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Journal of Emergency Medicine

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https://www.readbyqxmd.com/read/28511774/an-unusual-case-of-flank-pain-more-than-just-an-inguinal-hernia
#1
Kareem S Elsayed, Raymond J Melder, Michael C Nguyen
No abstract text is available yet for this article.
May 13, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28511773/psychiatric-patient-length-of-stay-in-the-emergency-department-following-closure-of-a-public-psychiatric-hospital
#2
Ryan K Misek, Ashley D Magda, Samantha Margaritis, Robert Long, Erik Frost
BACKGROUND: Psychiatric patient boarding in the emergency department (ED) is a ubiquitous problem associated with increased morbidity and mortality. OBJECTIVE: We evaluate the effect of closing a public psychiatric facility in a major metropolitan area on the ED length of stay (LOS) of psychiatric patients. METHODS: This was a retrospective chart review at two metropolitan EDs of all patients assessed to require inpatient psychiatric hospitalization...
May 13, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28506546/a-model-for-electronic-handoff-between-the-emergency-department-and-inpatient-units
#3
Leon D Sanchez, David T Chiu, Larry Nathanson, Steve Horng, Richard E Wolfe, Mark L Zeidel, Kirsten Boyd, Carrie Tibbles, Shelley Calder, Jane Dufresne, Julius J Yang
BACKGROUND: Patient handoffs between units can introduce risk and time delays. Verbal communication is the most common mode of handoff, but requires coordination between different parties. OBJECTIVE: We present an asynchronous patient handoff process supported by a structured electronic signout for admissions from the emergency department (ED) to the inpatient medicine service. METHODS: A retrospective review of patients admitted to the medical service from July 1, 2011 to June 30, 2015 at a tertiary referral center with 520 inpatient beds and 57,000 ED visits annually...
May 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28501386/atrioesophageal-fistula-after-ablation-for-atrial-fibrillation
#4
Trisha Mackle, Kevin Pistawka
BACKGROUND: Atrioesophageal fistula (AEF) is a rare and highly fatal complication of ablation procedures for atrial fibrillation. We report a diagnostically challenging case of AEF that highlights the unfortunate outcome that can be expected when this condition is not promptly diagnosed and managed accordingly. The varied clinical presentations are reviewed and recommended diagnostic and management approaches are presented. CASE REPORT: A 79-year-old female who was 5 weeks post-ablation presented to a community emergency department with chest pain and a transient episode of left-arm weakness...
May 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28501385/full-and-partial-thickness-burns-from-spontaneous-combustion-of-e-cigarette-lithium-ion-batteries-with-review-of-literature
#5
Daniela Treitl, Rachele Solomon, Dafney L Davare, Rafael Sanchez, Chauniqua Kiffin
BACKGROUND: In recent years, the use of electronic cigarettes (e-cigarettes) has increased worldwide. Most electronic nicotine delivery systems use rechargeable lithium-ion batteries, which are relatively safe, but in rare cases these batteries can spontaneously combust, leading to serious full and partial thickness burn injuries. Explosions from lithium-ion batteries can cause a flash fire and accelerant-related burn injuries. CASE REPORT: A retrospective chart review was conducted of 3 patients with lithium-ion battery burns seen at our Level I community-based trauma center...
May 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28501384/acute-heart-failure-in-the-emergency-department-the-safe-simeu-epidemiological-study
#6
Andrea Fabbri, Giulio Marchesini, Giorgio Carbone, Roberto Cosentini, Annamaria Ferrari, Mauro Chiesa, Alessio Bertini, Federico Rea
BACKGROUND: Patients with acute heart failure (AHF) have high rates of attendance to emergency departments (EDs), with significant health care costs. OBJECTIVES: We aimed to describe the clinical characteristics of patients attending Italian EDs for AHF and their diagnostic and therapeutic work-up. METHODS: We carried out a retrospective analysis on 2683 cases observed in six Italian EDs for AHF (January 2011 to June 2012). RESULTS: The median age of patients was 84 years (interquartile range 12), with females accounting for 55...
May 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28501383/intentional-misuse-and-abuse-of-loperamide-a-new-look-at-a-drug-with-low-abuse-potential
#7
Stephen W Borron, Susan H Watts, Jonathan Tull, Salvador Baeza, Stephanie Diebold, Alison Barrow
BACKGROUND: Despite its opioid properties, loperamide has long been thought to have low abuse potential due to its poor absorption from the gastrointestinal tract and limited potential to cross the blood-brain barrier. A recent patient reportedly taking loperamide to avoid heroin withdrawal symptoms, at doses approximately 100 times those recommended, directed our attention to this issue. OBJECTIVES: 1) Investigate number of cases of intentional loperamide abuse and misuse reported to poison centers between 2009 and 2015; 2) Compile reports of clinical effects of loperamide abuse; and 3) Search for evidence of increasing Internet interest in the central opioid effects of loperamide...
May 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28499745/distress-in-caregivers-accompanying-patients-to-an-emergency-department-a-scoping-review
#8
Thom Ringer, Daniel Moller, Adam Mutsaers
BACKGROUND: Despite substantial research interest in caregiver distress in the emergency department (ED), no recent review of the literature exists. OBJECTIVE: Our aims were to map primary research on caregiver distress in the ED, synthesize key concepts underpinning the literature, identify gaps, and provide guidance for future work. METHODS: We used a five-stage scoping review with tandem screening and data extraction. RESULTS: Of 2121 records, 29 studies were included...
May 9, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28495123/in-response-to-hypothermia-for-neuroprotection-in-convulsive-status-epilepticus
#9
LETTER
Stephane Legriel, Matthieu Resche-Rigon, Alain Cariou
No abstract text is available yet for this article.
May 8, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28477971/mandibular-degloving-a-case-report-and-literature-review
#10
Joshua M Jabaut, Joseph Kotora, Art Ambrosio
BACKGROUND: Degloving injuries of the extremities are well documented; however, there are few reports of degloving injuries to the mandible. A literature review demonstrates several cases of mandibular degloving in pediatric patients. However, no isolated mandibular degloving injuries have been reported in adults. CASE REPORT: We report a case of a 21-year-old male who presented to the emergency department with facial trauma after a motorcycle accident. Initial examination of the head and neck showed ecchymosis and edema overlying the left periorbital area, eye closure secondary to periorbital edema, upper eyelid and lower eyelid superficial lacerations, as well as a left oral commissural and lower intraoral lacerations...
May 3, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28433211/adverse-events-during-a-randomized-trial-of-ketamine-versus-co-administration-of-ketamine-and-propofol-for-procedural-sedation-in-a-pediatric-emergency-department
#11
Keith Weisz, Lalit Bajaj, Sara J Deakyne, Lina Brou, Alison Brent, Joseph Wathen, Genie E Roosevelt
BACKGROUND: The co-administration of ketamine and propofol (CoKP) is thought to maximize the beneficial profile of each medication, while minimizing the respective adverse effects of each medication. OBJECTIVE: Our objective was to compare adverse events between ketamine monotherapy (KM) and CoKP for procedural sedation and analgesia (PSA) in a pediatric emergency department (ED). METHODS: This was a prospective, randomized, single-blinded, controlled trial of KM vs...
April 19, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28416252/hydroceles-not-just-for-men
#12
Danielle Biggs, Amy Patwa, Steve Gohsler
BACKGROUND: Hydroceles develop in females through the canal of Nuck. This canal is formed when the processes vaginalis fails to obliterate during development. The canal of Nuck can lead to the formation of not only hydroceles, but hernias as well. Although physicians typically think of hydroceles occurring in males, on rare occasions, they do occur in females because of this defect. They are often mistaken for incarcerated hernias, making ultrasound an excellent tool to distinguish between them and guide further treatment...
April 14, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28416251/initial-asthma-severity-assessment-tools-as-predictors-of-hospitalization
#13
Natalia Paniagua, Amaia Elosegi, Isabel Duo, Ana Fernandez, Elisa Mojica, Lorea Martinez-Indart, Santiago Mintegi, Javier Benito
BACKGROUND: Assessment tools to classify and prioritize patients, such as systems of triage, and indicators of severity, such as clinical respiratory scores, are helpful in guiding the flow of asthmatic patients in the emergency department. OBJECTIVE: Our aim was to assess the performance of the Pediatric Assessment Triangle (PAT), triage level (TL), Pulmonary Score (PS), and initial O2 saturation (O2 sat), in predicting hospitalization in pediatric acute asthma exacerbations...
April 14, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28412073/pediatric-acute-flaccid-paralysis-enterovirus-d68-associated-anterior-myelitis
#14
James A Yoder, Michael Lloyd, Luke Zabrocki, Jonathan Auten
BACKGROUND: Enteroviral infections can cause acute flaccid paralysis secondary to anterior myelitis. Magnetic resonance imaging (MRI) is important in the diagnosis of this potentially devastating pediatric disease. Before the 2014 outbreak of Enterovirus D68 (EV-D68), the virus was considered a relatively benign disease. CASE REPORT: A fully immunized 8-year-old boy was brought to the emergency department complaining of a cough, headache, neck pain, and right arm pain and weakness...
April 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28412072/do-slow-and-steady-residents-win-the-race-modeling-the-effects-of-peak-and-overall-resident-productivity-in-the-emergency-department
#15
Joshua W Joseph, Victor Novack, Matthew L Wong, Larry A Nathanson, Leon D Sanchez
BACKGROUND: Emergency medicine residents need to be staffed in a way that balances operational needs with their educational experience. Key to developing an optimal schedule is knowing a resident's expected productivity, a poorly understood metric. OBJECTIVE: We sought to measure how a resident's busiest (peak) workload affects their overall productivity for the shift. METHODS: We conducted a retrospective, observational study of resident productivity at an urban, tertiary care center with a 3-year Accreditation Council for Graduate Medical Education-approved emergency medicine training program, with 55,000 visits annually...
April 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28412071/emergency-medicine-myths-cerebral-edema-in-pediatric-diabetic-ketoacidosis-and-intravenous-fluids
#16
Brit Long, Alex Koyfman
BACKGROUND: Pediatric diabetic ketoacidosis (DKA) is a disease associated with several complications that can be severe. One complication includes cerebral edema (CE), and patients may experience significant morbidity with this disease. OBJECTIVE: This review evaluates the myths concerning CE in pediatric DKA including mechanism, presentation of edema, clinical assessment of dehydration, and association with intravenous (i.v.) fluids. DISCUSSION: Multiple complications may occur in pediatric DKA...
April 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28410960/a-randomized-controlled-trial-of-a-citywide-emergency-department-care-coordination-program-to-reduce-prescription-opioid-related-visits-an-economic-evaluation
#17
Sean M Murphy, Donelle Howell, Sterling McPherson, Rebecca Grohs, John Roll, Darin Neven
BACKGROUND: Care provided in the emergency department (ED) can cost up to five times as much as care received for comparable diagnoses in alternative settings. Small groups of patients, many of whom suffer from an opioid use disorder, often account for a large proportion of total ED visits. We recently conducted, and demonstrated the effectiveness of, the first randomized controlled trial of a citywide ED care-coordination program intending to reduce prescription-opioid-related ED visits...
April 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28410961/heroin
#18
Sophia Valesca Görgens
No abstract text is available yet for this article.
April 11, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28408236/unintentional-pediatric-cocaine-exposures-result-in-worse-outcomes-than-other-unintentional-pediatric-poisonings
#19
Patil Armenian, Michelle Fleurat, George Mittendorf, Kent R Olson
BACKGROUND: Unintentional pediatric cocaine exposures are rare but concerning due to potentially serious complications such as seizures, dysrhythmias, and death. OBJECTIVES: The objectives were to assess the demographic and clinical characteristics of pediatric cocaine exposures reported to the California Poison Control System. METHODS: This is a retrospective study of all confirmed pediatric (< 6 years of age) cocaine exposures reported to the California Poison Control System from January 1, 1997-September 30, 2010...
April 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28408235/danger-triangle-of-face-and-septic-cavernous-sinus-thrombosis
#20
Ashok Kumar Pannu, Atul Saroch, Navneet Sharma
No abstract text is available yet for this article.
April 10, 2017: Journal of Emergency Medicine
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