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Use of ‘Low approach’ femoral central venous cannulation during COVID 19 pandemic
Central venous catheterization is one of the most commonly performed procedures in intensive care units. Wearing personal protective equipment (PPE) for placing central venous catheter can make the procedure challenging because of poor visibility. Insertion of central venous catheter becomes even more difficult when the patient is in respiratory distress and is unable to lie flat on the bed. All these increase chances of error and complication rate. Most common route of central venous access are through internal jugular or subclavian veins but slight mistake can lead to grave complications like pneumothorax or haemothorax ...
Source: The American Journal of Emergency Medicine - February 10, 2021 Category: Emergency Medicine Authors: Kunal Singh, Alok Kumar Bharti, Prakash K. Dubey Source Type: research

Efficacy and safety of tranexamic acid in pediatric trauma patients: Evidence from meta-analysis
Trauma requiring massive transfusions hinders the successful resuscitation and deteriorates outcomes [1]. Antifibrinolytic therapy has become an emerging standard in the resuscitation of patients in early hemorrhagic shock and should be administered as soon as potentially lethal hemorrhage is suspected [2]. Tranexamic acid (TXA) inhibits plasminogen activation. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - February 8, 2021 Category: Emergency Medicine Authors: Mahdi Al-Jeabory, Aleksandra Gasecka, Wojciech Wieczorek, Jaroslaw Mayer-Szary, Milosz J. Jaguszewski, Lukasz Szarpak Source Type: research

Descriptive analysis of prostatitis in the emergency department
Prostatitis is one of the most common urologic diseases in ambulatory patients. However, prostatitis data are limited from the emergency department (ED) setting. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - February 7, 2021 Category: Emergency Medicine Authors: Santiago Cantillo Campos, Justin M. Elkins, Johnathan M. Sheele Source Type: research

The effect of mild hypercapnia on hospital mortality after cardiac arrest may be modified by chronic obstructive pulmonary disease
The main objective was to evaluate the effect of carbon dioxide on hospital mortality in chronic obstructive pulmonary disease (COPD) and non-COPD patients with out-of-hospital cardiac arrest (OHCA). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - February 6, 2021 Category: Emergency Medicine Authors: Dawei Zhou, Yi Ye, Yueyue Kong, Zhimin Li, Guangzhi Shi, Jianxin Zhou Source Type: research

Assessment of benzodiazepine dosing strategies for the management of status epilepticus in the emergency department
Although guidelines recommend specific benzodiazepines doses for the treatment of generalized convulsive status epilepticus (GCSE), underdosing appears to be common. The purpose of this investigation was to assess benzodiazepine dosing strategies for the initial management of GCSE in patients presenting to the Emergency Department (ED). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - February 6, 2021 Category: Emergency Medicine Authors: Kyle A. Weant, Stephanie L. Barr é, Sara Bruner, Ryan Smiley, Gregory A. Hall Source Type: research

Sphenopalatine ganglion block for the treatment of acute headache: An old treatment revisited
The sphenopalatine ganglion (SPG) is a collection of parasympathetic nerve cells located just behind the bony structures of the nose. It is closely associated with the trigeminal nerve, which is the main nerve involved in headache disorders [1]. SPG nerve blocks for the treatment of headache were first described in the 1900's using a technique involving the application of numbing medication onto cotton swabs then placed into the back of the nose [1]. If effective, an SPG nerve block would potentially be the ideal headache treatment – fast acting, while avoiding the need for intravenous access, and minimal adverse effects...
Source: The American Journal of Emergency Medicine - February 6, 2021 Category: Emergency Medicine Authors: Meredith Busman, Tiffany Fleeger, Erin Leach, Natalie Payne, Andrew Nguyen, Kismet Gray, P.A. Russel Morris, Christopher Clark, Jeffrey Jones Source Type: research

Mind the caretaker: ED referrals of community-dwelling older adult patients by their primary caregivers are accurate
ED referral of older adults on the initiative of their family or paid live-in caregiver is common but not previously studied. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - February 6, 2021 Category: Emergency Medicine Authors: Ami Schattner, Amin Sabbah, Ina Dubin Source Type: research

Assessment of the SpO2/FiO2 ratio as a tool for hypoxemia screening in the emergency department
We assessed the performance of the ratio of peripheral arterial oxygen saturation to the inspired fraction of oxygen (SpO2/FiO2) to predict the ratio of partial pressure arterial oxygen to the fraction of inspired oxygen (PaO2/FiO2) among patients admitted to our emergency department (ED) during the SARS-CoV-2 outbreak. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - February 5, 2021 Category: Emergency Medicine Authors: Pierre Catoire, Eric Tellier, Caroline de la Riviere, Marie-Christine Beauvieux, Guillaume Valdenaire, Michel Galinski, Philippe Revel, Xavier Combes, C édric Gil-Jardine Source Type: research

Idarucizumab (PRADAXA ®) as a sole reversal agent in an unstable hemorrhagic shock patient on an unknown anticoagulant with elevated protime/international normalized ratio (PT/INR).
We present a case of an 85-year-old female with an unknown medication history, shortness of breath and severe anemia due to an upper gastrointestinal bleed. Laboratory abnormalities were significant for INR 6.43 and serum creatinine 2.21  mg/dL. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - February 5, 2021 Category: Emergency Medicine Authors: Sara Kutner, Nicholas Scaturo, Brett Williams Source Type: research

The efficacy of continuous use disposable N95 masks in clinical practice in the emergency department
This study investigates the efficacy of wearing disposable N95s continuously during clinical work. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - February 5, 2021 Category: Emergency Medicine Authors: Rebecca Jeanmonod, Leah Rivard, Jonathan Pester, Kathleen McMahon, Ronald Check, Brian Kelly, Vamsi Balakrishnan, Donald Jeanmonod Source Type: research

Prognostic value of admission serum magnesium in acute myocardial infarction complicated by malignant ventricular arrhythmias
Although electrolyte abnormalities are related to worse clinical outcomes in patients with acute myocardial infarction (AMI), little is known about the association between admission serum magnesium level and adverse events in AMI patients complicated by out-of-hospital cardiac arrest presenting with malignant ventricular arrhythmias (OHCA-MVA). We investigated the prognostic value of serum magnesium level on admission in these patients. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - February 5, 2021 Category: Emergency Medicine Authors: Yoshifumi Mizuguchi, Takao Konishi, Toshiyuki Nagai, Tomoya Sato, Sakae Takenaka, Atsushi Tada, Yuta Kobayashi, Hirokazu Komoriyama, Yoshiya Kato, Kazunori Omote, Takuma Sato, Kiwamu Kamiya, Shingo Tsujinaga, Hiroyuki Iwano, Kenjiro Kikuchi, Shinya Tanaka Source Type: research

Disaster medicine training: The case for virtual reality
The current Covid 19 pandemic has provided an opportunity to reflect on how future training and preparedness for pandemics and disasters might be improved upon. Previous authors have highlighted knowledge and skill gaps in disaster medicine (DM) training for physicians [1]. Integrating cutting-edge technology to improve cost effectiveness in DM training, quality and outcome goals can be achieved using virtual reality platforms. A number of emergency management and response organisations are currently exploring and incorporating its use as part of their training and education programs [2,3]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - February 4, 2021 Category: Emergency Medicine Authors: Derrick Tin, Attila J. Hertelendy, Gregory R. Ciottone Source Type: research

Experience with lower dose flumazenil at an academic medical center
Benzodiazepines (BZDs) are frequently used in self-poisonings [1]. Flumazenil effects for BZD reversal are dose-dependent and higher doses are often used to achieve desired outcomes. However, higher doses are associated with increased risk of seizures, cardiac dysrhythmias, and other adverse drug effects (ADEs) [2,3]. Multidrug intoxications involving tricyclic antidepressants (TCAs), stimulants, ethanol, anticonvulsants, propoxyphene, barbiturates, and other anxiolytics increase the frequency of significant ADEs from flumazenil [1-6]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - February 4, 2021 Category: Emergency Medicine Authors: Rachel F. Schult, Deena Omar, Timothy J. Wiegand, Rachel M. Gordetsky, Nicole M. Acquisto Source Type: research

Geriatric emergency department revisits after discharge with potentially inappropriate medications: A retrospective cohort study
To determine whether potentially inappropriate medications (PIMs) prescribed in an academic emergency department (ED) are associated with increased ED revisits in older adults. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - February 4, 2021 Category: Emergency Medicine Authors: Nada Hammouda, Carmen Vargas-Torres, John Doucette, Ula Hwang Source Type: research

Regional variation in outcomes and healthcare resources utilization in, emergency department visits for syncope
Management of patients with syncope lacks standardization. We sought to assess regional variation in hospitalization rates and resource utilization of patients with syncope. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - February 4, 2021 Category: Emergency Medicine Authors: Waseem Khaliq, Moeen Aboabdo, Che Harris, Noor Bazerbashi, Eric Moughames, Nour Al Jalbout, Karim Hajjar, Hind A. Beydoun, May A. Beydoun, Shaker M. Eid Source Type: research