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Annals of Emergency Medicine

Andrew A Herring, Jeanmarie Perrone, Lewis S Nelson
The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. The full Elsevier Policy on Article Withdrawal can be found at
January 4, 2019: Annals of Emergency Medicine
Narjes Akhlaghi, Pooya Payandemehr, Mehdi Yaseri, Ali A Akhlaghi, Ali Abdolrazaghnejad
STUDY OBJECTIVE: We evaluate the effect of midazolam and haloperidol premedication for reducing ketamine-induced recovery agitation in adult patients undergoing procedural sedation. We also compare physician satisfaction and recovery time. METHODS: We randomized emergency department patients older than 18 years who needed procedural sedation to receive 1 of the following 3 interventions in double-blind fashion 5 minutes before receiving intravenous ketamine at 1 mg/kg: intravenous distilled water, intravenous midazolam at 0...
January 3, 2019: Annals of Emergency Medicine
Brian W Patterson, Michael S Pulia, Shashank Ravi, Peter L T Hoonakker, Ann Schoofs Hundt, Douglas Wiegmann, Emily J Wirkus, Stephen Johnson, Pascale Carayon
STUDY OBJECTIVE: As electronic health records evolve, integration of computerized clinical decision support offers the promise of sorting, collecting, and presenting this information to improve patient care. We conducted a systematic review to examine the scope and influence of electronic health record-integrated clinical decision support technologies implemented in the emergency department (ED). METHODS: A literature search was conducted in 4 databases from their inception through January 18, 2018: PubMed, Scopus, the Cumulative Index of Nursing and Allied Health, and Cochrane Central...
January 3, 2019: Annals of Emergency Medicine
Elizabeth M Schoenfeld, Shelby Mader, Connor Houghton, Robert Wenger, Marc A Probst, David A Schoenfeld, Peter K Lindenauer, Kathleen M Mazor
STUDY OBJECTIVE: Shared decisionmaking has been promoted as a method to increase the patient-centeredness of medical decisionmaking and decrease low-yield testing, but little is known about its medicolegal ramifications in the setting of an adverse outcome. We seek to determine whether the use of shared decisionmaking changes perceptions of fault and liability in the case of an adverse outcome. METHODS: This was a randomized controlled simulation experiment conducted by survey, using clinical vignettes featuring no shared decisionmaking, brief shared decisionmaking, or thorough shared decisionmaking...
January 3, 2019: Annals of Emergency Medicine
Dustin W Ballard, Nathan Kuppermann, David R Vinson, Eric Tham, Jeff M Hoffman, Marguerite Swietlik, Sara J Deakyne Davies, Evaline A Alessandrini, Leah Tzimenatos, Lalit Bajaj, Dustin G Mark, Steve R Offerman, Uli K Chettipally, Marilyn D Paterno, Molly H Schaeffer, Rachel Richards, T Charles Casper, Howard S Goldberg, Robert W Grundmeier, Peter S Dayan
STUDY OBJECTIVE: To determine the effect of providing risk estimates of clinically important traumatic brain injuries and management recommendations on emergency department (ED) outcomes for children with isolated intermediate Pediatric Emergency Care Applied Research Network clinically important traumatic brain injury risk factors. METHODS: This was a secondary analysis of a nonrandomized clinical trial with concurrent controls, conducted at 5 pediatric and 8 general EDs between November 2011 and June 2014, enrolling patients younger than 18 years who had minor blunt head trauma...
December 22, 2018: Annals of Emergency Medicine
Michael Gottlieb, Somy M Thottathil, Jacob P Holton
No abstract text is available yet for this article.
December 19, 2018: Annals of Emergency Medicine
Michael Gottlieb, Keya A Patel, William G McDowell
No abstract text is available yet for this article.
December 19, 2018: Annals of Emergency Medicine
Edgar Argulian, Roberto Ramirez
No abstract text is available yet for this article.
December 19, 2018: Annals of Emergency Medicine
John C Moskop, Joel M Geiderman, Kenneth D Marshall, Jolion McGreevy, Arthur R Derse, Kelly Bookman, Norine McGrath, Kenneth V Iserson
This article revisits the persistent problem of crowding in US hospital emergency departments (EDs). It begins with a brief review of origins of this problem, terms used to refer to ED crowding, proposed definitions and measures of crowding, and causal factors. The article then summarizes recent studies that document adverse moral consequences of ED crowding, including poorer patient outcomes; increased medical errors; compromises in patient physical privacy, confidentiality, and communication; and provider moral distress...
December 19, 2018: Annals of Emergency Medicine
Jamin Brown, Aaron Lane, Craig Cooper, Matt Vassar
STUDY OBJECTIVE: Randomized controlled trials govern evidence-based clinical practice, and it is therefore critical that their results be robust. We aim to investigate the fragility of randomized controlled trials in emergency medicine by determining how often significance would be nullified with small changes in outcomes using the fragility index. METHODS: We conducted a methodological systematic review of randomized controlled trials in emergency medicine published in the top 10 general medicine journals and the top 10 emergency medicine journals...
December 12, 2018: Annals of Emergency Medicine
Jonathan M Kirschner, Benton R Hunter
No abstract text is available yet for this article.
December 11, 2018: Annals of Emergency Medicine
Wendy C Coates, Lalena M Yarris, Samuel O Clarke, Daniel Runde, Jacqueline Kurth, Emilie Fowlkes, Jaime Jordan
STUDY OBJECTIVE: Research in basic, translational, and clinical emergency medicine has made great strides since the formalization of emergency medicine as a specialty. Our objective is to identify and analyze strategies used by emergency medicine research pioneers to inform further advancement of research in emergency medicine, particularly for aspiring researchers and those in emerging areas, using emergency medicine medical education as one example. METHODS: This was a prospective, grounded-theory, qualitative study, using a constructivist/interpretivist paradigm...
December 7, 2018: Annals of Emergency Medicine
Aveh Bastani, Erica Su, David H Adler, Christopher Baugh, Jeffrey M Caterino, Carol L Clark, Deborah B Diercks, Judd E Hollander, Susan E Malveau, Bret A Nicks, Daniel K Nishijima, Manish N Shah, Kirk A Stiffler, Alan B Storrow, Scott T Wilber, Annick N Yagapen, Robert E Weiss, Benjamin C Sun
STUDY OBJECTIVE: Controversy remains in regard to the risk of adverse events for patients presenting with syncope compared with near-syncope. The purpose of our study is to describe the difference in outcomes between these groups in a large multicenter cohort of older emergency department (ED) patients. METHODS: From April 28, 2013, to September 21, 2016, we conducted a prospective, observational study across 11 EDs in adults (≥60 years) with syncope or near-syncope...
December 7, 2018: Annals of Emergency Medicine
Michael D April, Brit Long
No abstract text is available yet for this article.
December 7, 2018: Annals of Emergency Medicine
Jason R West
No abstract text is available yet for this article.
December 4, 2018: Annals of Emergency Medicine
Yohei Okada, Hiromichi Narumiya, Naho Kobayashi, Hirotake Nishimura, Hirokazu Kotani, Kaoru Koike, Taku Iwami, Ryoji Iiduka
Instantaneous rigor is the immediate appearance of rigor mortis after cardiac arrest. To our knowledge, no previous reports exist on resuscitation of such patients. A young athlete suddenly collapsed with cardiac arrest during a marathon; his legs stiffened with instantaneous rigorlike stiffness. This stiffening provoked hyperkalemia, rhabdomyolysis, and multiple organ failure. We decided to amputate both legs, with venoarterial extracorporeal membrane oxygenation support. The patient recovered and was discharged without neurologic impairment...
December 4, 2018: Annals of Emergency Medicine
Tricia Hengehold, Stephanie Boyd, Stacey Liddy-Hicks, Jeffrey Bridge, Jacqueline Grupp-Phelan
STUDY OBJECTIVE: We examine the characteristics of adolescents who select "no response" on a suicide screening instrument. METHODS: This study used a preexisting data set containing records of 3,388 patients aged 12 to 17 years who completed a suicide screen after presenting to the emergency department with nonpsychiatric complaints. Respondents who answered no response to at least one item without any yes responses were assigned to the no response group (n=58), whereas respondents who selected yes for any question (n=167) were assigned to the yes group...
November 28, 2018: Annals of Emergency Medicine
Jean Abbott
Physician Orders for Life-Sustaining Treatment forms convert patient wishes into physician orders to direct care patients receive near the end of life. Recent evidence of the challenges and opportunities for honoring patient end-of-life wishes in the emergency department (ED) is presented. The forms can be very helpful in directing whether cardiopulmonary resuscitation and intubation are desired in the first few minutes of a patient's presentation. After initial stabilization, understanding the intent of end-of-life orders and the scope of further interventions requires discussion with the patient or a surrogate...
November 28, 2018: Annals of Emergency Medicine
Kyle R Fischer, Katherine M Bakes, Theodore J Corbin, Joel A Fein, Erica J Harris, Thea L James, Marlene D Melzer-Lange
Violent traumatic injury remains a common condition treated by emergency physicians. The medical management of these patients is well described and remains an area of focus for providers. However, violently injured patients disproportionately carry a history of physical and psychological trauma that frequently affects clinical care in the emergency department. The alteration of our clinical approach, taking into consideration how a patient's previous experiences influence how he or she may perceive and react to medical care, is a concept referred to as trauma-informed care...
November 28, 2018: Annals of Emergency Medicine
Amber K Sabbatini, Brad Wright, Keith Kocher, M Kennedy Hall, Anirban Basu
STUDY OBJECTIVE: Observation stays are composing an increasing proportion of unscheduled hospitalizations in the United States, with unclear consequences for the quality of care. This study used a nationally representative data set of commercially insured patients hospitalized from the emergency department (ED) to compare 30-day postdischarge unplanned care events after an observation stay versus a short inpatient admission. METHODS: This was a retrospective analysis of ED hospitalizations using the 2015 Truven MarketScan Commercial Claims and Encounters data set...
November 20, 2018: Annals of Emergency Medicine
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