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A Serious Diagnosis Lacking Common Symptoms
​BY JENNIFER TUONG; IVAN KHARCHENKO; JEAN LUC AGARD; & AHMED RAZIUDDIN, MDA 65-year-old man who had HIV well-controlled with highly active antiretroviral therapy, hypertension, sciatica, and restless leg syndrome presented to the emergency department with left leg pain. He also had had chemotherapy and radiation for anal cancer. The patient said the pain had started 45 minutes earlier when he was sitting on the toilet.He described the pain as sore in quality and 10/10 on the pain scale. He reported that it had started in his lower back and radiated to his left leg. He said he had had no trauma or weakness to the regi...
Source: The Case Files - May 28, 2019 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Induction of a shorter compression phase is correlated with a deeper chest compression during metronome-guided cardiopulmonary resuscitation: a manikin study
Conclusions Induction of a shorter compression phase is correlated with a deeper chest compression during metronome-guided cardiopulmonary resuscitation.
Source: Emergency Medicine Journal - June 13, 2013 Category: Emergency Medicine Authors: Chung, T. N., Bae, J., Kim, E. C., Cho, Y. K., You, J. S., Choi, S. W., Kim, O. J. Tags: Resuscitation Original article Source Type: research

Admission rates of ED patients with transient ischemic attack have increased since 2000
This study is conducted in 6 New Jersey EDs with annual ED visits from 25000 to 65000. Consecutive patients seen by ED physicians between January 1, 2000, and December 31, 2010, were included. We identified TIA visits using the International Classification of Diseases, Ninth Revision, code. We analyzed the admission rates for TIA testing for significant differences using the Student t test and calculated 95% confidence intervals.Results: Of the 2622659 visits in the database, 8216 (0.3%) were for TIA. Females comprised 57%. There was a statistically significant increase in the annual admission rates for TIA patients from 2...
Source: The American Journal of Emergency Medicine - July 31, 2013 Category: Emergency Medicine Authors: Siama Durrani-Tariq, Barnet Eskin, John R Allegra Tags: Original Contributions Source Type: research

Severe Symptoms, but a Truly Treatable Disease
​BY NOURA MAHDI; DARRON LEWIS; JEREMY OSBORNE; & AHMED RAZIUDDIN, MDA 73-year-old man was brought to the emergency department from his nursing home for rectal bleeding and anemia. The patient mentioned he had had episodes of bright red rectal bleeding and constipation for a few months. A colonoscopy had been done prior to the visit, which revealed a large intestine tumor and biopsy confirming adenocarcinoma. He was awaiting an appointment with his surgeon.The patient reported bloody rectal leakage, and a CBC done at the nursing home showed a hemoglobin level of 7.2. He also complained of dyspnea but denied any other ...
Source: The Case Files - March 20, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Hypoglycemia in Emergency Department
Conclusions When hypoglycemic patients present in the emergency department, physicians should pay attention to the presence of infection, malignancy, liver diseases (liver cirrhosis and biliary tract infection), and acute renal failure.
Source: Journal of Acute Disease - April 22, 2015 Category: Emergency Medicine Source Type: research

Pre-hospital emergency skills for medical students
Conclusion These results show that there is some anxiety amongst students about being able to manage pre-hospital emergencies in which the public might expect them to cope or in which they feel obliged to help. The results show that although students would be willing to help they may not posess the necessary knowledge to do so. They show that there is a demand for teaching focussed on these skills but that there is not necessarily a need for it taking into account the frequency of incidents encountered. A trial teaching programme will take place in July.
Source: Emergency Medicine Journal - November 23, 2015 Category: Emergency Medicine Authors: Wheeler, C. Tags: Stroke RCEM LIGHTNING PRESENTATIONS Source Type: research

South Carolina EMS Integrates In-Hospital Sepsis Care into Protocols
Medic 29 is dispatched to a college dorm for a female with chief complaint of lower abdominal and flank pain for the past five days. The dorm room appears clean and well kept. The patient appears to be a typical 18-year-old college student. She's lying on her bed and is responsive to verbal stimuli, hot to touch, and tachycardic with weak and thready radial pulses at 128. She reports painful urinating for the past 48 hours, general malaise, weakness and nausea. She appears to have labored respirations with a room air SpO2 reading of 95% and is hypotensive with a systolic blood pressure of 88 mmHg that remains low during tr...
Source: JEMS Patient Care - September 1, 2016 Category: Emergency Medicine Authors: Jason G. Walchok, NRP, FP-C Tags: Patient Care Source Type: news

Not as Simple as Canker Sores
BY ​NANA P. MATSUMOTO, & DEREK MEEKS, DO​​A 16-year-old boy presented to a rural ED with a swollen jaw, painful blisters in the mouth, and earache for the past day. One week before, he had a fever with chills, sore throat, and dry coughs. He was not taking any medications, and his immunizations were up-to-date. He had a mild learning disorder but no significant past medical or surgical history.​An apthous ulcer, the most common and one of the earliest signs of Behçet's disease.The patient's vital signs were within normal limits, and his physical examination revealed anterior cervical lymphadenopathy, sinus con...
Source: The Case Files - October 11, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: research

In Loudon County, Tenn., Priority Ambulance Trains More Than 110 Residents to Stop the Bleed
Last week, Priority Ambulance and Fort Loudoun Medical Center observed the national Stop the Bleed initiative with training events and donations that targeted Loudon County schools and the general public. In total, more than 110 Loudon County community members were trained in lifesaving bleeding control techniques, including 40 teachers who serve as a medical first response team at each high school. Priority Ambulance and Fort Loudoun also donated bleeding control kits, which include gauze, gloves, tourniquet and trauma shears, to each public and private elementary, middle and high school in Loudon County. The kits will be...
Source: JEMS Administration and Leadership - April 3, 2018 Category: Emergency Medicine Authors: Priority Ambulance Tags: News Administration and Leadership Source Type: news

Fool Me Once: An Uncommon Presentation of PE
​BY FREDDIE IRIZARRY-DELGADO; VAROON KAKAIYA; & AHMED RAZIUDDIN, MDAn 86-year-old African-American woman was brought to the ED by her daughter after two days of nutritional neglect, abdominal pain, and altered mental status. Her daughter said her mother felt lightheaded, appeared dehydrated, and vomited nonbilious watery fluid once. The patient had a history of diabetes mellitus type 2, DVT/PE, dementia, and early signs of parkinsonism.Her vital signs were remarkable only for tachypnea (24 bpm). Her troponin I was markedly elevated at 1.7 ng/mL. A D-dimer was ordered because of her history of unprovoked DVT/PE, and i...
Source: The Case Files - November 27, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: research

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