Volume 16, Issue 3, May 2015
Larissa S. Dudley, MD
Anaphylaxis is a rapidly progressing, potentially life threatening allergic reaction that has been increasing in prevalence, most commonly triggered by foods, medications, and insect stings. Allergies in children are increasingly more common. Unfortunately, anaphylactic reactions are under-recognized, due to overlooked or under-appreciated symptoms, and therefore under-treated with epinephrine.1 For several years, epinephrine has been established as the drug of choice for anaphylaxis.2 Even a few minutes delay in the recognition and treatment of anaphylaxis can lead to hypoxia or death. Therefore, healthcare professionals and laypeople alike should be able to recognize the signs and symptoms of anaphylaxis and have accessible resources to initiate treatment.
Volume 16, Issue 3, May 2015
James Langabeer, PhD, MBA, et al.
Differences in after-hours capability or performance of ST-elevation myocardial infarction (STEMI) centers has the potential to impact outcomes of patients presenting outside of regular hours. Using a prospective observational study, we analyzed all 1,247 non-transfer STEMI patients treated in 15 percutaneous coronary intervention (PCI) facilities in Dallas, Texas, during a 24-month period (2010–2012). Controlling for confounding factors through a variety of statistical techniques, we explored differences in door-to-balloon (D2B) and in-hospital mortality for those presenting on weekends vs. weekdays and business vs. after hours.
Volume 16, Issue 3, May 2015
Ibrahim Abbass, RPh, PhD
The use of observation units (OUs) following emergency departments (ED) visits as a model of care has increased exponentially in the last decade. About one-third of U.S. hospitals now have OUs within their facilities. While their use is associated with lower costs and comparable level of care compared to inpatient units, there is a wide variation in OUs characteristics and operational procedures. The objective of this research was to explore the variability in the initial costs of care of placing patients with non-specific chest pain in observation units (OUs) and the one-year outcomes.
Volume 16, Issue 3, May 2015
Lisa R. Stoneking, MD, et al.
Timely recognition and treatment of sepsis improves survival. The objective is to examine the association between recognition of sepsis and timeliness of treatments.Patients whose emergency physicians articulated sepsis syndrome in their documentation or who launched the sepsis order set received antibiotics sooner and received more total volume of fluid.
Volume 16, Issue 3, May 2015
Vatsal Chikani, MPH, BHMS, et al.
Recognizing disparities in definitive care for traumatic injuries created by insurance status may help reduce the higher risk of trauma-related mortality in this population. Our objective was to understand the relationship between patients’ insurance status and trauma outcomes.We collected data on all patients involved in traumatic injury from eight Level I and 15 Level IV trauma centers, and four non-designated hospitals through Arizona State Trauma Registry between January 1, 2008 and December 31, 2011.
Volume 16, Issue 2, March 2015
Daniel K. Nishijima, MD, MAS et al.
The objective of this study was to compare long-term neurological outcomes in low-risk patients with traumatic intracranial hemorrhage (tICH) admitted to the ICU (intensive care unit) versus patients admitted to the floor.
Volume 16, Issue 2, March 2015
Caroline E. Freiermuth, MD et al.
Hypertensive emergency has a high mortality risk and the treatment goal is to quickly lower blood pressure with intravenous (IV) medications. Characteristics that are associated with non-response to IV antihypertensives have not been identified. The objective is to identify patient characteristics associated with resistance to IV antihypertensives.
Volume 16, Issue 2, March 2015
Elizabeth M. Schoenfeld, MD et al.
In the United States there is debate regarding the appropriate first test for new-onset renal colic, with non-contrast helical computed tomography (CT) receiving the highest ratings from both Agency for Healthcare Research and Quality and the American Urological Association. This is based not only on its accuracy for the diagnosis of renal colic, but also its ability to diagnose other surgical emergencies, which have been thought to occur in 10–15% of patients with suspected renal colic, based on previous studies.
Volume 16, Issue 1, January 2015
Kevin C. McCammack, MD
Evaluation recommendations for patients on anticoagulant and antiplatelet (ACAP) therapy that present after mild traumatic brain injury (TBI) are controversial. At our institution, an initial noncontrast head computed tomography (HCT) is performed, with a subsequent HCT performed six hours later to exclude delayed intracranial hemorrhage (ICH).
Volume 16, Issue 1, January 2015
Leana S. Wen, MD, MSc et al.
Understanding the cause of patients’ symptoms often requires identifying a pathological diagnosis. A single-center study found that many patients discharged from the emergency department (ED) do not receive a pathological diagnosis.
Volume 16, Issue 1, January 2015
David R. Vinson, MD et al.
Historically, emergency department (ED) patients with pulmonary embolism (PE) have been admitted for several days of inpatient care. Growing evidence suggests that selected ED patients with PE can be safely discharged home after a short length of stay.
