Slava V. Gaufberg, Michael J. Walta, Tom P. Workman
DOI: http://dx.doi.org/10.1016/j.ajem.2006.11.013
Published in issue: May 2007
xTopical anesthesia eliminates the need for injection of anesthetic. Most studies on the use of topical anesthesia were done on children, using 3 active ingredients (lidocaine, epinephrine, tetracaine, or tetracaine, adrenaline, cocaine) for relatively small wounds of the face and scalp.
Michel Galinski, François Dolveck, Xavier Combes, Véronique Limoges, Nadia Smaïl, Véronique Pommier, François Templier, Jean Catineau, Frédéric Lapostolle, Frédéric Adnet
DOI: http://dx.doi.org/10.1016/j.ajem.2006.11.016
Published in issue: May 2007
xThe aim of the study was to compare in emergency settings 2 analgesic regimens, morphine with ketamine (K group) or morphine with placebo (P group), for severe acute pain in trauma patients.
Cemil Kavalci, Murat Pekdemir, Polat Durukan, Necip Ilhan, Mustafa Yildiz, Selami Serhatlioglu, Dilara Seckin
DOI: http://dx.doi.org/10.1016/j.ajem.2006.10.008
Published in issue: May 2007
xTau protein localizes in the axons of neuron cells, and it is released secondarily from the central nervous system because of hypoxia and trauma. In the present study, it was aimed to investigate the value of serum tau protein levels in diagnosing intracranial pathologies in minor head trauma.
Michael Blaivas, Matthew Lyon
DOI: http://dx.doi.org/10.1016/j.ajem.2006.09.010
Published in issue: May 2007
xConcerns over rising imaging costs have led to the consideration by Medicare to limit the ability of clinicians to bill for image interpretation. This move has often been justified as a method to limit self-referral. However, clinicians may not be the only ones capable of referring imaging business to themselves.
Alex L. Rogovik, Ran D. Goldman
DOI: http://dx.doi.org/10.1016/j.ajem.2006.11.021
Published in issue: May 2007
xThe purpose of the study was to document prehospital analgesia (PA) for children with extremity injuries at home or en route to the hospital, as assessed by research personnel at the pediatric emergency department.
Chien-Chih Chen, Chee-Fah Chong, Cheng-Deng Kuo, Tzong-Luen Wang
DOI: http://dx.doi.org/10.1016/j.ajem.2006.09.009
Published in issue: May 2007
xSilent myocardial ischemia (SMI) is a relatively common complication in patients with coronary artery disease (CAD) under aspirin therapy presenting with upper gastrointestinal hemorrhage (UGIH).
Semir Nouira, Riadh Boukef, Noureddine Nciri, Habib Haguiga, Souheil Elatrous, Lamia Besbes, Mondher Letaief, Fekri Abroug
DOI: http://dx.doi.org/10.1016/j.ajem.2006.08.021
Published in issue: May 2007
xPredicting complications is a clinical challenge in the assessment of victims of scorpion envenomation (SE). We sought to develop a clinical score to predict need for hospitalization after scorpion sting.
Alexandra Schratter, Wolfgang Weihs, Michael Holzer, Andreas Janata, Wilhelm Behringer, Udo M. Losert, William J. Ohley, Robert B. Schock, Fritz Sterz
DOI: http://dx.doi.org/10.1016/j.ajem.2007.02.044
Published in issue: May 2007
xDuring surface cooling with ice-cold water, safety and effectiveness of transthoracic defibrillation was assessed.
Donald H. Arnold, Tebeb Gebretsadik, Patricia A. Minton, Stanley Higgins, Tina V. Hartert
DOI: http://dx.doi.org/10.1016/j.ajem.2006.09.006
Published in issue: May 2007
xWe sought to determine the association of select clinical measures of asthma severity with percent predicted forced expiratory volume in one-second (%FEV1).
Chu-Feng Liu, Chia-Te Kung, Ber-Ming Liu, Shu-Hang Ng, Chung-Cheng Huang, Sheung-Fat Ko
DOI: http://dx.doi.org/10.1016/j.ajem.2006.08.017
Published in issue: May 2007
xOur objective was to report 7 cases of splenic artery aneurysm (SAA) encountered in the emergency department (ED).
Hsiang-Yun Lo, Shu-Chen Liao, Chip-Jin Ng, Jen-Tse Kuan, Jih-Chang Chen, Te-Fa Chiu
DOI: http://dx.doi.org/10.1016/j.ajem.2006.10.009
Published in issue: May 2007
xDyspnea is one of the most common emergency department (ED) symptoms, but early diagnosis and treatment are challenging because of multiple potential causes. Hemodynamic parameters may aid in the evaluation of dyspnea, but are difficult to assess. Impedance cardiography is a noninvasive hemodynamic measurement method that may assist in early ED decision making.
Frank LoVecchio, Anthony F. Pizon, Christopher Berrett, Adam Balls
DOI: http://dx.doi.org/10.1016/j.ajem.2006.11.026
Published in issue: May 2007
xThis study was conducted to describe the characteristics and outcomes of patients who presented to the emergency department (ED) with presumed environmental hyperthermia.
James E. Svenson, Thomas D. Meyer
DOI: http://dx.doi.org/10.1016/j.ajem.2006.09.018
Published in issue: May 2007
xEmergency department (ED) overcrowding is a growing problem. Frequent visits for chronic pain are a significant subset of patients. The use of narcotics in these patients is controversial. The purpose of this study was to test a strict nonnarcotic protocol in reducing need for and number of ED visits for chronic pain while at the same time addressing their pain.
Alexander T. Limkakeng, Ethan Halpern, Kevin M. Takakuwa
DOI: http://dx.doi.org/10.1016/j.ajem.2006.10.012
Published in issue: May 2007
xMultidetector computed tomography (MDCT) imaging, a technological advance over traditional CT, is a promising possible alternative to cardiac catheterization for evaluating patients with chest pain in the emergency department (ED). In comparison with traditional CT, MDCT offers increased spatial and temporal resolution that allows reliable visualization of the coronary arteries. In addition, a “triple scan,” which includes evaluation for pulmonary embolism and thoracic aortic dissection, can be incorporated into a single study.
Huck Chin Chew, Swee Han Lim
DOI: http://dx.doi.org/10.1016/j.ajem.2006.10.007
Published in issue: May 2007
xThe management of broad complex atrial fibrillation is complex and may be a source of morbidity and mortality if not correctly recognized and treated appropriately. We present a case series of 3 patients who were managed in our emergency department after complaints of palpitations. They presented with varying forms of rapid atrial fibrillation that had broad complexes on the 12-lead electrocardiogram. The first 2 patients were treated with calcium channel blockers for rate control, and treatment was complicated by rapid arrhythmia that required cardioversion.
David Mountain, Ian Jacobs, Andrew Haig
DOI: http://dx.doi.org/10.1016/j.ajem.2006.09.004
Published in issue: May 2007
xAs a result of a number of clinical management studies, D-dimer (DD) tests such as VIDAS (BioMérieux Australia P/L-Sydney, NSW) have been recommended to reduce venous thromboembolism (VTE) investigations. Surveillance studies for new tests are recommended. We prospectively assessed VIDAS DD in normal practice.
Michael B. Stone, Daniel D. Price, Ralph Wang
DOI: http://dx.doi.org/10.1016/j.ajem.2006.08.019
Published in issue: May 2007
xEmergency department (ED) patients with fractures, dislocations, or abscesses of the upper extremities often require closed reduction or incision and drainage to treat these conditions. Procedural sedation is often necessary when infiltration of local anesthetic provides insufficient analgesia. Anesthesiologists commonly perform supraclavicular brachial plexus nerve blocks to achieve analgesia for upper extremity surgery. We report a series of 5 ED patients in whom supraclavicular brachial plexus nerve blocks using real-time ultrasound guidance provided excellent analgesia and obviated the need for procedural sedation.
A. Dosanjh
DOI: http://dx.doi.org/10.1016/j.ajem.2006.09.013
Published in issue: May 2007
xThe use of long-term controller medication (LTCM) in the management of persistent asthma is part of standard practice guidelines in the National Asthma Education and Prevention Program [1]. The LTCMs include numerous therapeutic options, all aimed at controlling the inflammation that underlies persistent asthma. Controller medications can include inhaled corticosteroids, leukotriene modifiers, mast cell stabilizers, long-acting inhaled β2 adrenergic medications, or combinations of these medications [1].
Joseph Varon
DOI: http://dx.doi.org/10.1016/j.ajem.2007.03.022
Published in issue: May 2007
xTherapeutic hypothermia (TH) has been used for millennia for a variety of reasons. However, the use of cold temperatures in modern clinical medicine is probably only 200 years old. The Russian method of resuscitation, described in 1803, consisted in covering a patient with snow, hoping for return of spontaneous circulation [1]. Therapeutic hypothermia was used during Napoleon's Russian campaign in 1812, by the surgeon Baron de Larrey, in an attempt to preserve injured limbs as well as for its anesthetic effects during amputation [2].
Kevin C. Osterhoudt, Diane P. Calello
DOI: http://dx.doi.org/10.1016/j.ajem.2005.09.011
Published in issue: May 2007
xA 2-year-old girl was heard by her parents to be making “gurgling” breathing noises and was subsequently found to be unresponsive. Emergency medical service personnel noted her to be cyanotic and provided bag-mask ventilatory support. Her pupils were small but equal. She had no history of preceding illness or trauma.
Katsutoshi Tanno, Eichi Narimatsu, Yoshihiro Takeyama, Yasufumi Asai
DOI: http://dx.doi.org/10.1016/j.ajem.2006.09.002
Published in issue: May 2007
xAn 18-month-old (9 kg in body weight) female, whose family history was unremarkable, accidentally took 100 mg (2 pills) of eperisone hydrochloride. Approximately 30 minutes after swallowing the tablets, her voice became peculiar, and she then lost consciousness. When emergency medical technicians arrived, she was already in a coma, accompanied by recurrent grand mal. Her cyanosis (Spo2, 93%) was immediately resolved by administration of oxygen (Spo2, 100%).
Todd McArthur, Chad S. Crystal, Michael A. Miller
DOI: http://dx.doi.org/10.1016/j.ajem.2006.08.018
Published in issue: May 2007
xRecently, a 30-year-old woman at 22 weeks' gestation presented to our emergency department (ED) with unremitting right flank pain. Her history was suspicious for urolithiasis, and a urinalysis showing 67 red blood cells was obtained. Because of the patient's extreme pain after medication, a renal ultrasound was obtained to evaluate both kidneys for hydronephrosis secondary to presumed ureteral obstruction.
Yoshito Kamijo, Toshimitsu Ide, Kazui Soma
DOI: http://dx.doi.org/10.1016/j.ajem.2006.06.019
Published in issue: May 2007
xAlthough neuron-specific enolase (NSE) has been shown to reflect neuronal damage, myelin basic protein (MBP), a major myelin component in the central nervous system, has been shown to reflect the degree of demyelination in cerebral white matter [1]. However, we know of no report dealing with NSE or MBP in cerebrospinal fluid (CSF) after carbon monoxide (CO) poisoning.
Nozha Brahmi
DOI: http://dx.doi.org/10.1016/j.ajem.2006.12.003
Published in issue: May 2007
xIn response to the letter from Drs Beecroft, Lu & Mycyk in the March issue [1], in our study [2] we based results on the serum carbamazepine (CBZ) concentration at admission and the peak value, which were similar in the 2 groups. Moreover, their supposed ingestion time was similar (6 ± 3 hours [G1] vs 5 ± 2 hours [G2]); in addition, the increase of the CBZ concentration in the non-multiple dose activated charwal (MDAC) group was not statistically significant.
Patrick Ray
DOI: http://dx.doi.org/10.1016/j.ajem.2006.12.004
Published in issue: May 2007
xWe appreciate the thoughtful letter from Dr. Houdijk [1] that summarizes important issues regarding the accuracy of D-dimer enzyme-linked immunosorbent assay in suspected venous thromboembolic disease (VTED). We do agree that previous studies demonstrated that a negative BioMérieux VIDAS BioMerieux, Marcy l'Etoile, France could rule out VTED in patients with low or intermediate pretest probability in a large proportion of suspected outpatients [2,3]. With this recent report, we only highlighted the risks taken by emergency physicians in performing D-dimer referent enzyme-linked immunosorbent assay without proper observation of patients' clinical conditions (prior anticoagulation, location of the clot, duration of symptoms, etc) [4].
Albert Salazar, Antoni Juan, Ricard Ballbe, Xavier Corbella
DOI: http://dx.doi.org/10.1016/j.ajem.2007.03.010
Published in issue: May 2007
xObservation and short-stay units are becoming common in hospitals and are an increasingly important component of the modern emergency department (ED) because they are an alternative to admission or discharge [1]. Acute exacerbation of chronic obstructive pulmonary disease (COPD) causes frequent hospitalizations in winter when there is often a coexisting in-hospital bed crisis and ED overcrowding [2]. However, there are few data to establish the duration of hospitalization in individual patients to achieve maximal benefit and to identify those patients with COPD suitable for early discharge from the hospital [3].
Cenker Eken, İsa Kilicaslan
DOI: http://dx.doi.org/10.1016/j.ajem.2007.03.023
Published in issue: May 2007
xBand et al [1] make an important point when they alert readers to the hazards of predicting renal function by a single creatinine measurement, which can be affected by multiple factors. We write to emphasize several other points that are also worthy of note in measuring glomerular filtration rate (GFR) in patients undergoing contrast-related diagnostic procedures in the emergency setting.
Ani Aydin, Christopher C. Lee, Eric Schultz, Jeremy Ackerman
DOI: http://dx.doi.org/10.1016/j.ajem.2006.11.015
Published in issue: May 2007
xInferior gluteal artery pseudoaneurysms are rare, with few cases reported in the recent literature. Such cases often present with a variable time course, mode of injury, and associated symptoms, leading to their misdiagnoses and improper treatment. We report a case of a posttraumatic inferior artery pseudoaneurysm that presented 3 months after the initial injury with a warm, tender, enlarging mass and numbness in the ipsilateral lower extremity. This article highlights the importance of placing a pseudoaneurysm in the differential diagnosis of an indurated, fluctuant, warm, erythematous posttraumatic mass, despite the absence of thrills, bruits, and pulsations.
Vei-Ken Seow, Chiu-Mei Lin, Tzong-Luen Wang, Chee-Fah Chong, I-Yin Lin
DOI: http://dx.doi.org/10.1016/j.ajem.2006.11.023
Published in issue: May 2007
xAcute emphysematous cholecystitis is a relatively rare disease, a severe variant of acute cholecystitis, that predominantly affects elderly diabetic men. The apparently high mortality and morbidity associated with acute emphysematous cholecystitis have previously emphasized the importance of prompt diagnosis and emergent surgical intervention. Radiological evaluation including plain plain abdominal radiograph (KUB), abdominal sonography, and computed tomography of abdomen is the cornerstone of diagnosis of acute emphysematous cholecystitis.
DOI: http://dx.doi.org/10.1016/S0735-6757(07)00225-2
Published in issue: May 2007
DOI: http://dx.doi.org/10.1016/S0735-6757(07)00226-4
Published in issue: May 2007
DOI: http://dx.doi.org/10.1016/S0735-6757(07)00227-6
Published in issue: May 2007
DOI: http://dx.doi.org/10.1016/S0735-6757(07)00228-8
Published in issue: May 2007
