Johanna Bischof, Stephen W. Smith
DOI: http://dx.doi.org/10.1016/j.ajem.2016.04.019
Publication stage: In Press Accepted Manuscript
Published online: April 13 2016
x We thank Dr. Cerlik very much for his comments relating to our paper, ‘ST depression in lead aVL differentiates inferior ST elevation myocardial infarction from pericarditis.’ Our aim with this paper was to identify a sensitive and specific finding to differentiate inferior STEMI from pericarditis in the acute clinical context of the emergency department. We found that any ST depression in aVL was highly sensitive and specific in this setting, and is a very useful clinical tool to quickly identify patients who require immediate cardiac catheterization.
Bedia Gulen, Cenker Eken, Okkes Taha Kucukdagli, Mustafa Serinken, Abdurrahim Kocyigit, Elif Kılıc, Hüseyin Uyarel
DOI: http://dx.doi.org/10.1016/j.ajem.2016.04.014
Publication stage: In Press Accepted Manuscript
Published online: April 13 2016
x Hypertension (HT) is the most important risk factor for cardiovascular diseases, and ranks 4th among the most frequently seen medical conditions. Nearly 75% of hypertensive USA population can not maintain their blood pressures at 140/90 mm Hg, and consequently many patients present to the emergency department (ED) because of high blood pressure. Most scaring complication of hypertension is hypertensive emergency which defined as large elevations in SBP or DBP (>
Seong Yeon Park, Won Sup Oh, Yeon-Sook Kim, Joon Sup Yeom, Hee Kyoung Choi, Yee Gyung Kwak, Jae-Bum Jun, Jin-Won Chung, Ji-Young Rhee, Baek-Nam Kim
DOI: http://dx.doi.org/10.1016/j.ajem.2016.04.018
Publication stage: In Press Accepted Manuscript
Published online: April 13 2016
x Acute pyelonephritis (APN) is one of the most common bacterial infections. Because healthcare-associated (HCA) infections in the community setting have similar characteristics to hospital-acquired infections, HCA infections should be distinguished from community-acquired (CA) infections. However, the impact of HCA-APN on treatment outcomes has not been clearly defined. This study aimed to analyze the impact of HCA-APN on the appropriateness of empiric antibiotic therapy and outcomes in community-onset APN.
Nicole Piela, Steven Kornweiss, Alfred Sacchetti, Amanda Gallagher, Allen Abrams
DOI: http://dx.doi.org/10.1016/j.ajem.2016.04.017
Publication stage: In Press Accepted Manuscript
Published online: April 13 2016
x Placement of TVPs is a core EM procedure. Despite this, there is no specific outcome data on this procedure in the ED setting. This study examines the success of Emergency Physician (EP) attempted TVPs as well as their hospital courses and survivals.
Alberto Bouzas-Mosquera, Jesús Peteiro, Francisco J. Broullón, Nemesio Álvarez-García, Nicolás Maneiro-Melón, Patricia Pardo-Martinez, Marta Sagastagoitia-Fornie, Dolores Martínez, Juan C. Yáñez, José Manuel Vázquez-Rodríguez
DOI: http://dx.doi.org/10.1016/j.ajem.2016.04.016
Publication stage: In Press Accepted Manuscript
Published online: April 12 2016
x Although cardiac stress testing may help establish the safety of early discharge in patients with suspected acute coronary syndromes and negative troponins, more cost-effective strategies are necessary. We aimed to develop a clinical prediction rule to safely obviate the need for cardiac stress testing in this setting.
Anand M. Prabhakar, H. Benjamin Harvey, Katelyn N. Brinegar, Ali S. Raja, James R. Kelly, James A. Brink, Sanjay Saini, Rahmi Oklu
DOI: http://dx.doi.org/10.1016/j.ajem.2016.04.015
Publication stage: In Press Accepted Manuscript
Published online: April 12 2016
x The purpose of this study was to investigate the role of imaging in transfers between an island Critical Access Hospital (CAH) Emergency Department (ED) and a quaternary care hospital.
Turgay Celık, Cengiz Ozturk, Sevket Balta, Atila Iyısoy
DOI: http://dx.doi.org/10.1016/j.ajem.2016.04.013
Publication stage: In Press Accepted Manuscript
Published online: April 12 2016
x We read with great interest the recently published article by Bischof and coworkers entitled with ‘ST depression in lead aVL differentiates inferior ST-elevation myocardial infarction from pericarditis’ [1]. The authors sought to determine if the presence of any ST-segment depression in lead aVL would differentiate inferior ST segment elevation myocardial infarction (STEMI) from pericarditis. This study consists of retrospective study of 3 populations. Cohort 1 included patients coded as inferior STEMI, cohort 2 included patients with pericarditis.
Łukasz Iskrzycki, Dorota Zyśko, Jakub J. Koch, Paweł GAwlowski, Lukasz Szarpak, Jacek Smereka
DOI: http://dx.doi.org/10.1016/j.ajem.2016.02.064
Publication stage: In Press Corrected Proof
Published online: April 12 2016
x Schoolchildren are the group most frequently educated in cardiopulmonary resuscitation (CPR), whereas the witnesses of the real life cardiac arrest events are mainly older people [1,2]. A possible way to bridge this gap would be to make children spread their newly acquired knowledge at home, especially by describing what they have learnt, and by showing educational materials to their parents. Such activity could also help children to consolidate their knowledge [3,4,5].
Nihat Kalay
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.071
Publication stage: In Press Accepted Manuscript
Published online: April 11 2016
x We read the published article by Kaya et al. [1] titled, “Carboxyhemoglobin levels predict the long-term development of acute myocardial infarction in carbon monoxide poisoning” with great interest. The researchers of the study demonstrated that elevated carboxyhemoglobin (COHb) levels in patients who applied to emergency services with carbon monoxide (CO) poisoning is an independent predictor of acute myocardial infarction (AMI) development in the long term. The cardiotoxic effects of CO are previously known and many studies have been published for the acute period cardiac effects of CO poisoning.
Ozcan Ozeke, Ozgur Kirbas, Ozlem Karabulut, Sefa Unal, Fatih Sen, Kumral Cagli, Zehra Golbasi, Serkan Topaloglu, Dursun Aras, Sinan Aydogdu
DOI: http://dx.doi.org/10.1016/j.ajem.2016.04.009
Publication stage: In Press Accepted Manuscript
Published online: April 9 2016
x We are pleased that our paper raised an interest among readers of the American Journal of Emergency Medicine [1] On behalf of co-authors, I would like to reply to the letter of titled by “Reversible Brugada-like electrocardiogram and acute renal failure, in a patient with takotsubo syndrome”. The brain, autonomic nerves, and heart are considered as an interactive system. “My heart is burning” is a common metaphor used to describe the intense emotional pain. Indeed, often emotional pain, sadness, or grief are experienced as physical pain distinctly in the heart region [2].
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
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.
Moon Seok Park, Jin Hee Lee, Hyuksool Kwon, Yu Jin Kim, Jae Yun Jung
DOI: http://dx.doi.org/10.1016/j.ajem.2016.04.012
Publication stage: In Press Accepted Manuscript
Published online: April 9 2016
x Nearly a dozen reduction methods for the treatment of anterior shoulder dislocation have been reported, but the majorities are painful and require patients to be in the supine or prone position. Nearly a dozen reduction methods for the treatment of anterior shoulder dislocation have been reported, but the majorities are painful and require patients to be in the supine or prone position.
Lukasz Szarpak, Ricardo Gadea Mateo, Giuseppe Marchese, Lukasz Czyzewski, Andrzej Kurowski, Jacek Smereka, Zenon Truszewski
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.069
Publication stage: In Press Accepted Manuscript
Published online: April 9 2016
x We read with great interest the article “Pneumothorax is a rare complication of thoracic central venous catheterization in community EDs” by Vinson et al. [1]. The authors of this study show that the incidence of pneumothorax (tPTX) from thoracic central venous catheterization in community EDs is low. However as research by Vinson et al. [1] and other authors shows the risk of tPTX is higher with a failed access at the initial vein, subclavian vein approach [2] or positive pressure ventilation [3].
Ari B. Friedman, D. Daphne Owen, Victoria E. Perez
DOI: http://dx.doi.org/10.1016/j.ajem.2016.04.006
Publication stage: In Press Accepted Manuscript
Published online: April 9 2016
x Low reimbursement from the uninsured has been claimed to threaten hospital finances and even hospital emergency department (ED) closure. We hypothesized in advance of beginning data collection that states that expanded Medicaid ("expansion states") under the 2010 Patient Protection and Affordable Care Act (ACA) would experience a reduced rate of ED closure compared to states that did not.
Harald Helling, Gerhard Pindur, Bernhard Stephan
DOI: http://dx.doi.org/10.1016/j.ajem.2016.04.011
Publication stage: In Press Accepted Manuscript
Published online: April 8 2016
x To the Editor,
Erik A. Kumetz, Nicole D. Hurst, Raymond J. Cudnik, Sherri L. Rudinsky
DOI: http://dx.doi.org/10.1016/j.ajem.2016.04.010
Publication stage: In Press Accepted Manuscript
Published online: April 8 2016
x Electronic cigarettes (e-cigarettes) were introduced into the US market in 2007 and have increasingly become a popular alternative to tobacco smoking. These devices simulate smoking by heating a nicotine-containing solution producing an aerosol that the user inhales. Increasing reports in the media have highlighted significant injuries following spontaneous explosion of these devices, however there has been limited mention in the medical literature to date. We present two cases of serious thermal and blast injuries secondary to e-cigarette malfunction to bring an awareness of the injury potential to medical providers and their patients.
Karin Howe, David Griffen, Cassie Jaeger
DOI: http://dx.doi.org/10.1016/j.ajem.2016.04.008
Publication stage: In Press Accepted Manuscript
Published online: April 8 2016
x Methylene chloride is a common occupational exposure. A metabolic product of methylene chloride is carbon monoxide (CO) and toxicity can lead to increased carboxyhemoglobin (COHb) levels. The half-life of COHb is prolonged in methylene chloride toxicity as the conversion to CO can last several hours beyond the exposure. In addition, methylene chloride can be stored in tissues, particularly adipose tissue, and converted to CO over time. The following case demonstrates that patients exposed to methylene chloride can essentially become CO factories with the production of CO within the body continuing long after exposure to the toxin.
Dong Hun Lee, Byung Kook Lee, Kyoung Hwan Song, Yong Hun Jung, Jung Soo Park, Sung Min Lee, Yong Soo Cho, Jin Woong Kim, Kyung Woon Jeung
DOI: http://dx.doi.org/10.1016/j.ajem.2016.04.005
Publication stage: In Press Accepted Manuscript
Published online: April 8 2016
x Central diabetes insipidus (CDI) is a marker of severe brain injury. Here we aimed to investigate the prevalence and risk factors of CDI in cardiac arrest survivors treated with targeted temperature management (TTM).
Umut Gulacti, Ugur Lok, Murat Çelik
DOI: http://dx.doi.org/10.1016/j.ajem.2016.04.004
Publication stage: In Press Accepted Manuscript
Published online: April 8 2016
x Verbal report via telephones method is usually used for consultations in ED. However, this method does not allow for the transfer of images to the consultant and cannot be objective and precise (1). Smartphones have emerged as essential tools providing assistance in patient care, monitoring, rehabilitation, communication, diagnosis, teaching, research and reference and almost all health professionals in the United States of America, the United Kingdom and the other countries now carry smartphones.
Resa E. Lewiss, Srikar Adhikari, Kristin Carmody, J. Matthew Fields, Patrick Hunt, Andrew S. Liteplo, Arun Nagdev, Christopher Raio, Romolo Gaspari
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.070
Publication stage: In Press Accepted Manuscript
Published online: April 8 2016
x To the Editor, (See Figs. 1 and 2.)
Robert McArthur, Jonathan A. Edlow, Lise E. Nigrovic
DOI: http://dx.doi.org/10.1016/j.ajem.2016.04.003
Publication stage: In Press Accepted Manuscript
Published online: April 7 2016
x The Bacterial Meningitis Score classifies children with meningitis and none of the following high-risk predictors at very low risk for bacterial meningitis: Positive cerebrospinal fluid (CSF) Gram Stain, CSF protein ≥3 , peripheral ANC ≥ 10,000 cells/mm3 and seizure at or prior to presentation. Although extensively validated in children, the Bacterial Meningitis Score has not been rigorously evaluated in adults.
Pınar Yeşim Akyol, Başak Bayram, Aslı Acerer, Mehmet Can Girgin, Durgül Çelik Yılmaz, Süleyman Men, Rıdvan Atilla
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.068
Publication stage: In Press Accepted Manuscript
Published online: April 7 2016
x Traumatic head injury is disfunctioning of brain due to a mechanical force. Disfunctioning could be temporary or permanent, and may cause structural changes in the brain or not. Clinical severity might vary between very light (confusion or amnesia) and very severe (unresponsiveness and coma)(1).
Thomas Reydel, Jean-Christophe Callahan, Laurent Verley, Christelle Teiten, Christophe Andreotti, Yann Erick Claessens, David Missud, Erwan L'Her, Gael Le Roux, Nicolas Lerolle
DOI: http://dx.doi.org/10.1016/j.ajem.2016.04.002
Publication stage: In Press Accepted Manuscript
Published online: April 5 2016
x Routine biological tests are frequently ordered in self-poisoning patients, but their clinical relevance is poorly studied.
David S. Huckins, Harold K. Simon, Karen Copeland, Truman J. Milling Jr., Philip R. Spandorfer, Halim Hennes, Coburn Allen, Joseph Gogain, for the APAB Study Group
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.066
Publication stage: In Press Accepted Manuscript
Published online: April 5 2016
x To prospectively validate the diagnostic accuracy of a biomarker panel consisting of WBC, CRP, and MRP 8/14 levels in identifying pediatric patients with abdominal pain who are at low risk of appendicitis.
Theodoros Xanthos, Nikolaos Psichalakis, David Russell, Apostolos Papalois, Anastasios Koutsovasilis, Dimitrios Athanasopoulos, Georgios Gkiokas, Athanasios Chalkias, Nicoletta Iacovidou
DOI: http://dx.doi.org/10.1016/j.ajem.2016.04.001
Publication stage: In Press Accepted Manuscript
Published online: April 4 2016
x To investigate whether a lipid emulsion could counteract the hypotensive effects of amiodarone overdose after an acute intravenous administration and improve 4h survival in an established model of swine cardiovascular research.
Rui Zeng, Dongze Li, Lixia Deng, Yarong He, Xiaolin Sun, Zhi Wan, Hu Nie, Xiaodong Du, Yu Cao, Zhi Zeng
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.067
Publication stage: In Press Accepted Manuscript
Published online: April 4 2016
x Few studies have reported that serum albumin (SA) levels on admission were associated with increased risk of long-term outcomes in patients with type B acute aortic dissection (AAD). The aim of this study was to investigate the effect of admission levels of SA on survival among patients with type B AAD undergoing endovascular therapy (EVT).
Eric M. Rottenberg
DOI: http://dx.doi.org/10.1016/j.ajem.2016.02.077
Publication stage: In Press Accepted Manuscript
Published online: April 4 2016
x To the Editor,
Yuri van der Does, Pleunie P.M. Rood, Juanita A. Haagsma, Peter Patka, Eric C.M. van Gorp, Maarten Limper
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.065
Publication stage: In Press Accepted Manuscript
Published online: April 3 2016
x Procalcitonin (PCT) is a new biomarker with a higher accuracy in the diagnosis of bacterial infections. Utilization of PCT may reduce the number of unnecessary antibiotics prescribed to patients, and consequently may decrease the rise in antibiotic resistance. The aim of this systematic review is to determine if a PCT-guided algorithm can safely reduce the number of antibiotics prescribed to all patients with a suspected of infection in the emergency department(ED).
Emily Aaronson, Yuchiao Chang, Pierre Borczuk
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.063
Publication stage: In Press Accepted Manuscript
Published online: April 3 2016
x Patients with abdominal diagnoses constitute 5 to 10% of all ED presentations. The goal of this study is to identify which of these patients will have a non-concerning diagnosis based on demographic, physical exam and basic laboratory testing.
Dong Young Seo, Sion Jo, Jae Baek Lee, Young Ho Jin, Taeoh Jeong, Jaechol Yoon, Boyoung Park
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.062
Publication stage: In Press Accepted Manuscript
Published online: April 3 2016
x The purpose of the present study was to investigate the diagnostic value of lactate for predicting bacteremia in female patients with acute pyelonephritis (APN)
Cornelius A. Thiels, Matthew C. Hernandez, Martin D. Zielinski, Johnathon M. Aho
DOI: http://dx.doi.org/10.1016/j.ajem.2016.02.078
Publication stage: In Press Accepted Manuscript
Published online: April 2 2016
x Fishing is a common pastime. In the developed world, it is commonly performed as a recreational activity. We aim to determine injury patterns and outcomes among patients injured while ice fishing.
Rieko Yamada, Koichi Maruyama, Go Hirabayashi, Yukihide Koyama, Tomio Andoh
DOI: http://dx.doi.org/10.1016/j.ajem.2016.02.076
Publication stage: In Press Accepted Manuscript
Published online: April 2 2016
x To evaluate the effect of head position on the performance of intubating supraglottic airway devices, we compared the success rate of blind intubation in the head-elevated and the pillowless head positions with the LMA Fastrach and the air-Q, and the change of glottic visualization through the air-Q.
Nirupama Kannikeswaran, Mary Lieh-Lai, Monica Malian, Bo Wang, Ahmad Farooqi, Mark G. Roback
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.064
Publication stage: In Press Accepted Manuscript
Published online: April 2 2016
x To compare need for re-dosing, sedation efficacy, duration and adverse events between three commonly administered doses of parenteral ketamine in the Emergency Department (ED).
Patrick Horn, Andreas Pasch, Bujar Maxhera, Malte Kelm, Ralf Westenfeld
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.060
Publication stage: In Press Accepted Manuscript
Published online: April 1 2016
x Cardiopulmonary resuscitation with assisted extracorporal life-support (ECLS) can be an option in cardiac arrest as a rescue therapy for those patients in whom initial advanced life support is unsuccessful and time is needed to treat a reversible underlying condition as acute intoxication. We report a failure of ECLS due to refractory ionized hypocalcemia, generalized tetany and vasospasm in a case of severe salicylate intoxication and cardiac arrest. (See Fig..)
Ivan Comelli, Giuseppe Lippi, Andrea Magnacavallo, Gianfranco Cervellin
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.059
Publication stage: In Press Accepted Manuscript
Published online: March 31 2016
x Background: Direct muscle injury is the most common cause of rhabdomyolysis, but infections, endocrine and metabolic disorders, environmental conditions, and drugs have also been recognized as potential causes. The most common adverse effects of mefloquine, an antimalarial drug, are gastrointestinal, and neurological. Rhabdomyolysis in association with mefloquine has not been previously reported. Case Report: A 36 years old man presented to the ED complaining for malaise, fatigue, and difficulty in performing the usual daily activities.
Karsten Keller, Johannes Beule, Jörn Oliver Balzer, Wolfgang Dippold
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.061
Publication stage: In Press Accepted Manuscript
Published online: March 31 2016
x Syncope and collapse (=
Marc A. Probst, Michelle P. Lin, Lindsey G. Lawrence, Erin Robey-Gavin, Leslie S. Pendery, Reuben J. Strayer
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.056
Publication stage: In Press Corrected Proof
Published online: March 30 2016
x Emergency contraception (EC) offers women the option of preventing undesired pregnancy after unprotected sexual intercourse, suspected contraceptive failure, or sexual assault. It is not uncommon for patients to present to the emergency department requesting EC [1]. Currently, there are several different EC options available to patients in the United States including 2 doses of an estrogen-progesterone combination, known as the Yuzpe method ; a progesterone-only regimen using levonorgestrel (Plan B); and placement of an intrauterine device (IUD), which offers the advantage of continued contraception if kept in place [2].
Soumitra S. Bhuyan, Anand Saha, Jay Bhatt
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.057
Publication stage: In Press Corrected Proof
Published online: March 29 2016
x Reducing Emergency Department use Requires Interventions at Multiple Levels
Andrzej Kurowski, Łukasz Szarpak, Michael Frass, Silvia Samarin, Łukasz Czyzewski
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.055
Publication stage: In Press Corrected Proof
Published online: March 29 2016
x We read with great interest the article “Early neurologic examination is not reliable for prognostication in post–cardiac arrest patients who undergo therapeutic hypothermia” [1]. Sudden cardiac arrest (SCA) outside the hospital due to heart disease is the most common cause of performing cardiopulmonary resuscitation (CPR). Survival after prehospital cardiac arrest primarily determines factors associated with the prehospital period during the course of resuscitation [2,3]. Studies on the pathomechanism of damage to the central nervous system as a result of cardiac arrest were mainly conducted on animals, and only a few clinical studies of hypoxia in neonates and hypoperfusion of the brain during cardiopulmonary bypass provided insights into underlying pathomechanisms in humans [4].
Bernard P. Chang, Ellen D. Sano, Edward H. Suh, Alesander Tichter
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.054
Publication stage: In Press Accepted Manuscript
Published online: March 29 2016
x Suicide is the 16th leading cause of death worldwide and accounted for 38,364 deaths in the United States in 2010. [1] Suicidal ideation is a common condition evaluated in the ED, with nearly 420,000 annual ED visits for SI. [2,3] Inpatient admission or admission to a psychiatric facility for these patients represent an outcome/disposition associated with increased healthcare costs and prolonged care. [4,5] While there has been extensive past work regarding suicide risk factors such as a history of psychiatric disease or previous suicide attempt, [6] little work has examined the patient characteristics of patients presenting with SI in the ED who are subsequently admitted to the hospital.
Arthur K. Au, Dean Steinberg, Christopher Thom, Maziar Shirazi, Dimitrios Papanagnou, Bon S. Ku, J. Matthew Fields
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.058
Publication stage: In Press Accepted Manuscript
Published online: March 29 2016
x Study Objectives Hypotension is a common side effect of propofol, but there are no reliable methods to determine which patients are at risk for significant propofol-induced hypotension (PIH). Ultrasound has been used to estimate volume status by visualization of inferior vena cava (IVC) collapse. This study explores whether IVC assessment by ultrasound can assist in predicting which patients may experience significant hypotension.
Selçuk Yazıcı, Tuncay Kırış, Ayşe Emre, Ufuk S. Ceylan, Şükrü Akyüz, Ahmet O. Uzun, Recep Hacı, Sait Terzi, Aysun Erdem, Kemal Yeşilçimen
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.053
Publication stage: In Press Corrected Proof
Published online: March 29 2016
x Limited data exist on the incidence of contrast induced nephropathy (CIN) and its impact on in-hospital prognosis of patients diagnosed with acute pulmonary embolism (APE) using contrast computerized tomography pulmonary angiography (CTPA). In this study, we examined the frequency of nephropathy after CTPA in APE patients and its link to in-hospital adverse outcomes.
Brit Long, Alex Koyfman
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.049
Publication stage: In Press Corrected Proof
Published online: March 23 2016
x Emergency physicians must be masters of the airway. The patient with tracheostomy can present with complications, and because of anatomy, airway and resuscitation measures can present several unique challenges. Understanding tracheostomy basics, features, and complications will assist in the emergency medicine management of these patients.
Omer Uz, Mustafa Aparci, Zafer Isilak, Mehmet Uzun
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.052
Publication stage: In Press Corrected Proof
Published online: March 22 2016
x We have read the case report of Yoo et al [1], entitled “Comparison between systemic vs catheter thrombolysis in patients with pulmonary embolism” with great interest. The authors have compared the clinical outcomes (mortality and major bleeding) between systemic thrombolysis (ST) and catheter-directed therapy (CDT) in patients with acute massive and submassive pulmonary embolism (PE). They have reported that similar clinical outcomes were shown between ST and CDT in patients presented with acute massive or submassive PE.
Cristian Abelairas-Gómez, Roberto Barcala-Furelos, José Palacios-Aguilar, Antonio Rodríguez-Núñez
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.051
Publication stage: In Press Corrected Proof
Published online: March 22 2016
x Dive related injuries have an estimated incidence of 30 cases per million [1], with 90% of lesions affecting the cervical spine [2]. Around 5% of rachimedular injuries are caused by dive accidents [1] and remain as a significant cause of acquired permanent disability [3]. Preventive strategies are essential to avoid primary damages but there is no consensus about the most adequate neck immobilization procedure to protect the spinal cord of the victim.
Mimi Juliano, Robert Domingo, Mary S. Mooney, Alex Trupiano
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.047
Publication stage: In Press Accepted Manuscript
Published online: March 22 2016
x We performed an independent study determine whether the anti-choking device LifeVac is capable of removing a food bolus from an obstructed airway when the potential for choking as a medical emergency exists.
Hui-Pu Liu, Chun-Lin Chen, Nan-Fu Chen, Chen-Yi Liao, Chien-Yu Ou
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.042
Publication stage: In Press Corrected Proof
Published online: March 22 2016
x Ligamentum flavum hematoma is a rare cause of spinal cord or root compression and usually occurs in the lower thoracic and lumbar spine. The differential diagnosis includes lumbar disk herniation and lumbar spinal canal stenosis caused by neoplasm, infection, epidural hematoma, and facet cyst.
Serife Ozdinc, Ebru Unlu, Zeynep Karakaya, Ozan Turamanlar, Nurhan Dogan, Yesim Isler, Yucel Gonul, Mehmet Gazi Boyaci
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.048
Publication stage: In Press Corrected Proof
Published online: March 21 2016
x Intracerebral hemorrhage (ICH) is a potentially life-threatening condition. Interventions and treatments should be managed on time to reduce mortality. It has been put forth that perihematomal edema absolute volume (PHEAV) is related to mortality, however the effect of perihematomal edema absolute area (PHEAA) on mortality is unknown. The objective of this study was to evaluate the effect of PHEAA on 30-day mortality in patients with ICH.
Lukasz Szarpak, Zenon Truszewski, Jacek Smereka, Marcin Madziała, Lukasz Czyzewski
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.046
Publication stage: In Press Corrected Proof
Published online: March 21 2016
x Rapid intravascular access is critical procedure in many emergency situations [1]. Gold standard of intravascular access in emergency scenarios it is still intravenous access. However, there are situations where intravenous (IV) access is difficult, or even impossible. Such situations can include hypovolemic shock or cardiac arrest, in which veins are collapsed [2]. Difficulties in access can also make use of personal protective equipment, including wearing chemical. Biological, radiological and nuclear (CBRN) protective equipment.
Stephanie N. Komura, Nadia I. Awad
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.050
Publication stage: In Press Corrected Proof
Published online: March 21 2016
x Nicardipine is a commonly used agent for the management of hypertensive emergencies due to its predictable pharmacokinetic profile and ease of titration. There is documented use of nicardipine administered as an intravenous (IV) bolus dose in several settings, particularly in the anesthesia literature. We describe the first 2 documented cases of use of nicardipine administered as an IV bolus dose in the emergency department (ED) for hypertensive emergencies involving acute ischemic stroke and hemorrhagic stroke.
