JOURNAL OF EMERGENCY MEDICINE

The Role of Troponin Testing in Patients with Supraventricular Tachycardia, Systematic Review and Meta-Analysis
Pourmand A, Checkeye H, Varghese B, Solomon AJ and Tran QK
Supraventricular tachycardia (SVT) is commonly evaluated in the emergency department (ED). While troponin has been shown to be elevated in SVT, its usefulness for predicting coronary artery disease and future adverse cardiovascular outcomes has not been shown.
A Teenager with Bleeding Lips
Azan L, Patton M, Arcia-Diaz R and McQueen A
Investigation of the Relationship Between the Measured Alpha Angle in Capnography and Readmission Within Thirty Days in Chronic Obstructive Pulmonary Disease Patients Who Presented to the Emergency Department
Tuncekin M, Ozbek AE, Sanci Şancı E, Tasolar FET and Halhalli HC
Individuals with chronic obstructive pulmonary disease (COPD) constitute a significant portion of patients who present to the emergency department with dyspnea. However, there is no ideal method for predicting mortality or making hospitalization decisions in the emergency department (ED). In this regard, objective findings are needed for these patients. Since there are no objective findings regarding the hospitalization decision, there may be an increase in the re-admission rate of patients who needed hospitalization but were decided to be discharged. Side-stream end-tidal carbon dioxide (EtCO) measurements offer a non-invasive, easy-to-interpret, quickly accessible, and reproducible method that can be applied at the bedside.
A Cluster-Randomized Control Study Comparing a New Cue "Two Compressions per Second" with "100-120 Compressions per Minute" in Training of Bystander Cardiopulmonary Resuscitation
Hsieh MJ, Lin HY, Ko YC, Yang CW, Chiang WC and Ma MH
Chest compression at a rate of 100-120 compressions per minute (cpm) during cardiopulmonary resuscitation (CPR) is associated with the highest survival rates. Performing compressions at a faster rate may exhaust the rescuers.
Emergency Department Screening and Interventions for Adolescents With Substance Use: A Narrative Review
Renny MH, Love JS, Walton MA, Levy S and Merchant RC
Adolescent substance use is a growing public health concern, particularly given rising mortality rates from drug overdose deaths. The emergency department (ED) provides a unique opportunity to screen adolescents for substance use and provide brief interventions and linkage to care.
Determinants of Early Mortality Among Deaths at Adult Emergency Departments in Southern Ethiopia
Gobena GG, Tadesse F, Beyene B, Yeheyis T, Jemebere W, Chekol AT, Borie YA, Molla E, Reta Y, Wale MA, Mekonen Z, Tunushe YM, Feleke B and Aynalem A
In Ethiopia, the first 3 days (72 h) after admission to the emergency department (ED) account for more than half (59.8%) of all deaths. However, little is known about the prevalence of early mortality and its associated factors in southern Ethiopia.
Increased Human Chorionic Gonadotropin Level in a Nonsexually Active Young Female
Elder NM and McCormick A
Quantitative and qualitative human chorionic gonadotropin (hCG) tests are obtained in the emergency department (ED) to determine if a female of child-bearing age is pregnant. A positive hCG result is commonly assumed to indicate an intrauterine or other form of pregnancy. However, elevated hCG levels can also result from various other conditions, such as ovarian tumors, pituitary tumors, and thyroid disorders. Intracranial germ cell tumors, rare central nervous system tumors capable of secreting hCG, primarily affect adolescent and young adult females.
Epidemiology of Testicular Trauma in Sports: Analysis of the National Electronic Injury Surveillance System Database
Jain R, Nadella M, Byrne R, Jayachandran N, Quinn M and Owens BD
The epidemiology of testicular trauma in sports on a national scale has not been well studied. Timely management and treatment after testicular trauma is critical to avoid serious, long-term ramifications of mismanagement.
Distinguishing Peripheral from Central Causes of Dizziness and Vertigo without using HINTS or STANDING
Edlow JA
Three validated diagnostic algorithms for diagnosing patients with acute onset dizziness or vertigo (HINTS, HINTS-plus and STANDING) exist. All are extremely accurate in distinguishing peripheral from central causes of dizziness when done by experienced clinicians. However, uptake of these diagnostic tools in routine emergency medicine practice has been sub-optimal, in part, due to clinicians' unease with the head impulse test, the most useful component contained of these algorithms. Use of these validated algorithms is the best way to accurately diagnose patients with acute dizziness. For clinicians who are unfamiliar with or uncomfortable performing or interpreting HINTS and STANDING, this article will suggest alternative approaches to help with accurate diagnosis of patients with acute dizziness or vertigo.
A Parasite Living Beneath the Conjunctiva
Curato M and Li A
An Unusual Case of Failure to Thrive: Respiratory Failure from a Vallecular Cyst in a Young Infant
Casas T, Murray M, Glenn T and Yaphockun K
A Young Woman with Apparent Brain Death
Prucnal CK, Jansson PS, Chai PR, Hallisey SD, Monette DL and Wittels KA
Selective Use of Positive-Pressure Ventilation for Preoxygenation During Air Medical Rapid Sequence Intubation
Herndon A, Chandran K and Davis DP
Preoxygenation is critical to safe performance of rapid sequence intubation (RSI). The use of positive-pressure ventilation (PPV) has been advocated during preoxygenation but may increase the risk of aspiration.
Factors Associated with Take Home Naloxone Refusal among Emergency Department Patients Participating in an Opioid Overdose Prevention Program
O'Brien-Lambert C, Althoff K, Barvincak J, Cirbus H, Singer-Pomerantz S and Cowan E
Increasing the equitable distribution of take home naloxone (THN) may result in reduced deaths from opioid overdose (OD).
Anoxic Brain Injury: A Subtle and Often Overlooked Finding in Non-Fatal Intimate Partner Strangulation
Dugan S, Patch M, Hoang T and Anderson JC
A paucity of literature exists dedicated to the identification of anoxic brain injury in patients that survive non-fatal intimate partner strangulation (NF-IPS). While some individuals report experiencing symptoms of brain hypoxia followed by a loss of consciousness, other individuals report symptoms of brain hypoxia prior to amnesia, rendering some unable to recall loss of consciousness (LOC).
Pulmonary Embolism Rule-out Criteria: Diagnostic Accuracy and Impact of COVID-19
Tanir SK, Eksioglu M and Ozturk TC
The Pulmonary Embolism Rule-Out Criteria (PERC), developed to minimize unnecessary testing in low-risk pulmonary embolism (PE) cases, lacks clear validation in the context of COVID-19.
The Lipliner Sign: Potential Cause of a False Positive Focused Assessment with Sonography in Trauma (FAST) Examination
Parker MA, Hicks BG, Kaili M, Silver A, Zhu M, Feuerherdt M, Zhang Y, Thomas C, Gregory CR, Gregory KW and Schnittke N
The focused assessment with sonography in trauma (FAST) examination plays an essential role in diagnosing hemoperitoneum in trauma patients to guide prompt operative management. The FAST examination is highly specific for hemoperitoneum in trauma patients, and has been adopted in nontrauma patients to identify intraperitoneal fluid as a cause of abdominal pain or distension. However, causes of false positive FAST examinations have been described and require prompt recognition to avoid diagnostic uncertainty and inappropriate procedures. Most causes of false positive FAST examinations are due to anatomic mimics such as perinephric fat or seminal vesicles, however, modern ultrasound machines use a variety of postprocessing image enhancement techniques that can also lead to novel false positive artifacts.
Low Incidence of Delayed Intracranial Hemorrhage in Geriatric Emergency Department Patients on Preinjury Anticoagulation Presenting with Blunt Head Trauma
Shih RD, Alter SM, Solano JJ, Engstrom G, Wells M, Clayton LM, Hughes PG, Goldstein LN, Azar FK and Ouslander JG
Delayed intracranial hemorrhage (ICH) after head injury in older patients taking anticoagulants has been reported to be as high as 7.2%. Other studies suggest much lower rates. Its incidence and clinical management are controversial, with some recommending observation and repeat head imaging at 24 h.
Safety of Diltiazem for Acute Management of Atrial Fibrillation (AF) in Patients with Heart Failure and Reduced Ejection Fraction in the Emergency Department
Schmitt CJ, Mattson AE, Cabrera D, Mullan A, Marí Chantada C, Howick AS, Kane GC and Bellolio F
Diltiazem is an effective rate control agent for atrial fibrillation with rapid ventricular rate (AF RVR). However, its negative inotropic effects may increase the risk for worsening heart failure in patients with a reduced ejection fraction (EF).
The Role of Language in Hospital Admissions: The COVID-19 Experience in a Safety-Net Hospital Emergency Department
Bacon E, Thiessen ME, Vogel J, Whitfield J, Cervantes L and Podewils LJ
Emergency departments (EDs) are often patients' first point of contact with the health care system. Race, ethnicity, and language all influence factors leading up to ED visits and patient experiences within the ED. There is limited evidence showing how race, ethnicity, and language interact to shape ED experiences, particularly during the COVID-19 pandemic when EDs were extremely strained.
Association Between Emergency Medical Services Intervention Volume and Out-of-Hospital Cardiac Arrest Survival: A Propensity Score Matching Analysis
Vincent T, Lefebvre T, Martinez M, Debaty G, Noto-Campanella C, Canon V, Tazarourte K, Benhamed A and
Out of hospital cardiac arrest (OHCA) survival rates are very low. An association between institutional OHCA case volume and patient outcomes has been documented. However, whether this applies to prehospital emergency medicine services (EMS) is unknown.