Gianluca Del Rossi, Glenn R. Rechtine, Bryan P. Conrad, MaryBeth Horodyski
DOI: http://dx.doi.org/10.1016/j.ajem.2009.03.014
Published online: February 26 2010
xIn the prehospital setting, spine-injured patients must be transferred to a spine board to immobilize the spine. This can be accomplished using both manual techniques and mechanical devices.
Alejandro Rodríguez-Molinero, María López-Diéguez, Ana I. Tabuenca, Juan J. de la Cruz, José R. Banegas
DOI: http://dx.doi.org/10.1016/j.ajem.2009.03.016
Published online: October 26 2009
xThis study analyzes the elements that compose the emergency physicians' criterion for selecting elderly patients for intensive care treatment. This issue has not been studied in-depth.
You Hwan Jo, Kyuseok Kim, Joong Eui Rhee, Tae Yun Kim, Jin Hee Lee, Sung-Bum Kang, Duck-Woo Kim, Young Hoon Kim, Kyoung Ho Lee, So Yeon Kim, Christopher C. Lee, Adam J. Singer
DOI: http://dx.doi.org/10.1016/j.ajem.2009.03.017
Published online: March 26 2010
xThis study was conducted to compare the diagnostic accuracy for acute appendicitis between emergency medicine residents (EMRs) and surgical residents (SRs).
Jesse M. Pines, Joshua A. Isserman, Demian Szyld, Anthony J. Dean, Christine M. McCusker, Judd E. Hollander
DOI: http://dx.doi.org/10.1016/j.ajem.2009.03.019
Published online: February 26 2010
xWe sought to determine whether risk tolerance as measured by scales (malpractice fear scale [MFS], risk-taking scale [RTS], and stress from uncertainty scale [SUS]) is associated with decisions to admit or use computed tomography (CT) coronary angiogram and decisions to order cardiac markers in emergency department (ED) patients with chest pain. We also studied if the opening of an ED-based observation unit affected the relationship between risk scales and admission decisions.
Henry A. Spiller, George M. Bosse, Mark L. Ryan
DOI: http://dx.doi.org/10.1016/j.ajem.2009.03.021
Published online: March 29 2010
xIn 2001, a new antivenin was introduced to the United States and became widely available in the snakebite season of 2002. We investigated what impact this may have had on snakebite treatment and medical outcome.
Tali Beni-Israel, Michael Goldman, Shmual Bar Chaim, Eran Kozer
DOI: http://dx.doi.org/10.1016/j.ajem.2009.03.025
Published online: February 26 2010
xThe aim of the study was to identify clinical findings associated with increased likelihood of testicular torsion (TT) in children.
Francis M. Fesmire
DOI: http://dx.doi.org/10.1016/j.ajem.2009.04.004
Published online: April 5 2010
xNo information is currently available regarding the optimal cutoff values of the baseline ST-segment deviation sum (STDsumbaseline) and 60-minute ST-segment deviation change (STDchange60min) for predicting acute myocardial infarction (AMI).
Joe G. Zein, David J. Wallace, Gary Kinasewitz, Nagib Toubia, Christine Kakoulas
DOI: http://dx.doi.org/10.1016/j.ajem.2009.04.005
Published online: February 26 2010
xThe study aimed to determine the incidence and clinical significance of early high (>15 mEq/L) anion gap metabolic acidosis in acetaminophen (APAP) overdose.
Chu-Lin Tsai, Sunday Clark, Carlos A. Camargo Jr
DOI: http://dx.doi.org/10.1016/j.ajem.2009.04.009
Published online: March 26 2010
xSimple risk stratification rules are limited in acute asthma. We developed and externally validated a classification tree for asthma hospitalization.
Rishi Sikka, Supriya Mehta, Carleen Kaucky, Erik B. Kulstad
DOI: http://dx.doi.org/10.1016/j.ajem.2009.06.023
Published online: September 18 2009
xWe measured the correlation between emergency department (ED) occupancy rate and time to antibiotic administration for patients with pneumonia treated in a community hospital setting.
Jacob K. Goertz, Seth Lotterman
DOI: http://dx.doi.org/10.1016/j.ajem.2009.06.028
Published online: September 18 2009
xThe aim of the study was to determine if the degree of hydronephrosis on focused emergency renal ultrasound correlates with kidney stone size on computed tomography.
Mathias B. Forrester
DOI: http://dx.doi.org/10.1016/j.ajem.2009.07.017
Published online: September 18 2009
xAlthough thousands of iguanas are kept as pets in the United States, information on their bites is limited. The intent of this investigation was to describe the pattern of iguana bites reported to Texas poison centers. Iguana bites reported during 1998-2008 were identified. The distribution of cases by various factors was determined. Of 59 total bites, 71% were managed on-site, 17% of the patients were at or en route to a health care facility when the poison center was contacted, and 10% were referred to a health care facility.
Laeben Lester, Darren A. Braude, Christopher Niles, Cameron S. Crandall
DOI: http://dx.doi.org/10.1016/j.ajem.2009.07.023
Published online: April 5 2010
xThe aim of this study was to describe the use and effect of low-dose ketamine (LDK) for analgesia in the emergency department (ED).
Li Yekuo, Wang Shasha, Zhu Xiansheng, Chen Qi, Luo Guoxin, Huo Feng
DOI: http://dx.doi.org/10.1016/j.ajem.2009.07.028
Published online: September 18 2009
xThe aim of this study was to study the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of active hemorrhage and intraparenchymal lesions in blunt hepatic trauma versus conventional ultrasound (US).
Sachita Shah, Nathan Teismann, Brita Zaia, Farnaz Vahidnia, Gerin River, Dan Price, Arun Nagdev
DOI: http://dx.doi.org/10.1016/j.ajem.2009.07.024
Published online: March 29 2010
xRapid and accurate determination of gestational age may be vital to the appropriate care of the critically ill pregnant patient. Before the use of emergency ultrasound, physical examination of fundal height (FH) in the nonverbal patient was considered the quickest method to estimate gestational age. We conducted a prospective, observational study of the performance of bedside sonography to determine gestational age.
George W. Balfour
DOI: http://dx.doi.org/10.1016/j.ajem.2010.05.009
Published in issue: September 2010
xTo the Editor,
Emanuele Piraccini, Alberto Bartolini, Vanni Agnoletti, Ruggero Corso, Giorgio Gambale, Claudio Vicini
DOI: http://dx.doi.org/10.1016/j.ajem.2010.06.009
Published in issue: September 2010
xProblems related to difficult airways are known to be the primary cause of life-threatening anesthesia-related accidents [1]. The i-gel disposable airway (Intersurgical Ltd, Workingham, UK) is a new supraglottic airway device, and its unique design does not need an inflatable cuff because the thermoplastic elastomer provides the seal sufficient for both spontaneously breathing patients and mechanical ventilation. The i-gel is gaining a reputation for ease of insertion and for its use in many situations as well as for the possibility to intubate the patient through the device [2,3].
Roxana C. Sisu, Gabriela Bicescu, Dragos Vinereanu
DOI: http://dx.doi.org/10.1016/j.ajem.2009.11.012
Published online: April 5 2010
xAcute life-threatening complications can arise during early postpartum period and result in maternal morbidity and mortality. Prompt recognition of life-threatening conditions and early effective management are essential to ensure optimal maternal outcome. Thus, peripartum acute respiratory failure is an important cause of mortality, accounting for 30% of maternal deaths. We report a rare case of complete left lung atelectasis, due to a massive fresh intrabronchial clot, with respiratory failure, occurring in early postpartum after cesarean delivery.
Selman Yeniocak, Ozgur Tatli, Aysegul Cansu, Engin Erturk, Mehmet Muharrem Erol, Suleyman Turedi
DOI: http://dx.doi.org/10.1016/j.ajem.2009.11.013
Published online: April 5 2010
xAnaphylactoid reactions have generally been reported in 3% to 6% of patients using N-acetylcysteine (NAC). Predisposing factors for anaphylactoid reactions to NAC are a history of atopy, asthma, drug allergy, low plasma acetaminophen concentrations, and incorrect high-dose intravenous use. We present a case, the first in the literature, of inadvertent direct swallowing of a 1200-mg NAC effervescent tablet that should have been entirely dissolved in water but which became stuck and aspirated in the subglottic region, the patient subsequently developing severe respiratory distress accompanied by subglottic edema, tachycardia, and widespread wheezing.
Chia-Te Kung, Kao-Hsin Li, Shin-Chiang Hung, Chen-Hsiang Lee
DOI: http://dx.doi.org/10.1016/j.ajem.2009.11.018
Published online: April 26 2010
xThe most common organisms cause septic arthritis were Staphylococcal and Streptococcal spp. Lacking of a rapid and reliable diagnostic tool results in emergency department (ED) physicians often prescribed inappropriate empirical antibiotics for patients with suspected septic arthritis especially those caused by gram-negative bacilli. Although low incidence of septic arthritis caused by Burkholderia pseudomallei pathogen for melioidosis is rare, a devastating outcome occurred if the infection is not diagnosed promptly for starting timely effective antibiotic therapy.
Alicia B. Minns, Shaun D. Carstairs, Richard F. Clark
DOI: http://dx.doi.org/10.1016/j.ajem.2009.11.019
Published online: April 26 2010
xSodasorb (soda lime) absorbent (W.R. Grace, Cambridge, MA) is used by military and recreational divers in closed-circuit rebreathers to remove expired carbon dioxide. We describe a case of a military diver who presented with a corrosive esophageal and lung injury after his closed-circuit diving apparatus was contaminated with water. A 23-year-old healthy male presented after ingestion and inhalation of a solution containing calcium hydroxide, potassium hydroxide, and sodium hydroxide. These compounds were contained in his closed-circuit diving apparatus in a mixture called Sodasorb, used to scavenge carbon dioxide.
Petros D. Karkos, Christos D. Karkos, Samuel C. Leong, Nagaraj Sivaji, Dimitrios Papadopoulos, Assimakis D. Assimakopoulos
DOI: http://dx.doi.org/10.1016/j.ajem.2009.11.024
Published online: April 28 2010
xLemierre syndrome is characterized by a history of recent oropharyngeal infection, clinical or radiologic evidence of internal jugular vein thrombosis, and isolation of anaerobic pathogens, mainly fusobacterium necrophorum. There has been an increase in reporting of Lemierre syndrome over the last 10 years. Whether this reflects a true increase in the incidence of this previously rare disease or just a literature/publishing trend, it remains to be seen. We present a case of a healthy teenager who was managed successfully, thanks to immediate multidisciplinary approach and high index of suspicion.
Yusuf Sezen, Unal Guntekin, Akın Iscan, Hasan Kapakli, Hakan Buyukhatipoglu, Zekeriya Kucukdurmaz
DOI: http://dx.doi.org/10.1016/j.ajem.2009.12.008
Published online: April 5 2010
xScorpion bites are common in various countries worldwide. In Turkey, scorpion bite cases occasionally are reported in rural areas. Such bites infrequently have serious clinical sequelae, including acute pulmonary edema, cardiogenic shock, and even death. In this case, a scorpion bite led to myocardial injury and consequent pulmonary edema and third degree mitral insufficiency. With aggressive medical management, the patient recovered within a few days. We present this case because of its unusual presentation, unexpected complications, and prompt resolution.
Yu-Tzu Tsao, Chia-Chao Wu, Yu-Juei Hsu, Pauling Chu
DOI: http://dx.doi.org/10.1016/j.ajem.2009.12.009
Published online: April 5 2010
xCentral pulmonary embolism with acute right ventricular failure usually represents an ominous sign and carries high risk of mortality. Across the broad spectrum of precipitating factors contributing to the prothrombotic milieu, protein-losing enteropathy has rarely been stressed to be associated with life-threatening thromboembolism. Of interest, protein-losing enteropathy can be the initial manifestation of systemic lupus erythematosus and harbinger of the autoimmune inflammation process antedating the lupus phase by months to years.
Seung Han Lee, Seung Ryu, Jin Woong Lee, Seung Whan Kim, In Sool Yoo, YeonHo You
DOI: http://dx.doi.org/10.1016/j.ajem.2009.12.010
Published online: April 5 2010
xHyperbaric oxygen (HBO) therapy is an effective tool for the treatment of conditions such as carbon monoxide poisoning, necrotizing soft tissue infection, decompression sickness, and arterial gas embolism [1]. However, there are a number of complications and adverse effects related to HBO therapy, including pressure equalization problems in the middle ear, cranial sinus squeeze, and tooth squeeze [2]. We describe a case of hyperthermia occurring after HBO therapy for carbon monoxide poisoning.
Jung Soo Park, Hoon Kim, Suk Woo Lee, Jin Hong Min, Si Wook Kim, Kyung Woo Lee
DOI: http://dx.doi.org/10.1016/j.ajem.2009.12.011
Published online: April 5 2010
xPneumorrhachis, the presence of intraspinal air, is classified as epidural or subarachnoid and is most commonly caused by trauma and iatrogenic factors. In general, epidural air bubbles neither migrate nor cause symptoms. Hence, no study has reported a case of symptomatic pneumorrhachis after chest tube insertion for spontaneous pneumothorax. A 28-year-old man visited the emergency department because of chest discomfort since 2 days. Chest radiography revealed a left pneumothorax. Left closed thoracostomy was immediately performed, and a chest tube (12F) was inserted through a trocar.
Amesh A. Adalja
DOI: http://dx.doi.org/10.1016/j.ajem.2009.12.012
Published online: April 5 2010
xGastrointestinal bleeding complicating influenza is uncommon; the follow is a a report of one such incidence.
DOI: http://dx.doi.org/10.1016/S0735-6757(10)00315-3
Published in issue: September 2010
DOI: http://dx.doi.org/10.1016/S0735-6757(10)00316-5
Published in issue: September 2010
DOI: http://dx.doi.org/10.1016/S0735-6757(10)00317-7
Published in issue: September 2010
DOI: http://dx.doi.org/10.1016/S0735-6757(10)00318-9
Published in issue: September 2010
