Publishing trends in the field of urgent care medicine from 2000 to 2020: A bibliometric analysis
With a steady rise in the number of urgent care centers in the United States and the establishment of urgent care medicine as a specialty, research in the field is likely to emerge. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 19, 2020 Category: Emergency Medicine Authors: Lauren A. McNickle, Kevin C. Chiang, Ellie M. McNulty, Robert P. Olympia Source Type: research

Cardiovascular complications in COVID-19
We read the article by Long et al. titled “Cardiovascular complications in COVID-19” published in the recent issue of American Journal of Emergency Medicine with immense interest [1]. We commend the authors on identifying Coronavirus Disease 2019 (COVID-19) associated cardiovascular complications including myocarditis, myocardial infarc tion, cardiomyopathy, dysrhythmias and venous thromboembolic events. However, we would like to highlight other possible cardiac complications which may also be observed with this disease. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 19, 2020 Category: Emergency Medicine Authors: Nausharwan Butt, Awais Arshid, Sarah Aftab Ahmad, Nauman Khalid, Waleed Tallat Kayani Source Type: research

Acute chloroquine and hydroxychloroquine toxicity: A review for emergency clinicians
Acute chloroquine and hydroxychloroquine toxicity is characterized by a combination of direct cardiovascular effects and electrolyte derangements with resultant dysrhythmias and is associated with significant morbidity and mortality. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 19, 2020 Category: Emergency Medicine Authors: Alessandra Della Porta, Kasha Bornstein, Austin Coye, Tim Montrief, Brit Long, Mehruba Anwar Parris Source Type: research

Should COVID-19 patients be taken to an airborne infection isolation room without cardiopulmonary resuscitation?
This article states “We should, moreover, remember that in a hospital setting, all aerosol-generating procedures should be done in an airborne infection isolation room.” A doctor at our hospital who read this article said, “If a patient collapses at the entrance of the hospital, cardiopulmonary resuscitation (CPR ) should not be started there, but should be taken to the emergency department in the Red Zone and then CPR”. While it's important to prevent nosocomial infections and protect hospital staff, isn't it too detrimental for patients to be transferred to an airborne infection isolation room wit...
Source: The American Journal of Emergency Medicine - July 19, 2020 Category: Emergency Medicine Authors: Masanao Kobayashi, Mikako Shinchi, Yoshihiro Takeda Source Type: research

Multiple thromboemboli in Covid-19
I read with great interest the article titled “Abdominal pain in a patient with COVID-19 infection: A case of multiple thromboemboli” by Mahan et al. [1] in The American Journal of Emergency Medicine. The authors reported an interesting novel coronavirus disease (COVID-19) case with venous and arterial thromboembolic disease. There are some important issues that need to be clarified about this case report. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 19, 2020 Category: Emergency Medicine Authors: Furkan Ufuk Source Type: research

Ambulatory care, insurance, and avoidable emergency department utilization in North Carolina
To examine whether and how avoidable emergency department (ED) utilization is associated with ambulatory or primary care (APC) utilization, insurance, and interaction effects. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 19, 2020 Category: Emergency Medicine Authors: Carlene A. Mayfield, Marco Geraci, Brisa Urquieta de Hernandez, Michael Dulin, Jan M. Eberth, Anwar T. Merchant Source Type: research

Postpartum headache: A broader differential
A 40-year-old female presented to the ED with a history of intermittent headaches since a vaginal delivery 8  days prior. Her pregnancy was unremarkable and was not complicated by pre-eclampsia. She did not present with signs or symptoms consistent with postdural puncture headache or pre-eclampsia. Her delivery was not complicated by hypotension or post-partum hemorrhage. By chance, she was found to be h yponatremic and admitted to internal medicine for further work-up. She was diagnosed with postpartum lymphocytic adenohypophysitis and treated with steroids. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 18, 2020 Category: Emergency Medicine Authors: Anton Nikouline, David Carr Source Type: research

Pulmonary fibrosis in critical ill patients recovered from COVID-19 pneumonia: Preliminary experience
To investigate chest computed tomography (CT) findings associated with severe COVID-19 pneumonia in the early recovery period. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 18, 2020 Category: Emergency Medicine Authors: Yu Fang, Jun Zhou, Xun Ding, Gonghao Ling, Shanshan Yu Source Type: research

Usage analysis of ketorolac in the emergency department
Ketorolac (Toradol ®) is a non-steroidal anti-inflammatory medication (NSAID) used in the emergency department (ED) for acute and chronic pain. Routes of administration include intramuscular (IM), intravenous (IV), or oral (PO). The onset of action of parenteral ketorolac is about 10 min for both routes, and time t o peak effect about 75 to 150 min [1]. Compared to other NSAIDs, ketorolac has the highest dose related side effect profile, with adverse effects including gastrointestinal toxicity, bleeding, impaired platelet aggregation, and renal toxicity [2-5]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 18, 2020 Category: Emergency Medicine Authors: Joshua da Silva, Alexa Gingras Source Type: research

Ideal high sensitivity troponin baseline cutoff for patients with renal dysfunction
High-sensitivity cardiac troponin assays (hs-cTn) aid in diagnosis of myocardial infarction (MI). These assays have lower specificity for non-ST Elevation MI (NSTEMI) in patients with renal disease. Our objective was to determine an optimized cutoff for patients with renal disease. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 17, 2020 Category: Emergency Medicine Authors: Alexander T. Limkakeng, Julian Hertz, Reginald Lerebours, Maragatha Kuchibhatla, James McCord, Adam J. Singer, Fred S. Apple, William F. Peacock, Robert H. Christenson, Richard M. Nowak Source Type: research

Predictors of emergency department opioid administration and prescribing: A machine learning approach
This study aims to examine patient sociodemographic and ED clinical factors to comprehensively determine predictors of opioid administration during an ED visit (ED-RX) and prescribing upon discharge (DC-RX). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 17, 2020 Category: Emergency Medicine Authors: Molly McCann Pineo, Julia Ruskin, Rehana Rasul, Eugene Vortsman, Kristin Bevilacqua, Samantha S. Corley, Rebecca M. Schwartz Source Type: research

Is social distancing keeping patients from the ED?
In response to COVID-19, public health organizations issued recommendations to limit transmission. These recommendations include physical distancing, frequent hand hygiene, and use of personal protective equipment (PPE) [1,2]. In conjunction with state-level mandated shelter-in-place orders and the closure of schools and non-essential businesses, daily life in the U.S. has changed dramatically. We sought to characterize perceptions of public health recommendations and explore the decision to seek medical care for common symptoms. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 16, 2020 Category: Emergency Medicine Authors: Claire M. Sokas, Margaret T. Berrigan, Scott C. Fligor, Aaron J. Fleishman, Kristin E. Raven, James R. Rodrigue Source Type: research

Highest reported clearance of valproate by hemodialysis in massive overdose
Valproic acid (VPA) is a commonly prescribed anti-epileptic used therapeutically for a range of conditions including bipolar disorder and migraines. It is a small molecule with a low volume of distribution (0.22  L/kg). At therapeutic levels, protein binding of valproic acid is high (90 to 95%) [1]. However, in overdose protein binding becomes saturated and the percentage of free valproic acid increases substantially. At valproic acid levels of 1000 mg/L, protein binding has been shown to decrease to 15 %. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 15, 2020 Category: Emergency Medicine Authors: Alexander M. Sidlak, Samuel R. York, Adam J. Janicki, Anthony F. Pizon Source Type: research

Surge activation by the emergency department for COVID-19
In March 2020, the American College of Emergency Physicians (ACEP) published a national strategic plan for COVID-19, which provides general guidelines yet leaves logistical details for institutions to determine. Key capabilities from this plan provided a crucial foundation for a 16-day Emergency Department (ED) surge planning process at one pediatric institution. This paper describes critical milestones and lessons learned during this brief period, including derivation of criteria for ED surge activation, a full-scale surge drill, and the resultant ED surge protocol. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 15, 2020 Category: Emergency Medicine Authors: Anita R. Schmidt, Phung K. Pham, Deborah R. Liu, Bradley S. Goldberg Source Type: research

The new prognostic factor for pulmonary embolism: The ratio of monocyte count to HDL cholesterol
Aim of this study is to investigate effectiveness of the monocyte to HDL cholesterol ratio in patients diagnosed with pulmonary embolism for predicting intra-hospital mortality. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 15, 2020 Category: Emergency Medicine Authors: Akkan Avci, Serdar Biricik, Begum Seyda Avci, Onder Yesiloglu, Hilmi Erdem Sumbul, Ferhat Icme, Hasan Koca, Hayri Çınar, Mevlut Koc, Salim Satar Source Type: research

Pregnant patient in the emergency department: An observational investigation of predictive values of symptoms and lab measures in predicting culture confirmed urinary tract infection.
Many women in their first trimester present to the Emergency Department (ED) for evaluation. Urinalysis is a common test performed with these patients to evaluate for possible UTI. There are no clear results to determine if a patient requires antibiotic in the ED vs waiting for the culture result to start antibiotics. We prospectively studied a convenience sample of 198 women in their first trimester of pregnancy presenting to a community ED recording standard symptoms and lab analysis and then compared these results to the urine culture. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 15, 2020 Category: Emergency Medicine Authors: Gleb Gendel, Robert Nolan Source Type: research

Hepatic portal venous gas: A case report and analysis of 131 aatients using PUBMED and MEDLINE database
Hepatic portal pneumatosis has a high mortality rate, and whether surgical intervention is necessary remains controversial. This experiment retrospectively analyzed the etiology, treatment methods and prognosis of adult patients with hepatoportal pneumocele to provide a theoretical basis for the treatment of this disease. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 13, 2020 Category: Emergency Medicine Authors: Chun Liu, Chang-Hei Wu, Xiang-De Zheng, Jin-Ping Liu, Chang-Long Li, Jie-Yu Zhao, Qing Lan, Wen-Lai Zhou, Wen-Bin Li Source Type: research

Correlation of history and physical examination with imaging in traumatic near-shore aquatic head and spinal injury
It remains unclear whether clinicians can rely on specific symptoms and signs to detect or exclude serious head and spinal injury sustained during near-shore aquatic activities. Our study investigated patients' history of present illness (HPI) and physical examination (PE) for their utility in detecting serious head and spinal injury. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 13, 2020 Category: Emergency Medicine Authors: Tucker Lurie, Bradford Schwartz, Daniel Najafali, Priyanka Gandhi, Matthew Jackson, Quincy K. Tran Source Type: research

Hepatic portal venous gas: A case report and analysis of 131 patients using PUBMED and MEDLINE database
Hepatic portal pneumatosis has a high mortality rate, and whether surgical intervention is necessary remains controversial. This experiment retrospectively analyzed the etiology, treatment methods and prognosis of adult patients with hepatoportal pneumocele to provide a theoretical basis for the treatment of this disease. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 13, 2020 Category: Emergency Medicine Authors: Chun Liu, Chang-Wei Wu, Xiang-De Zheng, Jin-Ping Liu, Chang-Long Li, Jie-Yu Zhao, Qing Lan, Wen-Lai Zhou, Wen-Bin Li Source Type: research

Management of the mild traumatic brain injured patient using a multidisciplinary observation unit protocol
We describe the cohort of patients who were placed in the ED OU and we evaluated if changes to our inclusion and exclusion criteria should be made. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 13, 2020 Category: Emergency Medicine Authors: Katherine Rhame, Diana Le, Amanda Ventura, Amy Horner, Norberto Andaluz, Christopher Miller, Uwe Stolz, Laura B. Ngwenya, Opeolu Adeoye, Natalie Kreitzer Source Type: research

Xuebijing combined with Ulinastatin for treating septic patients
The meta-analysis conducted by Zheng et al. that compared the efficacy of Xuebijing combined with Ulinastatin to that of the single administration of Ulinastatin for sepsis treatment is an interesting study [1]. However, after carefully reading the paper, we have some questions regarding the study. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 11, 2020 Category: Emergency Medicine Authors: Yuqiong Xu, Haiyan Zhong, Wei Liu, Jingfeng Du, Wei Han Source Type: research

Multicenter retrospective analysis of the risk factors for delayed neurological sequelae after acute carbon monoxide poisoning
This study aims at exploring the independent predictors of DNS in patients with CO exposure. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 11, 2020 Category: Emergency Medicine Authors: Yongxue Zhang, Qingsheng Lu, Jing Jia, Dekun Xiang, Yanan Xi Source Type: research

Bilateral spontaneous pneumothorax in SARS-CoV-2 infection: A very rare, life-threatening complication
In the coronavirus disease 2019 (COVID-19) era, the presence of acute respiratory failure is generally associated with acute respiratory distress syndrome; however, it is essential to consider other differential diagnoses that require different, and urgent, therapeutic approaches. Herein we describe a COVID-19 case complicated with bilateral spontaneous pneumothorax. A previously healthy 45-year-old man was admitted to our emergency department with sudden-onset chest pain and progressive shortness of breath 17  days after diagnosis with uncomplicated COVID-19 infection. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 11, 2020 Category: Emergency Medicine Authors: H éctor González-Pacheco, Rodrigo Gopar-Nieto, Gian-Manuel Jiménez-Rodríguez, Daniel Manzur-Sandoval, Julio Sandoval, Alexandra Arias-Mendoza Source Type: research

Transversus abdominis plane block: A new method in renal colic pain management
In recent decades, regional plane blocks via ultrasonography have become very popular in regional anesthesia and are more commonly used in pain management. The transversus abdominis plane (TAP) block is a procedure where local anesthetics are applied to block the anterior divisions of the tenth thoracic intercostal through the first lumbar nerves (T10 –L1) into the anatomic space formed amidst the internal oblique and transversus abdominis muscles located in the antero-lateral part of the abdomen wall. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 11, 2020 Category: Emergency Medicine Authors: Emine Kadioglu, Murtaza Kaya, Harun Yildirim Source Type: research

Some questions on the use of Xuebijing combined with Ulinastatin in treating patients with sepsis
The meta-analysis conducted by Zheng et al. that compared the efficacy of Xuebijing combined with Ulinastatin to that of the single administration of Ulinastatin for sepsis treatment is an interesting study [1]. However, after carefully reading the paper, we have some questions regarding the study. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 11, 2020 Category: Emergency Medicine Authors: Yuqiong Xu, Haiyan Zhong, Wei Liu, Jingfeng Du, Wei Han Source Type: research

Consistency and reliability of COVID-19 projection models as a means to save lives
In January 2020, the COVID-19 pandemic took the United States (US) by surprise. Projections were needed to estimate the magnitude and plan responses at national and local levels. In turn, the projections influenced decisions regarding social distancing, resource distribution, and lockdowns like the mandatory closing of businesses and schools [1]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 11, 2020 Category: Emergency Medicine Authors: Brendon Sen-Crowe, Mark McKenney, Adel Elkbuli Source Type: research

Predictive performance of SOFA and qSOFA for in-hospital mortality in severe novel coronavirus disease
This study was conducted to evaluate the effectiveness of the Sequential Organ Failure Assessment (SOFA) and Quick Sequential Organ Failure Assessment (qSOFA) scoring systems at admission for the prediction of mortality risk in COVID-19 patients. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 11, 2020 Category: Emergency Medicine Authors: Sijia Liu, Ni Yao, Yanru Qiu, Chengqi He Source Type: research

Retrospective analysis of the hemodynamic consequences of prehospital supplemental oxygen in acute stroke
This study examines the hemodynamic consequences of prehospital sO2 in stroke. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 10, 2020 Category: Emergency Medicine Authors: Layne Dylla, Jeremy T. Cushman, Beau Abar, Curtis Benesch, Courtney M.C. Jones, M. Kerry O'Banion, David H. Adler Source Type: research

A novel inline PEEP valve design for differential multi-ventilation
Ventilator sharing is one option to emergently increase ventilator capacity during a crisis but has been criticized for its inability to adjust for individual patient needs. Newer ventilator sharing designs use valves and restrictors to control pressures for each patient. A key component of these designs is an inline Positive End Expiratory Pressure (PEEP) Valve but these are not readily available. Creating an inline PEEP valve by converting a standard bag-valve-mask PEEP valve is possible with the addition of a 3D printer collar. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 10, 2020 Category: Emergency Medicine Authors: Leonard Bunting, Steven Roy, Hannah Pinson, Tobin Greensweig, International Differential Multi-Ventilation Working Group Source Type: research

Dilemnas raised by implementation of an unqualified STEMI algorithm
The authors of the study of the impact of patient delay in a modern real world STEMI network have rightly focussed on the adverse impact of delay in implementation of percutaneous coronary intervention [1]. The dilemna which faces clinicians who are aware of the existence of the entity of the mimicry of ST segment elevation myocardial infarction(STEMI) by dissecting aortic aneurysm(DAA), and the mimicry of STEMI by pulmonary embolism(PE) is that strategies such as point-of-care transthoracic echocardiography(TTE), which might mitigate the risk of misdiagnosis, also incur the risk of compounding the delay in achieving timel...
Source: The American Journal of Emergency Medicine - July 9, 2020 Category: Emergency Medicine Authors: Oscar M.P. Jolobe Source Type: research

Indications and preference considerations for using medical Cannabis in an emergency department: A National Survey
Due to its Schedule I drug designation, medical cannabis continues to remain a controversial topic [1] despite an increasing number of US states legalizing it2 and the growing acceptance of it socially [3] and even within some physicians in the medical community [4]. Because of federal laws, studying cannabis in randomized controlled trials remains a monumental challenge [5]. Meanwhile cannabis use, much by patients seeking symptomatic relief of their symptoms, is widespread. This has led to the acknowledgement and subsequent policy statement by the American College of Emergency Physicians (ACEP) to recommend rescheduling ...
Source: The American Journal of Emergency Medicine - July 9, 2020 Category: Emergency Medicine Authors: Kevin M. Takakuwa, Raquel M. Schears Source Type: research

Including syncope when assessing risk scores for atrial fibrillation in the ED
According to the authors of the recent study, one of their aims was to assess the potential to further improve the tools, namely, the RED AF score, AFTER score and the CHA2DS2-Vasc score, with the incorporation of new variables [1]. With that aim in mind I propose that syncope should be incorporated as a variable because the association of syncope and atrial fibrillation can be a predictor of sudden death. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 9, 2020 Category: Emergency Medicine Authors: Oscar M.P. Jolobe Source Type: research

Variation in opioid analgesia administration and discharge prescribing for emergency department patients with suspected urolithiasis
We examined opioid analgesic usage in ED patients with suspected urolithiasis across fifteen participating hospitals. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 9, 2020 Category: Emergency Medicine Authors: Anna E. Wentz, Ralph R.C. Wang, Brandon D.L. Marshall, Theresa I. Shireman, Tao Liu, Roland C. Merchant Source Type: research

Think about acute shisha carbon monoxide intoxication: that's one small step for the patient, one giant leap for our society
We report in this series 3 cases of acute carbon monoxide poisoning following active or passive consumption of chicha. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 9, 2020 Category: Emergency Medicine Authors: Nicolas Cazes, Caroline Duchier, S ébastien Beaume, Pascal Menot, Aurélien Renard, Frank Peduzzi Source Type: research

The authors' response: Propofol in COVID 19: From basic science to clinical impact
We thank you for your valuable comments on our manuscript. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 9, 2020 Category: Emergency Medicine Authors: Mitsuhito Soh, Toru Hifumi, Shutaro Isokawa, Masato Shimizu, Norio Otani, Shinichi Ishimatsu Source Type: research

An important caveat for all cases of suspected supraventricular tachycardia
The recruitment criteria in the recently reported randomised controlled trial specified that the participants should have narrow complex tachycardia with QRS duration (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 9, 2020 Category: Emergency Medicine Authors: Oscar M.P. Jolobe Source Type: research

The financial strain placed on America's hospitals in the wake of the COVID-19 pandemic
The current pandemic caused by the acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has profoundly impacted nearly every aspect of society. While mitigation strategies have curbed the spread of the disease caused by SARS-CoV-2, COVID-19, these policies have had deleterious effects on the United States (US) economy, leading to a large contraction in the Gross Domestic Product (GDP). Spending on healthcare services comprises a sizable portion of the GDP, reductions in GDP, driven by the current pandemic milieu, could potentially harm patients who still need timely, high-quality care. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 9, 2020 Category: Emergency Medicine Authors: Brad Boserup, Mark McKenney, Adel Elkbuli Source Type: research

Effect of heart failure on the outcome of COVID-19 — A meta analysis and systematic review
Several comorbidities have been associated with an increased risk of severity and mortality in coronavirus disease 2019 (COVID-19), including hypertension, diabetes, cerebrovascular disease, chronic kidney disease, and chronic obstructive pulmonary disease. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 9, 2020 Category: Emergency Medicine Authors: Emir Yonas, Idrus Alwi, Raymond Pranata, Ian Huang, Michael Anthonius Lim, Eddy Jose Gutierrez, Muhammad Yamin, Bambang Budi Siswanto, Salim S. Virani Source Type: research

Propofol in COVID 19 — From basic science to clinical impact
We read the case report by Soh et al. [1] and the comments of Sohn [2] with great interest. However, we would like to highlight some of the important actions of propofol and its current application to COVID-19 cases. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 9, 2020 Category: Emergency Medicine Authors: Subramanian Senthilkumaran, Koushik Murugan, Patne Sanjay, Ponniah Thirumalaikolundusubramanian Source Type: research

Characteristics of very elderly patients in the emergency department – A retrospective analysis
Elderly people, defined by age 65  years and older, made up 18.45% of the Swiss Population in 2018 and their number is projected to rise continuously. Data investigating specific characteristics of this patient subgroup, especially in the emergency setting, is scarce. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 9, 2020 Category: Emergency Medicine Authors: Bertram K. Woitok, Svenja Ravioli, Georg-Christian Funk, Gregor Lindner Source Type: research

Intramuscular medication for treatment of agitation in the emergency department: A systematic review of controlled trials
Severely agitated patients in the emergency department (ED) are often sedated with intramuscularly-administered medications. The evidence base underlying particular medication choices is surprisingly sparse, as existing reviews either have methodological limitations or have included data collected outside of emergent settings. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 9, 2020 Category: Emergency Medicine Authors: Allison Schneider, Samuel Mullinax, Nathanael Hall, Ashley Acheson, Alison H. Oliveto, Michael P. Wilson Source Type: research

A randomized cohort study of the efficacy of PO magnesium in the treatment of acute concussions in adolescents
Concussions are becoming a growing concern in society today with one out of every five adolescents being affected. This accounts for 1.6 to 3.8 million emergency department visits annually. The current standard of care involves an initial period of mental rest with symptomatic care and symptom-based return to daily activities/sports. High dose IV magnesium has been proven to be neuroprotective in severe TBI. We hypothesized that oral magnesium replacement following a concussion will decrease the overall symptomatic period allowing a quicker return to functional baseline. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 8, 2020 Category: Emergency Medicine Authors: Louis Standiford, Michael O'Daniel, Christopher Trigger, Matthew Hysell, Sam Wisniewski Source Type: research

The role of Chinese medicine in COVID-19 pneumonia: A systematic review and meta-analysis
Chinese medicine (CM) has been used to treat Novel Coronavirus 2019 (COVID-19) pneumonia in China. This meta-analysis was conducted to evaluate the clinical efficacy and safety of CM in the treatment of COVID-19 pneumonia. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 8, 2020 Category: Emergency Medicine Authors: Chun-Yang Sun, Ya-Lei Sun, Xin-Min Li Source Type: research

Cobra snakebite mimicking brain death treated with a novel combination of polyvalent snake antivenom and anticholinesterase: Case report
In toxicology literature, snake bites were the second toxicology-relevant cause mimicking brain death. A 57-year-old woman with history of cobra snake bite. On examination, the brain stem reflexes were absent with Glasgow coma score of 3. The patient accomplished full neurological recovery after using a novel combination of Polyvalent Snake Antivenom (PSA) and anticholinesterases. This case highlights a unique presentation of cobra bite induced brain death mimicking. Thus, intensivist should exclude neuroparalytic effect of snakebite before considering withdrawal of ventilatory support or organ donation. (Source: The Ameri...
Source: The American Journal of Emergency Medicine - July 6, 2020 Category: Emergency Medicine Authors: Musa S. ALfaifi, Atheer E. ALOtaibi, Ohood A. ALShahrani, Khalid M. ALSharani, Ali O. ALbshabshi, Hasan M. ALZahrani, Hadi E. ALAli Source Type: research

Amiodarone and/or lidocaine for cardiac arrest: A Bayesian network meta-analysis
Although available studies have not demonstrated that antiarrhythmic drugs could increase long-term survival or survival with favorable neurological outcome, some studies have shown that the rate of hospital admission is higher with amiodarone or lidocaine than with placebo. To study the effects of antiarrhythmic drugs during cardiac arrest, a meta-analysis was conducted to assess the efficacy of amiodarone and/or lidocaine. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 5, 2020 Category: Emergency Medicine Authors: Hongli Zhao, Kai Fan, Guilong Feng Source Type: research

Palliative care in the emergency department during a COVID-19 pandemic
The COVID-19 pandemic is challenging the healthcare system [1]. It is crucial for physicians to provide an opportunity for shared decision making and ascertain, without prejudice, a patient's goals of treatment and advanced directives [2]. Palliative care support at the point of initial care has the potential to play a vital role in assisting in ascertaining the patient's wishes for treatment, especially in the setting of a busy emergency department (ED). Palliative care specialists provide individualized, compassionate care including symptom control for those choosing to forgo aggressive interventions like ventilator supp...
Source: The American Journal of Emergency Medicine - July 5, 2020 Category: Emergency Medicine Authors: Jessica K. Eygnor, Alexander M. Rosenau, David B. Burmeister, David M. Richardson, Amy M. DePuy, Allison N. Kayne, Marna Rayl Greenberg Tags: Correspondence Source Type: research

Is novel coronavirus 2019 reinfection possible? Interpreting dynamic SARS-CoV-2 test results through a case report
Since December 2019, COVID-19, the clinical syndrome associated with SARS-CoV-2 infection, has infected more than 6.2 million people and brought the function of the global community to a halt. As the number of patients recovered from COVID-19 rises and the world transitions toward reopening, the question of acquired immunity versus the possibility of reinfection are critical to anticipating future viral spread. Here, we present a case of a patient previously recovered from COVID-19 who re-presents with new respiratory, radiographical, laboratory, and real-time reverse transcriptase-polymerase chain reaction (RT-PCR) findin...
Source: The American Journal of Emergency Medicine - July 4, 2020 Category: Emergency Medicine Authors: Nicole M. Duggan, Stephanie M. Ludy, Bryant C. Shannon, Andrew T. Reisner, Susan R. Wilcox Source Type: research

Guanfacine toxic ingestion with subsequent cardiogenic pulmonary edema: A case report
Guanfacine is a central alpha-2 agonist often prescribed for Attention-deficit hyperactive disorder as well as tic disorder, with a usual dose of 1 –4 mg per day. Due to its sympatholytic mechanism of action, Guanfacine can cause autonomic instability and hypotension. It can additionally cause cardiac dysfunction to include symptomatic bradycardias and contractility suppression. The authors present a case of a 17 year-old male with an ing estion of 80 mg of extended release Guanfacine with delayed onset cardiogenic pulmonary edema requiring mechanical ventilation. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 4, 2020 Category: Emergency Medicine Authors: Rachel E. Bridwell, Neil P. Larson, Jennifer B. Rosenthal, Jesse Wray, Zachary Baker, Amber Cibrario, Joshua J. Oliver Source Type: research

Prognostic performance of peripheral perfusion index and shock index combined with ESI to predict hospital outcome
Peripheral perfusion index (PPI) and shock index (SI) are considered valuable predictors of hospital outcome and mortality in various operative and intensive care settings. In the present study, we evaluated the prognostic capabilities of these parameters for performing emergency department (ED) triage, as represented by the emergency severity index (ESI). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 4, 2020 Category: Emergency Medicine Authors: Murat Da ş, Okan Bardakci, Duygu Siddikoğlu, Gökhan Akdur, Musa Caner Yilmaz, Okhan Akdur, Yavuz Beyazit Source Type: research

Influence of procedural factors on patient procedural pain in relation to diagnostic lumbar puncture
The aim of this study is to investigate the influence of local anesthetic (LA), operator experience level and needle type on patient procedural pain in relation to diagnostic lumbar puncture (LP). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 4, 2020 Category: Emergency Medicine Authors: R.B.A. S ørensen, M.J.V. Henriksen, T. Wienecke Source Type: research