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Journal of Emergency Medicine

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https://www.readbyqxmd.com/read/28764972/diagnostic-accuracy-of-clinical-decision-rules-to-exclude-fractures-in-acute-ankle-injuries-systematic-review-and-meta-analysis
#1
Ingrid Barelds, Wim P Krijnen, Johannes P van de Leur, Cees P van der Schans, Robert J Goddard
BACKGROUND: Ankle decision rules are developed to expedite patient care and reduce the number of radiographs of the ankle and foot. Currently, only three systematic reviews have been conducted on the accuracy of the Ottawa Ankle and Foot Rules (OAFR) in adults and children. However, no systematic review has been performed to determine the most accurate ankle decision rule. OBJECTIVES: The purpose of this study is to examine which clinical decision rules are the most accurate for excluding ankle fracture after acute ankle trauma...
July 29, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28756934/postoperative-anticholinergic-poisoning-concealed-complications-of-a-commonly-used-medication
#2
Xiao Chi Zhang, Natalija Farrell, Thomas Haronian, Jason Hack
BACKGROUND: Scopolamine is a potent anticholinergic compound used commonly for the prevention of postoperative nausea and vomiting. Scopolamine can cause atypical anticholinergic syndromes due to its prominent central antimuscarinic effects. CASE REPORT: A 47-year-old female presented to the emergency department (ED) 20 h after hospital discharge for a right-knee meniscectomy, with altered mental status (AMS) and dystonic extremity movements that began 12 h after her procedure...
July 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28756933/pericardial-herniation-of-small-bowel-post-minimally-invasive-hybrid-maze-of-atrial-fibrillation
#3
David A Farcy, Angelo Lapietra, Benjamin N Abo, Michael Dalley
BACKGROUND: Herniation of intraabdominal contents into the pericardial cavity is exceptionally rare, and when seen, it is most often the result of trauma, postsurgical complication, or genetic defect. There have been only a few case reports describing spontaneous bowel herniation into the pericardium in minimally invasive cardiac procedures like cardiac ablation, pacemaker placement, and minimally invasive coronary artery bypass graft. CASE REPORT: We report the case of a 65-year-old man who presented to an urgent care center complaining of abdominal and chest pain...
July 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28755998/loperamide-induced-torsades-de-pointes-a-case-series
#4
Kenneth D Katz, Robert D Cannon, Matthew D Cook, Alexandra Amaducci, Ryan Day, Joshua Enyart, Glenn Burket, Lauren Porter, Timothy Roach, Jennifer Janssen, Karl E Williams
Loperamide is an over-the-counter, inexpensive, antidiarrheal opioid that can produce life-threatening toxicity at high concentrations. CASE REPORT 1: A 28-year-old man with a history of depression and substance abuse disorder (SUD) presented to the emergency department (ED) with shortness of breath and lightheadedness. He ingested large amounts of loperamide daily. The patient's initial electrocardiogram (ECG) demonstrated sinus rhythm, right axis deviation, undetectable PR interval, QRS 168 ms, and QTc 693 ms...
July 26, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28739149/oral-medication-for-agitation-of-psychiatric-origin-a-scoping-review-of-randomized-controlled-trials
#5
Samuel Mullinax, Farhad Shokraneh, Michael P Wilson, Clive E Adams
BACKGROUND: Understanding more about the efficacy and safety of oral second-generation antipsychotic medications in reducing the symptoms of acute agitation could improve the treatment of psychiatric emergencies. OBJECTIVE: The objective of this scoping review was to examine the evidence base underlying expert consensus panel recommendations for the use of oral second-generation antipsychotics to treat acute agitation in mentally ill patients. METHODS: The Cochrane Schizophrenia Group's Study-Based Register was searched for randomized controlled trials comparing oral second-generation antipsychotics, benzodiazepines, or first-generation antipsychotics with or without adjunctive benzodiazepines, irrespective of route of administration of the drug being compared...
July 21, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28736097/alcoholic-pellagra-as-a-cause-of-altered-mental-status-in-the-emergency-department
#6
Sarah Kyuragi Luthe, Ryota Sato
BACKGROUND: Pellagra, which is caused by a deficiency of niacin and tryptophan, the precursor of niacin, is a rare disease in developed countries where alcoholism is a major risk factor due to malnutrition and lack of B vitamins. Although pellagra involves treatable dementia and psychosis, it is often underdiagnosed, especially in developed countries. CASE REPORT: In Japan, a 37-year-old man presented to the emergency department with altered mental status and seizures...
July 20, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28736096/pneumoperitoneum-by-inguinal-laceration-after-traffic-accident
#7
Daesung Lim, Soo Hoon Lee, Sang Bong Lee, TaeJin Park
BACKGROUND: The leading cause of surgical pneumoperitoneum is hollow viscus perforation, which accounts for approximately 90% of cases. A nonsurgical etiology may account for up to about 10% of the causes of pneumoperitoneum. However, a pneumoperitoneum often poses significant management dilemmas for surgeons, especially when signs of peritonitis are absent or when the cause is unknown prior to laparotomy. We present the first case of pneumoperitoneum due to inguinal laceration without viscus perforation after a traffic accident...
July 20, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28712685/emergency-medical-services-perspectives-on-identifying-and-reporting-victims-of-elder-abuse-neglect-and-self-neglect
#8
Tony Rosen, Cynthia Lien, Michael E Stern, Elizabeth M Bloemen, Regina Mysliwiec, Thomas J McCarthy, Sunday Clark, Mary R Mulcare, Daniel S Ribaudo, Mark S Lachs, Karl Pillemer, Neal E Flomenbaum
BACKGROUND: Emergency Medical Services (EMS) providers, who perform initial assessments of ill and injured patients, often in a patient's home, are uniquely positioned to identify potential victims of elder abuse, neglect, or self-neglect. Despite this, few organized programs exist to ensure that EMS concerns are communicated to or further investigated by other health care providers, social workers, or the authorities. OBJECTIVE: To explore attitudes and self-reported practices of EMS providers surrounding identification and reporting of elder mistreatment...
July 13, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28684061/back-pain-in-a-healthy-teenager
#9
Kelly Gardner, Sigmund Kharasch, Ali Raja, Rene Balza, Kriti Bhatia, Emily S Miller
No abstract text is available yet for this article.
July 3, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28684060/top-10-myths-regarding-the-diagnosis-and-treatment-of-cellulitis
#10
Erin K McCreary, Melissa E Heim, Lucas T Schulz, Robert Hoffman, Jeffrey Pothof, Barry Fox
BACKGROUND: Cellulitis is commonly treated in the emergency department (ED). Patients who present with cellulitis incur significant health care costs and may be overtreated with antibiotics. The accurate diagnosis and treatment of cellulitis plays an important role in cost-effective, high-quality medical care, as well as appropriate antibiotic utilization. OBJECTIVE: We aim to describe common fallacies regarding cellulitis. We present 10 myths that result in misdiagnosis, overtreatment, or inappropriate empiric management of cellulitis...
July 3, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28676415/emergency-department-flow-measures-for-adult-and-pediatric-patients-in-british-columbia-and-ontario-a-retrospective-repeated-cross-sectional-study
#11
Gregory Georgio, Astrid Guttmann, Quynh H Doan
BACKGROUND: Evidence suggests emergency department (ED) overcrowding is associated with poor health outcomes. Children comprise 20-25% of general ED visits, yet few studies have examined the differential impact of ED overcrowding on pediatric and adult populations. OBJECTIVE: The primary objective of this study was to compare flow measures, such as wait time to see a physician, length of stay (LOS), and rate of patients leaving without being seen by a physician (LWBS) between adults and children in British Columbia and Ontario, clustered by province, and then stratified by acuity level during the study period...
July 1, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28676414/cultural-competency-training-in-emergency-medicine
#12
Oren J Mechanic, Nicole M Dubosh, Carlo L Rosen, Alden M Landry
BACKGROUND: The Emergency Department is widely regarded as the epicenter of medical care for diverse and largely disparate types of patients. Physicians must be aware of the cultural diversity of their patient population to appropriately address their medical needs. A better understanding of residency preparedness in cultural competency can lead to better training opportunities and patient care. OBJECTIVE: The objective of this study was to assess residency and faculty exposure to formal cultural competency programs and assess future needs for diversity education...
July 1, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28666562/emergency-medicine-myths-computed-tomography-of-the-head-prior%C3%A2-to-lumbar-puncture-in-adults-with-suspected-bacterial-meningitis-due-diligence-or-antiquated-practice
#13
Michael D April, Brit Long, Alex Koyfman
BACKGROUND: Various sources purport an association between lumbar puncture and brainstem herniation in patients with intracranial mass effect lesions. Several organizations and texts recommend head computed tomography (CT) prior to lumbar puncture in selected patients. OBJECTIVE: To review the evidence regarding the utility of obtaining head CT prior to lumbar puncture in adults with suspected bacterial meningitis. DISCUSSION: Observational studies report a risk of post-lumbar puncture brainstem herniation in the presence of intracranial mass effect (1...
June 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28662832/vascular-causes-of-syncope-an-emergency-medicine-review
#14
Brit Long, Alex Koyfman
BACKGROUND: Syncope is a common emergency department (ED) complaint, accounting for 2% of visits annually. A wide variety of etiologies can result in syncope, and vascular causes may be deadly. OBJECTIVE: This review evaluates vascular causes of syncope and their evaluation and management in the ED. DISCUSSION: Syncope is defined by a brief loss of consciousness with loss of postural tone and complete, spontaneous recovery without medical intervention...
June 26, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28651957/syringomyelia
#15
Michael L Sternberg, Michael L Gunter
No abstract text is available yet for this article.
June 23, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28651956/re-a-practical-approach-to-the-ethanol-intoxicated-patient-in-the-emergency-department
#16
LETTER
Marc L Martel, Lauren R Klein
No abstract text is available yet for this article.
June 23, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28651955/heaton-et%C3%A2-al-reply-to-rich
#17
LETTER
Heather A Heaton, David M Nestler, Derick D Jones, Rachelen S Varghese, Christine M Lohse, Eric S Williamson, Annie T Sadosty
No abstract text is available yet for this article.
June 23, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28651954/case-report-ultrasound-guided-infraclavicular-brachial-plexus-block-for-a-case-with-posterior-elbow-dislocation
#18
Sinan Akay, Sami Eksert, Murtaza Kaya, Kenan Keklikci, Ali Kantemir
BACKGROUND: The interest in regional anesthesia procedures for the management of upper-extremity emergencies has increased. Toward that end, supraclavicular, interscalene, or infraclavicular approaches, with or without ultrasound guidance, are used for brachial plexus nerve blocks. Although many studies have reported on the use of ultrasound-guided supraclavicular and interscalene brachial plexus blocks for upper-extremity dislocations, very few studies have reported on the use of ultrasound-guided infraclavicular brachial plexus blocks...
June 23, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28651953/ventricular-tachycardia-caused-by-ibrutinib
#19
LETTER
János Tomcsányi, Zoltán Mátrai, Kristóf Tomcsányi
No abstract text is available yet for this article.
June 23, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28651952/lung-ultrasound-in-pneumothorax-the-continuing-need-for-appropriate-use-and-correct-interpretation
#20
LETTER
Giovanni Volpicelli
No abstract text is available yet for this article.
June 23, 2017: Journal of Emergency Medicine
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