Operation care: a pilot case management intervention for frequent emergency medical system users Michael L. Rinke, Elisabeth Dietrich, Traci Kodeck, Kathleen Westcoat
DOI: http://dx.doi.org/10.1016/j.ajem.2010.12.012
The American Journal of Emergency Medicine , Vol. 30 , Issue 2 ,
Published online: January 27 2011
x This study aims to determine if a prehospital case management intervention reduces transport and nontransport emergency medical system (EMS) responses to frequent EMS users.
Airway management of adult patients without trauma in an ED led by internists Dominik Roth, Wolfgang Schreiber, Peter Stratil, Katharina Pichler, Christof Havel, Moritz Haugk
DOI: http://dx.doi.org/10.1016/j.ajem.2013.06.001
The American Journal of Emergency Medicine , Vol. 31 , Issue 9 ,
Published online: July 11 2013
x Airway management is a key competence in emergency medicine. Patients heavily differ from those in the operating room. They are acutely ill by definition and usually not fasting. Evaluation of risk factors is often impossible. Current literature primarily originates from countries where emergency medicine is an independent specialty. We evaluated intubations in a high-volume emergency department run by internists and comprising its own distinctive intensive care unit.
Creating ED point-of-care testing protocols: an expert panel and Delphi process Jesse M. Pines, Mark S. Zocchi, Mary-Elizabeth Buchanan, Khaled Alghamdi, Danielle Lazar, Alex Rosenau, Manish Shah, Debbie Travers
DOI: http://dx.doi.org/10.1016/j.ajem.2014.12.018
The American Journal of Emergency Medicine , Vol. 33 , Issue 3 ,
Published online: December 18 2014
x In recent years, point-of-care (POC) testing has gained popularity in emergency departments (EDs) to facilitate rapid laboratory test results [1-4]. Despite increasing popularity, few studies have addressed POC use early in ED care, specifically around ED triage. Availability of laboratory testing may help risk-stratify patients by providing additional information early in ED care. In a prospective study, triage POC testing changed patient management in 14% of cases, Emergency Severity Index (ESI) triage level in 15%, and 56% found POC testing to be helpful in the triage process [5].
Care plans reduce ED visits in those with drug-seeking behavior Frederick Fiesseler, Renee Riggs, David Salo, Richard Klemm, Ashley Flannery, Richard Shih
DOI: http://dx.doi.org/10.1016/j.ajem.2015.08.038
The American Journal of Emergency Medicine , Vol. 33 , Issue 12 ,
Published online: August 25 2015
x Patients with drug-seeking behavior can be both labor and resource intensive to the emergency department (ED).
Diagnosis and disposition are changed when board-certified emergency physicians use CT for non-traumatic abdominal pain Aaron Nathan Barksdale, Jeff Lee Hackman, Monica Gaddis, Matt Christopher Gratton
DOI: http://dx.doi.org/10.1016/j.ajem.2015.07.082
The American Journal of Emergency Medicine , Vol. 33 , Issue 11 ,
Published online: August 4 2015
x To determine the effect of abdominal computed tomographic (CT) scan results on diagnosis and disposition of patients with non-traumatic abdominal pain who were evaluated by board-certified emergency physicians (EPs).
The prehospital and hospital costs of emergency care for frequent ED patients Robert G. Solberg, Brandy L. Edwards, Jeffrey P. Chidester, Debra G. Perina, William J. Brady, Michael D. Williams
DOI: http://dx.doi.org/10.1016/j.ajem.2015.11.066
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: December 4 2015
x Frequent emergency department (ED) use has been identified as a cause of ED overcrowding and increasing health care costs. Studies have examined the expense of frequent patients (FPs) to hospitals but have not added the cost Emergency Medical Services (EMS) to estimate the total cost of this pattern of care.
Computed tomography is not justified in every pediatric blunt trauma patient with a suspicious mechanism of injury Yehuda Hershkovitz, Itai Zoarets, Albert Stepansky, Eran Kozer, Zahar Shapira, Baruch Klin, Ariel Halevy, Igor Jeroukhimov
DOI: http://dx.doi.org/10.1016/j.ajem.2014.04.024
The American Journal of Emergency Medicine , Vol. 32 , Issue 7 ,
Published online: April 21 2014
x Computed tomography (CT) has become an important tool for the diagnosis of intra-abdominal and chest injuries in patients with blunt trauma. The role of CT in conscious asymptomatic patients with a suspicious mechanism of injury remains controversial. This controversy intensifies in the management of pediatric blunt trauma patients, who are much more susceptible to radiation exposure. The objective of this study was to evaluate the role of abdominal and chest CT imaging in asymptomatic pediatric patients with a suspicious mechanism of injury.
Frequent attenders to the ED: patients who present with repeated asthma exacerbations Shu Fen Lim, Win Wah, Yogeswary Pasupathi, Susan Yap, Mariko Siyue Koh, Keng Leong Tan, Cass Jwee Cheong Chay, Marcus Eng Hock Ong
DOI: http://dx.doi.org/10.1016/j.ajem.2014.04.052
The American Journal of Emergency Medicine , Vol. 32 , Issue 8 ,
Published online: May 12 2014
x Asthma has been reported as one of the main causes of frequent attendance to the emergency department (ED), and many of those visits are potentially preventable. Understanding the characteristics of frequent attender (FA) patients with asthmatic exacerbations will help to identify factors associated with frequent attendance and improve case management. The aim of this study is to describe the characteristics of FA who present multiple times to the ED for asthma exacerbations.
Comparison of oral oxycodone and naproxen in soft tissue injury pain control: a double-blind randomized clinical trial Marzieh Fathi, Mohammad Amin Zare, Hamid Reza Bahmani, Shahriar Zehtabchi
DOI: http://dx.doi.org/10.1016/j.ajem.2015.05.021
The American Journal of Emergency Medicine , Vol. 33 , Issue 9 ,
Published online: May 29 2015
x This randomized clinical trial compares the efficacy and safety of oral oxycodone (an oral opioid) with naproxen (a nonsteroidal anti-inflammatory drug) in acute pain control in patients with soft tissue injury. It also evaluates the need for additional doses of analgesics in the first 24 hours of discharge from emergency department (ED).
The hateful physician: the role of affect bias in the care of the psychiatric patient in the ED Daniel B. Park, Adam K. Berkwitt, Rachel E. Tuuri, W. Scott Russell
DOI: http://dx.doi.org/10.1016/j.ajem.2014.02.007
The American Journal of Emergency Medicine , Vol. 32 , Issue 5 ,
Published online: February 19 2014
x Although the role of cognitive biases has received significant attention in recent years as the worlds of behavioral economics and patient safety have collided, emotional influences may play a more crucial function in the outcomes of medical decision making [1]. In 1979, Groves [2] published a controversial article in the New England Journal of Medicine titled “Taking Care of the Hateful Patient,” in which he described the powerful effect a provider's emotional state can have on patient care. Current work explores how such a phenomenon can contribute to the formation of negative emotional influences (affect bias) that may cloud clinical judgment [3-6].
Alvarado score: is it time to develop a clinical-pathological-radiological scoring system for diagnosing acute appendicitis? Jyotindu Debnath, R. Ravikumar, C.G. Muralidharan, Giriraj Singh
DOI: http://dx.doi.org/10.1016/j.ajem.2015.03.010
The American Journal of Emergency Medicine , Vol. 33 , Issue 6 ,
Published online: March 14 2015
x We read with interest the article titled “Alvarado score: can it reduce unnecessary computed tomographic (CT) scans for evaluation of acute appendicitis (AA)?” written by Apisarnthanarak et al and published online ahead of print in the Am J Emerg Med 2014 [1]. We find the article interesting on several accounts as detailed below.
Survival after prolonged resuscitation from cardiac arrest due to diabetic ketoacidosis using extracorporeal life support Toru Hifumi, Nobuaki Kiriu, Hiroshi Kato, Junichi Inoue, Yuichi Koido
DOI: http://dx.doi.org/10.1016/j.ajem.2012.12.041
The American Journal of Emergency Medicine , Vol. 31 , Issue 5 ,
Published online: March 4 2013
x Management of cardiac arrest due to severe diabetic ketoacidosis (DKA) using bicarbonate therapy and extracorporeal life support (ECLS) remains controversial. We report a case of a 24-year-old man with insulin-dependent type 1 diabetes mellitus who survived without any neurologic complications after prolonged ECLS (including fluid resuscitation and insulin but no aggressive bicarbonate) for cardiac arrest due to severe DKA. In post-DKA cardiac arrest, insulin and fluid resuscitation is the mainstay of treatment, but ECLS should be considered when prolonged cardiac arrest is expected.
Subject Index
DOI: http://dx.doi.org/10.1016/S0735-6757(12)00518-9
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published in issue: November 2012
Description of procedures performed on patients by emergency medical services during mass casualty incidents in the United States Mazen El Sayed, Hani Tamim, N. Clay Mann
DOI: http://dx.doi.org/10.1016/j.ajem.2015.04.035
The American Journal of Emergency Medicine , Vol. 33 , Issue 8 ,
Published online: April 25 2015
x Emergency medical services (EMS) preparedness is essential to reduce morbidity and mortality from mass casualty incidents (MCIs).
Elderly fall patients triaged to the trauma bay: age, injury patterns, and mortality risk Daniel Evans, Jonathan Pester, Luis Vera, Donald Jeanmonod, Rebecca Jeanmonod
DOI: http://dx.doi.org/10.1016/j.ajem.2015.07.044
The American Journal of Emergency Medicine , Vol. 33 , Issue 11 ,
Published online: July 28 2015
x Falls in the elderly are a significant cause of morbidity and mortality. We sought to better categorize this patient population and describe factors contributing to their falls.
Subject Index
DOI: http://dx.doi.org/10.1016/S0735-6757(15)00997-3
The American Journal of Emergency Medicine , Vol. 33 , Issue 12 ,
Published in issue: December 2015
A modified paravertebral block to reduce risk of mortality in a patient with multiple rib fractures Hitoshi Yoshida, Shinya Yaguchi, Atsufumi Matsumoto, Hiroyuki Hanada, Hidetomo Niwa, Masatou Kitayama
DOI: http://dx.doi.org/10.1016/j.ajem.2014.10.032
The American Journal of Emergency Medicine , Vol. 33 , Issue 5 ,
Published online: October 25 2014
x The risk of mortality due to multiple rib fractures elevates with increasing age or severity of injury. Although sufficient pain relief with thoracic epidural block or paravertebral block has been recommended for prevention of critical pneumonia that causes late death, their indications are limited in patients with coagulation disorder. We tested a new modified ultrasound-guided paravertebral block, retrolaminar block (RB)/costovertebral canal block (CVCB), instead of the recommended regional analgesic techniques in a 79-year-old multiple-injured man with routine antiplatelet therapy.
Clinical predictors of Pseudomonas aeruginosa or Acinetobacter baumannii bacteremia in patients admitted to the ED Cheol-In Kang, Doo Ryeon Chung, Kyong Ran Peck, Jae-Hoon Song, the Korean Network for Study on Infectious Diseases (KONSID)
DOI: http://dx.doi.org/10.1016/j.ajem.2011.08.021
The American Journal of Emergency Medicine , Vol. 30 , Issue 7 ,
Published online: October 26 2011
x The identification of clinical characteristics that could identify patients at high risk for Pseudomonas aeruginosa or Acinetobacter baumannii bacteremia would aid clinicians in the appropriate management of these life-threatening conditions, especially in patients admitted to the emergency department (ED) with community-onset infections. To determine clinical risk factors for P aeruginosa or A baumannii bacteremia in patients with community-onset gram-negative bacteremia (GNB), a post hoc analysis of a nationwide bacteremia surveillance database including patients with microbiologically documented GNB was performed.
Presentation of an adolescent with delayed-onset massive hemorrhage and shock from a tongue piercing Michael W. Sauer, Christopher J. Siano, Harold K. Simon
DOI: http://dx.doi.org/10.1016/j.ajem.2010.09.018
The American Journal of Emergency Medicine , Vol. 29 , Issue 9 ,
Published online: October 22 2010
x Tongue piercing is becoming increasingly common among adolescents in the United States. These piercings come with several known complications such as pain, local infection, and minor bleeding. We present the case as well as management strategy of a 16-year-old adolescent girl with insulin-dependent diabetes mellitus who developed a significant hemorrhage following tongue piercing with subsequent clinical shock and diabetic ketoacidosis. Practitioners and patients alike should be aware that this routine procedure may lead to significant, even life-threatening, consequences.
Table of Contents
DOI: http://dx.doi.org/10.1016/S0735-6757(12)00009-5
The American Journal of Emergency Medicine , Vol. 30 , Issue 2 ,
Published in issue: February 2012
