American Journal of Emergency Medicine最新文献

{"title":"Naloxone knowledge, interest, and obtainment among a general emergency department patient population.","authors":"Carrie Gold, Troy Madsen, Marina Griffith, Sikoti Langi, Andrew Jones, Gerrit Seymour, Jacob Steenblik","doi":"10.1016/j.ajem.2024.08.043","DOIUrl":"10.1016/j.ajem.2024.08.043","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":" ","pages":"159-169"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perforated bowel following hysteroscopy with myomectomy in the emergency department.","authors":"Kevin Watkins, Adriana G Arribas, Erin L Simon","doi":"10.1016/j.ajem.2024.11.022","DOIUrl":"10.1016/j.ajem.2024.11.022","url":null,"abstract":"<p><strong>Background: </strong>Abdominal pain remains a top chief complaint for patients presenting to the emergency department (ED). Benign or emergent etiologies can present similarly. A thorough history and physical examination are critical for emergency physicians, especially for post-operative patients with concerns for a possible bowel perforation. Hysteroscopies with myomectomies are a minimally invasive surgical technique to remove fibroids. Gynecologic procedures historically have a low incidence of bowel perforation, however, in patients with post-operative pain presenting to the ED, distinguishing between a normal post-operative course and a post-operative complication can be challenging.</p><p><strong>Case: </strong>A 33-year-old female with a history of obesity, colitis, type II diabetes, and hypertension presented to the freestanding ED with complaints of severe lower abdominal following a hysteroscopy with myomectomy earlier that day. The initial differential diagnosis had concern for a surgical complication, although her computed tomography of the abdomen and pelvis revealed mildly dilated loops of small bowel, suggestive of a low-grade small bowel obstruction (SBO) or enteritis. On reassessment, she noted pre-operative diarrhea after taking antibiotics. After admission, a transvaginal ultrasound revealed a collection of fluid in her pelvis prompting a diagnostic laparoscopy. Two enterotomies in her ileum with two uterine defects were successfully repaired, and she recovered several days later with minimal complications.</p><p><strong>Discussion: </strong>This patient initially presented with abdominal pain associated with nausea and vomiting following a hysteroscopy with myomectomy, where initial testing led to a possible diagnosis of enteritis. Due to her continued abdominal pain, the ED physician admitted the patient, and it was found that she had two ileum perforations from suspected uterine perforations.</p>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":" ","pages":"216.e1-216.e3"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"After-hours house call services in Japan: Perspectives of physicians in secondary hospital emergency departments.","authors":"Ryota Inokuchi, Ayaka Sakamoto, Yu Sun, Masao Iwagami, Kent Doi, Nanako Tamiya","doi":"10.1016/j.ajem.2024.08.009","DOIUrl":"10.1016/j.ajem.2024.08.009","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":" ","pages":"135-138"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation considerations for the adoption of artificial intelligence in the emergency department.","authors":"Haihua Wang, Ji Lan","doi":"10.1016/j.ajem.2024.09.006","DOIUrl":"10.1016/j.ajem.2024.09.006","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":" ","pages":"176"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The authors respond \"Ultrasound-guided erector spinae nerve block for relief of endometriosis pain in the emergency department\".","authors":"Anju Gupta, Amiya Kumar Barik, Chitta Ranjan Mohanty, Rakesh Vadakkethil Radhakrishnan, Aditya Vikram Prusty","doi":"10.1016/j.ajem.2024.08.022","DOIUrl":"10.1016/j.ajem.2024.08.022","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":" ","pages":"147-148"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Achieving successful CPR protocol training on schoolchildren: Insights from experiences in developing countries.","authors":"Ricardo Allende-Carrera, Jorge Álvarez de la Cadena-Sillas, Agustín Urzúa-González, Alan Rodrigo Gutiérrez-Vega, David Martínez-Dunker, Manuel Celaya-Cota, Luisa F Aguilera-Mora, José Salvador Lainez-Zelaya, Luis Lojero-Wheatley, Enrique Asensio-Lafuente, Erik H González-Cruz","doi":"10.1016/j.ajem.2024.09.044","DOIUrl":"10.1016/j.ajem.2024.09.044","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":" ","pages":"198-200"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute death Camas (Toxicoscordion venenosum) plant poisoning in seven family members following foraging for wild onions.","authors":"Kevin A Padrez, Benjamin L Stix, Cody A Cunningham, Abdelmohaymin Abdalla, Marisa Oishi, Vanessa Cardy, Sean Patrick Nordt","doi":"10.1016/j.ajem.2024.10.027","DOIUrl":"10.1016/j.ajem.2024.10.027","url":null,"abstract":"<p><strong>Background: </strong>Unintentional plant ingestions and poisoning are common. Generally, these ingestions are asymptomatic or minimally symptomatic. Increased toxicity is often associated with the foraging for plants incorrectly identified as edible plants. We present a case series of seven family members poisoned by suspected Death Camas, also known as Meadow Death Camas, (Toxicoscordion venenosum), when the plant was misidentified as edible while foraging for Wild Onion (Allium canadense).</p><p><strong>Case series: </strong>Five children and two adults presented to the emergency department after eating bulbs of suspected Death Camas (Toxicoscordion venenosum). Symptoms began within 30 to 60 min including nausea, vomiting, and abdominal pain. This was followed by bradycardia and hypotension consistent with Death Camas poisoning from alpha blockade, sodium channel activation, and increased vagal activity from the toxins. All of the patients required admission to the intensive care unit. Six patients were treated with supportive care alone and two patients required vasopressor support. An 89-year-old female developed a wide complex tachycardia and was treated with amiodarone. All patients had resolution of toxicity within 24 h and were discharged to home. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Foodborne illness is a common presentation highlighted by signs and symptoms manifesting in multiple people eating the same meal. The misidentification of toxic plants as edible is associated with acute onset of signs and symptoms of toxicity. The toxins associated with Death Camas (Toxicoscordion venenosum), commonly thought to be edible Wild Onion (Allium canadense), are unique as these can cause gastrointestinal effects (e.g., nausea, vomiting, diarrhea), and cardiovascular effects (e.g., bradycardia, hypotension), which are often refractory to supportive therapy alone (e.g., crystalloid fluids), and can require atropine and vasopressors.</p>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":" ","pages":"217.e1-217.e5"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prospective single-blinded randomized field-based trial to evaluate the prophylactic treatment of oral prochlorperazine for acute mountain sickness.","authors":"Kayla Vanderkooi, Peter Richman, Joshua White, Laura Sample, K Tom Xu, Michael Miller","doi":"10.1016/j.ajem.2024.10.048","DOIUrl":"10.1016/j.ajem.2024.10.048","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":" ","pages":"214-215"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful recovery of vision following intravenous thrombolysis using low-dose alteplase in central retinal artery occlusion.","authors":"Shun Tanaka, Mikito Hayakawa, Kuniharu Tasaki, Ryohei Ono, Koji Hirata, Hisayuki Hosoo, Yoshiro Ito, Aiki Marushima, Hiroshi Yamagami, Tetsuro Oshika, Yuji Matsumaru","doi":"10.1016/j.ajem.2024.11.017","DOIUrl":"10.1016/j.ajem.2024.11.017","url":null,"abstract":"<p><p>Central retinal artery occlusion (CRAO) is an ophthalmic emergency characterized by sudden loss of vision with a low chance of spontaneous recovery. This case report presents a 49-year-old female with sudden right eye visual loss, diagnosed as non-arteritic CRAO. Fundoscopic examination revealed retinal pallor, and optical coherence tomography demonstrated edema of the inner retinal layer, consistent with CRAO. Brain magnetic resonance imaging (MRI) showed an acute ischemic lesion in the right occipital subcortex. The patient received intravenous recombinant tissue plasminogen activator (IV rt-PA) at a lower-than-standard dose of 0.6 mg/kg within 4 h and 17 min of symptom onset, resulting in significant visual improvement. Extensive etiological investigation, including transesophageal echocardiography, uncovered a large, high-risk patent foramen ovale (PFO), leading to the diagnosis of PFO-associated CRAO and concomitant embolic stroke. This case suggests the effectiveness of low-dose IV rt-PA in treating CRAO, which might offer comparable efficacy to the standard dose while potentially minimizing bleeding risks. It also emphasizes the importance of considering cardiac comorbidities, particularly PFO, in younger CRAO patients, and underscores the need for a multidisciplinary approach and comprehensive stroke-etiology workups in CRAO management. This report contributes to the limited evidence on CRAO treatment in Japan, particularly in the context of lower tPA dosing and associated cardiac abnormalities. It underscores the importance of early diagnosis, treatment, and thorough etiological investigation in improving outcomes for CRAO patients.</p>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":" ","pages":"216.e5-216.e9"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric urgent care fellowships: A national survey of training opportunities.","authors":"Natan Cramer, Emily Willner, Deena Berkowitz","doi":"10.1016/j.ajem.2024.08.014","DOIUrl":"10.1016/j.ajem.2024.08.014","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":" ","pages":"139-141"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}