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Western Journal of Emergency Medicine

Steve Christos, Robin Naples
[This corrects the article on p. 264 in vol. 17, PMID: 27330657.].
September 2016: Western Journal of Emergency Medicine
Megan H Halliday, Andrew J Bouland, Benjamin J Lawner, Angela C Comer, Daniel C Ramos, Mark Fletcher
INTRODUCTION: A lack of coordination between emergency medical services (EMS), emergency departments (ED) and systemwide management has contributed to extended ambulance at-hospital times at local EDs. In an effort to improve communication within the local EMS system, the Baltimore City Fire Department (BCFD) placed a medical duty officer (MDO) in the fire communications bureau. It was hypothesized that any real-time intervention suggested by the MDO would be manifested in a decrease in the EMS at-hospital time...
September 2016: Western Journal of Emergency Medicine
Matthew Hansen, William Loker, Craig Warden
INTRODUCTION: The association between geographic factors, including transport distance, and pediatric emergency medical services (EMS) run clustering on out-of-hospital pediatric endotracheal intubation is unclear. The objective of this study was to determine if endotracheal intubation procedures are more likely to occur at greater distances from the hospital and near clusters of pediatric calls. METHODS: This was a retrospective observational study including all EMS runs for patients less than 18 years of age from 2008 to 2014 in a geographically large and diverse Oregon county that includes densely populated urban areas near Portland and remote rural areas...
September 2016: Western Journal of Emergency Medicine
Lori L Boland, Jonathan S Hokanson, Karl M Fernstrom, Tyler G Kinzy, Charles J Lick, Paul A Satterlee, Brian K LaCroix
INTRODUCTION: We aimed to pilot test the delivery of sepsis education to emergency medical services (EMS) providers and the feasibility of equipping them with temporal artery thermometers (TATs) and handheld lactate meters to aid in the prehospital recognition of sepsis. METHODS: This study used a convenience sample of prehospital patients meeting established criteria for sepsis. Paramedics received education on systemic inflammatory response syndrome (SIRS) criteria, were trained in the use of TATs and hand-held lactate meters, and enrolled patients who had a recent history of infection, met ≥ 2 SIRS criteria, and were being transported to a participating hospital...
September 2016: Western Journal of Emergency Medicine
Lucas A Myers, Charles G Gallet, Logan J Kolb, Christine M Lohse, Christopher S Russi
INTRODUCTION: This study aimed to identify factors associated with successful endotracheal intubation (ETI) by a multisite emergency medical services (EMS) agency. METHODS: We collected data from the electronic prehospital record for all ETI attempts made from January through May 2010 by paramedics and other EMS crew members at a single multistate agency. If documentation was incomplete, the study team contacted the paramedic. Paramedics use the current National Association of EMS Physicians definition of an ETI attempt (laryngoscope blade entering the mouth)...
September 2016: Western Journal of Emergency Medicine
Christopher S Russi, Lucas A Myers, Logan J Kolb, Christine M Lohse, Erik P Hess, Roger D White
INTRODUCTION: American Heart Association (AHA) guidelines recommend cardiopulmonary resuscitation (CPR) chest compressions 1.5 to 2 inches (3.75-5 cm) deep at 100 to 120 per minute. Recent studies demonstrated that manual CPR by emergency medical services (EMS) personnel is substandard. We hypothesized that transport CPR quality is significantly worse than on-scene CPR quality. METHODS: We analyzed adult patients receiving on-scene and transport chest compressions from nine EMS sites across Minnesota and Wisconsin from May 2008 to July 2010...
September 2016: Western Journal of Emergency Medicine
Andrew Grock, Wendy Chan, Ian S deSouza
An otherwise healthy 36-year-old man presented with sudden-onset right upper quadrant abdominal pain and vomiting. A bedside ultrasound, performed to evaluate hepatobiliary pathology, revealed a normal gallbladder but free intraperitoneal fluid. After an expedited CT and emergent explorative laparotomy, the patient was diagnosed with a small bowel obstruction with ischemia secondary to midgut volvulus. Though midgut volvulus is rare in adults, delays in definitive diagnosis and management can result in bowel necrosis...
September 2016: Western Journal of Emergency Medicine
Faried Banimahd, Tricia Loo, Manish Amin, Omeed R Ahadiat, Bharath Chakravarthy, Shahram Lotfipour
No abstract text is available yet for this article.
September 2016: Western Journal of Emergency Medicine
Jessa Baker, Chris Jeziorkowski, Cory Siebe, Megan Boysen Osborn
No abstract text is available yet for this article.
September 2016: Western Journal of Emergency Medicine
Adrienne Hughes, Alisha Brown, Matthew Valento
Baking soda is a readily available household product composed of sodium bicarbonate. It can be used as a home remedy to treat dyspepsia. If used in excessive amounts, baking soda has the potential to cause a variety of serious metabolic abnormalities. We believe this is the first reported case of hemorrhagic encephalopathy induced by baking soda ingestion. Healthcare providers should be aware of the dangers of baking soda misuse and the associated adverse effects.
September 2016: Western Journal of Emergency Medicine
Nicole Mansfield, Sarab Sodhi, Richard Pescatore, Andrew Nyce
No abstract text is available yet for this article.
September 2016: Western Journal of Emergency Medicine
Kristopher R Brickman, Rajiv Bahl, Nathan F Marcinkowski, Katelyn R Ammons, Peter Akpunonu
INTRODUCTION: The objective of this study was to explore associations between presenting chief complaints of prolonged symptomatology, patient usage of the emergency department (ED), and underlying depression so that emergency physicians may better target patients for depression screening. METHODS: A convenience sample of ED patients were administered the Beck Depression Inventory-II (BDI-II) to assess for depression. We correlated completed BDI-II surveys to patient information including demographics, pertinent history of present illness information, and past medical history...
September 2016: Western Journal of Emergency Medicine
Chun Nok Lam, Sanjay Arora, Michael Menchine
INTRODUCTION: Patients with mental health conditions frequently use emergency medical services. Many suffer from substance use and homelessness. If they use the emergency department (ED) as their primary source of care, potentially preventable frequent ED revisits and hospital readmissions can worsen an already crowded healthcare system. However, the magnitude to which homelessness affects health service utilization among patients with mental health conditions remains unclear in the medical community...
September 2016: Western Journal of Emergency Medicine
Scott A Simpson, Jagoda Pasic
Many emergency department (ED) psychiatric patients present after traveling. Although such travel, or peregrination, has long been associated with factitious disorder, other diagnoses are more common among travelers, including psychotic disorders, personality disorders, and substance abuse. Travelers' intense psychopathology, disrupted social networks, lack of collateral informants, and unawareness of local resources complicate treatment. These patients can consume disproportionate time and resources from emergency providers...
September 2016: Western Journal of Emergency Medicine
James Hart, Michael Woodruff, Elizabeth Joy, Joseph Dalto, Gregory Snow, Rajendu Srivastava, Brad Isaacson, Todd Allen
INTRODUCTION: Little data exists to help urgent care (UC) clinicians predict morbidity and mortality risk. Age, systolic blood pressure (SBP), and heart rate (HR) are easily obtainable and have been used in other settings to predict short-term risk of deterioration. We hypothesized that there is a relationship between advancing age, SBP, HR, and short-term health outcomes in the UC setting. METHODS: We collected retrospective data from 28 UC clinics and 22 hospitals in the Intermountain Healthcare system between years 2008-2013...
September 2016: Western Journal of Emergency Medicine
Brian R Sharp, Kristen M Sharp, Brian Patterson, Suzanne Dooley-Hash
INTRODUCTION: Nausea and vomiting in pregnancy (NVP) is a condition that commonly affects women in the first trimester of pregnancy. Despite frequently leading to emergency department (ED) visits, little evidence exists to characterize the nature of ED visits or to guide its treatment in the ED. Our objectives were to evaluate the treatment of NVP in the ED and to identify factors that predict return visits to the ED for NVP. METHODS: We conducted a retrospective database analysis using the electronic medical record from a single, large academic hospital...
September 2016: Western Journal of Emergency Medicine
Teresa M Chan, Brent Thoma, Keeth Krishnan, Michelle Lin, Christopher R Carpenter, Matt Astin, Kulamakan Kulasegaram
INTRODUCTION: Online education resources (OERs), like blogs and podcasts, increasingly augment or replace traditional medical education resources such as textbooks and lectures. Trainees' ability to evaluate these resources is poor, and few quality assessment aids have been developed to assist them. This study aimed to derive a quality evaluation instrument for this purpose. METHODS: We used a three-phase methodology. In Phase 1, a previously derived list of 151 OER quality indicators was reduced to 13 items using data from published consensus-building studies (of medical educators, expert podcasters, and expert bloggers) and subsequent evaluation by our team...
September 2016: Western Journal of Emergency Medicine
Benjamin H Schnapp, Benjamin H Slovis, Anar D Shah, Abra L Fant, Michael A Gisondi, Kaushal H Shah, Christie A Lech
INTRODUCTION: Several studies have shown that workplace violence in the emergency department (ED) is common. Residents may be among the most vulnerable staff, as they have the least experience with these volatile encounters. The goal for this study was to quantify and describe acts of violence against emergency medicine (EM) residents by patients and visitors and to identify perceived barriers to safety. METHODS: This cross-sectional survey study queried EM residents at multiple New York City hospitals...
September 2016: Western Journal of Emergency Medicine
Jeffrey J Guterman, Scott R Lundberg, Geoffrey P Scheib, Sandra G Gross-Schulman, Mark J Richman, Chien-Ju Wang, David A Talan
INTRODUCTION: Attending physician judgment is the traditional standard of care for emergency department (ED) admission decisions. The extent to which variability in admission decisions affect cost and quality is not well understood. We sought to determine the impact of variability in admission decisions on cost and quality. METHODS: We performed a retrospective observational study of patients presenting to a university-affiliated, urban ED from October 1, 2007, through September 30, 2008...
September 2016: Western Journal of Emergency Medicine
Michael P Phelan, Edmunds Z Reineks, Fredric M Hustey, Jacob P Berriochoa, Seth R Podolsky, Stephen Meldon, Jesse D Schold, Janelle Chamberlin, Gary W Procop
INTRODUCTION: Our goal was to determine if the hemolysis among blood samples obtained in an emergency department and then sent to the laboratory in a pneumatic tube system was different from those in samples that were hand-carried. METHODS: The hemolysis index is measured on all samples submitted for potassium analysis. We queried our hospital laboratory database system (SunQuest(®)) for potassium results for specimens obtained between January 2014 and July 2014...
September 2016: Western Journal of Emergency Medicine
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