Copper-coated thermometer for the prevention of cross-infections: preliminary results Panos Efstathiou, Evangelia Kouskouni, Zaharoula Manolidou, Maria Tseroni, Katerina Karageorgou, Helena C. Maltezou, Athanasios Chalkias, Seraphim Papanikolaou, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2015.12.028
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: December 17 2015
x Research has shown that axillary thermometers are contaminated at a rate of 80% to 100% [1–3]. Although the common digital thermometer is always disinfected with an alcohol solution after each use, disinfection is only partially achieved or fails, potentially leading to resistant bacteria and sepsis [4–6].
Risk factors for QT prolongation associated with acute psychotropic drug overdose Naoya Miura, Takeshi Saito, Takayuki Taira, Rimako Umebachi, Sadaki Inokuchi
DOI: http://dx.doi.org/10.1016/j.ajem.2014.09.048
The American Journal of Emergency Medicine , Vol. 33 , Issue 2 ,
Published online: October 3 2014
x Antipsychotic/Antidepressant use is a risk factor for QT interval (QT) prolongation and sudden cardiac death. However, it is unclear which drugs are risk factors for QT prolongation and torsades de pointes in cases of psychotropic drug overdose.
Cardiac disease and probable intent after drowning Andreas Claesson, Henrik Druid, Jonny Lindqvist, Johan Herlitz
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.004
The American Journal of Emergency Medicine , Vol. 31 , Issue 7 ,
Published online: May 22 2013
x The aim of this study is to determine the prevalence of cardiac disease and its relationship to the victim's probable intent among patients with cardiac arrest due to drowning.
Vibrio vulnificus sepsis misdiagnosed as simple deep vein thrombosisJe Sung You, Seunghwan Kim, Incheol Park, Seungho Kim
DOI: http://dx.doi.org/10.1016/j.ajem.2012.01.031
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published online: May 25 2012
x A 46-year-old man was transferred to the emergency department and suspected of having a deep vein thrombosis. The patient reported swelling and pain in both lower legs for 16 hours. His medical history included liver cirrhosis secondary to alcohol. A detailed history revealed raw fish consumption 1 day before admission. Within 2 hours of arrival, several hemorrhagic bullae developed in the color-changed lesions of both lower legs. The patient's level of consciousness deteriorated to a stupor. He was admitted to the intensive care unit.
Incidence and patterns of hemolytic anemia in acute dapsone overdose Yong Sung Cha, Hyun Kim, Juwon Kim, Oh. Hyun Kim, Hyung Il Kim, KyoungChul Cha, Kang Hyun Lee, Sung Oh Hwang
DOI: http://dx.doi.org/10.1016/j.ajem.2015.09.021
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: September 19 2015
x Hemolytic anemia is one of the complications related to the chronic consumption of dapsone. However, in acute dapsone overdose, there have been few case reports regarding hemolytic anemia. Herein, we reported the prevalence and patterns of hemolytic anemia in acute dapsone overdose, and compared clinical features including mortality in the non-hemolytic anemia and the hemolytic anemia groups.
Early identification of an atypical case of type A dissection by transthoracic echocardiography by the emergency physician Scott Edward Sparks, Michael Kurz, Doug Franzen
DOI: http://dx.doi.org/10.1016/j.ajem.2014.12.024
The American Journal of Emergency Medicine , Vol. 33 , Issue 7 ,
Published online: December 20 2014
x Thoracic aortic dissection is a lethal disease, and emergency department diagnosis is limited by imperfect diagnostic testing and limited resources; however, this case report illustrates the nonspecific presentation of thoracic aortic dissection and the use of emergency physician use of transthoracic echocardiography with the addition of suprasternal notch views to help differentiate all-cause chest pain and aid in accurate diagnosis, as well as earlier surgical correction for best patient outcomes in cases of thoracic aortic dissection.
An alternative for rapid administration of medication and fluids in the emergency setting using a novel device Neal Lyons, Daniel Nejak, Nadine Lomotan, Robert Mokszycki, Stephen Jamieson, Marc McDowell, Erik Kulstad
DOI: http://dx.doi.org/10.1016/j.ajem.2015.01.028
The American Journal of Emergency Medicine , Vol. 33 , Issue 8 ,
Published online: January 21 2015
Open Access x Routes of administration for medications and fluids in the acute care setting have primarily focused on oral, intravenous, or intraosseous routes, but, in many patients, none of these routes is optimal. A novel device (Macy Catheter; Hospi Corp) that offers an easy route for administration of medications or fluids via rectal mucosal absorption (proctoclysis) has recently become available in the palliative care market; we describe here the first known uses of this device in the emergency setting.
Recurrent hypoglycemia in a toddler Marissa Cohen, Sean Zwiebel, Rebecca Jeanmonod
DOI: http://dx.doi.org/10.1016/j.ajem.2015.04.074
The American Journal of Emergency Medicine , Vol. 33 , Issue 12 ,
Published online: April 30 2015
x Idiopathic ketotic hypoglycemia is the most common cause of hypoglycemia in toddlers. This diagnosis should be considered in any hypoglycemic toddler with no prior history of abnormal growth who is developmentally normal when toxic ingestions and sepsis are inconsistent with the clinical picture. Diagnosis is important in preventing serious long-term sequelae and is made in the setting of hypoglycemia, ketonuria, and ketonemia. Therefore, checking urine and blood ketones is an essential part of the evaluation in any hypoglycemic toddler.
Safety and efficacy of intravenous combination sedatives in the ED Siu Fai Li, Amy Kumar, Susan Thomas, Yelena Sorokina, Vanessa Calderon, Elizabeth Dubey, Lani Lee, Ludmilla Gustave
DOI: http://dx.doi.org/10.1016/j.ajem.2013.06.017
The American Journal of Emergency Medicine , Vol. 31 , Issue 9 ,
Published online: August 7 2013
x The objective of the study is to determine the safety of intravenously administered combination sedatives in the emergency department (ED).
Prescription opioid misuse among ED patients discharged with opioids Francesca L. Beaudoin, Steven Straube, Jason Lopez, Michael J. Mello, Janette Baird
DOI: http://dx.doi.org/10.1016/j.ajem.2014.02.030
The American Journal of Emergency Medicine , Vol. 32 , Issue 6 ,
Published online: February 27 2014
x The purposes of this study were to determine the prevalence of prescription opioid misuse in a cohort of discharged emergency department (ED) patients who received prescription opioids and to examine factors predictive of misuse.
Urban overdose hotspots: a 12-month prospective study in Dublin ambulance services Jan Klimas, Martin O'Reilly, Mairead Egan, Helen Tobin, Gerard Bury
DOI: http://dx.doi.org/10.1016/j.ajem.2014.07.017
The American Journal of Emergency Medicine , Vol. 32 , Issue 10 ,
Published online: July 30 2014
x Opioid overdose (OD) is the primary cause of death among drug users globally. Personal and social determinants of overdose have been studied before, but the environmental factors lacked research attention. Area deprivation or presence of addiction clinics may contribute to overdose.
Withdrawal Seizures Seen In the Setting of Synthetic Cannabinoid Abuse Christopher S. Sampson, Starr-Mar’ee Bedy, Terry Carlisle
DOI: http://dx.doi.org/10.1016/j.ajem.2015.03.025
The American Journal of Emergency Medicine , Vol. 33 , Issue 11 ,
Published online: March 15 2015
x The recent rise in the abuse of synthetic cannabinoid receptor agonists (Spice, K2) has led to an increase of patients presenting to emergency departments (EDs) with complications stemming from their abuse. We present a case of withdrawal seizures seen in a chronic abuser of these herbal mixtures who stopped using them abruptly. Seizures have been reported in the literature in the setting of abuse, but not during withdrawal [1].
The impact of overcrowding on the bacterial contamination of blood cultures in the ED Ching-Chi Lee, Nan-Yao Lee, Ming-Che Chuang, Po-Lin Chen, Chia-Ming Chang, Wen-Chien Ko
DOI: http://dx.doi.org/10.1016/j.ajem.2011.05.026
The American Journal of Emergency Medicine , Vol. 30 , Issue 6 ,
Published online: December 14 2011
x This study aims to determine the risk factors associated with the bacterial contamination of blood cultures among adults visiting the emergency department (ED).
Early antidote use associated with noninvasive ventilation in prehospital treatment of methadone intoxication J. Gonzva, B. Prunet, C. Deniel, P. Benner, F. Toppin, P.M. Brun
DOI: http://dx.doi.org/10.1016/j.ajem.2012.06.015
The American Journal of Emergency Medicine , Vol. 31 , Issue 2 ,
Published online: September 3 2012
x Opioid addiction is a major public health problem in France. However, because substitution therapies are available, the number of fatal intoxications decreased.
Characteristics of Medicaid enrollees with frequent ED use Roberta Capp, Marjorie S. Rosenthal, Mayur M. Desai, Lauren Kelley, Christopher Borgstrom, Darcey L. Cobbs-Lomax, Peggy Simonette, Erica S. Spatz
DOI: http://dx.doi.org/10.1016/j.ajem.2013.05.050
The American Journal of Emergency Medicine , Vol. 31 , Issue 9 ,
Published online: July 15 2013
x Medicaid enrollees are disproportionately represented among patients with frequent Emergency Department (ED) visits, yet prior studies investigating frequent ED users have focused on patients with all insurance types.
Superwarfarin ingestion treated successfully with prothrombin complex concentrate Olivia Haesloop, Allison Tillick, Graham Nichol, Jared Strote
DOI: http://dx.doi.org/10.1016/j.ajem.2015.05.033
The American Journal of Emergency Medicine , Vol. 34 , Issue 1 ,
Published online: May 29 2015
x Superwarfarin, a common component of rat poison, can cause long-lasting, severe coagulopathy and life-threatening hemorrhage when ingested. We report a case of intentional rat poison consumption with subsequent hemorrhage and hypotension requiring rapid coagulopathy reversal and resuscitation in the emergency department. In addition to traditional blood products, prothrombin complex concentrate was administered. Although prothrombin complex concentrate is increasingly used for severe hemorrhage in anticoagulated patients, it may be particularly useful in superwarfarin ingestions given the extreme, persistent coagulapathies that can occur.
A retrospective review of the prehospital use of activated charcoal Joseph Villarreal, Christopher A. Kahn, James V. Dunford, Ekta Patel, Richard F. Clark
DOI: http://dx.doi.org/10.1016/j.ajem.2014.10.019
The American Journal of Emergency Medicine , Vol. 33 , Issue 1 ,
Published online: October 21 2014
x We studied the complications and timing implications of prehospital activated charcoal (PAC). Appropriateness of PAC administration was also evaluated.
Thyrotoxic periodic paralysis presenting with ventricular storm Daniel Weingrow, Faith Quenzer, Rodney Borger
DOI: http://dx.doi.org/10.1016/j.ajem.2012.05.024
The American Journal of Emergency Medicine , Vol. 31 , Issue 2 ,
Published online: July 18 2012
x Thyrotoxic periodic paralysis (TPP) is a rare accompaniment to hyperthyroidism in western populations. Severe hypokalemia with resultant muscle weakness and arrhythmias are frequently precipitated by acute stressors or carbohydrate meals from catecholamine release and insulin release, respectively. Ventricular arrhythmia, during the hypokalemic events, usually terminates easily with standard anti-arrhythmic treatment. This report describes a case of TPP complicated by ventricular storm/incessant ventricular tachycardia (VT) with subsequent cardiac arrest.
Who is prescribing controlled medications to patients who die of prescription drug abuse? Roneet Lev, Oren Lee, Sean Petro, Jonathan Lucas, Edward M. Castillo, Gary M. Vilke, Christopher J. Coyne
DOI: http://dx.doi.org/10.1016/j.ajem.2015.09.003
The American Journal of Emergency Medicine , Vol. 34 , Issue 1 ,
Published online: September 7 2015
x Prescription drug–related fatalities remain a significant issue in the United States, yet there is a relative lack of knowledge on the specialty-specific prescription patterns for drug-related deaths.
Observation vs admission in syncope: can we predict short length of stays? Margaret Lin, Richard E. Wolfe, Nathan I. Shapiro, Victor Novack, Yotam Lior, Shamai A. Grossman
DOI: http://dx.doi.org/10.1016/j.ajem.2015.08.010
The American Journal of Emergency Medicine , Vol. 33 , Issue 11 ,
Published online: August 10 2015
x Rising health care costs demands justifying prolonged hospitalization for syncope, yet predictors of shorter length of stay (LOS) have not been identified.
