Accuracy of lung ultrasound for the diagnosis of consolidations when compared to chest computed tomography Peiman Nazerian, Giovanni Volpicelli, Simone Vanni, Chiara Gigli, Laura Betti, Maurizio Bartolucci, Maurizio Zanobetti, Francesca Romana Ermini, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2015.01.035
The American Journal of Emergency Medicine , Vol. 33 , Issue 5 ,
Published online: January 27 2015
x Despite emerging evidences on the clinical usefulness of lung ultrasound (LUS), international guidelines still do not recommend the use of sonography for the diagnosis of pneumonia. Our study assesses the accuracy of LUS for the diagnosis of lung consolidations when compared to chest computed tomography (CT).
High total carbon dioxide predicts 1-year readmission and death in patients with acute dyspnea Nathalie Lund, Anders Rohlén, Per Simonsson, Sofia Enhörning, Torgny Wessman, Klas Gränsbo, Olle Melander
DOI: http://dx.doi.org/10.1016/j.ajem.2015.07.079
The American Journal of Emergency Medicine , Vol. 33 , Issue 10 ,
Published online: July 29 2015
Open Access x Patients with acute dyspnea are a large heterogeneous patient group where initial management is important for outcome.
Use of capnographs to assess quality of pediatric ventilation with 3 different airway modalities Julia Fuzak Freeman, Christopher Ciarallo, Lara Rappaport, Maria Mandt, Lalit Bajaj
DOI: http://dx.doi.org/10.1016/j.ajem.2015.09.012
The American Journal of Emergency Medicine , Vol. 34 , Issue 1 ,
Published online: September 19 2015
x Prehospital pediatric airway management is difficult and controversial. Options include bag-mask ventilation (BMV), endotracheal tube (ETT), and laryngeal mask airway (LMA). Emergency Medical Services personnel report difficulty assessing adequacy of BMV during transport. Capnography, and capnograph tracings in particular, provide a measure of real-time ventilation currently used in prehospital medicine but have not been well studied in pediatric patients or with BMV. Our objective was to compare pediatric capnographs created with 3 airway modalities.
Double-lung point sign in traumatic pneumothorax Anne Aspler, Emanuele Pivetta, Michael B. Stone
DOI: http://dx.doi.org/10.1016/j.ajem.2013.12.059
The American Journal of Emergency Medicine , Vol. 32 , Issue 7 ,
Published online: January 10 2014
x Lung ultrasound has emerged as a rapid and accurate screening tool for pneumothorax. The lung point sign, a sonographic representation of the point on the chest wall where the pleural layers re-adhere, is 100% specific to confirm the diagnosis. Double lung point sign for a single pneumothorax is extremely unusual and has only been reported twice in the literature.
Misdiagnosed rare subglottic lesions with bronchial asthma as the initial symptom Ya-Feng Yu, Hong-Yang Ling, Gen-Sheng Xiao, Peng Sun, Man-Yi Li, Wen-Ying Wu
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.023
The American Journal of Emergency Medicine , Vol. 31 , Issue 8 ,
Published online: May 22 2013
x Early-stage subglottic lesions are easily misdiagnosed as bronchial asthma. We report on 4 cases of rare subglottic lesions. Our aim is to provide insights for the accurate diagnosis of subglottic lesions.
Central extracorporeal membrane oxygenation requiring pulmonary arterial venting after near-drowning Mitsutoshi Kimura, Osamu Kinoshita, Yoshifumi Fujimoto, Arata Murakami, Takahiro Shindo, Koichi Kashiwa, Minoru Ono
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.031
The American Journal of Emergency Medicine , Vol. 32 , Issue 2 ,
Published online: October 30 2013
x Extracorporeal membrane oxygenation (ECMO) is an effective respiratory and circulatory support in patients in refractory cardiogenic shock or cardiac arrest. Peripheral ECMO sometimes requires left heart drainage; however, few reports state that pulmonary arterial (PA) venting is required during ECMO support. We present a case of a 14-year-old boy who required PA venting during ECMO support after resuscitation from near-drowning in freshwater. A biventricular assist device with an oxygenator implantation was intended on day 1; however, we were unable to proceed because of increasing of pulmonary vascular resistance from the acute lung injury.
Emergency management of community-acquired bacterial pneumonia: what is new since the 2007 Infectious Diseases Society of America/American Thoracic Society guidelines Gregory J. Moran, Richard E. Rothman, Gregory A. Volturo
DOI: http://dx.doi.org/10.1016/j.ajem.2012.12.002
The American Journal of Emergency Medicine , Vol. 31 , Issue 3 ,
Published online: February 4 2013
x Community-acquired pneumonia (CAP) is a major health problem in the United States and is associated with substantial morbidity, mortality, and health care costs. Patients with CAP commonly present to emergency departments where physicians must make critical decisions regarding diagnosis and management of pneumonia in a timely fashion, with emphasis on efficient and cost-effective diagnostic choices, consideration of emerging antimicrobial resistance, timely initiation of antibiotics, and appropriate site-of-care decisions.
The role of inferior vena cava diameter in the differential diagnosis of dyspneic patients; best sonographic measurement method? Adnan Yamanoğlu, Nalan G. Çelebi Yamanoğlu, İsmet Parlak, Pelin Pınar, Ali Tosun, Burak Erkuran, Alper Akgür, Neslihan Satılmış Siliv
DOI: http://dx.doi.org/10.1016/j.ajem.2014.12.032
The American Journal of Emergency Medicine , Vol. 33 , Issue 3 ,
Published online: December 26 2014
x We aimed to determine the role of inferior vena cava (IVC) diameter in making a differentiation between dyspnea of cardiac (acute heart failure [AHF]) and pulmonary origin. We also attempted to determine the best sonographic method for the measurement of IVC diameter.
Diagnostic performance of cardiopulmonary ultrasound performed by the emergency physician in the management of acute dyspnea Emeric Gallard, Jean-Philippe Redonnet, Jean-Eudes Bourcier, Dominique Deshaies, Nicolas Largeteau, Jeanne-Marie Amalric, Fouad Chedaddi, Jean-Marie Bourgeois, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2014.12.003
The American Journal of Emergency Medicine , Vol. 33 , Issue 3 ,
Published online: December 11 2014
x The etiologic diagnosis of acute dyspnea in the emergency department (ED) remains difficult, especially for elderly patients or those with previous cardiorespiratory medical history. This may lead to inappropriate treatment and potentially a higher mortality rate. Our objective was to evaluate the performance of cardiopulmonary ultrasound compared with usual care for the etiologic diagnosis of acute dyspnea in the ED.
A woman with cough: gastrobronchial fistula as a delayed complication of bariatric surgery. Case report and literature review Sofiya Greenberg, Nalini Kanth, Anil Kanth
DOI: http://dx.doi.org/10.1016/j.ajem.2013.11.022
The American Journal of Emergency Medicine , Vol. 33 , Issue 4 ,
Published online: November 18 2013
x Bariatric surgery has become the treatment of choice for morbid obesity. This case report aims to increase awareness of the emergency physician of a possible presentation of a gastrobronchial fistula after bariatric surgery. Similar presentation may occur after esophageal or other upper abdominal surgery. Appropriate studies for diagnosis are contrast-enhanced abdominal computed tomography and upper gastrointestinal studies.
Diffuse idiopathic skeletal hyperostosis as an acute airway presentation requiring urgent tracheostomy Jonathan H. Bird, Timothy C. Biggs, Petros D. Karkos, Costa Repanos
DOI: http://dx.doi.org/10.1016/j.ajem.2014.10.050
The American Journal of Emergency Medicine , Vol. 33 , Issue 5 ,
Published online: November 8 2014
x Diffuse idiopathic skeletal hyperostosis is an idiopathic disorder characterized by intervertebral bridges of ossification along the anterior and lateral aspects of the spine. This case report describes an 87-year-old man presenting with an acute onset of stridor. Computed tomography revealed a large osteophyte originating from the cervical spine requiring tracheostomy due to a critical narrowing of the laryngeal inlet. Diffuse idiopathic skeletal hyperostosis is a common cause of dysphagia but rarely results in critical airway obstruction.
Cardiac disease in pediatric patients presenting to a pediatric ED with chest pain David M. Drossner, Daniel A. Hirsh, Jesse J. Sturm, William T. Mahle, David J. Goo, Robert Massey, Harold K. Simon
DOI: http://dx.doi.org/10.1016/j.ajem.2010.01.011
The American Journal of Emergency Medicine , Vol. 29 , Issue 6 ,
Published online: July 14 2010
x Chest pain is a frequent chief complaint among the pediatric population. To date, limited data exist on the full spectrum of emergent cardiac disease among such patients; and existing data have been limited to relatively small cohorts.
Sevoflurane administration initiated out of the ED for life-threatening status asthmaticus Daniel Ng, Jahan Fahimi, H. Gene Hern
DOI: http://dx.doi.org/10.1016/j.ajem.2015.01.005
The American Journal of Emergency Medicine , Vol. 33 , Issue 8 ,
Published online: January 16 2015
x Status asthmaticus is both a common and dangerous cause of acute dyspnea in the emergency department (ED) setting. Although most cases respond favorably to standard treatment, there are rare cases in which therapy beyond traditional treatment is needed. One of these treatment modalities includes inhalational anesthesia. We present a case in which inhaled sevoflurane was initiated out of the ED for a life-threatening asthma exacerbation refractory to conventional treatment. To our knowledge, this is only the second case to report the use of inhaled anesthetics initiated out of the ED for status asthmaticus and is the first report of its kind to thoroughly detail the respiratory response noted while inhalation anesthesia was being implemented.
Extracorporeal membrane oxygenation for refractory, life-threatening, and herpes simplex virus 1–induced acute respiratory distress syndrome. Our experience and literature review Massimo Bonacchi, Gabriella Di Lascio, Guy Harmelin, Andrea Pasquini, Adriano Peris, Guido Sani
DOI: http://dx.doi.org/10.1016/j.ajem.2011.04.011
The American Journal of Emergency Medicine , Vol. 30 , Issue 6 ,
Published online: June 13 2011
x We report our first experience of treating an immunocompetent adult patient with acute respiratory distress syndrome (ARDS) due to type 1 herpes simplex (HSV1) pneumonitis, using extracorporeal membrane oxygenation (ECMO). Similar cases reported in literature are reviewed as well. The therapeutic options for this particular complication are discussed. Pneumonia caused by HSV1 is a rare finding in immunocompetent individuals; it occurs more often in immunosuppressed and ventilated patients. It is a severe illness; therefore, early diagnosis and initiation of treatment are imperative.
Cytokine markers as predictors of type of respiratory infection in patients during the influenza season John Patrick Haran, Rachel Buglione-Corbett, Shan Lu
DOI: http://dx.doi.org/10.1016/j.ajem.2013.01.030
The American Journal of Emergency Medicine , Vol. 31 , Issue 5 ,
Published online: March 7 2013
x The objective of this study is to characterize the cytokine response among patients presenting with an influenza-like illness who are infected with the influenza virus, a bacterial pneumonia, or another viral infection. We hypothesize that there are differences in proinflammatory and anti-inflammatory cytokines in relation to cytokines associated with the humoral response during viral and bacterial respiratory infections.
Adult asthma exacerbations and environmental triggers: a retrospective review of ED visits using an electronic medical record Larissa May, Marianne Carim, Kabir Yadav
DOI: http://dx.doi.org/10.1016/j.ajem.2010.06.034
The American Journal of Emergency Medicine , Vol. 29 , Issue 9 ,
Published online: August 16 2010
x Despite familiarity with triggers for asthma, there is little recent study on the association of triggers with the emergency department (ED) presentation of adult asthma exacerbation.
Severe dengue with massive pleural effusion requiring urgent intercostal chest tube drainage: a case report Afzal Azim, Jyoti N. Sahoo, Arvind K. Baronia, Mohan Gurjar, Ratendra K. Singh, Banani Poddar, Armin Ahmed, Piyush Garg, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2010.12.024
The American Journal of Emergency Medicine , Vol. 30 , Issue 2 ,
Published online: February 28 2011
x Dengue is one of the most common mosquito-borne infection affecting more than 50 million people worldwide annually. Most common causes for dengue-associated mortality are shock, bleeding, and respiratory failure.
A comparison of different diagnostic tests in the bedside evaluation of pleuritic pain in the ED Giovanni Volpicelli, Luciano Cardinale, Paola Berchialla, Alessandro Mussa, Fabrizio Bar, Mauro F. Frascisco
DOI: http://dx.doi.org/10.1016/j.ajem.2010.11.035
The American Journal of Emergency Medicine , Vol. 30 , Issue 2 ,
Published online: January 31 2011
x Bedside lung ultrasound (LUS) is useful in detecting radio-occult pleural-pulmonary lesions. The aim of our study is to compare the value of LUS with other conventional routine diagnostic tools in the emergency department (ED) evaluation of patients with pleuritic pain and silent chest radiography (CXR).
Sonographic evidence of spontaneous pneumomediastinum Lorraine Ng, Turandot Saul, Resa E. Lewiss
DOI: http://dx.doi.org/10.1016/j.ajem.2012.08.019
The American Journal of Emergency Medicine , Vol. 31 , Issue 2 ,
Published online: November 19 2012
x Spontaneous pneumomediastinum (SPM) is defined as a non-traumatic air leak from alveolar, bronchial or esophageal rupture along vascular sheaths and tissue planes into the mediastinum due to increased pressure in the trachea, bronchi, alveoli or esophagus [1]. SPM is rare in children, with a bimodal incidence peaking in children less than 7 years of age and then again in adolescence [1]. Historically, the diagnosis of SPM is made with physical examination findings and chest radiography.
Endogenous carboxyhemoglobin concentrations in the assessment of severity in patients with community-acquired pneumonia Seref Kerem Corbacioglu, Isa Kilicaslan, Fikret Bildik, Atacan Guleryuz, Burak Bekgoz, Ayca Ozel, Ayfer Keles, Ahmet Demircan
DOI: http://dx.doi.org/10.1016/j.ajem.2012.10.005
The American Journal of Emergency Medicine , Vol. 31 , Issue 3 ,
Published online: December 7 2012
x Previous studies have shown that carbon monoxide, which is endogenously produced, is increased in community-acquired pneumonia (CAP). However, it has not been studied enough whether severity of pneumonia is correlated with increased carboxyhemoglobin (COHb) concentrations in CAP. The aim of this study was to determine whether endogenous carbon monoxide levels in patients with CAP were higher compared with the control group and, if so, to determine whether COHb concentrations could predict severity in CAP.
