Risk factors for aortic dissection in patients aged < 40
When a male patient aged (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 11, 2020 Category: Emergency Medicine Authors: Oscar M.P. Jolobe Tags: Correspondence Source Type: research

Factors associated with pediatric drowning admissions and outcomes at a trauma center, 2010 –2017
Drowning is a leading cause of preventable mortality and morbidity in children. Its high fatality rate and frequent severe sequelae (e.g. brain damage and permanent loss of functioning) place a premium on preventive efforts. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 11, 2020 Category: Emergency Medicine Authors: Tara Loux, Fahad Mansuri, Sandra E. Brooks, Nicole Slye, Briana Lewis, Yuanyuan Lu, Henian Chen, Kevin E. Kip Source Type: research

The rise of non-traumatic extremity compartment syndrome in light of the opioid epidemic
Compartment syndrome of the extremity occurs when pressure within muscle fascia exceed the ability to perfuse the muscle. The elevated pressure compromises the circulation, ultimately resulting in tissue necrosis. It most often occurs in the lower leg or forearm, but can also occur in the upper arm, hand, thigh, abdomen, buttock or foot [1]. Compartment syndrome has many causes but can largely be divided into two categories: traumatic and non-traumatic. Traumatic compartment syndrome is seen after direct trauma to the tissue, such as after a motor vehicle accident or crush injury. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 10, 2020 Category: Emergency Medicine Authors: Clifford C. Sheckter, Urska Cebron, Paola Suarez, Danielle Rochlin, Dario Tedesco, Tina Hernandez-Boussard, Catherine Curtin Source Type: research

Association between the NACA score and clinical outcomes
Leszczy ński et al. [1] are to be thanked for exploring the association between the prehospital National Advisory Committee for Aeronautics (NACA) score and outcome, an important issue. In the light of our recently published study [2] we would like to underline some aspects relative to the NACA score. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 10, 2020 Category: Emergency Medicine Authors: Fabrice Dami, Vincent Darioli, Mathieu Pasquier Source Type: research

Oxidative storm in a patient with acute rotenone-containing plant poisoning
A 64-year-old woman presented with coma, seizure, and lactic acidosis after ingesting 80 yam bean seeds. This rotenone-containing seeds cause cellular asphyxia via blockage of the mitochondrial electron transport. Subsequent oxidative stress results in the formation of lipid peroxidation (LPO). Rotenone analysis via liquid chromatography mass spectrometry revealed the following: 31,590  ng/mL in cooked yam bean seed and 100 ng/mL in the blood. We attempted to use N-acetylcysteine to alleviate oxidative stress and documented the continuous decline in the plasma concentration of LPO. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 9, 2020 Category: Emergency Medicine Authors: Jiun-Hao Yu, Chun-Fa Huang, Te-Hao Wang, Dong-Zong Hung, Han-Wei Mu, Chi-Syuan Pan Source Type: research

Meropenem as an antidote for intentional valproic acid overdose
Valproic acid (VPA) is a broad-spectrum antiepileptic drug indicated for monotherapy and adjunctive therapy of seizures, and complex manic episodes associated with bipolar disorder [1]. While uncommon due to monitoring, VPA can cause toxicity at supratherapeutic levels [1, 2]. Traditional treatment for VPA toxicity is primarily supportive care, however activated charcoal, l-carnitine, and hemodialysis have been successful in removing free VPA [2]. An interaction between carbapenem antibiotics and VPA is well-established and listed in respective package inserts as a combination to be avoided due to decreased VPA efficacy [1...
Source: The American Journal of Emergency Medicine - January 8, 2020 Category: Emergency Medicine Authors: Caitlin Thomas, James Priano, Tracey L. Smith Tags: Case Report Source Type: research

Meropenem as an antidote for intentional valproic acid overdose: A case report
Valproic acid (VPA) is a broad-spectrum antiepileptic drug indicated for monotherapy and adjunctive therapy of seizures, and complex manic episodes associated with bipolar disorder [1]. While uncommon due to monitoring, VPA can cause toxicity at supratherapeutic levels [1, 2]. Traditional treatment for VPA toxicity is primarily supportive care, however activated charcoal, l-carnitine, and hemodialysis have been successful in removing free VPA [2]. An interaction between carbapenem antibiotics and VPA is well-established and listed in respective package inserts as a combination to be avoided due to decreased VPA efficacy [1...
Source: The American Journal of Emergency Medicine - January 8, 2020 Category: Emergency Medicine Authors: Caitlin Thomas, James Priano, Tracey L. Smith Source Type: research

Intrathecal bupivacaine and morphine toxicity leading to transient hypotension and delayed status epilepticus
Local anesthetic systemic toxicity characteristically occurs after inadvertent intravascular injection of local anesthetics; however it is unclear if similar symptoms arise after intrathecal adminstration. Intrathecal use of local anesthetics for chronic pain is increasing and carries a potential risk of toxicity. Experience with the presenting symptoms and appropriate treatment for intrathecal local anesthetic toxicity is limited. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 8, 2020 Category: Emergency Medicine Authors: Alexander M. Sidlak, Joseph H. Yanta, Michael J. Lynch Source Type: research

Utilization and extravasation of peripheral norepinephrine in the emergency department
Vasopressors are typically administered through central venous catheters (CVC) due to a historical risk of extravasation with peripheral administration. However, CVC insertion is a time-consuming process that may delay vasopressor administration and is associated with complications. The Virginia Commonwealth University Health System (VCUHS) Emergency Department (ED) implemented a protocol that recommends peripheral norepinephrine (pNE) be administered through an 18 gauge or larger at or above the antecubital fossa or the external jugular vein with a maximum dose of 20  μg/min. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 8, 2020 Category: Emergency Medicine Authors: Tammy T. Nguyen, Aaron Surrey, Benjamin Barmaan, Stephen Miller, Allison Oswalt, David Evans, Harinder Dhindsa Source Type: research

Evaluation of corrosive poisoning in adult patients
To evaluate the demographic characteristics, endoscopy results, emerging complications and the final status of caustic intake cases admitted to our emergency department. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 8, 2020 Category: Emergency Medicine Authors: Selen Acehan, Salim Satar, Muge Gulen, Akkan Avc ı Source Type: research

Racial disparities in analgesic use amongst patients presenting to the emergency department for kidney stones in the United States
We sought quantify racial disparities in use of analgesia amongst patients seen in Emergency Departments for renal colic. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 8, 2020 Category: Emergency Medicine Authors: Alexandra Joice Berger, Ye Wang, Courtney Rowe, Benjamin Chung, Steven Chang, George Haleblian Source Type: research

A novel social work approach to emergency department buprenorphine induction and warm hand-off to community providers
Medications for opioid use disorder (MOUD) is considered gold standard treatment for persons with an opioid use disorder and can be successfully initiated in emergency departments (EDBUP). Perceived provider barriers to EDBUP adoption include increased provider work, lack of provider knowledge about outpatient MOUD resources, and a lack of viable MOUD treatment options within health systems. We evaluated the feasibility of a novel EDBUP institutional design that utilizes the social work team to drive ED care for patients with OUD and coordinate MOUD referral to existing community resources. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 7, 2020 Category: Emergency Medicine Authors: Timothy Kelly, Jason A. Hoppe, Matthew Zuckerman, Angela Khoshnoud, Benjamin Sholl, Kennon Heard Source Type: research

Impact of SEP-1 on broad-spectrum combination antibiotic therapy in the emergency department
The SEP-1 measures have tied financial reimbursement to the treatment of patients with severe sepsis and septic shock. The purpose of this study was to assess the impact of a SEP-1 initiative on the utilization of broad-spectrum combination therapy (BSCT) in the emergency department (ED). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 7, 2020 Category: Emergency Medicine Authors: Justin Miller, Brad Hall, Kayla Wilson, Jessica Cobian Source Type: research

Comparison of effectiveness coolant spray and placebo in patients with acute ankle trauma prospective randomized controlled trial
This study assessed the clinical value of coolant spray application on patient comfort before and during the radiographic imaging process along with its early analgesic and anti-edema effects. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 7, 2020 Category: Emergency Medicine Authors: Sultan Tuna Akgol Gur, Sinem Dogruyol, Abdullah Osman Kocak, Ilker Akbas, Kutsi Tuncer, Hatice Karabulut, Zeynep Cakir Source Type: research

Emergency department evaluation of patients with angiotensin converting enzyme inhibitor associated angioedema
Angiotensin converting enzyme inhibitor (ACEi) associated angioedema is frequently encountered in the emergency department. Airway management is the primary treatment, but published evidence supporting the decision to intubate patients with this condition is extremely limited. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 7, 2020 Category: Emergency Medicine Authors: Philip A. Mudd, Edmond A. Hooker, Uwe Stolz, Kimberly W. Hart, Jonathan A. Bernstein, Joseph J. Moellman Source Type: research

Erector spinae and serratus anterior blocks for the management of rib fractures: A retrospective exploratory matched study
The gold standard for rib fracture analgesia includes the early use of thoracic epidural (TE) or paravertebral blocks (PVB) [1,2]. Recently, there has been a surge in literature, particularly in The American Journal of Emergency Medicine celebrating the success of superficial chest wall blocks such as the erector spinae block (ESB) and the serratus anterior block (SAB) [3-7]. The ESB and SAB have not been compared with each other or to any other analgesic strategy in the management of rib fractures. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 7, 2020 Category: Emergency Medicine Authors: B. Riley, U. Malla, N. Snels, A. Mitchell, C. Abi-Fares, W. Basson, C. Anstey, L. White Source Type: research

Collegiate EMS providers' role in vaping education
Vaping is a nationwide epidemic that has gained well-deserved attention due to recent case reports seeming to increase in number daily. These realities of deaths related to e-cigarette usage has sparked medical community discussion ranging from an entire section designated on this topic in the New England Journal of Medicine (NEJM) to an ever-present media coverage featuring anecdotal experiences with the addictive effects of vaping, accusations of misinformation from the manufacturers of the products, and research advances that bring to light potential culprits for the harms of vaping [1]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 7, 2020 Category: Emergency Medicine Authors: Christopher Gaeta Source Type: research

Dysnatremias in emergency patients with acute kidney injury: A cross-sectional analysis
We aimed to investigate the prevalence, risk factors and outcome of hypo- and hypernatremia in emergency patients with acute kidney injury (AKI). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 7, 2020 Category: Emergency Medicine Authors: Bertram K. Woitok, Georg-Christian Funk, Philipp Walter, Christoph Schwarz, Svenja Ravioli, Gregor Lindner Source Type: research

Heart rate variability measures for prediction of severity of illness and poor outcome in ED patients with sepsis
This study evaluates the utility of heart rate variability (HRV) for assessment of severity of illness and poor outcome in Emergency Department (ED) patients with sepsis. HRV measures evaluated included low frequency (LF) signal, high frequency (HF) signal, and deviations in LF and HF signal from age-adjusted reference values. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 7, 2020 Category: Emergency Medicine Authors: John E. Arbo, Jeremy K. Lessing, William J.H. Ford, Sunday Clark, Eli Finkelsztein, Edward J. Schenck, Rahul Sharma, Paul M. Heerdt Source Type: research

Change in T/QRS ratio can be a supplementary diagnostic tool in predicting coronary artery disease in patients with NSTEMI
Changes in the electrocardiographic findings, namely the ratio T sum to QRS sum (T/QRS ratio), between the initial electrocardiogram (ECG) and the baseline ECG have rarely been investigated in patients with non-ST elevation myocardial infarction (NSTEMI). Thus, we aimed to determine whether changes in various parameters on ECG, including T/QRS ratio, can assist in distinguishing between coronary artery disease (CAD) and NSTEMI without CAD with low to moderate risk. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 7, 2020 Category: Emergency Medicine Authors: Yuri Choi, Jae Hoon Lee, Jung In Seo Source Type: research

Fluid resuscitation following rib fractures
I have read a manuscript about risk factors for pneumonia following rib fractures in American Journal of Emergency Medicine [1] and would like to highlight some errors and I so sustenances that merit explanation/comment from the authors. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 6, 2020 Category: Emergency Medicine Authors: Fatih Cakmak Tags: Correspondence Source Type: research

Sialolithiasis with abscess: An uncommon presentation of a Ludwig's angina mimic
We present a case of a large and obstructive sialolith with abscess whose initial presentation was concerning for Ludwig's angina with impending airway compromise. While a common complaint, emergency providers should be aware of the nefarious presentation of an everyday complaint. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 6, 2020 Category: Emergency Medicine Authors: Rachel E. Bridwell, Joshua J. Oliver, Sean A. Griffiths, Brit Long Source Type: research

History of appendectomy? An atypical case of recurrent abdominal pain
Acute appendicitis is a common condition emergency physician encounter during pediatric emergency visits. With a reported incidence of 1 in 50,000 appendectomies, stump appendicitis, an acute inflammation of the residual appendicular tissue, is a rare post-operative complication. The diagnosis of stump appendicitis is time-critical to prevent associated morbidities of abscess formation, perforation and sepsis. Another atypical presentation of appendicitis includes recurrent appendicitis, which is recognized as one or more previous episodes of similar clinical presentation as acute appendicitis, but symptoms subside within ...
Source: The American Journal of Emergency Medicine - January 6, 2020 Category: Emergency Medicine Authors: Kei Wong, Doruk E. Ozgediz, James Dodington Source Type: research

Decision rule to predict pneumonia in children presented with acute febrile respiratory illness
It is a frequent challenge for physicians to identify pneumonia in patients with acute febrile respiratory symptoms, particularly in stable pediatric patients without respiratory distress. A decision rule is required to assist judgement on the need of ordering a chest radiograph. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 5, 2020 Category: Emergency Medicine Authors: Fiona Y.Y. Chan, C.T. Lui, C.F. Tse, K.M. Poon Source Type: research

Should we be vaccinating our patients against influenza?
This article calls attention to this opportunity for Emergency Physicians to fill an unmet need with minimal impact to work-flow. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 5, 2020 Category: Emergency Medicine Authors: Bruce J. Grattan Source Type: research

The author responds: Risk factors for pneumonia following rib fractures
We wish to thank Dr. Cakmak for the review of our manuscript, entitled “Risk Factors for Pneumonia Following Rib Fractures”. We appreciate the reader's comments and questions. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 5, 2020 Category: Emergency Medicine Authors: Catherine A. Marco Source Type: research

Loneliness at the emergency department
Chronic loneliness is a pandemic [1]. 5 –18% of adults in the UK feel lonely always or often ([2]; p. 6), and one third of adults 45 and older in the USA are chronically lonely ([3]; p. IV). A study of 2770 elderly folks in Shanghai, China, found high rates of loneliness [4]. A comparative study found that 22% of people in the US, 23% i n the UK, and 9% in Japan reported chronically feeling lonely or socially isolated [5]. In the UK, loneliness costs employers £2.5 billion every year through ill health associated with loneliness, lower productivity and increased staff turnover ([2]; p. (Source: The American Jou...
Source: The American Journal of Emergency Medicine - January 5, 2020 Category: Emergency Medicine Authors: Zohar Lederman Source Type: research

An unusual complication of urinary stone disease: Spontaneous ureteral rupture
Spontaneous ureter rupture (SUR) is a rare condition that can present mimicking many acute abdominal diseases. There is no probable explanation of the theoretical mechanism of spontaneous ureter rupture in the literature. Mostly calculus can cause spontaneous ureter rupture with ureteral obstruction. If left untreated, it can lead to life-threatening complications. Herein we report a case of SUR that was occurred due to urinary stone disease in a male patient who presented with abdominal pain. A non-contrast enhanced and a late phase contrast-enhanced abdominal computed tomography (CT) demonstrated the urinary stone diseas...
Source: The American Journal of Emergency Medicine - January 5, 2020 Category: Emergency Medicine Authors: Ahmet Yasin Yitik, Sinan Çelen, Furkan Ufuk Source Type: research

Emergency preparedness in a level 1 trauma center: The 2018 Miami bridge collapse
Emergency preparedness in trauma centers is a vital component in dealing with unforeseen disasters. On March 15, 2018 a newly built pedestrian bridge collapsed onto a busy, eight-lane thoroughfare, crushing cars and passengers underneath in Miami, Florida. This mass disaster involved the sudden structural failure of a 174-foot-long bridge that fell 18.5  ft onto eight cars below. This resulted in the death of six individuals and nine other non-lethal crush victims with injuries. Five of the six deaths were pronounced at the scene and not transported. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 5, 2020 Category: Emergency Medicine Authors: Brianna Dowd, Dessy Boneva, Mark McKenney, Adel Elkbuli Source Type: research

Same provider, different location: Variation in patient satisfaction scores between freestanding and hospital-based emergency departments
Patient satisfaction scores have become quality benchmarks for hospitals, are publicly reported, and are often tied to financial incentives. We determined whether patient satisfaction scores for individual emergency medicine providers varied according to the clinical setting. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 2, 2020 Category: Emergency Medicine Authors: Erin L. Simon, Sunita Shakya, Courtney M. Smalley, McKinsey Muir, Seth R. Podolsky, Baruch Fertel Source Type: research

RE: Sublingual buprenorphine Vs IV or IM morphine in acute pain: A systematic review and meta-analysis
We write to request retraction of our recently published manuscript Sublingual buprenorphine versus intravenous or intramuscular morphine in acute pain: A systematic review and meta-analysis of randomized control trials. (American Journal of Emergency Medicine 37 (2019) 381 –386). Although we submitted the manuscript in good faith, upon reflection we believe that the paper has not clearly or fully disclosed that it better represents a subset of a previously published manuscript in the British Journal of Anaesthesia (White LD, Hodge A, Vlok R, Hurtado G, Eastern K, Me lhuish TM. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 30, 2019 Category: Emergency Medicine Authors: Ruan Vlok, Gun An, Matthew Binks, Thomas Melhuish, Leigh White Source Type: research

The safety of oral anticoagulants registry (SOAR): A national, ED-based study of the evaluation and management of bleeding and bleeding concerns due to the use of oral anticoagulants
The Safety of Oral Anticoagulants Registry (SOAR) was designed to describe the evaluation and management of patients with oral anticoagulant (OAC)-related major bleeding or bleeding concerns who present to the emergency department (ED) with acute illness or injury. Patients in the ED are increasingly taking anticoagulants, which can cause bleeding-related complications as well as impact the acute management of related or unrelated clinical issues that prompt presentation. Modifications of emergency evaluation and management due to anticoagulation have not previously been studied. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 28, 2019 Category: Emergency Medicine Authors: Charles V. Pollack, W. Frank Peacock, Richard A. Bernstein, Carol L. Clark, James Douketis, Gregory J. Fermann, Gregory J. Fiore, Alex Frost, Babak Jahromi, Charles Johnson, Geno Merli, Steven Silber, Todd C. Villines, John Fanikos, Hospital Quality Found Source Type: research

A carbon monoxide poisoning case due to lung diffusion test
Carbon monoxide (CO) poisoning occurs due to CO gas which is produced by the incomplete combustion of hydrocarbons. Several causes of CO poisoning have been defined in the literature. The most frequent causes are defective heaters, fires and exposure to exhaust gas in closed areas. The lung diffusion test is a method used to detect alveolar membrane diffusion capacity. The standart gas used in the diffusion test is CO. The case is here presented of a patient who was poisoned by CO during a DLCO test. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 28, 2019 Category: Emergency Medicine Authors: Serkan Erg özen, Ahmet Demir, Ethem Acar Source Type: research

High-sensitivity-cardiac troponin for accelerated diagnosis of acute myocardial infarction: A systematic review and meta-analysis
Cardiovascular disease is the leading cause of mortality and morbidity. Serial troponin tests have been endorsed as essential diagnostic steps to rule out/ −in acute myocardial infarction (AMI), and hs-cTn assays have shown promise in enhancing the accuracy and efficiency of AMI diagnosis in the emergency department (ED). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 27, 2019 Category: Emergency Medicine Authors: Chien-Chang Lee, Sih-Shiang Huang, Yee Hui Yeo, Yi-Ting Hou, James Yeongjun Park, Kenji Inoue, Wan-Ting Hsu Source Type: research

Limitations of poison center data analysis
We read with interest the recent publication regarding Cycas exposures and would like to raise some concerns [1]. Retrospective analyses of poison center data are inherently flawed and their misinterpretation may confound the risk assessment and management of truly poisoned patients [2]. Given that all 192 cases were self-reported, there is considerable concern for incorrect self-identification of exact genus and species of exposure. Additionally, there was no confirmatory testing or expert opinion to support that these patients were actually exposed to Cycas. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 27, 2019 Category: Emergency Medicine Authors: Angelo Mascia, Josh Wang, Robert Hoffman Tags: Correspondence Source Type: research

Evaluation of a health system-wide pharmacist-driven emergency department laboratory follow-up and antimicrobial management program
Emergency Department (ED) follow-up programs ensure that cultures, laboratory studies, and empiric antimicrobials are appropriately managed post-discharge. We sought to provide a comprehensive assessment of a pharmacist-driven laboratory follow-up process in a large, integrated health system. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 27, 2019 Category: Emergency Medicine Authors: Janet Wu, Ryan Balmat, Maria Kahle, Meredith Blynn, Rachel Hipp, Seth Podolsky, Baruch Fertel Source Type: research

Screening and falls in community hospital emergency rooms in the 12  months following implementation of MEDFRAT
Falls continue to be a public health problem. They are the leading cause of morbidity and mortality in US adults aged 65  years and older and a 2014 survey found that 28.7% of older adults reported having fallen at least once in the previous 12 months [1]. Much has been written about falls prevention in the community and inpatient settings, but less has been written about preventing falls in emergency departments. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 26, 2019 Category: Emergency Medicine Authors: Catherine A. McCarty, Melissa L. Harry, Theo A. Woehrle, Laura A. Kitch Tags: Correspondence Source Type: research

Clinical factors associated with intubation in the high flow nasal cannula era
Bronchiolitis is the most common cause for hospitalization in infants. While the use of high flow nasal cannula (HFNC) has increased, it has not uniformly reduced intubation rates. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 26, 2019 Category: Emergency Medicine Authors: Anna Suessman, Lauren L. Gray, Sarah Cavenaugh, Elizabeth A. Camp, Yan Shi, Sarah D. Meskill Source Type: research

The NACA score as a predictor of ventricular cardiac arrhythmias – A retrospective six-year study
Helicopter Emergency Medical Service (HEMS) conducts the evaluation of a patient's condition using NACA score before transporting the patient to hospital. The conditions inside the rescue helicopter limit or even make it impossible to conduct some medical procedures. An appropriate classification of the patient may lead to a lower possibility of occurrence of adverse events during the flight. The aim of the research was to evaluate the correlation of NACA score with the cardiac arrhythmia that may be life threatening. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 26, 2019 Category: Emergency Medicine Authors: Piotr Leszczy ński, Mariusz Mioduski, Robert Gałązkowski Source Type: research

Beta-blockers' effect on Levels of Lactate in patients with suspected sepsis – The BeLLa study
In the assessment and management of septic patients in the emergency department (ED), serum lactate is often measured to stratify severity to guide decision making. Increased adrenergic drive has been postulated as a contributory factor for hyperlactatemia in sepsis. We aim to prospectively evaluate the effect of chronic beta-blocker use on serum lactate levels in sepsis at initial presentation to the ED. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 26, 2019 Category: Emergency Medicine Authors: Jonathan Zhao Wang Chan, Jung Hiong Tan, Kanwar Sudhir Lather, Alexander Jet Yue Ng, Zhengxuan Ong, Xiangyu Zou, Mui Teng Chua, Win Sen Kuan Source Type: research

Anticoagulant acrobatics: Surviving the global heparin shortage in the emergency department
The United States (U.S.) faces a heparin shortage due to an African Swine Fever (ASF) outbreak in China [1]. Approximately 80% of global crude medical heparin is produced in China from pig intestines; the U.S. is 60% dependent on China for final heparin preparations. When nearly 50% of China's pig population was culled in response to ASF concerns, heparin became scarce in many U.S. markets [2]. While manufacturers now show limited availability, experts predict the shortage will continue [3]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 26, 2019 Category: Emergency Medicine Authors: Joshua J. Baugh, Russel J. Roberts, Paul D. Biddinger, Ali S. Raja, Rachel P. Rosovsky, Jennifer S. Andonian, Bryan D. Hayes Source Type: research

Screening and falls in community hospital emergency rooms in the 12  months following implementation of MEDFRAT
Falls continue to be a public health problem. They are the leading cause of morbidity and mortality in US adults aged 65  years and older and a 2014 survey found that 28.7% of older adults reported having fallen at least once in the previous 12 months [1]. Much has been written about falls prevention in the community and inpatient settings, but less has been written about preventing falls in emergency departments. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 26, 2019 Category: Emergency Medicine Authors: Catherine A. McCarty, Melissa L. Harry, Theo A. Woehrle, Laura A. Kitch Tags: Correspondence Source Type: research

Double sequential defibrillation for out-of-hospital refractory ventricular fibrillation: A scoping review
Double sequential defibrillation (DSD) has been proposed as a viable treatment option for patients in refractory ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT) out-of-hospital cardiac arrests (OHCA). However, currently there is insufficient evidence to support a widespread implementation of this therapy.Study objectives.The aim of this scoping review was to summarize the current available evidence of DSD for patients with refractory VF/pVT OHCA as well as to identify gaps in the literature that may require further research. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 24, 2019 Category: Emergency Medicine Authors: Dennis Miraglia, Lourdes A. Miguel, Wilfredo Alonso, Jonathan E. Ayala Source Type: research

Physiological demands of quality cardiopulmonary resuscitation performed at simulated 3250 meters high. A pilot study
To analyse the effect of oxygen fraction reduction (O2 14%, equivalent to 3250  m) on Q-CPR and rescuers' physiological demands. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 24, 2019 Category: Emergency Medicine Authors: Aida Carballo-Fazanes, Roberto Barcala-Furelos, Juan Eiroa-Berm údez, María Fernández-Méndez, Cristian Abelairas-Gómez, Santiago Martínez-Isasi, Manuel Murciano, Felipe Fernández-Méndez, Antonio Rodríguez-Núñez Source Type: research

Pain in the hip: Spontaneous retroperitoneal hemorrhage in an elderly patient on apixaban
We present a case of an 86-year-old female taking apixaban for atrial fibrillation who presented with right hip pain upon standing. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 24, 2019 Category: Emergency Medicine Authors: Adil Khan, Joshua Mastenbrook, Laura Bauler Source Type: research

Tuberculosis: a focused review for the emergency medicine clinician
Tuberculosis (TB) is a common disease worldwide, affecting nearly one-third of the world's population. While TB has decreased in frequency in the United States, it remains an important infection to diagnose and treat. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 21, 2019 Category: Emergency Medicine Authors: Brit Long, Stephen Y. Liang, Alex Koyfman, Michael Gottlieb Source Type: research

Evaluation of opioid requirements in the management of renal colic after guideline implementation in the emergency department
Evaluate opioid prescribing before and after emergency department (ED) renal colic guideline implementation focused on multi-modal pain management. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 21, 2019 Category: Emergency Medicine Authors: Faisal Syed Minhaj, Mercy Hoang-Nguyen, Austin Tenney, Andrew Bragg, Wen Zhang, Justin Foster, Jason Rotoli, Nicole M. Acquisto Source Type: research

Should we use receiver operator characteristics for binary predictors?
We have enjoyed reading Croft et al.'s article where the authors evaluated the emergency physicians' (EP) ability to detect regional wall motion anomaly (RWMA) compared to cardiologists' [1]. Authors' have concluded that EPs can identify accurately in patients with ST segment elevation, using cardiologist ’ evaluation as a gold standard. But there are few points we want to point about the use of Receiver Operator Characteristics (ROC) in the statistical analysis of this study. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 21, 2019 Category: Emergency Medicine Authors: Serhat Akay, Huriye Akay Source Type: research

National trends in mental health-related emergency department visits by children and adults, 2009 –2015
Examine trends in mental health-related emergency department (ED) visits, changes in disposition and length of stay (LOS), describe disposition by age and estimate proportion of ED treatment hours dedicated to mental health-related visits. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 20, 2019 Category: Emergency Medicine Authors: Sarah Axeen, Genevieve Santillanes, Chun Nok Lam, Michael Menchine Source Type: research

Demographic characteristics and delayed neurological sequelae risk factors in carbon monoxide poisoning
Carbon monoxide (CO) is a colorless, odorless gas and tasteless. CO poisoning (COP) is one of the most frequently encountered inhalation poisonings. The most common cause of morbidity in COP is delayed neurological sequelae (DNS). DNS is the occurrence of neuropsychiatric findings within 2 –240 days after discharge of patients with COP and there are no definitive diagnostic criteria.The aim of our study is; to determine the risk factors and incidence of DNS. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 20, 2019 Category: Emergency Medicine Authors: Fatma Sari Do ğan, Özlem Güneysel, Eren Gökdağ, Merve Güneş, Selin Gamze Sümen Source Type: research