Articles

Comparing the accuracy of the three popular clinical dehydration scales in children with diarrhea

Dehydration due to acute gastroenteritis is one of the leading causes of mortality in children worldwide. The World Health Organization (WHO) scale, the Gorelick scale, and the Clinical Dehydration Scale (CDS)...

Authors: Kimberly Pringle, Sachita P Shah, Irenee Umulisa, Richard B Mark Munyaneza, Jean Marie Dushimiyimana, Katrina Stegmann, Juvenal Musavuli, Protegene Ngabitsinze, Sara Stulac and Adam C Levine

A protocol for the emergency department management of acute undifferentiated febrile illness in India

Fever is a common presenting complaint in the developing world, but there is a paucity of literature to guide investigation and treatment of the adult patient presenting with fever and no localizing symptoms.

Authors: Sudhagar Thangarasu, Piruthiviraj Natarajan, Parivalavan Rajavelu, Arjun Rajagopalan and Jeremy S Seelinger Devey

Intracranial internal carotid aneurysm causing diplopia

Internal carotid intracranial aneurysms are a relatively rare form of intracranial aneurysm that presents with diplopia, retro-orbital pain and unilateral headaches. The symptoms are progressive and the diagno...

Authors: Brian T Kloss, Rahul Patel and Anne Marie Sullivan

Air ambulance flights in northern Norway 2002-2008. Increased number of secondary fixed wing (FW) operations and more use of rotor wing (RW) transports

Air ambulance service in Norway has been upgraded during the last years. European regulations concerning pilots' working time and new treatment guidelines/strategies have called for more resources.

Authors: Jan Norum and Trond M Elsbak

Fatal myocardial infarction associated with intravenous N-acetylcysteine error

N-acetylcysteine is used to treat acetaminophen toxicity and is available in both intravenous and oral formulations. Our report describes a patient treated with intravenous N-acetylcysteine for acetaminophen t...

Authors: Andrew R Elms, Kelly P Owen, Timothy E Albertson and Mark E Sutter

Can we make the basilic vein larger? maneuvers to facilitate ultrasound guided peripheral intravenous access: a prospective cross-sectional study

Studies have shown that vein size is an important predictor of successful ultrasound-guided vascular access. The objective of this study is to evaluate maneuvers designed to increase basilic vein size, which c...

Authors: Simon A Mahler, Greta Massey, Liliana Meskill, Hao Wang and Thomas C Arnold

Meningeal carcinomatosis diagnosed during stroke evaluation in the emergency department

A 70-year-old female presented to the emergency department with a 3-day history of intermittent dysphasia and right facial droop. Computed tomography (CT) and magnetic resonance imaging (MRI) were obtained, an...

Authors: Derek R Cooney and Norma L Cooney

Technology-assisted education in graduate medical education: a review of the literature

Studies on computer-aided instruction and web-based learning have left many questions unanswered about the most effective use of technology-assisted education in graduate medical education.

Authors: Sharhabeel Jwayyed, Kirk A Stiffler, Scott T Wilber, Alison Southern, John Weigand, Rudd Bare and Lowell W Gerson

Auricular squamous cell carcinoma

Squamous cell carcinoma is a common cancer to the head and neck region that is typically diagnosed when it is 2 cm in size. This case report illustrates a patient who had neglected an auricular carcinoma for o...

Authors: Brian Kloss, Jeff Lapoint and Katherine Dougher

Prognostic utility of the acute cardiac ischemia time-insensitive predictive instrument (ACI-TIPI)

We sought to evaluate the test characteristics of the acute cardiac ischemia time-insensitive predictive instrument (ACI-TIPI) in relation to 30-day major adverse cardiac events (MACE) among patients who prese...

Authors: Jonathan S Ilgen, Alex F Manini, Udo Hoffmann, Vicki E Noble, Ediza Giraldez, Supapan Nualpring and J Stephen Bohan

Epidemiology of major incidents: an EMS study from Pakistan

A major incident is defined as an event that owing to the number of casualties has the potential to overwhelm the available resources. This paper attempts to describe the incidence and epidemiology of major in...

Authors: Hunniya Waseem, Luca Carenzo, Junaid Razzak and Rizwan Naseer

Changing patterns in diagnostic strategies and the treatment of blunt injury to solid abdominal organs

In recent years there has been increasing interest shown in the nonoperative management (NOM) of blunt traumatic injury. The growing use of NOM for blunt abdominal organ injury has been made possible because o...

Authors: Cornelis H van der Vlies, Dominique C Olthof, Menno Gaakeer, Kees J Ponsen, Otto M van Delden and J Carel Goslings

A brachialis muscle rupture diagnosed by ultrasound; case report

Trauma to the elbow caused by lifting heavy objects frequently involves rupture of the tendon of the biceps brachii muscle. Less frequently a rupture of the brachialis muscle occurs. To our knowledge, only fiv...

Authors: Titus JA Schönberger and Miranda F Ernst

Letter to the editors: the potential role for prehospital thrombolysis and time-critical stroke transfers in the northern Norway aeromedical retrieval system; In response to: Norum J, Elsbak TM: Air ambulance services in the Arctic: a Norwegian study. Int J Emerg Med 2011, 4:1

The role for prehospital thrombolysis for ST-elevation acute myocardial infarction and time-critical stroke transfers in the northern Norway aeromedical retrieval system as well as the aero-evacuation impact o...

Authors: Joseph Y Ting

The efficacy and value of emergency medicine: a supportive literature review

The goal of this study was to identify publications in the medical literature that support the efficacy or value of Emergency Medicine (EM) as a medical specialty and of clinical care delivered by trained emer...

Authors: C James Holliman, Terrence M Mulligan, Robert E Suter, Peter Cameron, Lee Wallis, Philip D Anderson and Kathleen Clem

Ting JY: Letter to the Editors: The potential role of prehospital thrombolysis and time-critical stroke transfers in the northern Norway aeromedical retrieval system

Authors: Jan Norum

Characterizing emergency departments to improve understanding of emergency care systems

International emergency medicine aims to understand different systems of emergency care across the globe. To date, however, international emergency medicine lacks common descriptors that can encompass the wide...

Authors: Anne P Steptoe, Blanka Corel, Ashley F Sullivan and Carlos A Camargo Jr

A five-year retrospective review of snakebite patients admitted to a tertiary university hospital in Malaysia

Although the majority of the snakebite cases in Malaysia are due to non-venomous snakes, venomous bites cause significant morbidity and mortality if treatment measures, especially ant-venom therapy, are delayed.

Authors: Keng Sheng Chew, Heng Wei Khor, Rashidi Ahmad and Nik Hisamuddin Nik Abdul Rahman

Treatments for reversing warfarin anticoagulation in patients with acute intracranial hemorrhage: a structured literature review

The acute management of patients on warfarin with spontaneous or traumatic intracranial hemorrhage continues to be debated in the medical literature. The objective of this paper was to conduct a structured rev...

Authors: Brett F Bechtel, Timothy C Nunez, Jennifer A Lyon, Bryan A Cotton and Tyler W Barrett

Dealing with the difficult student in emergency medicine

Dealing with a student who is perceived as difficult to work with or teach is inevitable in any academic physician's career. This paper will outline the basic categories of these difficulties pertinent to Emer...

Authors: Sarah E Ronan-Bentle, Jennifer Avegno, Cullen B Hegarty and David E Manthey

Folic acid use in pregnant patients presenting to the emergency department

The US Preventive Services Task Force has recommended daily folic acid supplementation for women planning on becoming pregnant in an effort to prevent fetal neural tube defects. We evaluated pregnant patients ...

Authors: Jacob Steenblik, Erika Schroeder, Burke Hatch, Steven Groke, Camille Broadwater-Hollifield, Michael Mallin, Matthew Ahern and Troy Madsen

Value of high-sensitivity C-reactive protein in low risk chest pain observation unit patients

High-sensitivity C-reactive protein (hs-CRP) rises with cardiac injury/ischemia. We evaluated its efficacy in aiding in the identification of an acute coronary syndrome (ACS) in patients (pts) admitted to the ...

Authors: Deborah B Diercks, J Douglas Kirk, Seif Naser, Samuel Turnipseed and Ezra A Amsterdam

The new wave: time to bring EEG to the emergency department

Emergency electroencephalography (EEG) is indicated in the diagnosis and management of non-convulsive status epilepticus (NCSE) underlying an alteration in the level of consciousness. NCSE is a frequent, treat...

Authors: Samah G Abdel Baki, Ahmet Omurtag, André A Fenton and Shahriar Zehtabchi

Admission hypo- or hyperthermia and survival after trauma in civilian and military environments

In the care of patients with traumatic injuries, focus is placed on hypothermia secondary to its deleterious impact on the coagulation cascade. However, there is scant information on the mortality effect of hy...

Authors: Charles E Wade, José Salinas, Brian J Eastridge, John G McManus and John B Holcomb

Respiratory distress and chest pain: a perforated peptic ulcer with an unusual presentation

Dyspnea and chest pain are common presenting complaints to the ED, and coupled together can present a challenging diagnostic dilemma in patients in extremis. A thoughtful evaluation is required, giving due dil...

Authors: David I Bruner and Corey Gustafson

"Case files from the University of Florida: When an Earache is more than an Earache": A case report

Brain abscess is not a common diagnosis as there are only approximately 2000 cases reported each year in the United States. There are three main routes of access to the brain including contiguous infection fro...

Authors: Bobby K Desai and Thomas Walls

Accidental organophosphate insecticide intoxication in children: a reminder

Misuse of organophosphate insecticides, even in case of domestic application, can be life threatening. We report the case of siblings admitted with respiratory distress, pinpoint pupils and slurred speech. The...

Authors: Willemijn van Heel and Said Hachimi-Idrissi

Datura stramonium L. poisoning in a geophagous child: a case report

Datura stramonium L. (DS) is a wild-growing plant widely distributed and easily accessible. It contains a variety of toxic anticholinergic alkaloids such as atropine, hyoscamine, and scopolamine. Voluntary or ac...

Authors: Asma Bouziri, Asma Hamdi, Aida Borgi, Sarra Bel Hadj, Zohra Fitouri, Khaled Menif and Nejla Ben Jaballah

Albuterol enantiomer levels, lung function and QTc interval in patients with acute severe asthma and COPD in the emergency department

This observational study was designed to investigate plasma levels of albuterol enantiomers among patients with acute severe asthma or COPD presenting to the emergency department, and the relationship with ext...

Authors: Kwang Choon Yee, Glenn A Jacobson, Richard Wood-Baker and E Haydn Walters

The effects of publishing emergency department wait time on patient utilization patterns in a community with two emergency department sites: a retrospective, quasi-experiment design

Providing emergency department (ED) wait time information to the public has been suggested as a mechanism to reduce lengthy ED wait times (by enabling patients to select the ED site with shorter wait time), bu...

Authors: Bin Xie and Sabrina Youash

A retrospective evaluation of the impact of a dedicated obstetric and neonatal transport service on transport times within an urban setting

To determine whether the establishment of a dedicated obstetric and neonatal flying squad resulted in improved performance within the setting of a major metropolitan area.

Authors: Shaheem De Vries, Lee A Wallis and David Maritz

Alcohol use disorders in the emergency ward: choice of the best mode of assessment and identification of at-risk situations

This study aims to identify the prevalence and at-risk situations of alcohol use disorders among patients examined in the emergency department and to compare the scales commonly used to identify alcohol use di...

Authors: Charlotte Richoux, Isabelle Ferrand, Enrique Casalino, Benoit Fleury, Christine Ginsburg and Michel Lejoyeux

Emphysematous cystitis with clinical subcutaneous emphysema

Emphysematous cystitis (EC) is the presence of intramural gas, with or without luminal gas, within the bladder as a result of a primary infection of the lower urinary tract with a gas-producing organism. It is...

Authors: Ahmed-Ramadan Sadek, Helen Blake and Anand Mehta

Troponin utilization in patients presenting with atrial fibrillation/flutter to the emergency department: retrospective chart review

There are few recommendations about the use of cardiac markers in the investigation and management of atrial fibrillation/flutter. Currently, it is unknown how many patients with atrial fibrillation/flutter un...

Authors: Nazanin Meshkat, Emily Austin, Rahim Moineddin, Hamidreza Hatamabadi, Behzad Hassani, Ali Abdalvand and Amanda Marcuzzi

Characteristics and predictors of readiness to quit among emergency medical patients presenting with respiratory symptoms

To examine behavioral factors that lead patients to consider quitting smoking and features associated with readiness to quit among adults who are seeking treatment in the emergency department (ED) for respirat...

Authors: Beth C Bock, Ernestine Jennings, Bruce M Becker, Robert Partridge and Raymond S Niaura

Angioplasty in acute middle cerebral artery stroke due to atrial fibrillation selected by CT perfusion: a case report

We report the experience of a case of acute stroke in a patient affected by Rendu Osler syndrome and atrial fibrillation. The combination of dynamic computerized tomography perfusion scans and the use of a hig...

Authors: Andrea Saletti, Ilaria Morghen, Luca Finessi and Enrico Fainardi

The prevalence of polypharmacy in elderly attenders to an emergency department - a problem with a need for an effective solution

We studied the prevalence of polypharmacy in attenders aged 75 years and over to an emergency department (ED) in North London over a period of 1 month. We identified 467 patients in this age group. Analysis of...

Authors: Ashis Banerjee, David Mbamalu, Sayed Ebrahimi, Arshad Ali Khan and Toong Foo Chan

Abdominal pain with a twist

Malrotation in children is due to either an incomplete or non-rotation of the foetal mid-gut during perinatal development. Presentation is usually in the first few weeks of life, often with life-threatening vo...

Authors: Rachael Mathews, Sam Thenabadu and Thiagarajan Jaiganesh

Acute severe non-traumatic muscle injury following reperfusion surgery for acute aortic occlusion: case report

Acute aortic occlusion is a rare but catastrophic disease with a high mortality rate. Severe perioperative complications could result from revascularization of infarcted muscles. Muscle cell ischaemia and mass...

Authors: Joseph Y Ting and Arash Dehdary

Abdominal imaging utilization in the emergency department: trends over two decades

To assess patterns of use of abdominal imaging in the emergency department (ED) from 1990 to 2009.

Authors: Ali S Raja, Koenraad J Mortele, Richard Hanson, Aaron D Sodickson, Richard Zane and Ramin Khorasani

Charcot's triad

Biliary stones are usually found in the gallbladder, but about 10-20% may spontaneously migrate into the common bile duct where they either remain trapped or migrate subsequently via the papilla of Vater into ...

Authors: Jean Louis Frossard and Florent Bonvin

Takotsubo cardiomyopathy vs acute myocardial infarction: diagnostic utility of subtle ECG differences

The clinical findings of Takatsubo Cardiomyopathy and acute myocardial infarction can be very similar. While Takatsubo cardiomyopathy rarely leads to severe complications, acute myocardial infarction can be li...

Authors: Asma Saba Syed and Umair Khalid

Impact of additional module training on the level of basic life support knowledge of first year students at the University of Maribor

The aim of this study was to investigate the impact of additional (two versus one session) basic life support (BLS) training of university students on knowledge and attitude concerning the performance of cardi...

Authors: Damjan Lešnik, Bojan Lešnik, Jerneja Golub, Miljenko Križmarić, Štefan Mally and Štefek Grmec

Massive acute colonic pseudo-obstruction successfully managed with conservative therapy in a patient with cerebral palsy

Acute colonic pseudo-obstruction (ACPO), also known as Ogilvie syndrome, is a massive dilation of the colon in the absence of mechanical obstruction. Treatment measures may include anticholinergic agents such ...

Authors: Derek R Cooney and Norma L Cooney

Gas gangrene and osteomyelitis of the foot in a diabetic patient treated with tea tree oil

Diabetic foot wounds represent a class of chronic non-healing wounds that can lead to the development of soft tissue infections and osteomyelitis. We reviewed the case of a 44-year-old female with a diabetic f...

Authors: Derek R Cooney and Norma L Cooney

A unique cause of hemoperitoneum: spontaneous rupture of a splenic hemangiopericytoma

Non-traumatic hemoperitoneum may be catastrophic if it is not promptly diagnosed and treated. It is critical to identify this clinical picture and treat any active bleeding. We report the first case in the lit...

Authors: Picozzi Stefano Carlo Maria, Massimo Mauri and Luca Carmignani

Exertional heat stroke in a marathon runner with extensive healed deep burns: a case report

Exertional heat illness typically occurs over hours in younger athletic patients or military recruits who exercise at elevated temperatures for a sufficient period of time to cause the rate of heat production ...

Authors: Puneet Seth and Poh Juliana

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

To quantify injuries in children that result from toppled televisions.

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

Pneumothorax and subcutaneous emphysema secondary to blunt chest injury

This is the case of a patient with a history of blunt chest trauma associated with subcutaneous emphysema and pneumothorax. The patient complained of inspiratory stridor on presentation. Anatomical relationshi...

Authors: Jahan Porhomayon and Ralph Doerr

Idiopathic adult intussusception

Intussusception is an uncommon cause of abdominal pain in adults and poses diagnostic challenges for emergency physicians, due to its varied presenting symptoms and time course. Diagnosis is thus often delayed...

Authors: Sanooj Soni, Philip Moss and Thiagarajan Jaiganesh