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International Journal of Emergency Medicine

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https://www.readbyqxmd.com/read/28421563/the-current-utilization-and-perceptions-of-prescription-drug-monitoring-programs-among-emergency-medicine-providers-in-florida
#1
Henry W Young, Joseph A Tyndall, Linda B Cottler
BACKGROUND: Pain is among the most commonly treated symptoms in the emergency department, and opioids are commonly prescribed from the emergency department to treat moderate to severe pain. Prescription drug monitoring programs (PDMP) can be used to assist physicians identify individuals at increased risk to misuse or abuse opioids. While the use of the PDMP has been shown useful among clinicians, in the past, utilization of the PDMP has been less than optimal. The objective of this study was to assess the current utilization and perceptions of the prescription drug monitoring program among emergency medicine providers in Florida...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28405953/angioedema-in-the-emergency-department-a-practical-guide-to-differential-diagnosis-and-management
#2
REVIEW
Jonathan A Bernstein, Paolo Cremonesi, Thomas K Hoffmann, John Hollingsworth
BACKGROUND: Angioedema is a common presentation in the emergency department (ED). Airway angioedema can be fatal; therefore, prompt diagnosis and correct treatment are vital. OBJECTIVE OF THE REVIEW: Based on the findings of two expert panels attended by international experts in angioedema and emergency medicine, this review aims to provide practical guidance on the diagnosis, differentiation, and management of histamine- and bradykinin-mediated angioedema in the ED...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28378268/carbon-dioxide-poisoning-a-literature-review-of-an-often-forgotten-cause-of-intoxication-in-the-emergency-department
#3
REVIEW
Kris Permentier, Steven Vercammen, Sylvia Soetaert, Christian Schellemans
The goal of this article was to provide an overview of the literature available on carbon dioxide intoxication. Articles were included based on their focus on medical or physiological effects of carbon dioxide. Studies related to decompression sickness were excluded. Mechanisms of carbon dioxide poising (both as an asphyxiant and as a toxicant) were described. Our review suggested that precautions are needed when handling dry ice or while working in confined spaces. Pre-hospital responders also need to pay attention for the possible diagnosis of CO2 intoxication for their own safety...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28357722/health-among-disaster-survivors-and-health-professionals-after-the-haiyan-typhoon-a-self-selected-internet-based-web-survey
#4
Karin Hugelius, Mervyn Gifford, Per Örtenwall, Annsofie Adolfsson
BACKGROUND: Natural disasters affected millions of people worldwide every year. Evaluation of disaster health and health response interventions is faced with several methodological challenges. This study aimed (1) to describe survivors' and health professionals' health, 30 months after a natural disaster using a web-based self-selected Internet sample survey designed and (2) to evaluate the health effects of disaster response interventions, in the present study with a focus on disaster radio...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28324468/ascariasis-and-hyperosmolar-hyperglycemic-state-a-surprising-ultrasound-finding-in-the-emergency-department
#5
Giles N Cattermole, Jean-Paul Nzabandora
BACKGROUND: We report the ultrasound finding of ascariasis in a patient with hyperosmolar hyperglycemic state (HHS). Although ascariasis is common in low-resource settings, there has been no previous report associating ascariasis with HHS. CASE PRESENTATION: A 26-year-old Rwandan man was admitted to the emergency department in coma, with a glycemia of 600 mg/dl. He was resuscitated with fluids, intubated and ventilated, and treated with insulin and antibiotics...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28321786/adherence-to-pediatric-diabetic-ketoacidosis-guidelines-by-community-emergency-departments-providers
#6
Janine E Zee-Cheng, Emily C Webber, Samer Abu-Sultaneh
BACKGROUND: Diabetic ketoacidosis (DKA) is a common presentation of type I diabetes mellitus to the emergency departments. Most children with DKA are initially managed in community emergency departments where providers may not have easy access to educational resources or pediatric-specific guidelines and protocols that are readily available at pediatric academic medical centers. The aim of this study is to evaluate adherence of community emergency departments in the state of Indiana to the pediatric DKA guidelines...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28224348/a-need-to-reconsider-guidelines-on-management-of-primary-spontaneous-pneumothorax
#7
Jiyoon Yoon, Parthipan Sivakumar, Kevin O'Kane, Liju Ahmed
BACKGROUND: The key guidelines in the management of primary spontaneous pneumothorax (PSP) include the 2010 British Thoracic Society (BTS) Pleural Disease guideline and 2001 American College of Chest Physicians (ACCP) Consensus Statement. Current recommendations are dependent on radiographic measures which differ between these two guidelines. The aim of this study is to compare size classification of PSP cases, according to BTS and ACCP guidelines, and to evaluate guideline compliance...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28224347/emergency-medical-service-systems-in-sri-lanka-problems-of-the-past-challenges-of-the-future
#8
Kelum Wimalaratne, Jeong Il Lee, Kang Hyun Lee, Hee Young Lee, Jung Hun Lee, In Hye Kang
INTRODUCTION: The concept of emergency medical services (EMS) is new to Sri Lanka. This article describes the development, delivery, and future ideas for EMS in Sri Lanka. Sri Lanka also faces frequent natural hazards that justify the establishment of an EMS service. METHODOLOGY: Data and information regarding emergency medical care in Sri Lanka were collected and reviewed from resources including websites and research papers. RESULTS: Currently, there are no qualified emergency medical physicians in Sri Lanka...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28224346/dedication-increases-productivity-an-analysis-of-the-implementation-of-a-dedicated-medical-team-in-the-emergency-department
#9
Pedro Ramos, José Artur Paiva
BACKGROUND: In several European countries, emergency departments (EDs) now employ a dedicated team of full-time emergency medicine (EM) physicians, with a distinct leadership and bed-side emergency training, in all similar to other hospital departments. In Portugal, however, there are still two very different models for staffing EDs: a classic model, where EDs are mostly staffed with young inexperienced physicians from different medical departments who take turns in the ED in 12-h shifts and a dedicated model, recently implemented in some hospitals, where the ED is staffed by a team of doctors with specific medical competencies in emergency medicine that work full-time in the ED...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28220347/stercoral-colitis-mimicking-appendicitis
#10
Abdelghafour Elkoundi, Mustapha Bensghir, Charki Haimeur
BACKGROUND: Stercoral colitis is an inflammatory process involving the colonic wall related to fecal impaction. This rare condition is associated with high morbidity-mortality. FINDINGS: We report a case of a 78-year-old woman with a history of dementia under clozapine who presented a clinical and sonographic presentation of acute appendicitis. The worsening of her clinical condition prompted us to review our diagnosis and modify our approach using the CT scan which was consistent with stercoral colitis...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28160170/implementation-strategies-for-procedural-sedation-and-analgesia-in-the-emergency-department
#11
LETTER
Maybritt I Kuypers, Frans B Plötz, Francis Mencl
Implementing procedural sedation and analgesia in the emergency department is still is a challenge on an international scale. Here, we describe the Dutch setting of emergency medicine and explain the strategies that were successful for the implementation of safe and effective procedural sedation and analgesia by emergency physicians. We describe strategies on how to bridge the gap of knowledge and skills and how to deal with a resistance to change.
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28155184/blood-product-transfusion-in-emergency-department-patients-a-case-control-study-of-practice-patterns-and-impact-on-outcome
#12
Alexander Beyer, Ryan Rees, Christopher Palmer, Brian T Wessman, Brian M Fuller
BACKGROUND: Blood product transfusion occurs in a significant percentage of intensive care unit (ICU) patients. Pulmonary complications, such as acute respiratory distress syndrome (ARDS), occurring in the setting of transfusion, are associated with increased morbidity and mortality. Contrary to the ICU setting, there is little evidence describing the epidemiology of transfusion in the emergency department (ED) or its potential impact on outcome. The objectives of this study were to: (1) characterize transfusion practices in the ED with respect to patient characteristics and pre-transfusion laboratory values; and (2) investigate the effect of ED blood product transfusion on the incidence of pulmonary complications after admission...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28127711/how-to-manage-tension-gastrothorax-a-case-report-of-tension-gastrothorax-with-multiple-trauma-due-to-traumatic-diaphragmatic-rupture
#13
Naofumi Bunya, Keigo Sawamoto, Shuji Uemura, Takashi Toyohara, Yukino Mori, Ryoko Kyan, Kei Miyata, Hideto Irifune, Keisuke Harada, Eichi Narimatsu
BACKGROUND: Tension gastrothorax is a kind of obstructive shock with prolapse and distention of the stomach into the thoracic cavity. Progressive gastric distension leads to mediastinal shift, reduced venous return, decreased cardiac output, and ultimately cardiac arrest. Therefore, it is crucial to decompress the stomach distension for the initial resuscitation of tension gastrothorax. CASE PRESENTATION: A 75-year-old female was transported to our resuscitation bay due to motor vehicle crash...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28124201/hyperkalemia-masked-by-pseudo-stemi-infarct-pattern-and-cardiac-arrest
#14
Shareez Peerbhai, Luke Masha, Adrian DaSilva-DeAbreu, Abhijeet Dhoble
BACKGROUND: Hyperkalemia is a common electrolyte abnormality and has well-recognized early electrocardiographic manifestations including PR prolongation and symmetric T wave peaking. With severe increase in serum potassium, dysrhythmias and atrioventricular and bundle branch blocks can be seen on electrocardiogram. Although cardiac arrest is a worrisome consequence of untreated hyperkalemia, rarely does hyperkalemia electrocardiographically manifest as acute ischemia. CASE PRESENTATION: We present a case of acute renal failure complicated by malignant hyperkalemia and eventual ventricular fibrillation cardiac arrest...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28124200/operational-demands-on-pre-hospital-emergency-care-for-burn-injuries-in-a-middle-income-setting-a-study-in-the-western-cape-south-africa
#15
Rachel L Allgaier, Lucie Laflamme, Lee A Wallis
BACKGROUND: Burns occur disproportionately within low-socioeconomic populations. The Western Cape Province of South Africa represents a middle-income setting with a high rate of burns, few specialists and few burn centres, yet a well-developed pre-hospital system. This paper describes the burn cases from a viewpoint of operational factors important to pre-hospital emergency medical services. METHODS: A retrospective, cross-sectional study of administrative and patient records was conducted...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28124199/the-effectiveness-of-rapid-sequence-intubation-rsi-versus-non-rsi-in-emergency-department-an-analysis-of-multicenter-prospective-observational-study
#16
Masashi Okubo, Koichiro Gibo, Yusuke Hagiwara, Yukiko Nakayama, Kohei Hasegawa
BACKGROUND: Although rapid sequence intubation (RSI) is the method of choice in emergency department (ED) airway management, data to support the use of RSI remain scarce. We sought to compare the effectiveness of airway management between RSI and non-RSI (intubation with sedative agents only or without medications) in the ED. METHODS: Secondary analysis of the data from a multicenter prospective observational registry at 13 Japanese EDs. All non-cardiac-arrest patients who underwent intubation with RSI or non-RSI were included for the analysis...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28032307/intravenous-enalaprilat-for-treatment-of-acute-hypertensive-heart-failure-in-the-emergency-department
#17
Syed Imran Ayaz, Craig M Sharkey, Gregory M Kwiatkowski, Suprat Saely Wilson, Reba S John, Rosa Tolomello, Arushi Mahajan, Scott Millis, Phillip D Levy
BACKGROUND: Afterload reduction with bolus enalaprilat is used by some for management of acute hypertensive heart failure (HF) but existing data on the safety and effectiveness of this practice are limited. The purpose of this study was to evaluate the clinical effects of bolus enalaprilat when administered to patients with acute hypertensive heart failure. FINDINGS: We performed an IRB-approved retrospective cohort study of patients who presented to the emergency department of a large urban academic hospital...
December 2016: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27757807/funding-global-emergency-medicine-research-from-seed-grants-to-nih-support
#18
Bhakti Hansoti, Adam Levine, Latha Ganti, Rockefeller Oteng, Taylor DesRosiers, Payal Modi, Jeremy Brown
BACKGROUND: Funding for global health has grown significantly over the past two decades. Numerous funding opportunities for international development and research work exist; however, they can be difficult to navigate. The 2013 Academic Emergency Medicine consensus conference on global health and emergency care identified the need to strengthen global emergency care research funding, solidify existing funding streams, and expand funding sources. RESULTS: This piece focuses on the various federal funding opportunities available to support emergency physicians conducting international research from seed funding to large institutional grants...
December 2016: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27718129/the-readiness-of-emergency-and-trauma-care-in-low-and-middle-income-countries-a-cross-sectional-descriptive-study-of-42-public-hospitals-in-albania
#19
Rifat Latifi, Jayleen K L Gunn, John A Stroster, Edmond Zaimi, Fatos Olldashi, Agron Dogjani, Mihal Kerci, Xheladin Draçini, Julian Kuçani, Zhaneta Shatri, Agim Kociraj, Arian Boci, Ross I Donaldson
BACKGROUND: Traumatic injuries have become a substantial but neglected epidemic in low- and middle-income countries (LMICs), but emergency rooms (ERs) in these countries are often staffed with healthcare providers who have minimal emergency training and experience. The aim of this paper was to describe the specialized training, available interventions, and the patient management strategies in the ERs in Albanian public hospitals. METHODS: A cross-sectional descriptive study of 42 ERs in the Republic of Albania between September 5, 2014, and December 29, 2014 was performed...
December 2016: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27623956/creating-a-contemporary-clerkship-curriculum-the-flipped-classroom-model-in-emergency-medicine
#20
Edward K Lew
BACKGROUND: The teaching modality of "flipping the classroom" has garnered recent attention in medical education. In this model, the lecture and homework components are reversed. The flipped classroom lends itself to more interaction in "class" and theoretically improved clinical decision-making. Data is lacking for this model for students in emergency medicine clerkships. We trialed the flipped classroom in our fourth-year student clerkship. Our aim was to learn student and faculty facilitator perceptions of the experience, as it has not been done previously in this setting...
December 2016: International Journal of Emergency Medicine
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