart, Romain Momal, Delphine Garrigue-Huet, Elodie Drumez, Sophie Susen, Benjamin Bijok Source Type: research

A case report of possible novel coronavirus 2019 reinfection
Since December 2019, COVID-19, the clinical syndrome associated with SARS-CoV-2 infection, has infected more than 6.2 million people and brought the function of the global community to a halt. As the number of patients recovered from COVID-19 rises and the world transitions toward reopening, the question of acquired immunity versus the possibility of reinfection are critical to anticipating future viral spread. Here, we present a case of a patient previously recovered from COVID-19 who re-presents with new respiratory, radiographical, laboratory, and RT-PCR findings concerning for re-infection. (Source: The American Journa...
Source: The American Journal of Emergency Medicine - July 3, 2020 Category: Emergency Medicine Authors: Nicole M. Duggan, Stephanie M. Ludy, Bryant C. Shannon, Andrew T. Reisner, Susan R. Wilcox Source Type: research

Initial emergency department mechanical ventilation strategies for COVID-19 hypoxemic respiratory failure and ARDS
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging viral pathogen that causes the novel coronavirus disease of 2019 (COVID-19) and may result in hypoxemic respiratory failure necessitating invasive mechanical ventilation in the most severe cases. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 3, 2020 Category: Emergency Medicine Authors: Skyler Lentz, Matthew A. Roginski, Tim Montrief, Mark Ramzy, Michael Gottlieb, Brit Long Source Type: research

Utilizing technology as a method of contact tracing and surveillance to minimize the risk of contracting COVID-19 infection
Currently, there are two major forms of testing in the U.S.: testing for SARS-CoV-2 RNA and serologic testing [1,2]. However, only testing those experiencing symptoms is not a practical way of obtaining a true picture of the infection status of the nation, as the majority of infected individuals do not exhibit symptoms [3]. Healthcare personnel who are in close contact with ill patients may be asymptomatic themselves and unknowingly transmit the infection to others. A call for new methods of testing and surveillance on a large scale will be important if we hope to control the spread of SARS-CoV-2 infections. (Source: The A...
Source: The American Journal of Emergency Medicine - July 3, 2020 Category: Emergency Medicine Authors: Brendon Sen-Crowe, Mark McKenney, Adel Elkbuli Source Type: research

Should prolonged ceftriaxone infusions be preferred in septic patients?
We read with interest the article by Agunbiade et al. about ‘The effects of ceftriaxone by an intravenous push on adverse drug reactions in the emergency department’. Ceftriaxone intravenous push (IVP) decreases time of administration when compared with intravenous infusion (IVI). In addition, the rate of adverse reactions does not increase with IVP [1]. However, some efficacy concerns can arise, especially in sepsis and critically ill patients. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 3, 2020 Category: Emergency Medicine Authors: Emre Kara, Melda Bahap, Ahmet Cagkan Inkaya Source Type: research

Clostridioides difficile infection evaluation and management in the emergency department
Clostridioides difficile infection (CDI), characterized primarily by diffuse diarrhea in the setting of recent healthcare and antibiotic exposure, maintains significantly high rates of diagnosis in the U.S., even in the emergency department (ED). Recent updates in the literature concerning CDI should be considered for effective clinical practice in the ED setting. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 2, 2020 Category: Emergency Medicine Authors: Brandon M. Carius, Stephen Y. Liang, Alex Koyfman, Brit Long Source Type: research

Should be preferred ceftriaxone prolonged infusions in septic patients?
We read with interest the article by Agunbiade et al. about ‘The effects of ceftriaxone by an intravenous push on adverse drug reactions in the emergency department’. Ceftriaxone intravenous push (IVP) decreases time of administration when compared with intravenous infusion (IVI). In addition, the rate of adverse reactions does not increase with IVP [1]. However, some efficacy concerns can arise, especially in sepsis and critically ill patients. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 2, 2020 Category: Emergency Medicine Authors: Emre Kara, Melda Bahap, Ahmet Cagkan Inkaya Source Type: research

Methamphetamine-associated pulseless electrical activity in a young child
This is a case report of a 19-month-old female who presented to the emergency department in cardiac arrest after methamphetamine exposure. Prior to presentation, she had seizure-like activity and then became unresponsive. On arrival, she had dilated pupils, intermittent clonus, and pulseless electrical activity. She was found to have full thickness circumferential burns of her bilateral lower extremities. She received 12 doses of epinephrine, cardiopulmonary resuscitation, and volume resuscitation after which she had return of spontaneous circulation and was transferred to the intensive care unit on an epinephrine drip. (S...
Source: The American Journal of Emergency Medicine - July 2, 2020 Category: Emergency Medicine Authors: Carmelle Tsai, Maria Quidgley-Martin, Natalie Laub, Tracey G. Polsky, Kevin C. Osterhoudt Source Type: research

The significance of repetitive yawning in the emergency patient - A warning of imminent death or disability
Premortem yawning is absent from almost all major medical textbooks but has been associated for more than 2000  years with impending death from acute infections and hemorrhage and was commonly known during the Bubonic Plague pandemic [1,2]. Medical reports of premortem yawning identify multiple causes of shock including vasovagal reflex, severe hypoxia/anemia/hypoglycemia, stroke, and intracranial hyperten sion [3-5]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 2, 2020 Category: Emergency Medicine Authors: Joan E. Rothenberg Tags: Correspondence Source Type: research

A young man with palpitations
A 32-year-old male of African descent presented to the Emergency Department (ED) with palpitations lasting for several hours that day. He was previously diagnosed with arrhythmogenic right ventricular cardiomyopathy (ARVC) and had an implanted cardioverter defibrillator (ICD) and permanent pacemaker (PPM), recently checked and found to be functioning correctly by his primary electrophysiologist. He was also on sotalol 80 mg twice a day. He had no history of smoking, consuming alcohol, or illicit drugs. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 1, 2020 Category: Emergency Medicine Authors: Maxim Ben-Yakov, Vigil James, Amal Mattu, William J. Brady Source Type: research

Traditional chinese medicine and COVID-19: should emergency practitioners use it?
At the end of January 2020, the World Health Organization (WHO) shook the World to a standstill, as they had announced the novel coronavirus 2019 (SARS-Co-V-2) or COVID-19 as the “public enemy number 1”. Emergency medical practitioners all over the World, have been on the frontlines of this modern-day crusade against the COVID-19 [1,2]. A variety of attempts at eradicating this illness have failed and emergency practitioners are confronted every day with these critically ill patients. In many instances, despite of best medical care, the prognosis is dismal [3]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 1, 2020 Category: Emergency Medicine Authors: L. Dr Adylle Varon, Daryelle S. Varon, Joseph Varon Source Type: research

The authors respond: Sepsis criteria and data interpretation
We wish to thanks the authors for their comments in the letter to the editor in regarding our study describing time to antibiotics for sepsis alerts called in the emergency department compared to those called in the field by emergency medical services [1]. We agree that the sample sizes were disproportionate between groups, however would point out that all patients within the specified timeframe were considered for our study. As both groups had large enough samples to have relatively stable estimates, the methodological impact or risk of bias is minimal. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 30, 2020 Category: Emergency Medicine Authors: Mark Mixon, Scott Dietrich, Michael Floren, Ryan Rogoszewski Source Type: research

Assessing procedural satisfaction in the pediatric ED: A systematic review
Healthcare satisfaction has been correlated with better health measures [1-5]. There is evidence that patients may not assess satisfaction in the expected or desired way [6]. Satisfaction in the field of pediatrics can be more nuanced as it can involve the perception of both the child and caregiver. Several pediatric fields have attempted to develop field-specific validated tools to capture true opinions regarding aspects of care that contribute to satisfaction [7]. To our knowledge no study has systematically reviewed satisfaction assessment of pediatric procedures. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 30, 2020 Category: Emergency Medicine Authors: Caitlin Crumm, Sonia Kaushal, Corrie E. Chumpitazi Source Type: research

Administration of inhaled noble and other gases after cardiopulmonary resuscitation: A systematic review
This article discusses up-to-date information on this novel therapeutic intervention. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 30, 2020 Category: Emergency Medicine Authors: Abbas Alshami, Sharon Einav, Markus B. Skrifvars, Joseph Varon Source Type: research

Editorial Board
(Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 30, 2020 Category: Emergency Medicine Source Type: research