Spontaneous Necrotizing Fasciitis.

Necrotizing soft tissue infections typically begin with direct inoculation of bacteria into the subcutaneous tissues. Here, we present a case with no such exposure, but with severe necrotizing fasciitis. We present a middle-aged man presented to the emergency department for a presumed allergic reaction after having initially sought care twice at an urgent care facility.

Delayed vertebral artery dissection after mild trauma in a motor vehicle collision.

Vertebral artery dissection can be insidious and is a leading cause of stroke in young patients, second only behind cardioembolic events [1]. We present the case of a 42-year-old patient who presented to the emergency department with diaphoresis and a complaint of neck pain one month after a low speed motor vehicle collision. The patient was transferred to a stroke center where cerebral angiography showed severe vertebral artery stenosis with likelihood of dissection after a noncontrast CT was negative for hemorrhage.

Feasibility of Health Literacy Tools for Older Patients in the Emergency Department.

Introduction: This study evaluates the feasibility of using a volunteer research associate (RA) to administer two separate health literacy assessment tools in the emergency department (ED), specifically in an older population of patients. The outcomes measured were administration time and interruptions.

Methods: Using a prospective, cross-sectional study with a convenience sample, adult patients over the age of 55 presenting between June-August 2018 to one urban, academic ED were evaluated by a volunteer RA using either the Newest Vital Sign (NVS) or the Short Assessment of Health Literacy (SAHL).

Mistriaged Advanced Life Support Patients in a Two-Tiered, Suburban Emergency Medical Services System.

Introduction: Emergency medical services (EMS) systems exist to provide prehospital care in diverse environments throughout the world. Advanced Life Support (ALS) services can provide advanced care including 12-lead electrocardiogram (ECG), endotracheal intubation and parenteral medication administration. Basic Life Support (BLS) can provide basic care such as splinting, wound care and cardiopulmonary resuscitation.

Emergent Complications of Rheumatoid Arthritis.

Background: Rheumatoid arthritis (RA) is an autoimmune disease resulting in polyarthritis and systemic effects that may result in morbidity and mortality.

Objective: This review provides the emergency physician with an updated analysis of acute complications seen with RA, as well as an evidence-based approach to the management of these complications.

Discussion: While the joint characteristics of RA are commonly recognized, the extra-articular manifestations may be overlooked.

EMS providers do not use FOAM for education.

Background: Free open access to medical education (FOAM, #FOAM) is the free availability of educational materials on various medicine topics. We hope to evaluate the use of social media and FOAM by emergency medical services (EMS) providers.

Methods: We designed an online survey distributed to EMS providers with questions about demographics and social media/FOAM use by providers.

Procedure rates performed by emergency medicine residents: a retrospective review.

Background: The purpose of our study is to investigate rates of individual procedures performed by residents in our emergency medicine (EM) residency program. Different programs expose residents to different training environments. Our hypothesis is that ultrasound examinations are the most commonly performed procedure in our residency.

EMS Dispatches during Hurricanes Irene and Sandy in New Jersey.

Background: Hurricanes Irene and Sandy heavily impacted New Jersey. Investigating EMS dispatch trends during these storms may allow us to prepare for future disasters.

Objectives: Our objectives to characterize the types of EMS dispatches immediately before, during, and after landfall compared to a control period.

Spontaneous renal artery dissection presenting as an aortic dissection: a case report.

Background: Renal artery dissection is a condition that has been associated with traumatic injuries and connective tissue disorders. It has been managed in the past by multiple methods because there is no standard treatment, including vascular intervention with angioplasty and stenting, anticoagulation/antiplatelet therapy, and hypertension management.

Case Presentation: We present a case of a spontaneous renal artery dissection in a 55-year-old white man with no traditional risk factors who presented twice to our emergency department in a 2-day period with different symptoms; on his first presentation he presented with symptoms consistent with renal colic and on the second visit he presented with symptoms consistent with aortic dissection.

Hand Washing Practices Among Emergency Medical Services Providers.

Introduction: Hand hygiene is an important component of infection control efforts. Our primary and secondary goals were to determine the reported rates of hand washing and stethoscope cleaning in emergency medical services (EMS) workers, respectively.

Methods: We designed a survey about hand hygiene practices.

Intubation of the Neurologically Injured Patient.

Background: Intubation of the neurologically injured patient is a critical procedure that must be done in a manner to prevent further neurologic injury. Although many different medications and techniques have been used to meet specific needs, there is little to no evidence to support many claims.

Objective: To review the literature regarding important topics relating to intubating patients with neurologic injury.

Rapid Extrication versus the Kendrick Extrication Device (KED): Comparison of Techniques Used After Motor Vehicle Collisions.

Introduction: The goal of this study was to compare application of the Kendrick Extrication Device (KED) versus rapid extrication (RE) by emergency medical service personnel. Our primary endpoints were movement of head, time to extrication and patient comfort by a visual analogue scale.

Methods: We used 23 subjects in two scenarios for this study.

Psychostimulant drug abuse and personality factors in medical students.

Background: Psychostimulants have a high abuse potential and are appealing to college students for enhancing their examination performance.

Aim: This study was designed to examine the prevalence of psychostimulant drug abuse among medical students and to test the hypothesis that medical students who use psychostimulant drugs for non-medical reasons are characterized by a sensation seeking and aggressive-hostility personality and exhibit lower empathy.

Methods: The Zuckerman-Kuhlman personality questionnaire and the Jefferson scale of empathy were completed anonymously on-line by 321 medical students in 2010-2011 academic year.