Volume 14 Issue 5 Archives - The Western Journal of Emergency Medicine

Discourse in Emergency Medicine and Population Health

In Response to “Temperature and Violent Crime in Dallas, Texas: Relationships and Implications of Climate Change”

Volume 14, Issue 5, September 2013
Matt N. Williams, MA, et al.

To the editor:

We were interested to read Gamble and Hess’s study finding that the daily incidence of violent crime in Dallas increased with temperatures up to 90°F (32.2°C), but decreased above this threshold. On this basis, their abstract surprisingly concludes that “higher ambient temperatures expected with climate change…. are not likely to be accompanied by markedly higher rates of violent crime” (p.239). This conclusion contrasts with the findings of previous studies.1–3

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Discourse in Emergency Medicine and Population Health

In Response to “Education on Prehospital Pain Management: A Follow-up Study”

Author Affiliation Kieran Walsh, FRCPI BMJ Learning, London, United Kingdom To the Editor: French et al should be congratulated for reporting their study of the effects of an educational intervention on prehospital care management of pain.1 Following the educational intervention paramedics certainly improved their management of pain– but there remain some unanswered questions on the intervention […]

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Ethical and Legal Issues

Medical-legal Issues in the Agitated Patient: Cases and Caveats

Volume 14, Issue 5, September 2013
Jessica Thomas, MD, et al.

More than any other area of emergency medicine, legal issues are paramount when caring for an agitated patient. It is imperative to have a clear understanding of these issues to avoid exposure to liability. These medico-legal issues can arise at the onset, during, and at discharge of care and create several duties. At the initiation of care, the doctor has a duty to evaluate for competence and the patient’s ability to consent. Once care has begun, patients may require restraint if they become combative or violent.

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Ethical and Legal Issues

When a Patient Declines Curative Care: Management of a Ruptured Aortic Aneurysm

Volume 14, Issue 5, September 2013
Sangeeta Lamba, MD, et al.

The management of major vascular emergencies in the emergency department (ED) involves rapid, aggressive resuscitation followed by emergent definitive surgery. However, for some patients this traditional approach may not be consistent with their goals and values. We explore the appropriate way to determine best treatment practices when patients elect to forego curative care in the ED, while reviewing such a case.

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Emergency Department Operations

Measuring Power in an Emergency Department to Improve Processes and Decrease the Length of Stay to their Optimum Value

Volume 14, Issue 5, September 2013
Bert A. Silich, MD, MS

Many emergency departments (EDs) compare themselves to national productivity benchmarks, such as the average patients/hour or relative value units (RVUs)/hour. Making these comparisons does not provide a tool to determine which processes need improvement, most urgently, within the ED to improve efficiency. Furthermore, there has been no clear means to determine how to set reasonable goals based on the capabilities of the particular ED under study.

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Emergency Department Operations

Perception of Noise by Emergency Department Nurses

Volume 14, Issue 5, September 2013
John Graneto, DO, MEd, et al.

Noise in the emergency department (ED) may be perceived to be high by both patients and nurses alike. This increased noise level is hypothesized to be responsible for communication interference and subsequent disruption of complex procedures and decision-making. The objective of this study is to quantify ambient noise level in an ED while obtaining coincident subjective surveys from nurses in the assessment of actual versus perceived noise.

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Practice Variability

Warming Intravenous Fluids for Improved Patient Comfort in the Emergency Department: A Pilot Crossover Randomized Controlled Trial

Author Affiliation Wesley H. Self, MD, MPH Vanderbilt University School of Medicine, Department of Emergency Medicine, Nashville, Tennessee Steven J. White, MD Vanderbilt University School of Medicine, Department of Emergency Medicine, Nashville, Tennessee Candace D. McNaughton, MD, MPH Vanderbilt University School of Medicine, Department of Emergency Medicine, Nashville, Tennessee Alan B. Storrow, MD Vanderbilt University […]

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Societal Impact on Emergency Care

Racial Disparity in Duration of Patient Visits to the Emergency Department: Teaching Versus Non-teaching Hospitals

Author Affiliation Zeynal Karaca, PhD Social and Scientific Systems, Inc., Silver Spring, MarylandAgency for Healthcare Research and Quality, Rockville, Maryland George Washington University, Health Policy Department, Washington, DC Herbert S. Wong, PhD Agency for Healthcare Research and Quality, Rockville, Maryland Introduction Methods Results Discussion Limitations Conclusion Abstract Introduction: The sources of racial disparity in duration […]

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Emergency Department Access

Need for Intervention in Families Presenting to the Emergency Department with Multiple Children as Patients

Author Affiliation Jesus Lemus, MD Keck School of Medicine, University of Southern California, Department of Emergency Medicine, Los Angeles, California Melissa Chacko, MD Keck School of Medicine, University of Southern California, Department of Emergency Medicine, Los Angeles, California Ilene Claudius, MD Keck School of Medicine, University of Southern California, Pediatric Emergency Medicine Division, Los Angeles, […]

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Emergency Department Access

Emergency Department Crowding and Time to Antibiotic Administration in Febrile Infants

Author Affiliation Jennifer K. Light, MD University of Florida, College of Medicine, Department of Emergency Medicine Gainesville, Florida Robyn M. Hoelle, MD University of Florida, College of Medicine, Department of Emergency Medicine Gainesville, Florida Jill Boylston Herndon, PhD University of Florida, College of Medicine, Institute for Child Health Policy, Department of Health Outcomes and Policy, […]

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Prognostic Value of Emergency Physician Performed Echocardiography in Patients with Acute Pulmonary Thromboembolism

Author Affiliation Maurizio Zanobetti, MD Department of Critical Care Medicine and Surgery, University of Florence, Florence, Italy Cristiano Converti, MD Department of Critical Care Medicine and Surgery, University of Florence, Florence, Italy Alberto Conti, MD Department of Critical Care Medicine and Surgery, University of Florence, Florence, Italy Gabriele Viviani, MD Department of Critical Care Medicine […]

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Ultrasound-guided Intraarticular Hip Injection for Osteoarthritis Pain in the Emergency Department

Author Affiliation Erik S. Anderson, MD Alameda County Medical Center, Highland Hospital, Department of Emergency Medicine, Oakland, California Andrew A. Herring, MD Alameda County Medical Center, Highland Hospital, Department of Emergency Medicine, Oakland, California Caitlin Bailey, MD Alameda County Medical Center, Highland Hospital, Department of Emergency Medicine, Oakland, California Daniel Mantuani, MD Alameda County Medical […]

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Prehospital Care

In-flight Medical Emergencies

Author Affiliation Amit Chandra, MD, MSc University of Botswana School of Medicine, Botswana Shauna Conry, MD CEP America, United States Introduction Discussion Abstract Introduction: Research and data regarding in-flight medical emergencies during commercial air travel are lacking. Although volunteer medical professionals are often called upon to assist, there are no guidelines or best practices to […]

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Prehospital Care

Reducing Ambulance Diversion at Hospital and Regional Levels: Systemic Review of Insights from Simulation Models

Author Affiliation M. Kit Delgado, MD, MS Stanford University, Division of Emergency Medicine, Stanford, California Lesley J. Meng, HBA, BMSc Columbia University, Mailman School of Public Health, New York City, New York Mary P. Mercer, MD, MPH University of California San Francisco, San Francisco General Hospital, San Francisco, California Jesse M. Pines, MD, MBA, MSCE […]

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Prehospital Care

Electronic Prehospital Records are Often Unavailable for Emergency Department Medical Decision Making

Author Affiliation Bryan E. Bledsoe, DO University of Nevada School of Medicine, Department of Emergency Medicine, Las Vegas, Nevada MedicWest Ambulance/American Medical Response, Las Vegas, Nevada Chad Wasden, MD University of Nevada School of Medicine, Department of Emergency Medicine, Las Vegas, Nevada Larry Johnson, NREMTP University of Nevada School of Medicine, Department of Emergency Medicine, […]

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Emergency Medicine in Guyana: Lessons from Developing the Country’s First Degree-conferring Residency Program

Author Affiliation Nicolas P. Forget, MD, MPH Vanderbilt University, Department of Emergency Medicine, Nashville, Tennessee John Paul Rohde, MD Vanderbilt University, Department of Emergency Medicine, Nashville, Tennessee Navindranauth Rambaran, MBBS Georgetown Public Hospital Corporation, Institute of Health Sciences Education, Guyana Madan Rambaran, MBBS Georgetown Public Hospital Corporation, Institute of Health Sciences Education, Guyana Seth W. […]

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English-based Pediatric Emergency Medicine Software Improves Physician Test Performance on Common Pediatric Emergencies: A Multicenter Study in Vietnam

Author Affiliation Michelle Lin, MD University of California, San Francisco, Department of Emergency Medicine, San Francisco, California KidsCareEverywhere – Vietnam, Berkeley, California Trevor N. Brooks, BS University of California, San Francisco, Department of Emergency Medicine, San Francisco, California Alex C. Miller, BA KidsCareEverywhere – Vietnam, Berkeley, California Jamie L. Sharp, BA KidsCareEverywhere – Vietnam, Berkeley, […]

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Emergency Physicians’ Knowledge of Cannabinoid Designer Drugs

Author Affiliation Patrick M. Lank, MD Northwestern University Feinberg School of Medicine, Department of Emergency Medicine, Chicago, Illinois Elizabeth Pines, MD Northwestern University Feinberg School of Medicine, Department of Emergency Medicine, Chicago, Illinois Mark B. Mycyk, MD Northwestern University Feinberg School of Medicine, Department of Emergency Medicine, Chicago, Illinois Introduction Methods Results Discussion Limitations Conclusion […]

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Sexual Assault Training in Emergency Medicine Residencies: A Survey of Program Directors

Author Affiliation Margaret K. Sande, MD, MS Denver Health & Hospital Authority, Denver, Colorado University of Colorado, Aurora, Colorado Kerry B. Broderick, MD Denver Health & Hospital Authority, Denver, Colorado University of Colorado, Aurora, Colorado Maria E. Moreira, MD Denver Health & Hospital Authority, Denver, Colorado University of Colorado, Aurora, Colorado Brooke Bender, MPH Denver […]

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Predictive Value of Initial Triage Vital Signs for Critically Ill Older Adults

Author Affiliation Michael A. LaMantia, MD, MPH Indiana University Center for Aging Research and Regenstrief Institute, Indianapolis, Indiana Paul W. Stewart, PhD University of North Carolina, Department of Biostatistics, Chapel Hill, North Carolina Timothy F. Platts-Mills, MD University of North Carolina, Department of Emergency Medicine, Chapel Hill, North Carolina Kevin J. Biese, MD, MAT University […]

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Asymmetrical Bilateral Hip Dislocation

Author Affiliation Bruce M. Lo, MD Eastern Virginia Medical School, Sentara Norfolk General Hospital, Department of Emergency Medicine, Norfolk, Virginia A previously healthy 36-year-old male who was a restrained driver presented with bilateral hip pain after a motor vehicle collision (MVC) put his vehicle in a ditch. On examination, the patient was alert and oriented […]

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Bullous Lung Disease

Author Affiliation Corey Goldberg, MD University of Florida College of Medicine, Department of Emergency Medicine, Jacksonville, Florida Kathleen E. Carey, MD Mayo Clinic, Department of Radiology, Jacksonville, Florida Diagnosis A 34-year-old black man presented to the emergency department with right-sided pleuritic chest pain, productive cough, low grade fever, and dyspnea. He had a history of […]

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Levamisole Contaminated Cocaine Induced Cutaneous Vasculitis Syndrome

Author Affiliation Kellee T. James, PharmD University of California San Francisco, Department of Clinical Pharmacy, San Francisco, California Alissa Detz, MD Robert Wood Johnson Foundation Clinical Scholar, University of California Los Angeles, Department of Medicine, Los Angeles, California Zlatan Coralic, PharmD University of California San Francisco, Department of Clinical Pharmacy, San Francisco, CaliforniaUniversity of California […]

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Uterine Rupture Due to Invasive Metastatic Gestational Trophoblastic Neoplasm

Author Affiliation David I. Bruner, MD Naval Medical Center Portsmouth, Emergency Medicine Program, Portsmouth, Virginia Amy M. Pritchard, DO Naval Medical Hospital Camp Pendleton, Oceanside, California Jonathan Clarke, MD Naval Medical Center Jacksonville, Jacksonville, Florida Introduction Case report Discussion Conclusion ABSTRACT While complete molar pregnancies are rare, they are wrought with a host of potential […]

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Complication with Intraosseous Access: Scandinavian Users’ Experience

Author Affiliation Peter Hallas, MD Copenhagen University Hospital, Department of Pediatric Anesthesia, Rigshospitalet, Denmark Mikkel Brabrand, MD Hospital of Southwest Denmark, Department of Medicine, Esbjerg, Denmark Lars Folkestad, MD Hospital of Southwest Denmark, Department of Endocrinology, Esbjerg, Demark Introduction Methods Results Discussion Limitations Conclusion Abstract Introduction: Intraosseous access (IO) is indicated if vascular access cannot […]

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Vaginal Foreign Bodies and Child Sexual Abuse: An Important Consideration

Author Affiliation Forrest T. Closson, MD University of Maryland School of Medicine, Department of Pediatrics, Division of Pediatric Emergency Medicine, Baltimore, Maryland Richard Lichenstein, MD University of Maryland School of Medicine, Department of Pediatrics, Division of Pediatric Emergency Medicine, Baltimore, Maryland Introduction Case reports Discussion Recommendations ABSTRACT Vaginal foreign bodies are a complaint occasionally encountered […]

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