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American Journal of Emergency Medicine

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https://www.readbyqxmd.com/read/29463438/intubation-of-prehospital-patients-with-curved-laryngoscope-blade-is-more-successful-than-with-straight-blade
#1
Scott M Alter, Eithan D Haim, Alex H Sullivan, Lisa M Clayton
OBJECTIVE: Direct laryngoscopy can be performed using curved or straight blades, and providers usually choose the blade they are most comfortable with. However, curved blades are anecdotally thought of as easier to use than straight blades. We seek to compare intubation success rates of paramedics using curved versus straight blades. METHODS: Design: retrospective chart review. SETTING: hospital-based suburban ALS service with 20,000 annual calls...
February 17, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29456175/metformin-induced-lactic-acidosis-mila-a-case-report-and-review-of-current-diagnostic-paradigm
#2
Lauren Krowl, Hassan Al-Khalisy, Pratibha Kaul
A new diagnostic paradigm has been proposed to better categorize causes of Metformin-Associated Lactic Acidosis (MALA). The diagnostic criteria defines a link between Metformin and lactic acidosis if lactate is >5mmol/L, Ph<7.35 and Metformin assay >5mg/L. Metformin assays are not readily available in emergency departments including nationwide Veteran's Affairs Hospitals; thereby making this proposed classification tool difficult to use in today's clinical practice. We describe a case report of a 45-year-old male, who took twice the amount of Metformin prescribed and presented with Metformin-induced lactic acidosis...
February 15, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29467087/simulated-internal-jugular-vein-cannulation-using-a-needle-guiding-device
#3
Ji Hoon Kim, Jin Ha Park, Junho Cho, Tae Young Kong, Ji Hwan Lee, Jin Ho Beom, Young Seon Joo, Dong Ryul Ko, Hyun Soo Chung
BACKGROUND: Using a two-dimensional ultrasound-guided approach does not guarantee success during the first attempt at internal jugular vein cannulation. Our randomized, parallel simulation study examined whether a new disposable device could improve the success rate of the first attempt at ultrasound-guided internal jugular vein cannulation of a simulated internal jugular vein. METHODS: Eighty-eight participants were randomized to perform needle insertion for internal jugular vein cannulation of a phantom using the ultrasound-guided approach with (case group) or without (control group) this new device...
February 12, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29463437/prehospital-quick-sequential-organ-failure-assessment-as-a-tool-to-predict-in-hospital-mortality
#4
Kyohei Miyamoto, Naoaki Shibata, Tsuyoshi Nakashima, Seiya Kato
OBJECTIVE: This study aimed to evaluate the predictive ability of quick sequential organ failure assessment (qSOFA) score for in-hospital mortality among patients transported by physician-staffed helicopters. METHODS: We conducted a single-center, retrospective observational study using the physician-staffed helicopter registry data between 2003 and 2016. We calculated the qSOFA scores based on the patients' vital signs, which were measured on the scene. The tool's discriminatory ability was determined using the area under the curve of the receiver operating characteristic...
February 10, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29459173/acute-corrosive-poisonings-frequent-cause-for-fatal-outcome
#5
LETTER
Andon Chibishev, Natasha Davceva, Emilija Shikole, Cvetanka Bozinovska
No abstract text is available yet for this article.
February 9, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29454508/the-has-choice-study-utilizing-the-heart-score-an-adp-and-shared-decision-making-to-decrease-admissions-in-chest-pain-patients
#6
Gregory Gafni-Pappas, Susanne D DeMeester, Michael A Boyd, Arun Ganti, Adam M Nicholson, Jeremy Albright, Juan Wu
OBJECTIVE: The HAS-Choice pathway utilizes the HEART Score, an accelerated diagnostic protocol (ADP), and shared decision-making using a visual aid in the evaluation of chest pain patients. We seek to determine if our intervention can improve resource utilization in a community emergency department (ED) setting while maintaining safe patient care. METHODS: This was a single-center prospective cohort study with historical that included ED patients ≥21years old presenting with a primary complaint of chest pain in two time periods...
February 8, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29452919/high-dose-insulin-for-beta-blocker-and-calcium-channel-blocker-poisoning-17years-of-experience-from-a-single-poison-center
#7
Jon B Cole, Ann M Arens, JoAn R Laes, Lauren R Klein, Stacey A Bangh, Travis D Olives
BACKGROUND/OBJECTIVES: High dose insulin (HDI) is a standard therapy for beta-blocker (BB) and calcium channel-blocker (CCB) poisoning, however human case experience is rare. Our poison center routinely recommends HDI for shock from BBs or CCBs started at 1U/kg/h and titrated to 10U/kg/h. The study objective was to describe clinical characteristics and adverse events associated with HDI. METHODS: This was a structured chart review of patients receiving HDI for BB or CCB poisoning with HDI defined as insulin infusion of ≥0...
February 6, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29452921/comparison-of-primary-compliance-in-electronic-versus-paper-prescriptions-prescribed-from-the-emergency-department
#8
LETTER
Shannon L Toohey, Jessica Andrusaitis, Megan Boysen-Osborn, John Billimek, Maxwell Jen, Scott Rudkin
No abstract text is available yet for this article.
February 5, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29452920/patient-centered-medical-homes-did-not-improve-access-to-timely-follow-up-after-ed-visit
#9
Shih-Chuan Chou, Craig Rothenberg, Alicia Agnoli, Ilse Wiechers, Jason Lott, Jennifer Voorhees, Steven L Bernstein, Arjun K Venkatesh
BACKGROUND: Patients newly insured through coverage expansion under the Affordable Care Act (ACA) may have difficulty obtaining timely primary care follow-up appointments after emergency department (ED) discharge. We evaluated the association between availability of timely follow-up appointment with practice access improvements, including patient-centered medical home (PCMH) designations or extended-hours appointments. METHODS: We performed a secret-shopper audit of primary care practices in greater New Haven, Connecticut...
February 4, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29397258/comparison-of-the-combination-of-propofol-fentanyl-with-combination-of-propofol-ketamine-for-procedural-sedation-and-analgesia-in-patients-with-trauma
#10
Hamed Aminiahidashti, Sajad Shafiee, Seyed Mohammad Hosseininejad, Abulfazl Firouzian, Ayyub Barzegarnejad, Alieh Zamani Kiasari, Behzad Feizzadeh Kerigh, Farzad Bozorgi, Misagh Shafizad, Ahmad Geraeeli
OBJECTIVE: Many procedures performed in emergency department are stressful and painful, and creating proper and timely analgesia and early and effective assessment are the challenges in this department. This study has been conducted in order to compare the efficacy of propofol and fentanyl combination with propofol and ketamine combination for procedural sedation and analgesia (PSA) in trauma patients in the emergency department. METHOD: This is a randomized prospective double-blind clinical trial conducted in the emergency department of Imam Khomeini Hospital, a tertiary academic trauma center in northern Iran...
February 4, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29454509/group-c-strep-mediastinitis-a-case-report
#11
Joseph G Kotora, Eric J Schmieler, Christian S McEvoy, Stephen L Noble
This case is significant to the practice of emergency medicine because it represents the development of an uncommon and potentially fatal mediastinal infection from a commonly encountered and appropriately treated community respiratory pathogen. Most published reports on mediastinitis are those that are status-post cardiothoracic surgery. In our report, we discuss a case of a healthy, young individual who developed this morbid entity from extension of a simple respiratory infection where Group C Streptococcus has been isolated as the causative organism, which to our knowledge has not been previously reported...
February 3, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29444751/management-of-dyspepsia-the-role-of-the-emergency-department-observation-unit-to-optimize-patient-outcomes
#12
Wei Ping Daniel Chor, Pei Xian Lorraine Yong, Li Lin Lim, Chew Yian Chai, Tiong Beng Sim, Win Sen Kuan
BACKGROUND: Dyspepsia is a common complaint that can confer significant burden on one's quality of life and may also be associated with serious underlying conditions. The objective of this study was to determine if patients admitted to the emergency department observation unit (EDOU) for severe or persistent dyspepsia would have cost effective management in terms of investigations performed, length and cost of hospital stay. The secondary objective was to determine if any patient characteristics could predict a need for admission to the inpatient unit...
February 3, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29429798/ventricular-fibrillation-in-conscious-patients-witnessed-by-the-emergency-medical-service
#13
LETTER
Miguel Freire-Tellado, Rubén Navarro-Patón, Javier Mateos-Lorenzo, Álvaro Sende-Cenzano
No abstract text is available yet for this article.
February 3, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29409664/a-rare-case-of-spontaneous-methicillin-resistant-staphylococcus-aureus-mrsa-meningitis
#14
William D Longhurst, Johnathan M Sheele
Spontaneous methicillin-resistant Staphylococcus aureus (MRSA) meningitis is extremely rare and has a high mortality rate. We report a case of MRSA meningitis in an otherwise healthy young adult female with no recent trauma or neurosurgical interventions. Despite antibiotics she suffered a vasculitis-induced cerebral vascular ischemic event.
February 3, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29409663/penta-therapy-for-severe-acute-hyperlipidemic-pancreatitis-a-retrospective-chart-review-over-a-10-year-period
#15
Jian Lu, Yun Xie, Jiang Du, Mei Kang, Wei Jin, Yan Li, Hui Xie, Ruijie Cheng, Rui Tian, Ruilan Wang
INTRODUCTION: The purpose of our study is to evaluate the efficacy of penta-therapy for HL-SAP in a retrospective study. METHODS: Retrospective study between January 2007 and December 2016 in a hospital intensive care unit. HL-SAP patients were assigned to conventional treatment alone (the control group) or conventional treatment with the experimental protocol (the penta-therapy group) consists of blood purification, antihyperlipidemic agents, low-molecular weight heparin, insulin, covering the whole abdomen with Pixiao (a traditional Chinese medicine)...
February 3, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29429796/severe-deep-venous-thromboembolism-presenting-with-syncope-associated-with-airplane-travel-case-report-and-public-health-quandary
#16
LETTER
Nicholas A Daniels
No abstract text is available yet for this article.
February 2, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29402687/the-application-of-gap-analysis-to-develop-a-call-out-call-back-airway-checklist-an-ed-quality-improvement-study
#17
LETTER
Nicholas D Caputo, Marc P Kanter, Sandra Scott
No abstract text is available yet for this article.
February 2, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29402686/paramedics-attitudes-toward-endotracheal-intibation
#18
LETTER
Togay Evrin, Halla Kaminska, Wojciech Wieczorek
No abstract text is available yet for this article.
February 2, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29402685/is-computed-tomography-tractography-reliable-in-patients-with-anterior-abdominal-stab-wounds
#19
İnanc Samil Sarici, Mustafa Uygar Kalayci
INTRODUCTION: The current literature and guidelines recommend that determination of peritoneal violation is done first in cases of anterior abdominal stab wounds. The primary endpoint of this study was to determine the reliability of computed tomographic (CT) tractography to assess peritoneal violation in anterior abdominal stab wounds. The secondary endpoint is to compare local wound exploration between conventional CT and CT tractography in the evaluation of peritoneal violation. MATERIAL AND METHODS: A total of 252 patients who were referred with anterior abdominal stab wounds were included in this prospective observational study...
February 2, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29398076/cardiac-arrest-while-exercising-on-mountains
#20
LETTER
Martin Burtscher
No abstract text is available yet for this article.
February 2, 2018: American Journal of Emergency Medicine
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