Articles

State of emergency medicine in Rwanda 2015: an innovative trainee and trainer model

The 1994 Rwandan war and genocide left more than 1 million people dead; millions displaced; and the country’s economic, social, and health infrastructure destroyed. Despite remaining one of the poorest countri...

Authors: Gabin Mbanjumucyo, Elizabeth DeVos, Simon Pulfrey and Henry M Epino

Descriptive analysis of sepsis in a developing country

Most studies on sepsis were conducted in developed countries. The aim of this study is to report on a series of patients with sepsis in a tertiary hospital in a developing country.

Authors: Gilbert Abou Dagher, Mothana Saadeldine, Rana Bachir, Dina Zebian and Ralphe Bou Chebl

Prognostic performance of the Rapid Emergency Medicine Score (REMS) and Worthing Physiological Scoring system (WPS) in emergency department

The Rapid Emergency Medicine Score (REMS) and Worthing Physiological Scoring system (WPS) have been developed for predicting in-hospital mortality in nonsurgical emergency department (ED) patients. The prognos...

Authors: Duc T Ha, Tam Q Dang, Ngoc V Tran, Nhi Y Vo, Nguyen D Nguyen and Tuan V Nguyen

Burden of motorcycle-related injury in Malaysia

Road traffic injury (RTI) contributes to major morbidity and mortality in both developed and developing countries. Most of the injuries are caused by road-related injuries that specifically relate to motorcycl...

Authors: Nik Hisamuddin NA Rahman, Kamarul A Baharuddin and Syarifah Mastura S Mohamad

Traumatic lens dislocation

Point-of-care ultrasound has been widely used by clinicians, particularly those in emergency care settings.

Authors: Sangil Lee, Alison Hayward and Venkatesh R Bellamkonda

Erratum: Self-referred patients at the Emergency Department: patient characteristics, motivations, and willingness to make a copayment

Authors: Janneke de Valk, Elisabeth M Taal, Mariette S Nijhoff, Maren H Harms, Esther MM Van Lieshout, Peter Patka and Pleunie PM Rood

Managing the advanced cancer patient in the Australian emergency department environment: findings from a national survey of emergency department clinicians

Delivery of care to people with advanced cancer in the emergency department (ED) is complicated by competing service demands, workloads and physical design constraints. We explored emergency clinicians’ attitu...

Authors: Tracey J Weiland, Heather Lane, George A Jelinek, Claudia H Marck, Jennifer Weil, Mark Boughey and Jennifer Philip

Hypertensive emergency presenting as blurry vision in a patient with hypertensive chorioretinopathy

A 42-year-old man presented with 3 weeks of blurry vision in the right eye. His exam was significant for decreased vision in the right eye, diffuse retinopathy in both eyes, and serous retinal detachment in th...

Authors: Andrew W Stacey, Cemal B Sozener and Cagri G Besirli

Emergency medical services key performance measurement in Asian cities

One of the key principles in the recommended standards is that emergency medical service (EMS) providers should continuously monitor the quality and safety of their services. This requires service providers to...

Authors: Nik Hisamuddin Rahman, Hideharu Tanaka, Sang Do Shin, Yih Yng Ng, Thammapad Piyasuwankul, Chih-Hao Lin and Marcus Eng Hock Ong

Treatment outcome measures for randomized controlled trials of antibiotic treatment for acute bacterial skin and skin structure infections in the emergency department setting

Acute bacterial skin and skin structure infections (ABSSSIs), which include cellulitis, abscesses, and wound infections, are among the most commonly encountered conditions in emergency departments (EDs) intern...

Authors: Michael Quirke and Abel Wakai

Use of 4-factor prothrombin complex concentrate in the treatment of a gastrointestinal hemorrhage complicated by dabigatran

Target-specific oral anticoagulants (TSOACs) provide patients and healthcare providers with an alternative to vitamin K antagonists (VKA). The TSOACs are of similar or superior efficacy to warfarin, but unlike...

Authors: Terrance R McGovern, Justin J McNamee, Christopher Malabanan, Mohamed A Fouad and Nilesh Patel

State of emergency medicine in Colombia

Colombia is an upper-middle-income country with a population of 45 million people and one of the best national healthcare and medical education systems in South America. However, its widely diverse and difficu...

Authors: Christian Arbelaez and Andrés Patiño

A rare but important adverse event associated with adult voluntary medical male circumcision: prolonged bleeding

The majority of bleeding disorders worldwide are undiagnosed. Their moderate or severe forms are associated with considerable morbidity and mortality. In the advent of mass male circumcision for the partial pr...

Authors: Moses Galukande, Carol Kahendehe, Eria Buuza and Denis Bbaale Sekavuga

Framework for classifying compliance and medical immediacy among low-acuity presentations at an urban trauma center

This research offers two exploratory frameworks, one for medical regimen compliance and one for medical immediacy. The first classifies compliance awareness, compliance mitigation, and financial limitation for...

Authors: Joshua G Behr, Rafael Diaz, Barry Knapp and Cynthia Kratzke

Multi-organ dysfunction secondary to severe wasp envenomation

Wasp sting is not an uncommon incident. Around 56% to 94% of the population is stung at least once in their lifetime by a member of the order Hymenoptera which includes wasps, bees, and ants. The response to a...

Authors: Abraham M Ittyachen, Shanavas Abdulla, Rifzana Fathima Anwarsha and Bhavya S Kumar

‘Need-to-Know’ emergency medicine articles of 2014

Every year, thousands of articles are published in numerous medical journals that relate to the clinical practice of medicine. However, it is impossible for a single clinician to stay abreast of the literature...

Authors: Maite A Huis in ‘t Veld, Tu C Nguyen, Joseph P Martinez and Amal Mattu

A retrospective observational study of medical incident command and decision-making in the 2011 Oslo bombing

A core task for commanders in charge of an emergency response operation is to make decisions. The purposes of the study were to describe what critical decisions the ambulance commander and the medical commande...

Authors: Rune Rimstad and Stephen JM Sollid

Radiologic diagnostic procedures in severely injured patients - is only whole-body multislice computed tomography the answer?

Whole-body multislice computed tomography (WB-MSCT) has become an important diagnostic tool in the early treatment phase of severely injured patients. The optimal moment of WB-MSCT’s use during this treatment ...

Authors: Tobias Topp, Rolf Lefering, Caroline L Lopez, Steffen Ruchholtz, Wolfgang Ertel and Christian A Kühne

A pilot study to identify clinical predictors for wrist fractures in adult patients with acute wrist injury

To date, no clinical decision rules for acute wrist injuries are available. In the past, clinical decision rules for the knee, ankle and spine injuries have been developed and validated. Implementation of thes...

Authors: Anne Brants and Michiel A IJsseldijk

Establishing research priorities for patient safety in emergency medicine: a multidisciplinary consensus panel

Patient safety in the context of emergency medicine is a relatively new field of study. To date, no broad research agenda for patient safety in emergency medicine has been established. The objective of this st...

Authors: Amy C Plint, Antonia S Stang and Lisa A Calder

Isolated middle cerebral artery dissection: a systematic review

Acute stroke can be missed in the emergency department, particularly in younger patients and in those with more vague symptoms such as headache or dizziness. Cervicocephalic dissections are one group of etiolo...

Authors: Ganesh Asaithambi, Pradeepan Saravanapavan, Vaibhav Rastogi, Sheema Khan, Sharatchandra Bidari, Anna Y Khanna, Latha Ganti, Adnan I Qureshi and Vishnumurthy Shushrutha Hedna

A prospective evaluation of the contribution of ambient temperatures and transport times on infrared thermometry readings of intravenous fluids utilized in EMS patients

During cold weather months in much of the country, the temperatures in which prehospital care is delivered creates the potential for inadvertently cool intravenous fluids to be administered to patients during ...

Authors: Jeremy Joslin, Andrew Fisher, Susan Wojcik and Derek R Cooney

Trauma training course: innovative teaching models and methods for training health workers in active conflict zones of Eastern Myanmar

Myanmar has struggled through decades of internal conflict, which has negatively impacted the country’s health outcomes. Recent government changes have brought hope and reduced conflict. The ethnic minority gr...

Authors: Charles H Washington, Francis J Tyler, Julia Davis, Douglas R Shapiro, Adam Richards, Matthew Richard, Thomas J Lee, Taryn L Colton, Louis Berk, Loren Rauch, Eh Kalu Shwe Oo, Richard Hahn and Lawrence M Stock

Endotracheal intubation with a video-assisted semi-rigid fiberoptic stylet by prehospital providers

Emergency medical technicians intubate patients in unfamiliar surroundings and with less than ideal positioning. This study was designed to evaluate advanced life support (ALS) emergency medical technicians' (...

Authors: Derek R Cooney, Charles Beaudette, Brian M Clemency, Christopher Tanski and Susan Wojcik

Abdominal emergencies in the geriatric patient

Abdominal pain is one of the most frequent reasons that elderly people visit the emergency department (ED). In this article, we review the deadliest causes of abdominal pain in this population, including mesen...

Authors: Ryan Spangler, Thuy Van Pham, Danya Khoujah and Joseph P Martinez

Prospective external validation of an accelerated (2-h) acute coronary syndrome rule-out process using a contemporary troponin assay

Recently there have been efforts to derive safe, efficient processes to rule out acute coronary syndrome (ACS) in emergency department (ED) chest pain patients. We aimed to prospectively validate an ACS assess...

Authors: Anne-Maree Kelly and Sharon Klim

Ring-shaped calcific constrictive pericarditis strangling the heart: a case report

Constrictive pericarditis is caused by fibrosis and calcification of the pericardium, processes that inhibit diastolic filling of the heart. For the diagnosis of constrictive pericarditis, a combined approach ...

Authors: Mu Sook Lee, Joon Hyouk Choi, Young Uck Kim and Su Wan Kim

Emergency department diagnosis of pulmonary hypertension in a patient with left atrial sarcoma

Pulmonary hypertension is a disease with many etiologies and is responsible for 200,000 admissions and 25,000 hospitalizations in the United States each year. We report the case of a previously healthy 58-year...

Authors: Maricel Dela Cruz and Jeremy Seelinger Devey

Knowledge and practices of Thai emergency physicians regarding the care of delirious elderly patients

The Society for Academic Emergency Medicine (SAEM) Geriatric Emergency Medicine Task Force recommends assessment of delirium for all elderly emergency department (ED) patients. Little is known about emergency ...

Authors: Jiraporn Sri-on, Gregory Philip Tirrell, Prasit Wuthisuthimethawee and Shan Woo Liu

Teaching and evaluating multitasking ability in emergency medicine residents - what is the best practice?

Multitasking is an essential skill to develop during Emergency Medicine (EM) residency. Residents who struggle to cope in a multitasking environment risk fatigue, stress, and burnout. Improper management of in...

Authors: Kenneth WJ Heng

Lemierre's syndrome secondary to community-acquired methicillin-resistant Staphylococcus aureus infection presenting with cardiac tamponade, a rare disease with a life-threatening presentation: a case report

Lemierre's syndrome is a rare condition characterized by thrombophlebitis of internal jugular vein, septicemia and septic metastatic infection of different organs. It is preceded by an oropharyngeal infection ...

Authors: Sonali Sihindi Chapa Gunatilake, Lakmini Gunarathna Yapa, Malinga Gallala, Rohitha Gamlath, Chaturaka Rodrigo and Harith Wimalaratna

Challenging script concordance test reference standard by evidence: do judgments by emergency medicine consultants agree with likelihood ratios?

We aimed to compare the clinical judgments of a reference panel of emergency medicine academic physicians against evidence-based likelihood ratios (LRs) regarding the diagnostic value of selected clinical and ...

Authors: Seyed-Foad Ahmadi, Shahin Khoshkish, Kamran Soltani-Arabshahi, Peyman Hafezi-Moghadam, Golara Zahmatkesh, Parisa Heidari, Davood Baba-Beigloo, Hamid R Baradaran and Shahram Lotfipour

Fournier's gangrene after adult male circumcision

In the advent of mass voluntary medical male circumcision (VMMC) for the partial prevention of HIV, previously rare adverse events associated with adult male circumcision are likely to be encountered with high...

Authors: Moses Galukande, Dennis Bbaale Sekavuga, Alex Muganzi and Alex Coutinho

The display effects of patients’ self-assessment on traumatic acute pain on the proportion and timing of analgesics administration in the emergency department

Acute pain assessment in the emergency department (ED) is important in particular during the triage process. Early pain assessment and management improve outcome. The objective of this study was to determine t...

Authors: Nik Hisamuddin NA Rahman and Cecilia Ananthanosamy

Retrospective study of elderly frequent attenders presenting with chest pain at emergency department

The aims of the study were to identify the characteristics of elderly frequent attenders to the emergency department (ED) presenting with chest pain and to assess the 1-year prognosis for developing adverse ca...

Authors: Faraz Zarisfi, Qi En Hong, Pauline See Joon Seah, Huihua Li, Susan Yap and Marcus Eng Hock Ong

Takotsubo cardiomyopathy secondary to intracranial hemorrhage

Patients suffering from aneurysmal subarachnoid hemorrhage often present with electrocardiogram (ECG) abnormalities that mimic cardiac ischemia, but documented left ventricular regional wall-motion dysfunction...

Authors: Mai Shimada and Jonathan D Rose

Who gets post-concussion syndrome? An emergency department-based prospective analysis

The objective of this study was to determine who gets post-concussion syndrome (PCS) after mild traumatic brain injury or head injury.

Authors: Latha Ganti, Hussain Khalid, Pratik Shashikant Patel, Yasamin Daneshvar, Aakash N Bodhit and Keith R Peters

Perspectives of South American physicians hosting foreign rotators in emergency medicine

Emergency Medicine (EM) is increasingly becoming an international field. The number of fellowships in International EM in the USA is growing along with opportunities to complete international health electives ...

Authors: Steve O’Donnell, David H Adler, Pholaphat Charles Inboriboon, Hermenegildo Alvarado, Raul Acosta and Daniel Godoy-Monzon

Analysis of pediatric surgical trauma cases in a tertiary care center

Authors: Anjan Kumar Dhua, Lavanya Chellam and Manoj Joshi

Utilization of structured emergency transport system in optimizing burn center referral: a case record audit

Authors: Vanmathy Venkatapathy, Bhavani Muthukrishnan and Murugan Thalaippan

Maternal mortality and its relationship to Emergency Obstetric Care (EmOC) in a tertiary care hospital in South India

Authors: Papa Dasari

Mangled Extremity Severity Score - is it really useful in assessing limb salvage following open and crush injuries in the lower extremity?

Authors: Thomas Kurien Bhanu

Absence vs. presence

Authors: Swaminathane Ramkumar

Knowledge and attitude of medical students on brain death and organ donation

Authors: Elamurugan Tirthar Palanivelu, Sudarshanan Sundaramurthi, Shanmugam Dasarathan, Sreenath Gubbi Shamana and Vikram Kate

A two-year retrospective statistical analysis of trauma cases in our institute

Authors: Sateesh Kumar Muppasani and Vijaya Durga Reddy

Computed Tomography utilization in minor head injury

Authors: Anitha Durai and Rama Prakasha Saya

Implementation of triage in a pediatric emergency department

Authors: Uma Priya Narayanan, Swathi Padankatti and Kuruvilla Thomas

Neonatal transport in resource restricted settings: a simple clinical score at arrival and its role in predicting mortality

Authors: Deepak Rathod, Bethou Adhisivam and Vishnu Bhat

Road safety practices among school-going children in Chennai

Authors: Swathi Padankatti, Uma Narayanan, Jisha Susan Babu and Kuruvilla Thomas

Counts and cards – a novel way to detect typhoid infections in the ED

Authors: Pragya Mallick, Aditya Maddali, Tausif Thangalvadi and Parivalavan Rajavelu