Archives

Cecal Diverticulitis

A 56-year-old Hispanic male presented to the emergency department (ED) complaining of right lower quadrant abdominal pain for two days.

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Sporotrichosis

A 25-year-old healthy Hispanic male agricultural laborer presented to the emergency department with six weeks of a painless raised lesion on the proximal thumb with occasional drainage of fluid, without history of injury.

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Critical Care

Unsuspected Pulmonary Embolism in Observation Unit Patients

Many emergency department (ED) patients with cardiopulmonary symptoms such as chest pain or dyspnea are placed in observation units but do not undergo specific diagnostic testing for pulmonary embolism (PE). The role of observation units in the diagnosis of PE has not been studied. We hypothesized that there was a small but significant rate of unsuspected PE in our observation unit population.

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Infected Thyroglossal Duct Cyst

A 23-year-old female presented to the emergency department (ED) with a five-day history of sore throat, body aches and 24 hours of throat swelling accompanied by globus sensation and hoarseness.

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Methemoglobinemia and Sulfhemoglobinemia in Two Pediatric Patients after Ingestion of Hydroxylamine Sulfate

This case report describes two pediatric cases of immediate oxygen desaturation from methemoglobinemia and sulfhemoglobinemia after one sip from a plastic water bottle containing hydroxylamine sulfate used by a relative to clean shoes. Supplemental oxygen and two separate doses of methylene blue given to one of the patients had no effect on clinical symptoms or pulse oximetry. The patients were admitted to the pediatric Intensive Care Unit (ICU) with subsequent improvement after exchange transfusion. Endoscopy showed ulcer formation in one case and sucralafate was initiated; both patients were discharged after a one-week hospital stay.

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Violent Hiccups: An Infrequent Cause of Bradyarrhythmias

A hiccup, or singultus, results from a sudden, simultaneous, vigorous contraction of the diaphragm and inspiratory muscles, accompanied by closure of the glottis. Hiccups can be associated with bradyarrhythmias. The mechanism of this phenomenon is likely hiccup-induced Valsalva maneuver and increased parasympathetic tone. We present a case of a patient with violent hiccups producing a bradyarrhythmia.

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Education

Procedural Skills Training During Emergency Medicine Residency: Are We Teaching the Right Things?

The Residency Review Committee training requirements for emergency medicine residents (EM) are defined by consensus panels, with specific topics abstracted from lists of patient complaints and diagnostic codes. The relevance of specific curricular topics to actual practice has not been studied. We compared residency graduates’ self-assessed preparation during training to importance in practice for a variety of EM procedural skills.

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Critical Care

Linear Correlation of Endotracheal Tube Cuff Pressure and Volume

Endotracheal tube cuff (ETTc) inflation by standard methods may result in excessive ETTc pressure. Previous studies have indicated that methods of cuff inflation most frequently used to inflate ETTcs include palpation of the tension in the pilot balloon or injection of a predetermined volume of air to inflate the pilot balloon. If a logarithmic relationship exists between ETTc volume and ETTc pressure, small volumes of additional air will result in dramatic pressure increases after a volume threshold is reached. Our goal was to determine whether the relationship between ETTc volume and ETTc pressure is linear or non-linear.

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Critical Care

International Perspective from Turkey on “Unsuspected Pulmonary Embolism in Observation Unit Patients”

  Author Affiliation Arif Alper Cevik, MD Eskisehir Osmangazi University Medical Center, Department of Emergency Medicine, Turkey Pulmonary embolism (PE) is a challenging diagnosis for emergency physicians because of its non-specific clinical presentation. Although “chest pain” is one of the major symptoms of PE,1 it can be part of other serious diagnoses, such as aortic dissection, […]

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Contact Information

WestJEM/ Department of Emergency Medicine
UC Irvine Health

333 The City Blvd. West, Rt 128-01
Suite 640
Orange, CA 92868, USA
Phone: 1-714-456-6389
Email: editor@westjem.org

Our Philosophy

Emergency Medicine is a specialty which closely reflects societal challenges and consequences of public policy decisions. The emergency department specifically deals with social injustice, health and economic disparities, violence, substance abuse, and disaster preparedness and response. This journal focuses on how emergency care affects the health of the community and population, and conversely, how these societal challenges affect the composition of the patient population who seek care in the emergency department. The development of better systems to provide emergency care, including technology solutions, is critical to enhancing population health.