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Annals of Emergency Medicine

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https://www.readbyqxmd.com/read/28089112/predictive-utility-of-the-total-glasgow-coma-scale-versus-the-motor-component-of-the-glasgow-coma-scale-for-identification-of-patients-with-serious-traumatic-injuries
#1
REVIEW
Roger Chou, Annette M Totten, Nancy Carney, Spencer Dandy, Rongwei Fu, Sara Grusing, Miranda Pappas, Ngoc Wasson, Craig D Newgard
STUDY OBJECTIVE: The motor component of the Glasgow Coma Scale (mGCS) has been proposed as an easier-to-use alternative to the total GCS (tGCS) for field assessment of trauma patients by emergency medical services. We perform a systematic review and meta-analysis to compare the predictive utility of the tGCS versus the mGCS or Simplified Motor Scale in field triage of trauma for identifying patients with adverse outcomes (inhospital mortality or severe brain injury) or who underwent procedures (neurosurgical intervention or emergency intubation) indicating need for high-level trauma care...
January 11, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28065452/value-based-approaches-for-emergency-care-in-a-new-era
#2
Laura Medford-Davis, David Marcozzi, Shantanu Agrawal, Brendan G Carr, Emily Carrier
Although emergency departments (EDs) play an integral role in the delivery of acute unscheduled care, they have not been fully integrated into broader health care reform efforts. Communication and coordination with the ambulatory environment remain limited, leaving ED care disconnected from patients' longitudinal care. In a value-based environment focused on improving quality, decreasing costs, enhancing population health, and improving the patient experience, this oversight represents a missed opportunity for emergency care...
January 5, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28069299/emergency-department-visits-without-hospitalization-are-associated-with-functional-decline-in-older-persons
#3
Justine M Nagurney, William Fleischman, Ling Han, Linda Leo-Summers, Heather G Allore, Thomas M Gill
STUDY OBJECTIVE: Among older persons, disability and functional decline are associated with increased mortality, institutionalization, and costs. The aim of the study was to determine whether illnesses and injuries leading to an emergency department (ED) visit but not hospitalization are associated with functional decline among community-living older persons. METHODS: From a cohort of 754 community-living older persons who have been followed with monthly interviews for up to 14 years, we matched 813 ED visits without hospitalization (ED only) to 813 observations without an ED visit or hospitalization (control)...
December 30, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28063614/analysis-of-emergency-department-length-of-stay-for-mental-health-patients-at-ten-massachusetts-emergency-departments
#4
Mark D Pearlmutter, Kristin H Dwyer, Laura G Burke, Niels Rathlev, Louise Maranda, Greg Volturo
STUDY OBJECTIVE: Prolonged boarding times in the emergency department (ED) disproportionately affect mental health patients, resulting in patient and provider dissatisfaction and increased patient morbidity and mortality. Our objective is to quantify the burden of mental health boarding and to elucidate the effect of insurance together with demographic, social, and comorbid factors on length of stay. METHODS: We conducted a cross-sectional observational study of 871 consecutive patients requiring an ED mental health evaluation at one of 10 unaffiliated Massachusetts hospitals...
December 30, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28041827/application-of-the-mascc-and-cisne-risk-stratification-scores-to-identify-low-risk-febrile-neutropenic-patients-in-the-emergency-department
#5
Christopher J Coyne, Vivian Le, Jesse J Brennan, Edward M Castillo, Rebecca A Shatsky, Karen Ferran, Stephanie Brodine, Gary M Vilke
STUDY OBJECTIVE: Although validated risk-stratification tools have been used to send low-risk febrile neutropenic patients home from clinic and inpatient settings, there is a dearth of research evaluating these scores in the emergency department (ED). We compare the predictive accuracy of the Multinational Association for Supportive Care in Cancer (MASCC) and Clinical Index of Stable Febrile Neutropenia (CISNE) scores for patients with chemotherapy-induced febrile neutropenia and presenting to the ED...
December 29, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28041826/interpretation-of-cerebrospinal-fluid-white-blood-cell-counts-in-young-infants-with-a-traumatic-lumbar-puncture
#6
Todd W Lyons, Andrea T Cruz, Stephen B Freedman, Mark I Neuman, Fran Balamuth, Rakesh D Mistry, Prashant Mahajan, Paul L Aronson, Joanna E Thomson, Christopher M Pruitt, Samir S Shah, Lise E Nigrovic
STUDY OBJECTIVE: We determine the optimal correction factor for cerebrospinal fluid WBC counts in infants with traumatic lumbar punctures. METHODS: We performed a secondary analysis of a retrospective cohort of infants aged 60 days or younger and with a traumatic lumbar puncture (cerebrospinal fluid RBC count ≥10,000 cells/mm(3)) at 20 participating centers. Cerebrospinal fluid pleocytosis was defined as a cerebrospinal fluid WBC count greater than or equal to 20 cells/mm(3) for infants aged 28 days or younger and greater than or equal to 10 cells/mm(3) for infants aged 29 to 60 days; bacterial meningitis was defined as growth of pathogenic bacteria from cerebrospinal fluid culture...
December 29, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28041825/sodium-nitrite-and-sodium-thiosulfate-are-effective-against-acute-cyanide-poisoning-when-administered-by-intramuscular-injection
#7
Vikhyat S Bebarta, Matthew Brittain, Adriano Chan, Norma Garrett, David Yoon, Tanya Burney, David Mukai, Michael Babin, Renate B Pilz, Sari B Mahon, Matthew Brenner, Gerry R Boss
STUDY OBJECTIVE: The 2 antidotes for acute cyanide poisoning in the United States must be administered by intravenous injection. In the out-of-hospital setting, intravenous injection is not practical, particularly for mass casualties, and intramuscular injection would be preferred. The purpose of this study is to determine whether sodium nitrite and sodium thiosulfate are effective cyanide antidotes when administered by intramuscular injection. METHODS: We used a randomized, nonblinded, parallel-group study design in 3 mammalian models: cyanide gas inhalation in mice, with treatment postexposure; intravenous sodium cyanide infusion in rabbits, with severe hypotension as the trigger for treatment; and intravenous potassium cyanide infusion in pigs, with apnea as the trigger for treatment...
December 29, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28041824/bending-the-curve-of-health-trajectories-for-older-adults-discharged-from-the-emergency-department
#8
EDITORIAL
Michael A LaMantia, Timothy F Platts-Mills
No abstract text is available yet for this article.
December 29, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27998625/a-consensus-driven-agenda-for-emergency-medicine-firearm-injury-prevention-research
#9
Megan L Ranney, Jonathan Fletcher, Harrison Alter, Christopher Barsotti, Vikhyat S Bebarta, Marian E Betz, Patrick M Carter, Magdalena Cerdá, Rebecca M Cunningham, Peter Crane, Jahan Fahimi, Matthew J Miller, Ali Rowhani-Rahbar, Jody A Vogel, Garen J Wintemute, Manish N Shah, Muhammad Waseem
STUDY OBJECTIVE: To identify critical emergency medicine-focused firearm injury research questions and develop an evidence-based research agenda. METHODS: National content experts were recruited to a technical advisory group for the American College of Emergency Physicians Research Committee. Nominal group technique was used to identify research questions by consensus. The technical advisory group decided to focus on 5 widely accepted categorizations of firearm injury...
December 17, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27993418/comparison-of-intravenous-ketorolac-at-three-single-dose-regimens-for-treating-acute-pain-in-the-emergency-department-a-randomized-controlled-trial
#10
Sergey Motov, Matthew Yasavolian, Antonios Likourezos, Illya Pushkar, Rukhsana Hossain, Jefferson Drapkin, Victor Cohen, Nicholas Filk, Andrew Smith, Felix Huang, Bradley Rockoff, Peter Homel, Christian Fromm
STUDY OBJECTIVE: Nonsteroidal anti-inflammatory drugs are used extensively for the management of acute and chronic pain, with ketorolac tromethamine being one of the most frequently used parenteral analgesics in the emergency department (ED). The drugs may commonly be used at doses above their analgesic ceiling, offering no incremental analgesic advantage while potentially adding risk of harm. We evaluate the analgesic efficacy of 3 doses of intravenous ketorolac in ED patients with acute pain...
December 16, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27986339/short-term-care-with-long-term-costs-the%C3%A2-unintended-consequences-of-emtala
#11
EDITORIAL
Karin V Rhodes, Kristofer L Smith
No abstract text is available yet for this article.
December 13, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27974171/design-a-neglected-modality-for-improvement
#12
EDITORIAL
Robert L Wears
No abstract text is available yet for this article.
December 11, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27974170/getting-it-right-the-first-time-defining-regionally-relevant-training-curricula-and-provider-core-competencies-for-point-of-care-ultrasound-education-on-the-african-continent
#13
Margaret Salmon, Megan Landes, Cheryl Hunchak, Justin Paluku, Luc Malemo Kalisya, Christian Salmon, Mundenga Mutendi Muller, Benjamin Wachira, James Mangan, Kajal Chhaganlal, Joseph Kalanzi, Aklilu Azazh, Sara Berman, El-Sayed Zied, Hein Lamprecht
Significant evidence identifies point-of-care ultrasound (PoCUS) as an important diagnostic and therapeutic tool in resource-limited settings. Despite this evidence, local health care providers on the African continent continue to have limited access to and use of ultrasound, even in potentially high-impact fields such as obstetrics and trauma. Dedicated postgraduate emergency medicine residency training programs now exist in 8 countries, yet no current consensus exists in regard to core PoCUS competencies...
December 11, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27974169/antibiotics-first-versus-surgery-for-appendicitis-a%C3%A2-us-pilot-randomized-controlled-trial-allowing-outpatient-antibiotic-management
#14
David A Talan, Darin J Saltzman, William R Mower, Anusha Krishnadasan, Cecilia M Jude, Ricky Amii, Daniel A DeUgarte, James X Wu, Kavitha Pathmarajah, Ashkan Morim, Gregory J Moran
STUDY OBJECTIVE: Randomized trials suggest that nonoperative treatment of uncomplicated appendicitis with antibiotics-first is safe. No trial has evaluated outpatient treatment and no US randomized trial has been conducted, to our knowledge. This pilot study assessed feasibility of a multicenter US study comparing antibiotics-first, including outpatient management, with appendectomy. METHODS: Patients aged 5 years or older with uncomplicated appendicitis at 1 US hospital were randomized to appendectomy or intravenous ertapenem greater than or equal to 48 hours and oral cefdinir and metronidazole...
December 11, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27974168/droperidol-or-olanzapine-intramuscularly-or-intravenously-monotherapy-or-combination-therapy-for-sedating-acute-behavioral-disturbance
#15
EDITORIAL
Geoffrey K Isbister
No abstract text is available yet for this article.
December 11, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27965031/in-patients-with-cardiac-arrest-does-amiodarone-or-lidocaine-increase-meaningful-survival
#16
EDITORIAL
Benton R Hunter, Paul I Musey
No abstract text is available yet for this article.
December 10, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27965030/does-this-patient-with-chest-pain-have-acute-coronary-syndrome
#17
EDITORIAL
Sameer Sharif, Suneel Upadhye
No abstract text is available yet for this article.
December 10, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27965029/packaging-patients-and-handing-them-over-communication-context-and-persuasion-in-the%C3%A2-emergency-department
#18
Peter Nugus, Sally McCarthy, Anne Holdgate, Jeffrey Braithwaite, Anna Schoenmakers, Cordula Wagner
STUDY OBJECTIVE: Communication is commonly understood by health professional researchers to consist of relatively isolated exchanges of information. The social and organizational context is given limited credit. This article examines the significance of the environmental complexity of the emergency department (ED) in influencing communication strategies and makes the case for adopting a richer understanding of organizational communication. METHODS: This study draws on approximately 12 months (1,600 hours) of ethnographic observations, yielding approximately 4,500 interactions across 260 clinicians and staff in the EDs of 2 metropolitan public teaching hospitals in Sydney, Australia...
December 10, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27914720/improving-publication-quality-and-quantity-for%C3%A2-acute-care-authors-from-low-and-middle-income-settings
#19
Stevan R Bruijns, Megan Banner, Gabrielle A Jacquet
STUDY OBJECTIVE: Researchers from low- and middle-income countries have limited access to publishing and editing resources. This study describes a journal-initiated platform to improve publication quantity and quality in Sub-Saharan Africa emergency care research: Author Assist. METHODS: This is a descriptive report of a quality improvement project of referrals to the African Journal of Emergency Medicine's (AfJEM's) Author Assist program between January 2011 and December 2015...
November 30, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27913059/cha2ds2-vasc-scores-and-major-bleeding-in-patients-with-nonvalvular-atrial-fibrillation-who-are-receiving-rivaroxaban
#20
W Frank Peacock, Sally Tamayo, Manesh Patel, Nicholas Sicignano, Kathleen P Hopf, Zhong Yuan
STUDY OBJECTIVE: Assessing stroke risk associated with nonvalvular atrial fibrillation depends on the evaluation of patient characteristics and clinical features. Clinicians must determine that the net clinical benefit from anticoagulation therapy outweighs its risk, namely, bleeding. Risk assessment for stroke is commonly performed by calculating a CHA2DS2-VASc (congestive heart failure/left ventricular dysfunction, hypertension, ≥75 years, diabetes mellitus, previous stroke or transient ischemic attack or thromboembolism, vascular disease, aged 65 to 74 years, sex female) score...
November 29, 2016: Annals of Emergency Medicine
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