Articles

Lung injury prediction score for the emergency department: first step towards prevention in patients at risk

Early identification of patients at risk of developing acute lung injury (ALI) is critical for potential preventive strategies. We aimed to derive and validate an acute lung injury prediction score (EDLIPS) in...

Authors: Marie-Carmelle Elie-Turenne, Peter C Hou, Aya Mitani, Jonathan M Barry, Erica Y Kao, Jason E Cohen, Gyorgy Frendl, Ognjen Gajic and Nina T Gentile

Is there a relationship between wound infections and laceration closure times?

Lacerations account for a large number of ED visits. Is there a “golden period” beyond which lacerations should not be repaired primarily? What type of relationship exists between time of repair and wound infe...

Authors: Muhammad Waseem, Viraj Lakdawala, Rohit Patel, Ramnath Kapoor, Mark Leber and Xuming Sun

The use of end-tidal carbon dioxide monitoring in patients with hypotension in the emergency department

The aim of this study was to determine the usefulness of end tidal carbon dioxide (ETCO₂) monitoring in hypotensive shock patients presenting to the ED.

Authors: Cheah P Kheng and Nik H Rahman

Carbon monoxide poisoning: Novel magnetic resonance imaging pattern in the acute setting

The presentation of carbon monoxide (CO) poisoning is non-specific and highly variable. The diagnosis is made when a compatible history and examination occur in a patient with elevated carboxyhaemoglobin level...

Authors: Ryan A Stephen, Sheehan W Donal, O’Neill B Siobhain, Clarkson R Michael and Costello J Daniel

Health care workers and disaster preparedness: barriers to and facilitators of willingness to respond

There is limited research on preparation of health care workers for disasters. Prior research addressed systems-level responses rather than specific institutional and individual responses.

Authors: Chinwe Ogedegbe, Themba Nyirenda, Gary DelMoro, Edward Yamin and Joseph Feldman

Analysis of traumatic injuries presenting to a referral hospital emergency department in Moshi, Tanzania

Injuries represent a significant and growing public health concern in the developing world, yet their impact on patients and the emergency health-care system in the countries of East Africa has received limite...

Authors: Erica R Casey, Florida Muro, Nathan M Thielman, Elifuraha Maya, Eric W Ossmann, Michael B Hocker and Charles J Gerardo

Spontaneous showering of tumor emboli in a patient with advanced primary lung cancer: a case report

Extension of primary lung tumors into the left atrium via pulmonary veins is a well-documented phenomenon. Peripheral arterial embolism and cerebral embolism originating from a primary lung neoplasm are rare e...

Authors: Susan M Schreffler, William F Paolo and Brian T Kloss

Diagnostic values of ultrasound and the Modified Alvarado Scoring System in acute appendicitis

Making the diagnosis of acute appendicitis is difficult, and is important for preventing perforation of the appendix and negative appendectomy results. Ultrasound and clinical scoring systems are very helpful ...

Authors: Shirzad Nasiri, Fatemeh Mohebbi, Nassim Sodagari and Anushiravan Hedayat

Medical students’ perceptions of an emergency medicine clerkship: an analysis of self-assessment surveys

No studies have been performed that evaluate the perceptions of medical students completing an emergency medicine (EM) clerkship. Given the variability of exposure to EM in medical schools nationwide, assessme...

Authors: Jennifer L Avegno, Heather Murphy-Lavoie, Daryl P Lofaso and Lisa Moreno-Walton

Performance of emergency physicians utilizing a video-assisted semi-rigid fiberoptic stylet for intubation of a difficult airway in a high-fidelity simulated patient: a pilot study

This study was designed to evaluate emergency physician success and satisfaction using a video-assisted semi-rigid fiberoptic stylet, the Clarus Video System (CVS), during a simulated difficult airway scenario.

Authors: Derek R Cooney, Norma L Cooney, Harry Wallus and Susan Wojcik

Prevalence of intimate partner violence in patients presenting with traumatic injuries to a Guyanese emergency department

Intimate partner violence (IPV) occurs throughout the world, and has both short- term and long- term negative health effects. Little is know about the prevalence of IPV in patients presenting to Emergency Depa...

Authors: Kendra P Parekh, Stephan Russ, David A Amsalem, Navindranauth Rambaran, Shannon Langston and Seth W Wright

Towards prevention of acute lung injury: frequency and outcomes of emergency department patients at-risk – a multicenter cohort study

Few emergency department (ED) evaluations on acute lung injury (ALI) have been carried out; hence, we sought to describe a cohort of hospitalized ED patients at risk for ALI development.

Authors: Peter C Hou, Marie-Carmelle Elie-Turenne, Aya Mitani, Jonathan M Barry, Erica Y Kao, Jason E Cohen, Gyorgy Frendl, Ognjen Gajic and Nina T Gentile

Continued rise in the use of mid-level providers in US emergency departments, 1993–2009

Emergency department (ED) visits in the US have risen dramatically over the past 2 decades. In order to meet the growing demand, mid-level providers (MLPs) – both physician assistants (PAs) and nurse practitio...

Authors: David F M Brown, Ashley F Sullivan, Janice A Espinola and Carlos A Camargo Jr

Improving the quality of emergency medicine care by developing a quality requirement framework: a study from The Netherlands

In The Netherlands, mainly inexperienced physicians work in the ED on all shifts, including the evening and night shifts, when no direct supervision is available. In 2004 a report of the Dutch Health Care Insp...

Authors: David E Ikkersheim and Harm van de Pas

Improvement of refractory migraine headache by propofol: case series

Several studies have been conducted on managing migraine headaches and developing effective medications for decreasing migraine-associated pain.

Authors: Hassan Soleimanpour, Aliakbar Taheraghdam, Rouzbeh Rajaei Ghafouri, Ali Taghizadieh, Karim Marjany and Maryam Soleimanpour

Applications of minimally invasive cardiac output monitors

Because of the increasing age of the population, critical care and emergency medicine physicians have seen an increased number of critically ill patients over the last decade. Moreover, the trend of hospital c...

Authors: Jahan Porhomayon, Gino Zadeii, Samuel Congello and Nader D Nader

Comparison of existing syncope rules and newly proposed anatolian syncope rule to predict short-term serious outcomes after syncope in the Turkish population

We wished to compare the San Francisco Syncope Rule (SFSR), Evaluation of Guidelines in Syncope Study (EGSYS) and the Osservatorio Epidemiologico sulla Sincope nel Lazio (OESIL) risk scores and to assess their...

Authors: Kamil Kayayurt, Haldun Akoglu, Onder Limon, Asım Oktay Ergene, Ozcan Yavasi, Serdar Bayata, Nergiz Vanden Berk and Erden Erol Unluer

A randomized open-label trial on the use of budesonide/formoterol (Symbicort^®) as an alternative reliever medication for mild to moderate asthmatic attacks

Conventionally, a nebulized short-acting β-2 agonist like salbutamol is often used as the reliever in acute exacerbations of asthma. However, recent worldwide respiratory outbreaks discourage routine use of ne...

Authors: Keng Sheng Chew, Hamizah Kamarudin and Che Wan Hashim

Subgaleal coiling of the proximal and distal components of a ventriculoperitoneal shunt

Migration is a rare complication of venticuloperitoneal shunts and is thought to be associated with the "memory" of the plastic tubing and the windlass effect of neck flexion and extension. The purpose of this...

Authors: Brian T Kloss, David M Hart and LaLainia Secreti

Intraorbital foreign body projectile as a consideration for unilateral pupillary defect

Intraorbital foreign bodies are frequently the result of high-velocity injuries with varying clinical presentations. The resultant diagnosis, management, and outcome depend on the type of foreign body present,...

Authors: Craig N Czyz, Thomas P Petrie, Jonathan D Harder, Kenneth V Cahill and Jill A Foster

The livelihoods of Haitian health-care providers after the january 2010 earthquake: a pilot study of the economic and quality-of-life impact of emergency relief

An effective international response to a disaster requires cooperation and coordination with the existing infrastructure. In some cases, however, international relief efforts can compete with the local work fo...

Authors: Rohini J Haar, Sassan Naderi, John R Acerra, Maxwell Mathias and Kumar Alagappan

Posterior reversible encephalopathy syndrome (PRES) and CT perfusion changes

Posterior reversible encephalopathy syndrome ( PRES) can present with focal neurologic deficits, mimicking a stroke and can often represent a diagnostic challenge when presenting atypically. A high degree of susp...

Authors: Vishnumurthy Shushrutha Hedna, Latha Ganti Stead, Sharathchandra Bidari, Akhil Patel, Amareshwari Gottipati, Christopher G Favilla, Arash Salardini, Aunali Khaku, Diana Mora, Ajay Pandey, Het Patel and Michael F Waters

Cross-sectional survey of malaria prevalence in tsunami-affected districts of Aceh Province, Indonesia

Malaria is endemic to Indonesia. However, there are few prevalence data available from Aceh Province because of the long-standing separatist conflict and decentralization of the public health system. The Mento...

Authors: David Muriuki, Sigrid Hahn, Braden Hexom and Richard Allan

Communicating carotid-cavernous sinus fistula following minor head trauma

A case of communicating carotid-cavernous sinus fistula (CCF) after minor closed head injury is presented.

Authors: Joshua B Kaplan, Aakash N Bodhit and Michael L Falgiani

Successful treatment of severe accidental hypothermia with cardiac arrest for a long time using cardiopulmonary bypass - report of a case

Accidental hypothermia is defined as an unintentional decrease in body temperature to below 35°C, and cases in which temperatures drop below 28°C are considered severe and have a high mortality rate. This stud...

Authors: Keigo Sawamoto, Katsutoshi Tanno, Yoshihiro Takeyama and Yasufumi Asai

Case report: successful lipid resuscitation in multi-drug overdose with predominant tricyclic antidepressant toxidrome

We report a case of profound neurologic and cardiovascular manifestations of tricyclic antidepressant intoxication following self-poisoning with multiple pharmaceuticals including amitriptyline in excess of 43...

Authors: Martyn Harvey and Grant Cave

Hypothermic cardiac arrest far away from the center providing rewarming with extracorporeal circulation

A 41-year-old man suffered hypothermic cardiac arrest after water immersion and was transported to our university hospital by ambulance helicopter for rewarming on cardiopulmonary bypass. He resumed spontaneou...

Authors: Eckhard Mark, Olaf Jacobsen, Astrid Kjerstad, Torvind Naesheim, Rolf Busund, Ramez Bahar, Jon Kjetil Jensen, Per Kristian Skorpen and Lars J Bjertnaes

Autonomic dysreflexia in a tetraplegic patient due to a blocked urethral catheter: spinal cord injury patients with lesions above T-6 require prompt treatment of an obstructed urinary catheter to prevent life-threatening complications of autonomic dysreflexia

The Manchester Triage System is commonly used as the triage system in emergency departments of the UK. As per the Manchester Triage System, patients presenting with retention of urine to the accident and emerg...

Authors: Subramanian Vaidyanathan, Bakul Soni, Tun Oo, Peter Hughes, Gurpreet Singh and Kamesh Pulya

Acute myocardial infarction and coronary vasospasm associated with the ingestion of cayenne pepper pills in a 25-year-old male

Capsaicin, one of the major active components of cayenne pepper pills, is an over-the-counter substance with sympathomimetic activity used commonly by young individuals for weight loss. Here we report the case...

Authors: Ozgur Sogut, Halil Kaya, Mehmet Tahir Gokdemir and Yusuf Sezen

The role of perfusion CT in identifying stroke mimics in the emergency room: a case of status epilepticus presenting with perfusion CT alterations

Emergency medicine physicians are often faced with the challenging task of differentiating true acute ischemic strokes from stroke mimics. We present a case that was initially diagnosed as acute stroke. Howeve...

Authors: Waldo R Guerrero, Haitham Dababneh and Stephan Eisenschenk

The impact of blood pressure hemodynamics in acute ischemic stroke: a prospective cohort study

To assess relationships between blood pressure hemodynamic measures and outcomes after acute ischemic stroke, including stroke severity, disability and death.

Authors: Latha Ganti Stead, Sailaja Enduri, M Fernanda Bellolio, Anunaya R Jain, Lekshmi Vaidyanathan, Rachel M Gilmore, Rahul Kashyap, Amy L Weaver and Robert D Brown Jr

Current status of establishing a venous line in CPA patients by Emergency Life-Saving Technicians in the prehospital setting in Japan and a proposal for intraosseous infusion

It is important to have a venous line in cardiopulmonary arrest (CPA) patients as an emergency treatment measure in prehospital settings, but establishment of a peripheral venous line is difficult in such pati...

Authors: Kenji Isayama, Toshio Nakatani, Masanobu Tsuda and Akihiko Hirakawa

Spontaneous upper limb monoplegia secondary to probable cerebral amyloid angiopathy

Cerebral amyloid angiopathy is a clinicopathological disorder characterised by vascular amyloid deposition initially in leptomeningeal and neocortical vessels, and later affecting cortical and subcortical regi...

Authors: Ahmed-Ramadan Sadek, Nandita K Parmar, Norah-Hager Sadek, Sanjana Jaiganesh, Samer Elkhodair and Thiagarajan Jaiganesh

Including emergency and acute care as a global health priority

A recent important global meeting to set the international action agenda concerning non-communicable diseases (NCDs) failed to draw substantial attention from the emergency medical and surgical community. Advo...

Authors: Nicholas Risko, Emilie JB Calvello, Sarah Stewart de Ramirez, Mayur Narayan and Jon Mark Hirshon

Visual Diagnosis: Pearling: a case study

We present the case of a patient who attempted to perform a type of body modification known as "pearling" or "genital beading" while in prison. This patient unfortunately caused severe trauma to his penis, req...

Authors: David P Nguyen, Bobby K Desai and Michael Falgiani

Visual diagnosis: Rectal foreign body: A primer for emergency physicians

We present a case that is occasionally seen within emergency departments, namely a rectal foreign body. After presentation of the case, a discussion concerning this entity is given, with practical information ...

Authors: Bobby Desai

Review article: Use of ultrasound in the developing world

As portability and durability improve, bedside, clinician-performed ultrasound is seeing increasing use in rural, underdeveloped parts of the world. Physicians, nurses and medical officers have demonstrated th...

Authors: Stephanie Sippel, Krithika Muruganandan, Adam Levine and Sachita Shah

Adequately assessing dehydration: A holy grail of paediatric emergency medicine

Authors: Damian Roland, Colin Clarke, Meredith Borland and Elaine Pascoe

Unexpected bilateral massive pulmonary embolism

Authors: Zaffer Qasim

Thrombolysis for massive pulmonary embolism in pregnancy: a case report

Mortality from pulmonary embolism (PE) in pregnancy might be related to challenges in targeting the right population for prevention. Such targeting could help ensure that the correct diagnosis is suspected and...

Authors: Sergio Fasullo, Giorgio Maringhini, Gabriella Terrazzino, Filippo Ganci, Salvatore Paterna and Pietro Di Pasquale

An international evaluation of ultrasound vs. computed tomography in the diagnosis of appendicitis

Abdominal computed tomography scan (CT) is the preferred radiographic study for the diagnosis of appendicitis in the United States, while radiologist-operated ultrasound (US) is often used in Israel. This comp...

Authors: Betzalel Reich, Todd Zalut and Scott G Weiner

Evaluation of the diagnostic indices and clinical utility of qualitative cardiodetect^® test kit in diagnosis of ami within 12 hours of onset of chest pain in the emergency department

Cardiac biomarkers may be invaluable in establishing the diagnosis of acute myocardial infarction (AMI) in the ED setting.

Authors: Nik Hisamuddin NAR and Ahmad Suhailan M

Transvaginal evisceration progressing to peritonitis in the emergency department: a case report

Abdominal pain is a common complaint among emergency department patients, making it essential to identify those with life-threatening etiologies. We report on the rare finding of atraumatic transvaginal bowel ...

Authors: Luan Lawson, Leigh Patterson and Kelly Carter

Gastrointestinal decontamination in the acutely poisoned patient

To define the role of gastrointestinal (GI) decontamination of the poisoned patient.

Authors: Timothy E Albertson, Kelly P Owen, Mark E Sutter and Andrew L Chan

Bilateral pyosalpinx in a peripubescent female with Hirschsprung's disease: a case report

This is a case report of bilateral pyosalpinx in a peripubescent female with a history of Hirschsprung's disease. Bilateral pyosalpinx is a rare condition in non-sexually active females. The presence of this d...

Authors: Bobby Desai and Timothy Ward

Pituitary apoplexy can mimic acute meningoencephalitis or subarachnoid haemorrhage

Pituitary apoplexy is an uncommon but life-threatening condition that is often overlooked and underdiagnosed. We report a 45-year-old man who presented to our emergency department with a sudden onset headache,...

Authors: Ahmed-Ramadan Sadek, Stephen Gregory and Thiagarajan Jaiganesh

CT angiography predicts use of tertiary interventional services in acute ischemic stroke patients

Patients with acute stroke are often transferred to tertiary care centers for advanced interventional services. We hypothesized that the presence of a proximal cerebral artery occlusion on CT angiography (CTA)...

Authors: Lisa E Thomas, Joshua N Goldstein, Reza Hakimelahi, Yuchiao Chang, Albert J Yoo, Lee H Schwamm and R Gilberto Gonzalez

Visual diagnosis: Enucleation status post gunshot wound to the head: A visual diagnosis/case report

We present the case of a patient who attempted to commit suicide via a gunshot to the head. However, instead of ending his life, he destroyed both of his eyes. Computed tomography scans are shown.

Authors: Bobby Desai and Benjamin Mahon

A case of a speech impediment following a near lightning strike

Environmental electrical injuries (electrical burns and lightning) are relatively common and are estimated to result in more than 3,000 admissions to specialized burn units each year here in the US. Lightning ...

Authors: Bobby K Desai and Rita Fairclough

Analysis of 22,655 presentations with back pain to Perth emergency departments over five years

Back pain is a significant cause of disability in the community, but the impact on Emergency Departments (EDs) has not been formally studied. Patients with back pain often require significant time and resource...

Authors: Michael T Lovegrove, George A Jelinek, Nicholas P Gibson and Ian G Jacobs