American Journal of Emergency Medicine最新文献

{"title":"Reader Comment Regarding Delta shock index in the emergency department as a predictor of clinical outcomes in traumatic injury.","authors":"Jen-Yu Hsu, Kazuhiro Komine, Fu-Shan Jaw, Chien-Chieh Hsieh","doi":"10.1016/j.ajem.2025.03.055","DOIUrl":"https://doi.org/10.1016/j.ajem.2025.03.055","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789437","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":"Response to: \"Chest tubes and cardiac complications: Time to reevaluate placement strategies\".","authors":"Julia A Holtmann","doi":"10.1016/j.ajem.2025.03.042","DOIUrl":"https://doi.org/10.1016/j.ajem.2025.03.042","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765958","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":"CuratED: The emergency medicine pharmacotherapy literature of 2024","authors":"Ryan Feldman ,&nbsp;Brett Faine ,&nbsp;Megan A. Rech ,&nbsp;David E. Zimmerman ,&nbsp;Tara Flack ,&nbsp;Gavin T. Howington ,&nbsp;Jessica Laub ,&nbsp;Blake Porter ,&nbsp;Giles W. Slocum ,&nbsp;Anne Zepeski ,&nbsp;Ruben D. Santiago ,&nbsp;Jordan Woolum ,&nbsp;James Krenz ,&nbsp;Preeyaporn Sarangarm ,&nbsp;Jennifer Koehl","doi":"10.1016/j.ajem.2025.03.046","DOIUrl":"10.1016/j.ajem.2025.03.046","url":null,"abstract":"<div><div>The purpose of this article is to summarize pharmacotherapy related emergency medicine (EM) literature indexed in 2024. Articles were selected utilizing a modified Delphi approach. The table of contents from predetermined journals were reviewed and independently evaluated via the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system by paired authors. Pharmacotherapy-related publications deemed to be GRADE 1A and 1B were reviewed by the collective group for inclusion in the review. This article synthesizes and evaluates findings from 11 randomized controlled trials, 10 guidelines, clinical policies, position statements, or consensus recommendations, and 7 meta-analyses, providing critical insight into their potential clinical impact. Covered topics include guideline updates on seizure prophylaxis in traumatic brain injury, corticosteroid use in sepsis and acute respiratory distress and antibiotic prophylaxis in trauma. Additional topics include updates on thrombolytic therapy for acute ischemic stroke, including tenecteplase versus alteplase, anticoagulation reversal strategies with andexanet alpha and prothrombin complex concentrate, and the use of tranexamic acid in traumatic brain injury, ketamine versus etomidate for intubation in critically ill adults, expert consensus on heart failure hospitalization management, geriatric emergency medication safety recommendations, and emerging data on dual antiplatelet therapy for stroke management.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"93 ","pages":"Pages 146-153"},"PeriodicalIF":2.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800546","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":"Comment on limitations of delta shock index in the emergency department.","authors":"Sungwook Park","doi":"10.1016/j.ajem.2025.03.054","DOIUrl":"https://doi.org/10.1016/j.ajem.2025.03.054","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744497","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":"Emergency medicine updates: Cardiopulmonary resuscitation","authors":"Brit Long MD ,&nbsp;Michael Gottlieb MD","doi":"10.1016/j.ajem.2025.03.057","DOIUrl":"10.1016/j.ajem.2025.03.057","url":null,"abstract":"<div><h3>Introduction</h3><div>Cardiac arrest is the loss of functional cardiac activity; emergency clinicians are integral in the management of this condition.</div></div><div><h3>Objective</h3><div>This paper evaluates key evidence-based updates concerning cardiopulmonary resuscitation (CPR).</div></div><div><h3>Discussion</h3><div>Cardiac arrest includes shockable rhythms (i.e., pulseless ventricular tachycardia and ventricular fibrillation) and non-shockable rhythms (i.e., asystole and pulseless electrical activity). The goal of cardiac arrest management is to achieve survival with a good neurologic outcome, in part by restoring systemic perfusion and obtaining return of spontaneous circulation (ROSC), while seeking to diagnose and treat the underlying etiology of the arrest. CPR includes high-quality chest compressions to optimize coronary and cerebral perfusion pressure. Chest compressions should be centered over the mid-sternum, with the compressor's body weight over the middle of the chest. A compression depth of 5–6 cm is recommended at a rate of 100–120 compressions per minute, while allowing the chest to fully recoil between each compression. Clinicians should seek to minimize any interruptions in compressions. When performed by bystanders, compression-only CPR may be associated with improved survival to hospital discharge when compared to conventional CPR with ventilations. However, in trained personnel, there is likely no difference with compression-only versus conventional CPR. Mechanical approaches for CPR are not associated with improved patient outcomes, including ROSC or survival with good neurologic function, but mechanical compression devices may be beneficial in select circumstances (e.g., few rescuers available, prolonged arrest/transport). Monitoring of chest compressions is not associated with improved ROSC, survival, or neurologic outcomes, but it can improve guideline adherence. Types of monitoring include real-time feedback, a CPR coach, end tidal CO₂, arterial line monitoring, regional cerebral tissue oxygenation, and point-of-care ultrasound.</div></div><div><h3>Conclusions</h3><div>An understanding of CPR literature updates can improve the ED care of patients in cardiac arrest.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"93 ","pages":"Pages 86-93"},"PeriodicalIF":2.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738305","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":"Trends in stimulant-related emergency department visits among adults in California, 2017–2021","authors":"Benjamin H. Han MD ,&nbsp;Jesse J. Brennan MA ,&nbsp;Wayne E. Kepner PhD ,&nbsp;Steven Chen BA ,&nbsp;Sidney Lin BA ,&nbsp;Joseph A. Carley MD ,&nbsp;Julia Larson MD ,&nbsp;Edward M. Castillo PhD","doi":"10.1016/j.ajem.2025.03.051","DOIUrl":"10.1016/j.ajem.2025.03.051","url":null,"abstract":"<div><h3>Background</h3><div>Stimulants are becoming increasingly prevalent among overdoses, yet little is understood about how stimulant use impacts emergency department (ED) utilization.</div></div><div><h3>Methods</h3><div>Using data from California's Department of Healthcare Access and Information, we conducted a five-year trend analysis of stimulant-related ED visits from acute care hospitals in California from 2017 to 2021. For each year, we determined the stimulant-related ED visit rate per 100,000 ED visits for adults aged ≥18 utilizing ICD-10 diagnosis codes. We estimated the percent changes in overall stimulant-related visit rates during the study period and by subgroup, including by demographic characteristics, Charlson comorbidity index score (CCIS), and cardiovascular (CV) diagnoses. We used chi-squared analyses to examine changes in trends over time.</div></div><div><h3>Results</h3><div>The rate of stimulant-related ED visits increased from 2064.4 per 100,000 ED visits in 2017 to 2586.1 per 100,000 ED visits in 2021, a 25.3 % increase (<em>P</em> &lt; 0.001). By race/ethnicity, people identified as Native American/Alaska Natives had the highest ED visit rate in 2021 (4713.5 per 100,000 ED visits) and the largest increase of 60.8 % (<em>P</em> &lt; 0.001). The proportion of stimulant-related ED visits with CV disease diagnoses increased from 13.8 % in 2017 to 18.0 % in 2021, a relative increase of 30.8 % (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Stimulant-related ED visits are increasing among adults in California, especially among non-white populations and those with higher comorbidity. This sharp rise highlights the critical need for targeted interventions and harm reduction strategies that consider the unique effects of stimulant use on ED rates and CV outcomes.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"93 ","pages":"Pages 94-98"},"PeriodicalIF":2.7,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nebulized ketamine at 3 different dosing regimens for acute traumatic pain in the emergency department: A sub-group analysis.","authors":"Jefferson Drapkin, Rukhsana Hossain, Ronald Simon, Sergey Motov","doi":"10.1016/j.ajem.2025.03.049","DOIUrl":"https://doi.org/10.1016/j.ajem.2025.03.049","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744505","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":"Length of stay of patients who presented to the ED with flank pain and received a CT scan.","authors":"Princy Shah, Arihant Kalidindi, Elani Colon, Hannah Beck, Ellen N Huhulea, Jillienne Mendoza, Dan Mor, Christina Ciraco, Hossein Kalantari, Hussein Matari, Getaw Worku Hassen","doi":"10.1016/j.ajem.2025.03.034","DOIUrl":"https://doi.org/10.1016/j.ajem.2025.03.034","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732606","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":"Bilateral globi pallidi infarctions from opioid and cocaine use.","authors":"Manvinder Toor, Casey Morris, Wesley Eilbert","doi":"10.1016/j.ajem.2025.03.047","DOIUrl":"https://doi.org/10.1016/j.ajem.2025.03.047","url":null,"abstract":"<p><p>The globi pallidi (GP) are paired structures present in the basal ganglia of the brain. Their primary function is to regulate motor movement. Due to their high metabolic activity, the GP are highly susceptible to injury from hypoxia and other metabolic insults. We report a case of bilateral GP infarction in a previously healthy 26 year old man due to opioid and cocaine use.</p>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733397","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":"Commentary on \"Artificial intelligence for the diagnosis of pediatric appendicitis: A systematic review\".","authors":"Rachana Mehta, Shubham Kumar, Ranjana Sah","doi":"10.1016/j.ajem.2025.03.045","DOIUrl":"https://doi.org/10.1016/j.ajem.2025.03.045","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733399","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}