Retraction notice to "Sublingual buprenorphine versus intravenous or intramuscular morphine in acute pain: A systematic review and meta-analysis of randomized control trials" [AJEM 37/3 (2019) 381 –386]
This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 30, 2020 Category: Emergency Medicine Authors: Ruan Vlok, Gun Hee An, Matthew Binks, Thomas Melhuish, Leigh White Tags: Retraction notice Source Type: research

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

Info for authors
(Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 30, 2020 Category: Emergency Medicine Source Type: research

Multi-centered evaluation of a novel fixed-dose four-factor prothrombin complex concentrate protocol for warfarin reversal
Previous studies have shown fixed-dose 4PCC to be as effective as standard-dose 4PCC for warfarin reversal. However, certain patient populations such as those with high total body weight (TBW) or elevated baseline INR may be at increased risk for treatment failure. The purpose of this study was to validate the efficacy of a novel fixed-dose 4PCC protocol for warfarin reversal. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 29, 2020 Category: Emergency Medicine Authors: Scott K. Dietrich, Mark Mixon, Michael Holowatyj, Josh C. Werth, Stephanie A. Delgado, Nicole E. Mascolo, Erin R. Meister, Shane M. Zoucha, Toby C. Trujillo Source Type: research

Challenges associated with blood banks and blood donations during the COVID-19 pandemic
Every 2 seconds, a patients in the United States (US) needs a red blood cell (RBC) transfusion [1,2]. Almost 5000 platelet units and 6500 units of plasma are required every day [2]. As the aging population advances along with developments in medical treatment and procedures, there is a constant need for blood and blood components. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 29, 2020 Category: Emergency Medicine Authors: Brendon Sen-Crowe, Kelly McKenney, Mark McKenney, Adel Elkbuli Source Type: research

Non-obstetric vulvovaginal lacerations: Conservative versus surgical management
Non-obstetric genital trauma is generally uncommon, however it is gradually becoming a more frequent cause of vulvovaginal lacerations. This type of injury is most commonly caused by direct blunt trauma to a highly vascular area which is then crushed against osseous planes [1]. Several mechanisms of injury have been described previously, including “straddle” injuries, accidental penetration, sexual abuse, tearing and laceration during sudden abduction of the lower extremities or due to pelvic fracture, self-mutilation, and burns by hot liquids [1,2]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 29, 2020 Category: Emergency Medicine Authors: Meredith Busman, Nathaniel Ladaga, Lindsey Ouellette, Linda Rossman, Stephanie Solis, Jason Seamon, Christian Kolacki, Jeffrey S. Jones Source Type: research

Physician assistant and nurse practitioner utilization in U.S. emergency departments, 2010 to 2017
Physician Assistants (PAs) and Nurse Practitioners (NPs) are widely utilized in United States (US) Emergency Departments(EDs). We sought to characterize ED PA and NP utilization and practice characteristics in US EDs 2010 –2017. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 27, 2020 Category: Emergency Medicine Authors: Fred Wu, Michael A. Darracq Source Type: research

Fluconazole-induced acute generalized exanthematous pustulosis
We report a case of 7-year-old boy who developed AGEP shortly after commencing oral fluconazole for Tinea capitis. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 27, 2020 Category: Emergency Medicine Authors: Elie Saliba, Remie Chrabieh, Zeina Tannous Source Type: research

Comparison of intravenous ibuprofen and paracetamol efficiency in soft tissue injuries: A randomized, double-blind study
Soft tissue injuries are painful injuries of the musculoskeletal system that occur after sprains, strains, and muscle contusions. Pain control is required in the management of these patients. Providing adequate pain control can allow patients to return to their regular physical activities by allowing early controlled mobilization, as well as patient comfort [1]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 27, 2020 Category: Emergency Medicine Authors: Yal çinli Sercan, Kiyan Güçlü Selahattin, Can Özge Source Type: research

The management of the poisoned patient using a novel emergency department-based resuscitation and critical care unit (ResCCU)
This study sought to identify characteristics of poisoned patients treated in the ResCCU. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 27, 2020 Category: Emergency Medicine Authors: Anita Mudan, Jennifer S. Love, John C. Greenwood, Carolyn Stickley, Victoria L. Zhou, Frances S. Shofer, David H. Jang Source Type: research

COVID-19 associated parotitis
We present a case of a 21-year-old woman diagnosed in our ED with COVID-19 associated parotitis and review the epidemiology and management of parotitis. We discuss the importance of considering COVID-19 in the differential of parotitis and other viral-associated syndromes and emphasize the importance of donning personal protective equipment during the initial evaluation. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 27, 2020 Category: Emergency Medicine Authors: Jennifer Fisher, Derek L. Monette, Krupa R. Patel, Brendan P. Kelley, Maura Kennedy Tags: Case Report Source Type: research

Comparison of manual and mechanical chest compression techniques using cerebral oximetry in witnessed cardiac arrests at the emergency department: A prospective, randomized clinical study
We aimed to compare regional cerebral oxygen saturation (rSO2) levels during cardiopulmonary resuscitation (CPR), performed either manually or using a mechanical chest compression device (MCCD), in witnessed cardiac arrest cases in the emergency department (ED), and to evaluate the effects of both the CPR methods and perfusion levels on patient survival and neurological outcomes. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 26, 2020 Category: Emergency Medicine Authors: Filiz Baloglu Kaya, Nurdan Acar, Engin Ozakin, Mustafa Emin Canakci, Caglar Kuas, Muzaffer Bilgin Source Type: research

Reply to correspondence: Intradermal sterile water injection for acute renal colic pain. MS 23569R1
We thank the authors for raising an important point concerning the analgesic efficacy of the intradermal sterile water injection (ISWI) for acute renal colic. The authors stated that multiple sites for ISWI may be more effective for pain relief of acute renal colic based on Melzack theory. They also mentioned that according to this theory, consecutive injections increase the pain threshold by the afferent sensory neuronal pathway to the brain. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 26, 2020 Category: Emergency Medicine Authors: Mohamad Moussa, Athanasios G. Papatsoris, Mohamed Abou Chakra Source Type: research

Prognosis of non-severely comorbid elderly patients admitted to emergency departments: A prospective study
The ageing of the population leads to a rising demand for urgent care among elderly patients, namely patients>75  years [1]. Visits to emergency department (ED) for elderly patients increased by 34% during a ten years period (1993–2003) and this trend is growing [1]. In a retrospective analysis of prospectively collected data of 120,123 patients, the absolute number and the proportion of patients aged over 80 years admitted to intensive care unit (ICU) significantly increased annually during the 6-year study period and those with comorbid illnesses had lower ICU and hospital survival [2]. (Source: The American...
Source: The American Journal of Emergency Medicine - June 26, 2020 Category: Emergency Medicine Authors: Laura Maarek, Florent Maillet, Aicha Turki, Adrien Altar, Hichem Hamdi, Mouna Berroukeche, Didier Haguenauer, Myriam Chemouny, Pierre-Emmanuel Cailleaux, Nicolas Javaud Source Type: research

Obesity is not associated with increased difficulty placing peripheral IVs in trauma activation patients
This study adds valuable considerations to the existing literature on obesity as a factor on the placement of peripheral venous catheters. However, there are a few concerns that we would like to raise. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 26, 2020 Category: Emergency Medicine Authors: Carol Sanchez, Amanda Baroutjian, Mark McKenney, Adel Elkbuli Source Type: research

Obesity is not associated with increased difficulty placing peripheral IVs in trauma activation patients
We would like to thank the authors for their interest and comments on our recent article “Obesity is not Associated with Increased Difficulty Placing Peripheral IVs in Trauma Activation Patients” (MS 23627) and welcome this opportunity to provide a response [1]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 26, 2020 Category: Emergency Medicine Authors: Aaron Nathan Barksdale, Matthew Goede, Scott Madden, Abraham Campos, Robin High Source Type: research

COVID-19 associated parotitis: A case report
We present a case of a 21-year-old woman diagnosed in our ED with COVID-19 associated parotitis and review the epidemiology and management of parotitis. We discuss the importance of considering COVID-19 in the differential of parotitis and other viral-associated syndromes and emphasize the importance of donning personal protective equipment during the initial evaluation. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 26, 2020 Category: Emergency Medicine Authors: Jennifer Fisher, Derek L. Monette, Krupa R. Patel, Brendan P. Kelley, Maura Kennedy Source Type: research

A systematic review of the causes and prevention strategies in reducing gun violence in the United States
Approximately 100 lives are lost each day as a result of gun violence in the United States (US) with civilian mass shootings increasing annually. The gun violence rate in the US is almost 20 times higher than other comparable developed countries and has the most gun ownership per capita of any nation in the world. Understanding the causes and risk factors are paramount in understanding gun violence and reducing its incidence. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 26, 2020 Category: Emergency Medicine Authors: Carol Sanchez, Daniella Jaguan, Saamia Shaikh, Mark McKenney, Adel Elkbuli Source Type: research

Lactate/albumin ratio: An early prognostic marker in critically ill patients
We investigate the clinical utility of the lactate/albumin (L/A) ratio as an early prognostic marker of ICU mortality in a large cohort of unselected critically ill patients. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 26, 2020 Category: Emergency Medicine Authors: Amin Gharipour Msc, Rouzbeh Razavi Msc, Mojgan Gharipour Msc, Mukasa David Source Type: research

Thyrotoxicosis and bilateral internal carotid artery dissections
Cervical artery dissection is a rare but important diagnosis to consider in young patients presenting with stroke. Multiple etiologies of cervical artery dissections have been previously reported, but the association with thyrotoxicosis is extremely rare. A previously healthy 43-year-old female presented to the emergency department with new symptoms related to thyrotoxicosis and bilateral internal carotid artery dissections. Her atrial fibrillation and hypertension resolved by treating the underlying hyperthyroidism with methimazole and propranolol. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 26, 2020 Category: Emergency Medicine Authors: Thomas Winter, Eyal Kraut, Kristjan Thompson Tags: Case Report Source Type: research

Cardiac injury, ARDS and COVID-19 meta-analysis validity – Correspondence in response to Santoso et al.
In the course of writing a rapid review for the University of Oxford, we came across an interesting and timely systematic review and meta-analysis in the American Journal of Emergency Medicine by Santoso and colleagues [1]. This paper was of note to us because it included a meta-analysis on acute respiratory distress syndrome (ARDS) and cardiac injury, based on two papers - one by Shi [2] and another by Wu [3]. On reading the paper by Wu, we have significant concerns about the inclusion of this study in Santoso's meta-analysis as we believe it currently underpins an inaccurate conclusion that cardiac injury is not signific...
Source: The American Journal of Emergency Medicine - June 25, 2020 Category: Emergency Medicine Authors: Catherine Carver, Nicholas Jones Source Type: research

Cardiac injury and ARDS meta-analysis validity – Correspondence in response to Santoso et al.
In the course of writing a rapid review for the University of Oxford, we came across an interesting and timely systematic review and meta-analysis in the American Journal of Emergency Medicine by and colleagues [1]. This paper was of note to us because it included a meta-analysis on acute respiratory distress syndrome (ARDS) and cardiac injury, based on two papers - one by Shi [2] and another by Wu [3]. On reading the paper by Wu, we have significant concerns about the inclusion of this study in Santoso's meta-analysis as we believe it currently underpins an inaccurate conclusion that cardiac injury is not significantly as...
Source: The American Journal of Emergency Medicine - June 25, 2020 Category: Emergency Medicine Authors: Catherine Carver, Nicholas Jones Source Type: research

A novel predictive tool for prognosis in elderly patients with urinary tract infection: Modified PRACTICE
We evaluated whether combining the serum albumin level and the Prediction Rule for Admission policy in Complicated urinary Tract InfeCtion LEiden (PRACTICE) class could be a prognostic predictor in elderly patients with urinary tract infection (UTI). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 25, 2020 Category: Emergency Medicine Authors: Seung Ryu, Se Kwang Oh, Sung Uk Cho, Yeonho You, Jung Soo Park, Jin Hong Min, Wonjoon Jeong, Yong Chul Cho, Hong Joon Ahn, Changshin Kang Source Type: research

A diagnostic confusion between Serotonin syndrome and Neuroleptic malignant syndrome
Soh et al. reported Neuroleptic malignant syndrome (NMS), fulfilling the Levenson's criteria, in two patients with COVID-19 [1]. The clinical phenomenon of NMS and Serotonin syndrome (SS) is very similar, and differentiation between these two clinical disease entities may be difficult, as patients can meet the criteria for both syndromes [2]. The two main points which help in differentiating SS with NMS are (i) type of precipitating drugs (serotonergic drug vs neuroleptic drug) and (ii) presence of neuromuscular hyperactivities (clonus and hyperreflexia vs hyporeflexia) [2,3]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 25, 2020 Category: Emergency Medicine Authors: Sanjay Prakash Source Type: research

A rare case of thyrotoxicosis and bilateral internal carotid artery dissections
Cervical artery dissection is a rare but important diagnosis to consider in young patients presenting with stroke. Multiple etiologies of cervical artery dissections have been previously reported, but the association with thyrotoxicosis is extremely rare. A previously healthy 43-year-old female presented to the emergency department with new symptoms related to thyrotoxicosis and bilateral internal carotid artery dissections. Her atrial fibrillation and hypertension resolved by treating the underlying hyperthyroidism with methimazole and propranolol. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 25, 2020 Category: Emergency Medicine Authors: Thomas Winter, Eyal Kraut, Kristjan Thompson Source Type: research

Comparison of an ED triage sepsis screening tool and qSOFA in identifying CMS SEP-1 patients
Sepsis is of great interest and concern to the medical community given its high risk of mortality, incidence and cost. Each year, at least 1.7 million adults in the United States develop sepsis, resulting in nearly 270,000 deaths [1]. The emergency department (ED) serves as a primary site of initial identification and treatment of most sepsis patients [2]. The cost of sepsis management in U.S. hospitals ranks highest among admissions for all disease states. For example, in 2013, sepsis accounted for more than $24 billion in hospital expenses, far surpassing the next most costly conditions [3]. (Source: The American Journal...
Source: The American Journal of Emergency Medicine - June 25, 2020 Category: Emergency Medicine Authors: Ethan Sterk, Byung Hun Hyun, Megan A. Rech Source Type: research

Evolution of emergency medical calls during a pandemic – An emergency medical service during the COVID-19 outbreak
Emergency Medical Services (EMS) are expected to be affected by a pandemic outbreak. However, the available data about trends and extents of these effects is limited. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 25, 2020 Category: Emergency Medicine Authors: Eli Jaffe, Roman Sonkin, Refael Strugo, Erik Zerath Source Type: research

Saliva ejector assisted laryngoscopy (SEAL) for protective intubation
We describe a potential method for reducing provider exposure during intubation using a saliva ejector suction system. This aerosol-reducing method has an easy-to-remember acronym: “SEAL” (saliva ejector assisted laryngoscopy). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 25, 2020 Category: Emergency Medicine Authors: Li-Wei Lin, Chee-Fah Chong Source Type: research

Measuring the physiological impact of extreme heat on lifeguards during cardiopulmonary resuscitation. Randomized simulation study
Lifeguard teams carry out their work in extremely hot conditions in many parts of the world. The aim of this study was to analyze the impact of high temperatures on physiological parameters during cardiopulmonary resuscitation (CPR). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 25, 2020 Category: Emergency Medicine Authors: Roberto Barcala-Furelos, Mar ía Fernández-Méndez, Francisco Cano-Noguera, Martín Otero-Agra, Ricardo Morán-Navarro, Santiago Martínez-Isasi Source Type: research

One-way-street revisited: Streamlined admission of critically-ill trauma patients
This study investigates the sustainability of the pathway, as well as its effectiveness in times of increased ED crowding. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 25, 2020 Category: Emergency Medicine Authors: Todd A. Jaffe, Jungyeon Kim, Christopher DePesa, Benjamin White, Haytham M.A. Kaafarani, Noelle Saillant, April Mendoza, David King, Peter Fagenholz, George Velmahos, Jarone Lee Source Type: research

Diaphragmatic excursion measurement in emergency department patients with acute dyspnea to predict mechanical ventilation use
Ultrasound is a feasible and reproducible method for measuring right diaphragmatic excursion (RDE) in ED patients with acute dyspnea (AD). In AD patients, the correlation between the RDE value and the need for mechanical ventilation (MV) is not known. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 25, 2020 Category: Emergency Medicine Authors: Aude Cl ément, Laurent Zieleskiewicz, Jean-Marie Bonnec, Bob-Valéry Occéan, Sophie Bastide, Laurent Muller, Jean Emmanuel de La Coussaye, Alain Boussuges, Pierre Géraud Claret, Xavier Bobbia Source Type: research

Acuity-appropriate triage of chief complaints found on urgent care center organization websites
Offering walk-in appointments during extended hours, shorter wait times and visits, and decreased costs, urgent care centers (UCCs) serve as an alternative to the emergency department (ED) for non-emergent (I.e. non-life or non-limb threatening) illnesses and injuries. Despite these advantages, 21% of adults indicate they would pursue care in the ED for non-emergent conditions [1]. Likewise, of all ED visits in 2016, only 8.7% were immediate or emergent, while 32.4% were urgent, 24.5% were semi-urgent and 4.3% were non-urgent [2]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 25, 2020 Category: Emergency Medicine Authors: Rachel Rothstein, Kevin Zhen, Raymond Y. Kim, Robert P. Olympia Source Type: research

COVID-19 associated Kawasaki-like multisystem inflammatory disease in an adult
Recent reports have described a secondary Multisystem Inflammatory Syndrome in Children (MIS-C) after a prior COVID-19 infection that often has features of Kawasaki disease (KD). Here, we report the case of a 36-year-old woman who presented to the emergency department hypotensive and tachycardic after 1  week of fevers, abdominal pain, vomiting and diarrhea, and was found to have the classic phenotype of complete Kawasaki's Disease including nonexudative conjunctivitis, cracked lips, edema of the hands and feet, palmar erythema, a diffuse maculopapular rash, and cervical lymphadenopathy. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 24, 2020 Category: Emergency Medicine Authors: Sabrina Sokolovsky, Parita Soni, Taryn Hoffman, Philip Kahn, Joshua Scheers-Masters Source Type: research

Bayes' theorem, COVID19, and screening tests
The COVID19 crisis has provided a portal to revisit and understand qualities of screening tests and the importance of Bayes' theorem in understanding how to interpret results and implications of next actions. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 24, 2020 Category: Emergency Medicine Authors: Gar Ming Chan Source Type: research

To solve our new emergency care crisis, let's start with the old one
While the COVID-19 pandemic has generated many new challenges for emergency departments (EDs) across the country, it has also created potential opportunities for the improvement of emergency care delivery, both during the pandemic and going forward. Certainly, in some hospitals, the lack of built-in reserve capacity that had previously led to chronic overcrowding and ED boarding resulted in even more unsafe crowding conditions during surges of COVID-19 patients [1]. However, in other hospitals, like ours, a fundamental shift in operations allowed for markedly improved ED flow despite a markedly increased volume of high acu...
Source: The American Journal of Emergency Medicine - June 24, 2020 Category: Emergency Medicine Authors: Joshua J. Baugh, Benjamin A. White, Paul D. Biddinger, Ali S. Raja, Kelley A. Wittbold, Jonathan D. Sonis, Brian J. Yun Source Type: research

Socioeconomic disparities in prehospital cardiac arrest outcomes: An analysis of the NEMSIS database
Socioeconomic disparities are engrained in the US healthcare system and may extend to the prehospital cardiac arrest setting where mortality is high. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 24, 2020 Category: Emergency Medicine Authors: Sriman Gaddam, Sukhjit Singh Source Type: research

Intradermal sterile water injection for acute renal colic pain
In this letter, we would like to comment on the study entitled “Intradermal sterile water injection versus diclofenac sodium in acute renal colic pain: A randomized controlled trial.” [1]. The established data related to subcutaneous distilled water injection in renal colic pain condition have been presented during the European Association of Urology Congre ss, which was held in Istanbul, Turkey in 2005 [2]. Besides, we have published a retrospective study paper on this method, which we have been applying for about 15 years [3]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 24, 2020 Category: Emergency Medicine Authors: Bekir Aras, Fatih Uru ç Tags: Letter to the Editor Source Type: research

The authors' response: A diagnostic confusion between serotonin syndrome and neuroleptic malignant syndrome
Thank you for the comments on our article. First, we could not describe the details of symptoms or the differential diagnosis in the text because of the word limit; therefore, we sincerely appreciate the authors/editors providing us the opportunity to describe the details of neuroleptic malignant syndrome (NMS) in patients with COVID-19 infection. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 24, 2020 Category: Emergency Medicine Authors: Mitsuhito So, Toru Hifumi, Shutaro Isokawa, Masato Shimizu, Norio Otani, Shinichi Ishimatsu Source Type: research

COVID-19 and preeclampsia with severe features at 34-weeks gestation
The evolving coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to a rapid expansion of knowledge on the disease's clinical manifestations, laboratory and radiographic abnormalities, and patient trajectories. One area of particular focus is the effect that this illness may have on pregnancy and maternal-fetal disease. As of April 24, 2020, we identified 55 English language reports in the scientific literature summarizing data for 339 women and 258 fetuses and neonates. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 24, 2020 Category: Emergency Medicine Authors: John N. Hansen, Jason Hine, Tania D. Strout Source Type: research

Use of an improvised clamp to manage bleeding tongue injuries
We report a case of a 67-year-old Chinese man admitted to the emergency department for a persistent bleed on the tongue. Initial digital pressure and application of topical tranexamic acid did not stop the bleeding. An improvised clamp applied to the tongue was successful in achieving haemostasis. Using this method, there was no need for a clinical staff to be present for manual application of pressure. This frees up the staff for other clinical duties and matters. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 24, 2020 Category: Emergency Medicine Authors: Matthias Wei Jin Chen, Chee Weng Yong, Jing Li Lum Source Type: research

Massive bladder inguinal hernia leading to acute urinary retention
We present a case of a patient with almost complete herniation of bladder into left inguinal canal into the left hemiscrotum. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 24, 2020 Category: Emergency Medicine Authors: Noah D. Bernhardson, Margaret H. Shepherd, Chester D. Shermer Source Type: research

The authors reply: Study selection for meta-analyses
We want to thank you for the opportunity to respond to the issue raised by Dr. Carver's letter about our manuscript “Cardiac injury is associated with mortality and critically-ill pneumonia in COVID-19: A meta-analysis”, recently published in “American Journal of Emergency Medicine” [1]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 23, 2020 Category: Emergency Medicine Authors: Anwar Santoso Source Type: research

A model for rapid emergency department expansion for the COVID-19 pandemic
COVID-19 has caused global dramatic change in medical practices including the introduction of temporary screening and assessment areas outside the footprint of the main hospital structures. Following the initial surge of patients with novel coronavirus (2019-nCoV) in the United States, our medical center rapidly designed and constructed an alternative assessment and treatment site in a converted parking garage deck for emergency department patients with suspected or confirmed 2019-nCoV. During the first month after opening, 651 patients were treated in this alternative assessment area including 54 patients who tested posit...
Source: The American Journal of Emergency Medicine - June 23, 2020 Category: Emergency Medicine Authors: Nathaniel M. Miller, Ian Jones, Stephan Russ, Corey Slovis, Jeanne Yeatman, Gary Clark, Ashley Jeffrey, Tyler W. Barrett Source Type: research

Effect of a split-flow physician in triage model on abdominal CT ordering rate and yield
The objective of this study was to compare the rate and clinical yield of computed tomography (CT) imaging between patients presenting with abdominal pain initially seen by a physician in triage (PIT) versus those seen only by physicians working in the main emergency department (ED). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 23, 2020 Category: Emergency Medicine Authors: Brian W. Patterson, Jordan Johnson, Michael Ward, Azita G. Hamedani, Brian Sharp Source Type: research

Of aortic valve and bleeding: Heyde's syndrome
An 80-year-old woman with severe aortic stenosis presented with relapsing enterorrhagia and severe anemia. A video capsule pan-endoscopy showed multiple sites of complex mucosal angiodysplasia in the jejunum. Direct hemostatic treatment of accessible angiodysplasia was done with argon plasma coagulation, and the patient was urgently referred for trans-catheter aortic valve replacement (TAVR). At follow-up 1  month and 3 months later, she was doing well with no further episodes of bleeding. Heyde's syndrome is referred to as the association of aortic stenosis, gastrointestinal angiodysplasia, bleeding, and anemia. (Sour...
Source: The American Journal of Emergency Medicine - June 22, 2020 Category: Emergency Medicine Authors: Giuseppe Famularo, Marzia Marrollo Source Type: research

Letter to the editor: Neuroleptic malignant syndrome in COVID-19 patients by Soh et al
We read with great interest the recent article by Soh et al. detailing two cases of Neuroleptic Malignant Syndrome (NMS) in COVID-19 patients being treated with favipiravir in Tokyo [1]. We recently published the first case report of NMS in a COVID-19 patient in Los Angeles [2]. Although our patient did not receive favipiravir, he had a history of haloperidol decanoate administration three weeks prior to his presentation. Neurologic symptoms including skeletal muscle injury have been observed in a notable percentage of COVID-19 patients [3]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 21, 2020 Category: Emergency Medicine Authors: Nitin Ubhayakar, Antonio Liu Source Type: research

The influence of corticosteroid on patients with COVID-19 infection: A meta-analysis
Coronavirus disease 2019 (COVID-19) has rapidly spread globally in just two more months. This emerging outbreak caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has already affected a large number of people from over 100 countries in the world [1]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 21, 2020 Category: Emergency Medicine Authors: Yushu Wang, Guangyu Ao, Xin Qi, Jian Zeng Source Type: research

Hemodynamic comparison of intravenous push diltiazem versus metoprolol for atrial fibrillation rate control
This study's objective was to determine if there was a significant difference in blood pressure reduction between agents. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 20, 2020 Category: Emergency Medicine Authors: Jessica Nicholson, Quinn Czosnowski, Tara Flack, Peter S. Pang, Kelsey Billups Source Type: research

Implementation of a tablet-based suicide screening tool in an emergency department
In adolescents and young adults, suicide is the second leading cause of death [2]. Identifying adolescents with suicidal ideation offers the potential to provide necessary resources and prevent suicide before an attempt is made. Universal screening for suicide in the emergency department (ED) has been shown to be feasible and has found a twofold increase in risk detection [5], but can be difficulty in already busy EDs. A quick, verbally administered, 4 –5 question screen, the Ask Suicide-Screening Questions (ASQ), was developed and validated for pediatric EDs to identify youth at risk of suicide, [6] but adolescents ...
Source: The American Journal of Emergency Medicine - June 19, 2020 Category: Emergency Medicine Authors: Michelle L. Pickett, Callie Krentz, Mark Nimmer, Ashley Servi, Anna Schmitz, Amy L. Drendel Source Type: research

Zone 3 REBOA does not provide hemodynamic benefits during nontraumatic cardiac arrest
Resuscitative endovascular balloon occlusion of the aorta (REBOA) may be a novel intervention to improve cardiopulmonary resuscitation (CPR) quality during cardiac arrest. Zone 1 supraceliac aortic occlusion improves coronary and cerebral blood flow. It is unknown if Zone 3 occlusion distal to the renal arteries offers a similar physiologic benefit while maintaining blood flow to organs above the point of occlusion. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 17, 2020 Category: Emergency Medicine Authors: Craig D. Nowadly, Guillaume L. Hoareau, J. Kevin Grayson, M. Austin Johnson Source Type: research