Archives

Emergency Medical Services Public Health Implications and Interim Guidance for the Ebola Virus in the United States

Volume 16, Issue 1, January 2015
Christopher E. McCoy, MD, MPH et al.

The 25th known outbreak of the Ebola Virus Disease (EVD) is now a global public health emergency and the World Health Organization (WHO) has declared the epidemic to be a Public Health Emergency of International Concern (PHEIC). Since the first cases of the West African epidemic were reported in March 2014, there has been an increase in infection rates of over 13,000% over a 6-month period.

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A BOLD IDEA: The “Population” Specialist

Volume 15, Issue 7, November 2014
Judith E. Tintinalli, MD, MS

Emergency medicine today is very different from emergency medicine of the 1970s, when our practice was limited to the physical confines of the emergency department (ED) and the ambulance.

So—WHO ARE WE ANYWAY?

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Ebola Virus Disease: Essential Public Health Principles for Clinicians

Volume 15, Issue 7, November 2014
Kristi L. Koenig, MD et al.

Ebola Virus Disease (EVD) has become a public health emergency of international concern. The World Health Organization and Centers for Disease Control and Prevention have developed guidance to educate and inform healthcare workers and travelers worldwide.

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Utility of Vital Signs in Mass Casualty-Disaster Triage

Volume 15, Issue 7, November 2014
David E. Hogan, DO, MPH et al.

The triage of patients during a mass casualty – disaster (MCD) event presents the emergency healthcare provider with a complex and difficult issue. The task of evaluating casualties rapidly, using primarily the skills of physical examination, while still accurately identifying casualties likely to have critical injury or illness, may be impossible to achieve in practice.

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Emergency Department Operations

Using Lean-Based Systems Engineering to Increase Capacity in the Emergency Department

Volume 15, Issue 7, November 2014
Benjamin A. White, MD et al.

While emergency department (ED) crowding has myriad causes and negative downstream effects, applying systems engineering science and targeting throughput remains a potential solution to increase functional capacity. However, the most effective techniques for broad application in the ED remain unclear.

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Technology in Emergency Care

Ultrasound-Guided Diagnosis and Aspiration of Subdeltoid Abscess from Heroin Injection

Volume 15, Issue 7, November 2014
Amanda Clauson, MD et al.

A 49-year-old man presented to the emergency department (ED) with shoulder pain after intramuscular injection of heroin into his right deltoid muscle. Point-of-care (POC) ultrasound identified a subdeltoid abscess, and ultrasound-guided aspiration of the fluid collection was performed.

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Ultrasound Evaluation of an Inguinal Mass

Volume 15, Issue 7, November 2014
Jeffrey L. Wiswell, MD et al.

A 33 year-old female presented to the emergency department (ED) with of two weeks of diffuse abdominal pain, right flank pain, and a slowly enlarging right inguinal mass.

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Technology in Emergency Care

Ultrasound-Guided Small Vessel Cannulation: Long-Axis Approach Is Equivalent to Short-Axis in Novice Sonographers Experienced with Landmark-Based Cannulation

Volume 15, Issue 7, November 2014
Catherine S. Erickson, MD et al.

Our primary objective was to describe the time to vessel penetration and difficulty of long-axis and short-axis approaches for ultrasound-guided small vessel penetration in novice sonographers experienced with landmark-based small vessel penetration.

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Diagnostic Acumen

Chikungunya Fever in Los Angeles, California

Volume 15, Issue 7, November 2014
Katherine R. Harter, MD, MPH et al.

We report the case of a 33-year-old woman returning from Haiti, presenting to our emergency department (ED) with fever, rash and arthralgia. Following a broad workup that included laboratory testing for dengue and malaria, our patient was diagnosed with Chikungunya virus, which was then reported to the Centers for Disease Control and Prevention for initiation of infection control.

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Technology in Emergency Care

Ultrasound Distinguishes Ascites from a Large Ovarian Fluid-Filled Cyst

Volume 15, Issue 7, November 2014
Marissa Camilon, MD et al.

A 51-year-old woman with Hepatitis C was referred to the emergency department (ED) for “massive ascites.” She reported increasing abdominal girth for six months with intermittent abdominal pain. An outpatient ultrasound performed two weeks prior to ED presentation was interpreted by a radiologist as “massive ascites, no masses within the abdomen” on the paper report the patient brought with her. In the ED, the patient was afebrile with normal vital signs. Her abdomen was distended with mild right upper quadrant tenderness.

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Technology in Emergency Care

Accuracy of a Novel Ultrasound Technique for Confirmation of Endotracheal Intubation by Expert and Novice Emergency Physicians

Volume 15, Issue 7, November 2014
Michael Gottlieb, et al.

Recent research has investigated the use of ultrasound (US) for confirming endotracheal tube (ETT) placement with varying techniques, accuracies, and challenges. Our objective was to evaluate the accuracy of a novel, simplified, four-step (4S) technique.

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Sydenham Chorea: Rare Consequence of Rheumatic Fever

Volume 15, Issue 7, November 2014
Paul J. Myers, DO, et al.

Sydenham Chorea (SC) is an acute rheumatic fever complication. SC is the most common acquired childhood chorea, usually affecting children five to fifteen years of age.1 It occurs following an untreated group A streptococcal infection and a latent period of one to six months.1,2 Despite rheumatic fever diminishing, 18% to 36% of acute rheumatic fever patients develop SC.3 Full recovery often takes several months; some patients suffer permanent neurologic sequelae.1

An 11-year old male presented to the Emergency Department with two days of uncontrolled body twitching. The movements affected his right arm and leg, with occasional lip twitches; he experienced intermittent confusion and hyperactivity. The patient denied recent illness, but recalled a fever with headache and vomiting several months prior. Besides the above findings, his physical examination was normal.

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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.