The Chief Wellness Officer: A long overdue catalyst for systemic change in Emergency Medicine.

Goals: The American healthcare system is amid a burnout epidemic, worsened by COVID, that must be addressed expeditiously and with high priority. The burden Emergency Physicians encountered before and during the pandemic is well known, with countless healthcare workers exiting the work force. A Chief Wellness Officer (CWO) is a senior leader who works primarily to cultivate organisational wellness and to foster and promote a culture of well-being throughout an institution.

Successful Distal Urethral Stone Removal in the Emergency Department.

Nephrolithiasis is a common pathology encountered in the primary care and emergency department (ED) setting. In 2009 alone, there were over one million ED visits related to nephrolithiasis Higa et al. (2017) [1].

Uterine Artery Pseudoaneurysm: A Life-Threatening Cause of Vaginal Bleeding in the Emergency Department.

Background: Vaginal bleeding is a common presenting complaint in the emergency department (ED); life-threatening hemorrhage is rare. Uterine artery pseudoaneurysm (UAP) is an uncommon but potentially life-threatening cause of vaginal bleeding that is most likely to present primarily to EDs, given its delayed postpartum or postoperative presentation.

Case Report: A 25-year-old female gravida two, para one, who was 19 days post dilation and evacuation for an elective termination of a pregnancy at 20 weeks, presented to the ED with profuse vaginal bleeding.

Idiopathic Spinal Epidural Lipomatosis Causing Cauda Equina Syndrome.

Spinal epidural lipomatosis (SEL) is a rare condition defined by the hypertrophy of adipose tissue in the spinal epidural space, often resulting in compression of nerves in the region affected.1 This case describes a 64-year-old man who presented with cauda equina syndrome. Magnetic resonance imaging of the spine revealed extensive SEL of the lumbar spine.

Facial Baroparesis Mimicking Stroke.

We report a case of a 55-year-old male who experienced unilateral facial muscle paralysis upon ascent to altitude on a commercial airline flight, with resolution of symptoms shortly after descent. The etiology was determined to be facial nerve barotrauma, or facial baroparesis, which is a known but rarely reported complication of scuba diving, with even fewer cases reported related to aviation. The history and proposed pathogenesis of this unique disease process are described.

Acute intractable vomiting and severe ketoacidosis secondary to the Dukan Diet©.

Background: The benefits of low-carbohydrate, high-protein diets, such as the Dukan Diet©, are well documented, whereas reported adverse effects are rare in literature. Such diets mimic starvation states in that they promote the breakdown of fat and the production of ketones secondary to fatty acid metabolism. In fact, one measure of the effectiveness of such diets is the presence of ketosis.

Observational study and estimate of cost savings from use of a health information exchange in an academic emergency department.

Background: Federal initiatives to improve health care information sharing have led to the development of a new type of regional electronic medical record known as a health information exchange (HIE).

Objective: Our aim was to investigate the ability of an HIE to decrease health services use for emergency department (ED) patients.

Methods: We performed an observational, prospective study using a voluntary, anonymous survey among clinicians at an urban academic ED.

Renal abscess in a patient presenting with persistent hiccups.

Hiccups are common, typically limited, and rarely present with adverse complications. In the context of persistent or intractable episodes, however, hiccups may signal a more serious underlying cause. Here, we present an unexpected and pathologic case of hiccups in a patient who was ultimately diagnosed with renal abscesses.

Gastric rupture from cardiopulmonary resuscitation or seizure activity? A case report.

Ascertaining the cause of a gastric rupture is difficult and can be complicated by events occurring in the pre-hospital phase of patient care. To our knowledge, only seven cases of cardiopulmonary resuscitation (CPR)-related injuries to the stomach have been reported in the literature since 1997. We found no reports of seizure-related gastric injury.

Detection of Loxosceles species venom in dermal lesions: a comparison of 4 venom recovery methods.

Study Objective: Loxosceles species spider envenomations may produce necrotic, disfiguring dermal inflammatory lesions resembling neutrophilic dermatoses. With definitive treatment options lacking, clinicians are reluctant to obtain invasive biopsy specimens for diagnostic analysis. We compared less invasive venom collection methods and determined the time limit after inoculation for feasible venom recovery in an animal model.

A new assay for the detection of Loxosceles species (brown recluse) spider venom.

Study Objective: Dermal lesions from unrelated arthropod species and medical causes appear similar to Loxosceles species (brown recluse spider) bites. This may result in delayed diagnosis and treatment. We developed a sensitive Loxosceles species venom enzyme-linked immunosorbent assay (ELISA) and characterized the specificity of the assay by evaluating antigenic cross-reactivity from a variety of North American arthropod venoms.