What echocardiographic findings suggest a pericardial effusion is causing tamponade?
Pericardial tamponade is neither a clinical nor an echocardiographic diagnosis alone. The echocardiogram carries diagnostic value and should be performed when there is suspicion for tamponade based on the history and physical exam. A pericardial effusion uncovered on point-of-care ultrasound (POCUS) may be mistaken for tamponade and thereby lead to inappropriate and invasive management with pericardiocentesis. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 16, 2018 Category: Emergency Medicine Authors: Stephen Alerhand, Jeremy M. Carter Source Type: research

Methodological characteristics of randomized controlled trials of ultrasonography in emergency medicine: A review
Interest in ultrasonography in emergency medicine has increased in recent years, as reflected by a marked increase in publications on the topic. The aim of this study was to 1) describe and evaluate methodological characteristics of randomized controlled trials (RCTs) evaluating an ultrasound intervention in emergency department and 2) estimate whether the reports adequately described the intervention to allow replication. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 16, 2018 Category: Emergency Medicine Authors: Quentin Daffos, Erwin Hansconrad, Patrick Plaisance, Dominique Pateron, Youri Yordanov, Anthony Chauvin Source Type: research

The use of cadaver models to diagnose rib fractures: A pilot study
In the emergency department, rib fractures are a common finding in patients who sustain chest trauma. Rib fractures may be a sign of significant, underlying pathology, especially in the elderly patients where rib fractures are associated with significant morbidity and mortality. To date, no studies have evaluated the ability of ultrasound to detect rib fractures using cadaver models and subsequently use this model as a teaching tool. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 16, 2018 Category: Emergency Medicine Authors: Josh Greenstein, Josie Acuna, Monica Kapoor, Cara Brown, Abbas Husain, Brendan Lally, Devjani Das Source Type: research

Successful resuscitation with extracorporeal membrane oxygenation support for refractory ventricular fibrillation caused by left main coronary artery occlusion
In this report, we describe the case of a 70-year-old male who presented to emergency department with chest pain. Electrocardiogram showed ST-segment elevation in leads aVR and aVL and ST-segment depression in leads v3, v4, v5, v6, 2, 3, and aVF. Occlusion of the left main coronary artery was suspected. While waiting for percutaneous coronary intervention, the patient experienced sudden refractory ventricular fibrillation with cardiac arrest. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 16, 2018 Category: Emergency Medicine Authors: Ting-Yuan Ni, Fu-Yuan Siao, Chun-Wen Chiu, Hsu-Heng Yen Source Type: research

Using ultrasound to guide fluid management in children
We read with great interest the study by Choi et al. where they suggest the aorta area/the inferior vena caval (Ao/IVCA) area index had better correlations with the volume of fluid administered when compared to the inferior vena caval index (IVCI) and the aorta diameter/IVC diameter index (Ao/IVCD) and it may help determine the effects of fluid administration in children [1]. Though the study sounds scientific, we still have some questions regarding the study. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 14, 2018 Category: Emergency Medicine Authors: Tao Cheng, Jun-Zhao Liu, Sheng Ye, Zhi-Han Gu, Pan Pan, Yu Cao Source Type: research

Does hospital mode of arrival influence women's decisions to participate in research?
The National Institutes of Health recommends that research studies recruit enough subjects to address relevant gender differences [1-3]. Recruiting volunteers for research, however, is a complicated process. Though some work has informed the barriers to and facilitators of research participation amongst women and other minority subjects [4-9], few have focused on how pre-hospital factors, specifically mode of Emergency Department (ED) arrival, may influence the recruitment of female subjects in emergency research settings. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 14, 2018 Category: Emergency Medicine Authors: Martina Anto-Ocrah, Jeremy Cushman, Madeline Karafanda, Vivian Lewis, Todd A. Jusko, Jeff Bazarian, Edwin van Wijngaarden, Courtney Marie Jones Source Type: research

Tenecteplase utility in acute ischemic stroke patients: A clinical review of current evidence
Acute ischemic stroke is leading cause of disability in the United States. Treatment is aimed at reducing impact of cerebral clot burden and life-long disability. Traditional fibrinolytic treatment with recombinant tissue plasminogen activator (tPA) has shown to be effective but at high risk of major bleeding. Multiple studies have evaluated tenecteplase as an alternative to tPA. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 14, 2018 Category: Emergency Medicine Authors: Amelia Nelson, Gregory Kelly, Richard Byyny, Catherine Dionne, Candice Preslaski, Kevin Kaucher Source Type: research

Atrioventricular nodal reentrant tachycardia and cannon A waves
We present a case of a 90-year-old woman presenting with shortness of breath in which the ECG was not diagnostic, but the presence of regular neck pulsations helped secure the diagnosis of AVNRT. In AVNRT, atria and ventricular contractions occur nearly simultaneously. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 12, 2018 Category: Emergency Medicine Authors: Benjamin L. Cooper, Jonas A. Beyene Tags: Case Report Source Type: research

Atrioventricular nodal reentrant tachycardia and cannon A waves: A case report
We present a case of a 90-year-old woman presenting with shortness of breath in which the ECG was not diagnostic, but the presence of regular neck pulsations helped secure the diagnosis of AVNRT. In AVNRT, atria and ventricular contractions occur nearly simultaneously. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 12, 2018 Category: Emergency Medicine Authors: Benjamin L. Cooper, Jonas A. Beyene Source Type: research

Assessing the CT findings and clinical course of ED patients with first-time versus recurrent acute pancreatitis
The primary objective of this study was to compare Emergency Department patients with first-time versus recurrent acute pancreatitis. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 9, 2018 Category: Emergency Medicine Authors: Maryam Boumezrag, Sormeh Harounzadeh, Hamza Ijaz, Angeline Johny, Lorna Richards, Yan Ma, Maxine A. Le Saux, Paige Kulie, Caitlin Davis, Andrew C. Meltzer Source Type: research

Efficacy of the presence of an emergency physician in prehospital major trauma care: A nationwide cohort study in Japan
The beneficial effect of the presence of an emergency physician in prehospital major trauma care is controversial. The aim in this study is to assess whether an emergency physician on scene can improve survival outcome of critical trauma patients. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 9, 2018 Category: Emergency Medicine Authors: Yohei Hirano, Toshikazu Abe, Hiroshi Tanaka Source Type: research

Do confidentiality concerns impact pre-exposure prophylaxis willingness in emergency department adolescents and young adults?
Daily oral pre-exposure prophylaxis (PrEP) is recommended to reduce the risk of human immunodeficiency virus (HIV) infection in adolescents and young adults (AYAs) [1]. National electronic pharmacy data suggest that emergency department (ED) providers provide approximately 12 –21% of PrEP prescriptions to AYAs [2]. The ED may be a key access for PrEP given the risk profile of the population served [3,4]. Yet, there have been limited studies to examine what factors impact willingness to take PrEP in ED settings. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 9, 2018 Category: Emergency Medicine Authors: Kelvin L. Moore, Shanna Dell, Miles Oliva, Yu-Hsiang Hsieh, Richard E. Rothman, Renata Arrington-Sanders Source Type: research

Sepsis alerts in EMS and the results of pre-hospital ETCO2
Field sepsis alerts have the ability to expedite initial ED sepsis treatment. Our hypothesis is that in patients that meet EMS sepsis alert criteria there is a strong relationship between prehospital end-tidal carbon dioxide (ETCO2) readings and the outcome of diagnosed infection. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 8, 2018 Category: Emergency Medicine Authors: Steven J. Weiss, Angel Guerrero, Christian Root-Bowman, Amy Ernst, Kurt Krumperman, Jon Femling, Phil Froman Source Type: research

C-reactive protein or erythrocyte sedimentation rate results reliably exclude invasive bacterial infections
Clinicians utilize inflammatory markers, including C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), to identify febrile children who may have an occult serious illness or infection. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 8, 2018 Category: Emergency Medicine Authors: Niloufar Paydar-Darian, Amir Kimia, Michael Monuteaux, Kenneth Michelson, Assaf Landschaft, Alexandra Maulden, Rachel Chenard, Lise Nigrovic Source Type: research

Mesenteric venous thrombosis presenting as gastrointestinal bleeding, a challenging diagnosis
Acute mesenteric venous thrombosis (MVT) is an uncommon cause of intestinal ischemia and is associated with high morbidity and mortality. Patients with acute MVT often present with gastrointestinal (GI) bleeding and other unspecific findings making the diagnosis challenging. This condition requires emergent treatment. The high rates of misdiagnosis of these patients and subsequently the delay in proper and quick management put patients at increased risk of having a negative outcome. Physicians should suspect acute MVT in patients with GI bleed while also considering other factors such as, a past medical history of pro-thro...
Source: The American Journal of Emergency Medicine - November 7, 2018 Category: Emergency Medicine Authors: Iskandar Berbari, Rawan Safa, Gilbert Abou Dagher Tags: Case Report Source Type: research

Comparison of SIRS, qSOFA, and NEWS for the early identification of sepsis in the Emergency Department
The increasing use of sepsis screening in the Emergency Department (ED) and the Sepsis-3 recommendation to use the quick Sepsis-related Organ Failure Assessment (qSOFA) necessitates validation. We compared Systemic Inflammatory Response Syndrome (SIRS), qSOFA, and the National Early Warning Score (NEWS) for the identification of severe sepsis and septic shock (SS/SS) during ED triage. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 7, 2018 Category: Emergency Medicine Authors: Omar A. Usman, Asad A. Usman, Michael A. Ward Source Type: research

Mesenteric venous thrombosis presenting as gastrointestinal bleeding, a challenging diagnosis: Review and case report
Acute mesenteric venous thrombosis (MVT) is an uncommon cause of intestinal ischemia and is associated with high morbidity and mortality. Patients with acute MVT often present with gastrointestinal (GI) bleeding and other unspecific findings making the diagnosis challenging. This condition requires emergent treatment. The high rates of misdiagnosis of these patients and subsequently the delay in proper and quick management put patients at increased risk of having a negative outcome. Physicians should suspect acute MVT in patients with GI bleed while also considering other factors such as, a past medical history of pro-thro...
Source: The American Journal of Emergency Medicine - November 7, 2018 Category: Emergency Medicine Authors: Iskandar Berbari, Rawan Safa, Gilbert Abou Dagher Source Type: research

Incidence of bacteremia and antimicrobial resistance, and associated factors among patients transferred from long-term care hospital
To evaluate the prevalence of bacteremia and antimicrobial resistance, and associated factors among infectious patients transferred from long-term care hospitals (LTCHs). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 7, 2018 Category: Emergency Medicine Authors: Sangmin Kim, Sion Jo, Jae Baek Lee, Youngho Jin, Taeoh Jeong, Jaechol Yoon, So Eun Kim, Boyoung Park, Hasan Bhally Source Type: research

Improving handoff efficiency for admitted patients: A multidisciplinary, lean-based approach
Although Emergency Department (ED) crowding remains a national problem, efforts to improve ED process efficiency and optimize throughput can potentially increase functional ED capacity [1,2]. As a frequently occurring process with potential for significant waste and complexity, handoffs between the ED and inpatient teams represent an opportunity to apply systems improvement science and reduce delays [3,4]. In addition, the inpatient handoff process represents the final bottleneck in patient progression through many EDs and thus is a particularly important area of focus given the theory of constraints and potential effects ...
Source: The American Journal of Emergency Medicine - November 6, 2018 Category: Emergency Medicine Authors: Benjamin A. White, Marjory A. Bravard, Kimiyoshi J. Kobayashi, Joshua C. Ziperstein, Joan Strauss, Maryfran Hughes, Ali S. Raja Tags: Correspondence Source Type: research

Effect of menstrual bleeding on the detection of anogenital injuries in sexual assault victims
The physical examination of sexual assault victims is performed to identify and treat injuries, as well as collect forensic evidence for prosecution. The combination of colposcopy with digital imaging and staining with contrast media such as toluidine blue, has led to reports of genital injury prevalence approaching 90% following nonconsensual sexual intercourse [1]. Such forensic evidence of anogenital injury influences decision making and legal outcomes throughout the criminal justice process. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 6, 2018 Category: Emergency Medicine Authors: Linda Rossman, Stephanie Solis, Janda Stevens, Barbara Wynn, Jeffrey S. Jones Source Type: research

Evaluation of abdominal aortic aneurysm in patients with nonvariceal upper gastrointestinal hemorrhage
Although potentially life-threatening, and potentially treatable, primary aortoduodenal fistula(PADF), a disorder most commonly secondary to abdominal aortic aneurysm(AAA), is notable for the absence of its mention in guidelines for management of nonvariceal upper gastrointestinal hemorrhage(NVUGH) [1-4]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 6, 2018 Category: Emergency Medicine Authors: Oscar M.P. Jolobe Source Type: research

Swollen and bloodshot eye following headache
A ruptured cavernous carotid aneurysm (CCA) with carotid cavernous fistula can appear as a benign headache but progress to a swollen and bloodshot eye overnight. A 66-year-old woman visited emergency department with sudden onset of pain behind her left forehead and vomiting. She was treated for a migraine-like headache and discharged. She presented again on the next day with a persistent headache and a swollen left eye with blurred vision. An ophthalmologic examination revealed erythema of the left lid and chemosis at the temporal and lower bulbar conjunctiva. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 6, 2018 Category: Emergency Medicine Authors: Chia-Cheng Hsu, Shih-Hung Tsai, Jen-Chun Wang, Hung-Wen Kao, Chin-Wang Hsu, Wei-Hsiu Liu, Sy-Jou Chen Source Type: research

Thyrotoxic periodic paralysis complicated by life-threatening acute hypercapnic respiratory failure in a Chinese male with painless thyroiditis
Thyrotoxic periodic paralysis (TPP) is a relatively common complication seen in Asian hyperthyroid patients. However, it is a rare occurrence to find a TPP case comprised of acute hypercapnic respiratory failure in patients with painless thyroiditis. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 6, 2018 Category: Emergency Medicine Authors: Yan-Ying Qian, Zhi-Juan Dai, Cong Zhu, Yao-Xin Zhu, Chao-Ming Wu Source Type: research

Predicting the need for critical care intervention in community acquired pneumonia
We have greatly enjoyed reading the recently published article by Ehsanpoor and colleagues [1]. In this prospective study 143 patients with clinical suspicion of community-acquired pneumonia (CAP), were enrolled. The authors found that SMART-COP score  ≥ 5 had a high sensitivity and specificity in the prediction of patients' prognosis with severe CAP. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 6, 2018 Category: Emergency Medicine Authors: Funda Sungur Biteker, O ğuzhan Çelik, Cem Çil, Eda Özlek, Bülent Özlek, Aysel Gökçek, Volkan Doğan Source Type: research

Acute ischemic stroke in a trauma cohort: Incidence and diagnostic challenges
We report its incidence in trauma patients following their presentation at our institution. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 3, 2018 Category: Emergency Medicine Authors: Kevin Yeboah, Aakash Bodhit, Ali Al Balushi, Erik Krause, Abhay Kumar Source Type: research

Effects of seasonality and daylight savings time on emergency department visits for mental health disorders
This study investigates if increased ED visits for MBH conditions are associated with seasonality and changes in daylight savings time. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 1, 2018 Category: Emergency Medicine Authors: Vah é Heboyan, Scott Stevens, William V. McCall Source Type: research

The neutrophil-lymphocyte count ratio as a diagnostic marker for bacteraemia: A systematic review and meta-analysis
Bacteraemia is a common cause of increased morbidity and mortality in critically ill patients, but its early diagnosis and identification are complicated. The neutrophil-lymphocyte count ratio (NLCR) has been suggested as a useful indicator for the diagnosis of bacteraemia. We performed this meta-analysis to investigate the diagnostic accuracy of the NLCR for bacteraemia. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - October 29, 2018 Category: Emergency Medicine Authors: Jiawei Jiang, Rui Liu, Xin Yu, Rui Yang, Hua Xu, Zhi Mao, Yongqiang Wang Source Type: research

Integrating point-of-care ultrasound in the ED evaluation of patients presenting with chest pain and shortness of breath
The differential diagnoses of patients presenting with chest pain (CP) and shortness of breath (SOB) are broad and non-specific. We aimed to 1) determine how use of point-of-care ultrasound (POCUS) impacted emergency physicians' differential diagnosis, and 2) evaluate the accuracy of POCUS when compared to chest radiograph (CXR) and composite final diagnosis. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - October 29, 2018 Category: Emergency Medicine Authors: Rasha E. Buhumaid, Julie St. -Cyr Bourque, Hamid Shokoohi, Irene W.Y. Ma, Mckenna Longacre, Andrew S. Liteplo Source Type: research

Predicting hospital admission at the emergency department triage: A novel prediction model
The objective of this study is to create a model that can predict a patient's need for hospital admission at the time of triage. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - October 29, 2018 Category: Emergency Medicine Authors: Clare Allison Parker, Nan Liu, Stella Xinzi Wu, Yuzeng Shen, Sean Shao Wei Lam, Marcus Eng Hock Ong Source Type: research

(MS 19010) Respond to: Comparison of sonographic inferior vena cava and aorta indexes during fluid administered in children
This study was conducted prospectively in South Korea. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - October 27, 2018 Category: Emergency Medicine Authors: Hyuksool Kwon Source Type: research

Left ventricular perforation with catheter decompression
Thoracostomy tube placement is one of the more common procedures performed in the Emergency Department, most commonly for treatment of pneumothorax or hemothorax but occasionally for drainage of empyema or pleural effusion. Thoracostomy may be a life-saving procedure with a wide range of complication rates reported, ranging from 19.4 –37%, most commonly extrathoracic placement. Most recent meta-analyses showed a relatively stable complication rate of 19% over the past three decades with the vast majority being benign in nature. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - October 26, 2018 Category: Emergency Medicine Authors: Janice Shin-Kim, Nathan Zapolsky, Elias Wan, Eric Steinberg, Michael Heller, Jeanne L. Jacoby Tags: Case Report Source Type: research

Scan the lung: Point-of-care ultrasound of a pulmonary consolidation with loculated pleural effusion
Thoracic ultrasound has become an increasingly valuable tool in the evaluation of critically ill patients in the emergency department (ED). The utility of point-of-care ultrasound (POCUS) to identify suspected pneumothorax, pulmonary edema, pleural effusion and pneumonia has been well established (Pagano et al.; Brogi et al.; Cortellaro et al.; Irwin and Cook [1 –4]). The 2014 American College of Emergency Physicians (ACEP) Ultrasound Imaging Compendium included lung and pleural ultrasound with the primary indication of identifying pneumothorax and pleural effusion as part of the core POCUS indications for all emerge...
Source: The American Journal of Emergency Medicine - October 26, 2018 Category: Emergency Medicine Authors: Jeffrey Gardecki, Kishan Patel, Omid Rowshan Source Type: research

Left ventricular perforation with catheter decompression: Case report and review of complications
Thoracostomy tube placement is one of the more common procedures performed in the Emergency Department, most commonly for treatment of pneumothorax or hemothorax but occasionally for drainage of empyema or pleural effusion. Thoracostomy may be a life-saving procedure with a wide range of complication rates reported, ranging from 19.4 –37%, most commonly extrathoracic placement. Most recent meta-analyses showed a relatively stable complication rate of 19% over the past three decades with the vast majority being benign in nature. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - October 26, 2018 Category: Emergency Medicine Authors: Janice Shin-Kim, Nathan Zapolsky, Elias Wan, Eric Steinberg, Michael Heller, Jeanne Jacoby Source Type: research

Corrigendum to “A role of the endothelial nitric oxide system in acute renal colic caused by ureteral stone” [Am J Emerg Med. 2018 Feb;36(2):266–270. doi: 10.1016/j.ajem.2017.08.008. Epub 2017 Aug 7]
The authors regret that the correct affiliation should have been ‘4Malatya State Hospital, Department of Emergency Medicine, Malatya, Turkey. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - October 25, 2018 Category: Emergency Medicine Authors: E. Bulbul, E.F. Sener, N.E. Gunay, B. Taslidere, E. Taslidere, S. Koyuncu, N. Gunay Tags: Corrigendum Source Type: research

Should we believe emergency department patients self-reported tetanus vaccine status?
Immunization surveying is the milestone in prevention of diseases and screening for populations at risk yet its reliability needs to be confirmed [1]. No study has assessed the reliability of ED patients' self-reported immunization status for tetanus. The reliability of self-reported immunization status for tetanus in ED has only been assessed by performing a rapid bed-side tetanus antibody testing. The lack of description for surveying methodology or reliability could not confer conclusive results [2-5]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - October 25, 2018 Category: Emergency Medicine Authors: Yannick Auffret, Jacques Y. Rousseaux, Florence Gatineau, Florian Hamoniaux, Ma ëlenn Gouillou, Lydie Abalea Le Dreff, Simplice Pina Silas, Frank Rakatobe, Zarrin Alavi Source Type: research

Prescription drug assistance for elderly patients in the emergency department
Over the past decade, prescription drug costs have risen rapidly and an increasing number of demographic groups, including many older Americans, are unable to afford their medications. This aging population, especially those with other risk factors, are at risk for medication non-adherence due to the inability to afford prescriptions [1-3]. Prior work has shown that cost-related noncompliance is common among the general population of emergency department users. In one study, 25% of emergency department (ED) patients reported cost-related barriers or concerns related to obtaining medications [4]. (Source: The American Journ...
Source: The American Journal of Emergency Medicine - October 25, 2018 Category: Emergency Medicine Authors: Lindsey Ouellette, Rachelle Halasa, Andrew Brown, Ryan Beckett, Deven Patel, Todd Chassee, Chad Sutliffe, Jeffrey Jones Source Type: research

Letter to the Editor Regarding Article, “Esmolol reduces apoptosis and inflammation in early sepsis rats with abdominal infection”
We have read with interest the article by Lu et al. [1] published in American Journal of Emergency Medicine, and thought that some issues should be addressed. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - October 23, 2018 Category: Emergency Medicine Authors: Feng Chen, Zhi-Qing Chen, Ji-Jin Zhu Source Type: research

Test performance of point-of-care ultrasound for gastric content
We sought to determine test performance characteristics of emergency physician ultrasound for the identification of gastric contents. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - October 23, 2018 Category: Emergency Medicine Authors: David C. Mackenzie, Aftab M. Azad, Vicki E. Noble, Andrew S. Liteplo Source Type: research

The use of point of care ultrasound in the evaluation of pediatric soft tissue neck masses
Most soft tissue neck masses represent benign inflammatory or infectious processes; however, in some cases the diagnosis is not clear and a broader differential must be considered. The aim of this study was to compare point-of-care ultrasound (POCUS) to radiology department imaging (RDI) in the diagnosis of soft tissue neck masses. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - October 23, 2018 Category: Emergency Medicine Authors: Marla C. Levine, Alexander Arroyo, Antonios Likourezos, Peter Homel, Eitan Dickman Source Type: research

History and physical exam predictors of intracranial injury in the elderly fall patient: A prospective multicenter study
A prior single-center study demonstrated historical and exam features predicting intracranial injury (ICI) in geriatric patients with low-risk falls. We sought to prospectively validate these findings in a multicenter population. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - October 23, 2018 Category: Emergency Medicine Authors: Rebecca Jeanmonod, Shellie Asher, Jamie Roper, Luis Vera, Josephine Winters, Nirali Shah, Mark Reiter, Eric Bruno, Donald Jeanmonod Tags: Prior Presentations: Oral Presentation. American Academy of Emergency Medicine Scientific Assembly, Las Vegas, Nevada 2016 (subset of data). Source Type: research

Brugada pattern exposed with administration of amiodarone during emergent treatment of ventricular tachycardia
Brugada pattern is a well-known pathological finding on electrocardiogram (ECG) which increases the likelihood of cardiac arrest due to ventricular arrhythmia. These cases generally present in younger patients without evidence of an electrolyte abnormality, structural heart disease, or cardiac ischemia. In many instances, this pattern is either hidden on initial presentation or presents as an incidental finding on an EKG. Often times the Brugada syndrome leads to sudden cardiac death or more rarely can be unmasked with a class 1A or 1C anti-arrhythmic agent. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - October 23, 2018 Category: Emergency Medicine Authors: Douglas Robinson, Greg Hand, Jason Ausman, Anthony Hackett Source Type: research

Pediatric subhepatic appendicitis with elevated lipase
We present a rare case of subhepatic appendicitis in an 11-year-old female, who presented with a three-day history of both right upper quadrant (RUQ) and right lower quadrant (RLQ) abdominal pain and serum lipase elevated four times the upper normal limit. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - October 22, 2018 Category: Emergency Medicine Authors: Scott A. McAninch, Austin Essenburg Tags: Case Report Source Type: research

A unique case of pediatric subhepatic appendicitis with elevated lipase
We present a rare case of subhepatic appendicitis in an 11-year-old female, who presented with a three-day history of both right upper quadrant (RUQ) and right lower quadrant (RLQ) abdominal pain and serum lipase elevated four times the upper normal limit. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - October 22, 2018 Category: Emergency Medicine Authors: Scott A. McAninch, Austin Essenburg Source Type: research

A comparison of analgesic prescribing among ED back and neck pain visits receiving physical therapy versus usual care
Physical therapy (PT) is commonly cited as a non-opioid pain strategy, and previous studies indicate PT reduces opioid utilization in outpatients with back pain. No study has yet examined whether PT is associated with lower analgesic prescribing in the ED setting. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - October 22, 2018 Category: Emergency Medicine Authors: Howard S. Kim, Sabrina H. Kaplan, Danielle M. McCarthy, Daniel Pinto, Kyle J. Strickland, D. Mark Courtney, Bruce L. Lambert Source Type: research

Acute liver failure: A review for emergency physicians
Acute liver failure (ALF) remains a high-risk clinical presentation, and many patients require emergency department (ED) management for complications and stabilization. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - October 22, 2018 Category: Emergency Medicine Authors: Tim Montrief, Alex Koyfman, Brit Long Source Type: research

National opioid prescribing trends in emergency departments by provider type: 2005 –2015
To describe opioid prescribing practice patterns and trends in emergency department visits (EDs) by provider type: physicians and advanced practice providers (APPs), which include nurse practitioners (NPs) and physician assistants (PAs). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - October 22, 2018 Category: Emergency Medicine Authors: Bo Kyum Yang, Carla L. Storr, Alison M. Trinkoff, Minji Sohn, Shannon K. Idzik, Mark McKinnon Source Type: research

Prehospital ketamine administration to pediatric trauma patients with head injuries in combat theaters
Head injuries frequently occur in combat. Tactical Combat Casualty Care (TCCC) guidelines recommend pre-hospital use of ketamine for analgesia. Yet the use of this medication in patients with head injuries remains controversial, particularly among pediatric patients. We compare survival to hospital discharge rates among pediatric head injury subjects who received prehospital ketamine versus those who did not. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - October 22, 2018 Category: Emergency Medicine Authors: Guyon J. Hill, Michael D. April, Joseph K. Maddry, Steven G. Schauer Source Type: research

Corrected carotid flow time and passive leg raise as a measure of volume status
The aim of this study was to investigate the value of corrected carotid flow time (FTc) with passive leg raise (PLR) as a non-invasive marker of volume status in end stage renal disease (ESRD) patients. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - October 22, 2018 Category: Emergency Medicine Authors: Ralphe Bou Chebl, Jeffrey Wuhantu, Shafeek Kiblawi, Gilbert Abou Dagher, Hady Zgheib, Rana Bachir, Jennifer Carnell Source Type: research

Early recognition of sepsis through emergency medical services pre-hospital screening
The Surviving Sepsis Campaign implemented a 3-hour bundle including blood cultures, lactate, intravenous fluids, and antibiotics to improve mortality in sepsis. Though difficult to achieve, bundle compliance is associated with decreased hospital mortality. We predict that the implementation of an Emergency Medical Services (EMS) sepsis screening tool will improve 3-hour bundle compliance. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - October 20, 2018 Category: Emergency Medicine Authors: George Borrelli, Erica Koch, Ethan Sterk, Shannon Lovett, Megan A. Rech Source Type: research

Emergency physicians can be leaders in clinical innovation: Tips to JumpStart the engine
Emergency physicians are well suited to develop new technologies that improve patient care. In day-to-day practice in the Emergency Department (ED), clinicians face a broad range of time-sensitive medical conditions that overlap multiple specialties and care settings. Emergency Medicine practitioners have demonstrated an innovative mindsets in the past [1,2]. This must grow. One recent study found that of 40 devices being developed by venture capitalists tested by 400 emergency physicians, only one-quarter were thought to actually assist emergency physicians in their workflow and improve patient care [3]. (Source: The Amer...
Source: The American Journal of Emergency Medicine - October 20, 2018 Category: Emergency Medicine Authors: David C. Sheridan, O. John Ma, Matthew L. Hansen Source Type: research