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Endemic Infections

Pneumothorax in Liberia: Complications of Tuberculosis

Tuberculosis (TB) is a known cause of secondary pneumothorax. In areas with endemic TB, complications from the disease, including pneumothorax, are increasing in prevalence. We present the cases of 3 patients (ages 32 years, 17 years, and 3 months) seen in the emergency department at John F. Kennedy Medical Center in Monrovia, Liberia, West Africa. Each presented with shortness of breath and cough, and with some degree of respiratory distress. Airway compromise was present with tracheal or mediastinal deviation. Each patient underwent tube thoracostomy with improvement in pneumothorax and respiratory status.

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International Disaster Medical Sciences Fellowship: Model Curriculum and Key Considerations for Establishment of an Innovative International Educational Program

As recent events highlight, a global requirement exists for evidence-based training in the emerging field of Disaster Medicine. The following is an example of an International Disaster Medical Sciences Fellowship created to fill this need. We provide here a program description, including educational goals and objectives and a model core curriculum based on current evidence-based literature. In addition, we describe the administrative process to establish the fellowship. Information about this innovative educational program is valuable to international Disaster Medicine scholars, as well as U.S. institutions seeking to establish formal training in Disaster Medical Sciences.

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Thyroid Gland Hematoma After Blunt Neck Trauma

Hemorrhage of a previously normal thyroid gland as a result of blunt trauma is a very rare condition. We report a case of blunt trauma that caused acute hemorrhage into the thyroid gland and presented with hoarseness. The diagnosis of thyroid gland hematoma was made with a combination of fiberoptic laryngoscopy, cervical computed tomography, and carotid angiography. The patient was treated conservatively, had a favorable course without further complications, and was discharged four days after admission.

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Lead Toxicity Resulting from Chronic Ingestion of Opium

A 32-year-old man presented to the emergency department (ED) with lower abdominal pain and constipation. He related chronic ingestion of large amounts of opium. Physical examination showed mild abdominal tenderness and gingival discoloration. Diagnostic studies showed a mild hypochromic, microcytic anemia with basophilic stippling of the red blood cells. Abdominal imaging showed no intra-abdominal pathology. A diagnosis of lead toxicity was confirmed through serum lead levels. The patient was put on chelation therapy and his signs and symptoms started to resolve. As a comprehensive search for other sources of lead was unsuccessful, opium adulterants were considered as the culprit. Chemical analysis of the opium confirmed this. Contaminated drugs have been reported as a source of exposure to toxins such as arsenic or lead. While other reports deal with patients from clinics, this report illustrates lead toxicity from ingestion of contaminated opium in the ED.

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Paramedics’ Ability to Perform Drug Calculations

The ability to perform drug calculations accurately is imperative to patient safety. Research into paramedics’ drug calculation abilities was first published in 2000 and for nurses’ abilities the research dates back to the late 1930s. Yet, there have been no studies investigating an undergraduate paramedic student’s ability to perform drug or basic mathematical calculations. The objective of this study was to review the literature and determine the ability of undergraduate and qualified paramedics to perform drug calculations.

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Promoting International Emergency Medicine through WestJEM

  Author Affiliation Mark I. Langdorf, MD, MHPE University of California, Irvine School of Medicine, Department of Emergency Medicine, Orange, CA Francesco Della Corte, MD University of Eastern Piedmont School of Medicine, Department of Anesthesia, Critical Care and Critical Emergency Medicine, Novara, Italy Roberta Petrino, MD St. Andrea Hospital, Department of Emergency Medicine, Vercelli, Italy […]

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Chilaiditi’s Syndrome

A 58-year-old man presented to the Emergency Department with a two-day history of vomiting, diarrhea and intermittent central abdominal pain.

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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

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.