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Journal of Emergency Medicine

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https://www.readbyqxmd.com/read/27913079/rash-decisions-an-approach-to-dangerous-rashes-based-on-morphology
#1
Jamie Santistevan, Brit Long, Alex Koyfman
BACKGROUND: Rash is a common complaint in the emergency department. Many causes of rash are benign; however, some patients may have a life-threatening diagnosis. OBJECTIVE: This review will present an algorithmic approach to rashes, focusing on life-threatening causes of rash in each category. DISCUSSION: Rash is common, with a wide range of etiologies. The differential is broad, consisting of many conditions that are self-resolving. However, several conditions associated with rash are life threatening...
November 29, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27899207/a-57-year-old-man-with-right-sided-chest-pain
#2
Betzalel Reich, Jonathan Edlow
No abstract text is available yet for this article.
November 26, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27899206/the-use-of-thrombolysis-for-acute-pulmonary-embolism-in-the-united-states-national-trends-and-patient-characteristics-from-2006-to-2011
#3
Barret Rush, Katie Wiskar, Landon Berger, Donald E Griesdale
BACKGROUND: Thrombolysis for the treatment of pulmonary embolism (PE) has received significant attention in the literature over the past 10 years. OBJECTIVE: Our primary objective was to examine the trend in thrombolysis use in the United States from 2006 to 2011. Secondary objectives include examining patient and hospital characteristics associated with receiving thrombolysis and rates of complications associated with thrombolysis. METHODS: In this retrospective cohort study, we used the Nationwide Inpatient Sample from 2006 to 2011 to identify patients with a diagnosis of PE who received or did not receive thrombolytic agents...
November 26, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27889359/elevated-liver-enzymes-emergency-department-focused-management
#4
Eric Sulava, Samuel Bergin, Brit Long, Alex Koyfman
BACKGROUND: Liver function test (LFT) abnormalities are a common problem faced by emergency physicians. This has become more common with the introduction of laboratory panels and automated routine laboratory testing. Fortunately, not all patients with irregularities in liver enzymes possess underlying pathology. This emergency medicine focused review provides a discussion of the various biochemical tests, their underlying biological basis, and an algorithmic approach to the interpretation of abnormalities...
November 23, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27887758/blind-nasal-intubation-revisited-no-longer-a-blind-technique
#5
Prakash K Dubey, Preksha Dubey, Niranjan Kumar, Gautam Bhardwaj, Neeraj Kumar
BACKGROUND: Advancements in airway management have made the practice of blind nasal intubation obsolete. We report on successful blind nasal intubation performed with the help of capnography and real-time ultrasonography in two patients with tempormandibular joint ankylosis. CASE REPORT: Blind nasal intubation was performed in a 12-year-old patient and a 17-year old patient under general anesthesia with spontaneous respiration. Capnography was used as an aid during insertion and dynamic ultrasonography was performed to guide and confirm proper tracheal tube placement...
November 22, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27887757/hepatic-artery-rupture-in-a-young-man-with-abdominal-pain%C3%A2-and%C3%A2-a%C3%A2-testicular-mass
#6
Kevin S Barlotta, David Page
BACKGROUND: Male patients presenting to the emergency department (ED) with abdominal pain accompanied by a testicular mass should be evaluated for the presence of hernia, epididymitis, orchitis, and testicular torsion. When a patient presents with an asymptomatic testicular nodule or mass, the emergency physician should consider testicular carcinoma, a diagnosis that typically warrants no more than prompt urologic outpatient referral. CASE REPORT: We present a case involving a young male whose presenting complaint was abdominal pain...
November 22, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27884578/frequent-emergency-department-users-with-human-immunodeficiency-virus-infection
#7
LETTER
Jordan Glaser, Neville K Mobarakai, Nicolle Berwald
No abstract text is available yet for this article.
November 21, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27884577/low-pressure-pericardial-tamponade-case-report-and-review-of-the-literature
#8
Brooks M Walsh, Lauren A Tobias
BACKGROUND: Focused cardiac ultrasound (FoCUS) is accurate for determining the presence of a pericardial effusion. Using FoCUS to evaluate for pericardial tamponade, however, is more involved. Many experts teach that tamponade is unlikely if the inferior vena cava (IVC) shows respiratory variation and is not distended. CASE REPORT: A 53-year-old woman presented to the emergency department (ED) with severe orthostatic hypotension, exertional dyspnea, and hypoxia...
November 21, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27884576/extracorporeal-life-support-for-refractory-cardiac-arrest-from-accidental-hypothermia-a-10-year-experience-in-edinburgh
#9
Maziar Khorsandi, Scott Dougherty, Neil Young, Dean Kerslake, Vincenzo Giordano, Robert Lendrum, William Walker, Vipin Zamvar, Ivan Yim, Renzo Pessotto
BACKGROUND: Cardiac arrest caused by accidental hypothermia is a rare phenomenon with a significant mortality rate if untreated. The consensus is that these patients should be rewarmed with extracorporeal life support (ECLS) with the potential for excellent survival and neurologic outcomes. However, given the lack of robust data and clinical trials, the optimal management of such patients remains elusive. OBJECTIVE: In this single-center study, we looked at the outcomes of all adult patients undergoing salvage ECLS for cardiac arrest caused by accidental hypothermia over a 10-year period from June 2006 to June 2016...
November 21, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27884575/brugada-pattern-caused-by-a-flecainide-overdose
#10
Elena Tessitore, Majd Ramlawi, Olivier Tobler, Henri Sunthorn
BACKGROUND: Brugada pattern can be found on the electrocardiogram (ECG) of patients with altered mental status, usually with fever or drug intoxication. Diagnosis remains challenging, because the ECG changes are dynamic and variable. In addition, triggers are not always clearly identified. In patients with atrial fibrillation (AF), the use of class IC antidysrhythmic drugs can unmask a Brugada pattern on the ECG, especially if combined with other medications acting on sodium channels...
November 21, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27876331/inferior-phrenic-artery-related-hemoptysis
#11
Sheng-Huei Wang, Kai-Hsiung Ko, Yu-Pang Lin, Chih-Feng Chian
No abstract text is available yet for this article.
November 19, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27876330/pneumomediastinum-pneumothorax-and-subcutaneous-emphysema-caused-by-colonoscopic-perforation-a-report-of-two-cases
#12
Pyong Wha Choi
BACKGROUND: Although colonoscopy is generally a safe procedure, lethal complications can occur. Colonoscopic perforation is one of the most serious complications, and it can present with various clinical symptoms and signs. Aggravating abdominal pain and free air on simple radiography are representative clinical manifestations of colonoscopic perforation. However, unusual symptoms and signs, such as dyspnea and subcutaneous emphysema, which are less likely to be related with complicating colonoscopy, may obscure correct clinical diagnosis...
November 19, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27876329/four-factor-versus-three-factor-prothrombin-complex-concentrate-is-more-always-better
#13
LETTER
B Tate Cutshall, G Morgan Jones
No abstract text is available yet for this article.
November 19, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27876328/best-clinical-practice-controversies-in-transient-ischemic-attack-evaluation-and-disposition-in-the-emergency-department
#14
Brit Long, Alex Koyfman
BACKGROUND: Transient ischemic attack (TIA) affects over 200,000 patients annually in the United States, and it precedes approximately 14% to 23% of strokes. Patients are typically admitted for evaluation and management. OBJECTIVE: This review investigates the controversies of emergency department (ED) evaluation of TIA, including imaging, clinical risk scores, rapid diagnostic protocols, and disposition. DISCUSSION: TIA is a common condition, with over 200,000 patients affected annually, and is associated with risk of stroke...
November 19, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27876327/endotracheal-intubation-with-the-king-laryngeal-tube%C3%A2-in-situ-using-video-laryngoscopy-and-a-bougie-a-retrospective-case-series-and-cadaveric-crossover-study
#15
Kenneth W Dodd, Rebecca L Kornas, Matthew E Prekker, Lauren R Klein, Robert F Reardon, Brian E Driver
BACKGROUND: Removal of a functioning King laryngeal tube (LT) prior to establishing a definitive airway increases the risk of a "can't intubate, can't oxygenate" scenario. We previously described a technique utilizing video laryngoscopy (VL) and a bougie to intubate around a well-seated King LT with the balloons deflated; if necessary, the balloons can be rapidly re-inflated and ventilation resumed. OBJECTIVE: Our objective is to provide preliminary validation of this technique...
November 19, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27876326/hypertriglyceridemia-induced-acute-pancreatitis
#16
Jasmit Minhas, Dhaval Thakkar, James Dargin
No abstract text is available yet for this article.
November 19, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27876325/does-early-goal-directed-therapy-decrease-mortality-compared-with-standard-care-in-patients-with-septic-shock
#17
Michael E Winters, Robert Sherwin, Gary M Vilke, Gabriel Wardi
BACKGROUND: Current international guidelines for the treatment of patients with severe sepsis and septic shock recommend that patients receive targeted care to various physiologic endpoints, thereby optimizing tissue perfusion and oxygenation. These recommendations are primarily derived from a protocol published >15 years ago, which was viewed by many as complex and was therefore not widely adopted. Instead, many emergency physicians focused on the administration of early antibiotics, source control, aggressive fluid resuscitation, vasoactive medications as needed to maintain mean arterial blood pressure, and careful monitoring of these patients...
November 19, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27876217/spontaneous-pneumothorax-complicating-miliary-tuberculosis
#18
Kuo-Hsuan Lin, I-Ting Tsai, Po-Jen Yang
No abstract text is available yet for this article.
November 18, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27866812/a-case-report-of-infectious-sacroiliitis-in-an-adult-presenting-to-the-emergency-department-with-inability-to-walk
#19
Douglas Brtalik, Manoj Pariyadath
BACKGROUND: Infectious sacroiliitis (ISI) is an uncommon cause of back and hip pain in which the sacroiliac joint, either unilateral or bilateral, is inflamed from an infectious source. Historically, this has been an easily missed diagnosis due to nonspecific presenting symptoms along with subtle nondistinguishable laboratory abnormalities. CASE REPORT: We describe an injection drug user presenting with right-sided ISI who presented with hip and back pain and inability to walk...
November 17, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27863834/correlation-between-united-states-medical-licensing-examination-and-comprehensive-osteopathic-medical-licensing-examination-scores-for-applicants-to-a-dually-approved-emergency-medicine-residency
#20
Kathleen E Kane, Dawn Yenser, Kevin R Weaver, Gavin C Barr, Terrence E Goyke, Shawn M Quinn, Charles C Worrilow, Andre J Burckhart, Adam L Leonetti, Isamu E Yoshioka, Stephen W Dusza, Bryan G Kane
BACKGROUND: It is important for emergency medicine (EM) residency programs to be able to correlate the United States (US) Medical Licensing Examination (USMLE) and Comprehensive Osteopathic Medical Licensing Examination (COMLEX) scores of applicants. OBJECTIVE: We sought to determine the correlation between USMLE and COMLEX scores for EM residency applicants. METHODS: Retrospectively, from 2006 through 2013, USMLE and COMLEX examination scores for applicants to our 4-year, 56-member, dually approved EM residency were analyzed...
November 15, 2016: Journal of Emergency Medicine
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