Utility of ECGs in the Pediatric Emergency Department for Patients Presenting with a Seizure
Seizure is a common presenting complaint in the pediatric emergency department (ED). Initial diagnostic investigation beyond a thorough history and physical examination typically focuses on searching for reversible causes of a seizure, predisposing factors which may have precipitated a seizure, and diagnoses which could mimic seizures. Initial evaluation is variable based on the clinical scenario and available resourced in the ED, but is generally minimal, sometimes involving neuroimaging or biochemical evaluation [1,2]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 19, 2019 Category: Emergency Medicine Authors: Anthony G Pompa, Peter LaRossa, Lee B. Beerman, Yoshimi Sogawa, Johanna Rosen, Gaurav Arora Source Type: research

Racial and Insurance Disparities Among Patients Presenting with Chest Pain in the US: 2009-2015
Nationally representative studies have shown significant racial and socioeconomic disparities in the triage and diagnostic evaluation of patients presenting to the emergency department (ED) with chest pain. However, these studies were conducted over a decade ago and have not been updated amidst growing awareness of healthcare disparities. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 19, 2019 Category: Emergency Medicine Authors: Amrita Mukhopadhyay, Robert D'Angelo, Ethan Senser, Kyle Whelan, Christina C. Wee, Kenneth J. Mukamal Source Type: research

Use of the Intubating Laryngeal Mask Airway in the Emergency Department: A Ten-year Retrospective Review
Extraglottic devices, such as the intubating laryngeal mask airway (ILMA), facilitate ventilation and oxygenation and are useful for emergency airway management, especially as rescue devices. In the operating room setting the ILMA has been highly successful. However, its performance in the ED has not been described. We sought to describe the indications for and success of the ILMA when used in the ED. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 19, 2019 Category: Emergency Medicine Authors: Brian E. Driver, Marc Martel, Tarissa Lai, Tracy A. Marko, Robert F. Reardon Source Type: research

Improved Emergency Medicine Physician Attitudes Towards Individuals with Opioid Use Disorder Following Naloxone Kit Training
Every day in the United States, 130 people die of opioid-related causes [1]. In 2017, there were 47,600 overdose deaths related to opioids, which accounted for approximately two-thirds of all drug overdose deaths that year [2]. Patients with opioid use disorder (OUD) who present to emergency departments are especially vulnerable, as they are at higher risk for fatal overdose, trauma and suicide, than patients not seen in emergency departments [4,5,32,33]. Despite the need for increased hospital engagement in mortality-reducing efforts, it stands that many physicians are unfamiliar with addiction treatment best practices an...
Source: The American Journal of Emergency Medicine - November 19, 2019 Category: Emergency Medicine Authors: Giselle Appel, Joseph J. Avery, Kaylee Ho, Zhanna Livshits, Rama B. Rao, Jonathan Avery Source Type: research

Improving antibiotic administration efficiency and patient outcomes in the emergency
Guidelines recommend antibiotics be administered within one hour of severe sepsis onset [1]. As reported previously in this Journal, computerized physician order entry (CPOE) improved antibiotic administration time in septic patients in the emergency department (ED), with no effect on survival [2]. Automatic dispensing cabinets (ADC) have also demonstrated improved administration times, but patient outcomes have not been evaluated when the strategies are combined [3]. Despite evidence supporting early intravenous antibiotics (IVA), a recent national survey demonstrated that not all hospital ED ’s routinely stock IVA,...
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Adam Wiss, Stephen Turner, Ana Negrete, Brian Wheeler, Justin Usery, Jacob Marler Source Type: research

The evolving role of novel treatment techniques in the management of patients with refractory VF/pVT out-of-hospital cardiac arrest
The purpose of this review is to provide a brief overview of new life-saving interventions and novel techniques that have been proposed as viable treatment options for patients presenting with refractory ventricular fibrillation/pulseless ventricular tachycardia  (VF/pVT) out-of-hospital cardiac arrest (OHCA). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Dennis Miraglia, Lourdes A. Miguel, Wilfredo Alonso Source Type: research

Clinical practice of pre-hospital analgesia: An observational study of 20,978 missions in Switzerland
Pain is a frequent problem faced by emergency medical services (EMS) in pre-hospital settings. This large observational study aims to assess the prevalence of sufficiently provided analgesia and to analyze the efficacy of different analgesics. Moreover, we evaluated if quality of analgesia changed with an emergency physician on scene or depended on paramedics ’ gender. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Greta Emilia Kiavialaitis, Stefan M üller, Julia Braun, Julian Rössler, Donat R. Spahn, Philipp Stein, Alexander Kaserer Source Type: research

Use of Femostop device in the setting of life threatening inguinal bleeding
Massive hemorrhage from the inguinal space is an indication for the use of the Femostop device in the emergency department. This case report describes a middle-aged male with metastatic and recurrent penile cancer status post inguinal lymph node dissection and chemoradiation with a nonhealing left groin wound with extension to the femoral vessels. The patient experienced massive bleeding from erosion of an open wound in left groin into femoral vein requiring massive transfusion. Direct pressure and pressure dressings were unable to control the bleeding present in the patient ’s left groin. (Source: The American Journ...
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: John Cambron, Michael A. Miller Source Type: research

Emergency physician in prehospital major trauma care: It is still up to date
It was with great interest that we read the article by Hirano and colleagues [1]. The question of the presence of an emergency physician in the prehospital setting is a very important issue from both a strictly medical point of view and from an economic point of view. Nevertheless, we have some concerns about the trial. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Nicolas Cazes, Pascal Menot, Daniel Meyran Source Type: research

Use of Fomepizole, N-acetylcysteine, and Hemodialysis for Massive Acetaminophen Overdose
We present the use of a novel antidote cocktail of n-acetylcysteine, fomepizole, and hemodialysis to treat a massive acetaminophen ingestion. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Jordan A. Woolum, William B. Hays, Kripa H. Patel Source Type: research

End Stage Renal Disease Modifies the Effect of Targeted Temperature Management after Out-of-Hospital Cardiac Arrest
Kidney function can affect the permeability of the blood-brain barrier; thus, end-stage renal disease (ESRD) may alter the effects of targeted temperature management (TTM) on the neurological outcomes of out-of-hospital cardiac arrest (OHCA) patients. We aimed to investigate whether the interaction effect of TTM on outcomes after OHCA was observed among patients with and without ESRD. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Min Woo Kim, Jeong Ho Park, Young Sun Ro, Sang Do Shin, Kyoung Jun Song, Ki Jeong Hong, Joo Jeong, Tae Han Kim, Won Pyo Hong Source Type: research

Repeat head CT in mild traumatic brain injury is really necessary?
We pleasantly read the paper by Van Ornam et al.[1] who collected data on the management of 1126 patients with mild traumatic intracranial hemorrhage (GCS> 13). The authors highlighted a very important topic: the repeat head CT scans (RHCT) to assess for progression of traumatic injuries. There are relatively limited number of reports focused on timing of radiologic controls in MTBI with a positive initial CT scan. Consequently, clinicians are often in the difficult position between avoiding unnecessary examinations and ensuring the safest treatment of their patients. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Alba Scerrati, Gianluca Trevisi, Pasquale De Bonis, Annunziato Mangiola Source Type: research

Homeless Patients Tend to Have Greater Psychiatric Needs when Presenting to the Emergency Department,
Homeless patients tend to visit Emergency Departments (EDs) more frequently than the non-homeless population. The goal of this study was to assess differences in chief complaint, medical conditions, and disposition between homeless patients compared to non- homeless patients presenting to an urban ED. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Lauren E. Lamparter, A. Megan, Theresa Nguyen Source Type: research

Significant Elevations in Serum Lipase in the Emergency Department: When It is Not Pancreatitis!
To the Editor. Serum lipase levels are widely and exclusively used in the diagnosis of acute pancreatitis, as it is a central component of the Revised Atlanta Criteria. Significant elevations in serum lipase can however be found in association with other pathologies, without evidence of pancreatitis. The purpose of this short report is to provide a brief overview of the potential etiologies behind significant elevations in serum lipase levels in a tertiary care center in Lebanon. Using a retrospective cross-sectional study design conducted at the Emergency Department (ED) of the American University of Beirut Medical Center...
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Karine Kahil, Maan El Halabi, Halim Bou Daher, Luma Basma O. Rustom, Majd Marrache, Yervant Ichkhanian, Mazen El Sayed, Ala I. Sharara Source Type: research

Willingness to Consider Alternatives to Ambulance Use Among Adult Emergency Department Patients
Dear Editor, (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Samuel H.F. Lam, Yuko Nakajima, Edward M. Castillo, Jesse Brennan, Gary M Vilke Source Type: research

The unrealistic depiction of trauma resuscitation in popular medical dramas: A content analysis
American televised (TV) medical dramas often portray unrealistic, fantastic, or otherwise unlikely events which are meant to frame what reality is like in typical hospitals in the Unites States (US). While the accuracy of these shows is often called into question, the dramatic construct allows the producers of the serial to communicate a story within the constraints of a 1-hour TV show. Many medical dramas have come under criticism for unrealistic content, including cardiopulmonary resuscitation (CPR) survival rates, intubation technique, diagnoses, and patient demographics [1 –4]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Patrick McFadden, Sierra Debenham, Lindsey Ouellette, Stephanie Wigstadt, Chris Benner, Todd Chassee, Jeffrey S Jones Source Type: research

Delayed adenosine therapy is associated with the refractory supraventricular tachycardia in children
To study the association of time intervals on adenosine therapy with the occurrence of refractory supraventricular tachycardia (SVT) in children. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Jung Heon Kim, Jae Yun Jung, Se Uk Lee, Joong Wan Park, Jea Yeon Choi Source Type: research

Evaluating Barriers to Community CPR Education in Baltimore, Maryland, USA
The primary objective of this study is to better understand the preferences of the general public regarding cardiopulmonary resuscitation (CPR) education as it relates to both format and the time and place of delivery. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Kyle A. Fratta, Andrew J. Bouland, Roumen Vesselinov, Matthew J. Levy, Kevin G. Seaman, Benjamin J. Lawner, Jon Mark Hirshon Source Type: research

Prognostic value of neutrophil-to-lymphocyte ratio in sepsis: a meta-analysis
Neutrophil-to-lymphocyte ratio (NLR) has been used to predict the prognosis of patients with sepsis with inconsistent results. This meta-analysis aimed to clarify the prognostic value of NLR in patients with sepsis. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Zhiwei Huang, Zhaoyin Fu, Wujun Huang, Kegang Huang Source Type: research

Opioid Prescribing Patterns in Emergency Departments and Future Opioid Use in Adolescent Patients
Evidence suggests that exposure to opioids in adolescence increases risk of future opioid use. We evaluate if exposure to high versus low intensity opioid prescribers in the Emergency Department (ED) influences the risk of future opioid use in adolescents. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Patrick J. Van Winkle, Ali Ghobadi, Qiaoling Chen, Michael Menchine, Adam L. Sharp Source Type: research

Risk Factors for Pneumonia Following Rib Fractures
This study was undertaken to identify clinical and demographic factors associated with the development of pneumonia among trauma patients with rib fractures. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Catherine A. Marco, Derek Sorensen, Claire Hardman, Brittany Bowers, Jasmine Holmes, Mary C. McCarthy Source Type: research

Diagnostic utility of fecal calprotectin in patients presenting to the emergency department with suspected acute appendicitis
Acute appendicitis (AA) is one of the most common diseases faced by the surgeon in the emergency department. In clinical practice, how to diagnose patients with AA accurately is still challenging. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Wenqing Zhou, Huiying Qiao, Weiguo Yuan, Zhibing Yao, Kai Liu, Jun Wang, Yongkui Pang Source Type: research

Impact of Viral Symptoms on the Performance of the Modified Centor Score to Predict Pediatric Group A Streptococcal Pharyngitis
Clinicians use the Modified Centor Score (MCS) to estimate the risk of group A streptococcal (GAS) pharyngitis in children with sore throat. The Infectious Diseases Society of America (IDSA) recommends neither testing nor treating patients with specific viral symptoms. The goal of this study is to measure the impact of those symptoms on the yield of GAS testing predicted by the MCS. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Nicole Nadeau, Amir Kimia, Andrew M. Fine Source Type: research

Impact of increased calls to rapid response systems on unplanned ICU admissions: Japanese database study
Whether hospital bed number and rapid response system (RRS) call rate is associated with the clinical outcomes of patients who have RRS activations is unknown. We test a hypothesis that hospital volume and RRS call rates are associated with the clinical outcomes of patients with RRSs. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Takeo Kurita, Taka-aki Nakada, Rui Kawaguchi, Shigeki Fujitani, Kazuaki Atagi, Takaki Naito, Masayasu Arai, Hideki Arimoto, Tomoyuki Masuyama, Shigeto Oda, IHER-J collaborators Source Type: research

Is epistaxis associated with high blood pressure and hypertension? Propensity score matching study
We aimed to investigate whether high blood pressure and hypertension are associated with epistaxis. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Changhyun Kim, Changsun Kim, Jae ho Chung, Jeong-Hun Shin Source Type: research

Visual outcomes after traumatic retrobulbar hemorrhage are not related to time or intraocular pressure
Retrobulbar hemorrhage (RBH) is a serious injury associated with midface trauma that can lead to the permanent loss of vision. Retrospective studies have shown that this injury is rare, occurring in 0.45% to 3.6% of patients with traumatic orbital fractures[1 –5]. Clinically RBH accounts for half of all cases of traumatic blindness[1,2]. Recognition and treatment of this injury is therefore an essential skill for the emergency physician (EP). Survey data have suggested that EPs are uncomfortable recognizing and performing appropriate vision-sparing tre atment for such injuries[3,6]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Jessica L. Dixon, Owen K. Beams, Brian J. Levine, Mia A. Papas, Brent A. Passarello Source Type: research

Patients with Pulmonary Hypertension Presenting to the Emergency Department
The objective of this study is to analyze the demographics, dispositions and the rates of return visits for PH patients visiting the ED, focusing on PH patients identified as having high frequency visits. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Jason K. Bowman, Sayon Dutta, Hui Zheng, Cassie Kraus, Susan R. Wilcox Source Type: research

Clinical practice of pre-hospital analgesia: an observational study of 20978 missions in Switzerland
Pain is a frequent problem faced by emergency medical services (EMS) in pre-hospital settings. This large observational study aims to assess the prevalence of sufficiently provided analgesia and to analyze the efficacy of different analgesics. Moreover, we evaluated if quality of analgesia changed with an emergency physician on scene or depended on paramedics ’ gender. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Greta Emilia Kiavialaitis, Stefan M üller, Julia Braun, Julian Rössler, Donat R. Spahn, Philipp Stein, Alexander Kaserer Source Type: research

Heart Rate and Heart Rate Variability in Emergency Medicine
The objective of this study is to examine heart rate trends present among emergency medicine trainees over a standard emergency room shift to measure the frequency and severity of stress experienced while on shift. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Shane Jenks, W Frank Peacock, Angela P Cornelius, Sarah Shafer, Malford T Pillow, Swathi S Rayasam Source Type: research

Use of Femostop device in the setting life threatening inguinal bleeding
Massive hemorrhage from the inguinal space is an indication for the use of the Femostop device in the emergency department. This case report describes a middle-aged male with metastatic and recurrent penile cancer status post inguinal lymph node dissection and chemoradiation with a nonhealing left groin wound with extension to the femoral vessels. The patient experienced massive bleeding from erosion of an open wound in left groin into femoral vein requiring massive transfusion. Direct pressure and pressure dressings were unable to control the bleeding present in the patient ’s left groin. (Source: The American Journ...
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: John Cambron, Michael A. Miller Source Type: research

Improving Antibiotic Administration Efficiency and Patient Outcomes in the Emergency Department
Guidelines recommend antibiotics be administered within one hour of severe sepsis onset [1]. As reported previously in this Journal, computerized physician order entry (CPOE) improved antibiotic administration time in septic patients in the emergency department (ED), with no effect on survival [2]. Automatic dispensing cabinets (ADC) have also demonstrated improved administration times, but patient outcomes have not been evaluated when the strategies are combined [3]. Despite evidence supporting early intravenous antibiotics (IVA), a recent national survey demonstrated that not all hospital ED ’s routinely stock IVA,...
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Adam Wiss, Stephen Turner, Ana Negrete, Brian Wheeler, Justin Usery, Jacob Marler Source Type: research

Some questions on the meta-analysis of Xuebijing combined with ulinastation benefits patients with sepsis
For more comprehensive understanding of the diagnosis and treatment on sepsis,we read with great interest the enchanting article [1] by Zheng et al,which is a meta-analysis about Xuebijing combined with ulinastation benefits patients with sepsis. But we have some questions and different points after reading the article. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Zhuang Jieqin, Dai Xingzhen, Cai Hairong, Chen Bojun Source Type: research

Author ’s response to letter ‘‘Emergency physician in prehospital major trauma care: it is still up to date’’
We thank for your interest in our study which assessed the efficacy of the presence of an emergency physician in prehospital major trauma care on survival outcome to discharge by retrospectively analyzing nationwide Japanese Trauma Data Bank (JTDB) between 2004 and 2015 (1). We are willing to provide our answers to some concerns. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Yohei Hirano Source Type: research

Loperamide Toxicity Mimicking Peripartum Cardiomyopathy
We present a case of loperamide toxicity that has not been previously reported in the literature. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Anderson Wang, Michael Nguyen, Jesus Diaz, Travis Smith Source Type: research

Smart watch recording of ventricular tachycardia: case study
We report the case of a patient presenting to the emergency department complaining of palpitations and syncope. Standard investigations were unremarkable. However, an electrocardiogram recorded through his Apple Watch ® indicated ventricular tachycardia. This case highlights the importance of proactively requesting such information from patients, though normal recordings may not preclude cardiac arrhythmia. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Maxime Ringwald, Alexandre Crich, Nicolas Beysard Source Type: research

The timing for percutaneous coronary intervention for patients with Chapman's sign
We read the recent case report by Idris et al. [1] about acute myocardial infarction presenting with left bundle branch block and Chapman ’s sign with great interest. Although it is a very interesting case report, we want to address some points that need more attention. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Özge Turgay Yildirim, Fatih Aydin, Ercan Akşit, Ayşe Hüseyinoğlu Aydin Source Type: research

Automatic Acoustic Gunshot Sensor Technology ’s Impact on Trauma Care
As cities nation-wide combat gun violence, with less than 20% of shots fired reported to police, use of acoustic gunshot sensor (AGS) technology is increasingly common. However, there are no studies to date investigating whether these technologies affect outcomes for victims of gunshot wounds (GSW). We hypothesized that the AGS technology would be associated with decreased prehospital transport time. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Genna Beattie MD, Caitlin Cohan MD, Magdalene Brooke MD, Stefania Kaplanes MSW, Gregory P. Victorino MD FACS Source Type: research

Dodgeball-related injuries treated at emergency departments
The objective is to eliminate all of the members of the opposing team by hitting them with thrown balls, catching a ball thrown by an opponent, or violation of the rules by an opponent. The sport is played informally in schools and elsewhere under varying rules and formally as an international sport. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Mathias B. Forrester Source Type: research

Agreement between Actual and Synthesized Right-Sided and Posterior Electrocardiographic Leads in Identifying Ischemia
A 12-lead electrocardiogram (ECG) is the standard of care for chest pain patients. However, 12-lead ECGs have difficulty detecting ischemia of the right ventricle or posterior wall of the heart. New technology exists to mathematically synthesize these leads from a 12-lead ECG; however, this technology has not been evaluated in the emergency department (ED). We assessed the level of agreement between synthesized 18-lead ECGs and actual 18-lead ECGs in identifying ST elevations, ST depressions, and T wave inversions in ED patients. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Timmy Li, Koichiro Shinozaki, Martina Brave, Tsukasa Yagi, Lance B. Becker Source Type: research

Emergency physician in prehospital major trauma care : it is still up to date
It was with great interest that we read the article by Hirano and colleagues [1]. The question of the presence of an emergency physician in the prehospital setting is a very important issue from both a strictly medical point of view and from an economic point of view. Nevertheless, we have some concerns about the trial. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Nicolas Cazes, Pascal Menot, Daniel Meyran Source Type: research

Is it feasible “scoop and run while playing” resuscitation on a Rescue Water Craft? A randomized simulation study with lifeguards
Providing high-quality rescue care in aquatic environments is a challenge for lifeguard teams, which is why they usually use lifeboats in order to intervene. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Roberto Barcala-Furelos, Cristian Abelairas-Gomez, Silvia Aranda-Garc ía, Miguel Lorenzo-Martínez, Santiago Martínez-Isasi, Carlota Durán-Álvarez, José Palacios-Aguilar, Antonio Rodríguez-Núñez Source Type: research

Prehospital Supplemental Oxygen for Acute Stroke – a Retrospective Analysis
This study examines the effects of prehospital sO2 in stroke. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Layne Dylla, David H. Adler, Beau Abar, Curtis Benesch, Courtney MC Jones, M. Kerry O'Banion, Jeremy T Cushman Source Type: research

The Evolving Role of Novel Treatment Techniques in the Management of refractory VF/pVT Patients With Out-of-Hospital Cardiac Arrest
Study objectives: The purpose of this review is to provide a brief overview of new life-saving interventions andnovel techniques that have been proposed as viable treatment options for patients presenting with refractory VF/pVT OHCA. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Dennis Miraglia, Lourdes A. Miguel, Wilfredo Alonso Source Type: research

Lactic Acidemia Due to an Infliximab Infusion Reaction
We present the case of a patient who presented to the emergency department complaining of diffuse myalgias, severe jaw pain and chills. She met criteria for severe sepsis and received treatment including analgesia, antibiotics, intravenous fluids, and antipyretics. Workup revealed an elevated lactate and leukocytosis however, did not reveal any infectious source. The patient had a history of Crohn ’s disease and had received an infusion of infliximab ten days prior to the onset of her symptoms. After ruling out other potential causes of lactic acidemia, her final diagnosis was determined to be the rare presentation o...
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Nicole Vigh, David Levy Source Type: research

Gender Differences in Funding Among Grant Recipients in Emergency Medicine: A Multicenter Analysis
To describe differences in funded grants between male and female faculty in two academic emergency departments. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 18, 2019 Category: Emergency Medicine Authors: Nicole M. Dubosh, Katherine L. Boyle, Stephanie Carreiro, Tuyen Yankama, Alden M. Landry Source Type: research

Prehospital Amputation: An Experimental Comparison of Techniques
The objective was to experimentally compare three prehospital amputation techniques on porcine legs. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 17, 2019 Category: Emergency Medicine Authors: Bradley W. Emmerich, Julie A.W. Stilley, Christopher S. Sampson, Bobby G. Horn, Kelly E. Pollock, Joshua D. Stilley Source Type: research

A PRESing Case of Visual Changes and Confusion
We report a 10-year-old female with a history of systemic lupus erythematosus complicated by hypertension and cardiomyopathy secondary to lupus who presented to the emergency department with a history of vision loss and headache. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 17, 2019 Category: Emergency Medicine Authors: Tanisha Ronnie, Larrisa Beyerlein, Michael Murati, Jeffrey P. Louie Source Type: research

“Robo-tripping”: Dextromethorphan toxicity and abuse
Dextromethorphan (DXM) is a medication available in both prescription and non-prescription over the counter (OTC) formulations and is utilized as an antitussant. DXM is available in many product types, including tablets, syrups, lozenges and capsules which may contain other active ingredients such as analgesics, antihistamines and expectorants [1]. There is abuse potential for DXM and supratherapeutic doses can cause euphoria, hallucinations, disorientation, confusion, impaired coordination, and dissociative sedation [1,2]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 17, 2019 Category: Emergency Medicine Authors: Daniel Ritter, Lindsey Ouellette, J.D. Sheets, Brad Riley, Bryan Judge, Allison Cook, Justin Houseman, J.S. Jones Source Type: research

Emergency Physician-Based Intensive Care Unit for Critically Ill Patients Visiting Emergency Department
To provide a prompt and optimal intensive care to critically ill patients visiting our emergency department (ED), we set up and ran a specific type of emergency intensive care unit (EICU) managed by emergency physician (EP) intensivists. We investigated whether this EICU reduced the time interval from ED arrival to ICU transfer (ED-ICU interval) without altering mortality. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 16, 2019 Category: Emergency Medicine Authors: Hwain Jeong, Yoon Sun Jung, Gil Joon Suh, Woon Yong Kwon, Kyung Su Kim, Taegyun Kim, So Mi Shin, Min Woo Kang, Min Sung Lee Source Type: research

Selling poison by the bottle: Availability of dangerous substances found on eBay ®
During the 19th century, many new poisonous substances came onto the market to aid in controlling undesirable plant life and pests, for use as cleaning agents, and for medicinal purposes [1]. Poison bottles were often made with distinctive coloring and/or patterns or marked with certain raised shapes in order to warn individuals of the contents and to make adults aware of the necessity to keep them away from children [1]. While this warning was necessary, it wasn ’t until the 1930s that medical and other professionals realized these attributes actually made the bottles more attractive to children, thus resulting in t...
Source: The American Journal of Emergency Medicine - November 16, 2019 Category: Emergency Medicine Authors: Derek Blok, Lisa Ambrose, Lindsey Ouellette, Emily Seif, Brad Riley, Bryan Judge, Aaron Ziegler, Jeffrey Jones Source Type: research