Outcomes in Hispanics With COVID-19 Are Similar to Those of Caucasian Patients in Suburban New York.

Background: Despite reported higher rates and worse outcomes due to COVID-19 in certain racial and ethnic groups, much remains unknown. We explored the association between Hispanic ethnicity and outcomes in COVID-19 patients in Long Island, New York.

Methods: We conducted a retrospective cohort study of 2,039 Hispanic and non-Hispanic Caucasian patients testing positive for SARS-CoV-2 between March 7 and May 23, 2020, at a large suburban academic tertiary care hospital near New York City.

Emergency department and hospital crowding: causes, consequences, and cures.

Overcrowding with associated delays in patient care is a problem faced by emergency departments (EDs) worldwide. ED overcrowding can be the result of poor ED department design and prolonged throughput due to staffing, ancillary service performance, and flow processes. As such, the problem may be addressed by process improvements within the ED.

Sinusitis Update.

Rhinosinusitis affects many pediatric patients as well as 1 in 6 adults in any given year, resulting in ambulatory care, pediatric, and emergency department visits. Uncomplicated rhinosinusitis requires no imaging or testing and does not require antibiotic treatment. Using strict clinical diagnostic criteria may minimize unnecessary antibiotics.

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.

HOT WAX.

High-potency marijuana wax smoked via dabbing is a newly encountered phenomenon with relevance to prehospital care providers and emergency physicians.The extract is only recently described in current peer-reviewed literature. The drug may produce paranoia and psychosis and mimic psychiatric problems.

Nebulized Tranexamic Acid as a Noninvasive Therapy for Cancer-Related Hemoptysis.

Background: Many patients with cancer involving the respiratory system suffer from the frequent recurrence of significant, submassive hemoptysis, which may result in invasive procedures, hospital stays, and a reduction in quality of life. Currently, there are no widely accepted noninvasive therapeutic options. Few case studies have looked at the benefit of tranexamic acid (TXA) as a noninvasive therapy in the treatment of hemoptysis.

Chikungunya fever in Los Angeles, California.

We report the case of a 33-year-old woman returning from Haiti, presenting to our emergency department (ED) with fever, rash and arthralgia. Following a broad workup that included laboratory testing for dengue and malaria, our patient was diagnosed with Chikungunya virus, which was then reported to the Centers for Disease Control and Prevention for initiation of infection control. This case demonstrates the importance of the ED for infectious disease case identification and initiation of public health measures.

A survey of the beliefs regarding international emergency medicine among fourth-year medical students planning on matching in emergency medicine.

Background: With the recent growth of fellowships in international emergency medicine, the authors sought to evaluate medical students' attitudes toward international emergency medicine and to determine the effects these attitudes have on their residency selection.

Study Design: Cross-sectional survey.

Data Collection: An anonymous, eight-question online survey was distributed to all members of the American Academy of Emergency Medicine Resident and Student section.

Tattoos and piercings: a review for the emergency physician.

Tattoos and piercings are increasingly part of everyday life for large sections of the population, and more emergency physicians are seeing these body modifications (BM) adorn their patients. In this review we elucidate the most common forms of these BMs, we describe how they may affect both the physical and psychological health of the patient undergoing treatment, and also try to educate around any potential pitfalls in treating associated complications.

Financial impact of emergency department crowding.

Objective: The economic benefits of reducing emergency department (ED) crowding are potentially substantial as they may decrease hospital length of stay. Hospital administrators and public officials may therefore be motivated to implement crowding protocols. We sought to identify a potential cost of ED crowding by evaluating the contribution of excess ED length of stay (LOS) to overall hospital length of stay.

Reimbursement for emergency department electrocardiography and radiograph interpretations: what is it worth for the emergency physician.

Background: Physician reimbursement laws for diagnostic interpretive services require that only those services provided contemporaneously and /or contribute directly to patient care can be billed for. Despite these regulations, cardiologists and radiologists in many hospitals continue to bill for ECG and plain film diagnostic services performed in the emergency department (ED). The reimbursement value of this care, which is disconnected in time and place from the ED patient encounter, is unknown.

Takotsubo cardiomyopathy: a case series and review of the literature.

Takotsubo cardiomyopathy (TCM) is an unusual form of acute cardiomyopathy showing left ventricular apical ballooning. It is often triggered by intense physical or emotional distress. We report here four cases of TCM and a review of the literature on the topic.

Rocuronium vs. succinylcholine in the emergency department: a critical appraisal.

Background: Two methods of paralysis are available for rapid sequence intubation (RSI) in the emergency department (ED): depolarizing agents such as succinylcholine, and non-depolarizing drugs such as rocuronium. Rocuronium is a useful alternative when succinylcholine is contraindicated. Contraindications to succinylcholine include allergy, history of malignant hyperthermia, denervation syndromes, and patients who are 24-48 h post burn or crush injury.

Enoxaparin-induced bleeding resulting in compartment syndrome of the thigh: a case report.

Background: Enoxaparin-related bleeding has usually been described as excess minor bleeding.

Objectives: To describe a case of major bleeding with a compartment syndrome secondary to enoxaparin. The utility of bedside emergency department ultrasonography as a diagnostic tool is evident.

Severe hypokalemia, paralysis, and AIDS-associated isospora belli diarrhea.

Background: Hypokalemia of clinical significance, severe enough to cause paralysis and cardiac dysrhythmias, is an uncommon life-threatening medical disorder. Hypokalemic periodic paralysis (HPP), where an abrupt intracellular shift of potassium has occurred, must be distinguished from hypokalemic non-periodic paralysis (non-HPP), where a total body potassium deficit exists. The challenge for emergency physicians is to swiftly and accurately differentiate disease etiology and institute prompt treatment.

Identification of subcutaneous myiasis using bedside emergency physician performed ultrasound.

Background: Subcutaneous myiasis, a maggot infiltration of human tissue, is common in tropical countries. However, physicians in the United States may be unlikely to consider this etiology of dermatologic abnormalities even when a travel history suggests the diagnosis should be included in the differential.

Case Report: We report the case of a patient who returned from Sierra Leone with an infestation of a maggot of Cordylobia anthropophaga (tumbu fly) that was diagnosed and appropriately treated based on ultrasound findings.

Emphysematous pyelonephritis: clues to rapid diagnosis in the Emergency Department.

Emphysematous pyelonephritis (EPN) is an acute life-threatening bacterial infection. EPN leads to rapid necrotizing destruction of the renal parenchyma and peri-renal tissue, requiring early and aggressive care to reduce morbidity and mortality. Previous studies have described the use of computed tomography scan and radiology-performed ultrasound to make the diagnosis of EPN We report a case of EPN diagnosed by bedside Emergency Department (ED) ultrasound performed by emergency physicians, allowing a more rapid diagnosis and subsequent treatment.

The AIDS patient with abdominal pain: a new challenge for the emergency physician.

As the prevalence of HIV infection continues to increase, EPs will be called upon to evaluate increasing numbers of AIDS patients who have abdominal pain, some of whom will require emergent surgical intervention. In addition to the myriad causes of abdominal pain in the nonimmunocompromised patient, the differential diagnosis in the AIDS patient includes a wide variety of opportunistic infections and neoplasms (Table 5). Evaluation frequently requires extensive laboratory studies and cultures and advanced imaging (CT, ultrasound, and so forth).

Manual measurement of QT dispersion in patients with acute myocardial infarction and nondiagnostic electrocardiograms.

Objective: To determine whether manually measured QT dispersion (QTD) may be a useful diagnostic adjunct for acute myocardial infarction (AMI) in emergency department patients with chest pain (CP) and nondiagnostic initial electrocardiograms (ECGs).

Methods: This was a retrospective review of a cohort of patients admitted to the coronary triage unit (CTU) at a large urban facility over a two-year period (1997-1999). Cases included all patients with nondiagnostic initial ECGs diagnosed as having AMI by enzymatic criteria.