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Source: The American Journal of Emergency Medicine

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Total 186 results found since Jan 2013.

Patient, provider, and environmental factors associated with adherence to cardiovascular and cerebrovascular clinical practice guidelines in the emergency department
Myocardial infarction and stroke are two of the leading causes of death in the U.S. Both diseases have clinical practice guidelines (CPGs) specific to the emergency department (ED) that improve patient outcomes. Our primary objectives were to estimate differences in ED adherence across CPGs for these diseases and identify patient, provider, and environmental factors associated with adherence.
Source: The American Journal of Emergency Medicine - December 28, 2017 Category: Emergency Medicine Authors: Stacy A. Trent, Michael A. Johnson, Erica A. Morse, Edward P. Havranek, Jason S. Haukoos Source Type: research

Red blood cell distribution width is associated with mortality in elderly patients with sepsis
RDW is a prognostic biomarker and associated with mortality in cardiovascular disease, stroke and metabolic syndrome. For elderly patients, malnutrition and multiple comorbidities exist, which could affect the discrimination ability of RDW in sepsis. The main purpose of our study was to evaluate the prognostic value of RDW in sepsis among elderly patients.
Source: The American Journal of Emergency Medicine - October 25, 2017 Category: Emergency Medicine Authors: An-Yi Wang, Wei-Fong Kao, Shin-Han Tsai Source Type: research

Cannabis can augment thrombolytic properties of rtPA: Intracranial hemorrhage in a heavy cannabis user
Cannabis is one of the most commonly used illicit drugs in the United States and is considered to have several adverse health effects. There is evidence suggesting that its recreational use is associated with both increased cardio- and cerebrovascular events. Recently, multiple cases of ischemic and hemorrhagic strokes associated with cannabis use were reported in the literature (Goyal et al., 2017). It has been suggested that cannabis can affect cerebral auto-regulation and vascular tone leading to vasoconstriction and acute ischemic stroke.
Source: The American Journal of Emergency Medicine - September 28, 2017 Category: Emergency Medicine Authors: Amar Shere, Hemant Goyal Tags: Case Report Source Type: research

Cannabis can augment thrombolytic properties of rtPA: Case report of an intracranial hemorrhage in a heavy cannabis user
Cannabis is one of the most commonly used illicit drugs in the United States and is considered to have several adverse health effects. There is evidence suggesting that its recreational use is associated with both increased cardio- and cerebrovascular events. Recently, multiple cases of ischemic and hemorrhagic strokes associated with cannabis use were reported in the literature (Goyal et al., 2017). It has been suggested that cannabis can affect cerebral auto-regulation and vascular tone leading to vasoconstriction and acute ischemic stroke.
Source: The American Journal of Emergency Medicine - September 28, 2017 Category: Emergency Medicine Authors: Amar Shere, Hemant Goyal Source Type: research

Predictors of false negative diffusion-weighted MRI in clinically suspected central cause of vertigo
Vertigo is classified as peripheral and central. Differentiation of stroke mimics is the most important diagnostic challenge. There is no clinical guidance for the indications of neuroimaging in isolated vertigo patients. The primary aim of this study is to test the diagnostic value of a DWI-MRI protocol to rule-out a central cause in patients with acute isolated vertigo in the ED.
Source: The American Journal of Emergency Medicine - September 23, 2017 Category: Emergency Medicine Authors: Ebru Unal Akoglu, Haldun Akoglu, Tuba Cimilli Ozturk, Bahaeddin Onur, Serkan Emre Eroglu, Ozge Onur, Arzu Denizbasi Source Type: research

Management of Factor Xa inhibitor-associated life-threatening major hemorrhage: A retrospective multi-center analysis
This study describes a cohort of patients with FXa inhibitor-associated life-threatening bleeding events, their clinical characteristics, interventions and outcomes.
Source: The American Journal of Emergency Medicine - August 19, 2017 Category: Emergency Medicine Authors: Truman J. Milling, Carol L. Clark, Charles Feronti, Shlee S. Song, Sam S. Torbati, Gregory J. Fermann, Jeffrey Weiss, Dony Patel Source Type: research

Investigation of UCH-L1 levels in ischemic stroke, intracranial hemorrhage and metabolic disorder induced impaired consciousness
We aimed to determine the levels of ubiquitin C-terminal hydrolase-L1 (UCH-L1) in patients admitted to the emergency department with impaired consciousness due to metabolic or neurological reasons.
Source: The American Journal of Emergency Medicine - June 21, 2017 Category: Emergency Medicine Authors: Ihsan Yigit, Metin Atescelik, Mustafa Yilmaz, Mehmet Cagri Goktekin, Mehtap Gurger, Nevin Ilhan Source Type: research

Bi-objective approach for placing ground and air ambulance base and helipad locations in order to optimize EMS response
Shortening the travel time of patient transfer has clinical implications for many conditions such as cardiac arrest, trauma, stroke and STEMI. As resources are often limited precise calculations are needed. In this paper we consider the location problem for both ground and aerial emergency medical services. Given the uncertainty of when patients are in need of prompt medical attention we consider these demand points to be uncertain. We consider various ways in which ground and helicopter ambulances can work together to make the whole process go faster.
Source: The American Journal of Emergency Medicine - June 15, 2017 Category: Emergency Medicine Authors: Milad Shahriari, Ali Bozorgi-Amiri, Shayan Tavakoli, Abolghasem Yousefi-Babadi Source Type: research

The challenge of coprescription of antiplatelet therapy and oral anticoagulants
The coexistence of symptomatic carotid artery stenosis and nonvalvular atrial fibrillation (NVAF) in the recently reported 85year old man [1] bears out the findings of the study which documented a 24.3% prevalence of high-grade (50% or more) carotid artery stenosis among 103 consecutive NVAF patients (mean age 69) who presented with stroke [2]. Among these patients with high-grade stenosis 66.7% had stenosis ipsilateral to the cerebral infarct [2]. Given the fact that patients with symptomatic carotid artery stenosis are at high risk of stroke recurrence and/or worsening neurological disability during the first 14days foll...
Source: The American Journal of Emergency Medicine - May 22, 2017 Category: Emergency Medicine Authors: Oscar M.P. Jolobe Source Type: research

Alterations in optic nerve sheath diameter according to cerebrovascular disease sub-groups
ONSD (optic nerve sheath diameter) is a method used for indirect measurement of the increased intracranial pressure. In previous studies, the relation between the increased intracranial pressure and ONSD was analyzed in the patients suffering from cerebrovascular diseases (CVD). In our study, the patients suffering from ischemic CVD were categorized into 4 subgroups according to Oxfordshire Community Stroke Project classification (OCSP); the relationship between each group and ONSD, and the influence on each eye were analyzed.
Source: The American Journal of Emergency Medicine - April 29, 2017 Category: Emergency Medicine Authors: Emre G ökcen, İbrahim Caltekin, Atakan Savrun, Hilal Korkmaz, Şeyda Tuba Savrun, Gökhan Yıldırım Source Type: research

Simple and effective method to lower body core temperatures of hyperthermic patients
Hyperthermia is a potentially life threatening scenario that may occur in patients due to accompanying morbidities, exertion, or exposure to dry and arid environmental conditions. In particular, heat stroke may result from environmental exposure combined with a lack of thermoregulation. Key clinical findings in the diagnosis of heatstroke are (1) a history of heat stress or exposure, (2) a rectal temperature greater than 40 °C, and (3) central nervous system dysfunction (altered mental state, disorientation, stupor, seizures, or coma) (Prendergast and Erickson, 2014 [1]).
Source: The American Journal of Emergency Medicine - January 30, 2017 Category: Emergency Medicine Authors: John P. O'Connor Source Type: research

Cardiac Direct Access Centers and the Mission of Emergency Medicine
In the past 60 years, rigorous emphasis on rapid diagnosis, evidence-based treatment, team dynamics and targeted resuscitation of critically ill and injured patients has led to dramatic improvements in emergency department patient outcomes including mortality [1,2]. This is especially true in severely injured trauma patients, those suffering from ST-elevation myocardial infarctions (STEMI), sepsis and stroke [3-5]. In an effort to distinguish themselves as providers of sophisticated specialty and general emergency care, many organizations and departments seek designations as “centers of excellence,” such as the America...
Source: The American Journal of Emergency Medicine - January 19, 2017 Category: Emergency Medicine Authors: Emily Brumfield, Corey Slovis Source Type: research

Akinetic mutism revealing an ischemic stroke
We describe a 44-year-old man who developed akinetic mutism following a cerebrovascular accident involving his left middle cerebral artery. We discuss this rare condition and its unusual clinical picture.
Source: The American Journal of Emergency Medicine - November 4, 2016 Category: Emergency Medicine Authors: Zidouh Saad, Jidane Said, Belkouch Ahmed, Bakkali Hicham, Belyamani Lahcen Source Type: research

Impact of an emergency medicine pharmacist on time to thrombolysis in acute ischemic stroke: strength of association
We appreciate your insight and review of our manuscript in the American Journal of Emergency Medicine [1]. We acknowledge that measures such as odds ratio (OR) or relative risk may help the reader further understand the strength of association of our outcomes.
Source: The American Journal of Emergency Medicine - October 18, 2016 Category: Emergency Medicine Authors: Kayla Montgomery, A. Brad Hall Tags: Correspondence Source Type: research

Re: Impact of an emergency medicine pharmacist on time to thrombolysis in acute ischemic stroke: strength of association
To the Editor,
Source: The American Journal of Emergency Medicine - October 18, 2016 Category: Emergency Medicine Authors: Kayla Montgomery, A. Brad Hall Tags: Correspondence Source Type: research

Hemorrhagic stroke following consumption of an energy drink
We present here the first-ever reported case of an intracranial hemorrhage associated with the consumption of an energy drink. Our patient developed symptoms of sensory changes in the right arm and leg, with ataxia, within minutes of consuming a bottle of Redline, a well-known energy drink. A CT head revealed a small intracranial hemorrhage near the left thalamus. The Redline bottle notes that the serving size is only half a bottle, and also recommends that people with hypertension not use it, but our patient had not read these instructions.
Source: The American Journal of Emergency Medicine - October 11, 2016 Category: Emergency Medicine Authors: A Venkatraman, A Khawaja, AH Shapshak Tags: Case Report Source Type: research

Hemorrhagic stroke after consumption of an energy drink
We present here the first-ever reported case of an intracranial hemorrhage associated with the consumption of an energy drink. Our patient developed symptoms of sensory changes in the right arm and leg, with ataxia, within minutes of consuming a bottle of Redline, a well-known energy drink. A computed tomography of the head revealed a small intracranial hemorrhage near the left thalamus. The Redline bottle notes that the serving size is only half a bottle, and also recommends that people with hypertension not use it, but our patient had not read these instructions.
Source: The American Journal of Emergency Medicine - October 11, 2016 Category: Emergency Medicine Authors: A. Venkatraman, A. Khawaja, A.H. Shapshak Tags: Case Report Source Type: research

Central venous sinus thrombosis presenting with generalized tonic-clonic seizures in a patient with no known risk factors
We present a case of a previously healthy woman with a new onset seizure, whose only other complaint was weakness despite a normal neurological examination. Her head computed tomography (CT) showed an intraparenchymal hemorrhage of the left frontal lobe and signs of infarction of the right frontal lobe.
Source: The American Journal of Emergency Medicine - October 10, 2016 Category: Emergency Medicine Authors: Patricia Khatib, Omar Mostafa, Erin L. Simon Tags: Case Reports Source Type: research

Central venous sinus thrombosis presenting with generalized tonic –clonic seizures in a patient with no known risk factors
We present a case of a previously healthy woman with a new onset seizure, whose only other complaint was weakness despite a normal neurologic exam. Her head CT showed an intraparenchymal hemorrhage of the left frontal lobe, and signs of infarction of the right frontal lobe.
Source: The American Journal of Emergency Medicine - October 10, 2016 Category: Emergency Medicine Authors: Patricia Khatib, Omar Mostafa, Erin Simon Tags: Case Report Source Type: research

Preclinical and clinical data for factor Xa and “Universal” reversal agents
Oral Factor Xa (FXa) inhibitors, a growing class of direct-acting anticoagulants, are frequently used to prevent stroke and systemic embolism in patients with atrial fibrillation and to prevent and treat venous thromboembolism. These drugs reduce the risk of clotting at the expense of increasing the risk of bleeding, and currently they have no specific reversal agent. However, andexanet alfa, a recombinant modified FXa decoy molecule, is in a late-phase clinical trial in bleeding patients, and ciraparantag, a small molecule that appears to reverse many anticoagulants including the FXa inhibitors, is in development.
Source: The American Journal of Emergency Medicine - September 28, 2016 Category: Emergency Medicine Authors: Truman J. Milling, Scott Kaatz Tags: Review Source Type: research

Safety of Direct Oral Anticoagulants: Insights from Postmarketing Studies
Direct oral anticoagulants (DOACs) have been marketed in the United States since 2010. While numerous large-scale prospective phase 3 outcomes studies have documented the effectiveness of DOACs for the prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation, the primary safety concern with all of these drugs —as it is with the more established oral anticoagulant warfarin—is the risk of major bleeding. Postmarketing surveillance studies (PMSS) provide the opportunity to evaluate the safety of these recently approved drugs across a spectrum of patients that may be broader than those in...
Source: The American Journal of Emergency Medicine - September 28, 2016 Category: Emergency Medicine Authors: Todd C. Villines, W. Frank Peacock Tags: Review Source Type: research

Intracerebral hemorrhage in a middle-aged cocaine user despite normal blood pressures
We report the case of a 40-year-old woman who did not declare at admission her 4-year history of intranasal cocaine hydrochloride and developed an intracerebral subcortical spontaneous hemorrhage. She documented a normal blood pressure, and computer tomography angiography did not show vascular abnormalities and excluded the presence of arterial aneurisms.
Source: The American Journal of Emergency Medicine - September 3, 2016 Category: Emergency Medicine Authors: Antonio Siniscalchi, Walter Lentidoro, Ermanno Pisanil, Giovamabattista De Sarro, Luca Gallelli Tags: Case Report Source Type: research

Intracerebral hemorrhage in a middle aged cocaine user despite normal blood pressures
We report the case of a 40-year-old woman with a not declared at admission with a 4 year history of intranasal cocaine hydrochloride who developed an intracerebral subcortical spontaneous hemorragie. She documented a normal blood pressure and a CT angiography did not shown vascular abnormalities and excluded the presence of arterial aneurisms.
Source: The American Journal of Emergency Medicine - September 3, 2016 Category: Emergency Medicine Authors: Antonio Siniscalchi, Walter Lentidoro, Ermanno Pisanil, Giovamabattista De Sarro, Luca Gallelli Tags: Case Report Source Type: research

2016: Emergency Medical Services Annotated Literature in Review
In the daily practice of emergency medicine, physicians constantly interact with components of emergency medical services (EMS) systems. The provision of high quality care in the prehospital setting requires emergency physicians to remain abreast of recent literature that may inform the care of patients prior to their arrival at the emergency department. This literature review will examine some recent trends in the prehospital literature, including cardiac arrest care, trauma, myocardial infarction, and stroke.
Source: The American Journal of Emergency Medicine - July 18, 2016 Category: Emergency Medicine Authors: Jose V. Nable, Benjamin J. Lawner, William J. Brady Source Type: research

Fatal hemopericardium after intravenous recombinant transplasminogeen activator (rt-PA) for acute ischaemic stroke
A 57-year old man presented to the emergency department with complaints of nausea, fatigue and burning throat which had been present since one week. Except for mild mental retardation and epilepsy for which anti-epileptic medication was used, he was healthy. Physical examination was normal except for tachycardia (133 beats /minute). Laboratory investigation showed creatine kinase (CK) of 220 U/L (10–171), CK-MB 15 U/L (0–15) and troponine 10,8 ug/L (
Source: The American Journal of Emergency Medicine - May 27, 2016 Category: Emergency Medicine Authors: Hanna Hensen, Fianne Spaander, Matthijs Bax, Hille Koppen Source Type: research

Differentiating contrast staining after acute ischemic stroke from hemorrhagic transformation during emergency evaluation
A hyperdense lesion observed in a computed tomographic (CT) image of the brain is usually suspected to be a hemorrhage during an emergency evaluation. Other rare differential diagnoses include contrast-induced encephalopathy (CIN) and acute cerebral infarction with contrast staining (CS). Recent contrast administration is a common risk factor for both CIN and CS. The former has been associated with favorable neurologic outcomes, whereas CS might have complications, such as hemorrhagic transformation (HT).
Source: The American Journal of Emergency Medicine - May 18, 2016 Category: Emergency Medicine Authors: Sing-Kong Ho, Jen-Kuang Lee, Yen-Jun Lai, Tzu-Chiao Lin, Cheng-Wei Liu Tags: Case Report Source Type: research

Wallenberg's lateral medullary syndrome in an adolescent
Concussion and sports-related injuries are common in children. Given the heightened awareness about concussion in recent years, there has been an increase in the diagnosis of concussion in children presenting to the emergency department with head injuries. Often, little consideration is given to other etiologies of neurologic symptoms such as stroke. This may be due to the fact that stroke is uncommon in children when compared to adults. However, there are several case reports of arterial dissection and stroke in the pediatric age group resulting from trivial trauma.
Source: The American Journal of Emergency Medicine - May 12, 2016 Category: Emergency Medicine Authors: Elizabeth Day Ruedrich, Mahesh Chikkannaiah, Gogi Kumar Tags: Case Report Source Type: research

Wallenberg's Lateral Medullary Syndrome in an Adolescent
Concussion and sports-related injuries are common in children. Given the heightened awareness about concussion in recent years, there has been an increase in the diagnosis of concussion in children presenting to the emergency department with head injuries. Often, little consideration is given to other etiologies of neurologic symptoms such as stroke. This may be due to the fact that stroke is uncommon in children when compared to adults. However, there are several case reports of arterial dissection and stroke in the pediatric age group resulting from trivial trauma.
Source: The American Journal of Emergency Medicine - May 12, 2016 Category: Emergency Medicine Authors: Elizabeth Ruedrich, Mahesh Chikkannaiah, Gogi Kumar Tags: Case Report Source Type: research

Hyperthermia and Severe Rhabdomyolysis From Synthetic Cannabinoids Am J Emerg Med 2016;34:121.e1-2. Doi: 10.1016/j.Ajem.2015.05.052. Epub 2015 Jun 12
We read with great interest the case report by Sweeney et al. [1] discussing severe hyperthermia and rhabdomyolysis following a reported exposure to a synthetic cannabinoid receptor agonist (SCRA). SCRA exposures, first reported in NYC in 2010, were at an all-time high in 2015 [2]. Confirmed cases of significant SCRA-associated acute kidney injury, stroke, and acute psychosis are reported [3,4].
Source: The American Journal of Emergency Medicine - May 11, 2016 Category: Emergency Medicine Authors: Mark Su, Larissa Laskowski, Robert S. Hoffman Tags: Correspondence Source Type: research

Letter in response to: Hyperthermia and severe rhabdomyolysis from synthetic cannabinoids. Am J Emerg Med 2016;34:121.e1–2. doi: 10.1016/j.ajem.2015.05.052. Epub 2015 Jun. 12
We read with great interest the case report by Sweeney et al. [1] discussing severe hyperthermia and rhabdomyolysis following a reported exposure to a synthetic cannabinoid receptor agonist (SCRA). SCRA exposures, first reported in NYC in 2010, were at an all-time high in 2015 [2]. Confirmed cases of significant SCRA-associated acute kidney injury, stroke and acute psychosis are reported [3,4].
Source: The American Journal of Emergency Medicine - May 11, 2016 Category: Emergency Medicine Authors: Mark Su, Larissa Laskowski, Robert S. Hoffman Tags: Correspondence Source Type: research

Higher prehospital blood pressure prolongs door to needle thrombolysis times: a target for quality improvement?
Per the American Heart Association guidelines, blood pressure (BP) should be less than 185/110 to be eligible for stroke thrombolysis. No studies have focused on prehospital BP and its impact on door to needle (DTN) times. We hypothesized that DTN times would be longer for patients with higher prehospital BP.
Source: The American Journal of Emergency Medicine - April 16, 2016 Category: Emergency Medicine Authors: Digvijaya D. Navalkele, Chunyan Cai, Farhaan Vahidy, Mohammad H. Rahbar, Renganayaki Pandurengan, Tzu-Ching Wu, Amrou Sarraj, Andrew Barreto, James C. Grotta, Nicole Gonzales Tags: Brief Report Source Type: research

The Utility of Bolus IV Nicardipine for Hypertensive Emergencies in the Emergency Department
We describe the first two documented cases of use of nicardipine administered as an IV bolus dose in the emergency department for hypertensive emergencies involving acute ischemic stroke and hemorrhagic stroke.
Source: The American Journal of Emergency Medicine - March 21, 2016 Category: Emergency Medicine Authors: Stephanie N. Komura, Nadia I. Awad Tags: Case Report Source Type: research

The utility of bolus intravenous nicardipine for hypertensive emergencies in the ED
We describe the first 2 documented cases of use of nicardipine administered as an IV bolus dose in the emergency department (ED) for hypertensive emergencies involving acute ischemic stroke and hemorrhagic stroke.
Source: The American Journal of Emergency Medicine - March 21, 2016 Category: Emergency Medicine Authors: Stephanie N. Komura, Nadia I. Awad Tags: Case Report Source Type: research

Cerebral hyperperfusion syndrome: a rare postoperative complication of carotid endarterectomy
Acute neurological deficits are common presentations to the emergency department. Cerebral hyperperfusion syndrome, a rare phenomenon which can occur within one month following carotid surgical revascularization, may be challenging for the emergency physician to diagnose in the setting of an acute neurological presentation. Carotid arterial disease contributes 15-20% of ischemic cerebrovascular accidents and surgical revascularization is the commonest intervention for preventing stroke in patients with significant carotid disease.
Source: The American Journal of Emergency Medicine - March 5, 2016 Category: Emergency Medicine Authors: Mina Guirgis, Kishore Sieunarine Source Type: research

Cerebral hyperperfusion syndrome: A rare postoperative complication of carotid endarterectomy
Acute neurological deficits are common presentations to the emergency department. Cerebral hyperperfusion syndrome, a rare phenomenon which can occur within one month following carotid surgical revascularization, may be challenging for the emergency physician to diagnose in the setting of an acute neurological presentation. Carotid arterial disease contributes 15 –20% of ischemic cerebrovascular accidents and surgical revascularization is the commonest intervention for preventing stroke in patients with significant carotid disease.
Source: The American Journal of Emergency Medicine - March 5, 2016 Category: Emergency Medicine Authors: Mina Guirgis, Kishore Sieunarine Tags: Case Report Source Type: research

Protective effects of cyclosporine A and hypothermia on neuronal mitochondria in a rat asphyxial cardiac arrest model
Cyclosporine A (CsA) was neuroprotective in the settings of traumatic brain injury and stroke. We sought to investigate the protective effects of CsA and hypothermia on neuronal mitochondria after cardiac arrest.Methods and Results.Five groups were included: sham (S), normothermia (N), CsA (C), hypothermia (H), and CsA plus hypothermia (C+H). Cardiac arrest was induced by 10min of asphyxia. CsA (10mg/kg) was administered immediately after return of spontaneous circulation in the CsA groups. Temperature of the rats was maintained at 33±0.5°C after return of spontaneous circulation in the hypothermia groups.
Source: The American Journal of Emergency Medicine - March 1, 2016 Category: Emergency Medicine Authors: Jie Liu, Yue Wang, Qiwei Zhuang, Meng Chen, Yufeng Wang, Lina Hou, Fei Han Tags: Original Contributions Source Type: research

Brugada Electrocardiogram Pattern Induced by Cannabis; is cannabis safe?
The objective of this study was to present a case report that bring attention to relationship between cannabis consumption and Brugada electrocardiogram pattern (BEP). Here we present a case of a 19-year-old male patient with symptomatic BEP induced after cannabis consumption. With the potential for more widespread legalization of cannabis several studies are raising the issue of adverse vascular effects of cannabis, including myocardial infarction, sudden cardiac death, cardiomyopathy, stroke, transient ischemic attack, and cannabis arteritis.
Source: The American Journal of Emergency Medicine - December 30, 2015 Category: Emergency Medicine Authors: Joaquín Valle Alonso, Beatrix Theo, F. Javier Fonseca del Pozo, Miguel Angel Aguayo, Almudena Sanchez Tags: Case Report Source Type: research

Admission serum lactate predicts mortality in aneurysmal subarachnoid hemorrhage
Aneurysmal SAH is the most devastating form of hemorrhagic stroke. Primary predictors of mortality are based on initial clinical presentation. Initial serum lactic acid levels have been shown to predict mortality and disease severity. Initial serum lactate may be an objective predictor or mortality.
Source: The American Journal of Emergency Medicine - December 30, 2015 Category: Emergency Medicine Authors: Imo P. Aisiku, Peng Roc Chen, Hanh Truong, Daniel R. Monsivais, Jonathan Edlow Tags: Original Contribution Source Type: research

Brugada electrocardiogram pattern induced by cannabis; is cannabis safe?
The objective of this study was to present a case report that brings attention to relationship between cannabis consumption and Brugada electrocardiogram pattern. Here, we present a case of a 19-year-old male patient with symptomatic Brugada electrocardiogram pattern induced after cannabis consumption. With the potential for more widespread legalization of cannabis, several studies are raising the issue of adverse vascular effects of cannabis, including myocardial infarction, sudden cardiac death, cardiomyopathy, stroke, transient ischemic attack, and cannabis arteritis.
Source: The American Journal of Emergency Medicine - December 30, 2015 Category: Emergency Medicine Authors: Joaqu ín Valle Alonso, Beatrix Huei-Yi Teo, F. Javier Fonseca del Pozo, Miguel Angel Aguayo, Almudena Sanchez Tags: Case Report Source Type: research

Bradycardia caused by Intravenous Nicardipine in an Elderly Patient with Acute Ischemic Infarct
We report the case of an elderly patient with an acute ischemic stroke who developed nicardipineinduced bradycardia in the ED.
Source: The American Journal of Emergency Medicine - August 17, 2015 Category: Emergency Medicine Authors: Michael E. Abboud, Sarah E. Frasure Tags: Case Report Source Type: research

Cerebral Oximetry with Cerebral Blood Volume Index (CBVI) in detecting Pediatric Strokes in a Pediatric Emergency Department
Despite pediatric stroke awareness and Pediatric Stroke Activation systems, recognition and imaging delays along with activation inconsistency still occurs. Reliable objective pediatric stroke detection tool are needed to improve detection and activations. Cerebral rcSO2 with cerebral blood volume index (CBVI) can detect abnormal cerebral physiology.
Source: The American Journal of Emergency Medicine - July 22, 2015 Category: Emergency Medicine Authors: Thomas J. Abramo, Z. Leah Harris, Mark Meredith, Kristen Crossman, Abby Williams, Sheila McMorrow, Jennifer Dindo, Angela Gordon, Maria Melguizo-Castro, Zhuopei Hu, Todd Nick Tags: Original Contribution Source Type: research

Achieving regionalization through rural interhospital transfer
Regionalization of emergency medical care aims to provide consistent and efficient high-quality care leading to optimal clinical outcomes by matching patient needs with appropriate resources at a network of hospitals. Regionalized care has been shown to improve outcomes in trauma, myocardial infarction, stroke, cardiac arrest, and acute respiratory distress syndrome. In rural areas, effective regionalization often requires interhospital transfer. The decision to transfer is complex and includes such factors as capabilities of the presenting hospital; capacity at the receiving hospital; and financial, geographic, and patien...
Source: The American Journal of Emergency Medicine - May 29, 2015 Category: Emergency Medicine Authors: Leah Feazel, Adam B. Schlichting, Gregory R. Bell, Dan M. Shane, Azeemuddin Ahmed, Brett Faine, Andrew Nugent, Nicholas M. Mohr Tags: Review Source Type: research

Achieving Regionalization through Rural Inter-hospital Transfer
Regionalization of emergency medical care aims to provide consistent and efficient high quality care leading to optimal clinical outcomes by matching patient needs with appropriate resources at a network of hospitals. Regionalized care has been shown to improve outcomes in trauma, myocardial infarction, stroke, cardiac arrest, and acute respiratory distress syndrome. In rural areas, effective regionalization often requires inter-hospital transfer. The decision to transfer is complex and includes such factors as capabilities of the presenting hospital, capacity at the receiving hospital, financial, geographic, and patient-p...
Source: The American Journal of Emergency Medicine - May 29, 2015 Category: Emergency Medicine Authors: Leah Feazel, Adam B. Schlichting, Gregory R. Bell, Dan M. Shane, Azeemuddin Ahmed, Brett Faine, Andrew Nugent, Nicholas M. Mohr Tags: Review Source Type: research

Association of Plasma DAO and iFABP with Severity of Disease In Patient with Heat Stroke
The aim of this study was to describe the role of intestinal fatty acid-binding protein (iFABP) and allergy-related diamine oxidase (DAO) in HS patients.
Source: The American Journal of Emergency Medicine - February 2, 2015 Category: Emergency Medicine Authors: Lin Zhang, Xiaoming Fan, Zhiyue Zhong, Guoxiong Xu, Jie Shen Tags: Original Contribution Source Type: research

Intraparenchymal hemorrhage after heroin use
Heroin-associated stroke is a rare complication of use. Various proposed mechanisms of heroin-associated ischemic stroke have been proposed, including the following: cardioembolism in the setting of infective endocarditis, hypoxic ischemic brain injury in the setting of hypoxemia and hypotension, and infective arteritis or vasculitis from drug adulterants. A previously healthy 28-year-old woman presented to the emergency department with altered mental status and normal vitals after she was found wandering outside her apartment.
Source: The American Journal of Emergency Medicine - January 16, 2015 Category: Emergency Medicine Authors: Neha Kumar, Mary Colleen Bhalla, Jennifer A. Frey, Alison Southern Tags: Case Report Source Type: research