Jennifer L. Martindale
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.043
Publication stage: In Press Corrected Proof
Published online: March 19 2016
x Objective noninvasive measures of dyspnea in patients with acute heart failure are lacking. In this review, we describe lung ultrasound as a tool to estimate the degree of pulmonary congestion in patients presenting with acute heart failure and to monitor therapeutic efficacy. Serial semiquantitative measures of sonographic B-lines in acute heart failure patients can be converted to pulmonary edema scores obtained at admission and hospital discharge. These scores provide prognostic information for short-term clinical outcomes.
Daniele Coraci, Marina A. Bellavia, Valter Santilli, Luca Padua
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.045
Publication stage: In Press Corrected Proof
Published online: March 19 2016
x We have read with great attention the work “Novel technique in ED: supracondylar ultrasound-guided nerve block for reduction of distal radius fractures”, by Aydin and colleagues [1]. The authors presented four patients with distal radius fracture and given a radial nerve anesthetic block in order to perform painless bone reduction. The block was performed by the help of ultrasound (US). This paper is informative and it may represent a possible guide for physicians in emergency conditions. The authors, in fact, show the high usefulness of this block technique, which represents a possible approach for the treatment of distal radius fracture.
Erik M. Koopman, Sten Scholtens, Johannes M. Huitink
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.044
Publication stage: In Press Corrected Proof
Published online: March 19 2016
x Pre-hospital airway management is complex and complications occur frequently. Guidelines advice using waveform capnography to confirm correct tube position, but in the emergency setting this is not universally available. Continuous visualization of the airway with a video tube (VivaSight SL™) could serve as an alternative confirmation method, provided that airway structures are properly recognized. With this study we wanted to investigate whether airway management practitioners were able to recognize anatomical structures both in a circulated and in a non-circulated airway.
Masayuki Kubota, Hiroaki Daidoji, Nobuhiro Takaya, Kurato Tokunaga, Tomohiro Sonoo, Kensuke Nakamura
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.040
Publication stage: In Press Corrected Proof
Published online: March 19 2016
x The use of anticoagulants for patients with Lemierre syndrome, which consists of pharyngeal infection-related thrombophlebitis of the internal jugular vein and septic embolism, is controversial. In this study, we report a 65-year-old woman with Lemierre syndrome in whom anticoagulant therapy was effective for thrombotic occlusion involving the sigmoid sinus. She consulted our hospital with pharyngeal pain and dyspnea. Contrast-enhanced cervical computed tomography revealed thrombus formation involving the right internal jugular vein to sigmoid sinus.
Paul J. Wong, Abby M. Bailey, Regan A. Baum
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.041
Publication stage: In Press Corrected Proof
Published online: March 17 2016
x Warfarin is a vitamin K antagonist used to treat patients with hypercoagulable disease states but increases the risk of life-threatening bleeding. Prothrombin complex concentrate has been recommended if these bleeds occur. Kcentra, a 4-factor prothrombin complex concentrate, has been Food and Drug Administration approved for the urgent reversal of vitamin K antagonist–associated major bleeding. Hypotension has been reported with Kcentra use, but limited information is available about these reactions.
Denise McCormack, Avi Ruderman, William Menges, Miriam Kulkarni, Tiffany Murano, Steven E. Keller
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.037
Publication stage: In Press Corrected Proof
Published online: March 17 2016
x The Mortality in Severe Sepsis in the Emergency Department (MISSED) score is a newly proposed scoring system. The goal of this study is to determine if the MISSED score is generalizable to an urban tertiary care hospital.
Albert Arslan, Lindsey Flax, Robert Fraser, Marc Kanter, Ronald Simon, Nicholas D. Caputo
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.036
Publication stage: In Press Corrected Proof
Published online: March 17 2016
x Injury severity score, serum lactate, and shock index help the physician determine the severity of injuries present and have been shown to relate to mortality. We sought to determine if an increasing amount of packed red blood cells (PRBCs) given in the first 24 hours of admission is an independent predictor of mortality and how it compares to other validated markers.
Ichiro Hirayama, Takahiro Hiruma, Yoshihiro Ueda, Kent Doi, Susumu Nakajima
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.039
Publication stage: In Press Corrected Proof
Published online: March 17 2016
x Although the causes for pneumomediastinum can be iatrogenic, postoperative, or traumatic, it is diagnosed as idiopathic when the apparent cause is not clear. In 1937, Hamman first described Hamman syndrome, which is pneumomediastinum combined with diabetic ketoacidosis (DKA). We describe a case of a 78-year-old man with a background of untreated diabetes mellitus that developed into hyperosmolar hyperglycemic state (HHS), which was complicated by pneumomediastinum. DKA and HHS are similar conditions that result in poor nutrition and Kussmaul breathing due to metabolic acidosis.
Bülent Serhan Yurtlu, Şule Özbilgin, Derya Arslan Yurtlu, Nilay Boztaş, Gonca Kamacı, Mahmut Akaltun, Volkan Hancı, Osman Yılmaz
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.038
Publication stage: In Press Corrected Proof
Published online: March 17 2016
x Intravenous lipid emulsion eliminates the toxicity-related symptoms of several drugs. We hypothesized that intravenous lipid emulsion prolongs the survival time in digoxin-intoxicated rats.
Neil B. Hampson
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.035
Publication stage: In Press Corrected Proof
Published online: March 16 2016
x I read with great interest the article by Kaya and co-workers, “Carboxyhemoglobin levels predict the long-term development of acute myocardial infarction in carbon monoxide poisoning” [1]. They observed that 100 of 1013 consecutive patients presenting to their emergency department in Turkey with carbon monoxide (CO) poisoning experienced acute myocardial infarction (AMI) during an average follow-up of fifty-six months after the event. While I am unable to explain their observation, I was struck by the degree of carboxyhemoglobin (COHb) elevation described in their patients.
Joseph Cesarine, Lisa M. Filippone, Edward J. Filippone
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.034
Publication stage: In Press Corrected Proof
Published online: March 16 2016
x Hemophagocytic lymphohistiocytosis (HLH) is a hyperinflammatory syndrome characterized by tissue invasion of liver, spleen, and lymph nodes by benign lymphocytes and hemophagocytosing macrophages with marked release of inflammatory cytokines. The result is a cytokine storm with systemic inflammatory response syndrome, multiorgan dysfunction, and often death. Patients present with fever, hepatospenomegaly, unexplained cytopenias, marked hyperferetinemia, liver dysfunction, coagulopathy, central nervous system dysfunction, and/or renal dysfunction.
Başak Bayram, Önder Limon, Gülsüm Limon, Volkan Hancı
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.033
Publication stage: In Press Corrected Proof
Published online: March 16 2016
x We identify and characterize the most highly cited articles related to ultrasonographic evaluations occurring in the emergency department.
Majid Hajimaghsoudi, Elnaz Vahidi, Mehdi Momeni, Abbas Arabinejhad, Morteza Saeedi
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.030
Publication stage: In Press Corrected Proof
Published online: March 16 2016
x Usual routes of drug administration are often painful and invasive. Nowadays, using jet injection has been introduced successfully, as a noninvasive and painless method of anesthetic delivery in performing different procedures.
Turkmen Suha, Mutlu Asli, Sahin Aynur, Karaca Yunus, Mentese Ahmet, Demir Selim, Yulug Esin, Tatli Ozgur, Neziha Senem Ari, Turedi Süleyman
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.032
Publication stage: In Press Corrected Proof
Published online: March 15 2016
x This study was planned as a histopathologic evaluation of the effectiveness of ethyl pyruvate (EP) and N-acetylcysteine (NAC) in reducing electric burn–related organ damage in an experimental model.
Kailyn Elliott, Jared W. Klein, Anirban Basu, Amber K. Sabbatini
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.029
Publication stage: In Press Corrected Proof
Published online: March 15 2016
x Transitional care clinics (TCCs) represent one strategy to facilitate follow-up and primary care linkage for patients with no regular source of care who are discharged from the emergency department (ED). We assessed factors associated with completion of TCC follow-up among these patients and characterized their subsequent ED use.
Crystal M. Glover, Yanina A. Purim-Shem-Tov
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.031
Publication stage: In Press Corrected Proof
Published online: March 15 2016
x A wealth of literature [1,2] addresses the multifaceted problem posed by frequent, nonurgent emergency department (ED) use to the health care system (eg, costs) as well as patients (eg, disease management). As Medicaid patients visit the ED more than those privately insured [3], numerous interventions [2,4,5] aim to decrease ED use among Medicaid patients. The State of Illinois developed the Medical Home Network (MHN) [6] in 2012 to address frequent, nonurgent ED use by Medicaid recipients living in Chicago.
Mark Su, Robert S. Hoffman
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.019
Publication stage: In Press Corrected Proof
Published online: March 15 2016
x We read with great interest the case report by Haesloop and Tillick [1] describing the use of prothrombin complex concentrates (PCCs) in a patient with superwarfarin-induced coagulopathy. Based on our personal clinical experience, treatment of these cases can be quite complex due to the prolonged and sustained coagulopathy that may occur.
Naoya Matsumoto, Osanori Sogabe, Osamu Yoshida, Izuru Endo, Sumiharu Yamamoto, Hidetoshi Inokawa, Masatoshi Kubo, Tetsunobu Udaka, Hiroya Maeda, Minoru Mizuta
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.026
Publication stage: In Press Accepted Manuscript
Published online: March 14 2016
x Resuscitative endovascular balloon occlusion of the aorta (REBOA) has recently been applied for hemorrhagic shock due to abdominal or pelvic trauma. There are few reports about the advantages of REBOA except maintaining the hemodynamic status. However, its effect on the survival remains controversial. Case Report A 37-year-old-man was transferred to our hospital due to blunt abdominal trauma. He had been wedged between a crane and a platform. An initial evaluation revealed that he was in shock. Enhanced CT revealed a hemorrhage from the mesentery proper and an intra-abdominal hematoma.
Serhat Celikkanat, Salih Hamcan, Ugur Bozlar, Mustafa Tasar
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.027
Publication stage: In Press Corrected Proof
Published online: March 12 2016
x Epipericardial fat necrosis is a rare pathology among the causes of chest pain. In this case report, we aimed to present computed tomographic findings of epipericardial fat necrosis, which was detected in a 22-year-old man. The patient with a sudden onset of chest pain was referred to the emergency department, and then computed tomographic angiography examination was performed with an initial diagnosis of pulmonary embolism.
Byung Kook Lee, Mu Jin Kim, Kyung Woon Jeung, Sung Soo Choi, Sang Wook Park, Seong Woo Yun, Sung Min Lee, Dong Hun Lee, Yong Il Min
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.025
Publication stage: In Press Corrected Proof
Published online: March 11 2016
x Ischemic contracture compromises the hemodynamic effectiveness of cardiopulmonary resuscitation (CPR) and resuscitability from cardiac arrest. In a pig model of cardiac arrest, 2,3-butanedione monoxime (BDM) attenuated ischemic contracture. We investigated the effects of different doses of BDM to determine whether increasing the dose of BDM could improve the hemodynamic effectiveness of CPR further, thus ultimately improving resuscitability.
Ryan Gallagher, Jonathan Dangers, Stephen L. Thornton
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.022
Publication stage: In Press Corrected Proof
Published online: March 11 2016
x Phencyclidine (PCP) use is anecdotally associated with agitation and injury and is frequently tested for in the setting of trauma. We sought to determine characteristics of trauma patients with a PCP-positive urine immunoassay drug screen (UDS) and if they had increased levels of care or mortality.
Akın Bodur, Ahmet Alver, Cemil Kahraman, Diler Us Altay, İmran İnce
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.021
Publication stage: In Press Corrected Proof
Published online: March 11 2016
x The aim of the study was to investigate long-term effects of N -acetylcysteine (NAC) on contralateral testes by experimental testicular torsion using histopathologic and biochemical parameters.
Mustafa Murat Özgenç, Serdar Çevik, Celaleddin Soyalp, Hakan Hanımoğlu, Ahmet Fırat Bektaş
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.028
Publication stage: In Press Corrected Proof
Published online: March 11 2016
x Acute subdural hematoma is one of the neurosurgical emergencies that could lead to mortality, thus needing urgent surgical intervention in most of the cases. A 1-year-old female patient was admitted to the emergency department after she fell from a 2-m height. She had 5 × 2-cm acute traumatic subdural hematoma diagnosed with computed tomographic (CT) scan of the head. She was rushed to the operating room for a need of possible surgical intervention. Her vital signs improved before she was operated on.
Amir M. Mohareb, Andrea F. Dugas, Yu-Hsiang Hsieh
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.024
Publication stage: In Press Corrected Proof
Published online: March 11 2016
x The rise of antibiotic-resistant pathogens is believed to have influenced the emergency department (ED) epidemiology and management of infectious diseases (IDs) since 2000.
Kwok Kei Wu, Chun Tat Lui, Chik Leung Ho, Kwok Leung Tsui, Hin Tat Fung
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.023
Publication stage: In Press Corrected Proof
Published online: March 11 2016
x The objective was to evaluate if existence of hydrothorax in initial chest radiograph predicts treatment outcome in patients with primary spontaneous pneumothorax who received needle thoracostomy.
Mustafa Aparci, Omer Uz, Ejder Kardesoglu, Mehmet Uzun
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.018
Publication stage: In Press Corrected Proof
Published online: March 9 2016
x We have read the article of Kozik et al [1] titled “Cardiovascular responses to energy drinks in a healthy population: The C-energy study” with great interest. Authors evaluated the effects of consumption of energy drink with high content of caffeine and additional energetic supplements such as guarana and others on the cardiovascular and electrocardiogram (ECG) parameters in healthy young individuals. Indeed, they reported clinically significant and potentially lethal ECG changes and hemodynamic abnormalities.
Jared Strote, Olivia Haesloop, Graham Nichol
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.020
Publication stage: In Press Corrected Proof
Published online: March 9 2016
x We appreciate the opportunity to respond to the excellent points brought up regarding our case report describing the use of prothromin complex concentrates (PCCs) in a patient with superwarfarin-induced coagulopathy and bleeding [1].
Ryan P. Bodkin, Kyle A. Weant, Stephanie Baker Justice, Matthew T. Spencer, Nicole M. Acquisto
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.016
Publication stage: In Press Corrected Proof
Published online: March 8 2016
x Glucagon is thought to decrease lower esophageal sphincter tone and is used as an alternative to invasive endoscopy for esophageal foreign body impaction (EFBI). The purpose of this study was to evaluate efficacy and safety of glucagon and identify characteristics associated with success.
Gabrielle Jacknin, Michael C. Overbeck
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.009
Publication stage: In Press Corrected Proof
Published online: March 8 2016
x Succinylcholine is a depolarizing neuromuscular blocker commonly used for paralysis in the setting of rapid sequence intubation. Despite the favorable pharmacokinetic profile of succinylcholine, the safety profile of this agent remains controversial. Concerns among clinicians reg arding hyperkalemia remain persistent despite demonstrated safety in the vast majority of patients.
Łukasz Szarpak, Łukasz Czyzewski, Bogumiła Woloszczuk-Gebicka, Paweł Krajewski, Marcin Fudalej, Zenon Truszewski
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.017
Publication stage: In Press Corrected Proof
Published online: March 8 2016
x Obtaining intravascular (IV) access is one of the key procedures during cardiopulmonary resuscitation (CPR), particularly during nondefibrillation rhythms, in which the rapid delivery of epinephrine is one of the main elements of the emergency treatment. The average time needed for peripheral IV catheterization is reported to be between 2.5 and 16 minutes in patients with difficult IV access [1]. The 2015 American Heart Association guidelines for CPR suggest that rescuers establish intraosseous (IO) access if an intravenous line is not easily obtainable [2].
Daniel S. Frank, Michael Heller, Jennifer Sedor, Namita Kedia, Adina Shulman, Elias E. Wan
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.012
Publication stage: In Press Accepted Manuscript
Published online: March 8 2016
x Intra-pericardial herniation of abdominal contents is rarely encountered in emergency practice. The entity is most often the result of blunt or penetrating trauma and also may occur post-operatively. Spontaneous herniation through a Morgagni hernia is even rarer but presents the opportunity for lifesaving diagnosis and treatment. We present the case of an octogenarian presenting with the acute onset of symptoms suggestive of aortic dissection. She was found to have herniated transverse colon within the pericardial sac concerning for strangulated bowel.
Aiqun Zhu, Jingping Zhang
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.008
Publication stage: In Press Corrected Proof
Published online: March 8 2016
x The post–cardiac arrest survival rate has remained low since the 2010 cardiopulmonary resuscitation (CPR) guidelines were published. The present study aimed to review the 2010 vs 2005 CPR guideline outcomes in adults with in-hospital cardiac arrest.
Giuseppe D. Sanna, Giuseppe Talanas, Cristiana Denurra, Paolo Ferrandu, Luca Bullitta, Pierfranco Terrosu
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.014
Publication stage: In Press Corrected Proof
Published online: March 7 2016
x Ruptured sinus of Valsalva aneurysm is a rare cardiac anomaly, and it can be acquired or congenital. Untreated, there is a substantial risk of complications, especially if rupture occurs with a subsequent intracardiac shunt and rapidly worsening cardiac insufficiency. Herein we describe a peculiar case of a ruptured aneurysm of the noncoronary sinus of Valsalva into the right atrium in a 44-year-old man with acute chest pain.
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
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.
Zinatossadat Bouzari, Shahla Yazdani, Toktam Sadeghi
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.015
Publication stage: In Press Corrected Proof
Published online: March 5 2016
x Ovarian hyperstimulation syndrome (OHSS) of the ovary is a medical complication of the ovulation induction, and it has been shown that OHSS may both mask the typical manifestations of appendicitis and compromise the concurrent intraperitoneal infection.
Elias E. Wan, Nathan Zapolsky, Nicole Nembhard, Jeremy Rose, Michael Heller, Christina Hsu
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.011
Publication stage: In Press Corrected Proof
Published online: March 5 2016
x Platypnea-orthodeoxia syndrome is a rare clinical diagnosis characterized by dyspnea which is improved by the supine position (platypnea ) and oxygenation which is worsened with upright posture (orthodeoxia ). Platypnea-orthodeoxia syndrome has several possible causes. It may result from right to left intra-cardiac shunting, an atypical pulmonary ventilation-perfusion mismatch or vascular shunting that might occur with pulmonary AV malformations. We present a case of a 52-year-old female with the platypnea-orthodeoxia syndrome possibly due to an atrial septal defect with right to left shunting worsened by pulmonary hypertension.
Mina Guirgis, Kishore Sieunarine
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.010
Publication stage: In Press Accepted Manuscript
Published online: March 5 2016
x Acute neurological deficits are common presentations to the emergency department. Cerebral hyperperfusion syndrome, a rare phenomenon which can occur within one month following carotid surgical revascularization, may be challenging for the emergency physician to diagnose in the setting of an acute neurological presentation. Carotid arterial disease contributes 15-20% of ischemic cerebrovascular accidents and surgical revascularization is the commonest intervention for preventing stroke in patients with significant carotid disease.
Andrew P. Harris, Jose M. Ramirez, Joey Johnson, Gregory R. Waryasz
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.006
Publication stage: In Press Corrected Proof
Published online: March 5 2016
x Subtalar dislocations are rare injuries that account for 1%-2% of all dislocations and are defined as a separation of the talocalcaneal and talonavicular articulations. Eighty percent of subtalar dislocations occur in the medial direction, with lateral dislocations accounting for the majority of the rest. Subtalar dislocations in the anterior, posterior, anteromedial, and posterolateral directions have been reported in the literature. Prompt recognition of this injury is necessary to prevent negative sequelae associated with delayed treatment, as open reduction is often required because of anatomical impedance.
Erin M. Kane, Jeremiah S. Hinson, Candice D. Jordan, Karolina Paziana, Nicholas J. Sauber, Richard E. Rothman, Andrew I. Stolbach
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.007
Publication stage: In Press Corrected Proof
Published online: March 4 2016
x Cardiotoxicity secondary to synthetic cannabinoid use has been reported to manifest with tachycardia and hypertension. We present here a case series of three patients who developed bradycardia and hypotension after synthetic cannabinoid use.
Taylor A. Bagwell, Thomas J. Abramo, Gregory W. Albert, Jonathan W. Orsborn, Elizabeth A. Storm, Nicolas W. Hobart-Porter, Tonya M. Thompson, Eylem Ocal, Zhuopie Hu, Todd Nick
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.005
Publication stage: In Press Corrected Proof
Published online: March 4 2016
x Hyperventilation-induced hypocapnia leads to cerebral vasoconstriction and hypoperfusion. Intubated patients are often inadvertently hyperventilated during resuscitations, causing theoretical risk for ischemic brain injury. Current emergency department monitoring systems do not detect these changes. The purpose of this study was to determine if cerebral oximetry (rc So 2 ) with blood volume index (CBVI) would detect hypocapnia-induced cerebral tissue hypoxia and hypoperfusion.
Erik S. Anderson, Sarah K. Pfeil, Laura J. Deering, Tamara Todorovic, Suzanne Lippert, Douglas A.E. White
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.004
Publication stage: In Press Corrected Proof
Published online: March 3 2016
x We implemented the “High-Impact Testing for Injection Drug Users”, or the “HIT IDU” initiative, an emergency physician (EP)–based hepatitis C virus (HCV) testing program. The objective of this study was to evaluate the outcomes of this clinical protocol.
Jacek Smereka, Łukasz Szarpak, Łukasz Czyzewski, Dorota Zysko, Adam Smereka
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.002
Publication stage: In Press Corrected Proof
Published online: March 3 2016
x We have read with great interest the letter by Rottenberg [1] concerning on the absence of gasping upon emergency medical services arrival as a predictor of the need to endotracheal intubation. Agonal breathing is brainstem reflex and the last respiratory pattern that occurs during the early stages of cardiac arrest (CA) [2]. Agonal breathing is defined as ineffective, gasping respirations. Lay persons’ descriptions of agonal breathing are varied and included terms of gasping , wheezing , groaning , snorting , weak breathing , occasional breathing , irregular breathing , and poor breathing [3].
Oğuz Karahan, Halit Acet, Faruk Ertaş, Orhan Tezcan, Ahmet Çalişkan, Muhammed Demir, Ahmet Ferhat Kaya, Sinan Demirtaş, Mehmet Uğur Çevik, Celal Yavuz
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.003
Publication stage: In Press Corrected Proof
Published online: March 3 2016
x Previous studies show that serum fibrinogen levels are established risk factors for coronary artery disease (CAD) and that serum albumin levels are of a higher specificity and sensitivity in ST-elevation myocardial infarction (STEMI). In this study, we sought to evaluate the association between fibrinogen to albumin ratio (FAR) and the extent and severity of CAD evaluated by TAXUS Drug-Eluting Stent Versus Coronary Artery Bypass Surgery for the Treatment of Narrowed Arteries (SYNTAX) Score (SS) in patients with STEMI.
Richard S. Klasco, Richard E. Wolfe, Terrance Lee, Philip Anderson, Lee S. Jacobson, Joshua Solano, Jonathan Edlow, Shamai A. Grossman
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.001
Publication stage: In Press Corrected Proof
Published online: March 3 2016
x Chart review has been the mainstay of medical quality assurance practices since its introduction more than a century ago. The validity of chart review, however, has been vitiated by a lack of methodological rigor.
Ozgur Kirbas, Ozcan Ozeke, 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.2016.02.075
Publication stage: In Press Corrected Proof
Published online: March 2 2016
x Rapid diagnosis of ST-segment elevation myocardial infarction (STEMI) is essential for the appropriate management of patients; however, various conditions may present with an identical electrocardiographic pattern as STEMI in clinical practice. Obtaining a satisfactory history, comparing previous electrocardiograms, and assessing serial tests may provide valuable clues. Brugada syndrome or phenocopy also has been reported as a misdiagnosis of STEMI in clinical practice. We present an interesting image of progressive Brugada-type ST elevation in precordial leads associated with takotsubo cardiomyopathy.
Takayuki Ogura, Alan Kawarai Lefor, Mamoru Masuda, Shigeki Kushimoto
DOI: http://dx.doi.org/10.1016/j.ajem.2016.02.072
Publication stage: In Press Corrected Proof
Published online: March 2 2016
x Determination of the need for massive transfusion (MT) is essential for early activation of a MT protocol. The Traumatic Bleeding Severity Score (TBSS) predicts the need for MT accurately, but takes time to determine because systolic blood pressure after a 1000 mL of crystalloid infusion is used. The aim of this study is to determine the how well the Modified TBSS (age, sonography, pelvic fracture, serum lactate and systolic blood pressure on arrival) predicts the need for MT (accuracy).
Bernard P. Chang, Eileen Carter, Edward H. Suh, Ian M. Kronish, Donald Edmondson
DOI: http://dx.doi.org/10.1016/j.ajem.2016.02.074
Publication stage: In Press Corrected Proof
Published online: March 2 2016
x In the setting of high patient volumes and boarding times across many emergency departments (EDs), clinicians are increasingly tasked with the challenge of managing patients in nonconventional care areas [1]. The use of hallway care areas, locations where patients are in close proximity to one another with little or no structural partitions separating them, has increased [2–3]. Several negative consequences of ED hallway care have been noted, including patient perceptions of compromised care [4] and poor infection prevention practices among staff [5].
Suguru Nonami, Taizo Nakanishi, Shinsuke Tanizaki, Takashi Matsumoto, Makoto Sera, Shigenobu Maeda, Hiroshi Ishida
DOI: http://dx.doi.org/10.1016/j.ajem.2016.02.073
Publication stage: In Press Corrected Proof
Published online: March 2 2016
x Spontaneous visceral artery dissection (VAD) is a rare disease that mainly occurs in the superior mesenteric artery and celiac artery. However, VAD has been detected more frequently in the past several years because of the increasing use of computed tomography (CT) for the evaluation of abdominal symptoms. A prompt diagnosis and referral to a specialist should be made, because VAD occasionally causes critical bowel ischemia. However, there is no well-established management approach. We performed a retrospective analysis to evaluate the characteristics and prognoses of patients diagnosed with VAD.
Teri M. Kozik, Sachin Shah, Mouchumi Bhattacharyya, Teresa T. Franklin, Therese Farrell Connolly, Walter Chien, George S. Charos, Michele M. Pelter
DOI: http://dx.doi.org/10.1016/j.ajem.2016.02.068
Publication stage: In Press Accepted Manuscript
Published online: March 1 2016
x The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated.
Jie Liu, Yue Wang, Qiwei Zhuang, Meng Chen, Yufeng Wang, Lina Hou, Fei Han
DOI: http://dx.doi.org/10.1016/j.ajem.2016.02.066
Publication stage: In Press Corrected Proof
Published online: March 1 2016
x Cyclosporine A (CsA) was neuroprotective in the settings of traumatic brain injury and stroke. We sought to investigate the protective effects of CsA and hypothermia on neuronal mitochondria after cardiac arrest.
