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American Journal of Emergency Medicine

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https://www.readbyqxmd.com/read/29042095/can-emergency-physicians-accurately-distinguish-retinal-detachment-from-posterior-vitreous-detachment-with-point-of-care-ocular-ultrasound
#1
Nicola Baker, Richard Amini, Elaine H Situ-LaCasse, Josie Acuña, Tomas Nuño, Uwe Stolz, Srikar Adhikari
STUDY OBJECTIVE: There is significant overlap between the symptoms of patients presenting with retinal detachment (RD) and posterior vitreous detachment (PVD). Urgency to obtain consultation and treatment are dependent on the ability to accurately distinguish these two conditions. The objective of this study was to determine the ability of emergency physicians to differentiate RDs from PVDs using point-of-care (POC) ocular ultrasound. METHODS: Single blinded cross-sectional study at an academic medical center...
October 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29050845/high-rate-of-isolated-right-ventricular-dysfunction-in-patients-with-non-significant-computed-tomographic-pulmonary-angiography
#2
Frances M Russell, Jeffrey A Kline, Timothy Lahm
BACKGROUND: Right ventricular (RV) dysfunction and pulmonary hypertension (PH) are commonly unrecognized in the emergency department (ED), but are associated with poor outcomes. Prior research has found a 30% prevalence of isolated RV dysfunction in ED patients after non-significant computed tomographic pulmonary angiography (CTPA). We aimed to prospectively define the prevalence of RV dysfunction and/or PH in short of breath ED patients, and assess outcomes. METHODS: Prospective observational study of patients with a non-significant CTPA...
October 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29050844/monitoring-the-corrected-qt-in-the-acute-care-setting-a-comparison-of-the-12%C3%A2-lead-electrocardiogram-and-bedside-monitor
#3
James A Chenoweth, Aaron M Hougham, Daniel K Colby, Jonathan B Ford, Jordan Sandhu, Timothy E Albertson, Mark E Sutter
INTRODUCTION: Prolongation of the QT interval is a well-recognized complication associated with many commonly used medications. Emergency Department monitoring of the corrected QT (QTc) both before and after medication administration is typically performed using the 12‑lead electrocardiogram (ECG). The purpose of this study is to compare the QTc reported on the 12‑lead ECG to that reported by single brand of bedside monitor. METHODS: A convenience sample of emergency department patients over the age of 18 undergoing bedside monitoring and who had an ECG ordered by their treating physician were enrolled...
October 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29033344/a-prospective-study-of-ketamine-as-primary-therapy-for-prehospital-profound-agitation
#4
Jon B Cole, Lauren R Klein, Paul C Nystrom, Johanna C Moore, Brian E Driver, Brandon J Fryza, Justin Harrington, Jeffrey D Ho
OBJECTIVE: We investigated the effectiveness of ketamine as a primary therapy for prehospital profound agitation. METHODS: This was a prospective observational study of patients receiving 5mg/kg of intramuscular ketamine for profound agitation, defined as a score of +4 on the Altered Mental Status Scale (AMSS), a validated ordinal scale of agitation from -4 (unresponsive) to +4 (most agitated). The primary outcome was time to adequate sedation (AMSS<+1). Secondary outcomes included need for additional sedatives, intubation frequency, complications associated with ketamine, and mortality...
October 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29033343/symptomatic-relief-as-an-outcome-in-studies-of-nasogastric-decompression-in-small-bowel-obstruction
#5
LETTER
Stamatis Karakonstantis, Dimitra Kalemaki
No abstract text is available yet for this article.
October 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29033342/intentional-cyanoacrylate-ingestion-a-rare-cause-of-delayed-gastric-perforation-requiring-gastric-wedge-resection
#6
Sun Hwa Lee, Seong Jong Yun, Seokyong Ryu, Seung Won Choi, Hye Jin Kim, Tae Kyung Kang, Sung Chan Oh, Suk Jin Cho
Cyanoacrylate (LOCTITE® 401™) is a fast-acting adhesive available nationwide, with medical and household uses. Most cases of cyanoacrylate exposure are accidental and occur in children less than 5years old. Various routes of exposure have been reported including the dermal, oral, ocular, otic, nasal, and urethral routes; however, very few result in serious complication and mortality. Although a few cases of airway obstruction related to cyanoacrylate ingestion have been reported, intentional cyanoacrylate ingestion-induced gastrointestinal tract injury has scarcely been reported...
October 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29033340/nonepileptic-seizure-provoked-by-cardiac-dysrhythmia-a-case-of-st-elevation-myocardial-infarction
#7
A Pourmand, S Davis, K Yensen
Acute seizures represent 1% of all visits to emergency departments in the United States. While many acute seizures are correctly attributable to underlying epilepsy, approximately one-third of acute seizures are provoked by underlying and potentially life-threatening acute conditions. Many clinical syndromes associated with seizure-like activity are well-established and readily identified in the acute setting. Cardiac dysrhythmias are known causes of acute seizure-like activity and, if transient and not captured by electrocardiogram tracings during acute episodes, may be incorrectly diagnosed as epileptic seizures...
October 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29032876/clinical-value-of-triage-lactate-in-risk-stratifying-trauma-patients-using-interval-likelihood-ratios
#8
Bonny J Baron, Andrew Nguyen, Dimitre Stefanov, Amit Shetty, Shahriar Zehtabchi
Emergency physicians face the challenge of rapidly identifying high-risk trauma patients. Lactate (LAC) is widely used as a surrogate of tissue hypoperfusion. However, clinically important values for LAC as a predictor of mortality are not well defined. OBJECTIVES: 1. To assess the value of triage LAC in predicting mortality after trauma. 2. To compute interval likelihood ratios (LR) for LAC. METHODS: Retrospective chart review of trauma patients with a significant injury mechanism that warranted labs at an urban trauma center...
October 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29031481/systemic-lupus-erythematosus-following-meningococcal-vaccination
#9
Alexandria D Holmes, Osman Z Abbasi, Jeanne L Jacoby
No abstract text is available yet for this article.
October 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29031480/more-than-a-drink-a-rare-anaphylactic-reaction-to-sparkling-water
#10
Ryan K Dean, Rogin Subedi, Peter Christiano, Anil Ghimire
Anaphylaxis is a potentially life threatening, type I hypersensitivity reaction which can occur within seconds to minutes after exposure to an allergen. Sulfites have been implicated in causing such reactions with symptoms ranging from mild to potentially life threatening. Here we present a patient who had an anaphylactic reaction secondary to exposure to sulfites found in sparkling water.
October 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29031478/patterns-of-facial-trauma-before-and-after-legalization-of-marijuana-in-denver-colorado-a-joint-study-between-two-denver-hospitals
#11
Mofiyinfolu Sokoya, Justin Eagles, Tyler Okland, Dylan Coughlin, Hannah Dauber, Christopher Greenlee, Andrew A Winkler
INTRODUCTION: The effect of marijuana on human health has been studied extensively. Marijuana intoxication has been shown to affect performance, attention span, and reaction time. The public health relationship between trauma and cannabis use has also been studied, with mixed conclusions. In this report, the effect of marijuana legalization on many aspects of facial trauma at two hospitals in Denver, Colorado is examined. METHODS: A retrospective review of the electronic medical records was undertaken...
October 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29033345/along-the-colorado-trail-assessing-the-average-hikers-knowledge-of-altitude-sickness
#12
LETTER
Layne Dylla, Michael L Saulle, Edward Daingerfield, Courtney M C Jones, Ryan P Bodkin
No abstract text is available yet for this article.
October 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29032875/ventilator-use-by-emergency-medical-services-during-911-calls-in-the-united-states
#13
Mazen El Sayed, Hani Tamim, Aurelie Mailhac, Mann N Clay
BACKGROUND: Emergency and transport ventilators use in the prehospital field is not well described. This study examines trends of ventilator use by EMS agencies during 911 calls in the United States and identifies factors associated with this use. METHODS: This retrospective study used four consecutive releases of the US National Emergency Medical Services Information System (NEMSIS) public research dataset (2011-2014) to describe scene EMS activations (911 calls) with and without reported ventilator use...
October 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29033341/acute-intractable-headache-and-oculomotor-nerve-palsy-associated-with-nicorandil-a-case-report
#14
Seong-Hae Jeong, Hoon Kim
No abstract text is available yet for this article.
October 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29029798/effect-of-intravenous-ondansetron-on-qtc-interval-in-children-with-gastroenteritis
#15
Robert J Hoffman, Khalid Alansari
BACKGROUND: The potential for ondansetron to cause QT prolongation and fatal dysrhythmia is well-reported, including a 2011 FDA report on the topic. Few clinical trials evaluating this phenomenon in the ED setting exist, and only one is pediatric. OBJECTIVE: We have sought to determine the effect of a standardized dose of intravenous ondansetron on the QTc duration of children under 14years of age treated for gastroenteritis-associated vomiting in a pediatric ED...
October 4, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28988848/ed-utilization-of-medical-clearance-testing-for-psychiatric-admission-national-hospital-ambulatory-medical-care-survey-analysis
#16
Brian J Yun, Shih-Chuan Chou, Justine M Nagurney, Benjamin A White, Curtis W Wittmann, Ali S Raja
INTRODUCTION: Routine medical clearance testing of emergency department (ED) patients with acute psychiatric illnesses in the absence of a medical indication has minimal proven utility. Little is known about the variations in clinical practice of ordering medical clearance tests. METHODS: This study was an analysis of data from the annual United States National Hospital Ambulatory Medical Care Survey from 2010 to 2014. The study population was defined as ED visits by patients ≥18years old admitted to a psychiatric facility...
October 4, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28988847/impact-of-bacteremia-prediction-rule-in-cap-before-and-after-study
#17
Byunghyun Kim, Kyuseok Kim, Jieun Lee, Joonghee Kim, Yoo Hwan Jo, Jae Hyuk Lee, Ji Eun Hwang
OBJECTIVE: In cases of community acquired pneumonia (CAP), it has been known that blood cultures have low yields and rarely affect clinical outcomes. Despite many studies predicting the likelihood of bacteremia in CAP patients, those results have been rarely implemented in clinical practice, and use of blood culture in CAP is still increasing. This study evaluated impact of implementing a previously derived and validated bacteremia prediction rule. METHODS: In this registry-based before and after study, we used piecewise regression analysis to compare the blood culture rate before and after implementation of the prediction rule...
October 4, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29033346/emergency-sonographers-can-identify-and-inject-the-flexor-tendon-sheaths-in-human-cadaveric-models
#18
LETTER
Gabriel Rose, Nadia Baranchuk, Ryan Tansek, Nicholas Avitabile, Turandot Saul
No abstract text is available yet for this article.
September 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28982532/comparison-of-six-scoring-systems-for-predicting-the-mortality-of-severe-sepsis-patients-in-emergency-department
#19
LETTER
Si-Jia Liu, Hai Hu
No abstract text is available yet for this article.
September 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28978401/assessing-adherence-with-preventive-screening-recommendations-among-ed-patients-piloting-an-effective-use-of-wait-time
#20
LETTER
Beau Abar, Layne Dylla, Michael Sergeant, Julie Pasternack, David Adler
No abstract text is available yet for this article.
September 29, 2017: American Journal of Emergency Medicine
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