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Journal of Emergency Medicine

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https://www.readbyqxmd.com/read/29157798/euglycemic-diabetic-ketoacidosis-secondary-to-dapagliflozin-use-a-case-report
#1
Felicity Brown, Tamara McColl
BACKGROUND: Sodium-glucose co-transporter-2 (SGLT2) inhibitors are a novel class of oral antihyperglycemic agents. They are associated with rare cases of euglycemic diabetic ketoacidosis (DKA), which presents a diagnostic challenge in the emergency department (ED) and potentially severe consequences if missed. CASE REPORT: A 53-year-old man with type 2 diabetes mellitus and a recent Roux-en-Y gastric bypass surgery presented to the ED with nausea, vomiting, and generalized abdominal pain...
November 17, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29108736/a-randomized-double-blind-trial-comparing-the-effect-on-pain-of-an-oral-sucrose-solution-vs-placebo-in-children-1-to-3%C3%A2-months-old-undergoing-simple-venipuncture
#2
Serge Gouin, Nathalie Gaucher, Denis Lebel, Marie Pier Desjardins
BACKGROUND: Few clinical trials evaluating the efficacy of oral sweet solutions for procedures in the emergency department (ED) have been published. OBJECTIVES: To compare the efficacy of an oral sucrose solution vs. a placebo in reducing pain in infants undergoing venipuncture without cannulation. METHODS: A randomized, double-blinded clinical trial was conducted in a pediatric ED. Infants 1 to 3 months old were randomly allocated to receive 2 mL of 88% sucrose or 2 mL of placebo, 2 min prior to venipuncture...
November 3, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29108735/emergency-department-patient-burden-from-an-electronic-dance-music-festival
#3
Neeraj Chhabra, Renee P Gimbar, Lisa M Walla, Trevonne M Thompson
BACKGROUND: Electronic dance music (EDM) festivals are increasingly common and psychoactive substance use is prevalent. Although prehospital care can obviate the transfer of many attendees to health care facilities (HCFs), little is known regarding the emergency department (ED) burden of patients presenting from EDM festivals. OBJECTIVES: This study describes the patient volume, length of stay (LOS), and presenting complaints of patients from a 3-day EDM festival in close proximity to an area ED...
November 3, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29100653/understanding-the-struggles-to-be-a-medical-provider-view-through-medical-student-essays
#4
William J Peterson, Joseph B House, Cemal B Sozener, Sally A Santen
BACKGROUND: The clinical learning environment helps to shape the professional identity of medical students. This process begins from existing personal identity and is influenced by various factors, including clinical experiences and clinical learning environment. OBJECTIVE: The purpose of this study was to examine medical students' reflections as a way to identify and better characterize the modern struggles that medical students face, in order to inform the development of professional identity...
October 31, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29100652/team-focused-cardiopulmonary-resuscitation-prehospital%C3%A2-principles-adapted-for-emergency-department%C3%A2-cardiac%C3%A2-arrest-resuscitation
#5
Blake Johnson, Michael Runyon, Anthony Weekes, David Pearson
BACKGROUND: Out-of-hospital cardiac arrest has high rates of morbidity and mortality, and a growing body of evidence is redefining our approach to the resuscitation of these high-risk patients. OBJECTIVES: Team-focused cardiopulmonary resuscitation (TFCPR), most commonly deployed and described by prehospital care providers, is a focused approach to cardiac arrest care that emphasizes early defibrillation and high-quality, minimally interrupted chest compressions while de-emphasizing endotracheal intubation and intravenous drug administration...
October 31, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29110975/traumatic-perforation-of-the-tympanic-membrane-a-review-of-80-cases
#6
Doron Sagiv, Lela Migirov, Eran Glikson, Jobran Mansour, Ruth Yousovich, Michael Wolf, Yisgav Shapira
BACKGROUND: Traumatic perforation of the tympanic membrane (TPTM) is often encountered in primary care or in the emergency department (ED). Several therapeutic interventions have been described, but conservative follow-up until spontaneous complete recovery is the most common choice. OBJECTIVE: Our goal was to analyze the trauma mechanism, perforation characteristics, and outcome of patients with TPTM. METHODS: The study included patients examined in the ED of a tertiary, university-affiliated medical center because of TPTM between 2012 and 2016...
October 28, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29089155/ultrasound-for-the-diagnosis-and-management-of-suspected-urolithiasis-in-the-emergency-department
#7
Lisa Mills, Eric J Morley, Zachary Soucy, Gary M Vilke, Samuel H F Lam
BACKGROUND: This review provides practicing emergency physicians updated information regarding point-of-care ultrasound (POCUS) imaging of patients with suspected urolithiasis. METHODS: A PubMed literature search was conducted for articles published between January 1, 1996 and May 31, 2017 and limited to human clinical trials written in English with relevant keywords. High-quality studies identified then underwent a structured review. Recommendations herein are made based on the literature review...
October 28, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29089154/low-yield-of-clinically-significant-injury-with-head-to-pelvis-computed-tomography-in-blunt-trauma-evaluation
#8
Shelby P Murphy, Noah Hawthorne, David Haase, Chika Chiku, Jason Wen, Robert M Rodriguez
BACKGROUND: Many trauma centers have adopted routine head-to-pelvis computed tomography (CT) imaging for the evaluation of adults with blunt trauma. OBJECTIVE: We sought to determine the yields of detecting clinically significant injuries (CSIs) with CT in >1 anatomic region. METHODS: We conducted this observational cohort study of all trauma activation patients >14 years of age who received CT imaging during blunt trauma evaluation at a Level 1 trauma center from April to October 2014...
October 28, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29110983/view-from-the-top-point-of-care-ultrasound-diagnosis-of-type-a-aortic-dissection-using-the-suprasternal-view
#9
Shannon M Fernando, Magdalena Kisilewicz, Scott J Millington
No abstract text is available yet for this article.
October 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29110982/point-of-care-ultrasound-is-associated-with-decreased-length-of-stay-in-children-presenting-to-the-emergency-department-with-soft-tissue-infection
#10
Margaret J Lin, Mark Neuman, Rachel Rempell, Michael Monuteaux, Jason Levy
BACKGROUND: Point-of-care ultrasound (POCUS) is increasingly being used to differentiate cellulitis from abscess in the pediatric emergency department (ED). POCUS has also been shown to decrease length of stay (LOS) for other applications among adult patients. OBJECTIVE: We sought to determine if ED LOS differed for children presenting with skin and soft tissue infections who received POCUS versus radiology-performed ultrasound. METHODS: We performed a retrospective cohort study of children presenting to an urban pediatric ED between January 2011 and June 2013 with a diagnosis of cellulitis or abscess who underwent soft tissue ultrasound...
October 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29110981/distributive-shock-in-a-neonate-with-diffuse-infantile-hepatic-hemangioma
#11
James Brown, Rajan Arora, Usha Sethuraman
BACKGROUND: Hemangiomas are common cutaneous findings on healthy infants. These vascular malformations are generally benign, though in rare circumstances they can potentially be fatal. This is particularly true when the hemangiomas are large or numerous and occurring in visceral organs. Previously unrecognized visceral hemangiomas are part of the differential for any neonate presenting unexpectedly in shock. CASE REPORT: A 10-day-old neonate presented to the pediatric emergency department with difficulty breathing...
October 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29110980/benign-migratory-glossitis
#12
Eric T Stoopler, Katherine France, David Ojeda, Thomas P Sollecito
No abstract text is available yet for this article.
October 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29110979/complications-from-administration-of-vasopressors-through-peripheral-venous-catheters-an-observational-study
#13
Kamal Medlej, Amin Antoine Kazzi, Ahel El Hajj Chehade, Mothana Saad Eldine, Ali Chami, Rana Bachir, Dina Zebian, Gilbert Abou Dagher
BACKGROUND: The placement of a central venous catheter for the administration of vasopressors is still recommended and required by many institutions because of concern about complications associated with peripheral administration of vasopressors. OBJECTIVE: Our aim was to determine the incidence of complications from the administration of vasopressors through peripheral venous catheters (PVC) in patients with circulatory shock, and to identify the factors associated with these complications...
October 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29110978/mumps-an-emergency-medicine-focused-update
#14
Chelsea Bockelman, Thomas C Frawley, Brit Long, Alex Koyfman
BACKGROUND: Mumps is a Paramyxoviridae virus. This disease was rampant prior to introduction of the measles, mumps, and rubella vaccine, resulting in decreased incidence. This disease has demonstrated several outbreaks. OBJECTIVE: This review provides a focused evaluation of mumps, an update on outbreaks, management recommendations, and ways to decrease transmission. DISCUSSION: Clusters of mumps outbreaks continue to occur. The virus is a paramyxovirus, a single-stranded RNA virus...
October 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29110977/clinical-mimics-an-emergency-medicine-focused-review-of-syncope-mimics
#15
Diana K Coleman, Brit Long, Alex Koyfman
BACKGROUND: Syncope is an event that causes a transient loss of consciousness (LOC) secondary to global cerebral hypoperfusion. The transient nature of the event can make diagnosis in the emergency department (ED) difficult, as symptoms have often resolved by time of initial presentation. The symptoms and presentation of syncope are similar to many other conditions, which can lead to difficulty in establishing a diagnosis in the ED. OBJECTIVE: This review evaluates patients presenting with a history concerning for possible syncope, mimics of syncope, and approach to managing syncope mimics...
October 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29110976/emergency-medicine-myths-ectopic-pregnancy-evaluation-%C3%A2-risk%C3%A2-factors-and-presentation
#16
Jennifer J Robertson, Brit Long, Alex Koyfman
BACKGROUND: Ectopic pregnancy (EP) is an important cause of morbidity and mortality in females of reproductive age. Proper diagnosis and treatment are critical, as complications such as rupture, hemorrhagic shock, and even death can occur. OBJECTIVE: EP is a condition emergency physicians are trained to detect, yet there are multiple myths concerning its evaluation and diagnosis. This article reviews several of these myths in order to improve emergency department (ED) evaluation and diagnosis...
October 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29107482/prevalence-and-outcome-of-high-risk-qt-prolongation-recorded-in-the-emergency-department-from-an-institution-wide-qt-alert-system
#17
Heather N Anderson, J Martijn Bos, Kristina H Haugaa, Bruce W Morlan, Robert F Tarrell, Pedro J Caraballo, Michael J Ackerman
BACKGROUND: QT prolongation is an independent risk factor for sudden death, stroke, and all-cause mortality. However, additional studies have shown that in certain settings, QT prolongation may be transient and a result of external factors. OBJECTIVE: In this study, we evaluated the clinical characteristics and outcomes of patients seen in the emergency department (ED) with QT prolongation. METHODS: Between November 2010 and June 2011, 7522 patients had an electrocardiogram (ECG) obtained during their evaluation in the ED...
October 26, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29107481/physical-examination-is-the-best-predictor-of-the-need-for-abdominal-surgery-in-children-following-motor-vehicle-collision
#18
Natalie A Drucker, Lucas McDuffie, Eric Groh, Jodi Hackworth, Teresa M Bell, Troy A Markel
BACKGROUND: Exploratory laparotomy in children after motor vehicle collision (MVC) is rare. In the absence of definitive hemorrhage or free abdominal air on radiographic imaging, predictors for operative exploration are conflicting. OBJECTIVE: The purpose of this study was to explore objective findings that may aid in determining which children require operative abdominal exploration after MVC. METHODS: Data from 2010-2014 at an American College of Surgeons-certified level 1 pediatric trauma center were retrospectively reviewed...
October 26, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29107480/a-case-of-wooden-foreign-body-ingestion
#19
Sang Bong Lee, Ryun Kyung Lee, Ja Hyoen Suh, Jung Woo Choi, Chang Yoon Ha, Changwoo Kang
No abstract text is available yet for this article.
October 26, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29107479/clinical-factors-and-outcomes-of-dialysis-dependent-end-stage-renal-disease-patients-with-emergency-department-septic-shock
#20
Kevin M Lowe, Alan C Heffner, Colleen H Karvetski
BACKGROUND: Infection is the second leading cause of death in end-stage renal disease (ESRD) patients. Prior investigations of acute septic shock in this specific population are limited. OBJECTIVE: We aimed to evaluate the clinical presentation and factors associated with outcome among ESRD patients with acute septic shock. METHODS: We reviewed patients prospectively enrolled in an emergency department (ED) septic shock treatment pathway registry between January 2014 and May 2016...
October 26, 2017: Journal of Emergency Medicine
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