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.
Bleeding sites in elderly trauma patients who required massive transfusion: a comparison with younger patients Takao Ohmori, Taisuke Kitamura, Kimiaki Tanaka, Yuichi Saisaka, Junko Ishihara, Hirokazu Onishi, Tsuyoshi Nojima, Kotaro Yamamoto, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2015.09.047
The American Journal of Emergency Medicine , Vol. 34 , Issue 2 ,
Published online: October 2 2015
x Among elderly patients with severe trauma, the sites of massive hemorrhage and their clinical characteristics are not well understood. Therefore, we investigated the sites of massive hemorrhage in patients with severe trauma, and compared the results for younger and elderly patients.
Respiratory depression in the intoxicated trauma patient: are opioids to blame? Eleni Shenk, Cassie A. Barton, Nathan D. Mah, Ran Ran, Robert G. Hendrickson, Jennifer Watters
DOI: http://dx.doi.org/10.1016/j.ajem.2015.10.053
The American Journal of Emergency Medicine , Vol. 34 , Issue 2 ,
Published online: November 3 2015
x Providing effective pain management to acutely intoxicated trauma patients represents a challenge of balancing appropriate pain management with the risk of potential respiratory depression from opioid administration. The objective of this study was to quantify the incidence of respiratory depression in trauma patients acutely intoxicated with ethanol who received opioids as compared with those who did not and identify potential risk factors for respiratory depression in this population. Retrospective medical record review was conducted for subjects identified via the trauma registry who were admitted as a trauma activation and had a detectable serum ethanol level upon admission.
Myocardial injury through serum troponin I and echocardiography in anaphylaxis: Takotsubo cardiomyopathy and the Kounis hypersensitivity–associated acute coronary syndrome Nicholas G. Kounis, Andreas Mazarakis, Constantinos Bardousis
DOI: http://dx.doi.org/10.1016/j.ajem.2015.12.019
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: December 17 2015
x Measuring of high-sensitivity cardiac troponin levels is essential in the diagnosis of acute myocardial infarction. Acute myocardial infarction is defined as myocardial cell death due to prolonged myocardial ischemia. Indeed, in the third universal definition of myocardial infarction [1], detection of rise and/or fall of cardiac troponin above the 99th percentile of the upper reference limit together with ischemic symptoms, electrocardiographic changes of new ischemia, development of pathologic Q-waves in the electrocardiogram, or imaging evidence of new loss of viable myocardium or new regional wall motion abnormality is essential for defining myocardial infarction.
Zipline-related injuries treated in US EDs, 1997-2012 Rachael M. Billock, Jonathan J. Anderegg, Tracy J. Mehan, Thiphalak Chounthirath, Gary A. Smith
DOI: http://dx.doi.org/10.1016/j.ajem.2015.08.022
The American Journal of Emergency Medicine , Vol. 33 , Issue 12 ,
Published online: August 14 2015
x To investigate the epidemiology of zipline-related injuries in the United States.
Novel technique to diagnose parotid duct injuries at the bedside using fluorescein David T. Montag, Ashok R. Jethwa, Rick M. Odland
DOI: http://dx.doi.org/10.1016/j.ajem.2015.10.017
The American Journal of Emergency Medicine , Vol. 34 , Issue 2 ,
Published online: October 15 2015
x Deep penetrating facial soft tissue trauma can potentially involve the parotid duct. This injury requires a high degree of suspicion as it is not readily evident on physical examination, although buccal branch injury may accompany it. Unrecognized parotid duct injury could lead to sialocele, salivary fistula, parotitis, wound dehiscence, or abscess [1]. There are multiple methods of detecting parotid duct injury at the bedside. The most frequently utilized method is cannulation of the papilla with identification of the cannulating object in the wound [2].
Inpatient admissions from the ED for adults with injuries: the role of clinical and nonclinical factors William D. Spector, Rhona Limcangco, Ryan L. Mutter, Jesse M. Pines, Pamela Owens
DOI: http://dx.doi.org/10.1016/j.ajem.2015.02.045
The American Journal of Emergency Medicine , Vol. 33 , Issue 6 ,
Published online: March 6 2015
x Inpatient hospital costs represent nearly a third of heath care spending. The proportion of inpatients visits that originate in the emergency department (ED) has been growing, approaching half of all inpatient admissions. Injury is the most common reason for adult ED visits, representing nearly one-quarter of all ED visits.
Characteristics of trauma patients overimmobilized by prehospital providers Elizabeth Paterek, Derek L. Isenberg, Ellie Salinski, Herbert Schiffer, Bruce Nisbet
DOI: http://dx.doi.org/10.1016/j.ajem.2014.10.034
The American Journal of Emergency Medicine , Vol. 33 , Issue 1 ,
Published online: October 25 2014
x Previous studies have shown that prehospital providers, both emergency medical technicians (EMTs) and paramedics, can accurately apply selective spinal immobilization (SSI) to trauma patients [1–9]. However, no studies have examined why emergency medical services (EMS) providers overimmobilize trauma patients. Our study aimed to examine the reasons why prehospital providers in our system overimmobilized trauma patients.
Is arterial base deficit still a useful prognostic marker in trauma? A systematic review I. Ibrahim, W.P. Chor, K.M. Chue, C.S. Tan, H.L. Tan, F.J. Siddiqui, M. Hartman
DOI: http://dx.doi.org/10.1016/j.ajem.2015.12.012
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: December 14 2015
x Arterial base deficit (BD) has been widely used in trauma patients since 1960. However, trauma management has also evolved significantly in the last 2 decades. The first objective of this study was to systematically review the literature on the relationship between arterial BD as a prognostic marker for trauma outcomes (mortality, significant injuries, and major complications) in the acute setting. The second objective was to evaluate arterial BD as a prognosis marker, specifically, in the elderly and in patients with positive blood alcohol levels.
Fiberoptic intubation or video tube for trauma patient intubation—which method to choose? Randomized crossover manikin trial Lukasz Szarpak, Zenon Truszewski, Marcin Madziała, Lukasz Czyzewski
DOI: http://dx.doi.org/10.1016/j.ajem.2016.01.030
The American Journal of Emergency Medicine , Vol. 34 , Issue 4 ,
Published online: January 27 2016
x We read with interest the article of Bilge et al [1] concerning on endotracheal intubation (ETI) with tactical fiberoptic imaging systems. Under the conditions of cervical spine suspected damage and to limit the movements of the spine, direct laryngoscopy using laryngoscope with Macintosh or Miller blade may be difficult [1–3]. In such cases, we should use alternative methods of ETI, including videolaryngoscopes or fiberoptic intubation (FOB).
Pediatric craniomaxillofacial injuries after road traffic crashes: characteristics of injuries and protective equipment use Siti Salmiah Mohd Yunus, Wei Cheong Ngeow, Roszalina Ramli
DOI: http://dx.doi.org/10.1016/j.ajem.2015.05.009
The American Journal of Emergency Medicine , Vol. 33 , Issue 9 ,
Published online: May 15 2015
x A cross-sectional study to determine the pattern of craniomaxillofacial (CMF) injuries among children involved in road traffic crashes was performed. The association of protective equipment use with the CMF injuries was evaluated.
Softball injuries treated in US EDs, 1994 to 2010 John C. Birchak, Lynne M. Rochette, Gary A. Smith
DOI: http://dx.doi.org/10.1016/j.ajem.2013.02.039
The American Journal of Emergency Medicine , Vol. 31 , Issue 6 ,
Published online: April 19 2013
x Softball is a popular participant sport in the United States. This study investigated the epidemiology of softball injuries with comparisons between children and adults.
Swimming injuries treated in US EDs: 1990 to 2008 Katherine A. Pollard, Bethany L. Gottesman, Lynne M. Rochette, Gary A. Smith
DOI: http://dx.doi.org/10.1016/j.ajem.2013.01.028
The American Journal of Emergency Medicine , Vol. 31 , Issue 5 ,
Published online: March 13 2013
x Swimming is one of the most popular recreational activities in the United States. The objective of this study was to investigate the epidemiology of the complete spectrum of injuries associated with swimming and swimming pools treated in US hospital emergency departments.
A case of severe rhabdomyolysis with minor trauma: Is sickle cell trait to blame? Paul Krieger, Nathan Zapolsky, Stephen J. Lowery
DOI: http://dx.doi.org/10.1016/j.ajem.2015.06.035
The American Journal of Emergency Medicine , Vol. 34 , Issue 2 ,
Published online: June 18 2015
x A 37-year-old man with a past medical history of sickle cell trait (SCT) presented to our emergency department (ED) complaining of upper abdominal pain and bilateral shoulder pain, following an assault the prior evening. He reported being pinned on his back with knees on his chest, and repeated punching to his stomach. Physical exam revealed mild tachycardia and diffuse tenderness to palpation of the abdomen, without guarding, rebound, induration, or external signs of trauma. Bilaterally his shoulder exam revealed limited range of motion secondary to pain and tenderness over the trapezius muscles.
Evaluation of myocardial injury through serum troponin I and echocardiography in anaphylaxis Yong Sung Cha, Hyun Kim, Min Hyuk Bang, Oh Hyun Kim, Hyung Il Kim, KyoungChul Cha, Kang Hyun Lee, Sung Oh Hwang
DOI: http://dx.doi.org/10.1016/j.ajem.2015.09.038
The American Journal of Emergency Medicine , Vol. 34 , Issue 2 ,
Published online: October 2 2015
x Anaphylaxis is an acute, lethal, multisystem syndrome that results from the sudden release of mast cell- and basophil-derived mediators. Although anaphylaxis can cause cardiac complications, the incidence of myocardial injury using troponin I (TnI) has not been characterized. In addition, patterns of cardiomyopathy have not been evaluated in patients with elevated TnI. Therefore, we studied the occurrence and patterns of myocardial injury with TnI and echocardiography in anaphylaxis.
Analysis of risk classification for massive transfusion in severe trauma using the gray zone approach Takayuki Ogura, Minoru Nakano, Yoshimitsu Izawa, Mitsunobu Nakamura, Kenji Fujizuka, Alan T. Lefor
DOI: http://dx.doi.org/10.1016/j.ajem.2015.05.007
The American Journal of Emergency Medicine , Vol. 33 , Issue 9 ,
Published online: May 15 2015
x The Traumatic Bleeding Severity Score (TBSS) was developed to predict the need for massive transfusion (MT). The aim of this study is evaluation of clinical thresholds for activation of a MT protocol using the gray zone approach based on TBSS.
Injury and illness sustained by human competitors in the 2010 Iditarod Sled Dog Race James W. Gallea, George L. Higgins III, Carl A. Germann, Tania D. Strout
DOI: http://dx.doi.org/10.1016/j.ajem.2014.02.018
The American Journal of Emergency Medicine , Vol. 32 , Issue 7 ,
Published online: February 26 2014
x Alaska's 1049-mile Iditarod Trail Sled Dog Race is the world's longest sled dog race and the flagship event in the sport of sled dog racing. Race conditions are typically harsh. Physicians are not officially enlisted to care for human competitors. Instead, medical needs are met through an informal system of volunteers, local health care providers, and a fleet of bush planes. The goals of this study were to identify the types of human injury and illness experienced and the methods by which these conditions are treated.
Role of interventional radiology in trauma care: retrospective study from single trauma center experience Nam Yeol Yim, Yong Tae Kim, Hyoung Ook Kim, Jae Kyu Kim, Yang Jun Kang, Yun Chul Park, Chan Yong Park
DOI: http://dx.doi.org/10.1016/j.ajem.2014.07.037
The American Journal of Emergency Medicine , Vol. 32 , Issue 11 ,
Published online: August 7 2014
x Although interventional management is now regarded as essential in trauma care, the effect on clinical result remains uncertain. We conducted this retrospective study to figure out the role of interventional management in trauma care.
Stove-related injuries treated in EDs in the United States, 1990-2010 Anita Sivam, Lynne M. Rochette, Gary A. Smith
DOI: http://dx.doi.org/10.1016/j.ajem.2013.07.034
The American Journal of Emergency Medicine , Vol. 31 , Issue 11 ,
Published online: September 16 2013
x Household stoves are a common source of injury in the United States.
Microwave oven-related injuries treated in hospital EDs in the United States, 1990 to 2010 Dana F. Thambiraj, Thiphalak Chounthirath, Gary A. Smith
DOI: http://dx.doi.org/10.1016/j.ajem.2013.03.023
The American Journal of Emergency Medicine , Vol. 31 , Issue 6 ,
Published online: April 22 2013
x The widespread availability of microwave ovens has sparked interest in injuries resulting from their use.