Original Research

Serum Lactate Predicts Adverse Outcomes in Emergency Department Patients With and Without Infection

Kimie Oedorf, MD

Lactate levels are increasingly used to risk stratify emergency department (ED) patients with and without infection. Whether a serum lactate provides similar prognostic value across diseases is not fully elucidated. This study assesses the prognostic value of serum lactate in ED patients with and without infection to both report and compare relative predictive value across etiologies.

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Caudal Edge of the Liver in the Right Upper Quadrant (RUQ) View Is the Most Sensitive Area for Free Fluid on the FAST Exam

Viveta Lobo, MD

The focused assessment with sonography in trauma (FAST) exam is a critical diagnostic test for intraperitoneal free fluid (FF). Current teaching is that fluid accumulates first in Morison’s pouch. The goal of this study was to evaluate the “sub-quadrants” of traditional FAST views to determine the most sensitive areas for FF accumulation.

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Characteristics of Real-Time, Non-Critical Incident Debriefing Practices in the Emergency Department

Characteristics of Real-Time, Non-Critical Incident Debriefing Practices in the Emergency Department

Nur-Ain Nadir, MD, MEHP, et al.

Benefits of post-simulation debriefings as an educational and feedback tool have been widely accepted for nearly a decade. Real-time, non-critical incident debriefing is similar to post-simulation debriefing, however, data on its practice is limited.

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The Cost and Burden of the Residency Match in Emergency Medicine

The Cost and Burden of the Residency Match in Emergency Medicine

Aaron M. Blackshaw, MD, et al.

In order to obtain a residency match, medical students entering Emergency Medicine (EM) must
complete away rotations, submit a number of lengthy applications, and travel to multiple programs
to interview.

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Differences in Self-expression Reflect Formal Evaluation in a Fourth-year Emergency Medicine Clerkship

Differences in Self-expression Reflect Formal Evaluation in a Fourth-year Emergency Medicine Clerkship
Alternate Title

Michael Chary, MD, PhD, et al.

Medical schools have begun to incorporate self-reflection exercises into their curricula, with the belief that these exercises help students master the material more deeply and perform better. Reflection may be a potential learning tool for Emergency Medicine, but there are few data supporting this hypothesis. The authors evaluated the relationship between a linguistic marker of the degree of reflection after a student’s shift in an emergency department and that student’s clerkship performance.

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Healthcare Utilization

Alternative Destination Transport? The Role of Paramedics in Optimal Use of the Emergency Department

Michael M. Neeki, DO, MS et al.

Alternative destination transportation by emergency medical services (EMS) is a subject of hot debate between those favoring all patients being evaluated by an emergency physician (EP) and those recognizing the need to reduce emergency department (ED) crowding. This study aimed to determine whether paramedics could accurately assess a patient’s acuity level to determine the need to transport to an ED.

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Healthcare Utilization

Utility of Chest Radiography in Emergency Department Patients Presenting with Syncope

Matthew L. Wong, MD, MPH et al.

Syncope has myriad etiologies, ranging from benign to immediately life threatening. This frequently leads to over testing. Chest radiographs (CXR) are among these commonly performed tests despite their uncertain diagnostic yield. The objective is to study the distribution of normal and abnormal chest radiographs in patients presenting with syncope, stratified by those who did or did not have an adverse event at 30 days

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Prehospital Care

Endotracheal Tube Cuff Pressures in Patients Intubated Prior to Helicopter EMS Transport

Joseph Tennyson, MD et al.

Endotracheal intubation is a common intervention in critical care patients undergoing helicopter emergency medical services (HEMS) transportation. Measurement of endotracheal tube (ETT) cuff pressures is not common practice in patients referred to our service. Animal studies have demonstrated an association between the pressure of the ETT cuff on the tracheal mucosa and decreased blood flow leading to mucosal ischemia and scarring. Cuff pressures greater than 30 cmH2O impede mucosal capillary blood flow.

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Contact Information

WestJEM/ Department of Emergency Medicine
UC Irvine Health

3800 W Chapman Ave Ste 3200
Orange, CA 92868, USA
Phone: 1-714-456-6389
Email: editor@westjem.org

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WestJEM
ISSN: 1936-900X
e-ISSN: 1936-9018

CPC-EM
ISSN: 2474-252X

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.