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Journal of Emergencies, Trauma, and Shock

Wellingson Silva Paiva, Barbara Albuquerque Morais, Almir Ferreira de Andrade, Manoel Jacobsen Teixeira
No abstract text is available yet for this article.
April 2018: Journal of Emergencies, Trauma, and Shock
Takashi Iso, Youichi Yanagawa, Ikuto Takeuchi, Satoru Suwa
No abstract text is available yet for this article.
April 2018: Journal of Emergencies, Trauma, and Shock
Megri Mohammed, Shaheed Elhamdani, Waiel Abusnina, Aldliw Majdi, Shweihat Yousef
Shock is one of the most challenging life-threatening conditions with high mortality and morbidity; the outcomes are highly dependent on the early detection and management of the condition. Septic shock is the most common type of shock in the Intensive Care Unit. While not as common as other subsets of shock, obstructive shock is a significant subtype due to well defined mechanical and pathological causes, including tension pneumothorax, massive pulmonary embolism, and cardiac tamponade. We are presenting a patient with obstructive shock due to inferior vena cava obstruction secondary to extensive deep venous thrombosis...
April 2018: Journal of Emergencies, Trauma, and Shock
Mihaela Mihalcea-Danciu, Michel Zupan, Pierrick Le Borgne, Pascal Bilbault
Takotsubo cardiomyopathy (TTC), also known as transient left ventricular ballooning syndrome, is a stress-induced-cardiomyopathy. It is precipitated by emotional or physical stress and is characterized by normal coronary arteries and transient regional wall motion abnormalities. Variants of TTC include apical ballooning syndrome and, less commonly, mid, basal, and local variants. New onset heart failure or acute coronary syndromes are a common presentation of TTC. Arrhythmias such as VT, VF, and torsade de pointes have also been reported...
April 2018: Journal of Emergencies, Trauma, and Shock
William Wilson, Shakuntala Murty
Pesticide poisoning is always a clinical conundrum for the emergency physician (EP), the complexity of which increases when the pesticide has no antidote! Over the past decade, there has been a sharp increase in cases of Amitraz poisoning, a pesticide routinely used in veterinary medicine, available without a prescription. The usual presentation includes bradycardia, hypotension, poor sensorium, and miosis. In the absence of accurate history, these clinical features can be confused with the cholinergic toxidrome of organophosphorus poisoning...
April 2018: Journal of Emergencies, Trauma, and Shock
Elena Berg, Janel Paukovits, Jennifer Axelband, Jonathan Trager, Dina Ryan, Kathleen Cichonski, Mark Kopnitsky, Daniel Zweitzig, Rebecca Jeanmonod
Introduction: Early identification of sepsis is critical as early treatment improves outcomes. We sought to identify threshold values of secretory phospholipase A2 (sPLA2)-IIA that predict sepsis and bacterial infection compared to nonseptic controls in an emergency department (ED) population. Materials and Methods: This is a prospective cohort of consenting adult patients who met two or more systemic inflammatory response syndrome (SIRS) criteria with clinical diagnosis of infectious source likely (septic patients)...
April 2018: Journal of Emergencies, Trauma, and Shock
Laura N Medford-Davis, Nidal Moukaddam, Anu Matorin, Asim Shah, Veronica Tucci
Introduction: Medical clearance is required to label patients with mental illness as free of acute medical concerns. However, tests may extend emergency department lengths of stay and increase costs to patients and hospitals. The objective of this study was to determine how knowledgeable emergency and psychiatric providers are about the costs of tests used for medical clearance. Materials and Methods: We surveyed the department of psychiatry (Psych) and department of emergency medicine (EM) faculty and residents to obtain their estimates of the costs of 18 laboratory/imaging studies commonly used for medical clearance...
April 2018: Journal of Emergencies, Trauma, and Shock
Chirag J Patel, Hardik B Bhatt, Samira N Parikh, Binit N Jhaveri, Jyothi H Puranik
Objective: The objective of this study is to determine the accuracy of the bedside lung ultrasound in emergency (BLUE) protocol in giving a correct diagnosis in patients presenting with acute respiratory distress in emergency department. Materials and Methods: Patients with acute respiratory distress were evaluated. Ultrasound findings such as artifacts (A line, B line), lung sliding, alveolar consolidation or pleural effusion, and venous analysis were recorded...
April 2018: Journal of Emergencies, Trauma, and Shock
Tharwat El Zahran, Ziad Kazzi, Ahel Al-Hajj Chehadeh, Riyad Sadek, Mazen J El Sayed
Background: Snakebites lead to at least 421,000 envenomations and result in more than 20,000 deaths per year worldwide. Few reports exist in the Mediterranean region. This study describes demographic and clinical characteristics, treatment modalities, and outcomes of snakebites in Lebanon. Materials and Methods: This was a retrospective chart review of patients who presented with snakebite complaint to the emergency department between January 2000 and September 2014...
April 2018: Journal of Emergencies, Trauma, and Shock
Amit Bahl, Michael Bagan, Steven Joseph, Abigail Brackney
Objective: To compare emergency medicine (EM) resident physicians' ability to identify long-bone fractures using ultrasound (US) versus plain radiography (X-ray). Methods: This was an IRB-approved, randomized prospective study. Study participants included 40 EM residents at a single site. Fractures were mechanically induced in five chicken legs, and five legs were left unfractured. Chicken legs were imaged by both modalities. Participants were given 2 min to view each of the images...
April 2018: Journal of Emergencies, Trauma, and Shock
Aditya Maddali, Farook Abdul Razack, Srihari Cattamanchi, Trichur V Ramakrishnan
Background: Early recognition of Stroke is one of the key concepts in the "Chain of Survival" as described by the American Heart Association/American Stroke Association Stroke guidelines. The most commonly used tools for prehospital assessment of stroke are "The Cincinnati Prehospital Stroke Scale," (CPSS) the "Face, Arm, Speech Test," and "The Los Angeles Prehospital Stroke Screen." The former two are used to identify stroke using physical findings while the latter is used to rule out other causes of altered consciousness...
April 2018: Journal of Emergencies, Trauma, and Shock
Akilan Elangovan, Srihari Cattamanchi, Abdul Razack Farook, Ramakrishnan Venkatakrishnan Trichur
Context: Predicting hyperglycemic crisis death (PHD) score is a simple, rapid tool with six independent mortality predictors to calculate 30-day mortality and appropriately dispose patients to Intensive Care Unit (ICU) or ward. Aims: This study aimed at validating the efficiency of PHD score as a decision rule for prognosticating 30-day mortality and classifying hyperglycemic crisis patients for appropriate disposition from the emergency department (ED). Materials and Methods: This is a prospective, observational study done in the ED of a teaching hospital over 14 months...
April 2018: Journal of Emergencies, Trauma, and Shock
Bola Aladegbami, Pamela M Choi, Martin S Keller, Adam M Vogel
Background: Examine the characteristics and outcomes of pediatric trauma patients at risk for coagulopathy following implementation of viscoelastic monitoring. Materials and Methods: Injured children, aged <18 years, from September 7, 2014, to December 21, 2015, at risk for trauma-induced coagulopathy were identified from a single, level-1 American College of Surgeons verified pediatric trauma center. Patients were grouped by coagulation assessment: no assessment (NA), conventional coagulation testing alone (CCT), and conventional coagulation testing with rapid thromboelastography (rTEG)...
April 2018: Journal of Emergencies, Trauma, and Shock
Prakash Ranjan Mishra, Sanjeev Bhoi, Tej Prakash Sinha
Introduction: Airway and breathing management play critical role in trauma resuscitation. Early identification of esophageal intubation and detection of fatal events is critical. Authors studied the utility of integration of point-of-care ultrasound (POCUS) during different phases of rapid sequence intubation (RSI) in trauma resuscitation. Methods: It was prospective, randomized single-centered study conducted at the Emergency Department of a level one trauma center...
April 2018: Journal of Emergencies, Trauma, and Shock
Amit Bahl, Steven Schafer
Context: Geriatric head trauma resulting from falls has been extensively studied both in the presence and absence of blood thinners. In this population, however, the prevalence and extent of abdominal injury resulting from falls are much less defined. Aim: We aim to evaluate the utility of abdominal computed tomography (CT) imaging in geriatric patients on Warfarin with a recent history of fall. Setting and Design: A retrospective analysis was completed of consecutive geriatric patients who presented to a Level 1 Trauma Center emergency department after fall from standing while taking Warfarin...
April 2018: Journal of Emergencies, Trauma, and Shock
Emmanuel Lilitsis, Sofia Xenaki, Elias Athanasakis, Eleftherios Papadakis, Pavlina Syrogianni, George Chalkiadakis, Emmanuel Chrysos
Trauma is one of the leading causes of death worldwide, with road traffic collisions, suicides, and homicides accounting for the majority of injury-related deaths. Since trauma mainly affects young age groups, it is recognized as a serious social and economic threat, as annually, almost 16,000 posttrauma individuals are expected to lose their lives and many more to end up disabled. The purpose of this research is to summarize current knowledge on factors predicting outcome - specifically mortality risk - in severely injured patients...
April 2018: Journal of Emergencies, Trauma, and Shock
Fatimah Lateef
Physicians in general, including emergency physicians (EPs), are trained in the diagnostic, therapeutic, and administrative aspects of patient care but not so much in the theoretical and practical aspects of assuming and delivery of leadership. EPs are always taught to focus on their performance, to excel and achieve, to be accountable for their own clinical decisions, and to appreciate feedback and peer-to-peer review. Currently, if there are some semblances of formal or semi-formal leadership instruction, the organized theoretical curriculum often does not formally include very structured and planned departmental leadership and management elements...
April 2018: Journal of Emergencies, Trauma, and Shock
Dorian A Bogdanovski, Daniel Hakakian, Louis T DiFazio, Luca Antonioli, Zoltan H Nemeth
No abstract text is available yet for this article.
April 2018: Journal of Emergencies, Trauma, and Shock
Richard H Savel, Wess Cohen, Dena Borgia, Ronald J Simon
The primary purpose of this narrative is to elucidate the numerous significant changes that occur at the intensive care unit (ICU) level as a medical center pursues becoming a Level I trauma center. Specifically, we will focus on the following important areas: (1) leadership and strategy issues behind the decision to move forward with becoming a trauma center; (2) preparation needed to take a highly functioning surgical ICU and align it for the inevitable changes that happen as trauma go-live occurs; (3) intensivist staffing changes; (4) roles for and training of advanced practice practitioners; (5) graduate medical education issues; (6) optimizing interactions with closely related services; (7) nursing, staffing, and training issues; (8) bed allocation issues; and (9) reconciling the advantages of a "unified adult critical care service" with the realities of the central relationship between trauma and surgical critical care...
January 2018: Journal of Emergencies, Trauma, and Shock
Vivek Chauhan, Sagar Galwankar, Stanislaw P Stawicki, Naman Agrawal, S Vimal Krishnan, Sanjeev Bhoi, Tej Prakash Sinha, Praveen Aggarwal
INDUSEM was established as an INDO-US Satellite Knowledge Network in 2005. It brought together the academic leaders and innovators from India and the US with the goal of creating collaborative synergies and creative solutions to advance the knowledge and science of emergency medicine (EM) in India. Since 2005, the leadership of INDUSEM devoted substantial resources, effort, and expertise to ensure that newly implemented clinical institutes and training programs have the necessary resources and logistical support to effectively advance EM and Traumatology Sciences in India...
January 2018: Journal of Emergencies, Trauma, and Shock
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