Predicting a life-threatening disease and death among ambulance-transported patients with chest pain or other symptoms raising suspicion of an acute coronary syndrome Johan Herlitz, Elisabeth Hansson, Eva Ringvall, Mia Starke, Lisbeth Waagstein, Björn W. Karlson
DOI: http://dx.doi.org/10.1053/ajem.2002.35461
The American Journal of Emergency Medicine , Vol. 20 , Issue 7 ,
Published in issue: November 2002
x The purpose of this study was to evaluate the possibility to predict in the prehospital phase the occurrence of a life-threatening disease or death among ambulance transported patients with acute chest pain or other symptoms raising any suspicion of an acute coronary syndrome. All patients transported by ambulance during 3 months in the community of Göteborg because of symptoms raising any suspicion of an acute coronary syndrome were included in the study. In all, 930 transports (of 859 patients) fulfilled the inclusion criteria, of which 235 (25.3%) fulfilled the critera for a life-threatening disease.
Routine biological tests in self-poisoning patients: Results from an observational prospective multicenter study Thomas Reydel, Jean-Christophe Callahan, Laurent Verley, Christelle Teiten, Christophe Andreotti, Yann Erick Claessens, David Missud, Erwan L'Her, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2016.04.002
Publication stage: In Press Accepted Manuscript
The American Journal of Emergency Medicine
Published online: April 5 2016
x Routine biological tests are frequently ordered in self-poisoning patients, but their clinical relevance is poorly studied.
Acidosis is a life-threatening condition regardless of the underlying condition Cenker Eken
DOI: http://dx.doi.org/10.1016/j.ajem.2008.03.038
The American Journal of Emergency Medicine , Vol. 26 , Issue 6 ,
Published in issue: July 2008
x Firstly, thanks to Liu et al [1] for their article about the effect of acidosis on mortality in organophosphate poisonings. However, I have some concerns on the hypothesis of the article.
Non-life-threatening blunt chest trauma: Appropriate investigation and treatment Isser Dubinsky, Aaron Low
DOI: http://dx.doi.org/10.1016/S0735-6757(97)90004-8
The American Journal of Emergency Medicine , Vol. 15 , Issue 3 ,
Published in issue: May 1997
x Non-life-threatening blunt chest trauma is a commonly occurring phenomenon. No clear guidelines exist in the literature regarding the appropriate investigation and treatment, and most clinicians' practice patterns are based on anecdote, individual experience, and the theoretical risk of complications. A prospective study was undertaken of all patients with non-life-threatening blunt chest trauma presenting to a high-volume, community-based teaching hospital emergency department. No clinical features were found to have a high enough positive predictive value for rib fracture or any other injury to warrant their use as a screening tool for further investigations.
Prevalence of life-threatening arrhythmias in ED patients transported to the radiology suite while monitored by telemetry Selin Caglar, Stephen Leffler
DOI: http://dx.doi.org/10.1016/j.ajem.2006.01.028
The American Journal of Emergency Medicine , Vol. 24 , Issue 6 ,
Published in issue: October 2006
x The aim of this study was to determine the prevalence of life-threatening arrhythmias in monitored ED patients while in the radiology suite.
Erratum Shih-Hua Lin
DOI: http://dx.doi.org/10.1016/j.ajem.2009.01.019
The American Journal of Emergency Medicine , Vol. 27 , Issue 4 ,
Published in issue: May 2009
x In the article “In-flight Valsalva maneuver induced life-threatening Wünderlich syndrome,” published in Am J Emerg Med 2008 ;26(6):732.e5-6 listed the authors out of order. The correct byline is below.
Transarterial embolization in the management of life-threatening hemorrhage after maxillofacial trauma: a case report and review of literature Wei-Hsiu Liu, Yuan-Hao Chen, Cheng-Ta Hsieh, En-Yuan Lin, Tzu-Tsao Chung, Da-Tong Ju
DOI: http://dx.doi.org/10.1016/j.ajem.2007.07.036
The American Journal of Emergency Medicine , Vol. 26 , Issue 4 ,
Published in issue: May 2008
x There are many reasons for hypotension in trauma patients. Life-threatening hemorrhage associated with maxillofacial trauma is considered rare. Here, we present a 25-year-old patient with maxillofacial trauma complicated by life-threatening hemorrhage after a traffic accident. At the emergency department, massive epistaxis was noted. Nasal packing and blood transfusion were performed, but vital signs of the patient were still unstable. Cerebral angiography revealed contrast extravasation from the left superficial temporal and internal maxillary arteries of the left external carotid artery.
Transarterial embolization in the treatment of life-threatening maxillofacial bleeding Chih-Yuan Lee, Ming-Hong Chen, Tzu-Hsin Lin, Shyr-Chyr Chen
DOI: http://dx.doi.org/10.1053/ajem.2002.33773
The American Journal of Emergency Medicine , Vol. 20 , Issue 4 ,
Published in issue: July 2002
x —Traffic accidents are an important cause of facial trauma because the drivers usually have little facial protection. Those patients suffering facial trauma seldom die without airway problems, massive bleeding, or aspiration of blood into the lungs. However, facial trauma associated with life-threatening hemorrhage is rare. We present a patient with exsanguinating epistaxis after maxillofacial trauma caused by a traffic accident. Epistaxis was finally controlled by angiographic embolization.
Initial serum glucose level and white blood cell predict ventricular arrhythmia after first acute myocardial infarction Jiann-Hwa Chen, Chiu-Liang Tseng, Shin-Han Tsai, Wen-Ta Chiu
DOI: http://dx.doi.org/10.1016/j.ajem.2008.12.036
The American Journal of Emergency Medicine , Vol. 28 , Issue 4 ,
Published online: February 8 2010
x The aims of this study are to analyze the factors that predispose the occurrence of ventricular arrhythmia (VA) in young patients with a first acute myocardial infarction (AMI) in the emergency department (ED) and to establish predictive implications.
Angioembolization as an effective alternative for hemostasis in intractable life-threatening maxillofacial trauma hemorrhage: case study Shih-Chi Wu, Ray-Jade Chen, Kwo-Whei Lee, Cheng-Cheng Tung, Wen-Pei Lin, Poon Yi
DOI: http://dx.doi.org/10.1016/j.ajem.2007.02.039
The American Journal of Emergency Medicine , Vol. 25 , Issue 8 ,
Published in issue: October 2007
x Life-threatening maxillofacial trauma hemorrhage is not common; oronasal hemorrhage from maxillofacial trauma can often be managed with manual compression or efficient tight packing. Surgery is reserved for cases where failure of tight packing occurs. However, the use of angioembolization might decrease the need for blood transfusion and provide an effective alternative for early hemostasis after packing failure. We report 7 cases wherein angioembolization was successfully performed for hemostasis of life-threatening maxillofacial trauma hemorrhage.
Serious conditions for emergency department elderly fall patients: a secondary analysis of the Basel Nonspecific Complaints study Shan W. Liu, Jiraporn Sri-On, Gregory Philip Tirrell, Christian Nickel, Roland Bingisser
DOI: http://dx.doi.org/10.1016/j.ajem.2016.04.007
Publication stage: In Press Accepted Manuscript
The American Journal of Emergency Medicine
Published online: April 9 2016
x Falls among older adults are a public health problem and are multi-factorial. We sought to determine whether falls predict more serious conditions in older adult patients presenting to the emergency department (ED) with a nonspecific complaint (NSC). A secondary objective was to examine what factors predicted serious conditions among older adult patients with a fall.
Case of infective endocarditis with initial presentation of visual disturbances Fong-Pu Chang, Cheng-Yu Chien, Chung-Hsien Chaou, Ching-Hsing Lee
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.013
Publication stage: In Press Corrected Proof
The American Journal of Emergency Medicine
Published online: March 7 2016
x Infective endocarditis (IE) is not uncommonly treated in daily emergency department (ED) practice, but can sometimes be life-threatening. The diagnosis of IE may pose a challenge to ED physicians because of its possible vague or atypical presenting symptoms. We present herein a previously healthy 23-year-old woman who visited the hospital after having progressively blurred vision in the prior 3 days. During the medical history inquiry, she mentioned mild and intermittent low grade fevers but no other specific discomfort.
Clinical profile of injection drug users presenting to the ED Daniel R. Kievlan, Meri Gukasyan, Julie Gesch, Robert M. Rodriguez
DOI: http://dx.doi.org/10.1016/j.ajem.2015.02.020
The American Journal of Emergency Medicine , Vol. 33 , Issue 5 ,
Published online: February 19 2015
x Injection drug users (IDUs) commonly use the emergency department (ED) as their primary health care access point.
Anaphylaxis from administration of intravenous thiamine James M. Stephen, Robert Grant, Charlotte S. Yeh
DOI: http://dx.doi.org/10.1016/0735-6757(92)90129-L
The American Journal of Emergency Medicine , Vol. 10 , Issue 1 ,
Published in issue: January 1992
x The routine administration of intravenous thiamine in the emergency department has become widespread. Although anaphylaxis from intravenous thiamine is felt to be uncommon, it can be life threatening. The authors present such a case and review the literature regarding this clinical entity. This case of anaphylactic reaction appears to be the first instance reported since 1946 in the US literature. However a review revealed that cases of anaphylaxis from thiamine have been reported with some regularity in the non-US literature.
Severe explosive headache: a sole presentation of acute myocardial infarction in a young man Vei-Ken Seow, Chee-Fah Chong, Tzong-Luen Wang, Jiann-Ruey Ong
DOI: http://dx.doi.org/10.1016/j.ajem.2006.11.014
The American Journal of Emergency Medicine , Vol. 25 , Issue 2 ,
Published in issue: February 2007
x Acute myocardial infarction is a potentially life-threatening disease that must be diagnosed early and accurately at the emergency department. Its diagnosis may be difficult if manifested solely as a severe explosive headache in a young, nondiabetic, and nonobese man. We report a case of ST-elevation myocardial infarction that was initially misdiagnosed as a case of headache until routine electrocardiography was obtained.
Validation of a 6-hour observation period for cocaine body stuffers Zhanna Livshits, Delbert Clark, Miguel Gutierrez, Robert S. Hoffman
DOI: http://dx.doi.org/10.1016/j.ajem.2011.01.016
The American Journal of Emergency Medicine , Vol. 29 , Issue 5 ,
Published online: April 29 2011
x The recent article by Heard et al [1] heightened awareness of the challenges faced by physicians evaluating “body stuffers.” Although serious complications after cocaine body stuffing, such as seizures, typically occur rapidly after ingestion, there is at least 1 report of delayed seizures in a crack cocaine body stuffer, occurring at 10 to 24 hours postingestion [2]. This presents a controversy in defining an appropriate time for observation under medical supervision.
Acid-base interpretation as a predictor of outcome in acute organophosphate poisoning Ya-Fei Yang
DOI: http://dx.doi.org/10.1016/j.ajem.2008.03.039
The American Journal of Emergency Medicine , Vol. 26 , Issue 6 ,
Published in issue: July 2008
x We really appreciate Dr Eken's inspiring feedback about our article entitled “Acid-base interpretation can be the predictor of outcome among patients with acute organophosphate poisoning before hospitalization.” In regard to the null hypothesis, H1, that acidosis is associated with mortality regardless of the underlying condition, we agreed with Dr Eken's opinion that acidosis is a life-threatening condition. However, quite a few studies have shown that acidosis may not be associated with mortality in certain groups of patients[1-4], suggesting the need to study the influence of acidosis in patients with difference underlying conditions.
Triage flowchart to rule out acute coronary syndrome Miquel Sánchez, Beatriz López, Ernest Bragulat, Elisenda Gómez-Angelats, Sònia Jiménez, Mar Ortega, Blanca Coll-Vinent, Josep R. Alonso, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2006.12.025
The American Journal of Emergency Medicine , Vol. 25 , Issue 8 ,
Published in issue: October 2007
x The aim of the study was to establish a triage flowchart to rule out acute coronary syndrome (ACS) among patients with chest pain (CP) arriving on an Emergency Department (ED).
Prehospital seizure management: Triage criteria for the advanced life support rescue team Neal Robert Abarbanell
DOI: http://dx.doi.org/10.1016/0735-6757(93)90126-V
The American Journal of Emergency Medicine , Vol. 11 , Issue 3 ,
Published in issue: May 1993
x The present study was completed to establish advanced life support (ALS) versus non-ALS triage criteria for use by ALS prehospital personnel when faced with the seizure patient, in the hope of more efficient use of ALS rescue teams. Preselected triage criteria for acuity of care based on neurological condition, vital signs, and concomitant illness/injury were tested against retrospective data (paramedic run reports) collected on 230 patients. Triage criteria sensitivity (SENS), specificity (SPEC), positive predictive value (PPV), and negative predictive value (NPV) were determined with a 95% confidence interval (CI).
How well do General EMS 911 dispatch protocols predict ED resource utilization for pediatric patients? Stephanie J. Fessler, Harold K. Simon, Arthur H. Yancey II, Michael Colman, Daniel A. Hirsh
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.018
The American Journal of Emergency Medicine , Vol. 32 , Issue 3 ,
Published online: December 26 2013
x The use of Emergency Medical Services (EMS) for low-acuity pediatric problems is well documented. Attempts have been made to curb potentially unnecessary transports, including using EMS dispatch protocols, shown to predict acuity and needs of adults. However, there are limited data about this in children. The primary objective of this study is to determine the pediatric emergency department (PED) resource utilization (surrogate of acuity level) for pediatric patients categorized as “low-acuity” by initial EMS protocols.
