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Annals of Emergency Medicine

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https://www.readbyqxmd.com/read/30236418/expanding-health-information-exchange-improves-identification-of-frequent-emergency-department-users
#1
Xiao Han, Tina Y Lowry, George T Loo, Elaine J Rabin, Zachary M Grinspan, Lisa M Kern, Gilad J Kuperman, Jason S Shapiro
STUDY OBJECTIVE: Frequent emergency department (ED) users are of interest to policymakers and hospitals. The objective of this study is to examine the effect of health information exchange size on the identification of frequent ED users. METHODS: We retrospectively analyzed data from Healthix, a health information exchange in New York that previously included 10 hospitals and then grew to 31 hospitals. We divided patients into 3 cohorts: high-frequency ED users with 4 or more visits in any 30-day period, medium-frequency ED users with 4 or more visits in any year, and infrequent ED users with fewer than 4 visits in any year...
September 17, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/30236417/should-adults-with-mild-head-injury-who-are-receiving-direct-oral-anticoagulants-undergo-computed-tomography-scanning-a-systematic-review
#2
Gordon W Fuller, Rachel Evans, Louise Preston, Helen B Woods, Suzanne Mason
STUDY OBJECTIVE: Patients receiving direct oral anticoagulant medications commonly undergo computed tomography head scanning after mild traumatic brain injury, regardless of symptoms or signs. International guidelines have noted a lack of evidence to support management decisions for such patients. This systematic review aims to identify, appraise, and synthesize the current evidence for the risk of adverse outcome in patients receiving direct oral anticoagulants after mild head injury...
September 17, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/30236416/fast-protocol-for-treating-acute-ischemic-stroke-by-emergency-physicians
#3
Iiro Heikkilä, Hanna Kuusisto, Markus Holmberg, Ari Palomäki
STUDY OBJECTIVE: Thrombolysis with tissue plasminogen activator should occur promptly after ischemic stroke onset. Various strategies have attempted to improve door-to-needle time. Our objective is to evaluate a strategy that uses an emergency physician-based protocol when no stroke neurologist is available. METHODS: This was a retrospective before-after intervention analysis in an urban hospital. Reorganization of the acute ischemic stroke treatment process was carried out in 2013...
September 17, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/30205922/is-the-liberal-use-of-oxygen-associated-with-worse-outcomes-among-critically-ill-patients
#4
EDITORIAL
Michael Gottlieb, Corey Goldstein, Edward J Ward
No abstract text is available yet for this article.
September 8, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/30193754/the-2018-surviving-sepsis-campaign-s-treatment-bundle-when-guidelines-outpace-the-evidence-supporting-their-use
#5
EDITORIAL
Rory Spiegel, Joshua D Farkas, Philippe Rola, Jon-Emile Kenny, Segun Olusanya, Paul E Marik, Scott D Weingart
No abstract text is available yet for this article.
August 30, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/30174183/is-antibiotic-therapy-helpful-for-preventing-infection-after-acute-stroke
#6
EDITORIAL
Latha Ganti, Bryan Sleigh
No abstract text is available yet for this article.
August 30, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/30172448/the-relationship-between-ambient-air-pollution-and-acute-ischemic-stroke-a-time-stratified-case-crossover-study-in-a-city-state-with-seasonal-exposure-to-the-southeast-asian-haze-problem
#7
Andrew F W Ho, Huili Zheng, Deidre A De Silva, Win Wah, Arul Earnest, Yee H Pang, Zhenjia Xie, Pin P Pek, Nan Liu, Yih Y Ng, Ting H Wong, Ling L Foo, Marcus E H Ong
STUDY OBJECTIVE: Studies are divided on the short-term association of air pollution with stroke. Singapore is exposed to seasonal transboundary haze. We aim to investigate the association between air pollution and stroke incidence in Singapore. METHODS: We performed a time-stratified case-crossover analysis on all ischemic stroke cases reported to the Singapore Stroke Registry from 2010 to 2015. Exposure on days was compared with control days on which exposure did not occur...
August 29, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/30166204/what-is-the-diagnostic-accuracy-of-cardiac-biomarkers-for-the-prediction-of-adverse-cardiac-events-in-patients-presenting-with-acute-syncope
#8
EDITORIAL
Jason R West, James Russell
No abstract text is available yet for this article.
August 27, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/30146447/subarachnoid-mirage-a-case-of-pseudosubarachnoid-hemorrhage
#9
Mario A Camacho, Jeff Druck, Martin Musi
A 22-year-old man with a history of intravenous methamphetamine use presented with severe headache for 5 days, was afebrile, and had nuchal rigidity. Computed tomography and magnetic resonance imaging results were interpreted as revealing acute subarachnoid hemorrhage. Twenty-four hours later, he developed acute neurologic deterioration. A lumbar puncture was performed, revealing the presence of Staphylococcus aureus. The false-positive image mimicking blood was potentially a result of an extremely high protein concentration present in the cerebrospinal fluid, provoked by an intense inflammatory reaction leading to disruption of the blood-brain barrier...
August 23, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/30146446/normal-saline-solution-and-lactated-ringer-s-solution-have-a-similar-effect-on-quality-of-recovery-a-randomized-controlled-trial
#10
Andrew Friederich, Natalie Martin, Morgan B Swanson, Brett A Faine, Nicholas M Mohr
STUDY OBJECTIVE: The purpose of this study is to test the hypothesis that balanced crystalloids improve quality of recovery more than normal saline solution (0.9% sodium chloride) in stable emergency department (ED) patients. Secondary outcomes measured differences in health care use. METHODS: A single-site, participant- and evaluator-blinded, 2-arm parallel allocation (1:1), comparative effectiveness, randomized controlled trial allocated adults receiving intravenous fluids in the ED before discharge to receive 2 L of lactated Ringer's solution or normal saline solution...
August 23, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/30146445/evaluation-of-us-federal-guidelines-primary-response-incident-scene-management-prism-for-mass-decontamination-of-casualties-during-the-initial-operational-response-to-a-chemical-incident
#11
Robert P Chilcott, Joanne Larner, Adam Durrant, Philip Hughes, Devanya Mahalingam, Samantha Rivers, Elliot Thomas, Nevine Amer, Mark Barrett, Hazem Matar, Andreia Pinhal, Toni Jackson, Kate McCarthy-Barnett, Joseph Reppucci
STUDY OBJECTIVE: The aim of this study was to evaluate the clinical and operational effectiveness of US federal government guidance (Primary Response Incident Scene Management [PRISM]) for the initial response phase to chemical incidents. METHODS: The study was performed as a large-scale exercise (Operation DOWNPOUR). Volunteers were dosed with a chemical warfare agent simulant to quantify the efficacy of different iterations of dry, ladder pipe system, or technical decontamination...
August 23, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/30146444/diagnostic-imaging-in-emergency-medicine-how-much-is-too-much
#12
Cristiana Baloescu
No abstract text is available yet for this article.
August 23, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/30146443/use-of-pharmacologic-sleep-aids-and-stimulants-among-emergency-medicine-staff-physicians-in-a-canadian-tertiary-care-setting-a-web-based-survey
#13
Marc N Francis, Ian M Wishart, Tyler Williamson, Ryan Iverach
STUDY OBJECTIVE: Emergency medicine by its nature requires shift work that follows an erratic and unpredictable pattern. Faced with this challenge, we hypothesize that many emergency physicians have taken steps to minimize their personal sleep deprivation through the use of pharmacologic sleep aids. The extent and nature of pharmacologic sleep aid use in this population is not well studied. We seek to describe the use of pharmacologic sleep aids among practicing emergency physicians in a Canadian tertiary care setting...
August 23, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/30126754/abscess-incision-and-drainage-with-or-without-ultrasonography-a-randomized-controlled-trial
#14
Romolo J Gaspari, Alexandra Sanseverino, Timothy Gleeson
STUDY OBJECTIVE: We hypothesize that clinical failure rates will be lower in patients treated with point-of-care ultrasonography and incision and drainage compared with those who undergo incision and drainage after physical examination alone. METHODS: We performed a prospective randomized clinical trial of patients presenting with a soft tissue abscess at a large, academic emergency department. Patients presenting with an uncomplicated soft tissue abscess requiring incision and drainage were eligible for enrollment and randomized to treatment with or without point-of-care ultrasonography...
August 17, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/30119943/ultrasonography-for-the-confirmation-of-endotracheal-tube-intubation-a-systematic-review-and-meta-analysis
#15
Michael Gottlieb, Dallas Holladay, Gary D Peksa
STUDY OBJECTIVE: Intubation is routinely performed in the emergency department, and rapid, accurate confirmation is essential to avoid potentially serious adverse outcomes. The number of studies assessing ultrasonography for the verification of endotracheal tube placement has expanded rapidly in recent years. We performed this systematic review and meta-analysis to determine the sensitivity and specificity of transtracheal ultrasonography for the verification of endotracheal tube location...
August 14, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/30119942/ultrarapid-rule-out-for-acute-myocardial-infarction-using-the-generation-5-cardiac-troponin-t-assay-results-from-the-reaction-us-study
#16
Richard M Nowak, Chaun M Gandolfo, Gordon Jacobsen, Robert H Christenson, Michele Moyer, Michael Hudson, James McCord
STUDY OBJECTIVE: We determine how well a new Food and Drug Administration-approved single cardiac troponin T (cTnT) Generation 5 baseline measurement below the level of quantification (6 ng/L) and a novel study-derived baseline and 30-minute cTnT Generation 5 algorithm might adequately exclude acute myocardial infarction in patients with suspected acute coronary syndrome in a US emergency department (ED). METHODS: Patients presenting with any symptoms suspicious for acute coronary syndrome were enrolled at a single US ED...
August 14, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/30119941/randomized-controlled-trial-of-intravenous-acetaminophen-versus-intravenous-hydromorphone-for-the-treatment-of-acute-pain-in-the-emergency-department
#17
Douglas P Barnaby, Andrew E Chertoff, Andrew J Restivo, Caron M Campbell, Scott Pearlman, Deborah White, Polly E Bijur, E John Gallagher
STUDY OBJECTIVE: As clinicians look to nonnarcotic analgesics in the emergency department (ED), it is essential to understand the effectiveness and adverse effects of nonopioid medications in comparison with existing opioid treatments. Studies of intravenous acetaminophen for acute pain in the ED demonstrate mixed results and suffer from small sample sizes and methodological limitations. This study compares intravenous hydromorphone with intravenous acetaminophen in adult ED patients presenting with acute pain...
August 14, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/30119940/physical-restraint-use-in-adult-patients-presenting-to-a-general-emergency-department
#18
Ambrose H Wong, R Andrew Taylor, Jessica M Ray, Steven L Bernstein
STUDY OBJECTIVE: The prevalence of agitation among emergency department (ED) patients is increasing. Physical restraints are routinely used to prevent self-harm and to protect staff, but are associated with serious safety risks. To date, characterization of physical restraint use in the emergency setting has been limited. We thus aim to describe restraint patterns in the general ED to guide future investigation in the management of behavioral disorders. METHODS: We conducted a cross-sectional study of adult patients presenting to 5 adult EDs within a large regional health system for 2013 to 2015, and with a physical restraint order during their visit...
August 14, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/30115465/what-is-the-accuracy-of-physical-examination-imaging-and-the-lrinec-score-for-the-diagnosis-of-necrotizing-soft-tissue-infection
#19
EDITORIAL
Michael D April, Brit Long
No abstract text is available yet for this article.
August 13, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/30115464/is-point-of-care-ultrasonography-effective-for-the-diagnosis-of-urolithiasis
#20
EDITORIAL
Michael Gottlieb, E David Hill, Kimbia Arno
No abstract text is available yet for this article.
August 13, 2018: Annals of Emergency Medicine
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