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American Journal of Emergency Medicine

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https://www.readbyqxmd.com/read/28716593/the-critical-care-literature-2016
#1
REVIEW
Michael E Winters, Joseph P Martinez, Haney Mallemat, William J Brady
An emergency physician (EP) is often the first health care provider to evaluate, resuscitate, and manage a critically ill patient. Between 2001 and 2009, the annual hours of critical care delivered in emergency departments (EDs) across the United States increased >200%! (Herring et al., 2013). This trend has persisted since then. In addition to seeing more critically ill patients, EPs are often tasked with providing critical care long beyond the initial resuscitation period. In fact, >33% of critically ill patients who are brought to an ED remain there for >6h (Herring et al...
July 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28716591/clustering-making-model-for-diagnosis-of-acute-coronary-syndrome-using-pca-based-on-k-mica-algorithms
#2
LETTER
Mahsa Charkhkar, Hossien Vakili, Marzieh Kheirabadi, Javad Haddadnia
No abstract text is available yet for this article.
July 12, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28720402/comparison-of-different-airway-management-devices-used-by-non-anaesthetist-personnel-a-crossover-manikin-study
#3
LETTER
Daniele Orso, Tommaso Piani, Lorenzo Cristiani, Francesco L Cilenti, Nicola Federici, Elena Cecchin, Nicola Guglielmo, Roberto Copetti
No abstract text is available yet for this article.
July 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28712642/a-rare-case-of-febrile-abdominal-pain-revealing-horton-s-disease
#4
Arnaud Chaudet, Jean-Michel Goujon, Aiham Daniel Ghazali
BACKGROUND: Horton's disease is a systemic inflammatory vasculitis, usually found in persons over 50years old. It affects medium and large-sized arteries stemming from the external carotid, especially the superficial temporal arteries. It can affect extracranial large vessels but only rarely the aorta. Diagnosis of aortitis is difficult and its incidence is probably underestimated. CASE PRESENTATION: A 68-year-old Caucasian woman consulted in an emergency department for febrile abdominal pain with inflammatory syndrome...
July 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28712641/late-onset-postpartum-preeclampsia-is-it-time-to-reconsider-if-it-s-really-too-late-a-case-of-preeclampsia-3-months-after-delivery
#5
Al Giwa, Melissa Nguyen
No abstract text is available yet for this article.
July 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28711277/use-of-a-midstream-clean-catch-mobile-application-did-not-lower-urine-contamination-rates-in-an-emergency-department
#6
Mary S Jacob, Paige Kulie, Cameron Benedict, Alexander J Ordoobadi, Neal Sikka, Erika Steinmetz, Melissa L McCarthy
OBJECTIVES: Urine microscopy is a common test performed in emergency departments (EDs). Urine specimens can easily become contaminated by different factors, including the collection method. The midstream clean-catch (MSCC) collection technique is commonly used to reduce urine contamination. The urine culture contamination rate from specimens collected in our ED is 30%. We developed an instructional application (app) to show ED patients how to provide a MSCC urine sample. We hypothesized that ED patients who viewed our instructional app would have significantly lower urine contamination rates compared to patients who did not...
July 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28711276/association-of-clinician-burnout-and-perceived-clinician-patient-communication
#7
LETTER
Bernard P Chang, Eileen Carter, Nina Ng, Caitlin Flynn, Timothy Tan
No abstract text is available yet for this article.
July 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28711274/clinical-association-lyme-disease-and-guillain-barre-syndrome
#8
Kinner Patel, Siddharth Shah, Dinesh Subedi
Guillain-Barre Syndrome (GBS) is a life-threatening condition in which patients may present to the Emergency Department in respiratory distress leading to death. The early identification and treatment of such a condition is paramount in preventing mortality. While there are many infections associated with GBS, the association with Lyme disease is uncommon. Through our case we aim to highlight Borrelia burgdorferi as an important antecedent infection associated with the development of GBS. In this case we report a 31-year-old male who was diagnosed with Lyme disease and GBS with relevant clinical presentation including progressive numbness and weakness in bilateral hands and feet for the past 1week along with areflexia...
July 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28711273/treatment-methods-following-suicidal-self-administration-of-iv-organophosphate-what-can-additional-lipid-administration-change
#9
Kenan Ahmet Turkdogan, Ali Duman, Mucahit Avcil, Ayhan Akoz, Selcuk Eren Canakcı, Burcak Kantekin
Organic phosphor compounds are highly toxic and life-threatening compounds that are widely used in agriculture, households and gardens worldwide. While oral intakes are observed frequently, toxic effects can also be seen through contract or inhalation. However, toxic cases through the parenteral route have rarely been reported. We had three main aims: first, to present a male patient who self-administered 2ml of monocrotophos intravenously to commit suicide. Our second goal was to present the current multiple treatment methods, such as fast general support, antidote treatment, lipid emulsion treatment, and plasmapheresis along with the literature...
July 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28709715/social-media-for-health-care-education-can-it-make-a-difference
#10
LETTER
Subramanian Senthilkumaran, Florence Benita, Namasivayam Balamurugan, Ponniah Thirumalaikolundusubramanian
No abstract text is available yet for this article.
July 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28705744/the-relationship-between-ocular-trauma-and-substance-abuse-in-emergency-department-patients
#11
Sylvia L Chang, Vaama Patel, John Giltner, Richard Lee, Catherine A Marco
INTRODUCTION: Eye injury is the second most common cause of visual impairment and a leading cause of monocular blindness in the United States. There are approximately 6 million ED visits related to drug use annually, including misuse or abuse of pharmaceuticals and illicit drug use. The purpose of this study was to assess the relationship between ocular trauma and substance abuse among emergency department patients and to assess that relationship with demographic factors, including age and gender...
July 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28712645/comparison-of-qsofa-score-and-sirs-criteria-as-screening-mechanisms-for-emergency-department-sepsis
#12
Samir Haydar, Matthew Spanier, Patricia Weems, Samantha Wood, Tania Strout
OBJECTIVES: The Quick Sequential [Sepsis-related] Organ Failure Assessment (qSOFA) score has been shown to accurately predict mortality in septic patients and is part of recently proposed diagnostic criteria for sepsis. We sought to ascertain the sensitive of the score in diagnosing sepsis, as well as the diagnostic timeliness of the score when compared to traditional systemic inflammatory response syndrome (SIRS) criteria in a population of emergency department (ED) patients treated in the ED, admitted, and subsequently discharged with a diagnosis of sepsis...
July 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28711275/chemotherapy-induced-stroke-mimic-5-fluorouracil-encephalopathy-fulfilling-criteria-for-tissue-plasminogen-activator-therapy
#13
May Thuy Nguyen, Robyn Stoianovici, Luigi Brunetti
Stroke mimics, especially those involving chemotherapy related neurotoxicity, can confound the clinical diagnosis of acute stroke. Here we describe the case of a 63year-old male with a recent history of stage IIIC colon cancer who presented with confusion on the second day of modified FOLFOX6 (5-fluorouracil/oxaliplatin) chemotherapy and subsequently received alteplase, tissue plasminogen activator therapy (tPA), for presumed ischemic stroke. Magnetic resonance imaging scans after tPA administration did not reveal evidence of an infarction and the patients' neurological symptoms resolved completely after discontinuation of 5-fluorouracil (5-FU)...
July 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28705745/massive-diltiazem-and-metoprolol-overdose-rescued-with-extracorporeal-life-support
#14
James A Chenoweth, Daniel K Colby, Mark E Sutter, Joshua B Radke, Jonathan B Ford, J Nilas Young, John R Richards
The management of overdoses of cardioactive medications in the emergency department can be challenging. The reversal of severe toxicity from one or more types of cardioactive medication may fail maximal medical therapies and require extreme invasive measures such as transvenous cardiac pacing and extracorporeal life support. We present a case of massive diltiazem and metoprolol overdose refractory to maximal medical therapy, including intravenous calcium, glucagon, vasopressors, high dose insulin, and lipid emulsion...
July 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28720403/gradenigo-s-syndrome-a-case-of-a-common-infection-with-uncommon-consequences
#15
Matthew Vitale, Misra Amrit, Rajan Arora, Julie Lata
Acute otitis media is a common diagnosis encountered by emergency medicine providers. With appropriate antibiotic treatment, patients with otitis media, in general, have minimal long-term sequela from their underlying infection (Limb et al., 2017 [1]). However, untreated cases can develop life-threatening complications that require prompt intervention. We report a case of an 8-year-old that developed Gradenigo's syndrome, a condition characterized by the triad of otitis media, facial pain in the distribution of the trigeminal nerve, and abducens nerve palsy (Yeung and Lustig, 2016; Janjua et al...
July 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28705742/an-acute-oral-intoxication-with-haloperidol-decanoate-a-case-report
#16
Bart G J Dekkers, Ruben J Eck, Jan C Ter Maaten, Daniël J Touw
Haloperidol decanoate is a typical antipsychotic drug used as maintenance therapy for schizophrenia and mood disorders formulated as an ester for intramuscular injection. Cases of oral haloperidol decanoate intoxications have not been described in literature. In this report, we present for the first time a case of an oral ingestion of haloperidol decanoate of a young woman who presented to the emergency department following an intentional oral ingestion of 1 ampoule of haloperidol decanoate 100mg. At presentation, she had a bilateral rest tremor of both hands and mild hypothermia...
July 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28698134/effects-of-advanced-life-support-on-patients-who-suffered-cardiac-arrest-outside-of-hospital-and-were-defibrillated
#17
Akihito Hagihara, Daisuke Onozuka, Takashi Nagata, Manabu Hasegawa
BACKGROUND: The effects and relative benefits of advanced airway management and epinephrine on patients with out-of-hospital cardiac arrest (OHCA) who were defibrillated are not well understood. METHODS: This was a prospective observational study. Using data of all out-of-hospital cardiac arrest cases occurring between 2005 and 2013 in Japan, hierarchical logistic regression and conditional logistic regression along with time-dependent propensity matching were performed...
July 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28698133/randomized-controlled-trial-of-internal-and-external-targeted-temperature-management-methods-in-post-cardiac-arrest-patients
#18
Xinqi Look, Huihua Li, Mingwei Ng, Eric Tien Siang Lim, Sohil Pothiawala, Kenneth Boon Kiat Tan, Duu Wen Sewa, Nur Shahidah, Pin Pin Pek, Marcus Eng Hock Ong
BACKGROUND: Targeted temperature management post-cardiac arrest is currently implemented using various methods, broadly categorized as internal and external. This study aimed to evaluate survival-to-hospital discharge and neurological outcomes (Glasgow-Pittsburgh Score) of post-cardiac arrest patients undergoing internal cooling verses external cooling. METHODOLOGY: A randomized controlled trial of post-resuscitation cardiac arrest patients was conducted from October 2008-September 2014...
July 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28689859/pancreatitis-with-normal-lipase-and-amylase-in-setting-of-end-stage-renal-disease
#19
Anuj Sharma, Umair Masood, Babar Khan, Kunal Chawla, Divey Manocha
Pancreatitis with normal lipase and amylase level is a rare phenomenon. This is especially true in patient with end-stage renal disease as lipase and amylase are renally excreted. Literature review reveals previous case report of pancreatitis with normal lipase and amylase level, however, none of them occurred in the setting of end-stage renal disease. Our case is the first such reported case of pancreatitis in such setting. Here we report a 30year old male with past medical history of end-stage renal disease who presented in emergency department with acute abdominal pain...
July 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28716595/the-risk-stratification-and-prognostic-evaluation-of-soluble-programmed-death-1-on-patients-with-sepsis-in-emergency-department
#20
Yongzhen Zhao, Yumei Jia, Chunsheng Li, Yingying Fang, Rui Shao
OBJECTIVE: To evaluate the efficacy of soluble programmed death-1 (sPD-1) for risk stratification and prediction of 28-day mortality in patients with sepsis, we compared serum sPD-1 with procalcitonin (PCT), C-reactive protein (CRP), and the Mortality in Emergency Department Sepsis (MEDS) score. METHODS: A total of 60 healthy volunteers and 595 emergency department (ED) patients were recruited for this prospective cohort study. According to the severity of their condition on ED arrival, the patients were allocated to the systemic inflammatory response syndrome group (130 cases), sepsis group (276 cases), severe sepsis group (121 cases), and septic shock group (68 cases)...
July 4, 2017: American Journal of Emergency Medicine
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