Atypical presentation of COVID-19
Dear Editor, we found that the publication on “Abdominal and testicular pain: An atypical presentation of COVID-19” is very interesting [1]. Kim et al. noted that “HCW's need to be vigilant of atypical presentations of COVID-19 and consider full PPE for all patients as community spread increases [1].” In fact, atypical and uncommon clin ical presentation of COVID-19 is possible and it is usually under recognized [2]. A main pitfall in clinical practice is under diagnosis of COVID-19 patients with mild or no symptoms. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 10, 2020 Category: Emergency Medicine Authors: Beuy Joob, Viroj Wiwanitkit Source Type: research

Identifying ED patients with previous abnormal HIV or hepatitis C test results who may require additional services
Routine emergency department (ED) HIV or HCV screening may inadvertently capture patients already diagnosed but does not specifically prioritize identification of this group. Our objective was to preliminarily estimate the volume of this distinct group in our ED population through a pilot electronic health record (EHR) build that identified all patients with indications of HIV or HCV in their EHR at time of ED presentation. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 10, 2020 Category: Emergency Medicine Authors: Andrew H. Ruffner, Rachel M. Ancona, Catherine Hamilton, Francisco J. Fernandez, Kiran A. Faryar, Bennett H. Lane, Michael S. Lyons Source Type: research

Case report of an unusual cause of chest pain in a 33  year old male
We present the case of chest pain in a 33  year old male reporting no significant past medical history who developed spontaneous massive hemothorax while being evaluated in the ED. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 7, 2020 Category: Emergency Medicine Authors: John Lafleur, Adam Rutenberg Source Type: research

Heart rate outcomes with concomitant parenteral calcium channel blockers and beta blockers in rapid atrial fibrillation or flutter
Patients who present with atrial fibrillation (AF) or flutter with rapid ventricular response (RVR) and hemodynamic stability may be managed with either an intravenous (IV) nondihydropyridine calcium channel blocker (CCB) or a beta-blocker (BB). Patients without improved heart rates may need to switch to, or add, a second AV nodal blocker. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 7, 2020 Category: Emergency Medicine Authors: Shuroug A. Alowais, Bryan D. Hayes, Susan R. Wilcox, Jennifer Le, Jennifer L. Koehl, Lanting Fuh Source Type: research

Case report of an unusual cause of chest pain in a 33  year old male
We present the case of chest pain in a 33  year old male reporting no significant past medical history who developed spontaneous massive hemothorax while being evaluated in the ED. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 7, 2020 Category: Emergency Medicine Authors: John Lafleur, Adam Rutenberg Source Type: research

An unusual presentation of pulmonary artery sarcoma: Several pseudoaneurysms with massive hemoptysis
A 53-year-old woman was admitted to the emergency department with sudden onset of massive hemoptysis. She had previous history of dyspnea and cough for two months. She had no history of chronic disease, smoking, or use of anticoagulant and antiplatelet drugs. On arrival, she was tachycardic and tachypneic, but her body temperature was normal. Chest X-ray showed enlarged right hilus and multiple nodular opacities predominantly in the left lung basis. Computed tomography (CT) scan of the chest demonstrated massive intraluminal filling defect extending from the right pulmonary artery through the main and left pulmonary arteri...
Source: The American Journal of Emergency Medicine - May 7, 2020 Category: Emergency Medicine Authors: Oguzhan Yildiz, Emre Unal, Turkmen Turan Ciftci, Devrim Akinci, Orhan Macit Ariyurek Source Type: research

Non-tuberculosis cold abscess
An 85-year-old cachectic man was found unconscious in his home. He had no specific medical history. On arrival, he was in a deep coma and hypothermic state. He had a soft mass the size of his fist in the right lower abdomen without redness or heat. Truncal computed tomography revealed subcutaneous fluid collection with gas formation. A test puncture for right lower abdominal subcutaneous fluid collection revealed pus, so an open incision was performed, with the administration of broad-spectrum antibiotics. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 7, 2020 Category: Emergency Medicine Authors: Ken-ichi Muramatsu, Hiroki Nagasawa, Yuta Murai, Mutsumi Sakurada, Kei Jitsuiki, Youichi Yanagawa Source Type: research

Emergency Burr Hole utilizing the EZ-IO ™ drill: A pilot cadaver study
Delayed surgical care increases mortality and worsens neurologic outcomes in patients with an Epidural Hematoma (EDH) that are deteriorating and showing signs of herniation or coma [1-4]. This procedure and the equipment used are rarely encountered in the Emergency Department (ED) and may not be as familiar to the Emergency Medicine Physician as the EZ-IO ™ (EZ-IO™, Teleflex) drill they commonly use to obtain intraosseous (IO) access. There now have been two case reports describing the use of the EZ-IO™ drill in lieu of the traditional Emergency Burr hole procedure in patients with an EDH who are rapidly ...
Source: The American Journal of Emergency Medicine - May 7, 2020 Category: Emergency Medicine Authors: Mark L. Gustafson, Jerry Edwards, Alfred Tager Source Type: research

Clinical use of copeptin in migraine patients admitted to the emergency department
The purpose of this study was to investigate the clinical use of copeptin to evaluate migraine attacks in the Emergency Department. An additional aim was to detect changes in serum copeptin levels in migraine patients during attack and attack-free periods. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 7, 2020 Category: Emergency Medicine Authors: Derya Yal çın Yılmaz, Hamit Hakan Armağan, Kıvanç Karaman, Fevziye Burcu Şirin, Mustafa Bozkurt, Adnan Karaibrahimoğlu, İsa Gökhan Yalçın, Nesrin Gökben Beceren, Önder Tomruk Source Type: research

Effects of ultrasound-guided techniques for radial arterial catheterization: A meta-analysis of randomized controlled trials
This study aimed to evaluate whether ultrasound-guided techniques are superior compared to traditional palpation techniques in patients undergoing radial artery catheterization (RAC). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 6, 2020 Category: Emergency Medicine Authors: Wenli Zhao, Huizhen Peng, Haiyun Li, Yinping Yi, Yufeng Ma, Yingkun He, Hongmei Zhang, Tianxiao Li Source Type: research

High early phase hemoglobin level is associated with favorable neurological outcome in patients with severe traumatic brain injury
The appropriate hemoglobin (Hb) level threshold for the early phase (i.e. from Emergency Department to ICU admission) in patients with severe traumatic brain injury (TBI) is still unknown. Therefore, we aimed to examine the association between Hb levels during the early phase and neurological outcomes in patients with severe TBI using data from the Brain Hypothermia (B-HYPO) Study Group. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 6, 2020 Category: Emergency Medicine Authors: Toru Hifumi, Kentaro Nakamura, Yasuhiro Kuroda, Kenya Kawakita, Motoki Fujita, Susumu Yamashita, Kenji Dohi, Hitoshi Kobata, Eiichi Suehiro, Tsuyoshi Maekawa, Brain Hypothermia (B-HYPO) Study Group in Japan Source Type: research

Non-evidenced based treatment: An unintended cause of morbidity and mortality related to COVID-19
In light of the Coronavirus Disease 2019 (COVID-19) pandemic, world leaders and the media have propelled various treatment modalities that have not been approved by the US Food and Drug Administration (FDA) to prevent or cure acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Such treatments include nucleotide analogs (remdesivir), anti-malarial drugs (chloroquine and hydroxychloroquine), protease inhibitors (lopinavir/ritonavir), interferon- β, nonsteroidal anti-inflammatory drugs (NSAIDs), and renin angiotensin aldosterone system (RAAS) antagonists [1-3]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 6, 2020 Category: Emergency Medicine Authors: Hamidreza Reihani, Mateen Ghassemi, Maryann Mazer-Amirshahi, Bandar Aljohani, Ali Pourmand Source Type: research

Use of drape/patient covering during potentially aerosolizing procedures
The rise of the novel coronavirus, SARS-CoV-2 or COVID-19, pandemic has illustrated the potential for the rapid spread of a highly infectious disease, both among lay people and healthcare workers. Early evidence of broad aerosolization of the virus in the hospital setting [1], coupled with demonstrated aerosolization with resuscitative and procedural interventions in the hospital setting of the SARS virus [2,3], has raised concern among healthcare workers regarding the use of advanced personal protective equipment (PPE) in the performance of such procedures [4]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 6, 2020 Category: Emergency Medicine Authors: Bryant Allen, Chris Gardner, Colin O'Neill, Michael Gibbs Source Type: research

Gun violence during COVID-19 pandemic: Paradoxical trends in New York City, Chicago, Los Angeles and Baltimore
COVID-19 has been declared a pandemic by the World Health Organization (WHO). The structure of daily life for most individuals in the United States (US) has changed dramatically. Businesses, schools, and entire industries have been forced to substitute in-person activities for remote/virtual replacements in compliance with recommendations of social distancing from the CDC. This practice has decreased the COVID-19 transmission and is essential to the eventual resolution of this pandemic [1]. As people practice social distancing, the trends of traumatic injuries are changing as well, with fewer vehicle related crashes and in...
Source: The American Journal of Emergency Medicine - May 6, 2020 Category: Emergency Medicine Authors: Mason Sutherland, Mark McKenney, Adel Elkbuli Source Type: research

Spontaneous celiac artery dissection
is a rare visceral artery dissection that typically presents with acute abdominal or flank pain. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 5, 2020 Category: Emergency Medicine Authors: Jessica R. Hoglund, Joseph H. Blackwell, Michael A. Gibbs Source Type: research

“I Felt Invisible Most of the Time”: Communication and satisfaction among patients treated in emergency department hallway beds
Hallway placement (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 4, 2020 Category: Emergency Medicine Authors: Seiichi Villalona, Cirenio Cervantes, Carol Boxtha, Wm. Alex Webb, Jason W. Wilson Tags: Correspondence Source Type: research

The financial implications of variability in decision to disposition times for patients placed in observation status
This study attempts to evaluate implications of variable decision-making for those patients placed in observation status for throughput and financial implications. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 4, 2020 Category: Emergency Medicine Authors: Richard Martin, Kraftin E. Schreyer Source Type: research

The relationship between two laboratory assays: High sensitivity troponin T and N-terminal pro-brain natriuretic peptide
This study sought to examine the relationship between two laboratory assays, hsTnT and N-terminal pro-brain natriuretic peptide (NT-proBNP), a marker for CHF, in patients prese nting to the ED. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 4, 2020 Category: Emergency Medicine Authors: Navkiranjot Kaur, Andrew Singletary, Rakesh Engineer, Amy S. Nowacki, Baruch S. Fertel, Courtney M. Smalley Source Type: research

Non-pharmacologic interventions improve comfort and experience among older adults in the Emergency Department
Determine if a comfort cart would improve older adults' comfort and facilitate communication during Emergency Department (ED) visits. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 4, 2020 Category: Emergency Medicine Authors: Isabella M. Lichen, Michelle J. Berning, Susan M. Bower, Jessica A. Stanich, Molly M. Jeffery, Ronna L. Campbell, Laura E. Walker, Fernanda Bellolio Source Type: research

High-flow nasal cannula oxygen therapy in acute respiratory failure at Emergency Departments: A systematic review
The use of high-flow oxygen therapy (HFOT) through nasal cannula for the management of acute respiratory failure at the emergency department (ED) has been only sparsely studied. We conducted a systematic review of randomized-controlled and quasi-experimental studies comparing the early use of HFOT versus conventional oxygen therapy (COT) in patients with acute respiratory failure admitted to EDs. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 4, 2020 Category: Emergency Medicine Authors: Nicolas Marjanovic, J érémy Guénézan, Jean-Pierre Frat, Olivier Mimoz, Arnaud W. Thille Source Type: research

Impact of triage liaison provider on emergency department throughput: A systematic review and meta-analysis
Emergency department (ED) overcrowding is linked to poor outcome and decreases patient satisfaction. Strategies to control Emergency department (ED) overcrowding has been subject of research. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 3, 2020 Category: Emergency Medicine Authors: Roshanak Benabbas, Rushabh Shah, Bobak Zonnoor, Ninfa Mehta, Richard Sinert Source Type: research

Prevalence of IgG antibodies to SARS-CoV-2 among emergency department employees
The prevalence of antibodies to SARS-CoV-2, the virus which causes Coronavirus disease 2019 (COVID-19), among healthcare personnel is unclear. A recent study noted an unadjusted prevalence of 1.5% of SARS-CoV-2 antibodies using a point of care test in a community surveillance study in Santa Clara, CA [1]. Other community surveillance projects have reported varying rates of COVID-19 antibody seropositivity, and were as high as 32% in an area of Boston considered a hot spot for COVID-19 [2-4]. Healthcare personnel may have a higher risk of exposure to COVID-19 than the general population. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 3, 2020 Category: Emergency Medicine Authors: Troy Madsen, Nicholas Levin, Karla Niehus, Karen Law, Jeanmarie Mayer, Matthew Chapman, Austin Johnson, Stephen Hartsell Source Type: research

Spanish proficiency and interpreter use among emergency providers: A survey study
For patients with limited English proficiency (LEP), language barriers can obstruct the provision of high-quality emergency care. While use of formal interpreter services has been shown to improve communication, many clinicians are reluctant to use these for practical reasons. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 3, 2020 Category: Emergency Medicine Authors: William A. Berk, Katleen S. Lozada, Ben A. McVane, Marc A. Probst Source Type: research

Cardiopulmonary resuscitation may cause paradoxical embolism
This paper reports a case of paradoxical embolism of right heart thrombi visualized on transesophageal echocardiography during cardiopulmonary resuscitation (CPR). CPR may cause a right-to-left shunt by producing a sudden increase in right atrial pressure during the compression phase. In cardiac arrest patients with right heart thrombi who have received CPR, systemic embolization can occur owing to paradoxical embolism. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 3, 2020 Category: Emergency Medicine Authors: Sun Ju Kim, Yunseob Kim, Kyo Jin Ahn, Sung Oh. Hwang Source Type: research

N,N-Dimethyltryptamine: A brief case series of DMT-induced psychosis
We report the cases of two young male patients with no prior psychiatric history who presented to an urban academic emergency department (ED) with psychotic symptoms after consumption of DMT. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 3, 2020 Category: Emergency Medicine Authors: David Barbic, Justin Fernandes, Caroline Eberdt, Apu Chakraborty Source Type: research

The impact on outcomes of the ACS committee on trauma delayed trauma center verifications secondary to COVID19
As this report is being written (04/09), there are 1.51 million confirmed COVID-19 cases worldwide, and 434,114 in the United States. The healthcare system is overwhelmed by patient volume and changing guidelines during this uncertain time [1]. As a result, the ability of trauma centers to care for critically injured patients will be affected. To alleviate the burden on trauma center preparation for triennial verification, the American College of Surgeons Committee on Trauma (ACS-COT) has granted extensions for trauma centers that are verified or applying for verification [2]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 3, 2020 Category: Emergency Medicine Authors: Amanda Baroutjian, Mark McKenney, Adel Elkbuli Source Type: research

Sleep deprivation hormesis: The shift that doesn't kill you makes you stronger
Emergency medicine approximates a prehistoric human schedule. Our ancestors spent most of their time walking, socializing, relaxing, and conserving energy [1]. When motivated, they could sprint away from a tiger or toward a mammoth. Humans fasted for hours or days, then consumed large amounts of food when they found a beehive or large mammal. Primitive humans faced a range of discomfort in their environments. Without gas-powered furnaces, car air conditioning and safe homes, they frequently felt cold, hot, and tired. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 3, 2020 Category: Emergency Medicine Authors: Martin R. Huecker, Jacob Shreffler, Brian Ferguson Tags: Correspondence Source Type: research

Incidence of adverse events among elderly vs non-elderly patients during procedural sedation and analgesia with propofol
The problems associated with an aging society have been recognized for quite some time. In Japan, the ratio of individuals 65  years or older has risen from 5.1% in 1950 to 8.3% in 2015, and will continue to rise rapidly over the next half century [1]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 3, 2020 Category: Emergency Medicine Authors: Hiroyasu Shimizu, Yosuke Homma, Tatsuya Norii, Japanese Procedural Sedation and Analgesia Registry investigators Source Type: research

Front-loaded diazepam versus lorazepam for treatment of alcohol withdrawal agitated delirium
Front-loaded diazepam is used to rapidly control agitation in patients with severe alcohol withdrawal syndrome (AWS). Our institution began using front-loaded lorazepam in August 2017 secondary to a nation-wide shortage of intravenous (IV) diazepam. Currently, there are no studies comparing lorazepam to diazepam for frontloading in severe AWS. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 3, 2020 Category: Emergency Medicine Authors: Alexander R. Levine, Varshitha Thanikonda, Jane Mueller, Edgar R. Naut Source Type: research

Editorial Board
(Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 1, 2020 Category: Emergency Medicine Source Type: research

Toc
(Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 1, 2020 Category: Emergency Medicine Source Type: research

Info for authors
(Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - May 1, 2020 Category: Emergency Medicine Source Type: research

Importance of respiratory airway management as well as psychological and rehabilitative treatments to COVID-19 patients
The clinical therapy for severe 2019 coronavirus disease (i.e., COVID-19) sufferers is relatively challenging. Herein, the processes involving salvage of a critical COVID-19 patient were retrospectively analyzed. The condition of an obese female critical COVID-19 sufferer progressively worsened in the initial period after admission. According to her symptoms and examination reports, endotracheal intubation and mechanical ventilation were timely conducted and meanwhile high-dose sedatives and analgesics were administrated. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 30, 2020 Category: Emergency Medicine Authors: Yichun Jiang Dr, Jun Chen Dr, Fulan Cen Dr, Xu Li Dr, Zhi Song Dr, Mian Peng Dr, Xueyan Liu Dr Source Type: research

Intradermal sterile water injection versus diclofenac sodium in acute renal colic pain: A randomized controlled trial
We aimed to evaluate the efficacy of intracutaneous sterile water injection (ISWI) to relieve the pain of acute renal colic compared with diclofenac and placebo. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 29, 2020 Category: Emergency Medicine Authors: Mohamad Moussa, Athanasios G. Papatsoris, Mohamed Abou Chakra Source Type: research

An emergency medicine-focused review of malignant otitis externa
Malignant otitis externa (MOE) is a progressive infection of the external auditory canal (EAC). This disease is rare but has severe morbidity and mortality. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 29, 2020 Category: Emergency Medicine Authors: Drew A. Long, Alex Koyfman, Brit Long Source Type: research

Massive pneumoperitoneum causing abdominal compartment syndrome
A 79-year-old male with a history of known inguinal hernia presented to the ED with report of urinary retention. The patient stated that he had not voided since the preceding night. He reported associated sharp, diffuse abdominal pain that was worsened with deep inspiration. He was nontoxic appearing on arrival. His initial vital signs were significant for a heart rate of 96  bpm, blood pressure of 118/73 mmHg, respiratory rate of 18 breaths per minute, and an oral temperature of 97.6 degrees Fahrenheit. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 29, 2020 Category: Emergency Medicine Authors: Jeffrey Gardecki, Neelesh Parikh, James F. Baird Source Type: research

Influence of emergency department patient volumes on CT utilization rate of the physician in triage
This study examined the relationship between computerized tomography (CT) utilization of PIT and ED patient volumes. We hypothesized that despite the pressure on PIT to improve throughput on the busiest days, they will continue to utilize CT at the same rate. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 29, 2020 Category: Emergency Medicine Authors: Matthew Ullrich, Virginia LaBond, Todd Britt, Kaitlyn Bishop, Kimberly Barber Source Type: research

Flow-safe disposable CPAP efficiency in cardiogenic pulmonary oedema
We are very pleased that our article has been read and evaluated by readers [1]. We would like to answer the questions as follows: (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 28, 2020 Category: Emergency Medicine Authors: İlhan Uz, Güçlü Selahattin Kiyan, Enver Özçete, Sercan Yalçinli, Mehmet Birkan Korgan, Yusuf Ali Altunci, Murat Ersel, Funda Karbek Akarca, Oğuz Yavuzgil Source Type: research

Imaging & other potential predictors of deterioration in COVID-19
This case report describes a young patient with COVID-19 who is initially diagnosed with CT chest imaging. Upon admission to the hospital, his clinical condition deteriorates requiring ventilatory support. We explore the value of imaging and other potential predictors of deterioration. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 28, 2020 Category: Emergency Medicine Authors: Kaushal Shah, Jonathan Kamler, Alexander Phan, Dennis Toy Source Type: research

Alarming trends in US domestic violence during the COVID-19 pandemic
The COVID-19 pandemic caused by the acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused significant destruction worldwide. In the United States (US) as of April 18, 2020 there were 690,714 reported cases and 35,443 deaths [1]. In order to curb the spread of SARS-CoV-2 quarantines, social isolation, travel restrictions and stay-at-home orders have been adopted [2,3]. While many states in the US implement stay-at-home orders differently, in most cases individuals are expected to stay indoors except for essential activities (e.g., obtaining food, medication, medical treatment) or for work in essential businesses ...
Source: The American Journal of Emergency Medicine - April 28, 2020 Category: Emergency Medicine Authors: Brad Boserup, Mark McKenney, Adel Elkbuli Source Type: research

COVID-19 myopericarditis: It should be kept in mind in today's conditions
A 78-year-old patient with acute respiratory distress was transferred to our hospital with ST segment elevation on electrocardiography. Coronary angiography revealed normal coronary arteries. Thorax computerized tomography showed ground glass opacification with consolidation in the lungs and mild pericardial effusion demonstrating myopericarditis associated with COVID-19. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 28, 2020 Category: Emergency Medicine Authors: Ahmet Yasar Cizgici, Hicaz Zencirkiran Agus, Mustafa Yildiz Source Type: research

Flow-safe disposable CPAP efficiency in cardiogenic pulmonary oedema
We have read with great interest the study “Is flow-safe disposable continuous positive airway pressure (CPAP) system as effective as non-invasive mechanical ventilation (NIMV) in the treatment of acute cardiogenic pulmonary oedema”, performed by İlhan et al. and published on American Journal of Emergency Medicine [1], where two treatme nt options in patients with cardiac pulmonary edema in an emergency department are compared. We congratulate the authors for this original contribution. The authors consider that both options have a solid basis of application in patients with cardiogenic pulmonary edema. (Sourc...
Source: The American Journal of Emergency Medicine - April 28, 2020 Category: Emergency Medicine Authors: Miguel Guia, Hilmi Demirkiran, Antonio Esquinas Tags: Correspondence Source Type: research

Severe hypernatremia and gastric dilation from chronic eating disorder and intentional salt ingestion
We report the case of a 21-year-old female presenting with severe hypernatremia and a gastric outlet obstruction due to chronic purging behavior with salt water flushes. She presented obtunded following emesis and a witnessed seizure. She was found to have a corrected sodium level of 177  mmol/L. Following initial intubation and resuscitation, her CT imaging showed massive gastric dilation with high-density material in the gastric lumen. After orogastric flushing was unsuccessful and the patient's abdominal distention worsened, she was managed surgically and found to have a salt b ezoar leading to bowel ischemia and perf...
Source: The American Journal of Emergency Medicine - April 28, 2020 Category: Emergency Medicine Authors: Jonathan Hancher, Joseph Fisher, Christina Shenvi Source Type: research

Diagnostic accuracy of combined WBC, ANC and CRP in adult emergency department patients suspected of acute appendicitis
To assess the sensitivity, specificity, and negative predictive value (NPV) of normal total white blood cell count (WBC) and normal absolute neutrophil count (ANC) combined with a normal proprietary C-reactive protein (pCRP) level in adult emergency department (ED) patients with abdominal pain suspected of possible acute appendicitis. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 28, 2020 Category: Emergency Medicine Authors: David S. Huckins, Karen Copeland Source Type: research

Diagnostic accuracy of ultrasound for upper extremity fractures in children: A systematic review and meta-analysis
Ultrasound has an excellent diagnostic accuracy for fractures that is reportedly comparable to plain radiographs. We aim to summarize the diagnostic accuracy of ultrasound for upper extremity fractures in children. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 27, 2020 Category: Emergency Medicine Authors: Po-Yang Tsou, Yu-Kun Ma, Yu-Hsun Wang, Jason T. Gillon, John Rafael, Julia K. Deanehan Source Type: research

COVID-19 response and containment strategies in the US, South Korea, and Iceland: Lessons learned and future directions
COVID-19 confirmed fatalities in the United States (US) now lead the world [1]. One reason for the pandemics rapid spread is the virus has the ability to spread infection from asymptomatic individuals [2]. To counter this, we must have a better understanding of who is currently infected and needs isolating. Mass testing, with or without symptoms, offers a method of controlling the spread of infection and provides epidemiologists with valuable information about viral hot spots. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 26, 2020 Category: Emergency Medicine Authors: Brendon Sen-Crowe, Mark McKenney, Adel Elkbuli Source Type: research

Fill rates and access to self-injectable epinephrine prescribed in a pediatric emergency department
Despite its life-saving potential in anaphylaxis, self-injectable epinephrine (SIE) is frequently not administered by caregivers prior to arrival in the emergency department (ED). Prescriptions from the ED often go unfilled which may contribute to the failure to receive SIE when needed. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 26, 2020 Category: Emergency Medicine Authors: William C. Sokoloff, Nicole C. O'Connell, Prasra G. Olson, Daniel M. Fein Source Type: research

ST segment elevation in an adult chest pain patient: A case of coronary artery vasospasm
We present a 55-year-old male who was brought in to the ED with sudden onset chest pain and was found to have ST-segment elevations in the infero-lateral leads on electrocardiogram (ECG). These changes resolved with nitroglycerin. Coronary artery vasospasm was diagnosed as coronary angiogram was normal. Calcium channel blocker was prescribed with good symptom relief. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 25, 2020 Category: Emergency Medicine Authors: Venkata Satish Pendela, Pujitha Kudaravalli, Mamta Chhabria, Mallory Balmer-Swain Source Type: research

Extracorporeal cardiopulmonary resuscitation in a hybrid resuscitation room
Extracorporeal cardiopulmonary resuscitation (ECPR) is a technique involving venoarterial extracorporeal circulation and membrane oxygenation, and it has the potential to improve the prognoses of cardiopulmonary arrest by allowing physicians some time for treating reversible causes of arrests [1]. However, it can cause various complications. The risk of complications with percutaneous cannulation, which is preferable in terms of speed, is relatively high. To reduce complications, cannulation under fluoroscopy is recommended [2]; however, transfer of patients to the angio-suite requires additional time. (Source: The America...
Source: The American Journal of Emergency Medicine - April 25, 2020 Category: Emergency Medicine Authors: Ryuichi Nishi, Shinji Nakahara, Yasufumi Miyake, Tetsuya Sakamoto Source Type: research

Acute aortic dissection in patients presenting to US emergency department, 2006 –2014
In this study, we sought to characterize demographics and outcomes of patients presenting to the U.S. EDs with AAD. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 22, 2020 Category: Emergency Medicine Authors: Maher Kazimi, Salil V. Deo, Salah E. Altarabsheh, Vaishali S. Deo, Joshua D. Niforatos, Yakov Elgudin Source Type: research