Efficacy and safety of Shenfu injection for septic shock: A systematic review and meta-analysis of randomized controlled trials
To evaluate the efficacy and safety of Shenfu injection (SFI) combined with standard therapy versus standard therapy for septic shock, three groups of patients with septic shock were analyzed based on the level of mean arterial lactate. They were mean arterial lactate level   (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 5, 2019 Category: Emergency Medicine Authors: Huang Po, Guo Yuhong, Feng Shuo, Zhao Guozhen, Li Bo, Liu Qingquan Source Type: research

Pentraxin 3 level in acute migraine attack with aura: Patient management in the emergency department
We investigated the state of inflammation, PTX3 level and other routine inflammatory markers (ceruloplasmin, high sensitivity C-reactive protein [hsCRP], and white blood cells [WBC]), in patients who presented to the emergency department (ED) with migraine. We also investigated the relationship between the clinical presentation, PTX3 level, and other routine inflammatory markers in the emergency management of these patients. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 4, 2019 Category: Emergency Medicine Authors: Mehmet Tahir Gokdemir, Cemal Nas, G ül Sahika Gokdemir Source Type: research

Physical findings in sexual assault cases when victims delay reporting
An important role for the forensic examiner in cases of sexual assault is to document physical injuries [1]. Research has consistently shown that documented injury plays a significant role at multiple decision-making points during criminal justice proceedings such as the decision to report, prosecute, and convict [2]. The most significant predictor of documented anogenital injury in victims of sexual assault is the time interval between assault and forensic evaluation [3-6]. Therefore, most of the literature regarding anogenital injuries resulting from sexual assault is limited to victims examined within examined within 24...
Source: The American Journal of Emergency Medicine - April 4, 2019 Category: Emergency Medicine Authors: Linda Rossman, Stephanie Solis, Barbara Wynn, Lindsey Ouellette, Jeffrey S. Jones Source Type: research

WAMAMI: emergency physicians can accurately identify wall motion abnormalities in acute myocardial infarction
The ability to identify wall motion abnormalities may be useful for emergency clinicians, but is not typically evaluated in point-of-care echocardiograms. We sought to determine if emergency physicians with basic training in emergency echocardiography could identify regional wall motion abnormalities (RWMA) in patients admitted with ST-elevation myocardial infarction (STEMI). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 2, 2019 Category: Emergency Medicine Authors: Peter E. Croft, Tania D. Strout, Randy M. Kring, Laura Director, Samip C. Vasaiwala, David C. Mackenzie Source Type: research

Berberine inhibits the ischemia-reperfusion induced testicular injury through decreasing oxidative stress
The aim of this study was to investigate the effect of berberine (BBR) on oxidative stress in an experimental testicular I/R injury model. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 2, 2019 Category: Emergency Medicine Authors: Ilke Onur Kazaz, Ahmet Mentese, Selim Demir, Gokcen Kerimoglu, Fatih Colak, Akin Bodur, Ahmet Alver, Omer Kutlu, Suleyman Turedi Source Type: research

Effects of videolaryngoscopes on cognitive workload during tracheal intubation performed by emergency residents
Tracheal intubation using direct laryngoscopy (DL) is the gold standard for airway management during resuscitation of severely ill patients [1]. The procedure may be challenging even for experienced physicians. In prehospital settings, tracheal intubation may be even more difficult considering unfavorable conditions such as poor or bright light, narrow space, and uncomfortable position of rescuers [2]. Lack of practice by emergency physicians due to the small number of procedures performed each year adds to the difficulty [3]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 2, 2019 Category: Emergency Medicine Authors: Nicolas Marjanovic, Julien Guilbot, Jean-Pierre Richer, Marie Dubocage, J érémy Guenezan, Olivier Mimoz Source Type: research

Epidemiology of opioid-related visits to US Emergency Departments, 1999 –2013: A retrospective study from the NHAMCS (National Hospital Ambulatory Medical Care Survey)
To characterize the epidemiology of opioid-related visits to United States (US) emergency departments (EDs) and describe trends in opioid-related visits over time. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 31, 2019 Category: Emergency Medicine Authors: Matthew Salzman, Christopher W. Jones, Rachel Rafeq, John Gaughan, Rachel Haroz Source Type: research

Dextrose dilution for pediatric hypoglycemia
Emergency physicians (EPs) commonly treat hypoglycemia. When parenteral dextrose is required for an adult patient, EPs feel comfortable ordering “1 ampule of D50”, which amounts to 25 g of 50% dextrose in sterile water. However, a solution of D50W is a significantly hypertonic solution. When a child has hypoglycemia, concentrations of dextrose must be lower than 50% due to increased risk of small vein sclerosis. Hypertonic solutions ma y lead to osmotic diuresis and tissue damage if extravasated. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 31, 2019 Category: Emergency Medicine Authors: Timothy P. Young, Caitlin Borkowski, Rhiannon Main, Heather M. Kuntz Source Type: research

Motorized scooter injuries in the era of scooter-shares: A review of the national electronic surveillance system
There has been a spike in recent news regarding motorized scooter injuries due to the expansion of scooter sharing companies. Given the paucity of literature on this topic, the purpose of our study was to describe and quantify emergency department encounters associated with motorized scooter related injuries. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 30, 2019 Category: Emergency Medicine Authors: Matthew Aizpuru, Kevin X. Farley, Jaimie C. Rojas, Robert S. Crawford, Thomas J. Moore, Eric R. Wagner Source Type: research

A checklist manifesto: Can a checklist of common diagnoses improve accuracy in ECG interpretation?
To determine whether a checklist of possible etiologies for syncope provided alongside ECGs helps Emergency Medicine (EM) residents identify ECG patterns more accurately than with ECGs alone. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 29, 2019 Category: Emergency Medicine Authors: Jillian Nickerson, Emily S. Taub, Kaushal Shah Source Type: research

“Bandemia” without leukocytosis: A potential Emergency Department diagnostic pitfall
Emergency physicians routinely employ leukocyte counts as a risk stratification tool in a variety of clinical presentations. While a leukocyte count within the normal reference range is widely acknowledged as unreliable, it is nonetheless commonly interpreted as reassuring in a patient not otherwise suspected of harboring severe and acute illness. However, recent data has drawn renewed attention to immature neutrophils ( “bands”) as a reliable predictor of acuity, even in the presence of a normal leukocyte count. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 29, 2019 Category: Emergency Medicine Authors: S. Davis, R. Shesser, K. Authelet, A. Pourmand Source Type: research

Slime product injuries managed at emergency departments
Homemade slime is promoted as a substance that can be produced by children at home or at school. One version of homemade slime uses water, borax (sodium tetraborate), and Elmer's glue, and sometimes food coloring, glitter, or other additives. The American Chemical Society website provides directions for this version of homemade slime [1]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 29, 2019 Category: Emergency Medicine Authors: Mathias B. Forrester Source Type: research

An analysis of randomized controlled trials underpinning ST-elevation myocardial infarction management guidelines
The fragility index (FI) is calculated by iteratively changing one outcome “event” to a “non-event” within a trial until the associated p-value exceeds 0.05. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 28, 2019 Category: Emergency Medicine Authors: Chase Meyer, Aaron Bowers, Dev Jaiswal, Jake Checketts, Michael Engheta, Caleb Severns, Sharolyn Cook, Corbin Walters, Matt Vassar Source Type: research

Angiotensin converting enzyme inhibitor intoxication: Naloxone to the rescue? Naloxone for ACE inhibitor intoxication
We report here the case of a patient with perindopril intoxication inducing severe bradycardia together with a profound hypotension. Initiation of a naloxone infusion completely resolved those symptoms. As a consequence, we could recommend as a first step the use of naloxone in order to prevent the use of more invasive therapeutic tools. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 28, 2019 Category: Emergency Medicine Authors: Martine Robert, David De Bels, Martin Chaumont, Patrick M. Honor é, Philippe Gottignies Source Type: research

Thrombolysis for atlantoaxial dislocation mimicking acute ischemic stroke
The frequency of stroke mimics among stroke patients has been reported to be up to 30%, and that in patients who receive thrombolytic therapy ranges between 1% and 16%. Atlantoaxial dislocation with myelopathy mimicking stroke is extremely rare. An 83-year-old man with a history of old cerebellar infarction presented to the emergency department with acute left hemiplegia after a chiropractic manipulation of the neck and back several hours before symptom onset. Mild hypoesthesia was observed on his left limbs. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 27, 2019 Category: Emergency Medicine Authors: Adam Tsou, Yu-Hsiu Juan, Tsu-Yi Chen, Shinn-Kuang Lin Tags: Case Report Source Type: research

Intravenous fluid bolus rates and pediatric diabetic ketoacidosis resolution
Recent data have challenged the notion that rapid intravenous fluid administration results in adverse neurologic outcomes in children with diabetic ketoacidosis (DKA). While many physicians still administer a cautious 10  cc/kg bolus of intravenous fluids for pediatric DKA patients, there may be benefits to using a larger bolus. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 27, 2019 Category: Emergency Medicine Authors: Louis Gordon Pruitt, Glenn Jones, Mandi Musso, Emilio Volz, Tony Zitek Source Type: research

A new marker identification of high risk stroke patients: Jugular saturation
The aim of this prospective study; to investigate in emergency patients with stroke the relationship between jugular saturation and National Institutes of Health Stroke Scale (NIHSS), lesion volume and mortality score. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 27, 2019 Category: Emergency Medicine Authors: Mevlut Guven, Nazire Belgin Akilli, Ramazan Koylu, Vefa Oner, Merve Guven, Muhammed Rasit Ozer Source Type: research

N95 filtering facepiece respirators do not reliably afford respiratory protection during chest compression: A simulation study
N95 filtering facepiece respirators (N95 respirators) may not provide adequate protection against respiratory infections during chest compression due to inappropriate fitting. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 27, 2019 Category: Emergency Medicine Authors: Sung Yeon Hwang, Hee Yoon, Aerin Yoon, Taerim Kim, Guntak Lee, Kwang Yul Jung, Joo Hyun Park, Tae Gun Shin, Won Chul Cha, Min Seob Sim, Seonwoo Kim Source Type: research

A physician's (and private citizen's) right to privacy against internet data brokers: Maintaining safety in an unsafe profession
As an EM physician of 20  years, I have never felt as threatened by anything as I have by opportunists of the insidious electronic information superhighway. Looking back, I have had my life threatened multiple times. I have been told by a patient that he was going to get his gun and return to shoot me. I have been called every derogatory name that someone could come up with directed at people of Asian descent. I have had to jump out of the way of patients who were trying to assault me. I have had to hide out of sight from angry patients who threatened me with physical harm. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 27, 2019 Category: Emergency Medicine Authors: Kevin M. Takakuwa Source Type: research

Electronic health record triggered hepatitis C screening in the ED
With an estimated prevalence of nearly 2.4 million in the United States (US) and over 185 million worldwide, infection with hepatitis C virus (HCV) carries a significant burden on the healthcare system (1; 2). In the US, upwards of 50% of affected patients are unaware of their diagnosis, putting them at an increased risk for progression to liver cirrhosis and subsequent organ failure [3]. With advancements in well-tolerated oral therapeutics, an increasing emphasis has been placed on early detection and routine screening practices. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 27, 2019 Category: Emergency Medicine Authors: Michael Ullo, Gregory Sugalski Source Type: research

Principles of safety for ultrasound-guided single injection blocks in the emergency department
Ultrasound-guided nerve blocks (UGNBs) allow emergency physicians an opportunity to provide optimal pain management for acute traumatic conditions. Over the past decade, a growing body of literature has detailed the novel ways clinicians have incorporated UGNBs for analgesia and an alternative to procedural sedation. UGNBs are considered a relatively safe procedure, and have been shown to increase rates of success and reduce complications (as compared to older techniques). Ultrasound allows the operator needle visualization and a clear anatomic overview. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 27, 2019 Category: Emergency Medicine Authors: Arun Nagdev, Andrea Dreyfuss, David Martin, Daniel Mantuani Source Type: research

Thrombolysis for atlantoaxial dislocation mimicking acute ischemic stroke: Case report and review
The frequency of stroke mimics among stroke patients has been reported to be up to 30%, and that in patients who receive thrombolytic therapy ranges between 1% and 16%. Atlantoaxial dislocation with myelopathy mimicking stroke is extremely rare. An 83-year-old man with a history of old cerebellar infarction presented to the emergency department with acute left hemiplegia after a chiropractic manipulation of the neck and back several hours before symptom onset. Mild hypoesthesia was observed on his left limbs. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 27, 2019 Category: Emergency Medicine Authors: Adam Tsou, Yu-Hsiu Juan, Tsu-Yi Chen, Shinn-Kuang Lin Source Type: research

Pharmacologic anisocoria due to nebulized ipratropium bromide: A diagnostic challenge
Anisocoria may be physiological or seen in fatal conditions, such as intracranial hemorrhage. Newly developing anisocoria may cause confusion and diagnostic difficulty in the emergency department (ED). A 35-year-old female was admitted to the ED with an asthma attack and dyspnea. On examination, the patient was observed to have bilateral rhonchi and was treated with nebulized albuterol (salbutamol) and ipratropium bromide. After the treatment, the dyspnea improved, and mydriasis developed in the left eye (left pupil diameter 9  mm, right 4 mm). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 27, 2019 Category: Emergency Medicine Authors: Kamil Kokulu, Haldun Öner, Can Özen, Serkan E. Eroğlu, İbrahim Altunok, H. Şeyma Akça Source Type: research

Orthostatic vital signs do not predict 30  day serious outcomes in older emergency department patients with syncope: A multicenter observational study
Syncope is a common chief complaint among older adults in the Emergency Department (ED), and orthostatic vital signs are often a part of their evaluation. We assessed whether abnormal orthostatic vital signs in the ED are associated with composite 30-day serious outcomes in older adults presenting with syncope. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 25, 2019 Category: Emergency Medicine Authors: Jennifer L. White, Judd E. Hollander, Anna Marie Chang, Daniel K. Nishijima, Amber L. Lin, Erica Su, Robert E. Weiss, Annick N. Yagapen, Susan E. Malveau, David H. Adler, Aveh Bastani, Christopher W. Baugh, Jeffrey M. Caterino, Carol L. Clark, Deborah B. Source Type: research

Editorial Board
(Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 23, 2019 Category: Emergency Medicine Source Type: research

table of contents
(Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 23, 2019 Category: Emergency Medicine Source Type: research

Info for authors
(Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 23, 2019 Category: Emergency Medicine Source Type: research

Effect of two tourniquet techniques on peripheral intravenous cannulation success: A randomized controlled trial
This study aimed to determine whether one method is superior for success on the first attempt. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 23, 2019 Category: Emergency Medicine Authors: Theresa Tran, Sarah R. Lund, Micah D. Nichols, Tobias Kummer Source Type: research

Incidence and risk factors for hyperlactatemia in ED patients with acute metformin overdose
The goals of this study are to describe clinical characteristics and risk factors for metabolic acidosis with hyperlactatemia in emergency department (ED) patients with acute metformin overdose. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 23, 2019 Category: Emergency Medicine Authors: Emily S. Taub, Robert S. Hoffman, Alex F. Manini Source Type: research

Role of dantrolene in dinitrophenol (DNP) overdose: A continuing question?
We present two cases of DNP toxicity that were treated with dantrolene. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 23, 2019 Category: Emergency Medicine Authors: Kathryn T. Kopec, Theresa Kim, James Mowry, Steve Aks, Louise Kao Source Type: research

A novel method of palpating the pancreas in children: Three cases of pediatric acute pancreatitis
Acute pancreatitis (AP) is a critical inflammatory process of the pancreas caused by the activation of pancreatic zymogens and resulting in pancreatic autodigestion and tissue damage [1,2]. While the mortality rate is high at 9.7%, diagnosing pediatric AP is still challenging due to the non-specificity of its clinical manifestations in children [3-5]. Therefore, a physical examination is clinically important for diagnosing this disease. Previous studies have demonstrated effective physical examination procedures in adults. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 22, 2019 Category: Emergency Medicine Authors: Takateru Ihara, Osamu Nomura, Takaaki Mori Source Type: research

Point of care ultrasound is associated with decreased ED length of stay for symptomatic early pregnancy
Emergency physicians (EP) can accurately rule out ectopic pregnancy with pelvic point of care ultrasound (PPOCUS). Multiple studies have suggested that PPOCUS may decrease length of stay (LOS) for emergency department (ED) patients presenting with early symptomatic pregnancy compared to comprehensive ultrasound (CUS). This systematic review and meta-analysis examines the association between the use of PPOCUS vs CUS and ED LOS. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 20, 2019 Category: Emergency Medicine Authors: Tyler Beals, Leily Naraghi, Anne Grossestreuer, Jesse Schafer, Dan Balk, Beatrice Hoffmann Tags: Review Source Type: research

Tetratrichomonas in pyopneumothorax
Pleural trichomonosis is clinically rare, and very few cases of trichomonal empyema have been reported so far. A rare case of an 81-year-old woman with pyopeumothorax presenting with recurrent fever and macroscopic pyuria was present. Microscopic examination of the pleural effusion showed mobile flagellated protozoa which molecular methods identified as Tetratrichomonas. In addition, Streptococcus anginosus was discovered in pleural fluid cultures. Treatment with imipenem/cilastatin and metronidazole successfully eliminated the pathogens and led to relief of clinical symptoms. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 20, 2019 Category: Emergency Medicine Authors: Nian Dong, Xuewen Jin, Juhong Huang, Kunlun Chen, Yuping Li, Chengshui Chen, Dongwei Hu, Yupeng Xie Tags: Case Report Source Type: research

Point of care ultrasound is associated with decreased emergency department length of stay for symptomatic early pregnancy
Emergency physicians (EP) can accurately rule out ectopic pregnancy with pelvic point of care ultrasound (PPOCUS). Multiple studies have suggested that PPOCUS may decrease length of stay (LOS) for emergency department (ED) patients presenting with early symptomatic pregnancy compared to comprehensive ultrasound (CUS). This systematic review and meta-analysis examines the association between the use of PPOCUS vs CUS and ED LOS. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 20, 2019 Category: Emergency Medicine Authors: Tyler Beals, Leily Naraghi, Anne Grossestreuer, Jesse Schafer, Dan Balk, Beatrice Hoffmann Source Type: research

Frequency of emergency medicine resident dosing miscalculations treating pediatric patients
We conducted a review of 500 consecutive IV orders placed by emergency medicine [EM] residents during the calendar year 2018 in the Pediatric Emergency Medicine Department of Mount Sinai St. Luke's Medical Center in New York City. We are located in an urban setting with an approximate census of 20,000  pediatric patient visits/year. We sponsor an active 3-year EM residency program during which residents [n = 50] work clinical shifts in the pediatric ER under the direct supervision of board-certified pediatric emergency medicine attending physicians. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 20, 2019 Category: Emergency Medicine Authors: William Bonadio Source Type: research

Is my baby normal? A review of seemingly worrisome but normal newborn signs, symptoms and behaviors
Infant patients are a unique challenge to emergency department (ED) physicians as the spectrum of normal infant signs, symptoms and behaviors are often difficult to differentiate from abnormal and potentially life-threatening conditions. In this article, we address some common chief complaints of neonates and young infants presenting to the ED, and contrast reassuring neonatal and young infant signs and symptoms against those that need further workup and intervention. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 20, 2019 Category: Emergency Medicine Authors: Zachary Drapkin, Kathleen Franchek-Roa, Ganga L. Srinivas, Karen F. Buchi, Michael J. Miescier Source Type: research

Tungiasis, a rare case of plantar inflammatory disease, a review of travelers skin lesions for emergency providers
We report a case of a thirty-three-year-old male with no past medical history who presented to the emergency department with a chief complaint of “eggs coming out of my foot” after returning home from Brazil. Based on clinical presentation, travel history, and appearance of the lesion, diagnosis was most consistent with tungiasis infection which was confirmed by the pathology examination. It is important to make the appropriate diagnosis when skin lesions are found in returning travelers and emergency providers should take broad differential diagnosis into consideration. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 20, 2019 Category: Emergency Medicine Authors: N. Sikka, A. Siev, R. Boyer, A. Pourmand Source Type: research

Tetratrichomonas in pyopneumothorax: Case report and literature review
Pleural trichomonosis is clinically rare, and very few cases of trichomonal empyema have been reported so far. A rare case of an 81-year-old woman with pyopeumothorax presenting with recurrent fever and macroscopic pyuria was present. Microscopic examination of the pleural effusion showed mobile flagellated protozoa which molecular methods identified as Tetratrichomonas. In addition, Streptococcus anginosus was discovered in pleural fluid cultures. Treatment with imipenem/cilastatin and metronidazole successfully eliminated the pathogens and led to relief of clinical symptoms. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 20, 2019 Category: Emergency Medicine Authors: Nian Dong, Xuewen Jin, Juhong Huang, Kunlun Chen, Yuping Li, Chengshui Chen, Dongwei Hu, Yupeng Xie Source Type: research

Angiotensin II in septic shock
Septic shock is a life threatening condition and a medical emergency. It is associated with organ dysfunction and hypotension despite optimal volume resuscitation. Refractory septic shock carries a very high rate of mortality and is associated with ischemic and arrhythmogenic complications from high dose vasopressors. Angiotensin II (AT-II) is a product of the renin-angiotensin-aldosterone system. It is a vasopressor agent that has been recently approved by FDA to be used in conjunction with other vasopressors (catecholamines) in refractory shock and to reduce catecholamine requirements. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 19, 2019 Category: Emergency Medicine Authors: Amar P. Jadhav, Farid G. Sadaka Source Type: research

Reliability of smartphone measurements of vital parameters: A prospective study using a reference method
In this study, we aimed to evaluate the accuracy of HR and SaO2 data obtained using a smartphone compared with the measurements of a vital signs monitor (VSM) and an arterial blood gas (ABG) device, respectively. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 16, 2019 Category: Emergency Medicine Authors: İsmail Tayfur, Mustafa Ahmet Afacan Source Type: research

Rhabdomyolysis – Go big or go home
To evaluate the occurrence of renal injury in hospitalized patients with the diagnosis of rhabdomyolysis among a series of patients presenting to an urban emergency department. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 13, 2019 Category: Emergency Medicine Authors: Tyler Manis, Blessit George-Varghese, John Kashani Source Type: research

Intranasal hydromorphone for treatment of acute pain in children: A pilot study
We aimed to describe the analgesic efficacy, duration of analgesia, and adverse event profile associated with intranasal hydromorphone in children with acute pain presenting to an emergency department. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 12, 2019 Category: Emergency Medicine Authors: Daniel S. Tsze, Sharon S. Pan, Kerrin C. DePeter, Anju M. Wagh, Stephen L. Gordon, Peter S. Dayan Source Type: research

Accuracy of ultrasound for endotracheal intubation between different transducer types
Ultrasound has been increasingly utilized for the identification of endotracheal tube (ETT) location after an intubation attempt, particularly among patients in cardiac arrest. However, prior studies have varied with respect to the choice of transducer and no studies have directly compared the accuracy between transducer types. Our study is the first to directly compare the accuracy of ETT confirmation between the linear and curvilinear transducer. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 12, 2019 Category: Emergency Medicine Authors: Michael Gottlieb, Dallas Holladay, Katharine Burns, Stephen R. Gore, Collin Wulff, Shital Shah, John Bailitz Source Type: research

Designing efficient emergency departments: Discrete event simulation of internal-waiting areas and split flow sorting
Evaluate nine different models, the interaction of three flow models (ESI, intake attending physician, and no split flow) and three physical design typologies (zero, one, and two internal-waiting areas), on Emergency Department (ED) flow and patient-centered metrics. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 12, 2019 Category: Emergency Medicine Authors: Benjamin Easter, Negin Houshiarian, Debajyoti Pati, Jennifer L. Wiler Source Type: research

Variability in emergency department electronic medical record default opioid quantities: A National Survey
While opioid prescribing in U.S. emergency departments (EDs) is more consistent with recommendations for a 3-day or less supply than in other settings, the average number of tablets prescribed still remains highly variable [1-3]. Furthermore, larger initial prescriptions are associated with prolonged opioid use and potential for misuse. Setting default tablet order amounts lower than the baseline average (e.g. 10 tablets) reduces the tablet number prescribed [4]. Conversely, if set too high (e.g. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 12, 2019 Category: Emergency Medicine Authors: Erik J. Blutinger, Frances S. Shofer, Zachary Meisel, Jeanmarie Perrone, Eden Engel-Rebitzer, M. Kit Delgado Source Type: research

Methamphetamine psychosis: Lack of association with stimulant prescription ADHD medications
Methamphetamine use is increasing nationwide [1]. Recently, cases of methamphetamine psychosis have been increasing in frequency in Montgomery County, Ohio, with up to 40% of methamphetamine users affected [2,3]. Methamphetamine psychosis is characterized by hallucinations, uncontrolled movements and potential violent behavior, and in a subset of patients may result in recurrent psychotic episodes [4]. Poison death review data for Montgomery County shows increasing methamphetamine associated overdose deaths, nearly doubling between 2016 and 2017 [1]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 11, 2019 Category: Emergency Medicine Authors: Dennis M. Mann, Catherine A. Marco, John P. Detherage, Peter J. Greene, Daniel E. Ross Source Type: research

Comments on GEDI vs. CVP goal-directed fluid resuscitation for chronic obstructive pulmonary disease patients with septic shock: A randomized controlled trial
We have greatly enjoyed reading the article by Yu et al. [1],which was a single-center, prospective, randomized, controlled trial (RCT) compared the effects of Global end-diastolic volume index (GEDI) vs. central venous pressure (CVP) goal-directed fluid resuscitation for chronic obstructive pulmonary disease (COPD) patients with septic shock. The authors conclude that GEDI goal-directed fluid resuscitation shows better clinical effects compared to CVP for COPD patients with septic shock. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 11, 2019 Category: Emergency Medicine Authors: Hairong Cai, Shuling Liu, Weizhang Zhang, Lieyuan Zhang, Jing Zeng, Shuai Zhao, Xingui Cai, Yongning Guo, Zhishang Li, Bojun Chen Source Type: research

Commentary on prophylactic systemic antibiotics for anterior epistaxis treated with nasal packing in the emergency department
We read with great interest the paper entitled “Prophylactic systemic antibiotics for anterior epistaxis treated with nasal packing in the emergency department” by Murano et al. [1]. The authors compared the infection rate between patients who were and were not prescribed prophylactic systemic antibiotics for anterior nasal packing in sponta neous epistaxis. They found that prophylactic antibiotic use for nasal packing in spontaneous epistaxis patients is unnecessary. This is an excellent study, and may help to avoid the abuse of antibiotics. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 11, 2019 Category: Emergency Medicine Authors: Zhengcai Lou Source Type: research

Antibiotics with nasal packing —The authors reply
On behalf of my co-authors, and myself I would like to thank you for your interest in our study as well as your thoughtful questions. The purpose for our study was to compare infection rates of patients with and without prophylactic systemic antibiotics who had anterior packing for spontaneous epistaxis as well as examine the management practices of prescribing prophylactic antibiotics for these patients in the emergency department. In performing our literature search, we have found that prescribing practices vary among otolaryngologists mainly because there is a paucity of literature that supports a clear benefit to its u...
Source: The American Journal of Emergency Medicine - March 11, 2019 Category: Emergency Medicine Authors: Tiffany Murano Source Type: research

Incorporation of Transcranial Doppler into the ED for the neurocritical care patient
In the catastrophic neurologic emergency, a complete neurological exam is not always possible or feasible given the time-sensitive nature of the underlying disease process, or if emergent airway management is indicated. As the neurologic exam may be limited in some patients, the emergency physician is reliant on the assessment of brainstem structures to determine neurological function. Physicians thus routinely depend on advanced imaging modalities to further investigate for potential catastrophic diagnoses. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 10, 2019 Category: Emergency Medicine Authors: Tim Montrief, Stephen Alerhand, Corlin Jewell, Jeffery Scott Tags: Diagnostic Source Type: research