Articles

Emergency medicine matters: epidemiology of medical pathology and changes in patient outcomes after implementation of a post-graduate training program at a Tertiary Teaching Hospital in Kigali, Rwanda

Emergency care is a new but growing specialty across Africa where medical conditions have been estimated to account for 92% of all disability-adjusted life years. This study describes the epidemiology of medic...

Authors: Katelyn Moretti, Doris Lorette Uwamahoro, Sonya Naganathan, Chantal Uwamahoro, Naz Karim, Menales Nkeshimana and Adam R. Aluisio

Hiccups and psychosis: two atypical presentations of COVID-19

The WHO defines a possible case of COVID-19 as a person experiencing fever, cough, shortness of breath, and neurological signs including anosmia, ageusia, or dysgeusia. However, experiences from hospitals all ...

Authors: Teresa Alvarez-Cisneros, Aldo Lara-Reyes and Stephanie Sansón-Tinoco

Role of liver enzymes in patients with blunt abdominal trauma to diagnose liver injury

The liver is the second most injured organ following blunt abdominal trauma (BAT) after the spleen. Although the computed tomography (CT) scan is considered as the gold standard for diagnosing liver injury in ...

Authors: Anup Shrestha, Harish Chandra Neupane, Kishor Kumar Tamrakar, Abhishek Bhattarai and Gaurav Katwal

Lack of racial and ethnic-based differences in acute care delivery in intracerebral hemorrhage

Early diagnosis and treatment of intracerebral hemorrhage (ICH) is thought to be critical for improving outcomes. We examined whether racial or ethnic disparities exist in acute care processes in the first hou...

Authors: Chun Mei Su, Andrew Warren, Cassie Kraus, Wendy Macias-Konstantopoulos, Kori S. Zachrison, Anand Viswanathan, Christopher Anderson, M. Edip Gurol, Steven M. Greenberg and Joshua N. Goldstein

The International Federation for Emergency Medicine report on emergency department crowding and access block: a brief summary

To develop comprehensive guidance that captures international impacts, causes, and solutions related to emergency department crowding and access block

Authors: A. P. Javidan, K. Hansen, I. Higginson, P. Jones and E. Lang

Healthcare in transition in the Republic of Armenia: the evolution of emergency medical systems and directions forward

Armenia, an ex-Soviet Republic in transition since independence in 1991, has made remarkable strides in development. The crisis of prioritization that has plagued many post-Soviet republics in transition has m...

Authors: Sharon Chekijian, Nune Truzyan, Taguhi Stepanyan and Alexander Bazarchyan

Successful management of retropharyngeal hematoma by trans-arterial embolism without intubation

Retropharyngeal hematoma can cause suffocation if there is delay in securing the airway by intubation. However, there are also concerns about complications that can arise with intubation; it is still unknown w...

Authors: Gaku Sugiura, Hiroyuki Takahashi, Yoshihisa Kodama and Satoshi Nara

Emergency medicine in Japan: past, present, and future

Quite a few changes and challenges have arisen in society in general as technology has advanced and the aging population has increased. These can lead to the recognition of the shortcomings of a society’s trad...

Authors: Kentaro Shimizu, Seikei Hibino, Michelle H. Biros, Taro Irisawa and Takeshi Shimazu

Feasibility and integration of an intensive emergency pediatric care curriculum in Armenia

Emergency pediatric care curriculum (EPCC) was developed to address the need for pediatric rapid assessment and resuscitation skills among out-of-hospital emergency providers in Armenia. This study was designe...

Authors: Aline Baghdassarian, Al M. Best, Anushavan Virabyan, Claire Alexanian, Shant Shekherdimian, Sally A. Santen and Hambartzum Simonyan

A scoping review of worldwide studies evaluating the effects of prehospital time on trauma outcomes

Annually, over 1 billion people sustain traumatic injuries, resulting in over 900,000 deaths in Africa and 6 million deaths globally. Timely response, intervention, and transportation in the prehospital settin...

Authors: Alexander F. Bedard, Lina V. Mata, Chelsea Dymond, Fabio Moreira, Julia Dixon, Steven G. Schauer, Adit A. Ginde, Vikhyat Bebarta, Ernest E. Moore and Nee-Kofi Mould-Millman

Cerebrospinal fluid findings and hypernatremia in COVID-19 patients with altered mental status

The objective of the study was to assess the cerebrospinal fluid (CSF) findings in COVID-19 patients.

Authors: Hale Toklu, Latha Ganti, Ettore Crimi, Cristobal Cintron, Joshua Hagan and Enrique Serrano

Rhythms and prognosis of patients with cardiac arrest, emphasis on pseudo-pulseless electrical activity: another reason to use ultrasound in emergency rooms in Colombia

The cardiac arrest is still an emergency with a bad prognosis. The growing adoption of bedside ultrasound allowed to classify PEA in two groups: the true PEA and the pseudo-PEA. pPEA is used to describe a pati...

Authors: German Devia Jaramillo, Norberto Navarrete Aldana and Zaira Rojas Ortiz

Urgent hyperbaric oxygen therapy for suicidal carbon monoxide poisoning: from a preliminary survey to a proposal for an integrated somatic-psychiatric protocol

A considerable number of patients who made a carbon monoxide (CO) suicidal attempt are treated with urgent hyperbaric oxygen therapy (HBOT). For these patients at potential persistent risk of suicide, the hype...

Authors: Alessandra Costanza, Julia Ambrosetti, Philippe Spagnoli, Andrea Amerio, Andrea Aguglia, Gianluca Serafini, Mario Amore, Guido Bondolfi, François Sarasin and Rodrigue Pignel

Impact of a financial incentive on the completion of educational metrics

The Accreditation Council for Graduate Medical Education (ACGME) requires all emergency medicine (EM) training programs to evaluate resident performance and also requires core faculty to attend didactic confer...

Authors: Andrew Pugh, Tabitha Ford, Troy Madsen, Christine Carlson, Gerard Doyle, Robert Stephen, Susan Stroud and Megan Fix

Air in the right ventricle and vein after basilar skull fracture: a case report

Air in the venous system may cause vascular air embolism, which is a potentially life-threatening event. The presence of air in venous system after basilar skull fracture is very rare.

Authors: Hiroki Kai, Tomoya Hirose, Takaya Nishiura, Takashi Noma, Yoshihito Ogawa, Tomoki Yamada, Haruhiko Nakae and Yasuaki Mizushima

An atypical presentation of multidermatomal herpes zoster: a case report

Herpes zoster (HZ) also known as shingles is a common dermatological pathology seen in the emergency department. Multidermatomal involvement is an uncommon presentation and usually is linked to immunocompromis...

Authors: Mohammed Alhayyas, Mehmood Chaudhry and Sabrina Berdouk

Learning process of ultrasound-guided Ilio-fascial compartment block on a simulator: a feasibility study

Ultrasound-guided fascia iliaca compartment block (US-FICB) is not part of the learning curriculum of the emergency physicians (EP) and is usually performed by anesthesiologists. However, several studies promo...

Authors: Julien Celi, Christophe A. Fehlmann, Olivier T. Rutschmann, Iris Pelieu-Lamps, Roxane Fournier, Mathieu Nendaz, François Sarasin and Frédéric Rouyer

Boerhaave syndrome due to excessive alcohol consumption: two case reports

Spontaneous esophageal rupture, or Boerhaave syndrome, is a fatal disorder caused by an elevated esophageal pressure owing to forceful vomiting. Patients with Boerhaave syndrome often present with chest pain, ...

Authors: Yuichiro Haba, Shungo Yano, Hikaru Akizuki, Takashi Hashimoto, Toshio Naito and Naoyuki Hashiguchi

Correction to: Evolution of emergency medical services in the Kingdom of Bahrain

An amendment to this paper has been published and can be accessed via the original article.

Authors: Feras H. Abuzeyad, Ghada Al Qasim, Leena Alqasem and Mudhaffar I. Al Farras

Efficacy of clinical evaluations for COVID-19 on the front line

Authors: Lili L. Barsky, Joseph E. Ebinger, Mona Alotaibi, Mohit Jain, Sam Torbati, Bradley T. Rosen and Susan Cheng

Knowledge and attitudes of us adults regarding COVID-19

This was a survey of the general non-healthcare-worker USA population regarding their knowledge and attitudes toward the COVID-19 pandemic. Almost everyone practiced social distancing. Women were significantly...

Authors: Christopher Hogan, Massud Atta, Paul Anderson, Tej Stead, Matthew Solomon, Paul Banerjee, Bryan Sleigh, John Shivdat, Amanda Webb McAdams and Latha Ganti

Cannabinoid hyperemesis syndrome in the pregnant patient: clinical case and literature review

Cannabis use is on the rise. Several cases of cannabinoid hyperemesis syndrome, secondary to chronic cannabis intoxication, have been described worldwide, but few cases have described this entity in pregnant w...

Authors: Julien Flament, Nathan Scius and Henri Thonon

Perichondritis: inspect the lobule

This is a brief report of a 57-year-old Caucasian female presented with a 4-day history of worsening left ear pain. Her symptoms began with left otalgia and otorrhea which progressed to helical erythema, promp...

Authors: Eli Bress and Jason E. Cohn

Experience repatriation of citizens from epicentre using commercial flights during COVID-19 pandemic

During the COVID-19 pandemic, many countries instituted closure of borders from international and local travels. Stranded citizens appeal to their governments to embark on citizen repatriation missions. Betwee...

Authors: Sarah Shaikh Abdul Karim, Fariza Anis Md Tahir, Umul Khair Mohamad, Marlina Abu Bakar, Khairul Nizam Mohamad, Maria Suleiman, Hussein Omar Khan and Julina Md Noor

The impact of teach-back on patient recall and understanding of discharge information in the emergency department: the Emergency Teach-Back (EM-TeBa) study

Previous research has demonstrated that patients leaving the emergency department (ED) have poor recall and understanding of their discharge information. The teach-back method is an easy technique that can be ...

Authors: Mandhkani Mahajan, Janine Alida Hogewoning, Jeroen Joseph Antonius Zewald, Margreet Kerkmeer, Mathilde Feitsma and Daphne Annika van Rijssel

Successful management of zinc phosphide poisoning—a Hungarian case

Zinc phosphide (ZnP) is the basic component of several insecticides easily accessible worldwide. Intentional or accidental intoxication may lead to severe complications and multiple organ failure, resulting in...

Authors: Gergely Bilics, Júlia Héger, Éva Pozsgai, Gábor Bajzik, Csaba Nagy, Csilla Somoskövi and Csaba Varga

Clinical and imaging profiles of pulmonary embolism: a single-institution experience

Pulmonary embolism (PE) is a common life-threatening condition with non-specific clinical presentations. The diagnosis of PE depends highly on imaging studies, which may also provide prognostic information. Th...

Authors: Omran Al Dandan, Ali Hassan, Hossain AbuAlola, Alaa Alzaki, Abrar Alwaheed, Mohannad Alalwan, Malak Al Shammari, Nouf AlShamlan and Hind S. Alsaif

A fatal fecaloma

Fecal impaction may complicate chronic constipation. We report a fatal case of fecal impaction in a patient treated with long-term neuroleptic treatment.

Authors: Elsa Logre, Lauriane Degravi, Gaëtan Plantefève and Damien Contou

Nebulized tranexamic acid for recurring hemoptysis in critically ill patients: case series

Hemoptysis is a clinical condition encountered in the emergency department (ED) and must be managed and investigated urgently to maintain the patient’s hemostasis. The management of hemoptysis depends on treat...

Authors: Fatimah Alabdrabalnabi, Mohammed Alshahrani and Nadia Ismail

Separating the wheat from the chaff—COVID-19 in a German emergency department: a case-control study

COVID-19 pandemia is a major challenge to worldwide health care systems. Whereas the majority of disease presents with mild symptoms that can be treated as outpatients, severely ill COVID-19 patients and patie...

Authors: David Fistera, Dirk Pabst, Annalena Härtl, Benedikt Michael Schaarschmidt, Lale Umutlu, Sebastian Dolff, Carola Holzner, Clemens Kill and Joachim Risse

Performance of the modified HEART score in an Asian population

Chest pain is the most common potentially life-threatening presentation to the emergency department (ED). Furthermore, the identification of acute coronary syndrome (ACS) including its risk stratification and ...

Authors: Shanaz Matthew Sajeed, Michael P. De Dios, Dan Wei Jun Ong and Amila Clarence Punyadasa

Intractable nausea and vomiting in naïve ingestion of kratom for analgesia

Kratom is a habit-forming opioid-like substance with an acute toxidrome of various symptoms such as diaphoresis, dizziness, nausea, and vomiting. Chronic users require increasing dosages for the analgesic effe...

Authors: Vir Singh, Nadir Mulla, James Link Wilson, Aaron Umansky, Jenny Lee, Trilok Stead and Latha Ganti

Comparison of various risk scores for the prognosis of hemorrhagic upper gastrointestinal mucosal disorder

Various risk scores have been proposed that are useful for the management of upper gastrointestinal bleeding (UGIB), which is an important disease in emergency medicine. Few studies have examined the usefulnes...

Authors: Shinya Kita, Yasuyuki Shirai, Tomoharu Yoshida, Kei Shiraishi, Ayako Nakamura, Michitaka Kawano, Yoshihiro Kinoshita, Tatsuya Noguchi and Syunsuke Ito

Physical and mental health impacts of COVID-19 on healthcare workers: a scoping review

Coronavirus disease (COVID-19) pandemic has spread to 198 countries, with approximately 2.4 million confirmed cases and 150,000 deaths globally as of April 18. Frontline healthcare workers (HCWs) face a substa...

Authors: Natasha Shaukat, Daniyal Mansoor Ali and Junaid Razzak

Elastomeric respirators are safer and more sustainable alternatives to disposable N95 masks during the coronavirus outbreak

In this paper, the authors review the safety and practicality of elastomeric respirators for protecting themselves and others from the novel coronavirus or COVID-19. They also describe the safe donning and dof...

Authors: James Chiang, Andrew Hanna, David Lebowitz and Latha Ganti

A randomised crossover comparison of two endotracheal tube introducers: the FROVA and the Flexible Tip Bougie for GlideScope intubation of a difficult airway manikin by infrequent intubators

This unblinded randomised crossover study compares two endotracheal tube introducers (ETIs): the FROVA and the “Flexible Tip Bougie” (FTB), in an airway manikin mimicking difficult intubation with a percentage...

Authors: John Cormack, Bridget Langley, Louisa-Rose Bhanabhai and Roman Kluger

Development of an interactive curriculum and trainee-specific preparedness plan for emergency medicine residents

To create an interactive mass casualty incident (MCI) curriculum for emergency medicine residents and to integrate them into the hospital disaster response, thereby creating a “trainee-specific emergency prepa...

Authors: Ayanna D. Walker, Nicholas Fusco, Joshua Tsau and Latha Ganti

Trauma team conformation in a war-influenced middle-income country in South America: is it possible?

Trauma teams (TTs) improve outcomes in trauma patients. A multidisciplinary TT was conformed in September 2015 in a tertiary level I trauma university hospital in southwestern Colombia, a middle-income war-inf...

Authors: Sandra Carvajal, Francisco L Uribe-Buritica, Ana Maria Ángel-Isaza, María Camila López-Girón, Andres González, Julian Chica, Manuel Benitez and Alberto F García

A rapid response-type doctor car system shortened time to intravenous thrombolytic therapy for patients with ischemic stroke: an observational study at a single emergency center in Japan

For patients with ischemic stroke, rapid reperfusion therapy is extremely important. In April 2015, our medical center introduced a rapid response-type doctor car (RRC) system. Here, an emergency medical team,...

Authors: Yuki Yoshioka, Mina Gamo, Ryuhei Yoneda, Naoki Matsunaga, Tadaaki Takada, Yasushi Fukuta and Koichi Sato

Emergency department utilization of case-managed patients following benign gynecologic surgery

Case management has been shown to reduce the amount of unnecessary emergency department visits among Medicaid or uninsured patients. This study aims to determine whether case management is associated with decr...

Authors: Elizabeth A. Kelly, Cara C. Keller, Megan R. Sax and Rocco A. Rossi

A qualitative study of workplace violence among healthcare providers in emergency departments in India

Emergency department (ED) workplace violence is increasingly recognized as an important issue for ED providers. Most studies have occurred in developed countries with established laws and repercussions for vio...

Authors: Kevin Davey, Veda Ravishankar, Nikita Mehta, Tania Ahluwalia, Janice Blanchard, Jeffrey Smith and Katherine Douglass

Reorganising the emergency department to manage the COVID-19 outbreak

The COVID-19 disease outbreak that first surfaced in Wuhan, China, in December 2019, has taken the world by storm and ravaged almost every country in the world. Emergency departments (ED) in hospitals are on t...

Authors: Li Juan Joy Quah, Boon Kiat Kenneth Tan, Tzay-Ping Fua, Choon Peng Jeremy Wee, Chin Siah Lim, Gayathri Nadarajan, Nur Diana Zakaria, Shi-En Joanna Chan, Paul Weng Wan, Lin Tess Teo, Ying Ying Chua, Evelyn Wong and Anantharaman Venkataraman

The effect of 10-min dispatch-assisted cardiopulmonary resuscitation training: a randomized simulation pilot study

Immediate bystander cardiopulmonary resuscitation (CPR) is essential for survival from sudden cardiac arrest (CA). Current CPR guidelines recommend that dispatchers assist lay rescuers performing CPR (dispatch...

Authors: Hidetada Fukushima, Hideki Asai, Tadahiko Seki, Keisuke Takano and Francesco Bolstad

Neuroprotective effect of paricalcitol in a rat model of transient global cerebral ischemia

Paricalcitol is known to attenuate ischemic-reperfusion injury of various organs. However, it is not known whether paricalcitol prevents neuronal injury after global cerebral ischemia. The purpose of this stud...

Authors: Sung Wook Kim, Joo Suk Oh, Jungtaek Park, Hyun Ho Jeong, Young Min Oh, Semin Choi and Kyoung Ho Choi

Public knowledge and attitudes towards bystander cardiopulmonary resuscitation (CPR) in Ghana, West Africa

Early bystander cardiopulmonary resuscitation (CPR) is one of the most important predictors of out-of-hospital cardiac arrests (OHCA) survival. There is a dearth of literature on CPR engagement in countries su...

Authors: Martina Anto-Ocrah, Nick Maxwell, Jeremy Cushman, Emmanuel Acheampong, Ruth-Sally Kodam, Christopher Homan and Timmy Li

Performance of a three-level triage scale in live triage encounters in an emergency department in Hong Kong

Despite its continued use in many low-volume emergency departments (EDs), 3-level triage systems have not been extensively studied, especially on live triage cases. We have modified from the Australasian Triag...

Authors: Rex Pui Kin Lam, Shing Lam Kwok, Vi Ka Chaang, Lujie Chen, Eric Ho Yin Lau and Kin Ling Chan

Keeping up with the information explosion: a surge in consumption of data on pediatric SARS-CoV-2 infection by pediatric emergency physicians

PEM-Database.​org is an unaffiliated, not-for-profit website, dedicated to the field’s advancement of pediatric emergency medicine. PEM-Database published the first early access pediatric-related SARS-CoV-2 articl...

Authors: Oren Feldman, Amit Boukai and Itai Shavit

Estimation of the burden of out-of-hospital traumatic cardiac arrest in Karachi, Pakistan, using a cross-sectional capture-recapture analysis

The burden of trauma-related-out-of-hospital cardiac arrest (OHCA) in developing countries like Pakistan remains largely unexplored due to a lack of organized pre-hospital systems. In order to estimate the bur...

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

Ruptured abdominal aortic aneurysm identified on point-of-care ultrasound in the emergency department

Ruptured abdominal aortic aneurysm (AAA) is a highly lethal condition which requires rapid identification and treatment to improve the chance of survival. Computed tomography is the diagnostic modality of choi...

Authors: Omar Diaz and Wesley Eilbert

Male infant patient with a mesenteric cyst in the greater and lesser omenta: a case report

Mesenteric cysts are intra-abdominal masses of congenital origin, which most frequently occur in children, with an incidence of approximately 1 case per 20,000 pediatric admissions. Its progression can be asym...

Authors: Rocio del Pilar Pereira-Ospina, Laura Catherine Montoya-Sanchez, Diana María Abella-Morales, Javier Yesid Pinzón-Salamanca, José Miguel Suescún-Vargas and Sergio Rueda-Martínez