Clinical Prediction Tool to Assess the Likelihood of a Positive SARS-Cov-2 (COVID-19) Polymerase Chain Reaction Test in Patients with Flu-like Symptoms.

Introduction: The clinical presentation of coronavirus disease 2019 (COVID-19) overlaps with many other common cold and influenza viruses. Identifying patients with a higher probability of infection becomes crucial in settings with limited access to testing. We developed a prediction instrument to assess the likelihood of a positive polymerase chain reaction (PCR) test, based solely on clinical variables that can be determined within the time frame of an emergency department (ED) patient encounter.

ST-Segment Elevation Myocardial Infarction and Out-of-Hospital Cardiac Arrest: Contemporary Management From the Multicenter START Registry.

Background: Recent studies suggest that primary percutaneous coronary intervention (PCI) and targeted temperature management (TTM) improve outcome in ST-segment elevation myocardial infarction (STEMI) complicated by out-of-hospital cardiac arrest (OHCA). The objective of this study was to evaluate a contemporary series of patients with STEMI and OHCA to characterize treatment approaches and predictors of neurologic outcome.

Methods: From January 2009 through November 2012, a total of 239 patients who underwent emergent coronary angiography at 10 medical centers across the United States were enrolled.

Use of the STEMI Team for Treatment of Patients With Pulmonary Embolism: A Pilot Study.

Background: Patients with massive and submassive pulmonary embolism (PE) require rapid identification, triage, and consideration for reperfusion therapy. Use of an existing ST-segment elevation myocardial infarction (STEMI) team and activation protocol may be an effective means to care for these patients.

Objective: The objective of this analysis was to evaluate a pilot study using the STEMI team and a dedicated PE protocol for treatment of patients with massive and submassive PE.

Does the Flipped Classroom Improve Learning in Graduate Medical Education?

Background: The flipped classroom model for didactic education has recently gained popularity in medical education; however, there is a paucity of performance data showing its effectiveness for knowledge gain in graduate medical education.

Objective: We assessed whether a flipped classroom module improves knowledge gain compared with a standard lecture.

Methods: We conducted a randomized crossover study in 3 emergency medicine residency programs.

Headache in the Emergency Department: Avoiding Misdiagnosis of Dangerous Secondary Causes.

There are a number of dangerous secondary causes of headaches that are life, limb, brain, or vision threatening that emergency physicians must consider in patients presenting with acute headache. Careful history and physical examination targeted at these important secondary causes of headache will help to avoid misdiagnosis in these patients. Patients with acute thunderclap headache have a differential diagnosis beyond subarachnoid hemorrhage.

Low Back Pain in the Emergency Medicine Department: A Flipped Classroom Module.

Introduction: Current residency didactic schedules that are built upon hour-long, lecture-based presentations are incongruous with adult learning theory and the needs of millennial generation residents. An alternative to the traditional lecture, the flipped classroom involves viewing a short video lecture at home, followed by an active discussion during class time. This module was developed for emergency medicine residents and rotating medical students without previous training on the subject.

Medication Overdoses at a Public Emergency Department in Santiago, Chile.

Introduction: While a nationwide poison control registry exists in Chile, reporting to the center is sporadic and happens at the discretion of the treating physician or by patients' self-report. Moreover, individual hospitals do not monitor accidental or intentional poisoning in a systematic manner. The goal of this study was to identify all cases of intentional medication overdose (MO) that occurred over two years at a large public hospital in Santiago, Chile, and examine its epidemiologic profile.

FAST ultrasound examination as a predictor of outcomes after resuscitative thoracotomy: a prospective evaluation.

Objective: The objective of this study was to examine the ability of Focused Assessment Using Sonography for Trauma (FAST) to discriminate between survivors and nonsurvivors undergoing resuscitative thoracotomy (RT).

Background: RT is a high-risk, low-salvage procedure performed in arresting trauma patients with poorly defined indications.

Methods: Patients undergoing RT from 10/2010 to 05/2014 were prospectively enrolled.

[Pediatric outpatient consultation at the emergency department of a university hospital].

Introduction: To determine the epidemiological profile of pediatric consultations treated at the emergency department (ED) is essential for planning processes of medical care and to guide education programs and research.

Objectives: To describe the characteristics of the child population and the main reasons for consultation (RFC) seen in a pediatric emergency service.

Patients And Method: A retrospective, descriptive clinical study was conducted regarding the visits to the Children's Emergency Service of an academic hospital in Santiago, for a period of twelve months.

Sensitivity of emergency bedside ultrasound to detect hydronephrosis in patients with computed tomography-proven stones.

Introduction: Non-contrast computed tomography (CT) is widely regarded as the gold standard for diagnosis of urolithiasis in emergency department (ED) patients. However, it is costly, time-consuming and exposes patients to significant doses of ionizing radiation. Hydronephrosis on bedside ultrasound is a sign of a ureteral stone, and has a reported sensitivity of 72-83% for identification of unilateral hydronephrosis when compared to CT.

Importance of hospital entry: walk-in STEMI and primary percutaneous coronary intervention.

Introduction: Patients with ST elevation myocardial infarction (STEMI) require rapid identification and triage to initiate reperfusion therapy. Walk-in STEMI patients have longer treatment times compared to emergency medical service (EMS) transported patients. While effective triage of large numbers of critically ill patients in the emergency department is often cited as the reason for treatment delays, additional factors have not been explored.

Left upper quadrant abdominal pain.

We present a case of acute appendicitis from mobile cecum presenting with left upper quadrant abdominal pain.

Emergency neurological life support: traumatic brain injury.

Traumatic brain injury (TBI) was chosen as an Emergency Neurological Life Support topic due to its frequency, the impact of early intervention on outcomes for patients with TBI, and the need for an organized approach to the care of such patients within the emergency setting. This protocol was designed to enumerate the practice steps that should be considered within the first critical hour of neurological injury.

Cutaneous conditions leading to dermatology consultations in the emergency department.

Introduction: We established the most common cutaneous diseases that received dermatology consultation in the adult emergency department (ED) and identified differentiating clinical characteristics of dermatoses that required hospital admission.

Methods: A retrospective chart review of 204 patients presenting to the ED who received dermatology consultations at Los Angeles County/University of Southern California Medical Center, an urban tertiary care teaching hospital.

Results: Of all patients, 18% were admitted to an inpatient unit primarily for their cutaneous disease, whereas 82% were not.

Pitfalls in the management of headache in the emergency department.

Headache is the fifth most common primary complaint of patients presenting to an emergency department (ED) in the United States. The emergency physician (EP) plays a unique role in the management of these patients, one that differs from that of the primary care physician, the neurologist, and other specialists. Diagnostic nomenclature used in the ED is necessarily less specific, as care is more appropriately focused on the relief of symptoms and the identification of life-threatening causes.

Evaluating the sensitivity of visual xanthochromia in patients with subarachnoid hemorrhage.

Combined computed tomography and cerebrospinal fluid (CSF) analysis has been shown to be 100% sensitive for detecting subarachnoid hemorrhage (SAH) when CSF is obtained between 12 h and 2 weeks from time of headache onset and spectrophotometry is used to evaluate CSF for xanthochromia. Because most hospitals do not use spectrophotometry, we sought to evaluate the sensitivity of CSF analysis for xanthochromia by visual inspection. We retrospectively identified all patients seen in the Emergency Department (ED) with an ED discharge diagnosis of SAH from June 1993 to November 2005.

The presence of an Emergency Airway Response Team and its effects on in-hospital Code Blue.

The survival rate from in-hospital cardiac arrest due to pulseless electrical activity (PEA)/asystole in our institution was higher than expected (70%). It was the impression of the Emergency Department-led Code Blue Team (CBT) that many of these patients were actually suffering respiratory arrests before their cardiac events. To address this, the facility developed an early intervention team focused on early airway intervention-the Emergency Airway Response Team (EART).