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Journal of Emergency Medicine

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https://www.readbyqxmd.com/read/28342574/ultrasound-findings-in-tension-pneumothorax-a-case-report
#1
Maxine Inocencio, Jeannine Childs, Mikaela L Chilstrom, Kristin Berona
BACKGROUND: Delayed recognition of tension pneumothorax can lead to a mortality of 31% to 91%. However, the classic physical examination findings of tracheal deviation and distended neck veins are poorly sensitive in the diagnosis of tension pneumothorax. Point-of-care ultrasound is accurate in identifying the presence of pneumothorax, but sonographic findings of tension pneumothorax are less well described. CASE REPORT: We report the case of a 21-year-old man with sudden-onset left-sided chest pain...
March 22, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28342573/capnography-assisted-nasotracheal-intubation-using-cuff-inflation-and-gum-elastic-bougie
#2
LETTER
Rajeev Sharma
No abstract text is available yet for this article.
March 22, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28336241/intracardiac-venous-stent-migration-emergency-department-presentation-of-a-catastrophic-complication
#3
Eric Steinberg, Christopher Gentile, Michael Heller, Nicole Kaban, Erica Bang, Terry Li
BACKGROUND: Venous stents are commonly placed to ensure patency in patients with chronic peripheral venous insufficiency. Although serious complications are uncommon, peripheral venous stent placement can have some potentially life-threatening complications. One of the most feared, and certainly the most dramatic, complication is stent migration. CASE REPORT: We report on a 55-year-old woman with transvenous migration of an infrarenal inferior vena cava stent into the right atrium and through the intra-atrial septum...
March 20, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28336240/what-s-the-evidence-self-assessment-implications-for-life-long-learning-in-emergency-medicine
#4
Margaret Wolff, Sally A Santen, Laura R Hopson, Robin R Hemphill, Susan E Farrell
BACKGROUND: The 2012 Academic Emergency Medicine Consensus Conference, "Education Research in Emergency Medicine: Opportunities, Challenges, and Strategies for Success" noted that emergency medicine (EM) educators often rely on theory and tradition when molding their approaches to teaching and learning, and called on the EM education community to advance the teaching of our specialty through the performance and application of research in teaching and assessment methods, cognitive function, and the effects of education interventions...
March 20, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28336239/penile-gangrene-by-calciphylaxis-an-unusual-clinical-presentation-in-a-patient-with-diabetic-nephropathy-on-hemodialysis
#5
Guevar Maselli, Marco Cordari, Francesco Catanzariti, Gaetano Donatelli, Lucio Dell'Atti, Andrea Benedetto Galosi
No abstract text is available yet for this article.
March 20, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28336238/hydropneumothorax-due-to-esophageal-rupture
#6
Joseph R Shiber, Emily Fontane, Jin H Ra, Andrew J Kerwin
BACKGROUND: A brief review of the historical aspects of esophageal rupture is presented along with a case and current recommendations for diagnostic evaluation and treatment. CASE REPORT: A 97-year-old woman complained of acute dyspnea without prior vomiting. Chest x-ray study showed a large right pneumothorax with associated effusion. A thoracostomy tube was placed with return of > 1 L turbid fluid with polymicrobial culture and elevated pleural fluid amylase level...
March 20, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28336237/point-of-care-ultrasound-sonographic-posterior-fat-pad-sign-a%C3%A2-case-report-and-brief-literature-review
#7
Yoshito Okumura, Nestor Maldonado, Kyle Lennon, Bryan McCarty, Philipp Underwood, Mathew Nelson
BACKGROUND: Diagnosis of elbow fracture can sometimes be difficult with plain radiography due to overlapping bones, growth plates, and maturing bones in the pediatric population. The radiographic posterior fat pad (PFP) sign is one of the frequently referenced indirect signs of an occult elbow fracture. This sign can be falsely negative if the sign is subtle, and can be falsely positive when the position of the elbow is not flexed at 90 degrees. CASE REPORT: We discuss a case in which sonographic PFP sign helped to diagnose an elbow fracture...
March 20, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28325628/an-unusual-cause-of-first-time-seizure-in-an-adult
#8
Andrew Eyre, C Eduardo Corrales, David Silvestri, Emily S Miller, Kriti Bhatia
No abstract text is available yet for this article.
March 18, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28318811/st-elevation-myocardial-infarction-after-penetrating-thoracic-trauma
#9
Kiran Faryar, Michael P Flaherty, Martin Huecker
BACKGROUND: ST-segment elevation myocardial infarction (STEMI) may complicate penetrating thoracic trauma. CASE REPORT: This report describes a 42-year-old man who sustained a self-inflicted gunshot wound to the left chest. Electrocardiogram showed ST elevation in the inferior leads. Emergent catheterization was not recommended and conservative management was initiated. Cardiac catheterization 4 days later showed no perturbation of the coronary arteries, neither atherosclerotic nor traumatic...
March 17, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28291638/lyme-disease-emergency-department-considerations
#10
Nathan D Applegren, Chadd K Kraus
BACKGROUND: Lyme disease (LD) is the most common vector-borne illness in North America. Reported cases of LD have increased from approximately 10,000 cases annually in 1991 to >25,000 cases in 2014. Greater recognition, enhanced surveillance, and public education have contributed to the increased prevalence, as have geographic expansion and the number of infected ticks. Cases are reported primarily in the Northeastern United States, Wisconsin, and Minnesota, with children having the highest incidence of LD among all age groups...
March 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28285869/use-of-capsaicin-cream-in-cannabis-hyperemesis-syndrome
#11
LETTER
F Pélissier, I Claudet, P Gandia-Mailly, A Benyamina, N Franchitto
No abstract text is available yet for this article.
March 9, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28285868/more-than-meets-the-eye-klebsiella-pneumoniae-invasive-liver-abscess-syndrome-presenting-with-endophthalmitis
#12
Jan Van Keer, Karel Van Keer, Joachim Van Calster, Inge Derdelinckx
BACKGROUND: Endophthalmitis is a feared complication of pyogenic liver abscesses caused by hypervirulent Klebsiella pneumoniae strains. First described in East Asia in the 1980s, this invasive syndrome is only recently emerging in Europe and America. CASE REPORT: We describe an 84-year-old man who presented to the emergency department with fever, orbital cellulitis, and bilateral visual loss. Although the patient had no overt abdominal symptoms, computed tomography scan revealed a pyogenic liver abscess...
March 9, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28285867/a-modified-lung-and-cardiac-ultrasound-protocol-saves-time-and-rules-in-the-diagnosis-of-acute-heart-failure
#13
Frances M Russell, Robert R Ehrman
BACKGROUND: Multiorgan ultrasound (US), which includes evaluation of the lungs and heart, is an accurate method that outperforms clinical gestalt for diagnosing acutely decompensated heart failure (ADHF). A known barrier to ultrasound use is the time needed to perform these examinations. OBJECTIVE: The primary goal of this study was to determine the test characteristics of a modified lung and cardiac US (LuCUS) protocol for the accurate diagnosis of ADHF. METHODS: This was a secondary analysis of a prospective observational study that enrolled adult patients presenting to the emergency department with undifferentiated dyspnea...
March 9, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28285866/obstructed-infradiaphragmatic-total-anomalous-pulmonary-venous-return-in-a-13-day-old-infant-presenting-acutely-to-the-emergency-department-a-case-report
#14
Elizabeth A Siacunco, Garrett S Pacheco, Dale P Woolridge
BACKGROUND: Total anomalous pulmonary venous return (TAPVR) is an uncommon congenital heart defect. Obstructed forms are more severe, and typically present earlier in life, usually in the immediate newborn period, with symptoms of severe cyanosis and respiratory failure. CASE REPORT: A 13-day-old boy presented to the emergency department (ED) with respiratory extremis. He appeared cyanotic and limp, and was found to have significant hypoxia with oxygen saturation of 40%...
March 9, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28284770/point-of-care-ultrasonography-to-assist-in-the-diagnosis-and-management-of-subluxation-of-the-radial-head-in-pediatric-patients-a-case-series
#15
Faruk Güngör, Taylan Kılıç
BACKGROUND: A subluxation of the radial head (SRH) is a clinical condition that commonly occurs in children under 6 years of age. History and physical examination findings typically include a child who presents with an elbow held in extension and with forearm pronation, after having suffered significant longitudinal traction on the arm, or after a fall on an outstretched hand. The diagnosis is often clinically obvious. The injury responds dramatically to closed reduction, and usually no imaging is required...
March 8, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28284769/sustainable-resuscitation-ultrasound-education-in-a-low-resource-environment-the-kumasi-experience
#16
Chelsea A Tafoya, Matthew J Tafoya, Maxwell Osei-Ampofo, Rockefeller A Oteng, Torben K Becker
BACKGROUND: Point-of-care-ultrasound (POCUS) is an increasingly important tool for emergency physicians and has become a standard component of emergency medicine residency training in high-income countries. Cardiopulmonary ultrasound (CPUS) is emerging as an effective way to quickly and accurately assess patients who present to the emergency department with shock and dyspnea. Use of POCUS, including CPUS, is also becoming more prevalent in low- and middle-income countries (LMICs); however, formal ultrasound training for emergency medicine resident physicians in these settings is not widely available...
March 8, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28283304/minor-injury-crashes-prevalence-of-driver-related-risk-factors-and-outcome
#17
Jeffrey R Brubacher, Herbert Chan, Elizabeth Purssell, Benjamin J Tuyp, Daniel K Ting, Vahid Mehrnoush
BACKGROUND: The majority of crashes cause "minor" injuries (i.e., treated and released from the emergency department [ED]). Minor injury crashes are poorly studied. OBJECTIVES: This study aims to determine the prevalence of driver-related risk factors and subsequent outcome in drivers involved in minor crashes. METHODS: We interviewed a convenience sample of injured drivers, aged over 17 years, who were treated and released from the ED. Follow-up interviews were conducted 6 months after the crash...
March 7, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28279544/inferior-vena-cava-filter-limb-fracture-with-embolization-to-the-right-ventricle
#18
Bradley S Jackson, Mykel Sepula, Jared T Marx, Chad M Cannon
BACKGROUND: Inferior vena cava (IVC) filter and filter limb embolization is a known phenomenon, with a prevalence of up to 25% for certain filter types. Most commonly, the site of embolization is to the heart. Point-of-care ultrasound is an easily accessible imaging modality that should be utilized when considering IVC filter complications. CASE REPORT: A 28-year-old woman with a history of metastatic sarcoma and IVC filter placement for deep venous thrombosis presented to the Emergency Department (ED) for chest pain...
March 6, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28279543/emergency-department-holding-orders
#19
Stephen J Traub, M'Hamed Temkit, Soroush Saghafian
BACKGROUND: Holding orders help transition admitted emergency department (ED) patients to hospital beds. OBJECTIVE: To describe the effect of ED holding orders. METHODS: We conducted a single-site retrospective study of ward admissions from the ED to the hospital internal medicine (HIM) service over 2 years. Patients were classified based on whether the ED did (group 1) or did not (group 2) write holding orders; group 1 was subdivided into patients sent to the floor with only ED holding orders (group 1A) vs...
March 6, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28279542/the-use-of-ketamine-for-acute-treatment-of-pain-a-randomized-double-blind-placebo-controlled-trial
#20
Billy Sin, Tamara Tatunchak, Mohammad Paryavi, Maria Olivo, Usman Mian, Josel Ruiz, Bupendra Shah, Sylvie de Souza
BACKGROUND: Pain is one of the most common reasons for emergency department (ED) visits in the United States. Ketamine is a sedative with N-methyl-D-aspartate (NMDA) receptor antagonism. Recent literature has suggested that the use of subdissociative dose ketamine (SDDK) may be safe and effective for acute pain. OBJECTIVE: The objective of our study was to evaluate ketamine in subdissociative doses as an adjunct for acute pain in the ED. METHODS: This was a single-center, prospective, randomized, double-blind, placebo-controlled trial that evaluated the use of SDDK in adult patients who presented to the ED with acute pain...
March 6, 2017: Journal of Emergency Medicine
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