Analgesic Effect of Nitrous Oxide/Oxygen Mixture for Traumatic Pain in the Emergency Department: A Randomized, Double-Blind Study
Acute pain is the most common complaint in Emergency Department (ED) admissions, and options for analgesia are limited. Nitrous oxide/oxygen possesses many properties showing it may be an ideal analgesic in the ED. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - September 9, 2019 Category: Emergency Medicine Authors: Lu-Lu Gao, Jian-Qiang Yu, Qiang Liu, Hai-Xiang Gao, Ya-Liang Dai, Jun-Jun Zhang, Yi-Ling Wang, Ting-Ting Zhang, Jian-Jun Yang, Yu-Xiang Li Tags: Original Contributions Source Type: research

Detecting Atrial Fibrillation in the Emergency Department in Patients with Cardiac Implantable Electronic Devices
Clinical guidelines emphasize identifying atrial fibrillation (AF) as a strategy to reduce stroke risk. Cardiac implantable electronic device (CIED) interrogation at the point of care may facilitate AF detection, increasing opportunities to identify patients at high risk for stroke. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - September 7, 2019 Category: Emergency Medicine Authors: Matthew Pugh, Peter Belott, Kristina L. Greenwood, Patricia L. McNamee, Besa Smith, Terri L. Craig, Jack Mardekian, Jeffrey Trocio, Divina Fanning, Eric Carda Tags: Original Contributions Source Type: research

Acute HIV Infection in a Patient with Repeat HIV Antibody/Antigen Negative Results Presenting at an Urban Emergency Department: A  Case Report
We report a case of a patient who initially screened reactive on a fourth generation HIV test and subsequently nonreactive twice, but ultimately had positive viral load tests. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - September 6, 2019 Category: Emergency Medicine Authors: Jason Wilson, Geetha Sanmugalingham, Oluwatobi Ozoya, Larissa Pierce, Kelsey Hundley, Sri Harsha Palakurty Tags: Clinical Communications: Adult Source Type: research

Clinical Scores and Formal Triage for Screening of Sepsis and Adverse Outcomes on Arrival in an Emergency Department All-Comer Cohort
Early recognition of sepsis remains a major challenge. The clinical utility of the Quick Sepsis-Related Organ Failure Assessment (qSOFA) score is still undefined. Several studies have tested its prognostic value. However, its ability to diagnose sepsis is still unknown. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - September 6, 2019 Category: Emergency Medicine Authors: Ricardo Nieves Ortega, Christiane Rosin, Roland Bingisser, Christian H. Nickel Tags: Original Contributions Source Type: research

Emergency Department Evaluation After Conducted Energy Weapon Use: Review of the Literature for the Clinician
Conductive energy weapons (CEWs) are used daily by law enforcement, and patients are often brought to emergency departments (EDs) for medical clearance. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - September 6, 2019 Category: Emergency Medicine Authors: Gary Vilke, Ted Chan, William P. Bozeman, Richard Childers Tags: AAEM Position Statement Source Type: research

Applicants with Prior Training
Emergency medicine (EM) has its challenges, downsides, advantages, and accompanying lifestyle. Additionally, graduates of EM residency programs have abundant job opportunities. Accordingly, there is an increased interest in residency training in EM, even among residents with prior training. Transitioning from another specialty to EM can be complicated yet achievable, especially if EM is the transitioning physician's passion and career goal. Therefore, in this article, we elaborate on the transition process from another discipline to EM in light of changes in residency funding. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - September 5, 2019 Category: Emergency Medicine Authors: Hilary Yokley, Daniel R. Martin, Dick Kuo, Kevin M. Ban, Amal Mattu, Mohamad Ali Cheaito, Shahram Lotfipour, Amin Kazzi Tags: Medical Student Forum Source Type: research

Toxicity From Unintentional Pediatric Ingestion of a Performance-Enhancing Drug: A Case Report With Review of Clenbuterol Toxicity and Treatment
Clenbuterol is a long-acting β-adrenergic agonist that is not Food and Drug Administration–approved for use in the United States, but may be obtained without a prescription from various unregulated sellers. It has seen increasing use as a performance-enhancing drug for sports. Literature on pediatric toxicity and treatment i s limited. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - September 4, 2019 Category: Emergency Medicine Authors: Caitlin F. Bonney, Benjamin Hatten, George S. Wang Tags: Selected Topics: Toxicology Source Type: research

Atrial Myxoma Presenting as Acute Bilateral Limb Ischemia
Cardiac myxoma is the most common primary benign tumor of the heart and it has diverse clinical presentations. It is known to embolize into systemic circulation. However, presentation with complete occlusion of the aorta is uncommon. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - September 3, 2019 Category: Emergency Medicine Authors: Roshan Mathew, Naman Agrawal, Praveen Aggarwal, Nayer Jamshed Tags: Ultrasound in Emergency Medicine Source Type: research

Latrodectus Facies After Latrodectus Hesperus Envenomation in  a Pediatric Patient
Black widow spider (Latrodectus spp) envenomation represents the most medically significant spider envenomation in the United States, prompting more than 2500 calls to poison centers annually. The female spider, which is responsible for symptomatic envenomations, is classically described as a shiny black spider with a red hourglass-shaped marking on the ventral abdomen. Clinical features of envenomation include painful muscle cramping, abdominal pain, and autonomic disturbances, such as tachycardia, hypertension, and diaphoresis. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - September 3, 2019 Category: Emergency Medicine Authors: Laurie Seidel Halmo, Irene A. Hurst, Patrick C. Ng, George Sam Wang Tags: Selected Topics: Toxicology Source Type: research

Buccal Mucosa Hyperpigmentation as a Differential Diagnosis in a Patient With Undifferentiated Shock
Adrenal crisis (AC) remains an important cause of mortality in patients with adrenal insufficiency (AI). These crises are difficult to diagnose due to the insidious and nonspecific clinical course of the disease. Here, we present the case of a 41-year-old woman with altered mental status with an episode of AC. The case reveals the importance of a complete clinical examination to reach the diagnosis. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - September 3, 2019 Category: Emergency Medicine Authors: Jorge Rafael Violante-Cumpa, Luis Alberto P érez-Arredondo, Mario Alberto Treviño-Castro Tags: Visual Diagnosis in Emergency Medicine Source Type: research

Hey, Can You See This Patient From Fast Track?
A 22-year-old man with intellectual disability presented to the emergency department (ED) with scalp and groin lesions. He had been seen previously for the groin problem, diagnosed with syphilis, and treated with doxycycline; mupirocin; azithromycin; and valacyclovir, as penicillin G was unavailable. The patient did not take his prescribed medications and was seen in the ED for various minor complaints without mentioning the worsening severity of the lesions. On examination, several round ulcerated scalp lesions were noted, as well as near-circumferential malodorous, ulcerated lesions on the shaft of the penis with associa...
Source: The Journal of Emergency Medicine - September 3, 2019 Category: Emergency Medicine Authors: Sean Hickey, Jennifer E. Sanders, James W. Tsung Tags: Visual Diagnosis in Emergency Medicine Source Type: research

Combined Residency Programs in Emergency Medicine
We describe the history and current status of the combined EM programs, discuss the process of applying to a combined EM program, describe the life of comb ined EM residents, and explore common career opportunities available to combined EM program graduates. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 31, 2019 Category: Emergency Medicine Authors: Michael E. Winters, Danielle C. Devereaux, Nikhil Goyal, Joseph P. Martinez, Amal Mattu, Pam L. Dyne, Mohamad Ali Cheaito, Shahram Lotfipour, Amin Kazzi Tags: Medical Student Forum Source Type: research

Neurogenic Stunned Myocardium: A Case Report and Brief Review
Neurogenic stunned myocardium (NSM) is a condition in a group of stress cardiomyopathies with evolving nomenclature that includes Takotsubo cardiomyopathy. It manifests through electrocardiogram changes, cardiac enzyme elevation, and regional or global kinetic wall motion abnormalities. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 31, 2019 Category: Emergency Medicine Authors: Andrew Zabel, Kyle Couperus, Scott Young Tags: Clinical Communications: Adult Source Type: research

Abdominal Pain After a Tick Bite
Dr. Derek Monette: Today's case is that of a 46-year-old male with recent diagnoses of Lyme disease and babesiosis who presented to our emergency department (ED) with abdominal pain, nausea, and diarrhea. The patient was previously healthy and had been well until approximately 2  weeks before the day of ED presentation, when he developed headache, fatigue, and myalgias. He also noticed that his right calf “looks sunburned,” and was warm to the touch. He was evaluated by his primary care physician (PCP) after 1 week of symptoms. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 31, 2019 Category: Emergency Medicine Authors: Derek L. Monette, Emily S. Miller, Kimon C. Zachary, Kathleen Wittels, Susan R. Wilcox Tags: Case Presentations of the Harvard Affiliated Emergency Medicine Residencies Source Type: research

Use of Emergency Departments for Preventative Care Among Adults in the United States: Estimates From the 2017 National Health Interview Survey
Use of the emergency department (ED) for routine or preventative care has been an abiding concern for policy makers and public health practitioners. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 30, 2019 Category: Emergency Medicine Authors: Kristin Primm, Daenuka Muraleetharan, Tamika Gilreath Tags: Public Health in Emergency Medicine Source Type: research

Systematic Review: The Role of Thrombolysis in Intermediate-Risk Pulmonary Embolism
This systemic review provides practicing emergency physicians updated information about the role of thrombolysis in the treatment of intermediate-risk pulmonary embolism. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 30, 2019 Category: Emergency Medicine Authors: David Pillus, Eric Bruno, David Farcy, Gary M. Vilke, Richard Childers Tags: Best Clinical Practice Source Type: research

Mandated 30-minute Scene Time Interval Correlates With Improved Return of Spontaneous Circulation at Emergency Department Arrival: A Before and After Study
Conflicting ideas exist about whether or not Emergency Medical Service (EMS) personnel should treat a cardiac arrest on scene or transport immediately. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 28, 2019 Category: Emergency Medicine Authors: Carly Eastin, Saleema Karim, Chris Hawthorn, M. Hunter Webb, Mian Adnan Waheed, Allen Buford, Mack Hutchison, Chuck Mason, Kevin Sexton Tags: Selected Topics: Prehospital Care Source Type: research

Fournier Gangrene: A Review for Emergency Clinicians
Fournier gangrene (FG) is a rare, life-threatening infection that can result in significant morbidity and mortality, with many patients requiring emergency department (ED) management for complications and stabilization. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 28, 2019 Category: Emergency Medicine Authors: Tim Montrief, Brit Long, Alex Koyfman, Jonathan Auerbach Tags: Clinical Reviews Source Type: research

Pharmacist Presence Decreases Time to Prothrombin Complex Concentrate in Emergency Department Patients with Life-Threatening Bleeding and Urgent Procedures
Reversal of anticoagulation with four-factor prothrombin complex concentrate (4F-PCC) is critical, yet the optimal timing to 4F-PCC administration and whether quicker administration improves hemostasis remains unknown. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 22, 2019 Category: Emergency Medicine Authors: Dalila Masic, Daniel Colon Hidalgo, Shannon Kuhrau, Whitney Chaney, Megan A. Rech Tags: Original Contributions Source Type: research

Initial and Sustained Response Effects of 3 Vagal Maneuvers in Supraventricular Tachycardia: A Randomized, Clinical Trial
For acute termination of supraventricular tachycardia (SVT), vagal maneuvers, including the standard Valsalva maneuver (sVM), modified Valsalva (mVM) maneuver, and carotid sinus massage (CSM), are first-line interventions. There is no criterion standard technique. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 20, 2019 Category: Emergency Medicine Authors: Ezgi Ceylan, Cigdem Ozpolat, Ozge Onur, Haldun Akoglu, Arzu Denizbasi Tags: Original Contributions Source Type: research

Medicine's Shame Problem
Physician mental health is an increasingly discussed topic. Despite the progress made regarding the discussion of physician mental health, these issues remain concerning. In particular, the discussion as to why these issues are so problematic remains limited. Contributors can include bullying, the “hidden curriculum” of medicine, how the medical culture handles errors, and importantly, shame. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 17, 2019 Category: Emergency Medicine Authors: Jennifer J. Robertson, Brit Long Tags: Clinical Review Source Type: research

High Flow Nasal Cannula Oxygen vs. Conventional Oxygen Therapy and Noninvasive Ventilation in Emergency Department Patients: A  Systematic Review and Meta-Analysis
Acute respiratory failure (ARF) is a common cause of presentation to the Emergency Department (ED). High flow nasal cannula (HFNC) has been introduced as an alternative way to administer oxygen. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 14, 2019 Category: Emergency Medicine Authors: Valentina Tinelli, Luca Cabrini, Evgeny Fominskiy, Stefano Franchini, Luca Ferrante, Lorenzo Ball, Paolo Pelosi, Giovanni Landoni, Alberto Zangrillo, Antonio Secchi Tags: Clinical Reviews Source Type: research

Rate of Airway Intervention for Croup at a Tertiary Children ’s Hospital 2015–2016
Croup admission decision making is challenging because the rate of further interventions after stabilization is unclear. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 12, 2019 Category: Emergency Medicine Authors: Gabrielle Hester, Timothy Barnes, Jodi O'Neill, Gloria Swanson, Tracey McGuinn, Amanda Nickel Tags: Original Contributions Source Type: research

Eye of the Needle, Stuck in the Middle
Foreign body lodged in the pharynx is not an uncommon presenting complaint to most emergency departments, but a sewing needle stuck in the posterior pharynx of an adult is a rare finding (1,2). Foreign body ingestion is commonly seen in the pediatric age group. In a retrospective Indian study that included 228 patients with foreign body ingestion, only 3.94% belonged to the age group 6 –20 years, whereas 84.64% belonged to the age group 1–6 years (3). (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 12, 2019 Category: Emergency Medicine Authors: Prakash K. Dubey Tags: Visual Diagnosis in Emergency Medicine Source Type: research

Case Report: Elderly Man with Post Myocardial Infarction Fatigue
An 83-year-old man with a history of hypertension presents to the emergency department with fatigue 2  weeks after an international hospitalization where he was medically managed for a myocardial infarction (MI). His vitals and physical examination were within normal limits; however, 12-lead electrocardiogram demonstrated evidence of anterolateral MI (Figure 1). Laboratory results were notable for a N-terminal prohormone of brain natriuretic peptide of 3020 pg/mL and high-sensitivity troponins 2 h apart of 558 ng/L and 541 ng/L. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 12, 2019 Category: Emergency Medicine Authors: Jamaji C. Nwanaji-Enwerem, Denie Bernier, Owen M. Harris Tags: Visual Diagnosis in Emergency Medicine Source Type: research

Utilization of the Electrocardiographic “Spiked Helmet” Sign in the Diagnosis of Intra-Abdominal Pathology Within the Emergency Setting
The differential diagnosis of electrocardiographic (ECG) ST-segment elevation includes a multitude of cardiopulmonary pathologies, including myocardial infarction, pericarditis, myocarditis, pulmonary embolism, takotsubo syndrome, ventricular aneurysm, and Brugada syndrome, among others (1). However, under the appropriate clinical presentation, this ECG finding expands to include extrathoracic pathology as part of the differential. A lesser-known manifestation of ST-segment elevation referred to as the “spiked helmet” sign (SHS) may represent a key diagnostic clue to the emergency provider of a critically evolv...
Source: The Journal of Emergency Medicine - August 10, 2019 Category: Emergency Medicine Authors: David H. Cisewski, John E. Madias, Lillian Wong Tags: Visual Diagnosis in Emergency Medicine Source Type: research

Clinical Report of an Unusual Life-Threatening Complication of Gingivostomatitis
A previously healthy boy aged 15  months presented to the emergency department (ED) with a 3-day history of fever, ulcerative and vesicular perioral lesions, and refusal to drink and eat, without improvement despite topical therapies. The patient had come to the ED 2 days earlier with good health and normal vital signs, so suppor tive care and recommendations were indicated, including maintenance of hydration and topical treatment. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 10, 2019 Category: Emergency Medicine Authors: Paula Garc ía Sánchez, Blanca Rosich del Cacho, Ángeles Calle Gómez, Rosario López López, Marta Bueno Barriocanal, María de Ceano-Vivas La Calle Tags: Visual Diagnosis in Emergency Medicine Source Type: research

Pediatric Emergency Medicine Point-of-Care Ultrasound for the Diagnosis of Intussusception
Delayed diagnosis of intussusception can lead to air enema failure and increased morbidity. There are limited studies reporting the accuracy of pediatric emergency medicine (PEM) physician point-of-care ultrasound (POCUS) in diagnosing intussusception. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 9, 2019 Category: Emergency Medicine Authors: Theodore E. Trigylidas, Mary A. Hegenbarth, Lina Patel, Christopher Kennedy, Kevin O'Rourke, James C. Kelly Tags: Ultrasound in Emergency Medicine Source Type: research

Epidemiology of Severe Acute Diarrhea in Patients Requiring Hospital Admission
Information on the epidemiology and susceptibility patterns of main pathogens causing severe acute diarrhea may help to reduce inappropriate antimicrobial use in emergency departments. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 9, 2019 Category: Emergency Medicine Authors: Javier Ena, Raisa Goretti Afonso-Carrillo, Miriam Bou-Collado, Ver ónica Galian-Nicolas, Maria Dolores Reyes-Jara, Carmen Martínez-Peinado, Barbara Gomez-Alonso, Francisco Arjona-Zaragozi Tags: Original Contributions Source Type: research

Thoracolumbar Evaluation in the Low-Risk Trauma Patient: A Pilot Study Towards Development of a Clinical Decision Rule to Avoid Unnecessary Imaging in the Emergency Department
Thoracolumbar (TL) injury is a common finding in the severely injured multi-trauma patient. However, the incidence and pattern of TL injury in patients with milder trauma is unclear. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 9, 2019 Category: Emergency Medicine Authors: Daniel Hercz, Timothy D. Montrief, Casey J. Kukielski, Mark Supino Tags: Original Contributions Source Type: research

Methicillin-Resistant Staphylococcus aureus Meningitis from Transanal Migration of a Ventriculoperitoneal Shunt
Bowel perforation is a rare complication of ventriculoperitoneal (VP) shunt placement that can result in anal protrusion of a VP shunt. Retrograde migration of bacteria through the shunt can lead to central nervous system (CNS) infections, such as meningitis, most commonly caused by Escherichia coli or other enteric pathogens. Here we present a case of methicillin-resistant Staphylococcus aureus (MRSA) meningitis from transanal migration of a VP shunt. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 8, 2019 Category: Emergency Medicine Authors: Megan Marino, Christopher Phillips Tags: Clinical Communications: Pediatric Source Type: research

Myonecrosis: A Rare Complication of Cryoneurolysis
Considered a safe and effective procedure, cryoneurolysis has been used to provide pain relief for chronic joint pain for decades. The procedure is similar to common ultrasound-guided percutaneous procedures. Although the literature is limited on the efficacy and safety of cryoneurolysis, there is a consensus that the use of cryoneurolysis is effective, with a risk profile similar to that of other percutaneous procedures. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 7, 2019 Category: Emergency Medicine Authors: Dafina Cahani, Jerel Chacko, Barry Hahn Tags: Clinical Communications: Adult Source Type: research

Profound Pneumocephalus in an Infant
A 4-month-old boy with history of communicating hydrocephalus, who was 5  days postoperative from a parieto-occipital ventriculoperitoneal (VP) shunt placement, presented to the emergency department with fussiness and clear drainage from the postoperative incision. The patient was afebrile, mildly tachycardic for age, awake, fussy, and difficult to console. His physical examination revealed a markedly sunken anterior fontanelle and a 5 cm × 1 cm × 2 cm area of fluctuance underlying the parietal incision. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 7, 2019 Category: Emergency Medicine Authors: Thomas Bottoni, William Bianchi, Sarah Wiegand Tags: Visual Diagnosis in Emergency Medicine Source Type: research

Fever Characteristics and Risk of Serious Bacterial Infection in Febrile Infants
Fever is a common complaint in the pediatric emergency department (ED), but the vast majority of children evaluated with fever do not have a serious bacterial infection (SBI). However, in the neonate, a missed SBI can have devastating consequences. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 7, 2019 Category: Emergency Medicine Authors: Joshua Davis, Erik Lehman Tags: Original Contributions Source Type: research

Should Target Glycemic Range Be Exactly the Same for Patients With Acute Myocardial Infarction Versus Without Diabetes?
Pronounced hyperglycemia by itself is a dangerous condition, but it is particularly dangerous when accompanied by ketoacidosis or a hyperglycemic hyperosmolar state (1). The measurement of glycemia is universally available and inexpensive. Glycemia is often measured in the emergency department (ED); in almost 20% of patients, glucose concentration in serum is evaluated, and capillary glucose measurement is required in an additional large number of patients (2). Another rationale for measuring glycemia in the ED is the fact that every fourth patient in the ED has diabetes mellitus (DM) (3). (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 1, 2019 Category: Emergency Medicine Authors: Goran Pante Koracevic Tags: Letters to the Editor Source Type: research

Blood Pressure Control and Endovascular Therapy
We read with keen interest the comprehensive review by Rezaie et  al. regarding the paradigm shift in the management of acute ischemic stroke (AIS) (1). Their review provides a comprehensive overview of the currently accepted standards for managing large vessel occlusion (LVO) through endovascular therapy (EVT) (1). A strength of their review is the acknowledgme nt of the heterogeneity of AIS disease based on infarct core and size of ischemic but salvageable brain tissue, assessed using advanced imaging. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 1, 2019 Category: Emergency Medicine Authors: Jonathan Ince, Jatinder S. Minhas, Cerebral Haemodynamics in Ageing and Stroke Medicine Research Group Tags: Letters to the Editor Source Type: research

Coronary Angiography after Cardiac Arrest without ST-Segment Elevation
Out of hospital cardiac arrest is a common cause of death in both the United States and Europe and coronary artery disease is the most frequent cause of cardiac arrest. Current international guidelines recommend coronary angiography and percutaneous coronary intervention (PCI) on an immediate basis in patients who have evidence of ST-segment elevation myocardial infarction (STEMI) in the setting of cardiac arrest. These guidelines on resuscitative care also recommend the same interventions in post-arrest patients without any evidence of STEMI if they do not have an obvious non-cardiac cause of arrest. (Source: The Journal ...
Source: The Journal of Emergency Medicine - August 1, 2019 Category: Emergency Medicine Authors: Alisa Fujihashi, Jerrilyn Jones Source Type: research

Bag-Mask Ventilation during Tracheal Intubation of Critically Ill Adults
Up to 40% of tracheal intubations are complicated by hypoxemia, which increases patients ’ risks for cardiac arrest and death. Bag-mask ventilation (BVM) is often used to prevent hypoxemia during intubation. This technique however, may increase the patient’s chance of aspiration. The risk of gastric or oropharyngeal aspiration versus the benefit of preventing hypoxemia has been deba ted for over many years and thus the guidelines for oxygenation during tracheal intubation remains controversial. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 1, 2019 Category: Emergency Medicine Authors: Bethany Dalby, Jerrilyn Jones Source Type: research

Association of Antibiotic Treatment With Outcomes in Patients Hospitalized for an Asthma Exacerbation Treated With Systemic Corticosteroids
For patients admitted to the hospital for asthma exacerbation, current guidelines do not recommend treating with antibiotics; however previous studies have shown a high rate of patients being prescribed antibiotics. It is unclear how treatment with antibiotics affects outcomes for hospitalized patients treated for asthma exacerbation. The purpose of this study was to determine if there is any added benefit in early antibiotic treatment in addition to systemic steroids for patients hospitalized with asthma exacerbation. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 1, 2019 Category: Emergency Medicine Authors: Laura Elizabeth Werline, Amanda Young Source Type: research

Thrombolysis Guided by Perfusion Imaging up to 9 Hours after Onset of Stroke
This study hypothesized that extending the time window for thrombolytic therapy to 9 hours after onset of symptoms in patients with a small core of infarction and a larger area of hypoperfusion would be beneficial. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 1, 2019 Category: Emergency Medicine Authors: Matthew W. Harrison, Amanda Young Source Type: research

Levetiracetam versus phenytoin for second-line treatment of convulsive status epilepticus in children (ConSEPT): an open-label, multicentre, randomised controlled trial
This study examined the comparative efficacy of levetiracetam and phenytoin as second-line agents for the treatment of pediatric convulsive status epilepticus. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 1, 2019 Category: Emergency Medicine Authors: Ryan Matthews, Amanda Young Source Type: research

Comparison of the efficacy of a bougie and stylet in patients with endotracheal intubation: A meta-analysis of randomized controlled trials
Endotracheal intubation (ETI) is a common procedure in the emergency department, one in which fist-attempt success is vital to preventing peri-intubation adverse events. Endotracheal intubation is often performed with assistance from either a flexible bougie or malleable stylet placed into the endotracheal tube. A recent article in the Journal of the American Medical Association found that the bougie had a higher first-attempt success rate. This meta-analysis took this recent study and compared it to other randomized controlled trials evaluating first-attempt success, intubation duration, and safety of using a bougie versu...
Source: The Journal of Emergency Medicine - August 1, 2019 Category: Emergency Medicine Authors: Seth Bartholomew, Amanda Young Source Type: research

The Restrictive IV Fluid Trial in Severe Sepsis and Septic Shock (RIFTS): A Randomized Pilot Study
The ideal amount of intravenous (IV) fluids to give septic patients is still controversial despite extensive research into the topic. Currently, it is generally accepted that initially these patients benefit from a 30 mL/kg bolus, however guidelines regarding further fluid resuscitation are less elucidated. Furthermore, there has been some research to suggest too much IV fluid resuscitation could worsen outcomes. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 1, 2019 Category: Emergency Medicine Authors: Meredith Von Dohlen, Jerrilyn Jones Source Type: research

JEM_Aug_19_AAEM
(Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 1, 2019 Category: Emergency Medicine Source Type: research

Editorial Board
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Source: The Journal of Emergency Medicine - August 1, 2019 Category: Emergency Medicine Source Type: research

Issue Highlights
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Source: The Journal of Emergency Medicine - August 1, 2019 Category: Emergency Medicine Source Type: research

Contents
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Source: The Journal of Emergency Medicine - August 1, 2019 Category: Emergency Medicine Source Type: research

(LEFT) Partial Contents; (RIGHT) Elsevier E-alert 1/2 pg vertical BW filler
(Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 1, 2019 Category: Emergency Medicine Source Type: research

Instructions for Authors
(Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 1, 2019 Category: Emergency Medicine Source Type: research

A Case of Burning Throat Pain
Throat pain is a common complaint in the emergency department. The related diagnoses are varied, from simple gastroesophageal reflux disease to catastrophic aortic dissection. This case highlights the importance of pertinent patient history and frequent reassessments in order to recognize the latter. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - August 1, 2019 Category: Emergency Medicine Authors: Alexis L. Cates, Theo Leriotis, Joseph Herres Tags: Clinical Communications: Adult Source Type: research