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

Treatment of opioid and alcohol withdrawal in a cohort of emergency department patients
In this study we examine a cohort of patients treated with buprenorphine and phenobarbital or benzodiazepines for co-occurring opioid and alcohol withdrawal. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 2, 2021 Category: Emergency Medicine Authors: Sally Mahmoud, Erik Anderson, Aidan Vosooghi, Andrew A. Herring Source Type: research

Rapid and severe neurologic deterioration due to influenza associated encephalopathy in a healthy child
We present the clinical details of a previously well child with two days of mild viral symptoms who progressed from playful and active to severe neurologic injury over the course of eight hours. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 2, 2021 Category: Emergency Medicine Authors: Dominic DiPrinzio, Taylor Roth, Jay D. Fisher Source Type: research

Medical needs of emergency department patients presenting with acute alcohol and drug intoxication
Some contend that patients with acute alcohol or illicit substance intoxication should be treated in outpatient detoxification centers rather than in the ED. However, these patients often have underlying acute medical needs. We sought to determine the frequency of medical interventions required by ED patients with alcohol or illicit substance intoxication. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - January 1, 2021 Category: Emergency Medicine Authors: Jamie L. Stang, Paige A. DeVries, Lauren R. Klein, Jon B. Cole, Marc Martel, Mackenzie L. Reing, Abagail M. Raiter, Brian E. Driver Source Type: research

Priapism in COVID-19: A thromboembolic complication
SARS-CoV-2 (COVID-19) infection is frequently associated with thromboembolic complications. In this case report, we describe the diagnosis and management of priapism as a thromboembolic complication of severe COVID-19. To our knowledge, this is only the second case report of penile thrombosis in a patient with COVID-19. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 31, 2020 Category: Emergency Medicine Authors: Matthew L. Silverman, Seth J. VanDerVeer, Thomas J. Donnelly Source Type: research

A primer for managing cardiac transplant patients in the emergency department setting
Cardiac transplant is an effective long-term management option for several severe cardiac diseases. These cardiac transplant patients may present to the emergency department with a range of issues involving the cardiac transplantation, including complications due to their transplant as well as altered presentations of disease resulting from their transplant. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 31, 2020 Category: Emergency Medicine Authors: Brit Long, William J. Brady, Alin Gragossian, Alex Koyfman, Michael Gottlieb Source Type: research

The burden of the pandemic on the non-SARS-CoV-2 emergencies: A multicenter study
Governments have implemented social distancing interventions to curb the speed of SARS-CoV-2 spread and avoid hospital overload. SARS-CoV-2 social distancing interventions have modified several aspects of society, leading to a change in the emergency medical visit profile. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 31, 2020 Category: Emergency Medicine Authors: Milton Steinman, Jorge Henrique Bento de Sousa, Francisco Tustumi, Nelson Wolosker Source Type: research

Tension pneumocephalus and bilateral orbital compartment syndrome relieved by lateral canthotomies
Traumatic tension pneumocephalus and orbital compartment syndrome are rare, tend to be associated with severe craniofacial injuries, and can occur following both blunt and penetrating injury. Early recognition and high index of clinical suspicion are important in both cases. Emergency decompression results in improvement in vast majority of cases. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 31, 2020 Category: Emergency Medicine Authors: Zachary Vanderlaan, Matt Singh, Melisa Gagrica, Jeffrey S. Jones Source Type: research

EMS responses and non-transports during the COVID-19 pandemic
The COVID-19 pandemic may affect both use of 9 –1-1 systems and prehospital treatment and transport practices. We evaluated EMS responses in an EMS region when it experienced low to moderate burden of COVID-19 disease to assess overall trends, response and management characteristics, and non-transport rates. Our goal is to inform current and f uture pandemic response in similar regions. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 31, 2020 Category: Emergency Medicine Authors: Timothy Satty, Sriram Ramgopal, Jonathan Elmer, Vincent N. Mosesso, Christian Martin-Gill Source Type: research

Neutrophil to lymphocyte ratio, lymphocyte to monocyte ratio and platelet to lymphocyte ratio to predict the severity of COVID-19
Dear Editor, (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 30, 2020 Category: Emergency Medicine Authors: Murat Seyit, Esin Avci, Rukiye Nar, Hande Senol, Atakan Yilmaz, Mert Ozen, Alten Oskay, Hulya Aybek Source Type: research

The analgesic effect of ketorolac addition for renal colic pain: A meta-analysis of randomized controlled studies
The effect of ketorolac addition for the pain control of renal colic remains controversial. We conduct a systematic review and meta-analysis to explore the analgesic efficacy of ketorolac addition for renal colic. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 30, 2020 Category: Emergency Medicine Authors: Shengcheng Tai, Yi Fan, Jiaguo Huang, Runmiao Hua Source Type: research

Exposure and confidence across critical airway procedures in pediatric emergency medicine: An international survey study
Airway management procedures are critical for emergency medicine (EM) physicians, but rarely performed skills in pediatric patients. Worldwide experience with respect to frequency and confidence in performing airway management skills has not been previously described. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 30, 2020 Category: Emergency Medicine Authors: Joshua Nagler, Marc Auerbach, Michael C. Monuteaux, John A. Cheek, Franz E. Babl, Ed Oakley, Lucia Nguyen, Arjun Rao, Sarah Dalton, Mark D. Lyttle, Santiago Mintegi, Rakesh D. Mistry, Andrew Dixon, Pedro Rino, Guillermo Kohn-Loncarica, Stuart R. Dalziel, Source Type: research

Inflammatory and hematologic markers as predictors of severe outcomes in COVID-19 infection: A systematic review and meta-analysis
Laboratory testing is commonly performed in patients with COVID-19. Each of the laboratory parameters has potential value for risk stratification and prediction of COVID-19 outcomes. This systematic review and meta-analysis aimed to evaluate the difference between these parameters in severe and nonsevere disease and to provide the optimal cutoff value for predicting severe disease. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 30, 2020 Category: Emergency Medicine Authors: Timotius Ivan Hariyanto, Karunia Valeriani, Felix Kwenandar, Vika Damay, Jeremia Siregar, Nata Pratama Hardjo Lugito, Margaret Merlyn Tjiang, Andree Kurniawan Source Type: research

COVID-19 publications in emergency medicine journals in 2020
The COVID-19 pandemic has influenced emergency medicine (EM) practice tremendously in 2020. The impact also emerged in EM journals. We did a brief study on the trend of COVID-19 related publications in EM journals in 2020. Journal list was adopted from 2019 Journal Citation Reports (JCR) category of EM [1]. All publication data were retrieved from SCOPUS database on December 25, 2020 [2]. A total of 762 COVID-19 related publications were found in 7287 (10.46% of total) EM journal publications. The American Journal of Emergency Medicine (AJEM) published the most COVID-19 related publications (183, 72 published, 111 in press...
Source: The American Journal of Emergency Medicine - December 29, 2020 Category: Emergency Medicine Authors: Ching-Hsing Lee Source Type: research

Haematological inflammatory prognostication in COVID-19: Points to ponder!
Dear Editor, (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 29, 2020 Category: Emergency Medicine Authors: Rohan Magoon, Ankur Jain Source Type: research

Electrocardiographic manifestations of COVID-19
Coronavirus disease of 2019 (COVID-19) is a lower respiratory tract infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This disease can impact the cardiovascular system and lead to abnormal electrocardiographic (ECG) findings. Emergency clinicians must be aware of the ECG manifestations of COVID-19. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 28, 2020 Category: Emergency Medicine Authors: Brit Long, William J. Brady, Rachel E. Bridwell, Mark Ramzy, Tim Montrief, Manpreet Singh, Michael Gottlieb Source Type: research

Calming the storm – Stellate ganglion block in refractory ventricular arrhythmia in the emergency department
Incidence and prevalence of coronary artery disease continues to rise in low- and middle-income countries (LMICs) [1]. Cardiac arrest management in emergency departments across LMICs remains poor and this is largely due to lack of trained personnel in acute and critical care, lack of established emergency care paraphernalia and lack of collaborative definitive care management. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 28, 2020 Category: Emergency Medicine Authors: Mohd. Yaseen, Akshay Kumar, Irtiqa Sheikh, Afroz Fatima, Sanjeev Bhoi, Nayer Jamshed, Praveen Aggarwal Source Type: research

Is “pain before vomiting” useful?: Diagnostic performance of the classic patient history item in acute appendicitis
In most surgical textbooks, it has been stated that pain almost always precedes vomiting in patients with appendicitis. However, the usefulness of this classic history item, “pain before vomiting”, has been investigated in only one study nearly 50 years ago, in which the cause of abdominal pain could not be identified in more than 40% of patients. Accordingly, our objective was to evaluate the performance of pain before vomiting for the diagnosis of acute appendic itis in patients who presented with both acute abdominal pain and vomiting. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 28, 2020 Category: Emergency Medicine Authors: Toshihiko Takada, Ryota Inokuchi, Hongja Kim, Sho Sasaki, Kazuhiko Terada, Hajime Yokota, Shinya Hattori, Wakako Mikami, Tadao Kubota, Shunichi Fukuhara Source Type: research

Effect of emergency critical care nurses and emergency department boarding time on in-hospital mortality in critically ill patients
We hypothesized that establishing a program of specialized emergency critical care (ECC) nurses in the ED would improve mortality of ICU patients boarding in the ED. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 28, 2020 Category: Emergency Medicine Authors: Jason Nesbitt, Tsuyoshi Mitarai, Garett Chan, Jennifer G. Wilson, Kian Niknam, Matthew J.R. Nudelman, Cristopher Cinkowski, Michael A. Kohn Source Type: research

The diamond of death: Hypocalcemia in trauma and resuscitation
Early recognition and management of hemorrhage, damage control resuscitation, and blood product administration have optimized management of severe trauma. Recent data suggest hypocalcemia exacerbates the ensuing effects of coagulopathy in trauma. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 27, 2020 Category: Emergency Medicine Authors: Jesse P. Wray, Rachel E. Bridwell, Steven G. Schauer, Stacy A. Shackelford, Vikhyat S. Bebarta, Franklin L. Wright, James Bynum, Brit Long Source Type: research

The reverse vagal manoeuvre: A new tool for treatment of supraventricular tachycardia?
Supraventricular tachycardia is a common cardiac arrhytmia with recurrent episodes. The rapid resolution of supraventricular tachycardia remains a challenge. Vagal manoeuvres are simple and non-invasive but yield positive results in less than half the cases. Currently, the modified Valsalva manoeuvre appears to be the most effective technique. We have tested the effectiveness of the reverse Valsalva manoeuvre without swallowing as new vagal manoeuvre for the treatment of supraventricular tachycardia. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 26, 2020 Category: Emergency Medicine Authors: Philippe Gaudard, Nicolas Cazes, Kimberley Simon, Denis Larger, Jean-Claude Deharo Source Type: research

L1 SMI from CT and mortality in CAP in the ED
Introduction: Low muscle mass is associated with an increased mortality risk due to medical comorbidities such as chronic obstructive pulmonary disease, cardiovascular disease, and cerebrovascular disease. Computed tomography (CT) has been identified as the gold standard for measuring body composition. We evaluated the relationship between the L1 SMI measured from CT and in-hospital mortality in patients with community-acquired pneumonia (CAP).Methods: From January 2015 to June 2015, 311 patients who were diagnosed with CAP and underwent CT in the ED were retrospectively analyzed. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 26, 2020 Category: Emergency Medicine Authors: Jeong Woo Han, Hwan Song, Soo Hyun Kim Source Type: research

A reappraisal of childhood drowning in a pediatric emergency department
In the present study, we aimed to investigate the demographic and clinical features, laboratory and radiologic characteristics, management, and outcomes of pediatric drowning patients in order to identify predictors of hospital admission, and to evaluate the need for respiratory support, and prognosis. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 25, 2020 Category: Emergency Medicine Authors: Nihan Şık, Hüseyin Bahadır Şenol, Ali Öztürk, Durgül Yılmaz, Murat Duman Source Type: research

Emergency department care coordination strategies and perceived impact under Maryland's hospital payment reforms
Emergency department (ED) care coordination plays an important role in facilitating care transitions across settings. We studied ED care coordination processes and their perceived effectiveness in Maryland (MD) hospitals, which face strong incentives to reduce hospital-based care through global budgets. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 25, 2020 Category: Emergency Medicine Authors: Jessica E. Galarraga, Derek DeLia, Daniel Wilhite, Ronald Romero-Barrientos, Kaitlin O ’Sullivan, Donna Noccolino, Laura Pimentel, Cynthia Woodcock, Rollin J. Fairbanks, Jesse M. Pines Source Type: research

Beyond the bedside: Clinicians as guardians of public health, medicine and science
COVID-19 has upended clinical practice across the globe. In a milieu of shifting scientific knowledge, clinicians have been tasked with rapidly evolving their practice while defending the validity of science. Historically, clinicians have been a trusted source for the evaluation and interpretation of medical knowledge. In this “digital age” pandemic, partisan messaging, heightened awareness, and rapid transmission of information, have placed medicine in a fragile position. Providers must fight for patients at the bedside, and battle mistruths and distrust emerging from avenues far beyond hospitals or clinics. (...
Source: The American Journal of Emergency Medicine - December 25, 2020 Category: Emergency Medicine Authors: Anish K. Agarwal, Megan L. Ranney, Bernard P. Chang Source Type: research

Tenecteplase for thrombolysis in stroke patients: Systematic review with meta-analysis
Alteplase is an approved treatment for acute ischemic stroke. Tenecteplase is a genetically modified form of alteplase, with lower cost and a more favourable pharmacokinetic profile allowing bolus injection. The aim of this study was to compare both drugs in adult patients with acute ischemic stroke undergoing thrombolysis. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 24, 2020 Category: Emergency Medicine Authors: M. Oliveira, M. Fidalgo, L. Font ão, J. Antão, S. Marques, V. Afreixo, T. Gregório Source Type: research

Ventricular tachycardia in an adolescent with severe diabetic ketoacidosis
We present the case of an adolescent who presented with severe DKA and wide complex tachycardia that was unresponsive to multiple doses of adenosine and ultimately required synchronized cardioversion. This case reminds the clinician of the importance of cardiac monitoring in children with DKA, particularly in the setting of hyperkalemia. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 23, 2020 Category: Emergency Medicine Authors: Kelly R. Bergmann, Valerie Whitcomb Source Type: research

The coping styles to stress of Italian emergency health-care professionals after the first peak of COVID 19 pandemic outbreak
In Italy, thousands of Emergency healthcare professionals were involved during the first COVID 19 pandemic outbreak, fighting at the frontline to address the challenges posed to the healthcare systems by almost 250.000 patients infected by the end of June 2020. Poor coping strategies to stress may lead to impaired job performance and risk of infection, as well as psychological distress and burnout, also in relation to coping styles [1]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 23, 2020 Category: Emergency Medicine Authors: Andrea Fabbri, Fabio De Iaco, Giulio Marchesini, Francesco Rocco Pugliese, Clemente Giuffrida, Mario Guarino, Giuseppina Fera, Alessandro Riccardi, Salvatore Manca, by Societ à Italiana di Emergenza Urgenza (SIMEU) Study Center and Research Group Source Type: research

Management of migraine in the emergency department: Findings from the 2010 –2017 national hospital ambulatory medical care surveys
The study objective was to describe trends in the medical management of migraine in the emergency department (ED) using the 2010 —2017 National Hospital Ambulatory Medical Care Survey (NHAMCS) datasets. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 23, 2020 Category: Emergency Medicine Authors: Philip R. Wang, Rocio Lopez, Spencer S. Seballos, Matthew J. Campbell, Belinda L. Udeh, Michael P. Phelan Source Type: research

Lidocaine versus dexketoprofen in treatment of tension-type headache: A double-blind randomized controlled trial
Tension-type headache, with a life time prevalence in the general population ranging between 30% and 78%, can be episodic or chronic [1,2]. Episodic tension-type headache, which can be infrequent episodic or frequent, has a high socio-economic impact [1,3]. Tension-type headache was reported as the third most prevalent disorder among all diseases in Global Burden of Diseases Study in 2016 [4], and headache composes one of the most common reasons for visiting primary care and emergency departments (EDs) [5,6]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 23, 2020 Category: Emergency Medicine Authors: Ilker Akbas, Abdullah Osman Kocak, Sultan Tuna Akgol Gur, Elif Oral Ahiskalioglu, Sinem Dogruyol, Turgut Dolanbay, Mehmet Demir, Zeynep Cakir Source Type: research

Abdominal mycotic aortic aneurysm presenting as chronic constipation
We describe a case of an abdominal mycotic aortic aneurysm presenting as chronic constipation for 3  weeks, without fever or abdominal pain. Point-of-care ultrasound has the ability to detect silent abdominal aortic aneurysms and serves as a follow-up tool for patients under medical treatment. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 22, 2020 Category: Emergency Medicine Authors: Yaw-Tzeng Liou, Chun-Yi Tsai Source Type: research

A prospective study of the incidence of intracranial hemorrhage in survivors of out of hospital cardiac arrest
This study aims to identify the incidence of ICH in US patients with OHCA who obtain return of spontaneous circulation (ROSC). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 21, 2020 Category: Emergency Medicine Authors: Jonathan Gelber, Martha E. Montgomery, Amandeep Singh Source Type: research

Isopropyl alcohol nasal inhalation for nausea in the triage of an adult emergency department
Nausea and vomiting (N&V) are among the most common complaints in the emergency department (ED). However, low acuity is assigned to most of these patients at the triage, and waiting for long hours without medication decreases patient safety and satisfaction. We aimed to compare the inhalation of isopropyl alcohol (IPA) with placebo (P) to treat nausea at the triage area of an ED. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 20, 2020 Category: Emergency Medicine Authors: Hande Candemir, Haldun Akoglu, Erkman Sanri, Ozge Onur, Arzu Denizbasi Source Type: research

Shock index as a predictor of mortality among the Covid-19 patients
In December 2019, several cases of pneumonia of unknown origin were detected in Wuhan, Hubei, China [1,2]. The pathogen was identified as a novel coronavirus (CoV) and renamed as severe acute respiratory syndrome CoV-2 (SARS-CoV-2) [3]. As of September 2020, more than 28  million cases and more than 900 thousand deaths have been reported worldwide [4]. Shock index (SI) is a ratio obtained by dividing heart rate by systolic blood pressure; it is a simple and easy to use formula for detecting changes in cardiovascular performance prior to systemic hypotension. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 20, 2020 Category: Emergency Medicine Authors: Fatih Do ğanay, Fuat Elkonca, Avni Uygar Seyhan, Erdal Yılmaz, Ayşe Batırel, Rohat Ak Source Type: research

Analgesic efficacy of the serratus anterior plane block in rib fractures pain: A randomized controlled trial
Serratus anterior plane block (SAPB) was evaluated that in patients with the complaint of rib fracture pain in terms of total analgesic consumption and pain scores. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 20, 2020 Category: Emergency Medicine Authors: Şeyma Tekşen, Gözen Öksüz, Hafize Öksüz, Muhammed Sayan, Mahmut Arslan, Aykut Urfalıoğlu, Gökçe Gişi, Bora Bilal Source Type: research

The gap of educational standards - Another reason for unsuccessful management of mass casualty incidents
We recently read the commentary published by Dr. Goniewicz and colleagues highlighting the gap of knowledge and skills in management of mass casualty incidents (MCI) [1]. We agree that there is much to improve in the teaching and drilling towards MCIs and to this end we would like to add our vision of this educational gap in concert with points raised by Goniewicz, et al. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 20, 2020 Category: Emergency Medicine Authors: Miklosh Bala, Tamara Worlton, Amila Ratnayake Source Type: research

Diagnosis and management of Ludwig's angina: An evidence-based review
Ludwig's angina is a potentially deadly condition that must not be missed in the emergency department (ED). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 19, 2020 Category: Emergency Medicine Authors: Rachel Bridwell, Michael Gottlieb, Alex Koyfman, Brit Long Source Type: research

Risk factors for acute stroke-associated pneumonia and prediction of neutrophil-to-lymphocyte ratios
This study aimed to analyze the risk factors for stroke-associated pneumonia (SAP) and assess the predictive effect of neutrophil-to-lymphocyte ratio (NLR) on acute SAP. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 19, 2020 Category: Emergency Medicine Authors: Sara M. Witcraft, Laura J. Dixon, Patric Leukel, Aaron A. Lee Source Type: research

Problems with interpreting troponins in chronic kidney disease patients for ruling out acute coronary syndrome
Chest pain is one of the most common reasons for emergency department visits worldwide, and troponins play a central role in diagnosing acute coronary syndrome (ACS) in these patients. Hence, the tests for these molecules are imperative in triage for ACS. Presently, multiple high-sensitivity troponin tests are available, including those for troponin T and I. However, in the presence of physiological and pathological alterations such as chronic kidney disease (CKD) and muscle dysfunction, these tests lose their sensitivity and specificity, especially if not interpreted in the right clinical background. (Source: The American...
Source: The American Journal of Emergency Medicine - December 19, 2020 Category: Emergency Medicine Authors: Tikal Kansara, Monil Majmundar, Craig Basman, Ferdinand Visco Source Type: research

Delay to initiation of out-of-hospital cardiac arrest EMS treatments
Time to initial treatment is important in any response to out-of-hospital cardiac arrest (OHCA). The purpose of this paper was to quantify the time delay for providing initial EMS treatments supplemented by comparison with those of other EMS systems conducting clinical trials. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 18, 2020 Category: Emergency Medicine Authors: Joseph P. Ornato, Mary Ann Peberdy, Charles R. Siegel, Rich Lindfors, Tom Ludin, Danny Garrison Source Type: research

The Authors' respond: The origin of intraventricular thrombus
We would like to thank the authors of the correspondence titled “A critical view on “An extremely rare complication of acute pancreatitis: Intraventricular thrombus” for their valuable contribution to our case report [1]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 18, 2020 Category: Emergency Medicine Authors: Bu ğra İlhan, Göksu Bozdereli Berikol, Halil Doğan Source Type: research

Cost-effectiveness of managing low-risk pulmonary embolism patients without hospitalization. The low-risk pulmonary embolism prospective management study
Evaluate the cost-effectiveness and difference in length-of-stay when patients in the ED diagnosed with low-risk pulmonary embolism (PE) are managed with early discharge or observation. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 18, 2020 Category: Emergency Medicine Authors: Joseph R. Bledsoe, Scott C. Woller, Scott M. Stevens, Valerie Aston, Rich Patten, Todd Allen, Benjamin D. Horne, Lydia Dong, James Lloyd, Greg Snow, Troy Madsen, Patrick Fink, C. Gregory Elliott Source Type: research

Predictive performance of blood urea nitrogen to serum albumin ratio in elderly patients with gastrointestinal bleeding
Acute gastrointestinal (GI) bleeding is one of the most important and the common causes of patients visiting the emergency department. Dehydrated state leads to increased blood urea nitrogen (BUN) and decreased albumin level. Many scoring systems had been developed to predict outcomes for patients with GI bleeding. Among the many scoring systems, the AIMS65 score was a simple and accurate risk assessment scoring tool. Therefore, in this study, we evaluated the prognostic performance of the blood urea nitrogen to serum albumin ratio (B/A ratio) compared to the AIMS65 score tool in elderly patients with GI bleeding. (Source:...
Source: The American Journal of Emergency Medicine - December 18, 2020 Category: Emergency Medicine Authors: Sung Jin Bae, Keon Kim, Sun Hwa Lee Source Type: research

Double external defibrillation for shock-refractory ventricular fibrillation cardiac arrest: A step towards standardization
Double (or dual) external defibrillation (DED) has increasingly been used in the last few years by a number of emergency medical services (EMS) as a last resort to terminate ventricular fibrillation and pulseless ventricular tachycardia in adult patients who remain refractory to standard defibrillation. However, no randomized controlled trials comparing DED with standard defibrillation focusing on patient-oriented outcomes as the primary objective have been published to date. Selection criteria, procedure techniques, and protocol are not clearly defined and vary across observational studies. (Source: The American Journal o...
Source: The American Journal of Emergency Medicine - December 18, 2020 Category: Emergency Medicine Authors: Dennis Miraglia, Mark Ramzy Source Type: research

In reply: Bias risk in systematic reviews
We would like to thank the editor for the opportunity to respond to the letter concerning our manuscript, Intramuscular medication for treatment of agitation in the emergency department: A systematic review [1]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 18, 2020 Category: Emergency Medicine Authors: B.S. Allison Schneider, B.A. Samuel Mullinax, Alison H. Oliveto, Ashley Acheson, Michael P. Wilson Source Type: research

Probable parenteral and oral contrast-induced Steven Johnson syndrome/toxic epidermal necrolysis: A case report
We report a case of contrast-inducted Steven Johnson Syndrome (SJS)/Toxic Epidermal Necrolysis (TEN). The patient had received parenteral iopamidol and oral iohexol five days prior. The patient's chief complaint at the Emergency Department (ED) presentation was shortness of breath and blisters throughout body. Upon arrival, the patient was awake, alert, and oriented with a blood pressure (BP) of 166/68, heart rate (HR) of 117 beats per minute, respiratory rate (RR) of 22 breaths per minute and oxygen saturation of 94% on room air. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 18, 2020 Category: Emergency Medicine Authors: Marianne Pop, Alice Hemenway, Faizan Shakeel Source Type: research

A critical view on “An extremely rare compliaction of acute pancreatitis: Intraventricular thrombus”
I have read with great interest the article “An extremely rare complication of acute pancreatitis: Intraventricular thrombus” by İlhan et al. [1] The case-report seems interesting and unusual; however, some clinical data are missing. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 17, 2020 Category: Emergency Medicine Authors: Erdi Babayi ğit Source Type: research

The usefulness of the percentage of immature granulocytes in predicting in-hospital mortality in patients with upper gastrointestinal bleeding
Upper gastrointestinal bleeding (UGIB) is an important health problem with a potentially life threatening course. Measurement of immature granulocytes percentage (IG %), reflecting the fraction of circulating immature granulocyte (IG), is associated with increased mortality in patients with systemic inflammation, or distress. The aim of this study was to evaluate whether the IG% is an effective predictive marker for estimating the in-hospital mortality for patients with UGIB admitting to the emergency department (ED). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 16, 2020 Category: Emergency Medicine Authors: H üseyin Narcı, Mustafa Berkeşoğlu, Enver Üçbilek, Cüneyt Ayrık Source Type: research

Associations between initial serum pH value and outcomes of pediatric out-of-hospital cardiac arrest
Pediatric out-of-hospital cardiac arrest (OHCA) is one of the most critical conditions seen in the emergency department (ED). Although initial serum pH value is reported to be associated with outcome in adult OHCA patients, the association is unclear in pediatric OHCA patients. Thus, we aimed to identify the association between initial pH value and outcome among pediatric OHCA patients. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 16, 2020 Category: Emergency Medicine Authors: Asami Okada, Yohei Okada, Kenji Kandori, Satoshi Nakajima, Nobunaga Okada, Tasuku Matsuyama, Tetsuhisa Kitamura, Narumiya Hiromichi, Ryoji Iiduka Source Type: research

Confounders in determining female authorship in the emergency medicine literature
In the article “First and last authorship by gender in emergency medicine publications- a comparison of 2008 vs 2018,” the authors conclude that women represent 28% of the academic emergency workforce and are proportionately represented as first authors [1]. However, this both fails to capture key data and fur ther lacks context, leaving the reader to surmise that a disparity does not exist when this is certainly not the case. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - December 16, 2020 Category: Emergency Medicine Authors: Jaclyn Jansen, Ryan McKenna, Alexandra Mannix Source Type: research