Archives

Injury Outcomes

Barriers and Disparities in Emergency Medical Services 911 Calls for Stroke Symptoms in the United States Adult Population: 2009 BRFSS Survey

Volume 15, Issue 2, March 2014
Munseok Seo, DrPH et al.

This study examines barriers and disparities in the intentions of American citizens, when dealing with stroke symptoms, to call 911. This study hypothesizes that low socioeconomic populations are less likely to call 911 in response to stroke recognition.

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Injury Outcomes

Motor Vehicle Crash-Associated Eye Injuries Presenting to U.S. Emergency Departments

Volume 15, Issue 6, September 2014
Grayson W. Armstrong, BA et al.

Motor vehicle crashes (MVCs) are a leading cause of injury in the United States (U.S.). Detailed knowledge of MVC eye injuries presenting to U.S. emergency departments (ED) will aid clinicians in diagnosis and management. The objective of the study was to describe the incidence, risk factors, and characteristics of non-fatal motor vehicle crash-associated eye injuries presenting to U.S. EDs from 2001 to 2008.

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Injury Outcomes

Comparison of Three Prehospital Cervical Spine Protocols for Missed Injuries

Volume 15, Issue 4, July 2014
Rick Hong, MD et al.

We wanted to compare 3 existing emergency medical services (EMS) immobilization protocols: the Prehospital Trauma Life Support (PHTLS, mechanism-based); the Domeier protocol (parallels the National Emergency X-Radiography Utilization Study [NEXUS] criteria); and the Hankins’ criteria (immobilization for patients <12 or >65 years, those with altered consciousness, focal neurologic deficit, distracting injury, or midline or paraspinal tenderness).To determine the proportion of patients who would require cervical immobilization per protocol and the number of missed cervical spine injuries, had each protocol been followed with 100% compliance.

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Injury Outcomes

Yield and Clinical Predictors of Thoracic Spine Injury from Chest Computed Tomography for Blunt Trauma

Volume 15, Issue 4, July 2014
Mark I. Langdorf, MD, MHPE et al.

Cost and radiation risk have prompted intense examination of trauma patient imaging. A proposed decision instrument (DI) for the use of chest computed tomography (CT), (CCT) in blunt trauma patients includes thoracic spine (TS) tenderness, altered mental status (AMS) and distracting painful injury (DPI) as potential predictor variables. TS CT is a separate, costly study whose value is currently ill-defined. The objective of this study is to determine test characteristics of these predictor variables alone, and in combination, to derive a TS injury DI.

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Injury Outcomes

Dysuria in the Emergency Department: Missed Diagnosis of Chlamydia trachomatis

Volume 15, Issue 2, March 2014
Morgan D Wilbanks, MD et al.

The clinical presentation of genital Chlamydia trachomatis infection (chlamydia) in women is often indistinguishable from a urinary tract infection. While merited in the setting of dysuria, emergency department (ED) clinicians do not routinely test for chlamydia in women. The primary aim of our study was to evaluate the frequency of chlamydia testing among women presenting to the ED with dysuria.

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Injury Outcomes

Tackling the Global Challenge: Humanitarian Catastrophes

Volume 15, Issue 2, March 2014
Kenneth V. Iserson, MD, MBA et al.

“Humanitarian catastrophes,” conflicts and calamities generating both widespread human suffering and destructive events, require a wide range of emergency resources. This paper answers a number of questions that humanitarian catastrophes generate: Why and how do the most-developed countries—those with the resources, capabilities, and willingness to help—intervene in specific types of disasters? What ethical and legal guidelines shape our interventions? How well do we achieve our goals? It then suggests a number of changes to improve humanitarian responses, including better NGO-government cooperation, increased research on the best disaster response methods, clarification of the criteria and roles for humanitarian (military) interventions, and development of post-2015 Millennium Development Goals with more accurate progress measures.

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Injury Outcomes

Onset and Duration of Intravenous and Intraosseous Rocuronium in Swine

Volume 15, Issue 2, March 2014
Michael Loughren, CRNA, PhD et al.

The intraosseous (IO) route has become a popular method to gain access to the peripheral circulation in emergency situations. Despite little supporting data, it is generally believed that IO absorption is immediate and equivalent to the intravenous (IV) route. It is important to determine if rocuronium can effectively be administered by the IO route. The aim of the study was to determine and compare the onset and duration of rocuronium when administered via the IO and IV routes in a normovolemic pig model.

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Injury Outcomes

The Effect of Compressor-administered Defibrillation on Peri-shock Pauses in a Simulated Cardiac Arrest Scenario

Volume 15, Issue 2, March 2014
Joshua Glick, BS et al.

Coordination of the tasks of performing chest compressions and defibrillation can lead to communication challenges that may prolong time spent off the chest. The purpose of this study was to determine whether defibrillation provided by the provider performing chest compressions led to a decrease in peri-shock pauses as compared to defibrillation administered by a second provider, in a simulated cardiac arrest scenario.

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Injury Outcomes Injury Prevention

Emergency Departments and Older Adult Motor Vehicle Collisions

In 2009 the Centers for Disease Control and Prevention reported that there were 33 million licensed drivers 65 years and older in the U.S. This represents a 23 percent increase from 1999, a number that is predicted to double by 2030. Although motor vehicle collisions related to emergency department visits for older adults are lower per capita than for younger adults, the older-adults MVCs require more resources, such as additional diagnostic imaging and increased odds of admission.

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Injury Outcomes

Unique Mechanism of Chance Fracture in a Young Adult Male

Since the first description of the Chance fracture in 1948, there have been few case reports of unique mechanisms causing this classical flexion-extension injury to the spine in motor vehicle accidents, sports injury, and falls. To our knowledge, this injury has not been reported from a fall with the mechanistic forces acting laterally on the spine and with spinal support in place. We present a 21-year-old male who slid down a flight of stairs onto his side wearing a heavy mountaineering style backpack, subsequently sustaining a Chance fracture of his first lumbar vertebrae.

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Injury Outcomes

Riding the Escalator: How Dangerous is it Really?

Intro: About 10,000 escalator-related injuries per year result in emergency department treatment in the United States. Since the 1990s, a steady increase has been reported, but few statistics on escalator-related injuries have been published worldwide.
Conclusion: Escalator accidents can result in severe trauma. Significant gender differences in escalator accidents have been observed. Alcohol intoxication and age are significant risk factors in escalator-related accidents and might be possible targets for preventive measures.

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Injury Outcomes

Pneumothorax in a Single Lung Patient

An 80-year old man referred to the emergency department for chest pain and dyspnea on exertion reported a medical history of left pulmonary tuberculosis in babyhood, treated by therapeutic pneumothorax.This was commonly used to treat tuberculosis prior to the development of antimycobacterial agents. Successful therapeutic…

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Injury Outcomes

Occult Pneumothoraces in Acute Trauma Patients

Introduction: Many traumatic pneumothoraces (PTX) are not seen on initial chest radiograph (CR) (occult PTX) but are detected only on computed tomography (CT). The primary objective of this study was to retrospectively determine the effectiveness of CR for detecting PTX in trauma patients.

Conclusion: Factors associated with PTX on CR included air in the soft tissue on CR and size of the PTX. Even when PTX is not apparent on CR, 44% of these PTXs received placement of a chest tube.

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WestJEM/ Department of Emergency Medicine
UC Irvine Health

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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.