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The feasibility of emergency department observation units in the management of mild to moderate hyponatremia Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-03-05 Jamal J. Taha, George Hughes, Matthew T. Keadey, Douglas W. Chesson, Tim P. Moran, Qasim Kazmi, Michael A. Ross
To describe the feasibility of managing hyponatremia patients under outpatient observation status in an academic medical center, and compare outcomes based on the use of an emergency department observation unit (EDOU). This is a retrospective cohort study of emergency department hyponatremic patients managed in four hospitals within a large urban academic medical center over 27 months. All patients
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Factors associated with pediatric trauma patients leaving against medical advice Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-25 Ali Makhdoom, Abimbola Pratt, Yen-Hong Kuo, Nasim Ahmed
Discharge against medical advice (AMA) leads to worse patient outcomes, increased readmission rates, and higher cost. However, AMA discharge has received limited study, particularly in pediatric trauma patients. Our objective was to explore the risk factors associated with leaving AMA in pediatric trauma patients. We performed a retrospective analysis on pediatric trauma patients from 2017 to 2019
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Acute aortic occlusion: A narrative review for emergency clinicians Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-24 Jessica Pelletier, Alex Koyfman, Brit Long
Acute aortic occlusion (AAO) is a rare but serious condition associated with significant morbidity and mortality. This review provides an emergency medicine focused evaluation of AAO, including presentation, assessment, and emergency department (ED) management based on current evidence. AAO refers to obstruction of blood flow through the aorta due to either thrombosis or embolism. This condition primarily
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Impact of time to revascularization on outcomes in patients after out-of-hospital cardiac arrest with STEMI Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-23 Satoshi Nakajima, Tasuku Matsuyama, Kenji Kandori, Asami Okada, Yohei Okada, Tetsuhisa Kitamura, Bon Ohta
International guidelines recommend emergency coronary angiography in patients after out-of-hospital cardiac arrest (OHCA) with ST-segment elevation on 12‑lead electrocardiography. However, the association between time to revascularization and outcomes remains unknown. This study aimed to evaluate the association between time to revascularization and outcomes in patients with OHCA due to ST-segment-elevation
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Performance of the European Society of Cardiology 0/1-hour algorithm with high-sensitivity cardiac troponin T at 90 days among patients with known coronary artery disease Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-23 Nicklaus P. Ashburn, Anna C. Snavely, Brandon R. Allen, Robert H. Christenson, Troy Madsen, James K. McCord, Bryn E. Mumma, Tara Hashemian, Jason P. Stopyra, R. Gentry Wilkerson, Simon A. Mahler
The European Society of Cardiology (ESC) 0/1-h high sensitivity troponin T (hs-cTnT) algorithm does not differentiate risk based on known coronary artery disease (CAD: prior myocardial infarction [MI], coronary revascularization, or ≥ 70% coronary stenosis). We recently evaluated its performance among patients with known CAD at 30-days, but little is known about its longer-term risk prediction. The
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Evaluating the impact of a discharge pharmacy in the emergency department on emergency department revisits and admissions Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-22 Thomas Chen, Thomas Spiegel, Hui Zhang, Laura Celmins, Daniel Bickley, Denise Scarpelli
Medication nonadherence leads to worse health outcomes, increased healthcare service utilization, and increased overall healthcare costs. To determine whether a discharge pharmacy located in the Emergency Department (ED) reduces ED revisits and hospitalizations. This is a cohort study where we extracted data from our electronic medical records with adult encounters between 12/2019–10/2021. For the
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Risk of falls is associated with 30-day mortality among older adults in the emergency department Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-21 Matthew P. Hamilton, Fernanda Bellolio, Molly M. Jeffery, Susan M. Bower, Allyson K. Palmer, Ericka E. Tung, Aidan F. Mullan, Christopher R. Carpenter, Lucas Oliveira J. e Silva
Falls in older adults correlate with heightened morbidity and mortality. Assessing fall risk in the emergency department (ED) not only aids in identifying candidates for prevention interventions but may also offer insights into overall mortality risk. We sought to examine the link between fall risk and 30-day mortality in older ED adults. Observational cohort study of adults aged ≥ 75years who presented
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Evaluating time until ligation in a novel tourniquet – A crossover randomized-controlled trial Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-21 Stephan Katzenschlager, Niko R.E. Schneider, Frank Weilbacher, Markus A. Weigand, Erik Popp
Severe external hemorrhage is a significant reason for morbidity and mortality in adults; thus, the swift and correct application of a tourniquet by laypersons can be lifesaving. We conducted this randomized-controlled cross-over study to investigate the use of a novel tourniquet. Participants were recruited at the Heidelberg University Hospital. Eligible participants were ≥ 18 years old with a medical
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Outcomes by time-to-OR for penetrating abdominal trauma patients Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-21 Braylee Grisel, Alexander Gordee, Maragatha Kuchibhatla, Zachary Ginsberg, Suresh Agarwal, Krista Haines
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Partial pressure of carbon dioxide/pH interaction and its association with mortality among patients mechanically ventilated in the emergency department Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-20 Gregory McCormick, Nicholas M. Mohr, Enyo Ablordeppey, Robert J. Stephens, Brian M. Fuller, Brian W. Roberts
There is currently conflicting data as to the effects of hypercapnia on clinical outcomes among mechanically ventilated patients in the emergency department (ED). These conflicting results may be explained by the degree of acidosis. We sought to test the hypothesis that hypercapnia is associated with increased in-hospital mortality and decreased ventilator-free days at lower pH, but associated with
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Spleno-Sigmoid Knotting - An Unfamiliar Cause of Intestinal Obstruction: A Case Report Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-20 Mulugeta Taeme Gebretsion, Yimam Ali Mergiyaw, Aschalew Tibebu Shumargaw
Spleno-sigmoid knotting is the twisting of the spleen around the sigmoid colon, causing obstruction of the sigmoid colon. It is an uncommon cause of intestinal obstruction. To our knowledge, there has been no previous case report of spleno-sigmoid knotting before our case. Here, we present the case of an 18-year-old female patient who visited the surgical emergency outpatient department with diffuse
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Utility of non-invasive monitoring of exhaled carbon dioxide and perfusion index in adult patients in the emergency department Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-20 Raúl López-Izquierdo, Daniel Zalama-Sánchez, de Salamanca Gambara Rodrigo Enríquez, Rodríguez Ana Ramos, Millán Laura Fadrique, Muñoz Mario Rodil, Rodríguez Virginia Carbajosa, García Rubén Pérez, Ancor Sanz-García, Carlos del Pozo Vegas, Francisco Martín-Rodríguez
Several noninvasive solutions are available for the assessment of patients at risk of deterioration. Capnography, in the form of end-tidal exhaled CO2 (ETCO2) and perfusion index (PI), could provide relevant information about patient prognosis. The aim of the present project was to determine the association of ETCO2 and PI with mortality of patients admitted to the emergency department (ED). Multicenter
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Ocular trauma from Lawn mower accidents: Clinical insights, visual outcomes and microbial profiles Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-20 Yan Yang, Juan Chen, Jingyi Hu, Hongyi Shen, Qiuying Chen, Hailu Huang, Yongxin Zheng, Liuxueying Zhong
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AI in the ED: Assessing the efficacy of GPT models vs. physicians in medical score calculation Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-20 Gal Ben Haim, Adi Braun, Haggai Eden, Livnat Burshtein, Yiftach Barash, Avinoah Irony, Eyal Klang
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News reports on cardiac arrest in famous people: The undervalued opportunity to enhance public attitudes towards resuscitation Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-20 Alexei A. Birkun
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Pilot intervention to increase uptake of lung cancer screening through the emergency department Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-20 Nicholas R. Pettit, Diane Horner, Sara Freeman, Karen Rieger
The goal of this study is to demonstrate the feasibility of referring patients for lung cancer screening (LCS) from the emergency department (ED) as a method to increase the uptake of LCS. This is a single-arm pilot study at a large safety-net ED. ED LCS-eligible patients were offered a referral to our LCS clinic upon ED discharge. The primary outcome was the frequency at which patients connected with
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Development of prognostic models for predicting 90-day neurological function and mortality after cardiac arrest Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-19 Guangqian Ding, Ailing Kuang, Zhongbo Zhou, Youping Lin, Yi Chen
The survivors of cardiac arrest experienced vary extent of hypoxic ischemic brain injury causing mortality and long-term neurologic disability. However, there is still a need to develop robust and reliable prognostic models that can accurately predict these outcomes. To establish reliable models for predicting 90-day neurological function and mortality in adult ICU patients recovering from cardiac
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Point-of-care ultrasound associated with shorter length of stay than computed tomography for renal colic Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-19 Emily Orosco, Hiromi Terai, Seth Lotterman, Riley Baker, Cade Friedman, Aren Watt, Drew Beaubian, James Grady, João Delgado, Meghan Kelly Herbst
Despite similar diagnostic effectiveness for renal colic, computed tomography (CT) is more resource intensive than point-of-care ultrasound (PoCUS). We sought to compare Emergency Department (ED) length of stay (LOS) among patients with renal colic according to imaging modality utilized. We secondarily compared rates of infection, return ED visits, missed significant pathology, and urologic intervention
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Is the lactate value predictive of the return of spontaneous circulation during CPR in nontraumatic OHCA? Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-19 J. Contenti, C. Occelli, A. Lemachatti, F. Hamard, D. Giolito, J. Levraut
Cardiac arrest is a major public health issue, in which emergency medical services (EMS) initiating or continuing resuscitation in about 50% to 60% of cases. The aim of this study was to determine whether blood lactate levels and their course during cardiopulmonary resuscitation are prognostic indicators of the return of spontaneous cardiac activity (ROSC) in non-traumatic out-of-hospital cardiac arrest
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Efficacy of conventional rewarming therapy for accidental hypothermia: A secondary analysis of a multicenter prospective study Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-15 Kana Sugiyama, Osamu Nomura, Jin Irie, Yoshiya Ishizawa, Shuhei Takauji, Mineji Hayakawa, Yoshinori Tamada, Hiroyuki Hanada
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The presence of abdominal pain associated with acetaminophen overdose does not predict severity of liver injury Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-10 Chen Wang, Anselm Wong
Whilst it is known that abdominal pain is a common symptom in patients with acetaminophen overdose, its association with severity of liver injury has not been clearly defined. This study investigates the association between the symptom of abdominal pain on presentation to hospital and the degree of liver injury post-acetaminophen overdose. Admissions with acetaminophen poisoning, requiring treatment
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Navigating the landscape of medical triage: Unveiling the potential and challenges of large language models and beyond Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-10 Edouard Lansiaux
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Waterpipe vs non-Waterpipe carbon monoxide poisoning: Comparison of patient characteristics, clinical presentation and outcomes Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-10 Sarah S Abdul-Nabi, Hani Tamim, Eveline Hitti
The aim of this study is to describe the difference between carboxyhemoglobin (CO-Hb) acute poisoning caused by waterpipe vs non-waterpipe exposures as they relate to demographics, clinical presentations and outcome of patients. Retrospective cohort study conducted in the Emergency Department (ED) at the Lebanon. All adult patients presenting with a CO-Hb level ≥ 10 between January 2019 and August
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Differentiating hidradenitis suppurativa flare from infection in the emergency department and recommendations for transitioning care to the outpatient setting Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-10 Soumya Reddy, Gabrielle Schwartzman, Lydia A. Luu, Grace Im, R. Hal Flowers, Darren J. Guffey
Hidradenitis suppurativa is a painful and often progressive inflammatory skin condition that presents with papules, nodules, abscesses, and tunnels in the axillary, inframammary and anogenital regions. HS can be difficult to differentiate from a skin infection, such as a bacterial abscess. However, differentiation between the two is important as management of hidradenitis suppurativa often requires
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High risk and low prevalence diseases: Acute mastoiditis Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-07 Rachel E. Bridwell, Alex Koyfman, Brit Long
Acute mastoiditis is a serious condition that carries with it a high rate of morbidity and mortality. This review highlights the pearls and pitfalls of mastoiditis, including the presentation, diagnosis, and management in the emergency department (ED) based on current evidence. Acute mastoiditis most commonly affects pediatric patients and is a suppurative infection of the mastoid air cells. It is
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Human intelligence versus Chat-GPT: who performs better in correctly classifying patients in triage? Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-07 Arian Zaboli, Francesco Brigo, Serena Sibilio, Michael Mian, Gianni Turcato
Chat-GPT is rapidly emerging as a promising and potentially revolutionary tool in medicine. One of its possible applications is the stratification of patients according to the severity of clinical conditions and prognosis during the triage evaluation in the emergency department (ED). Using a randomly selected sample of 30 vignettes recreated from real clinical cases, we compared the concordance in
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Interventions associated with survival after prehospital intubation in the deployed combat setting Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-07 L.T.C. Michael D. April, C.P.T. Rachel Bridwell, Maj William T. Davis, M.A.J. Joshua Oliver, Maj Brit Long, M.A.J. Andrew D. Fisher, Adit A. Ginde, L.T.C. Steven G. Schauer
Airway compromise is the second leading cause of potentially preventable death on the battlefield. Prehospital airway management is often unavoidable in a kinetic combat environment and expected to increase in future wars where timely evacuation will be unreliable and air superiority not guaranteed. We compared characteristics of survivors to non-survivors among combat casualties undergoing prehospital
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In-water resuscitation during a surf rescue: Time lost or breaths gained? A pilot study Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-06 Roberto Barcala-Furelos, Joel de Oliveira, Paula Duro-Pichel, Sergio Colón-Leira, Marcos Sanmartín-Montes, Silvia Aranda-García
A technique called in-water resuscitation (IWR) was devised on a surfboard to ventilate persons who seemingly did not breathe upon a water rescue. Despite IWR still raises uncertainties regarding its applicability, this technique is recommended by the International Liaison Committee for Resuscitation (ILCOR). Thus, this study aimed to evaluate the feasibility of IWR with a rescue board before and during
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The cause of cardiac arrest: A potential confounder affecting post-resuscitation arrhythmias Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-05 Hiroshi Ito
Abstract not available
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Tranexamic acid for angiotensin converting enzyme inhibitor induced angioedema: A retrospective multicenter study Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-05 Kristen E. Lindauer, Bruce M. Lo, Gregory S. Weingart, Matvey V. Karpov, Grace H. Gartman, Lexie E. Neubauer, Marcus C. Kaplan
Angiotensin converting enzyme inhibitors (ACEIs) prevent the breakdown of bradykinin and can lead to life threatening angioedema. Tranexamic acid is an antifibrinolytic that inhibits formation of precursors involved in bradykinin synthesis and, in case reports, has been described as a potential treatment for ACE-I angioedema. This retrospective study included patients who presented to the emergency
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Further considerations regarding myocarditis Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-04 David S. Ediger, William J. Brady, Alex Koyfman, Brit Long
Abstract not available
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Evaluation of HACOR scale as a predictor of non-invasive ventilation failure in acute cardiogenic pulmonary oedema patients: A prospective observational study Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-04 Chun Yip Chong, Aida Bustam, Muhaimin Noor Azhar, Abd Kursi Abdul Latif, Ramzuzaman Ismail, Khadijah Poh
Acute cardiogenic pulmonary oedema (ACPO) is a common indication for non-invasive ventilation (NIV) in the emergency department (ED). HACOR score of >5 is used to predict NIV failure. The predictive ability of HACOR may be affected by altered physiological parameters in ACPO patients due to medications or comorbidities. To validate the HACOR scale in predicting NIV failure among acute cardiogenic pulmonary
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Diagnostic accuracy of apple watch ECG outputs in identifying dysrhythmias: A comparison with 12-Lead ECG in emergency department Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-04 Sinan Paslı, Hazal Topçuoğlu, Mutlu Yılmaz, Metin Yadigaroğlu, Melih İmamoğlu, Yunus Karaca
Wearable devices, particularly smartwatches like the Apple Watch (AW), can record important cardiac information, such as single‑lead electrocardiograms (ECGs). Although they are increasingly used to detect conditions such as atrial fibrillation (AF), research on their effectiveness in detecting a wider range of dysrhythmias and abnormal ECG findings remains limited. The primary objective of this study
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AI in emergency medicine publishing: Ethics and accessibility Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-04 Nihat Müjdat Hökenek, Recep Demirhan
Abstract not available
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Utility of common bile duct measurement in the diagnosis of cholecystitis and choledocholithiasis in children Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-04 Marci Fornari, Mary Kate Claiborne, Kristen Breslin, Ramon Sanchez-Jacob, Muhammad A. Khan, Rosemary Thomas-Mohtat
Ultrasound is an integral part of evaluating for acute cholecystitis and choledocholithiasis in pediatric patients. Finding the common bile duct (CBD), a structure which is normally <4 mm in children, can be very challenging. The primary objective of this study was to determine the prevalence of isolated sonographic CBD dilation in pediatric patients with acute cholecystitis and/or choledocholithiasis
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Management of high-risk pulmonary embolism in the emergency department: A narrative review Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-03 Samuel G. Rouleau, Scott D. Casey, Christopher Kabrhel, David R. Vinson, Brit Long
High-risk pulmonary embolism (PE) is a complex, life-threatening condition, and emergency clinicians must be ready to resuscitate and rapidly pursue primary reperfusion therapy. The first-line reperfusion therapy for patients with high-risk PE is systemic thrombolytics (ST). Despite consensus guidelines, only a fraction of eligible patients receive ST for high-risk PE. This review provides emergency
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Diagnosis and treatment strategies for pediatric urogenital tract foreign bodies: A retrospective study Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-03 Chengpin Tao, Bo Peng, Changkun Mao, Xin Yu, Yongsheng Cao
Foreign bodies in the pediatric urogenital tract are rare but urgent clinical conditions that can cause severe symptoms and complications. The current management remains challenging. This study aims to provide an in-depth understanding of the clinical characteristics, diagnostic challenges, and treatment strategies for pediatric urogenital tract foreign bodies. Through a retrospective analysis of patient
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Ultrasound-guided central venous catheterization around the neck: Systematic review and network meta-analysis Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-03 Eriya Imai, Yuki Kataoka, Jun Watanabe, Hiromu Okano, Motoki Namekawa, Gen Owada, Yuko Matsui, Motoi Yokozuka
Ultrasound-guided central venous catheterization (CVC) has become the standard of care. However, providers use a variety of approaches, encompassing the internal jugular vein (IJV), supraclavicular subclavian vein (SupraSCV), infraclavicular subclavian vein (InfraSCV), proximal axillary vein (ProxiAV), distal axillary vein (DistalAV), and femoral vein. This review aimed to compare the first-pass success
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Scapula innervation and ultrasound-guided rhomboid intercostal block Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-03 Theodosios Saranteas
Abstract not available
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Comment on “Factors affecting the mortality of February earthquakes victims in Türkiye” Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-03 Amiya Kumar Barik, Chitta Ranjan Mohanty, Subhasree Das, Rakesh Vadakkethil Radhakrishnan, Samata Chororia
Abstract not available
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Prolonged capillary refill time and short-term mortality of critically ill patients: A meta-analysis Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-03 Mengqin Wang, Mengqi Tong, Zhaoxing Tian
Prolonged capillary refill time (CRT) is an indicator of poor peripheral perfusion. The aim of the systematic review and meta-analysis was to evaluate the association of prolonged CRT and mortality of critically ill patients. To achieve the objective of this meta-analysis, we conducted a thorough search of PubMed, Embase, Cochrane Library, and the Web of Science to identify relevant observational studies
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Assessing risk of major adverse cardiac events among patients with chest pain and cocaine use using the HEART score Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-03 Neeraja Murali, Afrah Ali, Robinson Okolo, Saad Pirzada, Benoit Stryckman, Lauren Day, Daniel Lemkin, Mark Sutherland, Zachary Dezman, Quincy K. Tran
Chest pain (CP), a common presentation in the emergency department (ED) setting, is associated with significant morbidity and mortality if emergency clinicians miss the diagnosis of acute coronary syndrome (ACS). The HEART (History, Electrocardiogram, Age, Risk Factors, Troponin) score had been validated for risk-stratification patients who are at high risk for ACS and major adverse cardiac events
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Treatable underlying causes of myocarditis Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-02-02 Oscar M.P. Jolobe
Abstract not available
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Takotsubo or Kounis syndrome; Diagnosis is made retrospectively Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-01-30 Gülaçan Tekin, Yusuf Kenan Tekin
Abstract not available
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Rabies post-exposure prophylaxis in the emergency department Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-01-29 Terese Lewis, Krysta Baack, Leigh Gomez, Heather Nichols, Caitlin Lemmons, Wesley Zeger
Study objectives Rabies is a zoonotic single-stranded RNA lyssavirus that can cause acute infections of the central nervous system (CNS) including encephalomyelitis, encephalitis, and meningoencephalitis that is progressively fatal. Rabies is more common in developing countries, but approximately 23,000 people in the United States (US) are estimated to have been exposed or to have received post exposure
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Pain management in sickle cell anemia as a prisoner's dilemma: A qualitative study of emergency medicine and internal medicine physicians Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-01-26 Ho-Man Yeung, Jessica Moore
Abstract not available
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Paramedic triggers for transfusion of prehospital whole blood Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-01-24 L.C.D.R. Brian Ferguson, William Bullock, Emmanuel Giovanni Rayas, Maj Adam Kruse, Mark Dieterle, David Wampler, Christopher “.C.J”. Winckler
Abstract not available
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Predicting septic shock in patients with sepsis at emergency department triage level using systolic and diastolic shock index Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-01-28 Yumin Jeon, Sungjin Kim, Sejoong Ahn, Jong-Hak Park, Hanjin Cho, Sungwoo Moon, Sukyo Lee
Introduction Identifying patients with at a high risk of progressing to septic shock is essential. Due to systemic vasodilation in the pathophysiology of septic shock, the use of diastolic blood pressure (DBP) has emerged. We hypothesized that the initial shock index (SI) and diastolic SI (DSI) at the emergency department (ED) triage can predict septic shock. Method This observational study used the
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Complication of head and neck cancer: A case report on carotid blowout syndrome Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-01-24 Kenlee Jonas, Aaron Meers, Matthew Gao
Carotid blowout syndrome (CBS) is an uncommon but potentially life-threatening condition characterized by the spontaneous or traumatic rupture of the carotid artery in the neck. Oftentimes, CBS is due a loss of structural arterial integrity from local radiotherapy or surgical procedures. A vast majority of patients who develop CBS also have a previous diagnosis of head and neck cancer. Due to the specific
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Systematic literature under the scanner: The Pandoras' box is set open! Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-01-21 Rohan Magoon
Abstract not available
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Ipsilateral orolingual angioedema following rhTNK-tPA administration for acute ischemic stroke Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-01-21 Guomei Shi, Jianfeng Lv, Weixiang Wu, Rujuan Zhou
Recombinant human tenecteplase tissue-type plasminogen activator (rhTNK-tPA), a genetically modified variant of conventional alteplase with longer half-life and higher fibrin specificity, has now emerged as a reasonable choice for thrombolytic treatment of acute ischemic stroke (AIS) in China. Orolingual angioedema is a rare but potentially life-threatening complication of intravenous thrombolysis
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Assessing the impact of pre-hospital airway management on severe traumatic Brain injury: A systematic review and Meta-analysis Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-01-24 Muhammad Ashir Shafique, Abdul Haseeb, Bushra Asghar, Aashish Kumar, Eymaan Riaz Chaudhry, Muhammad Saqlain Mustafa
Objective This study aimed to assess the impact of establishing a pre-hospital definitive airway on mortality and morbidity compared with no prehospital airway in cases of severe traumatic brain injury (TBI). Background Traumatic brain injury (TBI) is a global health concern that is associated with substantial morbidity and mortality. Prehospital intubation (PHI) has been proposed as a potential life-saving
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Assessing the precision of artificial intelligence in emergency department triage decisions: Insights from a study with ChatGPT Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-01-24 Sinan Paslı, Abdul Samet Şahin, Muhammet Fatih Beşer, Hazal Topçuoğlu, Metin Yadigaroğlu, Melih İmamoğlu
Background The rise in emergency department presentations globally poses challenges for efficient patient management. To address this, various strategies aim to expedite patient management. Artificial intelligence's (AI) consistent performance and rapid data interpretation extend its healthcare applications, especially in emergencies. The introduction of a robust AI tool like ChatGPT, based on GPT-4
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Lactate combined with SOFA score for improving the predictive efficacy of SOFA score in patients with severe heatstroke Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-01-23 Fujing Liu, Fang Jin, Lingling Zhang, Yun Tang, Jinhai Wang, He Zhang, Tijun Gu
Background The relationship between lactate levels and multiple organ dysfunction in patients with severe heatstroke remains unclear. In this study, we aimed to elucidate the clinical significance of lactate in severe heatstroke prognosis and assess whether incorporating lactate in the SOFA score improves its predictive efficacy. Methods This study was a multicenter retrospective cohort investigation
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Utility of emergency department triage tools in predicting the need for intensive respiratory or vasopressor support in adult patients with COVID-19 Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-01-23 Anandhi Deva, Ronit Juthani, Ezhil Kugan, N. Balamurugan, Manu Ayyan
Background Serum and radiological parameters used to predict prognosis in COVID patients are not feasible in the Emergency Department. Due to its damaging effect on multiple organs and lungs, scores used to assess multiorgan damage and pneumonia such as Pandemic Medical Early Warning Score (PMEWS), National Early Warning Score 2 (NEWS2), WHO score, quick Sequential Organ Failure Assessment (qSOFA)
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Combined modified Valsalva maneuver with adenosine supraventricular tachycardia: A comparative study Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-01-23 Lifeng Xiao, Xiaomin Ou, Wanshang Liu, Xiaorong Lin, Lin Peng, Shuyi Qiu, Qishuo Zhang
Background and importance Paroxysmal supraventricular tachycardia (PSVT) is an arrhythmia commonly seen in the emergency department. Both modified Valsalva maneuver (MVM) and intravenous adenosine are the first line treatment, of which the former has e lower success rate while the latter has a higher success rate but some risks and adverse effects. Given both of these reverse rhythms quickly, combining
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Re: Mortality as depicted in medical TV shows compared with reality Am. J. Emerg. Med. (IF 3.6) Pub Date : 2024-01-21 Sabine Lemoine, Daniel Jost, Stéphane Travers
Abstract not available