Prognostic significance of emergency department modified early warning score trend in critical ill elderly patients
To explore the relationship between trends in emergency department modified early warning score (EDMEWS) and the prognosis of elderly patients admitted to the intensive care unit (ICU). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 23, 2021 Category: Emergency Medicine Authors: Chih-Chun Kao, Yen-Chia Chen, Hsien-Hao Huang, The-Fu Hsu, David Hung-Tsang Yen, Ju-Sing Fan Source Type: research

Treatment of suspected sepsis and septic shock in children with chronic disease seen in the pediatric emergency department
Research demonstrates that timely recognition and treatment of sepsis can significantly improve pediatric patient outcomes, especially regarding time to intravenous fluid (IVF) and antibiotic administration. Further research suggests that underlying chronic disease in a septic pediatric patient puts them at higher risk for poor outcomes. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 22, 2021 Category: Emergency Medicine Authors: Emily Hegamyer, Nadine Smith, Amy D. Thompson, Andrew D. Depiero Source Type: research

Philadelphia versus Miami J cervical collar's impact on pulmonary function
The purpose of this study was to compare the effect of two types of cervical collars (Philadelphia and Miami-J) on pulmonary function and ventilation in healthy volunteers through spirometry, peak flow meter, and capnograph. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 22, 2021 Category: Emergency Medicine Authors: Alireza Ala, Samad Shams Vahdati, Parham Maroufi, Sadaf Hafezan, Niloufar Ansari, Amir Ghabousian Source Type: research

Can open access publishing be made ‘JUST’ for authors from low-middle income countries?
Medical innovation, scientific research and ultimately academic publication are vital for clinicians as they progress in their professional career [1]. All these three elements are necessary to enhance medical knowledge. This allows clinicians to be abreast with evidence-based medicine that can be applied to enhance patient care in a multitude of conditions. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 21, 2021 Category: Emergency Medicine Authors: Karthikeyan P. Iyengar, Vijay Kumar Jain, Shashi Bahl, Raju Vaishya Source Type: research

Comparison of MPL-ANN and PLS-DA models for predicting the severity of patients with acute pancreatitis: An exploratory study
Acute pancreatitis (AP) is a common inflammatory disorder that may develop into severe AP (SAP), resulting in life-threatening complications and even death. The purpose of this study was to explore two different machine learning models of multilayer perception-artificial neural network (MPL-ANN) and partial least squares-discrimination (PLS-DA) to diagnose and predict AP patients' severity. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 21, 2021 Category: Emergency Medicine Authors: Xinrui Jin, Zixuan Ding, Tao Li, Jie Xiong, Gang Tian, Jinbo Liu Source Type: research

Extreme weather conditions as a gender-specific risk factor for acute myocardial infarction
Acute coronary syndrome is a disease with high prevalence and high mortality. Exposure to heat or cold increases the risks of myocardial infarction significantly. Gender-specific effects of this have not yet been examined. Our goal was to determine whether extreme weather conditions, which become more and more frequent, are gender-specific risk factors for myocardial infarction, in order to help provide faster diagnosis and revascularization therapy for patients. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 21, 2021 Category: Emergency Medicine Authors: Calvin Lukas Kienbacher, Rainer Kaltenberger, Wolfgang Schreiber, Katharina Tscherny, Verena Fuhrmann, Dominik Roth, Harald Herkner Source Type: research

Cardiology emergency management and telecardiology within territorial hospital network. Four years activity results
In this study, four years of telecardiology activity managed by the Provincial Public Health Provider of Cosenza (ASP CS) are reviewed with a special focus on ST-Elevation Myocardial Infarction (STEMI) diagnosis. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 21, 2021 Category: Emergency Medicine Authors: Silvana De Bonis, Nadia Salerno, Antonio Bisignani, Antonio Capristo, Gennaro Sosto, Antonella Verta, Riccardo Borselli, Cristina Capristo, Giovanni Bisignani Source Type: research

The effectiveness of intradermal sterile water injection for low back pain in the emergency department: A prospective, randomized controlled study
In this study, it was aimed to compare the effectiveness of systemic treatment with intradermal sterile water injection (ISWI) treatment protocol combined with systemic therapy in patients with LBP of unclear chronicity. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 20, 2021 Category: Emergency Medicine Authors: Erdal Tekin, Ali Gur, Mustafa Bayraktar, Ibrahim Ozlu, Bahar Keskin Celik Source Type: research

Association between laboratory parameters and CT severity in patients infected with Covid-19: A retrospective, observational study
In this study we reported the clinical, laboratory and radiological features of the cases diagnosed with COVID-19. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 20, 2021 Category: Emergency Medicine Authors: Atakan Yilmaz, Ramazan Sabirli, Murat Seyit, Mert Ozen, Alten Oskay, Vefa Cakmak, Tarik Goren, Ibrahim Turkcuer Source Type: research

Ηypercoagulation and myocardial injury as risk factors for mortality in patients with COVID-19 pneumonia
In the very interesting study published in the American Journal of Emergency Medicine [1] assessing possible associations between one-month mortality and laboratory and clinical findings, it was found that neutrophil-to-lymphocyte ratio, white blood cells count together with increase age and presence of ischemic heart disease can be considered as predictors of survival in patients suffering from Coronavirus Disease 2019 (COVID-19). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 19, 2021 Category: Emergency Medicine Authors: Nicholas G. Kounis, Ioanna Koniari, Christos Gogos, Stelios F. Assimakopoulos Source Type: research

Pediatric emergency medicine literature 2020
Most children are treated at general Emergency Departments (EDs) and not specialized pediatric EDs. Therefore, it is crucial for emergency medicine physicians to be aware of recent developments in pediatric emergency medicine. Often impactfularticles on pediatric emergency medicine are not published in the journals regularly studied by general emergency medicine physicians. We selected ten studies that we found impactful, robust, and relevant for practicing general emergency physicians. This review includes studies of status epilepticus, cardiac arrest, asthma, infant fever, wound care, rapid sequence intubation, coronavir...
Source: The American Journal of Emergency Medicine - January 16, 2021 Category: Emergency Medicine Authors: Frank Petruzella, Joshua Easter Source Type: research

More than just gastritis: An unusual presentation of strangulated transmesenteric hernia in a pediatric patient
Internal hernias are a rare occurrence, reported in only 0.2 –0.9% of the general population, and predominantly occur in adult patients as postsurgical complications. However, internal hernias can occur in pediatric patients, typically due to herniation of bowel through congenital mesenteric defects, and are associated with high rates of strangulation or vo lvulus (up to 30–40%) in this population. These can be especially difficult to detect due to nonspecific symptoms and rarity, but carry a steep mortality rate of 45% if treated and virtually 100% if missed. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 16, 2021 Category: Emergency Medicine Authors: Elizabeth A. Payonk, Rachel J. Williams Source Type: research

An educational module to improve knowledge of delirium screening in the Emergency Department
Delirium, an acute condition characterized by reduced awareness, emotional disturbance, and mental confusion, is associated with increased morbidity and mortality [1-3]. In the emergency department (ED), delirium affects 7 to 10% of older adult patients but is overlooked in more than half of cases [3]. Delirium screening tools have been created to improve detection in at-risk patients and seem promising. However, provider time constraints, insufficient training, and the lack of a universal diagnostic assessment tool inhibit widespread utilization [4]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 16, 2021 Category: Emergency Medicine Authors: Sarah C. Minion, Brooks J. Obr, Ryan M. Carnahan, Sangil Lee Source Type: research

Utilization of lysis percentage via thromboelastography for tissue plasminogen activator-induced symptomatic intracranial hemorrhage
Alteplase, the only FDA approved tissue plasminogen activator (tPA), remains one of the cornerstones of acute ischemic stroke (AIS) management. Just as with endogenous tPA, recombinant tPA promotes the activation of plasmin and the subsequent degradation of cross-linked fibrin to fibrin byproducts [1]. The most feared complication of recombinant tPA administration is the development of symptomatic intracranial hemorrhage (sICH), which occurs in approximately 5.6% of tPA administrations, utilizing the European Cooperative Acute Stroke Study definition, with roughly half of these cases resulting in death [2]. (Source: The Am...
Source: The American Journal of Emergency Medicine - January 16, 2021 Category: Emergency Medicine Authors: Brian W. Gilbert, J. Spencer Dingman, Joel B. Huffman Source Type: research

Pediatric minor head injury related return visits to the emergency department and their outcome
The objective of this study was to describe the frequency and outcome of unscheduled return visits (RVs) for MHI in a pediatric ED. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 16, 2021 Category: Emergency Medicine Authors: Rajan Arora, Meghna Shukla, Elizabeth McQuillen, Usha Sethuraman Source Type: research

The authors respond: Assessing the confidence in network meta-analysis results
We would like to thank the authors for their careful reading and thoughtful comments on our recent article “Amiodarone and/or lidocaine for cardiac arrest: A Bayesian network meta-analysis” [1]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 15, 2021 Category: Emergency Medicine Authors: Hongli Zhao, Kai Fan, Guilong Feng Source Type: research

Pericardial decompression syndrome: A complication of pericardiocentesis
We report PDS after pericardiocentesis in two patients that presented to the emergency department with cardiac tamponade. In both cases, pericardiocentesis was performed under ultrasound guidance using the left parasternal approach and approximately 1200 –1500 mL of pericardial fluid was removed. Immediately after pericardiocentesis, the haemodynamic status of the patients improved. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 15, 2021 Category: Emergency Medicine Authors: Osman Adi, Chan Pei Fong, Azma Haryaty Ahmad, Azlizawati Azil, Asri Ranga, Nova Panebianco Source Type: research

The efficacy of telemedical care for heart failure: A meta-analysis of randomized controlled trials
The efficacy of telemedical care for the treatment of heart failure remains controversial. We conduct a systematic review and meta-analysis to explore the impact of telemedical care on heart failure. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 15, 2021 Category: Emergency Medicine Authors: XuHui Ma, Jie Li, XiuZan Ren Source Type: research

Topical capsaicin for the treatment of cannabinoid hyperemesis syndrome, a systematic review and meta-analysis
Cannabinoid hyperemesis syndrome (CHS) is a condition that is being recognized and treated more frequently in emergency departments (EDs) across the United States. Currently, ED providers rely on antiemetics, antipsychotics and benzodiazepines to alleviate the symptoms. Topical capsaicin, a transient receptor potential vanilloid 1 (TRPV1) agonist, has been proposed in recent years as a low-cost and effective alternative to the traditional antiemetic regimen when treating CHS. The aim of this systematic review and meta-analysis is to demonstrate the reliability and the gaps of what is known about the treating modality. (Sou...
Source: The American Journal of Emergency Medicine - January 15, 2021 Category: Emergency Medicine Authors: Ali Pourmand, Gabriel Esmailian, Maryann Mazer-Amirshahi, Owen Lee-Park, Quincy K. Tran Source Type: research

Glasgow coma scale score of more than four on admission predicts in-hospital survival in patients after out-of-hospital cardiac arrest
The aim of the study was to assess the usefulness of the Glasgow Coma Scale (GCS) scoring assessed by the EMS team in predicting survival to hospital discharge in patients with out-of-hospital cardiac arrest (OHCA). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 15, 2021 Category: Emergency Medicine Authors: Klaudiusz Nadolny, Kamil Bujak, Marta Obremska, Dorota Zysko, Maciej Sterlinski, Lukasz Szarpak, Jacek Kubica, Jerzy Robert Ladny, Mariusz Gasior Source Type: research

Plasma syndecan-1 is associated with fluid requirements and clinical outcomes in emergency department patients with sepsis
Degradation of the endothelial glycocalyx is recognized as a major part of the pathophysiology of sepsis. Previous clinical studies, mostly conducted in intensive care settings, showed associations between glycocalyx shedding and clinical outcomes. We aimed to explore the association of plasma syndecan-1, a marker of glycocalyx degradation, with the subsequent fluid requirements and clinical outcomes of emergency department patients with sepsis. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 15, 2021 Category: Emergency Medicine Authors: Jutamas Saoraya, Lipda Wongsamita, Nattachai Srisawat, Khrongwong Musikatavorn Source Type: research

Surviving traumatic cardiac arrest: Identification of factors associated with survival
The endpoint of resuscitative interventions after traumatic injury resulting in cardiopulmonary arrest varies across institutions and even among providers. The purpose of this study was to examine survival characteristics in patients suffering torso trauma with no recorded vital signs (VS) in the emergency department (ED). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 15, 2021 Category: Emergency Medicine Authors: Andrew Khalifa, Jacob B. Avraham, Kristina Z. Kramer, Francesco Bajani, Chih Yuan Fu, Alexandra Pires-Menard, Matthew Kaminsky, Faran Bokhari Source Type: research

Usefulness of chloride levels for fluid resuscitation in patients undergoing targeted temperature management after out-of-hospital cardiac arrest
In this study, we aimed to evaluate the associations between chloride levels on emergency department (ED) admission and neurologic outcomes by stratifying patients undergoing targeted temperature management (TTM) after out-of-hospital cardiac arrest (OHCA) into three groups (hyper/normo/hypochloremia); we also assessed the effect of changes in chloride levels from baseline over time on outcomes. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 15, 2021 Category: Emergency Medicine Authors: Taeyoung Kong, Yong Eun Chung, Hye Sun Lee, Je Sung You, Hyun Soo Chung, Incheol Park, Sung Phil Chung Source Type: research

Chloride in targeted temperature management: Where is the data?
Out of hospital cardiac arrest (OHCA) remains the leading cause of mortality in the World, with a documented good neurological outcome survival rate of less than 5% [1]. One therapeutic intervention that may increase the survival chances of these patients, as well as reasonable neurological outcomes, has been the early implementation of targeted temperature management (TTM) [2]. During the three phases of TTM, the patient is closely monitored in an attempt to avoid complications and improve their outcome. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 15, 2021 Category: Emergency Medicine Authors: Elizabeth Gamboa, Gabriel Cervera-Rodriguez, Joseph Varon Source Type: research

Modified HEART score to optimize risk stratification in cocaine-associated chest pain
We recently reported in this journal that the classification performance of the HEART score is inferior in patients presenting with cocaine associated chest pain (CACP), with 14% of those with CACP in the low risk group experiencing adverse cardiac events within 30 days of indexed admission, compared to 4% in the general chest pain population.1 This finding suggests that the HEART score, in its current form, has limited clinical utility in stratifying risk in those evaluated for CACP in the emergency department (ED). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 14, 2021 Category: Emergency Medicine Authors: Ziad Faramand, Christian Martin-Gill, Clifton Callaway, Salah Al-Zaiti Source Type: research

Effect of COVID19 on prehospital pronouncements and ED visits for stroke and myocardial infarction
In this study, our goal was to determine if there was an increase in prehospital ALS pronouncements and a decrease in ED visits for potentially serious conditions such as MI and stroke during the peak of the COVID-19 pandemic in northern NJ. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 14, 2021 Category: Emergency Medicine Authors: Nikhil Jain, Michael Berkenbush, David C. Feldman, Barnet Eskin, John R. Allegra Source Type: research

Lipid emulsion treatment as an antidote for chloroquine and hydroxychloroquine toxicity
Chloroquine and hydroxychloroquine, which have anti-malarial and anti-inflammatory effects, are used for treating malaria, rheumatoid arthritis, and systemic lupus erythematosus [1]. These drugs are quinine derivatives having similar cellular mechanisms behind their toxicities [1]. Because a toxic dose of chloroquine, which is a Vaughan –Williams Class IA antiarrhythmic, inhibits cardiac sodium, potassium, and calcium channels, it induces QT prolongation, QRS widening, and atrioventricular blockade, leading to hypotension and shock [2]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 14, 2021 Category: Emergency Medicine Authors: Soo Hee Lee, Ju-Tae Sohn Source Type: research

Hyperbaric oxygen therapy mobilized circulating stem cells and improved delayed encephalopathy after acute carbon monoxide poisoning with up-regulation of brain-derived neurotrophic factor
BackgroundDelayed encephalopathy (DE) is the most severe complication after acute carbon monoxide (CO) poisoning, which seriously affects the outcome of patients and leads to a high disability rate. Prior studies have shown that hyperbaric oxygen (HBO2) therapy is therapeutic for DE due to reducing immune-mediated neuropathology and thus improving cognitive performance.MethodsIn our present perspective study, five DE patients were treated regularly with HBO2 therapy. The mini-mental state examination (MMSE) and Barthel index (BI) were intermittently collected during their hospitalization for mental and physical status eval...
Source: The American Journal of Emergency Medicine - January 14, 2021 Category: Emergency Medicine Authors: Lina Zhang, Qing Sun, Qun Xin, Jiangnan Qin, Lu Zhang, Di Wu, Guangkai Gao, Yujun Xia Source Type: research

Ketamine for acute suicidality in the emergency department: A systematic review
There are no emergent pharmaceutical interventions for acute suicidal ideation, a common presenting complaint in the ED. Ketamine is a NMDA agonist frequently used by ED physicians for sedation and analgesia. Prior evidence from studies conducted in inpatient psychiatry units suggests that ketamine may have a role in alleviating treatment-resistant depression as well as suicidal ideation. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 13, 2021 Category: Emergency Medicine Authors: Lindsay Maguire, Timothy Bullard, Linda Papa Source Type: research

Impact of COVID-19 pandemic on visits of an urban emergency department
The aim of this study was to reveal how the pandemic process affected the number of ED visits and the reasons for application. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 13, 2021 Category: Emergency Medicine Authors: G ülşah Çıkrıkçı Işık, Yunsur Çevik Source Type: research

Effect of antiplatelet treatments on patients with COVID-19 infection: A systematic review and meta-analysis
Despite the rationale that early anti-platelet would lower the risk of major organ dysfunction, the effectiveness of this approach remains controversial. Therefore, we perform a systematic review and meta-analysis to investigate the effect of antiplatelet treatments on patients with COVID-19 infection. An electronic search was carried out in Pubmed, Embase, Cochrane library, Web of Science, MEDLINE, Wanfang and China National Knowledge Infrastructure (CNKI). Meta-analysis and statistical analyses were completed with using the RevMan 5.3 and Stata 12.0. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 13, 2021 Category: Emergency Medicine Authors: Yushu Wang, Guangyu Ao, Basma Nasr, Xin Qi Source Type: research

Preparing emergency and disaster medicine physicians to lead future responses: Crisis leadership a core competency
We are grateful to Dr. Bala and colleagues for taking up the discussion, pointing out more gaps [1], and willing to continue this important topic [2]. In our opinion, additional attention also needs to be given to the preparation of emergency medicine (EM) and disaster medicine (DM) physicians to lead in times of crisis [3-5]. Effective responses to the pandemic have required emergency physicians to transcend clinical patient care responsibilities and provide leadership within their own departments, often stepping into much larger roles such as leading the COVID-19 response for an entire hospital or health system, developi...
Source: The American Journal of Emergency Medicine - January 13, 2021 Category: Emergency Medicine Authors: Attila J. Hertelendy, Krzysztof Goniewicz, Amir Khorram-Manesh Source Type: research

Congenital hypothyroidism presenting as myxedema coma in a teenager
We describe a case of congenital hypothyroidism presenting as myxedema coma in an immigrant teenager. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 12, 2021 Category: Emergency Medicine Authors: T. Christy Hallett, Barbara Solomon, Daisy A. Ciener Source Type: research

STAT vs. CAT: A pilot comparison after a video demonstration
Tourniquets demonstrate effective hemorrhage control, but layperson application finds difficulty and abysmal success rates as low as 17% [1-3]. The Committee on Tactical Combat Casualty Care (CoTCCC) helps standardize tourniquet recommendations for first responder application [4]. Recommended devices include the Combat Application Tourniquet (CAT, C-A-T Resources, LLC, Rock Hill, South Carolina), which can serve as reference for newer device evaluation (Fig. 1) [5]. Furthermore, the Department of Homeland Security-led “Stop the Bleed” bystander hemorrhage control education campaign has prominently recommended t...
Source: The American Journal of Emergency Medicine - January 11, 2021 Category: Emergency Medicine Authors: C.P.T. Brandon M. Carius, Ashley D. Tapia, Nguvan Uhaa, Sarah A. Johnson, Camaren M. Cuenca, Ryann S. Lauby, M.A.J. Steven G. Schauer Source Type: research

Assessing the confidence in network meta-analysis results
We applaud Zhao et al. [1] for attempting to address the comparative efficacy of amiodarone and lidocaine in cardiac arrest using a Bayesian (rather than frequentist) network meta-analytic (NMA) approach. A Bayesian NMA provides a posterior distribution of all relative treatment effects between the interventions in the network and allows for probability statements for a particular outcome such as, “there is X% probability that treatment C is better than B,” or “there is Y% probability that treatment D is the most efficacious out of treatments A,B,C,D, and E.” [2] The Bayesian approach may, therefore...
Source: The American Journal of Emergency Medicine - January 11, 2021 Category: Emergency Medicine Authors: Ian S. de Souza, Robert Allen Source Type: research

COVID-19 testing for providers: Leading by example
This may sound like a broken record, but hospitals around the country are short-staffed and healthcare workers are paying the price [1]. An emergency medicine physician colleague at another institution recently confided that she felt terrible because she had to call in backup for a number of days while her COVID test was pending. Another had mild cold symptoms but needed a negative COVID test before working. When he called the hospital employee health COVID line, he was told to get testing in the community, which also took days. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 11, 2021 Category: Emergency Medicine Authors: David Greenky, Susan Wiltrakis Source Type: research

Electric scooter-related injuries: the desperate need for regulation
Our world is constantly changing. Modes of transportation are continuously being altered and refined to match the demands of the population. One growing problem is the integration of residential areas and new transportation infrastructures. Individuals may find themselves in the situation of being out of comfortable walking distance from their destination, but too close to drive the “last mile” phenomenon. As a result, electric scooters (e-scooters) have established their niche in the area of short-distance transportation. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 11, 2021 Category: Emergency Medicine Authors: Brendon Sen Crowe, Adel Elkbuli Source Type: research

Hyperbaric oxygen therapy in carbon monoxide poisoning in pregnancy: Maternal and fetal outcome
Closer monitoring and treatment is vital for pregnant carbon monoxide (CO) poisoning cases due to fetal poisoning component. Permanent damage can occur in both the mother and the baby. It may cause stillbirth even though no serious clinical symptoms occur in the mother. Hyperbaric oxygen (HBO) treatment is advised for all pregnant patients regardless of their clinical symptoms. Pregnant CO poisoning patients that received HBO treatment and their fetal status were evaluated in this study. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 10, 2021 Category: Emergency Medicine Authors: Abdullah Arslan Source Type: research

The impact of sleep on In-Training Examination (ITE) scores among emergency medicine residents
Sleep deprivation is a fundamental challenge of shift work and has been shown to impact emergency medicine (EM) physician-residents' performance and coordination [1-3]. It is not known if sleep deprivation impacts performance on the in-training emergency medicine examination (ITE), an examination used to inform EM residents and faculty about preparedness for the American Board of Emergency Medicine (ABEM) Qualifying Examination. We hypothesized that more sleep the night prior to the examination would be associated with higher ITE examination scores. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 9, 2021 Category: Emergency Medicine Authors: KristinS. Weeks, Joelle Borhart, Christian Defazio, Michael Takacs Source Type: research

Neutrophil-to-lymphocyte ratio on admission to predict the severity and mortality of COVID-19 patients: A meta-analysis
The neutrophil-to-lymphocyte ratio (NLR), an inflammatory marker, was suggested to be predictive of severity and mortality in COVID-19 patients. Here, we investigated whether NLR levels on admission could predict the severity and mortality of COVID-19 patients. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 8, 2021 Category: Emergency Medicine Authors: Daniel Martin Simadibrata, Julius Calvin, Alya Darin Wijaya, Naufal Arkan Abiyyu Ibrahim Source Type: research

Vasovagal syncope with asystole during repeated emesis in the emergency department
We describe the case of a 53-year-old female who presented to the Emergency Department (ED) with a one-day history of nausea, vomiting and diarrhea, who developed several subsequent syncopal episodes with asystole on the cardiac monitor. Both episodes were in the context of continued nausea and retching. The patient had no history of such events, no cardiac history, and no seizure history. The vasovagal response can be triggered by a variety of situations including positional changes, prolonged standing, and extreme emotional response, stress, or pain. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 8, 2021 Category: Emergency Medicine Authors: Zachary McCabe, Adam Schwartz, Sanjay Shetty Source Type: research

CPR by foot. An alternative in special circumstances? A randomized simulation study
To assess the differences in the quality and self-perception of CPR performed with foot technique compared to the standard technique with the hands in nursing students. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 8, 2021 Category: Emergency Medicine Authors: Mart ín Otero-Agra, Noemí Santiago-Urgal, María Teresa Hermo-Gonzalo, María Fernández-Méndez, Felipe Fernández-Méndez Source Type: research

Acuity patterns of heart failure among emergency departments in a large health system
The prognostic important of Emergency Heart Failure Mortality Risk Grade (EHMRG) score in assessing short term mortality in Congestive Heart Failure (CHF) patients has been validated in the past, however, few studies have examined acuity patterns in the CHF population across healthcare settings. We aim to understand acuity patterns of CHF patients across a large health system for better resource utilization. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 8, 2021 Category: Emergency Medicine Authors: Nidhi Garg, Jeff Yang, Renee Pekmezaris, Gerin Stevens, Adan Z. Becerra, Phillip Levy, Pridha Kumar, Mohanapriya Sayeen Nagarajan, Lance Becker Source Type: research

A comparison of in-hospital cardiac arrests between a United States and United Kingdom hospital
Cardiac arrest may be attributed to heart rhythm disturbances, drugs, poisoning, pre-existing heart disease, traumatic injury, coagulopathies, respiratory arrest, and anaphylaxis, amidst others [1]. Within 4 –5 min of circulation cessation, neurons in the brain and myocytes within the heart begin dying, resulting in brain damage and eventually, death [2,3]. Cardiopulmonary resuscitation (CPR), if administered within the first minutes of cardiac or respiratory arrest, can be a life-saving technique a llowing for continued circulation of oxygenated blood to vital organs [4,5]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 8, 2021 Category: Emergency Medicine Authors: Lauren E. Powell, William J. Brady, Robert C. Reiser, Daniel J. Beckett Source Type: research

Hyperthermia associated with methamphetamine and cocaine use: A case series
Hyperthermia is defined as a core body temperature in excess of 40  °C (104 °F). It is distinguished from a fever, or pyrexia, which is body temperature greater than euthermia 38 °C (100.4 °F), and hyperpyrexia, defined as a core temperature greater than 41.5 °C (106.7 °F), by the lack of an alteration in the hypothalamic homeoregulatory set point from either severe infection or central nervous system hemorrhage [1]. This occurs when excess core energy needed to be dissipated to maintain euthermia exceeds the body's regulatory mechanisms, either through a significant increase in core hea...
Source: The American Journal of Emergency Medicine - January 4, 2021 Category: Emergency Medicine Authors: Catherine A. Marco, Kunal Gupta, Janet Lubov, Aisha Jamison, Brian Patrick Murray Source Type: research

COVID-19-associated pancytopenia and typhlitis
Neutropenic enterocolitis is also known as typhlitis, is characterized by severe inflammation in the bowel loops. It is often seen in immunosuppressed patients, and it has high morbidity and mortality. Although the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) primarily affects the respiratory system and causes COVID-19 (Coronavirus Disease 2019), it may affect hematopoietic and gastrointestinal systems. Herein, we present a rare case of COVID-19-associated pancytopenia and typhlitis in a 60-year-old female who presented with abdominal pain. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 4, 2021 Category: Emergency Medicine Authors: Furkan Ufuk, Emre Bulgurcu, Tugba Sari Source Type: research

Outcomes of new-onset atrial fibrillation in patients with sepsis: A systematic review and meta-analysis of 225,841 patients
The outcomes of new-onset atrial fibrillation (AF) during sepsis are inconsistent and inconclusive. This meta-analysis aims to provide a comprehensive description of the impact of new-onset AF on the prognosis of sepsis. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 4, 2021 Category: Emergency Medicine Authors: Fang-ping Xiao, Ming-yue Chen, Lei Wang, Hao He, Zhi-qiang Jia, Lin Kuai, Hai-bo Zhou, Meng Liu, Mei Hong Source Type: research

Pilot randomized trial of pre-hospital advanced therapies for the control of hemorrhage (PATCH) using pelvic binders
Pelvic fractures represent a small percent of all skeletal injuries but are associated with significant morbidity and mortality secondary to hemodynamic instability from bleeding bone surfaces and disrupted pelvic vasculature. Stabilization of the pelvis prior to arrival at a treatment facility may mitigate the hemodynamic consequences of pelvic ring injuries and improve morbidity and mortality. Whether pelvic compression devices such as pelvic binders or sheets can be safely applied in the prehospital setting has not been well-studied. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 4, 2021 Category: Emergency Medicine Authors: Sarah N. Pierrie, Rachel B. Seymour, Meghan K. Wally, Jon Studnek, Allison Infinger, Joseph R. Hsu, Evidence-based Musculoskeletal Injury and Trauma Collaborative (EMIT) Source Type: research

Riot-related injuries managed at a hospital in Beirut, Lebanon
This study describes the clinical presentation, management, outcome, and healthcare costs of injuries. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 4, 2021 Category: Emergency Medicine Authors: Tharwat El Zahran, Hala Mostafa, Hani Hamade, Zeina Mneimneh, Ziad Kazzi, Mazen J. El Sayed Source Type: research

Prospective validation of the bedside sonographic acute cholecystitis score in emergency department patients
Acute cholecystitis can be difficult to diagnose in the emergency department (ED); no single finding can rule in or rule out the disease. A prediction score for the diagnosis of acute cholecystitis for use at the bedside would be of great value to expedite the management of patients presenting with possible acute cholecystitis. The 2013 Tokyo Guidelines is a validated method for the diagnosis of acute cholecystitis but its prognostic capability is limited. The purpose of this study was to prospectively validate the Bedside Sonographic Acute Cholecystitis (SAC) Score utilizing a combination of only historical symptoms, phys...
Source: The American Journal of Emergency Medicine - January 4, 2021 Category: Emergency Medicine Authors: Sally Graglia, Hamid Shokoohi, Michael Loesche, Daniel Dante Yeh, Rachel M. Haney, Calvin K. Huang, Christina C. Morone, Caitlin Springer, Heidi H. Kimberly, Andrew S. Liteplo Source Type: research