Delayed enterothorax and hepatothorax due to missed right-sided traumatic diaphragmatic rupture Ali Guner, Yildiray Bekar, Can Kece, Izzettin Kahraman, Cem Sezer, Erhan Reis
DOI: http://dx.doi.org/10.1016/j.ajem.2010.11.016
The American Journal of Emergency Medicine , Vol. 30 , Issue 1 ,
Published online: January 5 2011
x Traumatic diaphragma ruptures (DRs) are an unusual condition after blunt thoracoabdominal trauma, and there are some difficulties in the diagnosis, in the absence of the additional life-threatening injuries. Right-sided injuries are less frequent than left-sided injuries and may be missed easily. Intrathoracic herniation of abdominal organs is an uncommon condition for right-sided DR. Particularly, to our knowledge, progressive hepatothorax and enterothorax that develop over years are a very rare presentation of DR.
Analysis of closed malpractice medical claims against Taiwanese EDs: 2003 to 2012 Kuan-Han Wu, Chien-Hung Wu, Shih-Yu Cheng, Wen-Huei Lee, Chia-Te Kung
DOI: http://dx.doi.org/10.1016/j.ajem.2014.05.033
The American Journal of Emergency Medicine , Vol. 32 , Issue 9 ,
Published online: May 31 2014
x The objective of the study is to examine the epidemiologic data of closed malpractice medical claims against emergency departments (EDs) in Taiwanese civil courts and to identify high-risk diseases.
Urgent interscalene brachial plexus block for management of traumatic luxatio erecta in the ED Graham Brant-Zawadzki, Andrew Herring
DOI: http://dx.doi.org/10.1016/j.ajem.2014.12.036
The American Journal of Emergency Medicine , Vol. 33 , Issue 7 ,
Published online: December 26 2014
x Trauma in the emergency department may present providers with a myriad of unforeseen clinical scenarios. We present an example of how an urgent nerve block facilitated rapid management of a luxatio erecta shoulder fracture-dislocation without sedation. A 20-year-old female pedestrian presented to our level II trauma center after being stuck by a motor vehicle. At arrival, she had clinical indications of severe blunt trauma as well as a left-sided luxatio erecta shoulder dislocation and fracture.
Pulmonary laceration secondary to a traumatic soccer injury: a case report and review of the literature Sanjin Idriz, Ausami Abbas, Sufi Sadigh, Simon Padley
DOI: http://dx.doi.org/10.1016/j.ajem.2013.06.032
The American Journal of Emergency Medicine , Vol. 31 , Issue 11 ,
Published online: September 23 2013
x Pulmonary lacerations are an uncommon injury typically associated with high-impact trauma. Most cases occur as a result of high-speed road traffic collisions. Although chest wall and pleural injuries are commonly associated with sports-related thoracic trauma, pulmonary injuries are far less common. There are only a few reported cases of significant pulmonary trauma associated with sports injuries, the majority of which have described pulmonary contusions occurring as a result of thoracic injury sustained while playing high-impact contact sports such as American football.
Differences of postresuscitation myocardial dysfunction in ventricular fibrillation versus asphyxiation Cai-Jun Wu, Chun-Sheng Li, Yi Zhang, Jun Yang, Qin Yin, Chen-Chen Hang
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.017
The American Journal of Emergency Medicine , Vol. 31 , Issue 12 ,
Published online: September 16 2013
x This study aims to characterize postresuscitation myocardial dysfunction in 2 porcine models of cardiac arrest (CA): ventricular fibrillation cardiac arrest (VFCA) and asphyxiation cardiac arrest (ACA).
Sternal fractures and delayed cardiac tamponade due to a severe blunt chest trauma Huai-min Liang, Qiu-lin Chen, Er-yong Zhang, Jia Hu
DOI: http://dx.doi.org/10.1016/j.ajem.2015.07.075
The American Journal of Emergency Medicine , Vol. 34 , Issue 4 ,
Published online: July 29 2015
x Sternal fractures caused by blunt chest trauma are associated with an increased incidence of cardiac injury. Reports of the incidence of cardiac injury associated with sternal fracture range from 18% to 62% [1]. Delayed cardiac tamponade is a rare phenomenon that appears days or weeks after injury. Moreover, after nonpenetrating chest trauma, cardiac tamponade is very rare and occurs in less than 1 of 1000 [2]. This case describes a patient who had delayed cardiac tamponade 17 days after a severe blunt chest trauma.
Nebulized fentanyl vs intravenous morphine for ED patients with acute limb pain: a randomized clinical trial Shervin Farahmand, Said Shiralizadeh, Mohammad-Taghi Talebian, Shahram Bagheri-Hariri, Mona Arbab, Hamed Basirghafouri, Morteza Saeedi, Mojtaba Sedaghat, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2014.05.051
The American Journal of Emergency Medicine , Vol. 32 , Issue 9 ,
Published online: June 12 2014
x Intravenous morphine has been used as a common method of pain control in emergency care. Nebulized fentanyl is also an effective temporary substitute. This study was designed to compare the effectiveness of nebulized fentanyl with intravenous (IV) morphine on management of acute limb pain.
Atraumatic painless compartment syndrome Scott Blanchard, Gregory D. Griffin, Erin L. Simon
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.008
The American Journal of Emergency Medicine , Vol. 31 , Issue 12 ,
Published online: September 16 2013
x Acute compartment syndrome is a time-sensitive diagnosis and surgical emergency because it poses a threat to life and the limbs. It is defined by Matsen et al (Surg Gynecol Obstet . 1978;147(6):943–949) as “a condition in which increased pressure within a limited space compromises the circulation and function of the tissues within that space.” The most common cause of compartment syndrome is traumatic injury. A variety of other conditions such as vascular injuries, bleeding disorders, thrombosis, fasciitis, gas gangrene, rhabdomyolysis, prolonged limb compression, cellulitis, and nephrotic syndrome may also cause compartment syndrome.
Hollow organ perforation in blunt abdominal trauma: the role of diagnostic peritoneal lavage Yu-Chun Wang, Chi-Hsun Hsieh, Chih-Yuan Fu, Chun-Chieh Yeh, Shih-Chi Wu, Ray-Jade Chen
DOI: http://dx.doi.org/10.1016/j.ajem.2011.02.014
The American Journal of Emergency Medicine , Vol. 30 , Issue 4 ,
Published online: May 13 2011
x With recent advances in radiologic diagnostic procedures, the use of diagnostic peritoneal lavage (DPL) has markedly declined. In this study, we reviewed data to reevaluate the role of DPL in the diagnosis of hollow organ perforation in patients with blunt abdominal trauma.
Compartment syndrome on a patient's forearm related to carbon monoxide poisoning Behçet Al, Mehmet Subası, Burçin Karsli, Pınar Yarbil, Suat Zengin
DOI: http://dx.doi.org/10.1016/j.ajem.2012.03.011
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published online: June 4 2012
x Carbon monoxide (CO) is a colorless, odorless, nonirritating, toxic gas produced by the incomplete oxidation of hydrocarbons. Common sources of CO include motor vehicles, house fires, furnaces/heaters, and wood-burning stoves. It is a serious health problem resulting in approximately 50 000 visits to the emergency department and is responsible for 3500 deaths annually in the United States. Besides accidental exposure, CO is also one of the leading causes of death by suicide. In the present study, we discuss compartment syndrome caused by CO poisoning in a 15-year-old boy.
Cardiopulmonary arrest due to early hyperkalemia after liver injury Junna Matsuda, Tetsunosuke Shimizu, Tadahiro Kittaka, Makiko Fukuda, Hiroshi Akimoto
DOI: http://dx.doi.org/10.1016/j.ajem.2014.04.012
The American Journal of Emergency Medicine , Vol. 32 , Issue 11 ,
Published online: April 17 2014
x Hyperkalemia due to crush syndrome after trauma is a well-known fatal clinical condition, but early hyperkalemia with hemorrhage after trauma is a rare phenomenon. We report on a 5-year-old boy who bruised from the lumbers, had cardiopulmonary arrest caused by hyperkalemia, and underwent perihepatic packing twice before being discharged without any neurologic deficits. Clinicians should be vigilant for signs of hyperkalemia accompanying hemorrhagic shock, even in the early phase of trauma.
Imaging in the NEXUS-negative patient: when we break the rule John Morrison, Rebecca Jeanmonod
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.062
The American Journal of Emergency Medicine , Vol. 32 , Issue 1 ,
Published online: October 7 2013
x In spite of general acceptance and validation of NEXUS (National Emergency X-Radiography Utilization Study) in the clearance of cervical spine (C-spine) immobilized patients, clinicians often elect to image NEXUS-negative patients in clinical practice.
Major trauma registry of Navarre (Spain): the accuracy of different survival prediction models Tomas Belzunegui, Carlos Gradín, Mariano Fortún, Ana Cabodevilla, Adrian Barbachano, Jose Antonio Sanz
DOI: http://dx.doi.org/10.1016/j.ajem.2013.06.026
The American Journal of Emergency Medicine , Vol. 31 , Issue 9 ,
Published online: July 29 2013
x To determine which factors predict death among trauma patients who are alive on arrival at hospital.
Higher glucose on admission is associated with need for angioembolization in stable pelvic fracture Chih Yuan Fu, Yu Chun Wang, Shih Chi Wu, Yuan Fang Chen, Ray Jade Chen, Chi Hsun Hsieh, Hung Chang Huang, Jui Chien Huang, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2010.07.023
The American Journal of Emergency Medicine , Vol. 30 , Issue 1 ,
Published online: October 15 2010
x Angioembolization is an effective adjunct to the management of retroperitoneal hemorrhage in pelvic fractures. Most patients with stable-type pelvic fracture are treated conservatively. However, in some stable pelvic fracture cases, patients should receive angioembolization for hemostasis upon incidental finding of contrast extravasation on computed tomography (CT). In this study, we attempted to define the characteristics of patients with stable pelvic fracture requiring angioembolization.
Prognostic evaluation of the troponin I elevation after multiple spontaneous shocks of the implantable cardioverter/defibrillator Carlos Henrique Miranda, André Schmidt, Antônio Pazin-Filho
DOI: http://dx.doi.org/10.1016/j.ajem.2014.04.053
The American Journal of Emergency Medicine , Vol. 32 , Issue 9 ,
Published online: May 12 2014
x Multiple shocks of the implantable cardioverter/defibrillator (ICD) can cause myocardial injury, contributing to the progression of underlying heart disease. The aim was to evaluate if the elevation of troponin I after multiple ICD shocks has impact on the prognostic of these patients.
The sports medicine literature 2013 Monique Alworth, Michael C. Bond, William J. Brady
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.005
The American Journal of Emergency Medicine , Vol. 33 , Issue 9 ,
Published online: July 13 2015
x Concussion is one of the most widely discussed topics in sports medicine. The general public has an increasing awareness about closed head injuries and the devastating effects they can have on athletes. Some sports are changing the way the game is played—from adding protective equipment in women’s lacrosse to enforcing stricter rules against aggression in ice hockey. The Centers for Disease Control and Prevention (CDC) reports that emergency departments (ED) in the United States treat an estimated 173,285 sports- and recreation-related traumatic brain injuries (TBIs) in children and adolescents (from birth to 19 years of age) every year [1].
Comparing biomarkers of traumatic shock: the utility of anion gap, base excess, and serum lactate in the ED Nicholas D. Caputo, Marc Kanter, Robert Fraser, Ronald Simon
DOI: http://dx.doi.org/10.1016/j.ajem.2015.04.085
The American Journal of Emergency Medicine , Vol. 33 , Issue 9 ,
Published online: May 7 2015
x Biomarkers such as serum lactate, anion gap (AG), and base excess (BE) have been shown to be of use in determining shock in patients with seemingly normal vital signs. We seek to determine if these biomarkers can be used interchangeably in patients with trauma in the emergency setting based on their test characteristics and correlation to each other.
Symptomatic internal carotid artery thrombosis in acute carbon monoxide intoxication Tiago Teodoro, Ruth Geraldes, Teresa Pinho e Melo
DOI: http://dx.doi.org/10.1016/j.ajem.2013.11.047
The American Journal of Emergency Medicine , Vol. 32 , Issue 6 ,
Published online: December 9 2013
x Stroke has been rarely associated with carbon monoxide (CO) intoxication. We report a symptomatic internal carotid artery (ICA) thrombosis in a patient with acute CO intoxication.
Anterior chamber depth measurement using ultrasound to assess elevated intraocular pressure Getaw Worku Hassen, Brett Sweeney, Tania Portillo, Dinah Ali, Omer Nazeer, Rania Habal, Miguel Arbulu, Roger Chirurgi, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2014.11.042
The American Journal of Emergency Medicine , Vol. 33 , Issue 6 ,
Published online: December 1 2014
x Increased anterior chamber pressure also known as intraocular pressure can result from conditions such as glaucoma and trauma. The pressure in the anterior chamber is measured using tonometer. Measurement of the intraocular pressure is essential, as it requires immediate medical attention to alleviate pain and to avoid temporary or permanent damage to intraocular structures. Bedside ocular ultrasound (US) has gained popularity in recent years. It has been used to assess intracranial pressure via optic nerve sheath diameter (ONSD) and evaluate retinal detachment, vitreous hemorrhage, or pupillary reflex in a trauma patient.
The association between acute alcohol consumption and discharge against medical advice of injured patients in the ED Joo Jeong, Kyoung Jun Song, Yu Jin Kim, Jin Seong Cho, Ju Ok Park, Seung Chul Lee, Young Sun Ro, James F. Holmes
DOI: http://dx.doi.org/10.1016/j.ajem.2015.11.065
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: December 4 2015
x A paucity of data exists on the prevalence and predictors of discharging injured patients against medical advice from emergency departments. The aim of this study is to investigate the association between acute alcohol use and being discharged against medical advice.
