Vibrio vulnificus sepsis misdiagnosed as simple deep vein thrombosisJe Sung You, Seunghwan Kim, Incheol Park, Seungho Kim
DOI: http://dx.doi.org/10.1016/j.ajem.2012.01.031
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published online: May 25 2012
x A 46-year-old man was transferred to the emergency department and suspected of having a deep vein thrombosis. The patient reported swelling and pain in both lower legs for 16 hours. His medical history included liver cirrhosis secondary to alcohol. A detailed history revealed raw fish consumption 1 day before admission. Within 2 hours of arrival, several hemorrhagic bullae developed in the color-changed lesions of both lower legs. The patient's level of consciousness deteriorated to a stupor. He was admitted to the intensive care unit.
Pretest probability estimation in the evaluation of patients with possible deep vein thrombosis David R. Vinson, Jason P. Patel, Cedric S. Irving
DOI: http://dx.doi.org/10.1016/j.ajem.2010.01.002
The American Journal of Emergency Medicine , Vol. 29 , Issue 6 ,
Published online: April 5 2010
x An estimation of pretest probability is integral to the proper interpretation of a negative compression ultrasound in the diagnostic assessment of lower-extremity deep vein thrombosis. We sought to determine the rate, method, and predictors of pretest probability estimation in such patients.
High doses of warfarin are more beneficial than its low doses in patients with deep vein thrombosis Shervin Farahmand, Morteza Saeedi, Hooman Haji Seyed Javadi, Patricia Khashayar
DOI: http://dx.doi.org/10.1016/j.ajem.2010.07.008
The American Journal of Emergency Medicine , Vol. 29 , Issue 9 ,
Published online: November 1 2010
x The efficacy and safety of enoxaparin in outpatient treatment of deep vein thrombosis have been well studied. The present study aimed to compare the efficacy of a 10-mg loading dose of warfarin with 5 mg of the drug and enoxaparin in achieving the international normalized ratio (INR) range.
Blood pressure for outcome prediction and risk stratification in acute pulmonary embolism Karsten Keller, Johannes Beule, Jörn Oliver Balzer, Wolfgang Dippold
DOI: http://dx.doi.org/10.1016/j.ajem.2015.07.009
The American Journal of Emergency Medicine , Vol. 33 , Issue 11 ,
Published online: July 16 2015
x Risk stratification of patients with acute pulmonary embolism (PE) is crucial in deciding appropriate therapy management. Blood pressure (BP) is rapidly available and a reliable parameter. We aimed to investigate BP for short-term outcome in acute PE.
Evaluation of the pulmonary embolism rule-out criteria in a retrospective cohort at an urban academic hospital Andrew L. Bozarth, Navin Bajaj, Margaret R. Wessling, Dustin Keffer, Shais Jallu, Gary A. Salzman
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.010
The American Journal of Emergency Medicine , Vol. 33 , Issue 4 ,
Published online: March 4 2015
x The pulmonary embolism rule-out criteria (PERC) is an 8-variable clinical decision rule that identifies patients at low risk for pulmonary embolism (PE) to prevent unnecessary diagnostic testing in the evaluation of suspected PE in the emergency department (ED). The objective of this study was to determine PERC's safety and diagnostic use in our institution's ED population.
Pulmonary embolism and heparin-induced thrombocytopenia successfully treated with tissue plasminogen activator and argatroban Zachary Hourmouzis, Mary Colleen Bhalla, Jennifer A. Frey, Sharhabeel Jwayyed
DOI: http://dx.doi.org/10.1016/j.ajem.2014.11.027
The American Journal of Emergency Medicine , Vol. 33 , Issue 5 ,
Published online: November 28 2014
x Heparin-induced thrombocytopenia (HIT) is a disorder characterized by antibodies formed against the heparin–platelet factor 4 complex that results in thrombosis and platelet consumption. It can lead to extensive thromboembolic disease and coagulopathy. Diagnosis remains a challenge, but there are now assays that can be used for confirmation. A 56-year-old woman presented to the emergency department with a complaint of shortness of breath. She had been hospitalized 5 weeks prior for a laparatomy, which was complicated by pneumonia requiring intubation and deep vein thrombosis.
How do emergency medicine residency core faculty obtain their ultrasound training for credentialing? Dustin W. Anderson, Michael J. Vitto, David P. Evans
DOI: http://dx.doi.org/10.1016/j.ajem.2015.08.017
The American Journal of Emergency Medicine , Vol. 33 , Issue 12 ,
Published online: August 10 2015
x The evolution of emergency ultrasound (EUS) in resident education began in the early 1990s with the American College of Emergency Physicians (ACEP) publishing their first position statement supporting the use of ultrasound (US) by trained physicians [1]. Soon afterwards, The Society for Academic Emergency Medicine (SAEM) endorsed this statement and recommended formal EUS training for all emergency residency programs [2]. In 1994, Mateer et al published the “Model curriculum for physician training in emergency ultrasonography” that laid the template for standardized EUS education [3].
New oral anticoagulants in the ED setting: a review Charles V. Pollack Jr.
DOI: http://dx.doi.org/10.1016/j.ajem.2012.04.005
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published online: July 16 2012
x Emergency department (ED) clinicians are not typically involved in the long-term management of patients' anticoagulation therapy, but they are responsible for decision making for emergency conditions requiring anticoagulation, such as acute venous thromboembolism (VTE). In addition, emergency physicians are often faced with patients who present first to the ED with conditions that may prompt long-term anticoagulation upon hospital discharge, such as atrial fibrillation (AF), or who have acute or potential bleeding complications from anticoagulation.
Acute myocardial infarction with concomitant pulmonary embolism as a result of patent foramen ovale Mert İlker Hayıroğlu, Emrah Bozbeyoğlu, Şükrü Akyüz, Özlem Yıldırımtürk, Mehmet Bozbay, Nijad Bakhshaliyev, Emir Renda, Gülay Gök, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2014.12.025
The American Journal of Emergency Medicine , Vol. 33 , Issue 7 ,
Published online: January 16 2015
x Acute myocardial infarction (MI) and pulmonary embolism can alone lead to life-threatening conditions such as sudden cardiac death and congestive heart failure. We discuss a case of a 74-year-old man presented to the emergency department with acute dyspnea and chest pain. Acute anterior MI and pulmonary embolism concomitantly were diagnosed. Primary percutaneous coronary intervention performed because of preliminary acute anterior MI diagnosis. Transthoracic echocardiography was performed to determine further complications caused by acute MI because patient had a continuous tachycardia and dyspnea although hemodynamically stable.
The effects of air pollution and weather conditions on the incidence of acute myocardial infarction Taner Sen, Mehmet Ali Astarcioglu, Lale Dinc Asarcikli, Celal Kilit, Habibe Kafes, Afsin Parspur, Mehmet Yaymaci, Mesut Pinar, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2015.11.068
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: December 4 2015
x In this retrospective study, we investigated the association between air pollution and weather conditions with the incidence of acute myocardial infarction (AMI) in the city of Kutahya.
Paget-Schroetter syndrome: diagnostic limitations of imaging upper extremity deep vein thrombosis Victor Jourdain, William D. Goldenberg, Michael Matteucci, Jonathan Auten
DOI: http://dx.doi.org/10.1016/j.ajem.2015.07.018
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: July 22 2015
x Paget-Schroetter syndrome is a rare but potentially debilitating condition affecting young, otherwise healthy individuals. This condition, also known as effort thrombosis , is an upper extremity deep vein thrombosis classically caused by anatomical abnormalities compressing the neurovascular structures of the thoracic outlet. The diagnosis is important to emergency medicine providers due to its secondary morbidity and mortality. Common complications affecting these active adults are pulmonary embolism and postthrombotic syndrome.
Outcomes of warfarinized patients with minor head injury and normal initial CT scan Beng Leong Lim, Charmaine Manauis, Marxengel L. Asinas-Tan
DOI: http://dx.doi.org/10.1016/j.ajem.2015.09.009
The American Journal of Emergency Medicine , Vol. 34 , Issue 1 ,
Published online: September 18 2015
x We investigated delayed outcomes of patients with minor head injury, warfarin, and a normal initial head computer tomographic (CT) scan finding.
An observational case series of dabigatran and rivaroxaban exposures reported to a poison control system John W. Stevenson, Alicia B. Minns, Craig Smollin, Timothy E. Albertson, F. Lee Cantrell, Christian Tomaszewski, Richard F. Clark
DOI: http://dx.doi.org/10.1016/j.ajem.2014.04.031
The American Journal of Emergency Medicine , Vol. 32 , Issue 9 ,
Published online: April 30 2014
x Characterize clinical presentations and outcomes of dabigatran and rivaroxaban exposures reported to a poison control system.
Diagnostic value of platelet indexes for pulmonary embolism Jianqiang Huang, Yanyan Chen, Zhixiong Cai, Ping Chen
DOI: http://dx.doi.org/10.1016/j.ajem.2015.02.043
The American Journal of Emergency Medicine , Vol. 33 , Issue 6 ,
Published online: March 4 2015
x The aims of the study are to investigate the changes in platelet indexes, including platelet count, platelet distribution width (PDW), and mean platelet volume (MPV), in patients with pulmonary embolism (PE) and to evaluate their diagnostic values in relation to this disease.
Systemic thrombolysis for stroke in pregnancy Rossana Tassi, Maurizio Acampa, Giovanna Marotta, Samuele Cioni, Francesca Guideri, Simone Rossi, Alfonso Cerase, Giuseppe Martini
DOI: http://dx.doi.org/10.1016/j.ajem.2012.05.040
The American Journal of Emergency Medicine , Vol. 31 , Issue 2 ,
Published online: August 6 2012
x Pregnancy is an exclusion criterion for all clinical trials that validate alteplase in acute stroke, so our knowledge about its use in this condition is relative only to case reports and case series. Herein, we report the successful use of intravenous recombinant tissue-type plasminogen activator (rt-PA) in pregnant women with acute stroke. The patient was a 28-year-old who was 16 weeks pregnant. She presented to our hospital 1 hour after a sudden onset of mothor aphasia, hemiparesis, and hypoesthesia on the right side due to incipient ischemia in the left cerebral hemisphere resulting from ipsilateral middle cerebral artery subocclusion demonstrated by magnetic resonance imaging.
Compartment syndrome as a complication of ileofemoral deep venous thrombosis:a case presentation David R. Lamborn, Craig Schranz
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.050
The American Journal of Emergency Medicine , Vol. 32 , Issue 2 ,
Published online: October 2 2013
x A 22-year-old morbidly obese, nonpregnant woman presented with left ileofemoral deep vein thrombosis (DVT) presenting as low back pain and bilateral, left greater than right, leg swelling and pain for 2 days. While on heparin, she developed compartment syndrome in her left leg and had evidence of dead muscle tissue at the time of fasciotomy.
Initial accuracy of bedside ultrasound performed by emergency physicians for multiple indications after a short training period Juan Torres-Macho, Juan M. Antón-Santos, Isabel García-Gutierrez, María de Castro-García, Sergio Gámez-Díez, Pilar García de la Torre, Gonzalo Latorre-Barcenilla, Yolanda Majo-Carbajo, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2012.04.015
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published online: July 16 2012
x Emergency physician–performed ultrasonography holds promise as a rapid and accurate method to diagnose multiple diseases in the emergency department (ED). Our objective was to assess the initial diagnostic accuracy (first 55 explorations) of emergency physician–performed ultrasonography for multiple categories of ultrasound use after a short training period.
Pulmonary Embolism Rule-out Criteria vs D-dimer testing in low-risk patients for pulmonary embolism: a retrospective study J. Bokobza, A. Aubry, N. Nakle, C. Vincent-Cassy, D. Pateron, C. Devilliers, B. Riou, P. Ray, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2014.03.008
The American Journal of Emergency Medicine , Vol. 32 , Issue 6 ,
Published online: April 14 2014
x The Pulmonary Embolism Rule-out Criteria (PERC) score has shown excellent negative predictive value; however, its use in the European population with high prevalence of PE is controversial. In Europe, PERC is not part of routine practice. For low-risk patients, guidelines recommend D-dimer testing, followed if positive by imaging study. We aimed to study the rate of diagnosis of PE after D-dimer testing in PERC-negative patients that could have been discharged if PERC was applied.
Therapy and outcomes in massive pulmonary embolism from the Emergency Medicine Pulmonary Embolism in the Real World Registry Brian W. Lin, Donald H. Schreiber, Gigi Liu, Beau Briese, Brian Hiestand, David Slattery, Jeffrey A. Kline, Samuel Z. Goldhaber, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2012.02.012
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published online: May 25 2012
x Clinical guidelines recommend fibrinolysis or embolectomy for acute massive pulmonary embolism (PE) (MPE). However, actual therapy and outcomes of emergency department (ED) patients with MPE have not previously been reported. We characterize the current management of ED patients with MPE in a US registry.
Predictors of early death in patients with acute pulmonary embolism Çağdaş Akgüllü, İmran Kurt Ömürlü, Ufuk Eryılmaz, Mücahit Avcil, Evrin Dağtekin, Mehmet Akdeniz, Hasan Güngör, Cemil Zencir
DOI: http://dx.doi.org/10.1016/j.ajem.2014.11.022
The American Journal of Emergency Medicine , Vol. 33 , Issue 2 ,
Published online: November 25 2014
x We aimed to determine the predictors of early death in the course of acute pulmonary embolism (APE).
