A reply to Turcato et al.
We read with great enthusiasm the article entitled, “Risk factors associated with intracranial bleeding and neurosurgery in patients with mild traumatic brain injury who are receiving direct oral anticoagulants” by Turcato et al. [1] While we appreciate their work and effort to shed light on this extremely important topic we must highlight some k ey concepts that we believe may alter the manuscripts interpretation. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 20, 2020 Category: Emergency Medicine Authors: Brian W. Gilbert, Brady Dively, Jacob A. Reeder, George J. Philip Source Type: research

Interfacility transports by emergency medical services in the United States: Estimates from the National Hospital Ambulatory Medical Care Survey
To describe characteristics of encounters in U.S. emergency departments (EDs) brought by interfacility transport by emergency medical services (EMS) from other EDs or urgent care settings. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 20, 2020 Category: Emergency Medicine Authors: Sriram Ramgopal Source Type: research

Comparison of non-invasive CPAP with mask use in carbon monoxide poisoning: Some concerns about methodology
We have read with great interest this article where two options for the clinical control of carbon monoxide poisoning are analyzed, with great clinical repercussions and effects on the prognosis of this type of poisoning [1]. It may be a good treatment option in emergency departments, especially in patients with comorbidity such as heart failure [2]. However, there is not much data on the use of continuous positive airway pressure (CPAP) in these patients in the literature, but we think that the differences in CPAP application in general may cause a difference in treatment response. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 19, 2020 Category: Emergency Medicine Authors: Berrin Er, Antonio M. Esquinas Source Type: research

Hypoglycemic cardiac arrest and rapid return-of-spontaneous circulation (ROSC) with dextrose
We present a case of return of spontaneous circulation in a patient with cardiac arrest after administration of dextrose for hypoglycemia. Routine administration of dextrose to patients in cardiac arrest has been shown to be associated with increased mortality and worse neurological outcomes. However, this case reminds the clinician to consider hypoglycemia in patients with cardiac arrest, and to attempt correcting a low blood glucose if noted . (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 18, 2020 Category: Emergency Medicine Authors: Joan Rui Shan Fun, Michael Yih Chong Chia Source Type: research

Hypoglycemic cardiac arrest and rapid return-of-spontaneous circulation (ROSC) with dextrose – A case report
We present a case of return of spontaneous circulation in a patient with cardiac arrest after administration of dextrose for hypoglycemia. Routine administration of dextrose to patients in cardiac arrest has been shown to be associated with increased mortality and worse neurological outcomes. However, this case reminds the clinician to consider hypoglycemia in patients with cardiac arrest, and to attempt correcting a low blood glucose if noted . (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 17, 2020 Category: Emergency Medicine Authors: Joan Rui Shan Fun, Michael Yih Cong Chia Source Type: research

The geriatric emergency literature 2019
Geriatric Emergency Medicine is an important frontier for study and innovation by emergency practitioners. The rapid growth of this patient population combined with complex medical and social needs has prompted research ranging from which tests and screening tools are most effective for geriatric evaluation to how we can safely manage pain in the elderly or address goals of care in the Emergency Department. This review summarizes emergency medicine articles focused on the older patient population published in 2019, which the authors consider critical to the practice of geriatric emergency medicine. (Source: The American Jo...
Source: The American Journal of Emergency Medicine - May 16, 2020 Category: Emergency Medicine Authors: Danya Khoujah, Nicole Cimino-Fiallos Source Type: research

HHV 6 –7 reactivation causing Pityriasis Rosea and labyrinthitis
Pityriasis Rosea (PR) and labyrinthitis are most commonly caused by viral infections. PR presents with a characteristic rash while labyrinthitis presents with vertigo, tinnitus and hearing loss. However, the coexistence of PR and Labyrinthitis remains an uncommon event. Human Herpes Virus (HHV) 6 and 7, are common infections in childhood, and their reactivation causes Pityriasis Rosea. But these viruses are not known to have any involvement with the inner ear or the 8th cranial nerve (CN). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 15, 2020 Category: Emergency Medicine Authors: Mahmoud el- Hussein, Chady el- Tawil, Ramzi Nakhle, Naji Souaiby Source Type: research

The top 100 most cited articles on rhabdomyolysis: A bibliometric analysis
Over the past few decades, the incidence of Rhabdomyolysis (RM) has significantly increased. The prognosis is substantially worse if renal failure develops. Many problems remain to be addressed regarding the pathogenesis, prevention, and treatment of RM. The purpose of this study was to identify and characterize the top 100 most cited publications regarding rhabdomyolysis (RM) by performing a bibliometric analysis. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 15, 2020 Category: Emergency Medicine Authors: Chao Liu, Qian Yuan, Zhi Mao, Pan Hu, Kun Chi, Xiaodong Geng, Quan Hong, Xuefeng Sun Source Type: research

Assessing mortality outcomes of beta-lactam-allergic patients presenting with sepsis
To determine the impact of reported beta-lactam allergies on in-hospital mortality and other clinical outcomes in patients who presented with severe sepsis or septic shock. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 15, 2020 Category: Emergency Medicine Authors: Kelsey L. Komyathy, William R. Judd, Patrick D. Ratliff, Robert E. Hughes Source Type: research

Neurologic complications of COVID-19
Much of the focus regarding the global pandemic of coronavirus disease of 2019 (COVID-19) has been on the cardiovascular, pulmonary, and hematologic complications. However, neurologic complications have arisen as an increasingly recognized area of morbidity and mortality. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 15, 2020 Category: Emergency Medicine Authors: Rachel Bridwell, Brit Long, Michael Gottlieb Source Type: research

Value-based syncope evaluation and management: Perspectives of health care professionals on readiness, barriers and enablers
Syncope is a common condition seen in the emergency department. Given the multitude of etiologies, research exists on the evaluation and management of syncope. Yet, physicians' approach to patients with syncope is variable and often not value based. The 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients with Syncope includes a focus on unnecessary medical testing. However, little research assesses implementation of the guidelines. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 15, 2020 Category: Emergency Medicine Authors: Jing Li, Vedant Gupta, Susan S. Smyth, Amy Cowley, Gaixin Du, Matthew Sirrine, Seth Stearley, Romil Chadha, Vikas Bhalla, Mark Williams Source Type: research

Nitrous oxide inhalant abuse and massive pulmonary embolism in COVID-19
A patient presented to the emergency department with altered mental status and lower extremity weakness in the setting of nitrous oxide inhalant abuse and Coronavirus Disease-2019 (COVID-19) infection. He subsequently developed hypotension and severe hypoxia, found to have a saddle pulmonary embolus (PE) with right heart strain requiring alteplase (tPA). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 14, 2020 Category: Emergency Medicine Authors: Melanie F. Molina, Ahad A. Al Saud, Abdullah A. Al Mulhim, Andrew S. Liteplo, Hamid Shokoohi Source Type: research

Neurotoxicity secondary to local tetracaine use
Systemic reactions from local tetracaine use are often an anomaly – not only is tetracaine short-acting and quickly metabolized by the pseudocholinesterase system leading to very limited systemic uptake, but most adverse reactions are usually associated with dental or spinal anesthesia. Furthermore, reactions to local anesthetics manifest in standard allergy-typ e reactions. When local anesthetics lead to nervous or cardiac system abnormalities, it is termed a local anesthetic systemic toxicity – an event with an incidence currently estimated to be 0.03%. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 14, 2020 Category: Emergency Medicine Authors: Ayomide Adeleye, Lydia Sharp, Megan A. Rech Source Type: research

Suture removal by emergency department patients
According to the 2016 National Hospital Ambulatory Medical Care (NHAMC) Survey, there were an estimated 145 million visits to emergency departments (ED) during 2016 [1]. Anywhere from approximately 7 to 9 million lacerations are treated each year in EDs [2]. For each injury that requires sutures, there are a wide variety of wound closure materials, and which material is used depends on many factors. These factors may include the location of the wound, amount of tension on wound edges, provider preference, and patient factors [2]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 14, 2020 Category: Emergency Medicine Authors: Lindsey Ouellette, Allison Brown, Nadia Nikroo, Samir Yassin, Kyle Beasley, Noelle Kraus, Justin Houseman, Jeffrey Jones Source Type: research

Effect of previous emergency psychiatric consultation on suicide re-attempts – A multi-center observational study
The emergency department (ED) is one of the first gateways when suicide attempt patients seek health care services. The purpose of this study was to analyze the hypothesis that people who received emergency psychiatric services in previous suicide attempts will have a lower mortality rate in current ED visits owing to subsequent suicide attempts. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 14, 2020 Category: Emergency Medicine Authors: Jeong Min Son, Joo Jeong, Young Sun Ro, Wonpyo Hong, Ki Jeong Hong, Kyoung-Jun Song, Sang Do Shin Source Type: research

Anaphylaxis induced bradycardia, renal failure, AV-nodal blockade, shock, and hyperkalemia: A-BRASH in the emergency department
The emergency department (ED) is responsible for managing a variety of acute illnesses including undifferentiated shock. A newer less recognized syndrome termed BRASH – bradycardia, renal failure, AV-node blockers, shock and hyperkalemia – is a cycle of synergy between hyperkalemia and AV-blockade that can result in shock. This entity is more common amongst the elderly, considering polypharmacy and co-morbid diseases. Some cases have an inciting trigger of hy povolemia. Anaphylaxis is a potentially lethal form of shock that most emergency physicians (EP) treat in the ED. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 14, 2020 Category: Emergency Medicine Authors: Stefan Flores Source Type: research

COVID-19 infection with extensive thrombosis: A case of phlegmasia cerulea dolens
Reports have been published from multiple countries regarding increased thrombus formation in COVID-19 patients, especially critically ill patients. These include DVT formation as well as pulmonary embolism and stroke. Currently, the exact mechanism as to why COVID-19 patients are at higher risk for thrombotic complications has not been determined. It has been thought to be due to endothelial injury, blood stasis or a hypercoagulable state [1]. To our knowledge this is the first reported case of phlegmasia cerulea dolens in a patient diagnosed with COVID-19. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 14, 2020 Category: Emergency Medicine Authors: Michael H. Morales, Candace L. Leigh, Erin L. Simon Source Type: research

Obesity is not associated with increased difficulty placing peripheral IVs in trauma activation patients
Previous studies have identified obesity as a risk factor for difficult IV access, but this has not been studied in the acute trauma setting. The primary objective was to determine if obesity is associated with increased difficulty placing peripheral IVs in trauma patients. Secondary analysis evaluated IV difficulty and associations with nursing self-competence ratings, trauma experience, and patient demographics. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 14, 2020 Category: Emergency Medicine Authors: Aaron Nathan Barksdale, Matthew Goede, Scott Madden, Abraham Campos, Robin High Source Type: research

Spontaneous subcutaneous emphysema: An uncommon presentation of a common disease
A 16-year-old female, non-smoker, presented to the Emergency Department (ED) with sudden onset swelling over the face, neck, chest, and upper abdomen for 2  days. She had history of intermittent low-grade fever and dry cough for 1 month prior to the presentation. There was no history of exposure to any organic or inorganic particulate. Primary survey was normal, except low oxygen saturation (SpO2) of 93% which improved to 99% with 6 L/min of oxyg en by face mask. On examination, there was swelling over the face, neck and torso with crepitus palpated all over the swollen area. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 14, 2020 Category: Emergency Medicine Authors: Savan Pandey, Ankit Kumar Sahu, Ramkumar Sreenivasan, Meera Ekka Source Type: research

Myxedema ascites complicated by ischemic colitis
We present a rare case of myxedema ascites in an elderly female and highlight the importance of early diagnosis and management. We also present ischemic colitis in the same patient, which has not been reported thus far in literature as a complication of myxedema ascites. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 14, 2020 Category: Emergency Medicine Authors: Sana Riaz, Pujitha Kudaravalli, Michelle Bernshteyn, Umair Masood, Sriharsha Gowtham, Chilsia Shaffi, Anuj Sharma, Kanish Mirchia, Nuri Ozden Source Type: research

A rare case of myxedema ascites and uncommon complication of ischemic colitis
We present a rare case of myxedema ascites in an elderly female and highlight the importance of early diagnosis and management. We also present ischemic colitis in the same patient, which has not been reported thus far in literature as a complication of myxedema ascites. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 13, 2020 Category: Emergency Medicine Authors: Sana Riaz, Pujitha Kudaravalli, Michelle Bernshteyn, Umair Masood, Sriharsha Gowtham, Chilsia Shaffi, Anuj Sharma, Kanish Mirchia, Nuri Ozden Source Type: research

Place of prefilled syringes in COVID-19 patient based on current evidence
Effective implementation of both basic and advanced life support in children and adults requires rapid and accurate performing of all procedures, including the administration of drugs in appropriate doses and at the right time. Preparation of drugs for resuscitation when wearing personal protective equipment resulting from the COVID-19 pandemic may pose many problems related to limitation of movement range and speed of action of medical personnel. Mistakes in preparation of drugs for resuscitation occur even under typical conditions, without wearing protective clothing, visors and goggles and result from rush and action un...
Source: The American Journal of Emergency Medicine - May 10, 2020 Category: Emergency Medicine Authors: Kobi Ludwin, Krzysztof J. Filipiak, Milosz Jaguszewski, Michal Pruc, Michal Paprocki, Jacek Smereka, Lukasz Szarpak, Marek Dabrowski, Michael Czekajlo Source Type: research

COVID-19 in healthcare workers
Risk of coronavirus infections among medical personnel. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 9, 2020 Category: Emergency Medicine Authors: Michal Pruc, Dawid Golik, Lukasz Szarpak, Ishag Adam, Jacek Smereka Source Type: research

Prehospital sedation with ketamine vs. midazolam: Repeat sedation, intubation, and hospital outcomes
Emergency medical service (EMS) providers often encounter acutely agitated patients who can pose serious threats to themselves, bystanders, and EMS, Fire, and Law Enforcement personnel [1]. Severe, acute, undifferentiated agitation can be a symptom of drug ingestion or underlying medical or psychiatric disorders, and not all agitated patients respond similarly to chemical sedation [2]. Conventionally, paramedics treat agitated patients in the prehospital settings with benzodiazepines to calm the patient sufficiently to complete medical assessment and care. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 9, 2020 Category: Emergency Medicine Authors: Dustin Holland, Nancy Glober, Shawn Christopher, Evan Zahn, Thomas Lardaro, Dan O'Donnell Source Type: research

Vital sign thresholds predictive of death in the combat setting
This study measures the vital sign values predictive of mortality among combat casualties in Iraq and Afghanistan. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 9, 2020 Category: Emergency Medicine Authors: Michael D. April, Tyson E. Becker, Andrew D. Fisher, Jason F. Naylor, Steven G. Schauer Source Type: research

Non –Covid-19 clinical research in the era of pandemic
The Covid-19 pandemic has seized the medical landscape and drained national and local resources. The day-to-day clinical practice of our research hospitals has been disrupted by the relentless spread of this disease, which has had a secondary effect on our ability to perform clinical research. As we innovate and accommodate in the treatment of the disease, will clinical researchers also be able to adapt to life in the age of Covid-19? Unfortunately, there are no real-time data that show what stratagems and best practices are applicable to research in the shadow of this pandemic. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 9, 2020 Category: Emergency Medicine Authors: Onyinyechi F. Eke, Christina C. Morone, Andrew Liteplo, Hamid Shokoohi Source Type: research

Weakness and elevated creatinine kinase as the initial presentation of coronavirus disease 2019 (COVID-19)
COVID-19 is a global public health emergency with more than one million positive cases across the globe. COVID-19 has a multifaceted presentation. We are herein to report two cases of SARS-CoV-2 induced rhabdomyolysis with an initial presentation of weakness and elevated creatinine kinase (CK). Both patients had no respiratory symptoms, they only complained of generalized weakness and were found to have elevated CK. Routine chest X-ray showed bilateral infiltrates in both cases and subsequently reverse-transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2 was positive. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 9, 2020 Category: Emergency Medicine Authors: Kok Hoe Chan, Iyad Farouji, Amany Abu Harnoud, Jihad Slim Source Type: research

Respiratory protection among healthcare workers during cardiopulmonary resuscitation in COVID-19 patients
We have read with great interest the article Hwang et al. [1]. Although this is a simulation study, it shows that the N95 respirator did not provide adequate protection against respiratory infections during chest compression. The current SARS-CoV-2 pandemic poses a significant challenge for medical personnel, especially in the field of emergency medicine [2]. Following its initial outbreak on December 31, 2019, in Wuhan, a central city in China, COVID-19 has spread around the globe affecting almost all countries. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 9, 2020 Category: Emergency Medicine Authors: Kurt Ruetzler, Jacek Smereka, Kobi Ludwin, Lukasz Szarpak Source Type: research

Risk of coronavirus infections among medical personnel
Infections from the coronavirus group are a very important problem among medical personnel. This affects both the continuity of work of medical services, due to the compulsory quarantine of infected persons and their abandonment of work, and the insufficient number of employees to replace them in their tasks and duties. Due to the current situation of the COVID-19 pandemic, we can predict how the morbidity of health care workers will develop based on data on other viruses from the coronavirus group. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 9, 2020 Category: Emergency Medicine Authors: Michal Pruc, Dawid Golik, Lukasz Szarpak, Ishag Adam, Jacek Smereka Source Type: research

Management of acute ischemic stroke in patients with COVID-19 infection: Insights from an international panel
A corona virus (SARS-CoV-2) has infected 986,776 persons as of April 2nd, 2020 over a period of 4  months. There is a possibility that Coronavirus Disease 2019 (COVID-19) infection increases the risk of stroke similar to other respiratory tract infections [1]. Approximately 5% of hospitalized patients with COVID-19 infection suffer from stroke with over 80% of them being ischemic stroke [2]. T he reported mortality is 39% in patient with stroke [2] and COVID-19 infection which is much higher than the mortality observed in patients with stroke without COVID-19 infection [3]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 9, 2020 Category: Emergency Medicine Authors: Adnan I. Qureshi, Foad Abd-Allah, Fahmi Alsenani, Emrah Aytac, Afshin Borhani-Haghighi, Alfonso Ciccone, Camilo R. Gomez, Erdem Gurkas, Chung Y. Hsu, Vishal Jani, Liqun Jiao, Adam Kobayashi, Jun Lee, Jahanzeb Liaqat, Mikael Mazighi, Rajsrinivas Parthasara Source Type: research

Atypical presentation of COVID-19
Dear Editor, we found that the publication on “Abdominal and testicular pain: An atypical presentation of COVID-19” is very interesting [1]. Kim et al. noted that “HCW's need to be vigilant of atypical presentations of COVID-19 and consider full PPE for all patients as community spread increases [1].” In fact, atypical and uncommon clin ical presentation of COVID-19 is possible and it is usually under recognized [2]. A main pitfall in clinical practice is under diagnosis of COVID-19 patients with mild or no symptoms. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 9, 2020 Category: Emergency Medicine Authors: Beuy Joob, Viroj Wiwanitkit Source Type: research

Identifying ED patients with previous abnormal HIV or hepatitis C test results who may require additional services
Routine emergency department (ED) HIV or HCV screening may inadvertently capture patients already diagnosed but does not specifically prioritize identification of this group. Our objective was to preliminarily estimate the volume of this distinct group in our ED population through a pilot electronic health record (EHR) build that identified all patients with indications of HIV or HCV in their EHR at time of ED presentation. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 9, 2020 Category: Emergency Medicine Authors: Andrew H. Ruffner, Rachel M. Ancona, Catherine Hamilton, Francisco J. Fernandez, Kiran A. Faryar, Bennett H. Lane, Michael S. Lyons Source Type: research

An unusual cause of chest pain in a 33 year old male: neurofibromatosis
We present the case of chest pain in a 33  year old male reporting no significant past medical history who developed spontaneous massive hemothorax while being evaluated in the ED. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 7, 2020 Category: Emergency Medicine Authors: John Lafleur, Adam Rutenberg Source Type: research

Case report of an unusual cause of chest pain in a 33  year old male
We present the case of chest pain in a 33  year old male reporting no significant past medical history who developed spontaneous massive hemothorax while being evaluated in the ED. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 6, 2020 Category: Emergency Medicine Authors: John Lafleur, Adam Rutenberg Source Type: research

Heart rate outcomes with concomitant parenteral calcium channel blockers and beta blockers in rapid atrial fibrillation or flutter
Patients who present with atrial fibrillation (AF) or flutter with rapid ventricular response (RVR) and hemodynamic stability may be managed with either an intravenous (IV) nondihydropyridine calcium channel blocker (CCB) or a beta-blocker (BB). Patients without improved heart rates may need to switch to, or add, a second AV nodal blocker. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 6, 2020 Category: Emergency Medicine Authors: Shuroug A. Alowais, Bryan D. Hayes, Susan R. Wilcox, Jennifer Le, Jennifer L. Koehl, Lanting Fuh Source Type: research

Case report of an unusual cause of chest pain in a 33  year old male
We present the case of chest pain in a 33  year old male reporting no significant past medical history who developed spontaneous massive hemothorax while being evaluated in the ED. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 6, 2020 Category: Emergency Medicine Authors: John Lafleur, Adam Rutenberg Source Type: research

An unusual presentation of pulmonary artery sarcoma: Several pseudoaneurysms with massive hemoptysis
A 53-year-old woman was admitted to the emergency department with sudden onset of massive hemoptysis. She had previous history of dyspnea and cough for two months. She had no history of chronic disease, smoking, or use of anticoagulant and antiplatelet drugs. On arrival, she was tachycardic and tachypneic, but her body temperature was normal. Chest X-ray showed enlarged right hilus and multiple nodular opacities predominantly in the left lung basis. Computed tomography (CT) scan of the chest demonstrated massive intraluminal filling defect extending from the right pulmonary artery through the main and left pulmonary arteri...
Source: The American Journal of Emergency Medicine - May 6, 2020 Category: Emergency Medicine Authors: Oguzhan Yildiz, Emre Unal, Turkmen Turan Ciftci, Devrim Akinci, Orhan Macit Ariyurek Source Type: research

Non-tuberculosis cold abscess
An 85-year-old cachectic man was found unconscious in his home. He had no specific medical history. On arrival, he was in a deep coma and hypothermic state. He had a soft mass the size of his fist in the right lower abdomen without redness or heat. Truncal computed tomography revealed subcutaneous fluid collection with gas formation. A test puncture for right lower abdominal subcutaneous fluid collection revealed pus, so an open incision was performed, with the administration of broad-spectrum antibiotics. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 6, 2020 Category: Emergency Medicine Authors: Ken-ichi Muramatsu, Hiroki Nagasawa, Yuta Murai, Mutsumi Sakurada, Kei Jitsuiki, Youichi Yanagawa Source Type: research

Emergency Burr Hole utilizing the EZ-IO ™ drill: A pilot cadaver study
Delayed surgical care increases mortality and worsens neurologic outcomes in patients with an Epidural Hematoma (EDH) that are deteriorating and showing signs of herniation or coma [1-4]. This procedure and the equipment used are rarely encountered in the Emergency Department (ED) and may not be as familiar to the Emergency Medicine Physician as the EZ-IO ™ (EZ-IO™, Teleflex) drill they commonly use to obtain intraosseous (IO) access. There now have been two case reports describing the use of the EZ-IO™ drill in lieu of the traditional Emergency Burr hole procedure in patients with an EDH who are rapidly ...
Source: The American Journal of Emergency Medicine - May 6, 2020 Category: Emergency Medicine Authors: Mark L. Gustafson, Jerry Edwards, Alfred Tager Source Type: research

Clinical use of copeptin in migraine patients admitted to the emergency department
The purpose of this study was to investigate the clinical use of copeptin to evaluate migraine attacks in the Emergency Department. An additional aim was to detect changes in serum copeptin levels in migraine patients during attack and attack-free periods. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 6, 2020 Category: Emergency Medicine Authors: Derya Yal çın Yılmaz, Hamit Hakan Armağan, Kıvanç Karaman, Fevziye Burcu Şirin, Mustafa Bozkurt, Adnan Karaibrahimoğlu, İsa Gökhan Yalçın, Nesrin Gökben Beceren, Önder Tomruk Source Type: research

Effects of ultrasound-guided techniques for radial arterial catheterization: A meta-analysis of randomized controlled trials
This study aimed to evaluate whether ultrasound-guided techniques are superior compared to traditional palpation techniques in patients undergoing radial artery catheterization (RAC). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 5, 2020 Category: Emergency Medicine Authors: Wenli Zhao, Huizhen Peng, Haiyun Li, Yinping Yi, Yufeng Ma, Yingkun He, Hongmei Zhang, Tianxiao Li Source Type: research

High early phase hemoglobin level is associated with favorable neurological outcome in patients with severe traumatic brain injury
The appropriate hemoglobin (Hb) level threshold for the early phase (i.e. from Emergency Department to ICU admission) in patients with severe traumatic brain injury (TBI) is still unknown. Therefore, we aimed to examine the association between Hb levels during the early phase and neurological outcomes in patients with severe TBI using data from the Brain Hypothermia (B-HYPO) Study Group. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 5, 2020 Category: Emergency Medicine Authors: Toru Hifumi, Kentaro Nakamura, Yasuhiro Kuroda, Kenya Kawakita, Motoki Fujita, Susumu Yamashita, Kenji Dohi, Hitoshi Kobata, Eiichi Suehiro, Tsuyoshi Maekawa, Brain Hypothermia (B-HYPO) Study Group in Japan Source Type: research

Non-evidenced based treatment: An unintended cause of morbidity and mortality related to COVID-19
In light of the Coronavirus Disease 2019 (COVID-19) pandemic, world leaders and the media have propelled various treatment modalities that have not been approved by the US Food and Drug Administration (FDA) to prevent or cure acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Such treatments include nucleotide analogs (remdesivir), anti-malarial drugs (chloroquine and hydroxychloroquine), protease inhibitors (lopinavir/ritonavir), interferon- β, nonsteroidal anti-inflammatory drugs (NSAIDs), and renin angiotensin aldosterone system (RAAS) antagonists [1-3]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 5, 2020 Category: Emergency Medicine Authors: Hamidreza Reihani, Mateen Ghassemi, Maryann Mazer-Amirshahi, Bandar Aljohani, Ali Pourmand Source Type: research

Use of drape/patient covering during potentially aerosolizing procedures
The rise of the novel coronavirus, SARS-CoV-2 or COVID-19, pandemic has illustrated the potential for the rapid spread of a highly infectious disease, both among lay people and healthcare workers. Early evidence of broad aerosolization of the virus in the hospital setting [1], coupled with demonstrated aerosolization with resuscitative and procedural interventions in the hospital setting of the SARS virus [2,3], has raised concern among healthcare workers regarding the use of advanced personal protective equipment (PPE) in the performance of such procedures [4]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 5, 2020 Category: Emergency Medicine Authors: Bryant Allen, Chris Gardner, Colin O'Neill, Michael Gibbs Source Type: research

Gun violence during COVID-19 pandemic: Paradoxical trends in New York City, Chicago, Los Angeles and Baltimore
COVID-19 has been declared a pandemic by the World Health Organization (WHO). The structure of daily life for most individuals in the United States (US) has changed dramatically. Businesses, schools, and entire industries have been forced to substitute in-person activities for remote/virtual replacements in compliance with recommendations of social distancing from the CDC. This practice has decreased the COVID-19 transmission and is essential to the eventual resolution of this pandemic [1]. As people practice social distancing, the trends of traumatic injuries are changing as well, with fewer vehicle related crashes and in...
Source: The American Journal of Emergency Medicine - May 5, 2020 Category: Emergency Medicine Authors: Mason Sutherland, Mark McKenney, Adel Elkbuli Source Type: research

Spontaneous celiac artery dissection
is a rare visceral artery dissection that typically presents with acute abdominal or flank pain. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 4, 2020 Category: Emergency Medicine Authors: Jessica R. Hoglund, Joseph H. Blackwell, Michael A. Gibbs Source Type: research

“I Felt Invisible Most of the Time”: Communication and satisfaction among patients treated in emergency department hallway beds
Hallway placement (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 3, 2020 Category: Emergency Medicine Authors: Seiichi Villalona, Cirenio Cervantes, Carol Boxtha, Wm. Alex Webb, Jason W. Wilson Tags: Correspondence Source Type: research

The financial implications of variability in decision to disposition times for patients placed in observation status
This study attempts to evaluate implications of variable decision-making for those patients placed in observation status for throughput and financial implications. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 3, 2020 Category: Emergency Medicine Authors: Richard Martin, Kraftin E. Schreyer Source Type: research

The relationship between two laboratory assays: High sensitivity troponin T and N-terminal pro-brain natriuretic peptide
This study sought to examine the relationship between two laboratory assays, hsTnT and N-terminal pro-brain natriuretic peptide (NT-proBNP), a marker for CHF, in patients prese nting to the ED. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 3, 2020 Category: Emergency Medicine Authors: Navkiranjot Kaur, Andrew Singletary, Rakesh Engineer, Amy S. Nowacki, Baruch S. Fertel, Courtney M. Smalley Source Type: research

Non-pharmacologic interventions improve comfort and experience among older adults in the Emergency Department
Determine if a comfort cart would improve older adults' comfort and facilitate communication during Emergency Department (ED) visits. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 3, 2020 Category: Emergency Medicine Authors: Isabella M. Lichen, Michelle J. Berning, Susan M. Bower, Jessica A. Stanich, Molly M. Jeffery, Ronna L. Campbell, Laura E. Walker, Fernanda Bellolio Source Type: research