Prehospital ECG transmission results in shorter door-to-wire time for STEMI patients in a remote mountainous region
Pre-hospital triage with ECG-transmission may reduce time to reperfusion in patients with ST-elevation acute myocardial infarction (STEMI). Less, however, is known on potential benefit of ECG-transmission triage in mountain areas, with complex orography. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 29, 2019 Category: Emergency Medicine Authors: Natale Daniele Brunetti, Annarita Dell'Anno, Alessandro Martone, Emanuela Natale, Brian Rizzon, Ottavio Di Cillo, Aldo Russo Source Type: research

Association between adopting emergency department crowding interventions and emergency departments' core performance measures
To estimate the association between adopting emergency department (ED) crowding interventions and emergency departments' core performance measures. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 29, 2019 Category: Emergency Medicine Authors: Amir Alishahi Tabriz, Justin G. Trogdon, Bruce J. Fried Source Type: research

Left ventricular assist devices and their complications: A review for emergency clinicians
End stage heart failure is associated with high mortality. However, recent developments such as the ventricular assist device (VAD) have improved patient outcomes, with left ventricular assist devices (LVAD) most commonly implanted. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 29, 2019 Category: Emergency Medicine Authors: Brit Long, Jennifer Robertson, Alex Koyfman, William Brady Source Type: research

Opioid free treatment algorithm for ED headache management: Effect on revisit rate
The opioid epidemic is a crisis leading to over utilization of resources within emergency departments (EDs). We assessed how implementation of an opioid-free headache and migraine treatment algorithm in the ED impacted patient centered outcomes. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 27, 2019 Category: Emergency Medicine Authors: Justin Miller, Laura Koons, Daniel Longyhore Source Type: research

Dysrhythmias and heart failure complicating acute myocardial infarction: An emergency medicine review
Patients with acute myocardial infarction (AMI) may suffer several complications after the acute event, including dysrhythmias and heart failure (HF). These complications place patients at risk for morbidity and mortality. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 27, 2019 Category: Emergency Medicine Authors: William T. Davis, Tim Montrief, Alex Koyfman, Brit Long Source Type: research

Bedside hand vein inspection for noninvasive central venous pressure assessment
Rapid estimates of the central venous pressure (CVP) can be helpful to administer early fluid therapy or to manage cardiac preload in intensive care units, operating rooms or emergency rooms in order to start and monitor an adequate medical therapy. Invasive CVP measurements have inherent and non-negligible complication rates as well as great expenditures. Several noninvasive methods of CVP measurements, like ultrasound-guided techniques, are available, but require trained skills and special equipment which might not be at hand in all situations. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 26, 2019 Category: Emergency Medicine Authors: Franziska Vogel, Daniel Staub, Markus Aschwanden, Martin Siegemund, Stephan Imfeld, Gianmarco Balestra, Hak Hong Keo, Heiko Uthoff Source Type: research

The controversial role of corticosteroids in septic shock
Several clinical trials and literature reviews have been conducted to evaluate the impact of corticosteroids on the physiological markers and clinical outcomes of patients in septic shock. While the findings have been somewhat contradictory, there is evidence of moderate benefit from the administration of low-dose corticosteroids to patients in septic shock. In this review, we discuss recent studies evaluating the impact of corticosteroids on morbidity and mortality in septic shock and explore future directions to fully elucidate when and how the administration of corticosteroid therapies can be beneficial. (Source: The Am...
Source: The American Journal of Emergency Medicine - April 26, 2019 Category: Emergency Medicine Authors: Ali Pourmand, Tess Whiteside, David Yamane, Amir Rashed, Maryann Mazer-Amirshahi Source Type: research

Public interest in medication-assisted treatment for opioid used disorder in the United States
Opioid-related drug overdose deaths (OD) in the United States (U.S.) continue to increase yearly [1]. Emergency departments (EDs) are the frontline for the overdose epidemic, as well as provide acute treatment for those with opioid withdrawal [2,3]. Evidence-based treatment for Opioid Use Disorder (OUD) exists for managing overdose and withdrawal, as well as for ongoing care with medication-assisted therapy (MAT) [4,5]. Given that emergency physicians are frontline providers in the epidemic, EDs have developing MAT programs for identification, management, and transitions of care [6,7]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 25, 2019 Category: Emergency Medicine Authors: Joshua D. Niforatos, Alexander R. Zheutlin, Richard M. Pescatore, Ali S. Raja Source Type: research

Delayed diagnosis of splenic injuries: A case series
This study was undertaken to describe cases of delayed diagnosis, and to identify factors associated with delayed diagnosis, treatment, and outcomes. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 25, 2019 Category: Emergency Medicine Authors: Catherine A. Marco, Matthew Gangidine, Peter J. Greene, Daniel Taitano, Michael B. Holbrook, Michael Ballester Source Type: research

Editorial Board
(Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 24, 2019 Category: Emergency Medicine Source Type: research

Table of Contents
(Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 24, 2019 Category: Emergency Medicine Source Type: research

Info for authors
(Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 24, 2019 Category: Emergency Medicine Source Type: research

Reduction in unnecessary CT scans for head-injury in the emergency department using an FDA cleared device
Emergency Department (ED) visits for mild Traumatic Head Injury (mTBI) have greatly increased due to more awareness of potential consequences of such injuries [1]. While the vast majority (>80%) of mTBI patients who go to the ED receive a head CT scan,>90% of them are found to be negative [2]. This practice unnecessarily exposes these patients to radiation, increases the use of ED resources, and lengthens throughput times [3]. The integration of reliable, objective predictors of intracranial injury for making important initial assessment decisions [4] can impact significantly on this practice. (Source: The American J...
Source: The American Journal of Emergency Medicine - April 24, 2019 Category: Emergency Medicine Authors: Rosanne Naunheim, Monique Konstantinovic Koscso, Robert Poirier Source Type: research

Reduction in unnecessary CT scans head-injury in the emergency department using an FDA cleared device
Emergency Department (ED) visits for mild Traumatic Head Injury (mTBI) have greatly increased due to more awareness of potential consequences of such injuries [1]. While the vast majority (>80%) of mTBI patients who go to the ED receive a head CT scan,>90% of them are found to be negative [2]. This practice unnecessarily exposes these patients to radiation, increases the use of ED resources, and lengthens throughput times [3]. The integration of reliable, objective predictors of intracranial injury for making important initial assessment decisions [4] can impact significantly on this practice. (Source: The American J...
Source: The American Journal of Emergency Medicine - April 24, 2019 Category: Emergency Medicine Authors: Rosanne Naunheim, Monique Konstantinovic Koscso, Robert Poirier Source Type: research

Feasibility of point-of-care knee ultrasonography for diagnosing anterior cruciate and posterior cruciate ligament tears in the ED
To evaluate the feasibility of point-of-care knee ultrasonography (POCUS) compared with knee magnetic resonance imaging (MRI) for diagnosing anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) tears in patients with acute knee trauma. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 24, 2019 Category: Emergency Medicine Authors: Sun Hwa Lee, Seong Jong Yun Source Type: research

Buprenorphine charges to uninsured patients at top-ranked U.S. hospitals
Opioid-related overdose deaths (OD) in the United States (U.S.) have increased substantially [1], with counties with increased poverty and unemployment rates at higher risk [2]. Evidence-based treatment for Opioid Use Disorder (OUD) exists, such buprenorphine (a partial opioid agonist medication), and can be initiated in the Emergency Department (ED) and hospital settings [3-5]. Although the majority of Medicare Part B plans cover buprenorphine, the medication can be prohibitively expensive for uninsured patients [6-8]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 24, 2019 Category: Emergency Medicine Authors: Joshua D. Niforatos, Stephen C. Dorner, Richard M. Pescatore, Ali S. Raja Source Type: research

Serial measurement of glyphosate blood concentration in a glyphosate potassium herbicide-intoxicated patient: A case report
This report describes changes in blood and urine concentrations of glyphosate potassium over time and their correlations with clinical symptoms in a patient with acute glyphosate potassium poisoning. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 24, 2019 Category: Emergency Medicine Authors: Yongchul Cho, Wonjoon Jeong, Suncheun Kim, Hyunsoo Choi, Yeonho You, Sunguk Cho, Sekwang Oh, Hongjoon Ahn, Jungsoo Park, Jinhong Min Source Type: research

Can physicians detect hyperkalemia based on the electrocardiogram?
The objective of this study is to evaluate if physicians are able to detect hyperkalemia based on the ECG. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 22, 2019 Category: Emergency Medicine Authors: Zubaid Rafique, Jorge Aceves, Ilse Espina, Frank Peacock, David Sheikh-Hamad, Dick Kuo Source Type: research

ECPR in acute aortic dissection – Really a no-go?
The use of extracorporeal membrane oxygenation (ECMO) [1] and its implementation into institutional protocols for extracorporeal cardiopulmonary resuscitation (ECPR) is rapidly increasing [1-3]. One of the commonly reported contraindications of veno-arterial ECMO is acute aortic dissection, however no studies on feasibility, safety and efficacy of ECPR in this condition exist. In this context we read with great interest the report of Kelly et al. in the Journal [4]. While we fully agree that transesophageal echocardiography (TEE) is still underutilized especially in emergency medicine and intensive care, the decision again...
Source: The American Journal of Emergency Medicine - April 22, 2019 Category: Emergency Medicine Authors: L. Christian Napp, Andreas Martens Source Type: research

Reply to: ECPR in acute aortic dissection - Really a no-go?
We thank the authors for their reply and interest to our case report on using transthoracic echocardiography to identify an acute aortic dissection during ECMO initiation [1]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 22, 2019 Category: Emergency Medicine Authors: Christopher Kelly, Patrick Ockerse Source Type: research

Growth-differentiation factor-15 predicts adverse cardiac events in patients with acute coronary syndrome: A meta-analysis
We aimed to analyse the association between high-level growth-differentiation factor-15 (GDF-15) and mortality, recurrent MI and heart failure compared to low-level GDF-15 in patients with acute coronary syndrome (ACS). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 19, 2019 Category: Emergency Medicine Authors: Yabo Wang, Chao Zhen, Rui Wang, Ge Wang Source Type: research

Life-threatening massive empyema: A novel complication of intrathoracic omental herniation
Intrathoracic omental herniation (ITOH) is the herniation of the omentum through the esophageal hiatus without herniation of the stomach. It is a rare disease and serious complications due to ITOH have not been reported in the literature. Here, we reported the case of 47-year old man who presented to the emergency department with dyspnea and chest pain. Enhanced computed tomography (CT) demonstrated a large retrocardiac mass and ITOH was suspected. During the observation period in the emergency department, the patient's condition rapidly deteriorated. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 18, 2019 Category: Emergency Medicine Authors: Il Jae Wang, Sung Wook Park, Junepill Seok, Up Huh, Seunghwan Song, Hyo Yeong Ahn Source Type: research

Plasma oxidative-stress parameters and prolidase activity in patients with various causes of abdominal pain
We aimed to investigate the predictive power of plasma prolidase activity and oxidative-stress parameters for distinguishing in patients with various causes of non-traumatic abdominal pain who presented to the emergency department. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 16, 2019 Category: Emergency Medicine Authors: Levent Albayrak, Ozgur Sogut, S ümeyye Çakmak, Mehmet Tahir Gökdemir, Halil Kaya Source Type: research

Stop the bleed training outreach initiatives targeting high school students: It takes a community to save a life
Over the last several years, there has been an increase in mass shootings in the United States [1-3]. Although emergency response times are often (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 16, 2019 Category: Emergency Medicine Authors: Adel Elkbuli, Brianna Dowd, Astrid Casin, Madonna Stotsenburg, Tony Zitek, Mark McKenney, Dessy Boneva Source Type: research

Narrowing performance gap between rural and urban hospitals for acute myocardial infarction care
This study sought to determine if the population density of the county where Medicare patients were hospitalized following AMI predicted short-term outcomes and to quantify longitudinal changes in hospital performance on quality of care metrics. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 15, 2019 Category: Emergency Medicine Authors: Fares Alghanem, John M. Clements Source Type: research

The difference of subcutaneous digital nerve block method efficacy according to injection location
This study compared the efficacy levels of the subcutaneous method according to the different injection sites. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 15, 2019 Category: Emergency Medicine Authors: Sungwoo Choi, Young Soon Cho, Bora Kang, Gi Woon Kim, Sangsoo Han Source Type: research

Accuracy of patient self-administered medication history forms in the emergency department
The primary objective of this study was to determine the proportion of patients with medication discrepancies when using a self-administered medication history form in the emergency department (ED). The secondary objectives were to identify predictors of medication discrepancies and determine the proportion of patients with a high-risk medication discrepancy. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 13, 2019 Category: Emergency Medicine Authors: Angela Wai, Martina Salib, Sohileh Aran, James Edwards, Asad E. Patanwala Source Type: research

Pyogenic sacroiliitis: A rare complication of inflammatory bowel disease
We report a case of pyogenic sacroiliitis in a patient with Crohn's disease caused by Clostridia spp. and discuss key clinical components and protocol for the successful evaluation, diagnosis, and treatment of this uncommon illness. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 13, 2019 Category: Emergency Medicine Authors: Mariah Barnes, Colleen Bush, Jeffrey Jones Source Type: research

Comparing the effects of 3 oxygen delivery methods plus intravenous ketorolac on primary headaches: A randomized clinical trial
To compare three different oxygen therapy methods in primary headaches. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 13, 2019 Category: Emergency Medicine Authors: Morteza Saeedi, Seyed Mohammad Shahvaran, Mahtab Ramezani, Hossein Rafiemanesh, Ehsan Karimialavijeh Source Type: research

Distinct subgroups of emergency department frequent users: A latent class analysis
Emergency department (ED) frequent users have high resource utilization and associated costs. Many interventions have been designed to reduce utilization, but few have proved effective. This may be because this group is more heterogeneous than initially assumed, limiting the effectiveness of targeted interventions. The purpose of this study was to identify and describe distinct subgroups of ED frequent users and to estimate costs to provide hospital-based care to each group. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 13, 2019 Category: Emergency Medicine Authors: Lauren Birmingham, Vinay K. Cheruvu, Jennifer A. Frey, Kirk A. Stiffler, Jonathan VanGeest Source Type: research

Bug off! Severe toxicity following inhalational exposure to N, N-diethyl-meta-toluamide (DEET)
We report a patient with severe toxicity following inhalational exposure to a “bug bomb”.containing 98% DEET. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 12, 2019 Category: Emergency Medicine Authors: Erica M. Tavares, Bryan S. Judge, J.S. Jones Source Type: research

Safety and effectiveness of intravenous prochlorperazine for intractable vomiting in children with gastroenteritis
Prochlorperazine (PCZ) was first introduced as an anti-psychotic in the 1950s, and subsequently found to be effective to control vomiting. It is a weak dopamine receptor blocker and depresses the chemoreceptor trigger zone (1). Although pediatric studies are limited, research suggests the medication is effective to prevent vomiting, the need for intravenous fluids, and hospital admission. The majority of recent literature has focused on the use of PCZ for the treatment of migraine headaches in young people [2-4]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 12, 2019 Category: Emergency Medicine Authors: Lindsey Ouellette, Bryan Judge, Angela Zamarripa, Patrick McFadden, Jeffrey Jones Source Type: research

Effects of 20-degree spinal immobilization on respiratory functions in otherwise healthy volunteers with android-type obesity
The aim of the study was to assess whether spinal immobilization with long back board (LBB) and semi-rigid cervical collar (CC) at 20 ° instead of 0° conserves pulmonary functions in obese volunteers, including forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 12, 2019 Category: Emergency Medicine Authors: G ülşah Çıkrıkçı Işık, Osman Lütfi Demirci, Şeref Kerem Çorbacıoğlu, Yunsur Çevik Source Type: research

Hiccups as the only symptom of acute myocardial infarction
Hiccups are usually benign, while myocardial infarction (MI) has the potential for morbidity and mortality. Here, we report 3 cases of MI, with hiccups being the only symptom on presentation to the emergency department. Attention should be given to patients who present with hiccups and multiple risk factors for acute coronary syndrome, especially those with factors predisposing them to atypical presentations, such as diabetes mellitus, and old age. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 12, 2019 Category: Emergency Medicine Authors: Chih-Chun Kao, David Hung-Tsang Yen, Yi-Tzu Lee Source Type: research

Cardiopulmonary resuscitation ameliorates myocardial mitochondrial dysfunction in a cardiac arrest rat model
This study aimed to observe the dynamic changes of myocardial mitochondrial function and metabolic disorders during cardiac arrest (CA) and following cardiopulmonary resuscitation (CPR). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 12, 2019 Category: Emergency Medicine Authors: Wen Xu, Yue Fu, Longyuan Jiang, Zhengfei Yang, Yue Wang, Wanchun Tang, Xiangshao Fang Source Type: research

Quality retention of chest compression after repetitive practices with or without feedback devices: A randomized manikin study
This study was designed to investigate whether an audiovisual feedback (AVF) device is beneficial for quality retention of chest compression (CC) after repetitive practices (RP). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 12, 2019 Category: Emergency Medicine Authors: Xian-Long Zhou, Jing Wang, Xiao-Qing Jin, Yan Zhao, Rui-Ling Liu, Cheng Jiang Source Type: research

Effect of infarct site on the clinical endpoints of thrombolytic-treated ST-elevation myocardial infarction
Some studies suggest better outcomes after the use of thrombolytics in inferior ST-elevation myocardial infarction (STEMI) compared to other locations. The goal of this study is to compare the clinical endpoints of thrombolytic-treated STEMI based on coronary artery distribution. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 12, 2019 Category: Emergency Medicine Authors: Kristina Gifft, Mary Dohrmann, Mohammad Eniezat, Tariq Enezate Source Type: research

Anomalous left anterior descending artery diagnosed on pulmonary artery computed tomography
Typically, the left anterior descending artery (LAD) and left circumflex artery (LCX) arise from the left main coronary artery.However, uncommon coronary anomalies may be found in clinical practice. This case presents with a rare finding where the LAD originates from the right coronary artery (RCA) separately from the LCX and takes an interarterial pathway to reach its perfusion territory.A 49-year-old Hispanic female with hypertension and diabetes mellitus presented to the emergency department with a 7-day history of chest pain. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 12, 2019 Category: Emergency Medicine Authors: John Kim, Taylor Bergman, Andrew L. Juergens Source Type: research

Initial evaluation and management of wide-complex tachycardia: A simplified and practical approach
The evaluation and treatment of wide QRS-complex tachycardia remains a challenge, and mismanagement is quite common. Diagnostic aids such as wide-complex tachycardia algorithms perform poorly in the real-life setting. The purpose of this review is to offer a simple clinical-electrocardiographic approach for the initial evaluation and management of the adult patient with stable wide-complex tachycardia that does not require recollection of complex guidelines or algorithms. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 12, 2019 Category: Emergency Medicine Authors: Laszlo Littmann, Elizabeth G. Olson, Michael A. Gibbs Source Type: research

A systematic review of foam dressings for partial thickness burns
Partial thickness burns are the most common form of thermal burns. Traditionally, dressing for these burns is simple gauze with silver sulfadiazine (SSD) changed on a daily basis. Foam dressings have been proposed to offer the advantage of requiring less frequent dressing change and better absorption of exudates. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 11, 2019 Category: Emergency Medicine Authors: Praneetha Chaganti, Isaac Gordon, Jennifer H. Chao, Shahriar Zehtabchi Source Type: research

Factors associated with serious bacterial infections in infants ≤60 days with hypothermia in the emergency department
We sought to investigate risk factors for serious bacterial infection (SBI: bacterial meningitis, bacteremia, and urinary tract infection [UTI]) among infants ≤60 days of age presenting to the emergency department (ED) with hypothermia (temperature  (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 11, 2019 Category: Emergency Medicine Authors: Sriram Ramgopal, Lorne Walker, Melissa A. Vitale, Andrew J. Nowalk Source Type: research

A-scan ultrasonography to detect intracranial hypertension in patients with hyponatremia
Dear Editor, (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 10, 2019 Category: Emergency Medicine Authors: Livio Vitiello, Maddalena De Bernardo, Nicola Rosa Source Type: research

Type A aortic dissection associated with tension pneumothorax
A 61-year-old man presented to the emergency department of the University of Fukui Hospital because of sudden-onset chest and back pain. Three days prior to presentation, he suddenly experienced back pain followed by dyspnea on exertion. He denied any traumatic episodes and significant medical history. He had never undergone clinical evaluation. He had a smoking history of 20  pack-years. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 10, 2019 Category: Emergency Medicine Authors: Takashi Nihira, Naoki Yamada Source Type: research

Inferior lumbar triangle hernia with incarceration
Lumbar hernia is a rare condition in which intra or extraperitoneal tissue protrudes through a defect in the posterolateral region of the flank. Incarceration is uncommon but represents a surgical emergency when present. A 54-year-old-male presented to the ED after sudden onset left flank pain after coughing. He was in significant distress secondary to pain and vomiting, and his physical exam revealed a tender mass in his left lateral lumbar region near the site of a previous stab wound. Bedside ultrasound revealed a fluid-filled structure, and CT scan demonstrated herniation of small bowel though the inferior lumbar trian...
Source: The American Journal of Emergency Medicine - April 10, 2019 Category: Emergency Medicine Authors: Ran R. Pang, Andrew L. Makowski Source Type: research

Iatrogenic pediatric hydroxocobalamin overdose
Hydroxocobalamin, a precursor molecule to vitamin B12, has emerged as the preferred empiric treatment for patients rescued from enclosed-space fires with concern for inhalational injury and potential concomitant cyanide toxicity. Limited data exist on the effects of hydroxocobalamin toxicity, particularly in pediatric patients. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 10, 2019 Category: Emergency Medicine Authors: Benjamin T. Friedman, Betty C. Chen, Andrew J. Latimer, Matthew J. Valento Source Type: research

Kasabach-Merritt syndrome arising from a vascular fistula
A 58-year-old woman presented with gum bleeding, hematuria, and cutaneous ecchymoses. Left hip replacement had been performed five years prior. The overall findings of our work-up were consistent with ongoing DIC triggered by the presence of an arterio-venous left femoral fistula. The patient was treated successfully with fresh frozen plasma, the fistula was surgically repaired and a stent was placed. On the second day, bleeding had resolved and laboratory values reverted to normal. This uncommon scenario is reminiscent of the Kasabach –Merritt syndrome and well illustrates that patients with an arterio-venous fistul...
Source: The American Journal of Emergency Medicine - April 10, 2019 Category: Emergency Medicine Authors: Giuseppe Famularo, Michele Galluzzo, Pierfrancesco Ottaviani, Patrizia Tarsitani Source Type: research

Antibiotic selection and isolate susceptibility profile in patients who failed ciprofloxacin or TMP-SMX for pyelonephritis
We read with interest the retrospective study by Vogler and Pavich assessing treatment failure in women diagnosed with uncomplicated pyelonephritis who were discharged from the emergency department (ED) on an oral fluoroquinolone (FQ) or trimethoprim-sulfamethoxazole (TMP-SMX) versus an oral cephalosporin. The primary endpoint of treatment failure occurred in 0% of patients receiving an oral cephalosporin and 23% of patients receiving FQ or TMP-SMX [1]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 9, 2019 Category: Emergency Medicine Authors: William R. Truong, Kimberly J. Won, Jason Yamaki Tags: Correspondence Source Type: research

Mechanical, inflammatory, and embolic complications of myocardial infarction: An emergency medicine review
Despite the declining incidence of coronary heart disease (CHD) in the United States, acute myocardial infarction (AMI) remains an important clinical entity, with many patients requiring emergency department (ED) management for mechanical, inflammatory, and embolic complications. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 8, 2019 Category: Emergency Medicine Authors: Tim Montrief, William T. Davis, Alex Koyfman, Brit Long Source Type: research

Throwing it in reverse: An update on reversal of oral factor Xa inhibitors
In recent years, the use of oral Factor Xa (FXa) inhibitors such as rivaroxaban and apixaban, have seen more extensive utilization for stroke prevention in non-valvular atrial fibrillation and the prevention/treatment of venous thromboembolisms [1,2]. Some studies have shown a similar bleed risk between FXa inhibitors and warfarin while other studies demonstrated a decreased risk for a bleed with FXa inhibitors. Despite a possible decreased risk, the paucity of data available for treating an acute major bleed due to FXa inhibitors has led some clinicians to shy away from their use. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 8, 2019 Category: Emergency Medicine Authors: Brian W. Gilbert, Jacob A. Reeder, Mohammed A. Alkhalifah, David A. Moran, Michael A. Corvino Source Type: research

Developing neural network models for early detection of cardiac arrest in emergency department
Automated surveillance for cardiac arrests would be useful in overcrowded emergency departments. The purpose of this study is to develop and test artificial neural network (ANN) classifiers for early detection of patients at risk of cardiac arrest in emergency departments. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 7, 2019 Category: Emergency Medicine Authors: Dong-Hyun Jang, Joonghee Kim, You Hwan Jo, Jae Hyuk Lee, Ji Eun Hwang, Seung Min Park, Dong Keon Lee, Inwon Park, Doyun Kim, Hyunglan Chang Source Type: research