Articles

The use of capnometry to predict arterial partial pressure of CO₂ in non-intubated breathless patients in the emergency department

Capnometry measures carbon dioxide in expired air and provides the clinician with a noninvasive measure of the systemic metabolism, circulation and ventilation. This study was carried out on patients with acut...

Authors: Nik Hisamuddin Nik Ab Rahman and Amiruddin Fairuz Mamat

State of emergency medicine in Spain

Spain has universal public health care coverage. Emergency care provisions are offered to patients in different modalities and levels according to the characteristics of the medical complaint: at primary care ...

Authors: Òscar Miró

Home visits reduce the number of hazards for childhood home injuries in Karachi, Pakistan: a randomized controlled trial

Although unintentional injuries are major causes of morbidity and mortality in less developed countries, they have received scant attention, and injury prevention policies and programs have just begun to be ad...

Authors: Rifat Rehmani and John C. LeBlanc

Prevalence of undiagnosed hypoxemia in adults and children in an under-resourced district hospital in Zambia

In adequately resourced clinical environments, diagnosis of hypoxemia via pulse oximetry is routine. Unfortunately, pulse oximetry is rarely utilized in under-resourced hospitals in developing countries.

Authors: Mark Foran, Roy Ahn, Joseph Novik, Lynda Tyer-Viola, Kennedy Chilufya, Kasseba Katamba and Thomas Burke

Towards systemic sustainable performance of TBI care systems: emergency leadership frontiers

Traumatic brain injuries (TBIs) continue as a twenty-first century subterranean and almost invisible scourge internationally. TBI care systems provide a safety net for survival, recovery, and reintegration int...

Authors: Denis H. J. Caro

Public opinion of a stroke clinical trial using exception from informed consent

Acute stroke is a leading cause of morbidity and mortality. Clinical trials in stroke are challenging because victims often do not have the capacity to provide informed consent, excluding those patients most l...

Authors: Joshua N. Goldstein, Janice A. Espinola, Jonathan Fisher, Daniel J. Pallin and Carlos A. Camargo Jr.

Barbicidal overdose

Acute severe methemoglobinaemia is an uncommon but life-threatening condition caused by a variety of oxidizing agents commonly used in both health care and industrial settings. Thus, recognition is important a...

Authors: Asim Nayeem, Samer Elkhodair and Thiagarajan Jaiganesh

Phencyclidine false positive induced by lamotrigine (Lamictal®) on a rapid urine toxicology screen

This report describes two cases with unexplained positive results for phencyclidine (PCP).

Authors: Matthew J. Geraci, James Peele, Stacey L. McCoy and Brad Elias

Pain treatment in post-traumatic hip fracture in the elderly: regional block vs. systemic non-steroidal analgesics

This prospective, randomized double-blind study, conducted over 19 months in a tertiary care ED, sought to determine if a fascia-iliaca regional anesthetic block provides better and safer pain relief than does...

Authors: Daniel Godoy Monzón, Jorge Vazquez, José R. Jauregui and Kenneth V. Iserson

Treatment and prognosis of pyogenic liver abscess

There are many combinations of treatments for pyogenic liver abscess (PLA). Different treatments are indicated for different clinical courses of PLA.

Authors: Yu-Jang Su, Yen-Chun Lai, Yu-Chia Lin and Yu-Hang Yeh

Systematic review of emergency department central venous and arterial catheter infection

There is an extensive critical care literature for central venous catheter and arterial line infection, duration of catheterization, and compliance with infection control procedures. The emergency medicine lit...

Authors: Christopher H. LeMaster, Ashish T. Agrawal, Peter Hou and Jeremiah D. Schuur

Current challenges in the provision of ambulance services in New Zealand

Emergency Medical Services (EMS) in New Zealand has been serving the society since the first ambulance in 1892. Since then it has developed rapidly following national health system reforms and changes in lifes...

Authors: Sultan Al-Shaqsi

Mortality and morbidity in children caused by falling televisions: a retrospective analysis of 71 cases

Femoral artery pseudoaneurysm following cardiac catheterization is a serious groin complication requiring careful assessment and prompt intervention.

Authors: Servan Gokhan, Ozkan Kose, Ayhan Ozhasenekler, Murat Orak, Mehmet Ustundag and Cahfer Guloglu

Teaching about disasters in medical education: the need for international collaboration

Authors: Samy A. Azer

ECG interpretation skills of South African Emergency Medicine residents

The use and interpretation of electrocardiograms (ECGs) are widely accepted as an essential core skill in Emergency Medicine. It is imperative that emergency physicians are expert in ECG interpretation when th...

Authors: Japie de Jager, Lee Wallis and David Maritz

A delayed diagnosis: stridor secondary to hypocalcemia

Hypocalcemia with stridor is a well-known condition in the pediatric age group but has rarely been reported in the elderly. We report an elderly patient who presented with dyspnea and laryngeal stridor attack ...

Authors: Fatih Büyükcam, Feruza Turan Sönmez and Hayriye Şahinli

Outcomes considered most important by emergency physicians when determining disposition of patients with pulmonary embolism

Clinical decision rules for the disposition of patients with pulmonary embolism (PE) are typically validated against an outcome of 30-day mortality or disease recurrence. There is little justification for this...

Authors: Christopher Kabrhel, Weston Sacco, Shan Liu and Praveen Hariharan

A prospective study of tracheal intubation in an academic emergency department in Malaysia

Airway management is an important part of the management of the critically ill and injured patients in the Emergency Department (ED). Numerous studies from developed countries have demonstrated the competency ...

Authors: Shahridan Mohd. Fathil, Siti Nidzwani Mohd. Mahdi, Zuraidah Che’Man, Azhana Hassan, Zulkernain Ahmad and Ahmad Khaldun Ismail

Spinal cord toxoplasmosis as an unusual presentation of AIDS: case report and review of the literature

Approximately 10% of patients with AIDS present with some neurological deficit as their initial complaint, and up to 80% will have CNS involvement during the course of their disease. Toxoplasmosis is the most ...

Authors: Carlos Garcia-Gubern, Carmen R. Fuentes, Lissandra Colon-Rolon and Daniel Masvidal

Acute wound management: revisiting the approach to assessment, irrigation, and closure considerations

As millions of emergency department (ED) visits each year include wound care, emergency care providers must remain experts in acute wound management. The variety of acute wounds presenting to the ED challenge ...

Authors: Bret A. Nicks, Elizabeth A. Ayello, Kevin Woo, Diane Nitzki-George and R. Gary Sibbald

Perceptions of nurse practitioners by emergency department doctors in Australia

The Australian Medical Association is strongly opposed to the nurse practitioner (NP) role with concerns that NPs may become doctor substitutes without the requisite training and education that the medical rol...

Authors: Tracey J. Weiland, Claire Mackinlay and George A. Jelinek

Myocardial infarction with unusual presentation of otalgia: a case report

A rare case of a patient with unusual symptoms of earache and sore throat for cardiac ischemia is presented. A diagnosis of non-ST-segment elevation myocardial infarction (NSTEMI) was made based on initial ele...

Authors: Sorour Amirhaeri and Donnie Spencer

Prognostic factors for important clinical outcomes in patients with a severe infection

Patients who are admitted with a suspicion of a severe infection usually enter the hospital through the emergency department (ED). The recognition of prognostic factors in an early stage affects further treatm...

Authors: Charlotte F. J. van Tuijn, Maria Prins, Jan S. Luitse and Suzanne E. Geerlings

A multi-center study on the attitudes of Malaysian emergency health care staff towards allowing family presence during resuscitation of adult patients

The practice of allowing family members to witness on-going active resuscitation has been gaining ground in many developed countries since it was first introduced in the early 1990s. In many Asian countries, t...

Authors: Chew Keng Sheng, Chee Kean Lim and Ahmad Rashidi

Implementation of crowding solutions from the American College of Emergency Physicians Task Force Report on Boarding

We sought to measure the self-reported implementation of the crowding solutions outlined in the 2008 American College of Emergency Physicians (ACEP) Boarding Task Force report “Emergency Department Crowding: H...

Authors: Daniel A. Handel, Adit A. Ginde, Ali S. Raja, John Rogers, Ashley F. Sullivan, Janice A. Espinola and Carlos A. Camargo Jr.

Myopericarditis diagnosed by a 64-slice coronary CT angiography "triple rule out" protocol

We report a case of myopericarditis in a 30-year-old male complaining of shortness of breath. In an emergency department (ED) setting, the symptoms of myopericarditis may overlap with many disease entities and...

Authors: Kevin M. Takakuwa, Bon S. Ku and Ethan J. Halpern

Utilization of a mobile medical van for delivering pediatric care in the bateys of the Dominican Republic

Bateys are impoverished areas of housing for migrant Haitian sugar cane workers in the Dominican Republic (DR). In these regions, preventative health care is almost non-existent, public service accessibility is l...

Authors: Heather L. Crouse, Charles G. Macias, Andrea T. Cruz, Kim A. Wilson and Susan B. Torrey

Perforated Meckel diverticulum

Perforation of a Meckel diverticulum (MD) is a rare complication that can often mimic appendicitis. This case report identifies a child who presented to our Emergency Department (ED) with right lower quadrant ...

Authors: Brian T. Kloss, Claire E. Broton and Anne Marie Sullivan

Evaluating applicants to a new emergency medicine residency program: subjective assessment of applicant characteristics

Because of the Accreditation Council for Graduate Medical Education (ACGME) and the Residency Review Committee (RRC) approval timelines, new residency programs cannot use Electronic Residency Application Servi...

Authors: Steven F. Groke, Troy E. Madsen, Laura Strate, Stuart Knapp, Matt Dawson, Susan Stroud, Stephen Hartsell and Virgil Davis

Etoricoxib-induced life-threatening hyperkalemia and acute kidney dysfunction against the background of telmisartan and a low sodium diet

Drug-induced hyperkalemia is not uncommon and may be life-threatening when presenting acutely in the emergency department. We present a case of severe hyperkalemia precipitated acutely by etoricoxib in a patie...

Authors: Swagata Tripathy and Suresh Chandra Dash

The serotonin syndrome—the need for physician’s awareness

Serotonin syndrome is a potentially life-threatening adverse drug reaction that results from therapeutic drug use, usually of selective serotonin reuptake inhibitors (SSRIs), intentional excessive use or inter...

Authors: Bhawana Arora and Nirupama Kannikeswaran

An argument for the conservative management of small traumatic pneumathoraces in populations with high prevalence of HIV and tuberculosis: an evidence-based review of the literature

Traumatic pneumothoraces are common. Many are managed with tube thoracostomy. However, there is a high complication rate from chest tube placement, particularly in patients with HIV, TB, or both.

Authors: Zachary D. Tebb, Brad Talley, Marlow Macht and David Richards

Variation in the use of observation status evaluation in Massachusetts acute care hospitals, 2003–2006

Observation evaluation is an alternate pathway to inpatient admission following Emergency Department (ED) assessment.

Authors: Jeremiah D. Schuur, Arjun K. Venkatesh and J. Stephen Bohan

Emergency care in India: the building blocks

The Republic of India, the world’s most populous democracy, has struggled with establishing Emergency Medical Care. However, with the recent recognition of Emergency Medicine as a formal specialty in medical t...

Authors: Imron Subhan and Anunaya Jain

The epidemiology of childhood injury in Maputo, Mozambique

Injury remains a major cause of death and disability worldwide.

Authors: Delmira de sousa Petersburgo, Christine E. Keyes, David W. Wright, Lorie A. Click, Jana B. A. Macleod and Scott M. Sasser

The role of prophylactic anticonvulsants in moderate to severe head injury

Post-traumatic seizures cause secondary brain injury, contributing to morbidity and mortality after traumatic brain injury. Seizure activity may be undetectable if the patient is paralysed and ventilated.

Authors: Arshad Ali Khan and Ashis Banerjee

Use of bivalirudin for heparin-induced thrombocytopaenia after thrombolysis in massive pulmonary embolism: a case report

A 68-year-old man was referred to the emergency department 6 h after onset of sudden acute dyspnoea. Immediate ECG showed sinus tachycardia with the typical S1-Q3-T3 pattern and incomplete right bundle branch ...

Authors: Sergio Fasullo, Sebastiano Scalzo, Giorgio Maringhini, Filippo Ganci, Alfonso Giubilato, Sergio Cannizzaro, Roberto Baglini, Debora Cangemi, Gabriella Terrazzino, Salvatore Paterna and Pietro Di Pasquale

Use of an improvised pneumatic anti-shock garment and a non-pneumatic anti-shock garment to control pelvic blood flow

Pelvic bleeding from trauma and postpartum hemorrhage is often difficult to treat successfully by emergency providers particularly in low resource environments, when hospital presentation is delayed or there i...

Authors: Mark Hauswald, Michael R. Williamson, Gillian M. Baty, Nancy L. Kerr and Victoria L. Edgar-Mied

Epidemiology of injuries presenting to the national hospital in Kampala, Uganda: implications for research and policy

Despite the growing burden of injuries in LMICs, there are still limited primary epidemiologic data to guide health policy and health system development. Understanding the epidemiology of injury in developing ...

Authors: Renee Y. Hsia, Doruk Ozgediz, Milton Mutto, Sudha Jayaraman, Patrick Kyamanywa and Olive C. Kobusingye

Successful treatment of a severely injured soldier from Afghanistan with pumpless extracorporeal lung assist and neurally adjusted ventilatory support

Life-threatening acute lung injury due to combat and/or terror attacks is associated with high mortality. The successful management includes the use of “rescue” extracorporeal lung assist and early transport b...

Authors: Thomas Bein, Eric Osborn, Hans Stefan Hofmann, Markus Zimmermann, Alois Philipp, Hans J. Schlitt and Bernhard M. Graf

Dentist’s drill allergy?

Subcutaneous emphysema of the face and neck can develop following restorative dentistry, particularly when air turbine drills are used. We present a case in which the dentist mistook the subcutaneous emphysema...

Authors: David Sainsbury and Thiagarajan Jaiganesh

Alcohol-related emergency department attendances: is preloading a risk factor? Cross-sectional survey

‘Preloading’ is a phenomenon where people drink alcohol at a private residence before going out. We aimed to identify whether preloading is a risk factor for alcohol-related emergency department attendance. We...

Authors: Adrian Boyle, Naomi Wee, Richard Harris, Alison Tompkins, Michael Soper and Chris Porter

Emergency medicine in Paarl, South Africa: a cross-sectional descriptive study

Emergency Medicine (EM) in South Africa is in its earliest stages of development. There is a paucity of data about emergency department (ED) patient demographics, epidemiology, consultation and admission crite...

Authors: Rens Hanewinckel, Henri P. Jongman, Lee A. Wallis and Terrence M. Mulligan

Delayed intrathyroidal hematoma causing respiratory distress after a seemingly benign fall: a case report

A rare event of a fall causing delayed intrathyroidal hematoma and respiratory distress is reported here. A 75-year-old woman with symptoms of vertigo causing syncope and fall 24 h earlier was seen and dischar...

Authors: Lucas B. Chartier and Joel P. Turner

Ludwig’s angina

Authors: Kael Duprey, Jonathan Rose and Christian Fromm

Foreign body in the abdomen

Authors: Wei-Jing Lee, Yu-Hui Lu, Si-Chun Vong and Tang-Yu Lin

Meckel’s diverticulum-induced ileocolonic intussusception

Authors: Brian T. Kloss

Echo-enhanced needles for short-axis ultrasound-guided vascular access

Authors: Kumaresh Venkatesan

Traumatic bronchial rupture: an unusual cause of tension pneumothorax

Bronchial rupture is a rare and serious complication of blunt chest trauma, which can be easily overlooked on initial evaluation in the emergency room (ER) as the focus of the attending physician is diverted t...

Authors: Shankar Hanamantrao Hippargi

Health information technology in US emergency departments

Information technology may improve patient safety, and is a focus of health care reform. A minority of emergency departments (EDs) in Massachusetts, and in academic EDs throughout the US, have electronic healt...

Authors: Daniel J. Pallin, Ashley F. Sullivan, Rainu Kaushal and Carlos A. Camargo Jr.