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Journal of Emergency Medicine

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https://www.readbyqxmd.com/read/28416252/hydroceles-not-just-for-men
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
Ashok Kumar Pannu, Atul Saroch, Navneet Sharma
No abstract text is available yet for this article.
April 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28408234/the-acute-hemolytic-anemias-the-importance-of-emergency-diagnosis-and-management
#10
Jennifer J Robertson, Elizabeth Brem, Alex Koyfman
BACKGROUND: Hemolytic anemias are defined by the premature destruction of red blood cells. These anemias have many causes that are mostly due to chronic diseases, but, occasionally, cases of acute life-threatening hemolysis can occur. OBJECTIVE: The objectives of this article were to review the pathophysiology of hemolytic anemias, to discuss the general emergency department (ED) evaluation, and to discuss the assessment and treatment of important and "cannot miss" hemolytic diseases...
April 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28408233/securing-a-chest-tube-properly-a-simple-framework-for-teaching-emergency-medicine-residents-and-assessing-their-technical-abilities
#11
Raaj K Ruparel, Torrey A Laack, Rushin D Brahmbhatt, Phillip G Rowse, Johnathon M Aho, Yazan N AlJamal, Brian D Kim, David S Morris, David R Farley, Ronna L Campbell
BACKGROUND: Quality-improvement efforts at our institution have identified chest tube dislodgement as a preventable complication of tube thoracostomy. Because proper fixation techniques are not well described in the literature and are seldom formally taught, techniques vary among residents. OBJECTIVE: Our aim was to develop and test a framework for teaching and assessing chest tube securement. METHODS: A repeated-measures study design was used...
April 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28408232/a-novel-case-of-splenic-injury-after-shockwave-lithotripsy
#12
David Zodda, Meta Haley, Rocky Sayegh
BACKGROUND: Emergency departments (EDs) are gateways for patients presenting after minor surgical procedures, particularly shockwave lithotripsy. Complications include renal and extrarenal tissue injuries, with the latter having potentially serious consequences if not detected early. CASE REPORT: We describe a 70-year-old male presenting to the ED for syncope. The patient underwent shockwave lithotripsy (SWL) for left kidney stones 1 day prior. Upon initial evaluation, the patient had normal vital signs and a normal physical examination, without complaints of abdominal pain...
April 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28408231/japanese-immigrant-with-abdominal-pain
#13
Joshua McClain, Zachary D W Dezman
No abstract text is available yet for this article.
April 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28400081/unique-rash-after-beach-vacation
#14
Jennifer Pascual, Chaiya Laoteppitaks
No abstract text is available yet for this article.
April 8, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28396083/ecg-patterns-indicate-severity-of-acute-pulmonary-embolism-insights-from-serial-ecg-changes-in-a-patient-treated-with-thrombolysis
#15
Fu-Qiang Sheng, Rong Xu, Jin-Dong Xia, Mao-Rong He
No abstract text is available yet for this article.
April 7, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28396082/pregnancy-related-spontaneous-coronary-artery-dissection-a%C3%A2-case-series-and-literature-review
#16
Emily Rose, Maheedhar Gedela, Nathan Miller, Paul L Carpenter
BACKGROUND: Cardiac emergencies during pregnancy are rare but have significant associated morbidity and mortality when they do occur. The emergency physician must not only be aware of potentially life-threatening conditions in the pregnant woman, but also know the emergent management and treatment of these conditions to avoid worsening of the underlying condition. Pregnancy-related spontaneous coronary artery dissection has been described in the cardiology literature, but is not well-known in emergency medicine literature...
April 7, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28372830/air-and-its-sonographic-appearance-understanding-the-artifacts
#17
Simran Buttar, Denrick Cooper, Patrick Olivieri, Michael Barca, Aaran B Drake, Melvin Ku, Gabriel Rose, Sebastian D Siadecki, Turandot Saul
BACKGROUND: Although air has traditionally been considered a barrier to sonographic imaging, when encountered in unusual settings it can serve as an important indicator of various pathologic states as well. Clinician recognition and thorough understanding of the characteristic pattern of artifacts generated by air are critical for making a number of important diagnoses. CASE SERIES: We present five emergency department cases in which air was visualized in a pathologic location...
March 31, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28363634/diffuse-abdominal-pain-and-fever-in-an-elderly-man
#18
Margaret B Greenwood-Ericksen, Eric S Nadel, Emily S Miller, Kriti Bhatia, Karen Kinnaman, Sukhjit S Takhar, Ali S Raja, John T Nagurney, Elizabeth S Temin, Benjamin A White, Heidi H Kimberly, Regan H Marsh, David F Brown
No abstract text is available yet for this article.
March 28, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28351511/reliability-laterality-and-the-effect-of-respiration-on-the-measured-corrected-flow-time-of-the-carotid-arteries
#19
Michael Doctor, Sebastian D Siadecki, Denrick Cooper, Gabriel Rose, Aaran B Drake, Melvin Ku, Maria Suprun, Turandot Saul
BACKGROUND: Corrected flow time (FTc) measured via sonography of the carotid artery is a novel method that has shown promising results for predicting fluid responsiveness in shock states. It is a rapid and noninvasive examination that can be taught to emergency physicians with ease. However, its reliability has not been assessed, and the effects of several variables, including respiration and side of evaluation, are unclear. OBJECTIVES: The objectives were to compare carotid FTc during different phases of the respiratory cycle, (at end-inspiration and end-expiration), to compare FTc reproducibility among providers, and to compare FTc on the right and left sides in a given individual...
March 25, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28351510/the-2016-model-of-the-clinical-practice-of-emergency-medicine
#20
Francis L Counselman, Kavita Babu, Mary Ann Edens, Diane L Gorgas, Cherri Hobgood, Catherine A Marco, Eric Katz, Kevin Rodgers, Leonard A Stallings, Michael C Wadman, Michael S Beeson, Julia N Keehbauch
No abstract text is available yet for this article.
March 25, 2017: Journal of Emergency Medicine
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