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Journal of Emergency Medicine

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https://www.readbyqxmd.com/read/28233608/clinical-mimics-an-emergency-medicine-focused-review-of-asthma-mimics
#1
Kristen Kann, Brit Long, Alex Koyfman
BACKGROUND: Asthma is a common diagnosis or preexisting condition, and many patients with acute asthma exacerbation may present to the emergency department with wheezing and respiratory distress. However, many conditions may mimic this presentation. OBJECTIVES: This review provides an overview of common asthma mimics and an approach to evaluation and management. DISCUSSION: Asthma is characterized by an obstructive pulmonary disease with recurrent exacerbations...
February 20, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28228345/catamenial-epilepsy-the-menstrual-cycle-as-a-clue-to-effective-treatment
#2
LETTER
Stevo Lukić, Boban Biševac
No abstract text is available yet for this article.
February 19, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28228344/emergency-department-return-visits-within-a-large-geographic-area
#3
Mimi Truong, Garth Meckler, Quynh H Doan
BACKGROUND: Return visits to the emergency department (RTED) contribute to overcrowding and may be a quality of care indicator. Previous studies focused on factors predicting returns to and from the same center. Little is known about RTEDs across a range of community and specialty hospitals within a large geographic area. OBJECTIVE: We sought to measure the frequency of pediatric RTEDs and describe their directional pattern across centers in a large catchment area...
February 19, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28228343/ultrasound-guided-femoral-nerve-blockage-in-a-patellar-dislocation-an-effective-technique-for-emergency-physicians
#4
Sami Eksert, Sinan Akay, Murtaza Kaya, Ali Kantemir, Kenan Keklikci
BACKGROUND: Patellar dislocation is an orthopedic emergency and its reduction can be painful. The aim of this case is to show that the ultrasound-guided femoral nerve blockage can be effectively used in the pain management of patellar reduction in the emergency department (ED). CASE REPORT: A 21-year-old man was admitted to our ED after suffering a fall down a flight of stairs. The initial physical examination and plain radiography showed a patellar dislocation in the right knee...
February 19, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28238385/distributive-shock-in-the-emergency-department-sepsis-anaphylaxis-or-capillary-leak-syndrome
#5
Cansu Alyeşil, Nurettin Özgür Doğan, İbrahim Ulaş Özturan, Seda Güney
BACKGROUND: Distributive shock is a hyperdynamic process resulting from excessive vasodilatation. Impaired blood flow causes inadequate tissue perfusion, which can lead to end-organ damage. Although the most common etiology is septic shock, anaphylactic and other etiologies should be considered. CASE REPORT: We report the case of a 30-year-old female who presented to the emergency department with nonspecific symptoms and hypotension after a viral upper respiratory infection...
February 18, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28238384/abdominal-pain-in-the-post-menopausal-female-is-ovarian-torsion-in-the-differential
#6
Jason M Rotoli
BACKGROUND: Ovarian torsion is often thought of as a disease process of reproductive-aged women; however, it is also seen in the extremes of age. In post-menopausal women, it can be both a challenge to diagnose and associated with increased morbidity. CASE REPORT: We present a case of a 68-year-old woman with sudden onset of lower abdominal pain 6 h before arrival at the emergency department (ED). She was diagnosed with ovarian torsion, secondary to an ovarian mass, and underwent a full malignancy evaluation...
February 18, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28222930/the-importance-of-smiling
#7
Maryam Arshad
No abstract text is available yet for this article.
February 17, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28222929/magnesium-an-overlooked-electrolyte
#8
Jaya Kala, Ala Abudayyeh
BACKGROUND: Hypermagnesemia is rare and usually iatrogenic. Due to decreased renal function, older patients are generally more susceptible to hypermagnesemia than are younger patients. Because it is not one of the commonly assessed electrolytes in the blood work panel of patients, high levels are usually missed. CASE REPORT: An elderly gentleman with history of leukemia presented with complaints of shortness of breath and extreme weakness while walking. He was diagnosed with severe hypermagnesemia, but unfortunately succumbed to cardiorespiratory arrest...
February 17, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28215930/ultrasound-guided-resuscitative-endovascular-balloon-occlusion-of-the-aorta-in-the-resuscitation-area
#9
Takayuki Ogura, Alan Kawarai Lefor, Mitsunobu Nakamura, Kenji Fujizuka, Kousuke Shiroto, Minoru Nakano
BACKGROUND: In trauma resuscitation with resuscitative endovascular balloon occlusion of the aorta (REBOA), urgent and accurate placement of the catheter in the resuscitation area without fluoroscopy can shorten the time from admission to REBOA, allowing rapid, temporary control of bleeding. DISCUSSION: The experience-based protocol in our center for ultrasound-guided REBOA in the resuscitation area without fluoroscopy is as follows: the femoral artery is punctured and a guidewire inserted; sonography is used to verify that the guidewire is in the abdominal aorta; the position of the balloon is confirmed with ultrasound after estimating the distance to the clavicle, and the pressure in the radial artery and sheath is used to monitor correct positioning; connect the pressure transducer to the catheter sheath for continuous monitoring of the blood pressure in the sheath, and inflate the balloon until the blood pressure tracing at the sheath has disappeared; check the pulse in the left radial artery, and withdraw the catheter slightly if the pulse in the radial artery is not palpable or is decreased (if this pulse is not palpable or decreased, the balloon is in the aortic arch)...
February 17, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28215397/clinical-mimics-an-emergency-medicine-focused-review-of%C3%A2-influenza-mimics
#10
Erica Simon, Brit Long, Alex Koyfman
BACKGROUND: Influenza viruses are a significant cause of morbidity and mortality in the United States. Given the wide range of symptoms, emergency physicians must maintain a broad differential diagnosis in the evaluation and treatment of patients presenting with influenza-like illnesses. OBJECTIVE: This review addresses objective and subjective symptoms commonly associated with influenza and discusses important mimics of influenza viruses, while offering a practical approach to their clinical evaluation and treatment...
February 15, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28202206/retrospective-chart-analysis-of-concussion-discharge-instructions-in-the-emergency-department
#11
Allison D Lane, Matthew R Berkman, David Verbunker, Taylor Shekell, Michael Bouska, Lauren Barnett, Allie Keogh, Tomas Nuno, Uwe Stolz, Anna L Waterbrook
BACKGROUND: Recognition and diagnosis of concussion is increasing, but current research shows these patients are discharged from the emergency department (ED) with a wide variability of recommendations and instructions. OBJECTIVE: To assess the adequacy of documentation of discharge instructions given to patients discharged from the ED with concussions. METHODS: This was a quality-improvement study conducted at a University-based Level I trauma center...
February 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28209267/assessment-of-volume-status-and-appropriate-fluid-replenishment-in-the-setting-of-nephrotic-syndrome
#12
Pierluigi Marzuillo, Stefano Guarino, Andrea Apicella, Rosaria Marotta, Vincenzo Tipo, Laura Perrone, Angela La Manna, Giovanni Montini
BACKGROUND: When the permeability of the glomerular filtration barrier increases, leading to proteinuria, nephrotic syndrome (NS) occurs. First episodes or relapses of NS can be concurrent with acute gastroenteritis (AGE) infections. This condition can cause further deterioration of the hypovolemic state, as intravascular water is lost through both AGE-related vomiting/diarrhea and NS-related fluid shifting into the interstitium. In this case report, we wish to raise the issues about the difficult management of children presenting with both NS and AGE...
February 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28174034/perihepatic-pulmonary-and-renal-abscesses-due%C3%A2-to%C3%A2-spilled-gallstones
#13
Jacob Lentz, Maria A Tobar, Caleb P Canders
BACKGROUND: Spilled gallstones are common during laparoscopic cholecystectomy; however, they rarely lead to postoperative complications. Perihepatic abscesses develop in < 0.1% of patients with spilled gallstones and are typically contained within the peritoneal cavity. CASE REPORT: We present a 57-year-old man with history of cholecystectomy 2 years prior who presented with cough and flank pain and was discovered to have a perihepatic abscess invading his lung and kidney secondary to a spilled gallstone...
February 4, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28174033/acute-hypotonia-in-an-infant
#14
Jimme Sierakowski, Jason Arthur, Todd Wylie
BACKGROUND: Acute flaccid myelitis (AFM) is increasing in incidence in the United States and presenting to emergency departments (EDs) across the country. This clinical entity presents as acute paralysis, with magnetic resonance imaging changes in the gray matter only in children younger than 21 years of age. The etiology is unknown, although preceding viral illnesses are common. There are no consensus guidelines regarding treatment. CASE REPORT: A 4-month-old girl presented with decreased bilateral arm movement...
February 4, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28174032/emergency-medicine-myths-epinephrine-in-cardiac-arrest
#15
Brit Long, Alex Koyfman
BACKGROUND: Sudden cardiac arrest accounts for approximately 15% of deaths in developed nations, with poor survival rate. The American Heart Association states that epinephrine is reasonable for patients with cardiac arrest, though the literature behind its use is not strong. OBJECTIVE: To review the evidence behind epinephrine for cardiac arrest. DISCUSSION: Sudden cardiac arrest causes over 450,000 deaths annually in the United States. The American Heart Association recommends epinephrine may be reasonable in patients with cardiac arrest, as part of Advanced Cardiac Life Support...
February 4, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28169046/ileal-neobladder-an-important-cause-of-non-anion-gap-metabolic-acidosis
#16
Jesse W St Clair, Matthew L Wong
BACKGROUND: The differential diagnosis for a non-anion gap metabolic acidosis is probably less well known than the differential diagnosis for an anion gap metabolic acidosis. One etiology of a non-anion gap acidosis is the consequence of ileal neobladder urinary diversion for the treatment of bladder cancer. CASE REPORT: We present a case of a patient with an ileal neobladder with a severe non-anion gap metabolic acidosis caused by a urinary tract infection and ureteroenterostomy...
February 3, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28162834/a-type-ii-congenital-extrahepatic-portosystemic-shunt-a-rare-cause-of-abdominal-pain-diagnosed-by-point-of-care-ultrasound
#17
Sun Hwa Lee, Seong Jong Yun
No abstract text is available yet for this article.
February 2, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28161256/cecal-perforation-associated-with-clostridium-difficile-infection-a%C3%A2-case-report
#18
Sarah Kyuragi Luthe, Ryota Sato
BACKGROUND: Various complications are reported with Clostridium difficile infection (CDI), including fulminant CDI. Fulminant CDI is an underappreciated life-threatening condition associated with complications such as toxic megacolon and bowel perforation. CASE REPORT: A 79-year-old woman presented to the Emergency Department with altered mental status. She was admitted and conservatively treated for a left thalamic hemorrhage. While hospitalized, she developed watery diarrhea due to Clostridium difficile...
February 2, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28139270/an-unlikely-cause-of-hypokalemia
#19
Jason Hine, Ari Schwell, Norah Kairys
BACKGROUND: Hypokalemia is a common clinical disorder caused by a variety of different mechanisms. Although the most common causes are diuretic use and gastrointestinal losses, elevated cortisol levels can also cause hypokalemia through its effects on the renin-angiotensin-aldosterone system. Cushing's syndrome refers to this general state of hypercortisolemia, which often manifests with symptoms of generalized weakness, high blood pressure, diabetes mellitus, menstrual disorders, and psychiatric changes...
January 28, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28139269/calcium-pill-aspiration-a-case-report
#20
David Clark Brewer, Mark Regala, Jamie Hess
No abstract text is available yet for this article.
January 27, 2017: Journal of Emergency Medicine
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