Quantification of ventilation volumes produced by compressions during emergency department cardiopulmonary resuscitation
Clinical investigations have shown improved outcomes with primary compression cardiopulmonary resuscitation strategies. It is unclear whether this is a result of passive ventilation via chest compressions, a low requirement for any ventilation during the early aspect of resuscitation or avoidance of inadvertent over-ventilation. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 2, 2018 Category: Emergency Medicine Authors: Robyn McDannold, Bentley J. Bobrow, Vatsal Chikani, Annemarie Silver, Daniel W. Spaite, Tyler Vadeboncoeur Source Type: research

Non-surgical management in hemodynamically unstable blunt traumatic pericardial effusion: A feasible option for treatment
Little is known about the outcomes of deliberate non-surgical management for hemodynamically unstable patients with blunt traumatic pericardial effusion. We evaluated the efficacy of management with pericardiocentesis or subxiphoid pericardial window in hemodynamically unstable patients who reach the hospital alive with blunt traumatic pericardial effusion. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 2, 2018 Category: Emergency Medicine Authors: Shinsuke Tanizaki, Satoru Nishida, Shigenobu Maeda, Hiroshi Ishida Source Type: research

Secure smartphone application-based text messaging in emergency department, a system implementation and review of literature
The utilization of smartphone-based technology and applications to streamline patient care provides an exciting opportunity for quality improvement research. As traditional communication methods such as paging have repeatedly been shown to be susceptible to errors and inefficiency that can delay patient care, smartphones continue to be investigated as means of improving inter-hospital communication and patient outcomes. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 2, 2018 Category: Emergency Medicine Authors: Ali Pourmand, Jeffrey Roberson, Amanda Gallugi, Youssef Sabha, Francis O'Connell Source Type: research

Gender disparities in percutaneous coronary intervention in out-of-hospital cardiac arrest: A nationwide cross-sectional observational study
In this study, we evaluated gender disparities in the delivery of PCI among OHCA patients. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 2, 2018 Category: Emergency Medicine Authors: Jin Seop Jeong, So Yeon Kong, Sang Do Shin, Young Sun Ro, Kyoung Jun Song, Ki Jeong Hong, Jeong Ho Park, Tae Han Kim Source Type: research

Validating the LUCAS ® mechanical chest compression fit specifications
Annually, more than 350,000 out-of-hospital cardiac arrests (OHCA) occur in the United States, with nearly 90% of cases being fatal [1]. One critical factor impacting cardiac arrest survival is timely and continuous high-quality cardiopulmonary resuscitation (CPR) [2]. High-quality CPR is defined as compressions delivered with a depth of 5 to 6  cm, at a rate of 100–102 compressions a minute [2-5]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 2, 2018 Category: Emergency Medicine Authors: Kristina Brodal Syversen, Eric Souvannasacd, Wayne Booze, Ralph Renger Source Type: research

Clinical differences between visits to adult freestanding and hospital-based emergency departments
Compare clinical characteristics for adult visits to freestanding emergency departments (FEDs) and a hospital-based ED (HBED). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 2, 2018 Category: Emergency Medicine Authors: Ryan C. Burke, Erin L. Simon, Brian Keaton, Laura Kukral, Nicholas J. Jouriles Source Type: research

Erector spinae plane block for bilateral lumbar transverse process fracture in emergency department: A new indication
Plane blocks have become very popular in recent years with the introduction of ultrasonography into the regional anesthesia and algology practice. Ultrasound guided erector spinae plane (ESP) block was first described in 2016. ESP block involves injection of local anesthetics between erector spinae muscles and transverse process of thoracic or lumbar vertebrae and can block the dorsal and ventral rami of thoracolumbar spinal nerves. ESP block has been successfully reported to relieve the pain of multiple rib fracture in the emergency department (ED). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 2, 2018 Category: Emergency Medicine Authors: Ali Ahiskalioglu, Abdullah Osman Kocak, Omer Doymus, Emre Sengun, Mine Celik, Haci Ahmet Alici Source Type: research

Gender disparities in percutaneous coronary intervention in out-of-hospital cardiac arrest
In this study, we evaluated gender disparities in the delivery of PCI among OHCA patients. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 2, 2018 Category: Emergency Medicine Authors: Jin Seop Jeong, So Yeon Kong, Sang Do Shin, Young Sun Ro, Kyoung Jun Song, Ki Jeong Hong, Jeong Ho Park, Tae Han Kim Tags: Original Contribution Source Type: research

Stimulant drugs are associated with violent and penetrating trauma
Substance abuse is associated with traumatic injuries. Prior studies of drug use and injury have relied on urine drug of abuse screens, which have false positives, false negatives and inability to detect novel drugs. Our study characterizes the relationship between injury mechanism and drugs of abuse detected in serum via confirmatory testing. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 2, 2018 Category: Emergency Medicine Authors: Patil Armenian, Zachary Effron, Neev Garbi, Rachel Dirks, Neal L. Benowitz, Roy R. Gerona Tags: Original Contribution Source Type: research

Toc
(Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 28, 2018 Category: Emergency Medicine Source Type: research

Luxatio erecta humeri with humeral greater tuberosity fracture and axillary nerve injury
Luxatio erecta humeri is the rarest type of glenohumeral dislocation, which has been reported to be associated with humeral fracture, rotator cuff tear and neurovascular injury. To our knowledge, a single-sided acute inferior glenohumeral dislocation associated with humeral greater tuberosity fracture and axillary nerve injury has not yet been reported. Here, we reported a traumatic first-time inferior shoulder dislocation from a construction worker who got hyperflexion of the left shoulder when fell and grasped the railing causing. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 27, 2018 Category: Emergency Medicine Authors: Fei Yao, LiQian Zhang, JueHua Jing Tags: Case Report Source Type: research

Accuracy of pre-hospital trauma notification calls
The aim of this study is to determine the accuracy of pre-hospital trauma notifications and the effects of inaccurate information on trauma triage. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 27, 2018 Category: Emergency Medicine Authors: Melissa K. James, Lavonne A. Clarke, Rose M. Simpson, Anthony J. Noto, Joshua R. Sclair, Geoffrey K. Doughlin, Shi-Wen Lee Source Type: research

Machine learning approaches for predicting disposition of asthma and COPD exacerbations in the ED
The prediction of emergency department (ED) disposition at triage remains challenging. Machine learning approaches may enhance prediction. We compared the performance of several machine learning approaches for predicting two clinical outcomes (critical care and hospitalization) among ED patients with asthma or COPD exacerbation. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 27, 2018 Category: Emergency Medicine Authors: Tadahiro Goto, Carlos A. Camargo, Mohammad Kamal Faridi, Brian J. Yun, Kohei Hasegawa Source Type: research

The social media diagnosis of Superior Vena Cava Syndrome: A case report
Social media is becoming increasingly popular among the public. In 2017, Facebook had 2.2 Billion monthly active users [1]. Applications of social media in healthcare are growing. This includes utilization of social media in disaster preparedness, disease support forums, and research recruitment [2-5]. There has been limited research evaluating patients utilizing social media and crowdsourcing to aid in the diagnosis and treatment of their medical conditions [6]. Here, we report a case of a patient who turned to social media when she had recurrent syncope and facial swelling. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 27, 2018 Category: Emergency Medicine Authors: Pierre Charbonniez, Alfred Tager, Leon Kwei, Mark L. Gustafson Tags: Correspondence Source Type: research

Luxatio erecta humeri with humeral greater tuberosity fracture and axillary nerve injury: A case report and review of the literature
Luxatio erecta humeri is the rarest type of glenohumeral dislocation, which has been reported to be associated with humeral fracture, rotator cuff tear and neurovascular injury. To our knowledge, a single-sided acute inferior glenohumeral dislocation associated with humeral greater tuberosity fracture and axillary nerve injury has not yet been reported. Here, we reported a traumatic first-time inferior shoulder dislocation from a construction worker who got hyperflexion of the left shoulder when fell and grasped the railing causing. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 27, 2018 Category: Emergency Medicine Authors: Fei Yao, LiQian Zhang, JueHua Jing Source Type: research

Shark related injuries: A case series of emergency department patients
Shark-related-injuries (SRIs) are not thoroughly evaluated in the medical literature given their rare occurrence. Previous studies involve the utilization of large-independent databases and have demonstrated that shark attacks appear to be increasing, even though mortality of SRIs has decreased from 51% in 1958 to 8.3% in 2001. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 26, 2018 Category: Emergency Medicine Authors: Ryan J. Tomberg, Girlyn A. Cachaper, Gregory S. Weingart Source Type: research

Injury patterns and mechanisms related to refrigerator and freezer utilization in the United States
Refrigerators and freezers (R/F) are a common household item and injury patterns associated with these appliances are not well characterized. We aimed to characterize the injury patterns, mechanisms, and affected body parts in patients treated in the emergency departments nationally, hypothesizing that injury patterns would differ by age group. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 26, 2018 Category: Emergency Medicine Authors: Matthew C. Hernandez, Eric J. Finnesgard, Joel R. Anderson, Nicholas P. McKenna, Martin D. Zielinski, Johnathon M. Aho Source Type: research

Early diagnosis of atrial fibrillation using a E-health application
Cardiac events occur relatively commonly in patients with acute community-acquired pneumonia [1]. In the elderly, the pneumonia might cause a heart failure and might be a trigger for atrial fibrillation (AF) [2]. When patients without vital distress are treated in hospital, they are admitted to a medical unit without continuous monitoring. In our Emergency Department (ED), patients requiring oxygen for pneumonia without vital distress are hospitalized in our medical unit. In this unit, clinical monitoring of patients by the nurse is performed manually with a maximum frequency of three or four times per day. (Source: The Am...
Source: The American Journal of Emergency Medicine - June 26, 2018 Category: Emergency Medicine Authors: Aiham Daniel Ghazali, Christophe Choquet, Enrique Casalino Source Type: research

Chest wall hematoma after central venous hemodialysis catheter insertion
There were few case reports discuss about iatrogenic chest wall hematoma. Although it is rare life threatening, it still can result in significant morbidity. A 68-year-old woman with histories of end-stage renal disease under regular hemodialysis and congestive heart failure was sent to our emergency department because of progression of ecchymosis over the anterior chest wall a few hours after hemodialysis. The right subclavian hemodialysis catheter was inserted for hemodialysis on the same day. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 25, 2018 Category: Emergency Medicine Authors: Ming-Chan Wu, Kuan-Ting Liu, I-Jeng Yeh, Yen-Hung Wu Source Type: research

Risk factors of upper gastrointestinal hemorrhage with acute coronary syndrome: A nested case-control study
This study aimed to determine the risk factors that associated with an increased risk of ACS occurrence after UGH. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 24, 2018 Category: Emergency Medicine Authors: Nana Wang, Tiegang Li, Qiang Du Source Type: research

Risk factors of upper gastrointestinal hemorrhage with acute coronary syndrome
This study aimed to determine the risk factors that associated with an increased risk of ACS occurrence after UGH. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 24, 2018 Category: Emergency Medicine Authors: Nana Wang, Tiegang Li, Qiang Du Tags: Original Contribution Source Type: research

Aortic dissection and aneurysm are hypertensive target organ damages and should be listed in the guidelines
To the editor: (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 23, 2018 Category: Emergency Medicine Authors: Goran P. Koracevic Source Type: research

Effect of hypertension across the age group on survival outcomes in out-of-hospital cardiac arrest
This study aims to investigate whether hypertension is associated with survival outcomes in cardiac arrest patients across age groups. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 23, 2018 Category: Emergency Medicine Authors: Eujene Jung, Jeong Ho Park, Young Sun Ro, Kyoung Jun Song, Hyun Ho Ryu, Seung Chul Lee, Sang Do Shin Source Type: research

Editorial Board
(Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 22, 2018 Category: Emergency Medicine Source Type: research

Table Of Contents
(Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 22, 2018 Category: Emergency Medicine Source Type: research

Info For Authors
(Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 22, 2018 Category: Emergency Medicine Source Type: research

Heart rate variability in the risk stratification of emergency department patients with chest pain
Chest pain is the second most common presenting complaint in the emergency department (ED), accounting for 8 –10 million ED visits per year and between $10–13 billion dollars per year in ED costs [1, 2]. Several scoring systems developed recently have attempted to stratify patients based on their risk for major adverse cardiac events. The HEART score is a prospectively studied scoring system designed t o identify patients who are at highest risk of a major adverse cardiac event (MACE) in the next 6 weeks [3-5], and this score is used as a part of chest pain management protocols in many hospitals. (Source: The...
Source: The American Journal of Emergency Medicine - June 22, 2018 Category: Emergency Medicine Authors: Robert Welborn, Nicholas M. Mohr Source Type: research

Airway management in a prehospital combat setting
In a retrospective review of US Army medical evacuation patient care records, Hardy et al. [1] compared outcomes of US military injured that received prehospital advanced airway interventions. The authors conclude that patients who received a supraglottic airway devices (SAD) had higher morbidity demonstrated by fewer ventilator, hospital, and ICU free days than those receiving cricothyrotomy or mask ventilation. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 22, 2018 Category: Emergency Medicine Authors: Manuel Ángel Gómez-Ríos, José María Calvo-Vecino Source Type: research

Penile fracture: Surgical vs. conservative treatment
Penile fracture is a relatively uncommon form of urologic trauma, and is defined as blunt direct trauma to the fully erect or semi-erect penis resulting in rupture of the tunica albuginea of the corpora cavernosa [1, 2]. Due to a sudden increase in the intracorporeal pressure, over-stretching of the tunica albuginea occurs, causing rupture. Involvement of or injury to the corpus spongiosum, urethra, dorsal nerve and vessels may also be present [3]. Patients typically present with symptoms including sharp penile pain, hearing a ‘cracking’ sound, rapid detumescence and swelling with or without ecchymosis of the p...
Source: The American Journal of Emergency Medicine - June 22, 2018 Category: Emergency Medicine Authors: Lindsey Ouellette, Mary Hamati, Danielle Hawkins, Colleen Bush, Matthew Emery, Jeffrey Jones Source Type: research

Impact of prehospital airway management on combat mortality
We appreciate the inquiry regarding our publication and thank you for the letter. We were unable to determine the type or generation of supraglottic airway devices used in the prehospital combat setting from the MEDEVAC documentation. An additional consideration affecting patient outcomes regarding supraglottic airway devices in the prehospital combat setting is the difference in the combat environment versus the hospital environment. As mentioned in our discussion section, combat medics do not carry paralytics, the patients are not fasting, and the environment is considerably different than that of the hospital. (Source: ...
Source: The American Journal of Emergency Medicine - June 22, 2018 Category: Emergency Medicine Authors: Garrett Hardy, Joseph K. Maddry, Patrick C. Ng, Shelia C. Savell, Allyson A. Arana, Avery Kester, Vikhyat S. Bebarta Tags: Letter to the Editor Source Type: research

Newborn with a depression to her skull
A 9  week-old female, born via normal spontaneous vaginal delivery at 40 weeks, presented to the emergency department for a depression to her left skull, first noticed three weeks prior. Both parents denied perinatal or postnatal trauma. The child had been gaining weight appropriately and no behavio ral dysfunction was noticed. On examination, a depression to the left parietal skull was present. A computed tomography (CT) of the head was obtained (Figs. 1 and 2). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 22, 2018 Category: Emergency Medicine Authors: Simona Rudnin, Jeremy Neuman, Josh Greenstein, Barry Hahn Source Type: research

Factor Xa inhibition and sPESI failure in intermediate-high-risk pulmonary embolism
We report the case of a 61-year-old man who presented at the Emergency Department (ED), complaining of sudden-onset dyspnea and chest pain after a long flight from Tokyo to Houston. Considering his clinical stability and sPESI 0, enoxaparin 1  mg/kg BID was started for 24 h, and the patient was then considered for early discharge with apixaban 10 mg BID. Direct-factor Xa inhibition did not improve extensive thrombus burden and right ventricular dysfunction despite D-dimer measurement reduction. Because of the treatment failure, we considered thrombolysis. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 22, 2018 Category: Emergency Medicine Authors: Alejandro R. Trevino, Luis Perez, Carlos Jerjes-Sanchez, David Rodriguez, Jathniel Panneflek, Claudia Ortiz-Ledesma, Francisco Nevarez, Vicente Jimenez, Felipe Valdes, Eduardo de Obeso Source Type: research

Emergency medicine physicians' ability to predict hospital admission at the time of triage
We seek to determine if experienced emergency medicine physicians can accurately predict the likelihood of admission for patients at the time of triage. Such predictions, if proven to be accurate, could decrease the time spent in the ED for patients who will ultimately be admitted by hastening downstream workflow. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 21, 2018 Category: Emergency Medicine Authors: Zlata K. Vlodaver, Jeffrey P. Anderson, Brittney E. Brown, Michael D. Zwank Source Type: research

Left atrial rhabdomyosarcoma diagnosed by Emergency Department point-of-care echocardiography
We present a case of intracardiac rhabdomyosarcoma associated with cardiopulmonary instability which was diagnosed by emergency providers using point-of-care echocardiography. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 21, 2018 Category: Emergency Medicine Authors: Marshall Leonard, Michael Secko, Rolando Valenzuela, Lindsay Reardon Source Type: research

Prognostic factors for patients with accidental hypothermia: A multi-institutional retrospective cohort study
In cases of severe accidental hypothermia (AH) in urban areas, the prognostic factors are unknown. We identified factors associated with in-hospital mortality in patients with moderate-to-severe AH in urban areas of Japan. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 20, 2018 Category: Emergency Medicine Authors: Yohei Okada, Tasuku Matsuyama, Sachiko Morita, Naoki Ehara, Nobuhiro Miyamae, Takaaki Jo, Yasuyuki Sumida, Nobunaga Okada, Tetsuhisa Kitamura, Ryoji Iiduka Source Type: research

Cerebellar infarction following accidental inhalation of toluene-mixed paint
We report a case of atypical cerebellar infarction following accidental inhalation of toluene mixed paint. An unconscious 57-year-old housewife with hypertension arrived at our emergency department by ambulance. She had been rescued from a basement (30  m3) 12 h after exposure to paint containing toluene (34%). On arrival, she was comatose (E1V1M1) with a mild fever (37.4 °C). Physical examination showed chemical burns on her buttocks and rales on the left lung. Initial arterial blood gas with 15 L/min of oxygen showed a pH of 7.142, PCO2 of 47.3 mmHg, and PaO2 of 204.7 mmHg. (Source: The American Journal o...
Source: The American Journal of Emergency Medicine - June 20, 2018 Category: Emergency Medicine Authors: Jung Taek Park, Hyun Ho Jung, Kyoung Ho Choi Source Type: research

The authors respond “Metoprolol vs. diltiazem in the acute management of atrial fibrillation in patients with heart failure with reduced ejection fraction”
Thank you for the interest and feedback on our manuscript [1]. We disagree with the recommendation of a digoxin group being a more logical choice. The letter mentions digoxin being preferred in “patients with marked congestion who nonetheless have few symptoms at rest.” They also go on to mention considering digoxin or amiodarone in patients with hemodynamic instability. The referenced guidelines recommend digoxin in patients with marked congestion, which we specifically excluded those with decompensated heart failure to allow for better assessment of exacerbation symptoms [2,3]. (Source: The American Journal o...
Source: The American Journal of Emergency Medicine - June 19, 2018 Category: Emergency Medicine Authors: R. Hirschy, Kimberly A. Ackerbauer, Gary D. Peksa, E. Paul O'Donnell, Joshua M. DeMott Source Type: research

The value of endoplasmic reticulum stress markers (GRP78 and CHOP) in the diagnosis of acute mesenteric ischemia
To evaluate levels of the endoplasmic reticulum (ER) stress markers GRP78 and CHOP in acute mesenteric ischemia (AMI) and to examine relations with degrees of AMI-related intestinal injury. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 19, 2018 Category: Emergency Medicine Authors: Senol Ardic, Aysegul Gumrukcu, Ozgen Gonenc Cekic, Mehmet Erdem, Goksen Derya Reis Kose, Selim Demir, Bestami Kose, Esin Yulug, Ahmet Mentese, Suleyman Turedi Source Type: research

Emergency department utilization by a jail population
Incarcerated individuals represent a significant proportion of the US population and face unique healthcare challenges. Scarce articles have been published about emergency department (ED) care of these patients. We studied the ED visits from one urban jail to better describe this population. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 19, 2018 Category: Emergency Medicine Authors: Patrick J. Maher, Adeyinka A. Adedipe, Benjamin L. Sanders, Taylor Buck, Paul Craven, Jared Strote Source Type: research

Managing unplanned severe opiate withdrawal after Vivitrol
Having deliberately precipitated opiate withdrawal with naltrexone (NTX) in several thousand opiate-dependent patients, using a variety of techniques, between 1985 and my retirement two decades later, I think I can comment usefully on the difficulties experienced by Wightman et al. [1] in managing severe and unexpected opioid withdrawal precipitated by Vivitrol ®. The drug that is notably absent from their attempts at symptom control is octreotide. Other researchers have confirmed my original observation [2] that it effectively prevents the profuse diarrhea and vomiting that distress medical and nursing staff as well a...
Source: The American Journal of Emergency Medicine - June 19, 2018 Category: Emergency Medicine Authors: Colin Brewer Source Type: research

The effect of angioembolization for life-threatening retroperitoneal hemorrhage in patients with pelvic fracture
Conventionally, pelvic fracture-related acute retroperitoneal hemorrhage (ARH) is life threatening and difficult to control. However, the use of angioembolization to treat fracture-associated ARH improves the hemodynamic stability of patients with pelvic fractures. The role of angioembolization in the management of patients with pelvic fracture-related ARH was examined. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 19, 2018 Category: Emergency Medicine Authors: Chih-Yuan Fu, Sheng Yu Chan, Shang-Yu Wang, Chi-Hsun Hsieh, Chien-Hung Liao, Jen-Fu Huang, Yu-Pao Hsu, Shih-Ching Kang Source Type: research

Subacute aortic prosthetic mechanical valve thrombosis complicated with acute coronary syndrome
A prosthetic valve thrombosis (PVT), which is a potentially fatal complication, refers to the presence of non-infective thrombotic material on a prosthetic valve apparatus, interfering with its function. Possible complications of a PVT include transient neurologic embolic events, cardiac arrest due to a stuck valve prosthesis, and cardio-embolic myocardial infarction (MI). The choice of treatments, including a redo surgery, a percutaneous coronary intervention (PCI), and a fibrinolysis with PVT or MI dosages, depends on the patient's clinical and hemodynamic status and thrombotic burden involving the prosthetic valve and s...
Source: The American Journal of Emergency Medicine - June 19, 2018 Category: Emergency Medicine Authors: Batur Gonenc Kanar, Kursat Tigen, Halil Atas, Altug Cincin, Beste Ozben Source Type: research

Response by Hirschy et al. to letter regarding article, “Metoprolol vs. diltiazem in the acute management of atrial fibrillation in patients with heart failure with reduced ejection fraction”
Thank you for the interest and feedback on our manuscript [1]. We disagree with the recommendation of a digoxin group being a more logical choice. The letter mentions digoxin being preferred in “patients with marked congestion who nonetheless have few symptoms at rest.” They also go on to mention considering digoxin or amiodarone in patients with hemodynamic instability. The referenced guidelines recommend digoxin in patients with marked congestion, which we specifically excluded those with decompensated heart failure to allow for better assessment of exacerbation symptoms [2,3]. (Source: The American Journal o...
Source: The American Journal of Emergency Medicine - June 19, 2018 Category: Emergency Medicine Authors: RaeAnn Hirschy, Kimberly A. Ackerbauer, Gary D. Peksa, E. Paul O'Donnell, Joshua M. DeMott Source Type: research

Comparison of acute management of atrial fibrillation in heart failure with unequal sized groups
We read with interest the article recently published by Hirschy et al. entitled “Metoprolol vs. diltiazem in the acute management of atrial fibrillation in patients with heart failure with reduced ejection fraction” [1]. However, we have some concerns to merit more attention. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 19, 2018 Category: Emergency Medicine Authors: Gurbet Özge Mert, Muhammet Dural, Kadir Uğur Tags: Correspondence Source Type: research

Role of ED crowding relative to trauma quality care in a Level 1 Trauma Center
Trauma Quality Improvement Program participation among all trauma centers has shown to improve patient outcomes. We aim to identify trauma quality events occurring during the Emergency Department (ED) phase of care. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 16, 2018 Category: Emergency Medicine Authors: Natasha Singh, Richard D. Robinson, Therese M. Duane, Jessica J. Kirby, Cassie Lyell, Stefan Buca, Rajesh Gandhi, Shaynna M. Mann, Nestor R. Zenarosa, Hao Wang Source Type: research

Dangerous manifestations of reversible cerebral vasoconstriction syndrome
The spectrum of dangerous manifestations of reversible cerebral vasoconstrictive syndrome (RCVS) includes, not only the subtype characterised by rapid-onset headache, as in the recently reported case [1], but also subtypes characterised by potentially life-threatening manifestations such as status epilepticus (SE) [2], and Guillain-Barre syndrome (GBS) [3, 4], respectively. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 16, 2018 Category: Emergency Medicine Authors: Oscar M.P. Jolobe Source Type: research

Next day discharge rate has little use as a quality measure for individual physician performance
The objective was to determine if NDDR has validity as a measure for quality of individual ED physician performance. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 16, 2018 Category: Emergency Medicine Authors: Christopher Inabnit, Stephen Markwell, Jack Gruwell, Cassie Jaeger, Lance Millburg, David Griffen Source Type: research

Patient factors associated with nationwide emergency department utilization for cellulitis
In this study, we employ a nationally representative emergency department database to 1) characterize the utilization of ED services for cellulitis-related visits and 2) describe epidemiolocal factors associated with greater likelihood of ED visits for cellulitis. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 16, 2018 Category: Emergency Medicine Authors: David G. Li, Cara Joyce, Arash Mostaghimi Source Type: research

Acute stroke presenting with isolated acalculia
We report the case of a 63-year-old male with a 1  day history of isolated acalculia that was found to have a left parietal lobe infarct with several smaller infarcts in the left occipital lobe. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 16, 2018 Category: Emergency Medicine Authors: Michael Grimaldi, Rebecca Jeanmonod Source Type: research

Fixed dose 4-factor prothrombin complex concentrate for bleeding caused by long acting anticoagulant rodenticides
We report a case of an acute ingestion of two anticoagulant rodenticides and successful reversal of coagulation parameters using 4-factor prothrombin complex concentrate in a fixed-dose approach. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - June 16, 2018 Category: Emergency Medicine Authors: Richard J. Doyle, Zane Elfessi, Kevin Kolman Source Type: research