Articles

Clinical significance of urinary L-FABP in the emergency department

This study’s aim is to measure liver-type fatty acid-binding protein (L-FABP) levels in urine using a rapid semiquantitative assay kit in the emergency department and to investigate whether the onset of acute ...

Authors: Ginga Suzuki, Ryo Ichibayashi, Saki Yamamoto, Yoshimi Nakamichi, Masayuki Watanabe and Mitsuru Honda

New d-dimer threshold for Japanese patients with suspected pulmonary embolism: a retrospective cohort study

In the diagnosis of pulmonary embolism (PE), the d-dimer threshold is based on studies conducted in Western countries, where the incidence rate is 5 times higher than that in Asian countries, including Japan. If ...

Authors: Jin Takahashi, Takashi Shiga, Yuita Fukuyama, Yuiko Hoshina, Yosuke Homma, Michiko Mizobe, Kenji Numata, Tetsuya Inoue and Hiraku Funakoshi

Complications of subcutaneous penile modifications: a discussion of emergency department presentations and management

Subcutaneous penile modifications (SPMs) are more prevalent in Southeast Asian culture and have been growing in popularity in Western culture. SPMs are often made of domino tiles, or other available pieces of ...

Authors: Cali L. Kirkham, Stormy M. Monks and Scott B. Crawford

The impact of a multimodal intervention on emergency department crowding and patient flow

The objective of this study is to assess the impact of a multimodal intervention on emergency department (ED) crowding and patient flow in a Dutch level 1 trauma center.

Authors: M. C. (Christien) van der Linden, H. M. E. (Jet) van Ufford and N. (Naomi) van der Linden

Effect of new year holidays on hospital mortality: a time series study

Nowruz holidays, as one of the most important holidays in Iran, can lead to changes in the trend of hospital deaths. Due to changes in lifestyle and increased accidents, hospitals become crowded during the hol...

Authors: Mohadeseh Ghanbari Jahromi, Reza Goudarzi, Vahid Yazdi-Feyzabadi, Saeed Amini, Javad Nazari and Mohammadreza Amiresmaili

Interdisciplinary in situ simulation-based medical education in the emergency department of a teaching hospital in Nepal

Simulation is well established as an effective strategy to train health care professionals in both technical and nontechnical skills and to prevent errors. Despite its known efficacy, adequate implementation i...

Authors: Roshana Shrestha, Anmol Purna Shrestha, Sanu Krishna Shrestha, Samjhana Basnet and Alok Pradhan

Epidemiology of paediatric trauma in Norway: a single-trauma centre observational study

Trauma is a major cause of mortality and morbidity in children globally. The burden of injury shows substantial geographical differences, with a significant mortality reduction in children in Norway during the...

Authors: Eirik Nesje, Nadine Nalini Valøy, Andreas Jorstad Krüger and Oddvar Uleberg

The importance of platelet counts in severe hypothermia

Authors: Ian Joseph Cohen

Emergency medicine in Saudi Arabia: a century of progress and a bright vision for the future

Although emergency medical services (EMS) and pre-hospital care have existed in the Kingdom of Saudi Arabia (KSA) since 1934, emergency medicine (EM) is a relatively new medical field in the country that was n...

Authors: Eyad Khattab, Abdulrahman Sabbagh, Nawfal Aljerian, Hashim Binsalleeh, Mobarak Almulhim, Abdulrahman Alqahtani and Majid Alsalamah

A comparison of airway management devices in simulated entrapment-trauma: a prospective manikin study

In the patient entrapped after a motor vehicle collision (MVC), advanced airway management may need to be performed before extrication. The aim of this study was to compare four airway management devices utili...

Authors: Robin Pap and Charl van Loggerenberg

Outcomes following clonidine ingestions in children: an analysis of poison control center data

This paper sought to characterize pediatric clonidine ingestions, report trends in incidence, and evaluate outcomes using the Florida Poison Center’s data over a period of 15 years, from 2002 to 2016.

Authors: Kendra Amico, Rolando Cabrera and Latha Ganti

Medical students and metrics: seven techniques for a win-win situation

The authors present seven winning strategies for maintaining a rich academic environment for learners while working in a busy emergency department with expected productivity metrics.

Authors: Tracy MacIntosh, David C. Lebowitz and Latha Ganti

Differences in initial electrocardiographic findings between ST-elevation myocardial infarction due to left main trunk and left anterior descending artery lesions

Early discrimination of ST-elevation myocardial infarction (STEMI) due to a left main trunk (LMT) lesion provided by straightforward electrocardiographic criteria is useful for prompt treatment. The purpose of...

Authors: Toshiharu Fujii, Misaki Hasegawa, Junichi Miyamoto and Yuji Ikari

Improving the ability of ED physicians to identify subclinical/electrographic seizures on EEG after a brief training module

Approximately 5% of emergency department (ED) patients with altered mental status (AMS) have non-convulsive seizures (NCS). Patients with NCS should be diagnosed with EEG as soon as possible to initiate antiep...

Authors: Geetha Chari, Kabir Yadav, Daniel Nishijima, Ahmet Omurtag and Shahriar Zehtabchi

Quick SOFA vs Rockall preendoscopy scores for risk assessment in patients with nonvariceal upper gastrointestinal bleeding: a retrospective cohort study

Several scoring systems are used to evaluate the severity of nonvariceal upper gastrointestinal bleeding (NVUGB) and the risk of rebleeding or death. The most commonly used scoring systems include the Rockall ...

Authors: Vladimir Bagin, Evgenii Tarasov, Maria Astafyeva, Evgenii Nishnevich, Vladimir Rudnov and Mikhail Prudkov

A critical review of the factors leading to cardiopulmonary resuscitation as the default position of hospitalized patients in the USA regardless of severity of illness

Physicians are occasionally faced with patients requesting full resuscitation against medical advice. More commonly, neither patients nor their family members make such a request, but physicians simply presume...

Authors: Loukas Georgiou and Anastasios Georgiou

It’s not just FaceTime: core competencies for the Medical Virtualist

New applications for virtual healthcare have resulted in an expansion of medical care beyond traditional healthcare settings. However, the rapid development of telemedicine as a field has resulted in poor stan...

Authors: Rahul Sharma, Sapir Nachum, Karina W. Davidson and Michael Nochomovitz

A pilot study of improvised CPAP (iCPAP) via face mask for the treatment of adult respiratory distress in low-resource settings

Continuous positive airway pressure (CPAP) is a mode of non-invasive ventilation used to treat a variety of respiratory conditions in the emergency department and intensive care unit. In low-resource settings ...

Authors: Brendan H. Milliner, Suzanne Bentley and James DuCanto

Team-based learning improves knowledge and retention in an emergency medicine clerkship

Team-based learning (TBL) as an instructional pedagogy is increasingly recognized to improve student engagement, value of teamwork, and performance on standardized assessments when compared to traditional lect...

Authors: Arif Alper Cevik, Margaret ElZubeir, Fikri M. Abu-Zidan and Sami Shaban

Implementation and performance of the South African Triage Scale at Kenyatta National Hospital in Nairobi, Kenya

Triage protocols standardize and improve patient care in accident and emergency departments (A&Es). Kenyatta National Hospital (KNH), the largest public tertiary hospital in East Africa, is resource-limited an...

Authors: Ali A. Wangara, Katherine M. Hunold, Sarah Leeper, Frederick Ndiawo, Judith Mweu, Shaun Harty, Rachael Fuchs, Ian B. K. Martin, Karen Ekernas, Stephen J. Dunlop, Michèle Twomey, Alice W. Maingi and Justin Guy Myers

Evaluating the impact of emergency department crowding on disposition patterns and outcomes of discharged patients

Crowding is a major challenge faced by EDs and is associated with poor outcomes.

Authors: Mahshid Abir, Jason E. Goldstick, Rosalie Malsberger, Andrew Williams, Sebastian Bauhoff, Vikas I. Parekh, Steven Kronick and Jeffrey S. Desmond

Impact of short basic emergency medicine training in introducing emergency medicine as a specialty in Sub-Saharan Africa: experience from Tanzania

Emergency medicine (EM) is a new specialty in Tanzania. Little is known about how to introduce EM to health care providers (HCPs) in hospitals without EM. We determined the impact of a 2-day EM training progra...

Authors: Peter S. Mabula, Hendry R. Sawe, Victor Mwafongo, Juma A. Mfinanga, Michael S. Runyon and Brittany L. Murray

Relationship between level of CPR training, self-reported skills, and actual manikin test performance—an observational study

Quality of bystander cardiopulmonary resuscitation (CPR) skills may influence out of hospital cardiac arrest (OHCA) outcomes. We analyzed how the level of CPR training related to indicators of good CPR quality...

Authors: Inger Lund-Kordahl, Maria Mathiassen, Jørgen Melau, Theresa Mariero Olasveengen, Kjetil Sunde and Knut Fredriksen

The association between intravenous fluid resuscitation and mortality in older emergency department patients with suspected infection

Recent studies suggest that hypotension thresholds in current guidelines might be too low for older patients due to arterial stiffening, possibly leading to insufficient fluid resuscitation. We compared intraveno...

Authors: Sin Y. Ko, Laura M. Esteve Cuevas, Merel Willeboer, Annemieke Ansems, Laura C. Blomaard, Jacinta A. Lucke, Simon P. Mooijaart and Bas de Groot

Public perception of female paramedics at King Abdulaziz Medical City, Saudi Arabia

Although emergency medical service (EMS) providers recognize that both male and female paramedics are necessary, Saudi EMSs are currently fully staffed by men. Cultural bias against care provision by male para...

Authors: Nesrin Alharthy, Sara Alswaes, Alanoud Almaziad, Nourah Alenazi, Maha Abdallah and Moeed Alshehry

Correction to: Factors influencing medical students’ choice of emergency medicine as a career specialty—a descriptive study of Saudi medical students

Following publication of the original article [1], the authors reported that one of the authors’ names is spelled incorrectly. In this Correction the incorrect and correct author name are shown.

Authors: Hadeel Alkhaneen, Faisal Alhusain, Khalid Alshehri and Nawfal Al Jerian

The impact of prothrombin complex concentrates when treating DOAC-associated bleeding: a review

Bleeding complications are a risk associated with all anticoagulants. Currently, the treatment options for the management of direct oral anticoagulant (DOAC)-associated bleeding are limited. Prothrombin comple...

Authors: Maureane Hoffman, Joshua N. Goldstein and Jerrold H. Levy

Estimation of weight in adults from height: a novel option for a quick bedside technique

In critical care situations, there are often neither the means nor the time to weigh each patient before administering strict weight-based drugs/procedures. A convenient, quick and accurate method is a priorit...

Authors: Daniel D. Kokong, Ishaya C. Pam, Ayuba I. Zoakah, Solomon S. Danbauchi, Emmanuel S. Mador and Barnabas M. Mandong

Assessment of pre-hospital emergency medical services in low-income settings using a health systems approach

Emergency medical services (EMS) is defined as the system that organizes all aspects of care provided to patients in the pre-hospital or out-of-hospital environment. Hence, EMS is a critical component of the h...

Authors: Amber Mehmood, Armaan Ahmed Rowther, Olive Kobusingye and Adnan A. Hyder

Aligning emergency care with global health priorities

The availability of resources, knowledge, and will to expand access to high-quality emergency care in low- and middle-income countries has made strong progress in recent years. While the possibility for interv...

Authors: Thomas Shanahan, Nicholas Risko, Junaid Razzak and Zulfiqar Bhutta

Fatal orbital cellulitis with intracranial complications: a case report

Orbital cellulitis is a relatively uncommon presentation in the emergency department, but orbital cellulitis complicated by intracranial extensions, loss of vision, and death has rarely been reported in the li...

Authors: Sabrina Berdouk and Nirasha Pinto

Characteristics of traumatic out-of-hospital cardiac arrest patients presenting to major centers in Karachi, Pakistan—a longitudinal cohort study

Trauma is the leading cause of death for adults under 44 years of age. Survival after traumatic out-of-hospital cardiac arrest (OHCA) has been reported to be poor, and its epidemiology is not well defined. A f...

Authors: Minaz Mawani, Masood Kadir, Iqbal Azam and Junaid Abdul Razzak

Improving pediatric emergency department physicians’ adherence to clinical practice guidelines on the diagnosis and management of group A beta-hemolytic streptococcal pharyngitis—a cross-sectional study

Pharyngitis is one of the major and commonly seen presentations in pediatric emergency departments. While it could be caused by both bacterial and viral pathogens, antibiotics are improperly prescribed regardl...

Authors: Ahmed A. Alkhazi, Khalid M. Alessa, Ahmed M. Almutairi, Hamad A. Almadi, Abdullah Akkam, Mohammed K. Almutairi, Omar A. Alhamad and Hadeel S. Ghazal

Performance of an emergency department observation unit protocol in reducing length of stay for acetaminophen overdose: a retrospective study

Acetaminophen is one of the most common causes of poisoning among developed countries. The emergency department observation unit (EDOU) has been increasingly used in the management of various conditions to red...

Authors: Dilin Tang, Wui Ling Chan and Dong Haur Phua

Deciding to lead: a qualitative study of women leaders in emergency medicine

The aim of this study is to highlight career paths of senior women leaders in academic emergency medicine (EM) to encourage younger women to pursue leadership.

Authors: Mindi Guptill, Ellen T. Reibling and Kathleen Clem

Successful resuscitation for cardiac arrest due to severe accidental hypothermia accompanied by mandibular rigidity: a case of cold stiffening mimicking rigor mortis

In cases of severe accidental hypothermia, it was recommended that resuscitation should be continued until the patient has rewarmed, as hypothermia itself can preserve cerebral function, and hypothermic cardia...

Authors: Naofumi Bunya, Keigo Sawamoto, Ryuichiro Kakizaki, Kenshiro Wada, Yoichi Katayama, Hirotoshi Mizuno, Hiroyuki Inoue, Shuji Uemura, Keisuke Harada and Eichi Narimatsu

Acquired methemoglobinemia from phenazopyridine use

Phenazopyridine-induced methemoglobinemia is relatively rare with fewer than ten cases reported over the past 35 years. We describe a case of phenazopyridine-induced methemoglobinemia that is unique in the way...

Authors: Travis Murphy and Melinda Fernandez

Assessing utility and completeness of information transmission during emergency department transfers

The transfer of patients from community emergency departments to tertiary care centers is a daily occurrence in the practice of emergency medicine, but the completeness of medical data in the transfer document...

Authors: Jason J. Lewis, David W. Schoenfeld and Alden Landry

The feasibility of the 1-h high-sensitivity cardiac troponin T algorithm to rule-in and rule-out acute myocardial infarction in Thai emergency patients: an observational study

The 3-h high-sensitivity cardiac troponin T (hs-cTnT) algorithm is the most commonly used scheme to diagnose acute myocardial infarction. The 1-h hs-cTnT algorithm has recently been approved by the European So...

Authors: Onlak Ruangsomboon, Pattaraporn Mekavuthikul, Tipa Chakorn, Apichaya Monsomboon, Nattakarn Prapruetkit, Usapan Surabenjawong, Chok Limsuwat, Sattha Riyapan and Wansiri Chaisirin

Patients’ and healthcare professionals’ experiences and perceptions of physiotherapy services in the emergency department: a qualitative systematic review

Worldwide, emergency department (ED) attendances and admissions to acute care have increased significantly. Many EDs are adding physiotherapists to their team thereby allowing doctors to see more cases that ar...

Authors: Rosalie Barrett and Louise Terry

Idarucizumab for a traumatic head injury patient taking dabigatran

Dabigatran is one of the four drugs currently used as a direct oral anticoagulant in Japan. Idarucizumab, which specifically targets dabigatran, was recently approved in Japan. We present a case of intracrania...

Authors: Shuhei Maruyama, Koichi Hayakawa, Shuji Kanayama, Hiromu Iwamura, Daiki Wada, Fukuki Saito, Yasushi Nakamori and Yasuyuki Kuwagata

Outcomes following cardiopulmonary resuscitation in an emergency department of a low- and middle-income country

Cardiopulmonary resuscitation (CPR) is a key component of emergency care following cardiac arrest. A better understanding of factors that influence CPR outcomes and their prognostic implications would help gui...

Authors: Umme Salama Moosajee, Syed Ghazanfar Saleem, Sundus Iftikhar and Lubna Samad

Challenges in measuring ACGME competencies: considerations for milestones

Measuring milestones, competencies, and sub-competencies as residents progress through a training program is an essential strategy in Accreditation Council for Graduate Medical Education (ACGME)’s attempts to ...

Authors: Prathiba Natesan, Nicholas J. Batley, Rinad Bakhti and Philippe Z. El-Doueihi

Design and implementation of a medical student hazardous materials response team: the Medical Student HazMat Team

To design and implement a replicable disaster training curriculum for the first on-call medical student hazardous materials response team.

Authors: Joshua Verson, Nicholas Dyga, Nestor Agbayani, Fred Serafin and Louis Hondros

The influence of excluding patients with bystander return of spontaneous circulation in the current OHCA database

The effect of bystander interventions has been extensively evaluated by cerebral function after 1 month post-resuscitation. However, patients who received bystander cardiopulmonary resuscitation (BCPR) and ach...

Authors: Hiroshi Otani, Ryo Sagisaka, Hideharu Tanaka, Hiroshi Takyu, Takahiro Hara, Toru Shirakawa, Shota Tanaka and Akira Maki

Intracranial subdural hematoma after epidural anesthesia: a case report and review of the literature

Intracranial subdural hematoma occurring as a result of a procedure that causes a puncture of the spinal dura mater is extremely rare, with less than 100 cases reported. Often, this condition is initially misd...

Authors: Victor Szeto, Justin Kosirog and Wesley Eilbert

The emergency department landscape in The Netherlands: an exploration of characteristics and hypothesized relationships

Nationwide optimization of the emergency department (ED) landscape is being discussed in The Netherlands. The emphasis is put mostly on the number of EDs actually present at the time versus a proposed minimum ...

Authors: Menno I. Gaakeer, Rebekka Veugelers, Joris M. van Lieshout, Peter Patka and Robbert Huijsman

Airway obstruction due to sticky rice cake (mochi): a case series and review of the literature

Foreign body airway obstruction is a significant public health issue around the world. Mochi, a traditional sticky rice cake in Japan, has gained popularity in many countries including the USA. However, the as...

Authors: Shimpei Nagata, Sung-Ho Kim, Yasuaki Mizushima and Tatsuya Norii

A qualitative study of the determinants of adherence to NICE falls guideline in managing older fallers attending an emergency department

The National Institute for Health and Care Excellence (NICE) 2004 Falls guideline was developed to improve the assessment and management of falls and prevention of future falls. However, adherence to the guide...

Authors: Helen McEwan, Richard Baker, Natalie Armstrong and Jay Banerjee

Migraine with extensive skin markings: a case report

Migraines are a commonly seen complaint in the emergency department, but migraines with extensive skin markings have rarely been reported and so the cause is still unknown.

Authors: Sabrina Berdouk and Sobia Khan