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Journal of Emergency Medicine

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https://www.readbyqxmd.com/read/28712685/emergency-medical-services-perspectives-on-identifying-and-reporting-victims-of-elder-abuse-neglect-and-self-neglect
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
LETTER
Kristof Tomcsanyi, Janos Tomcsanyi, Zoltan Matrai
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
#13
LETTER
Giovanni Volpicelli
No abstract text is available yet for this article.
June 23, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28648783/an-unusual-cause-of-dynamic-airway-obstruction
#14
Rajeev Sharma, Abhity Gulia
No abstract text is available yet for this article.
June 22, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28648782/traumatic-thoracic-burst-fracture-associated-with-bronchial-rupture
#15
Wei-Ting Lin, Shih-Yang Su, Cheng-Fang Hsieh, Chih-Cheng Lai, Chien-Ming Chao
BACKGROUND: Rupture of, or injury to, the tracheobronchial tree is a rare occurrence in blunt chest trauma. CASE REPORT: We present a case of bronchial rupture caused by fragmented bone from a spinal burst fracture after blunt chest trauma. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although tracheobronchial injury is infrequent, clinicians should be aware of this possible complication after blunt chest trauma. Bronchoscopy can help in the diagnosis.
June 22, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28606617/management-of-patients-with-predicted-difficult-airways-in-an-academic-emergency-department
#16
John C Sakles, Matthew J K Douglas, Cameron D Hypes, Asad E Patanwala, Jarrod M Mosier
BACKGROUND: Patients with difficult airways are sometimes encountered in the emergency department (ED), however, there is a little data available regarding their management. OBJECTIVES: To determine the incidence, management, and outcomes of patients with predicted difficult airways in the ED. METHODS: Over the 1-year period from July 1, 2015 to June 30, 2016, data were prospectively collected on all patients intubated in an academic ED. After each intubation, the operator completed an airway management data form...
June 9, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28602460/in-response-to-impact-of-scribes-on-billed-relative-value-units-in-an-academic-emergency-department-by-heaton-et%C3%A2-al
#17
LETTER
Nicholas Rich
No abstract text is available yet for this article.
June 8, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28602459/an-unusual-apple-core-lesion-of-the-rectum
#18
Michael R Freund, Petachia Reissman, Yair Edden
No abstract text is available yet for this article.
June 8, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28602458/using-ultrasonography-to-assess-the-effectiveness-of-cricoid-pressure-on-esophageal-compression
#19
Jonathan Kei, Emily E Utschig, Reinier J van Tonder
BACKGROUND: Cricoid pressure during intubation has been used for decades as a way to potentially occlude the esophagus to avoid aspiration of gastric contents. However, recent evidence has questioned the effectiveness of this maneuver. OBJECTIVE: This study uses a noninvasive modality, ultrasonography, to determine the anatomic position of the cricoid cartilage and the esophagus and examines the effectiveness of cricoid pressure on esophageal compression. METHODS: Ultrasound imaging was used to describe the anatomic relationship of the esophagus to the trachea as either being directly behind the trachea, partially behind the trachea, or completely lateral to the trachea...
June 8, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28602457/acute-idiopathic-gastric-distension-causing-atrioventricular-block-and-cardiogenic-shock
#20
Ryan Stringer, Megan Schrader
BACKGROUND: We report a rare case of acute idiopathic gastric dilatation with associated severe bradycardia and shock. CASE REPORT: A 69-year-old woman presented to the emergency department (ED) with complaint of chest pain and dyspnea. The patient required transvenous cardiac pacing for profound bradycardia and cardiogenic shock. After a negative emergent cardiac catheterization, a flat plate abdominal x-ray study demonstrated massive gastric dilatation, prompting nasogastric tube placement, with subsequent rapid improvement of the patient's cardiovascular and metabolic instability...
June 8, 2017: Journal of Emergency Medicine
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