Christopher S. Russi, Cari L. Wilcox, Hans R. House
DOI: http://dx.doi.org/10.1016/j.ajem.2006.03.018
Published in issue: March 2007
xEndotracheal intubation (ETI) is a motor skill that demands practice. Emergency medical service providers with limited intubation experience should consider using airway adjuncts other than ETI for respiratory compromise. Prehospital ETI has been recently interrogated by evidence exposing worsened patient outcomes. The laryngeal tube (LT) airway was approved by the Food and Drug Administration in 2003 for use in the United States. Using difficult airway-simulated models, we sought to describe the time difference between placing the ETI and LT and the successful placement of each adjunct in varied levels of healthcare providers.
Roger A. Band, David F. Gaieski, Angela M. Mills, Keara L. Sease, Frances S. Shofer, Jennifer L. Robey, Judd E. Hollander
DOI: http://dx.doi.org/10.1016/j.ajem.2006.07.011
Published in issue: March 2007
xDespite creatinine clearance (CrCl) being a better estimate of renal function, serum creatinine (Cr) is more commonly used to screen for renal insufficiency in patients scheduled for an enhanced abdominal computed tomography (CT) in an attempt to reduce the likelihood of contrast-induced nephropathy (CIN). Our objective was to determine the incidence of renal insufficiency (a CrCl <60 mL/min) among patients who have serum Cr below 1.5 mg/dL (the most commonly accepted Cr cutoff for the administration of intravenous contrast).
Chi-Ming Tai, Shih-Pei Huang, Hsiu-Po Wang, Tsung-Chun Lee, Chi-Yang Chang, Chia-Hung Tu, Ching-Tai Lee, Tsung-Hsien Chiang, Jaw-Town Lin, Ming-Shiang Wu
DOI: http://dx.doi.org/10.1016/j.ajem.2006.07.014
Published in issue: March 2007
xThe optimal timing of interventional endoscopy within the initial 24 hours remains controversial. We designed a retrospective study to compare the outcomes between emergency endoscopy (EE) and urgent endoscopy (UE) for high-risk patients with nonvariceal upper gastrointestinal hemorrhage presenting to the emergency department (ED).
John L. Francis, Alane Drexler, Mary Kathryn Duncan, Jamie M. Walker, Marcie J. Hursting, Robert L. Levine
DOI: http://dx.doi.org/10.1016/j.ajem.2006.07.015
Published in issue: March 2007
xPatients with heparin–platelet factor 4 (PF4) antibodies, particularly platelet-activating ones, are at risk for heparin-induced thrombocytopenia if administered heparin. We determined the heparin-PF4 antibody prevalence in emergency department (ED) patients presenting with chest pain or symptoms of thrombosis.
Kristen E. Nordenholz, N. Ward Naviaux, Krynn Stegelmeier, Jason S. Haukoos, Stephen J. Wolf, Tracy McCubbin, Kennon Heard
DOI: http://dx.doi.org/10.1016/j.ajem.2006.08.016
Published in issue: March 2007
xDiagnostic evaluation for suspected pulmonary embolism (PE) is challenging. Dimerized plasmin fragment D (D-dimer) assays are increasingly used but have been validated only in “low-risk” patients. The accurate interpretation and application of risk assessment criteria are critical to the appropriate use of D-dimer. We sought to determine the interrater agreement of attending and third-year resident emergency medicine physicians in the specific elements of the Canadian and the Charlotte risk stratification tools and their clinical application.
Robinson M. Ferre, Timothy W. Sweeney
DOI: http://dx.doi.org/10.1016/j.ajem.2006.08.013
Published in issue: March 2007
xAlthough ultrasound has been used in administering epidural anesthesia, it is unknown if emergency physicians (EPs) can obtain ultrasound images useful for lumbar puncture.
Carl J. Bonnett, Ben N. Peery, Stephen V. Cantrill, Peter T. Pons, Jason S. Haukoos, Kevin E. McVaney, Christopher B. Colwell
DOI: http://dx.doi.org/10.1016/j.ajem.2006.08.011
Published in issue: March 2007
xThere is a need for emergency planners to accurately plan for and accommodate a potentially significant increase in patient volume in response to a disaster. In addition, an equally large political demand exists for leaders in government and the healthcare sector to develop these capabilities in a financially feasible and evidence-based manner. However, it is important to begin with a clear understanding of this concept on a theoretical level to create this capacity. Intuitively, it is easy to understand that surge capacity describes the ability of a healthcare facility or system to expand beyond its regular operations and accommodate a greater number of patients in response to a multiple casualty-producing event.
Christopher A. Kahn, Jennifer A. Oman, Scott E. Rudkin, Craig L. Anderson, Deeba Sultani
DOI: http://dx.doi.org/10.1016/j.ajem.2006.08.010
Published in issue: March 2007
xThe purpose of the study was to determine the accuracy of adult weight estimates by emergency department personnel.
Keri Tilman, Mini DeLashaw, Sean Lowe, Sandy Springer, Susan Hundley, Francis L. Counselman
DOI: http://dx.doi.org/10.1016/j.ajem.2006.09.007
Published in issue: March 2007
xThis study was conducted to determine if emergency medicine (EM) physicians recognize emergency department (ED) patients with asymptomatic elevated blood pressure (AEBP) by diagnosis, treatment, or referral. The study also evaluated whether differences exist in identification of AEBP based on patient age, sex, race, or insurance status.
Min-Shan Tsai, Chien-Hua Huang, Wei-Tien Chang, Wen-Jone Chen, Chiung-Yuan Hsu, Cheng-Chun Hsieh, Chih-Wei Yang, Wen-Chu Chiang, Matthew Huei-Ming Ma, Shyr-Chyr Chen
DOI: http://dx.doi.org/10.1016/j.ajem.2006.12.007
Published in issue: March 2007
xSeveral studies have disclosed the importance of serum adrenocorticotropic hormone and cortisol levels in resuscitation. The objective of this study was to observe the effect of hydrocortisone on the outcome of out-of-hospital cardiac arrest (OHCA) patients.
Ronald M. Moscati, E. Brooke Lerner, Jennifer L. Pugh
DOI: http://dx.doi.org/10.1016/j.ajem.2006.05.015
Published in issue: March 2007
xThe aim of the study was to determine if spinal-immobilized patients met clinical criteria for x-rays and which clinical criteria were associated with cervical fractures.
Kirk A. Stiffler, Sharhabeel Jwayyed, Scott T. Wilber, Angela Robinson
DOI: http://dx.doi.org/10.1016/j.ajem.2006.07.010
Published in issue: March 2007
xThis study was conducted to assess the ultrasound's (US's) ability to identify pertinent landmarks for lumbar puncture (LP) in patients of various body mass indices (BMIs) and establish spatial relationships of pertinent LP landmarks across BMIs.
Salvatore Di Somma, Laura Magrini, Marinella Mazzone, Raffaella De Leva, Fabio Tabacco, Rossella Marino, Veronica Talucci, Enrico Ferri, Paola Forte, Patrizia Cardelli, Nicola Gentiloni, Valerio Pittoni
DOI: http://dx.doi.org/10.1016/j.ajem.2006.08.012
Published in issue: March 2007
xThirthy-seven consecutive patients with acute decompensated heart failure (ADHF) admitted to emergency departments for acute dyspnea were investigated. Ten patients with acute exacerbation of chronic obstructive pulmonary disease and 10 patients with hypertension crisis were also included as controls. For each patient, a plasma amino-terminal pro-B-type natriuretic peptide (NTproBNP) concentration measurement was performed at admission, 4, 12, and 24 hours later, and on the day of discharge. In patients with ADHF, the observation of a progressive reduction to a complete relief of symptoms of heart failure was accompanied by a reduction of 58% of NTproBNP plasma levels on the day of discharge.
Stacie E. Byers, Carl R. Chudnofsky, Barbara Sorondo, Paul Dominici, Steven J. Parrillo
DOI: http://dx.doi.org/10.1016/j.ajem.2006.09.005
Published in issue: March 2007
xThe aim of the study was to determine the incidence of nasogastric (NG) aspiration revealing a clinically unsuspected upper gastrointestinal (GI) bleeding in patients presenting to the emergency department (ED) with hematochezia. A secondary aim was to identify factors associated with an upper GI source.
James E. Svenson, Jill E. O'Connor, M. Bruce Lindsay
DOI: http://dx.doi.org/10.1016/j.ajem.2006.09.003
Published in issue: March 2007
xUnderstanding patterns of use of emergency medical services is important for planning adequate programs, budgets, and schedules. Understanding the factors associated with use of these services can help systems target high-risk populations or behaviors and allocate budgetary resources appropriately. Previous data have shown an association between the use of emergency health care use and distribution of welfare check distribution in both the United States and Canada. These data have limitations. In these studies, no attempt was made to investigate whether this increase in use was for particular types of complaints (medical or traumatic) or true outside of an urban community.
Loren G. Yamamoto, Lynette L. Young
DOI: http://dx.doi.org/10.1016/j.ajem.2006.05.028
Published in issue: March 2007
xThe outcome of refractory cardiac arrest is poor. The purpose of this report is to describe two cases presenting with fulminant myocarditis and refractory cardiac arrest treated with emergency department cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO), with subsequent recovery.
W. Frank Peacock, Judd E. Hollander, Richard W. Smalling, Michael J. Bresler
DOI: http://dx.doi.org/10.1016/j.ajem.2006.07.013
Published in issue: March 2007
xPrompt restoration of blood flow is the primary treatment goal in ST-segment elevation myocardial infarction to optimize clinical outcomes. The ED plays a critical role in rapid triage, diagnosis, and management of ST-elevation myocardial infarction, and in the decision about which of the 2 recommended reperfusion options, that is, pharmacologic and mechanical (catheter-based) strategies, to undertake. Guidelines recommend percutaneous coronary intervention (PCI) if the medical contact-to-balloon time can be kept under 90 minutes, and timely administration of fibrinolytics if greater than 90 minutes.
Jeffrey M. Schussler, E. Reed Smith
DOI: http://dx.doi.org/10.1016/j.ajem.2006.08.014
Published in issue: March 2007
xSixty-four–slice computed tomographic (CT) coronary angiography is a new technique for the noninvasive visualization of the coronary arteries. It enables noninvasive detection of coronary plaque and determination of severity without instrumentation of the heart. Although not yet commonly used in the emergency department setting, it stands poised to dramatically change the way that patients with chest pain are evaluated. In addition to evaluation of the coronary arteries, CT angiography has long been used to evaluate patients for other dangerous causes of chest pain such as aortic dissection and pulmonary embolus.
Joseph Varon, Paul E. Marik
DOI: http://dx.doi.org/10.1016/j.ajem.2006.12.023
Published in issue: March 2007
xDespite an improved understanding and management of cardiac arrest, and the widespread application of do-not-resuscitate orders in an attempt to prevent the inappropriate use of cardiopulmonary resuscitation (CPR), the success rate after inhospital cardiac arrest has remained unchanged over the last 3 decades, with return of spontaneous circulation (ROSC) in about 30% with approximately 15% of patients being discharged neurologically intact [1-7].
Matthew J. Beecroft, Jenny J. Lu, Mark B. Mycyk
DOI: http://dx.doi.org/10.1016/j.ajem.2006.11.022
Published in issue: March 2007
xWe read with great interest the study by Brahmi et al [1] examining the effect of multiple-dose activated charcoal (MDAC) in carbamazepine (CBZ) poisoning. We applaud their prospective design, but we have questions about their group selection and half-life calculations.
DOI: http://dx.doi.org/10.1016/S0735-6757(07)00056-3
Published in issue: March 2007
DOI: http://dx.doi.org/10.1016/S0735-6757(07)00057-5
Published in issue: March 2007
DOI: http://dx.doi.org/10.1016/S0735-6757(07)00058-7
Published in issue: March 2007
DOI: http://dx.doi.org/10.1016/S0735-6757(07)00059-9
Published in issue: March 2007
