Interrater agreement of the HEART score history component: A chart review study.

Study Objectives: This study investigated the interrater reliability of the history component of the HEART (history, electrocardiogram, age, risk, troponin) score between physicians in emergency medicine (EM) and internal medicine (IM) at 1 tertiary-care center.

Methods: We conducted a retrospective, secondary analysis of 60 encounters selected randomly from a database of 417 patients with chest pain presenting from January to June 2016 to an urban tertiary-care center. A total of 4 raters (1 EM attending, 1 EM resident, 1 IM attending, and 1 IM resident) scored the previously abstracted history data from these encounters.

Interrater Agreement and Reliability of Burn Size Estimations Between Emergency Physicians and Burn Unit.

The initial approach to burn injuries has remained relatively unchanged over the past several decades and revolves around trauma assessment and fluid resuscitation, frequently initiated in the emergency department (ED). While previous research suggests that emergency physicians (EP) are poor estimators at total body surface area (TBSA) affected, we believe that estimation differences are improving, specifically at academic centers with co-located burn units that emphasize burn injury education. This study investigated the interrater agreement and reliability of burn size estimations at an academic ED and its co-located burn unit.

Analysis of U.S. Pacific Command Area of Operations Military Medical Transportations of Adult Patients, 2008 to 2018.

Introduction: With more than 370,000 military and civilian personnel stationed across Pacific Command (PACOM), medical evacuation in this largest command presents unique challenges. The authors describe medical evacuations analyzed from the U.S.

Cholesterol embolization and arterial occlusion from the Heimlich maneuver.

The Heimlich maneuver is a lifesaving bystander intervention to assist an individual with airway obstruction however, cholesterol embolization syndrome is a rare, but serious potential complication of the Heimlich maneuver. We present the case of the 56-year-old female presenting to the emergency department with acute right foot pain following performance of the Heimlich maneuver who was found to have distal arterial occlusion resulting from cholesterol embolization syndrome. The patient underwent right popliteal artery exploration, right popliteal and tibial thrombectomy, and popliteal patch angioplasty resulting in restoration of blood flow to her right foot.

A Case Report on Rhabdomyolysis After Multiple Bee Stings.

Envenoming syndrome is an uncommon condition associated with significant morbidity and mortality following multiple Hymenoptera stings. We review the case of a 90-year-old male who presented after receiving greater than 100 bee stings and was found to have rhabdomyolysis with concomitant acute kidney injury. Physicians should consider envenoming syndrome in all patients presenting with greater than 50 bee stings, despite hemodynamically stability upon initial presentation.

Large Vessel Occlusion Stroke Secondary to Acute Aortic Dissection.

Aortic dissection carries a high mortality of up to 40% at the time of initial dissection and an additional 1% per hour the dissection is untreated. Patients with acute aortic dissection most commonly present with chest or back pain. Less frequently, it manifests without pain with predominant neurologic symptoms secondary to an acute stroke.

Proton Pump Inhibitor-Induced Hypomagnesemia: A Rare, Potentially Fatal Complication.

Hypomagnesemia has been associated with a variety of abnormalities, including neurological, cardiac and secondary electrolyte abnormalities. We present the case of a 77-year-old male who presented to the emergency department with tremor and difficulty walking and was found to have severe hypomagnesemia necessitating hospital admission. After thorough workup, the patient's hospital course concluded that the profound hypomagnesemia was secondary to proton pump inhibitor use.

Self-reported history of seizure and baseline neurocognitive test performance in student-athletes: an initial investigation.

Objectives: Baseline neurocognitive assessment data can be critical in return to play (RTP) decision-making following a sport-related concussion (SRC). The literature indicates that many modifying factors of SRC have been studied empirically; however, there has been little investigation into the effect of a self-reported history of seizure(s) on baseline neurocognitive test data. The objective of this investigation was to determine whether a self-reported history of seizure(s) is associated with differences in baseline Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) performance.