The American Journal of Emergency Medicine This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Elevated bands as a predictor of bloodstream infection and in-hospital mortality
Although>10% bands on a CBC has been a part of the definition for sepsis, scant data exists regarding the clinical significance of lower percentages of bands. Our aim was to determine whether any associations exist between percentage of bands on an initial CBC and likelihood of a bloodstream infection and in-hospital mortality. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 1, 2020 Category: Emergency Medicine Authors: Leon Hsueh, Janine Molino, Leonard Mermel Source Type: research

The impact of COVID-19 lockdown on children with medical complexity in pediatric emergency department
Italy has been the first western country to be overwhelmed by the COVID-19 pandemic, forcing the Government to institute a strict national lockdown to limit virus spread, from 9 March to 3 May 2020. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 28, 2020 Category: Emergency Medicine Authors: Giacomo Brisca, Giulia Vagelli, Giulia Tagliarini, Andrea Rotulo, Daniela Pirlo, Marta Romanengo, Emanuela Piccotti Source Type: research

Emergency department-based rapid response team for hospital visitors, employees, and ambulatory clinic patients
The hospital's rapid response team (RRT) provides evaluation, triage, and management to patients who unexpectantly require a higher level of medical care [1]. RRTs have been shown to reduce in-hospital cardiorespiratory arrests in both adult and pediatric populations [2,3]. RRTs are traditionally developed for hospitalized patients and don't account for the unexpected deterioration of visitors, employees, and ambulatory clinic patients within the hospital campus. Minimal literature has been published surrounding this topic, and no workflows have been described to date [5-7]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 27, 2020 Category: Emergency Medicine Authors: Evan Yanni, David Koterwas, Ee Tein Tay Source Type: research

Use of point of care ultrasound in the diagnosis of subgaleal hematoma following an episode of accidental pilotraction: A case report
We present the first case report describing the use of point of care ultrasound (POCUS) in diagnosing subgaleal hematoma (SGH) in a case of accidental pilotraction. We review the incidence of SGH caused by pilotraction and sonographic findings of SGH in the literature. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 27, 2020 Category: Emergency Medicine Authors: S. Kim, M. Rizvi Source Type: research

Non-COVID-19 admissions to the emergency department during the pandemic second wave in Italy: What is changed from the first wave?
We recently read with interest the articles written by Baugh et al. [1] and Nourazari et al. [2] regarding a significant decrease in hospital admissions through the Emergency Department (ED) during the COVID-19 pandemic in US. Similarly, many other studies have shown a significant reduction in worldwide ED visits related to different disciplines over the first weeks of the pandemic ( “first wave”) [3-5]. The general opinion is that patients were avoiding hospitals, because of the fear of being infected with SARS-CoV-2, highlighting both the overuse of EDs by low complexity cases that could be managed by general practit...
Source: The American Journal of Emergency Medicine - November 26, 2020 Category: Emergency Medicine Authors: Guglielmo Mantica, Niccol ò Riccardi, Carlo Terrone, Angelo Gratarola Source Type: research

Case series: Hyperdense basilar artery identified on unenhanced head CT in three cases of pediatric basilar artery occlusion
Acute basilar artery occlusion (BAO) is an easily missed, potentially devastating type of ischemic stroke. Children with BAO can present with a range of clinical symptoms, from headache, dizziness, nausea and/or vomiting [1-3] to profound alterations of consciousness, including locked-in syndrome and coma [2]. Typically in children with BAO, only an unenhanced head Computed Tomography (CT) is initially performed. When an obvious finding is not identified, such as intracranial hemorrhage, the unenhanced CT is rarely carefully further scrutinized by emergency physicians. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 26, 2020 Category: Emergency Medicine Authors: Jennifer K. Potter, Jonathan D. Clemente, Andrew W. Asimos Source Type: research

An extremely rare complication of acute pancreatitis: Intraventricular thrombus
Acute pancreatitis is a frequent reason for emergency admission, which has seen its numbers increase over the years. This condition has systemic, local, and vascular complications. A 73-year-old male patient presented to our emergency department complaining of abdominal pain, nausea, and vomiting. During imaging, intraventricular thrombus was discovered, and following completion of diagnostic testing, he was diagnosed with acute pancreatitis. Herein, we present the first case of intraventricular thrombus related to acute pancreatitis prothrombotic process in the literature. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 26, 2020 Category: Emergency Medicine Authors: Bu ğra İlhan, Halil Doğan, Göksu Bozdereli Berikol, Yasemin Gündoğmuş Uçar, İbrahim Sarbay Source Type: research

Evaluation for septic arthritis of the native adult knee is aided by multivariable assessment
Evaluation of suspected septic arthritis of the native adult knee is a common diagnostic dilemma. Pre-aspirate criteria predictive of septic arthritis do not exist for the adult knee and investigations of aspiration results (cell count, differential, gram stain and crystal analysis) have been limited to univariate analyses. Given numerous clinical variables inform the risk of septic arthritis, multivariable analysis that incorporates all clinically available information is critical to allowing accurate decision-making. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 25, 2020 Category: Emergency Medicine Authors: Adam Holzmeister, Joseph Frazzetta, Frank Feng Ning Yuan, Arien Cherones, Hobie Summers, Joseph Cohen, William D. Lack Source Type: research

Geographic information system technology: Implications for disaster and emergency management in Sweden
The idea of using coordinated data in community planning was introduced in Sweden as early as 1955 and resulted in production of the real estate register and registration books to ADB (Automatic Data Processing) in digital form. A new department was established with the task of producing a digital central point for each property and the digital coordinates of the houses from the property map. Furthermore, another department was formed to develop the use of the property coordinates and integration between registers, and in this way the internationally recognized project FRIS (Experiment with the Spatial Information System) ...
Source: The American Journal of Emergency Medicine - November 25, 2020 Category: Emergency Medicine Authors: Amir Khorram-Manesh, Krzysztof Goniewicz, Attila J. Hertelendy Source Type: research

Comments on “Inter-facility transfer for patients with acute large vessel occlusion stroke receiving mechanical thrombectomy.”
We read the recently-published article by Schevin et al. [1] with great interest. We commended the authors for looking into the work flow in Emergency Departments (ED) in patients with acute ischemia from large vessel occlusion (AIS-LVO) to assess where the longest delays to thrombectomy might occur. Unfortunately, this study is significantly underpowered to comment on patient outcomes. In this retrospective study of 95 patients undergoing mechanical thrombectomy (MT), the authors showed that patients' total ED length of stay and successful MT were not associated with good neurological outcome, defined as 90-day modified R...
Source: The American Journal of Emergency Medicine - November 25, 2020 Category: Emergency Medicine Authors: Quincy K. Tran, Nicholas Morris Source Type: research

The role of mesenchymal stem/stromal cells in the acute clinical setting
Accumulating evidence supports the use of mesenchymal stem/stromal cells (MSCs), particularly bone marrow derived, as a safe and promising biologic therapy for promoting tissue repair and regeneration in various chronic diseases and disorders. Despite growing evidence that MSCs are potent anti-inflammatory mediators that can provide substantial benefits in acute organ injury, there are limited clinical trials utilizing MSCs in acute care settings, such as in the emergency department (ED) or intensive care unit (ICU). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 24, 2020 Category: Emergency Medicine Authors: Courtney Premer, Ivonne H. Schulman, Jennifer S. Jackson Source Type: research

Lipid emulsion in theophylline and salbutamol overdose: Lipid sink theory (MS 25092)
The author responds: (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 24, 2020 Category: Emergency Medicine Authors: V.P. Chandrasekaran, Anand Parthasarathy, Balaji Muruga, Senthamil, Tharanesh Source Type: research

Physiological status monitoring with shock indices: context and precision equally matter!
We read with interest the recent article by Gupta and Alam highlighting a superior performance of shock index (SI=Heart rate (HR)/systolic blood pressure (SBP)) paediatric age-adjusted (SIPA) compared to the isolated performance of conventional haemodynamic parameters, in predicting higher degree of support (vasopressor requirement and mechanical ventilation) and early mortality in a septic cohort of 116 children [1]. While the study attributes such as a prospective design, use of age-specific SI cut-offs and an outcome centric approach are noteworthy, additional points mandate elucidation for a holistic comprehension of t...
Source: The American Journal of Emergency Medicine - November 24, 2020 Category: Emergency Medicine Authors: Rohan Magoon Source Type: research

Potential mechanisms underlying the effects of lipid emulsion against theophylline-induced toxicity
To the Editor: (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 24, 2020 Category: Emergency Medicine Authors: Soo Hee Lee, Ju-Tae Sohn Source Type: research

Real world utilization of Andexanet Alfa at a community hospital
Factor Xa inhibitors have been shown to be effective in the treatment and prevention of venous thromboembolism and the prevention of ischemic cerebral vascular accidents in those with atrial fibrillation [1-4]. However, acute and life-threatening hemorrhage has been associated with their use and can cause significant morbidity and mortality [ 1-4]. With the increasing use of the factor Xa inhibitors, the number of patients who may potentially need reversal of their anticoagulation due to life-threatening hemorrhage is expected to increase over the next several years. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 24, 2020 Category: Emergency Medicine Authors: Anthony Santarelli, Tyson Dietrich, Robert Sprague, Anthonia Ajao, John Ashurst Source Type: research