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Emergency Medicine

News, opinions and meeting coverage in emergency medicine.

How to Replace IV Nitroglycerin in the Shortage

What are the alternatives for IV nitroglycerin in the emergency setting as the shortage saps reserves? Several experts share their thoughts.

ACC: Gout Drug Tames the Heart

WASHINGTON -- Colchicine may be as effective at reducing multiple recurrences of pericarditis as it is in treating acute episodes and first recurrences.

10 Ways to Safely Push Ketamine in the ED

A doctor recently took me on a Special K trip, and I enjoyed it immensely.

13 Mobile Apps Every ER Doc Should Test Drive

Here are the best mobile apps for emergency medicine physicians gleaned from a recent EMJ paper by Michelle Lin, MD, Iltifat Husain, MD, Salim Rezaie, MD, and remixed with a talk from last month's AAEM meeting by Graham Walker, MD.

Which Bullets Are Safe in an MRI?

Don't go ballistic -- only steel bullets will cause problems in MRI, says a study of 39 kinds of the projectiles.

ER Briefs: DIY Laptop to AED Kit -- Good Idea?

Inventors aim to resurrect laptops and tablets as AEDs. We asked Clifton Callaway, MD, PhD, an emergency medicine doctor who heads up EM research at the University of Pittsburgh, to weigh in.

A Brain-Dead Mother, a Million-Dollar Baby

The costs associated with maintaining a pregnant, brain-dead, Texas woman on life support until her fetus is viable are likely to approach $1 million, and long-term costs could easily top $1.5 million.

EMTs Can Give Positive Pressure Ventilation

Out-of-hospital noninvasive positive-pressure ventilation in patients with severe respiratory distress significantly reduced rates of inhospital mortality and need for invasive ventilation, researchers found.

What Bystanders Should Know About CPR -- and Why

Bystander-initiated cardiopulmonary resuscitation (CPR) has poor neurological outcome, and this is true even when bystanders are family members, which suggests deficits in public CPR training.

At-Home Seizure Tests Promising

WASHINGTON -- Technologies to provide instant at-home detection of life-threatening seizures and that could allow epilepsy patients to monitor their own drug levels are almost ready, researchers said here.

Use of Expired Auto-Injectors OK'd by FDA

WASHINGTON -- The FDA cautioned emergency medical staff to retain recently expired auto-injectors by Meridian Medical Technologies and to use them in emergencies if no other product is available.

ACE Inhibitors Linked to Severe Allergic Reactions

BALTIMORE -- Antihypertensive treatment with ACE inhibitors may prime oral allergy syndrome patients for severe reactions, a case-report suggested.

Teens More Apt to Fight Than Flee

SAN DIEGO -- Teens were more likely to actively respond to aggressive cues than were children or adults, researchers reported here.

Rape Laws Offer Little Protection

BOSTON -- The world over, laws to protect rape victims are paper tigers, often enacted but rarely enforced, a researcher said here.

Studies 'Validate' CDC HCV Testing Advice

WASINGTON -- Thousands of people in the U.S. -- including an estimated 50,000 veterans -- are infected with the hepatitis C virus, and don't know it, researchers reported here.

Supplements Blamed for Liver Toxicity

WASHINGTON -- The rate of liver damage caused by dietary and herbal supplements -- especially those used for bodybuilding -- appears to be on the rise, a researcher said here.

Striking a Nerve: Heinz Kerry Recovers

Teresa Heinz Kerry is back at work less than 4 months after a mysterious seizure hospitalized her. Striking a Nerve is a blog by John Gever for readers interested in neurology.

Add 'Shrapnel' to Workup for Lightning Strike

A shrapnel-like injury associated with a lightening strike provided a reminder for emergency physicians not to overlook the unexpected when examining patients.

Neurotransmitter Linked to Post-Traumatic Stress

Post-traumatic stress disorder is associated with lowered levels of norepinephrine transporter, a neurotransmitter in a brain region that plays a role in panic and stress, researchers reported.

Lab Notes: Meth May Worsen Fungal Infection

Mice injected with methamphetamine and exposed to Cryptococcus fungi showed more extensive and hard-to-eradicate infections. Also this week: an organic pesticide fights parasitic worms.

Honey, Cola May Disrupt Heart

A detailed history of patients with arrhythmia or syncope might need to include their cola intake or the origin of the honey they consume, two case studies suggest.

APA Leaders Defend New Diagnostic Guide

SAN FRANCISCO -- The fifth edition of the "psychiatrist's bible" was officially released here in all its 947-page glory, with its developers offering a spirited rebuttal to their critics.

Gun Control: Docs Told to Speak Up

WASHINGTON -- Physicians need to do a better job at promoting the data that supports stronger gun-control laws, experts here said.

On-Call Pay Varies Widely by Specialty

Surgeons commanded more than $1,000 a day for being on-call at the hospital, while primary care physicians reported compensation rates of around $150 a day, according to annually compiled data.

Cinnamon Game Harms Players

The "cinnamon challenge鈥� -- a party trick among youths who accept a dare to swallow a spoonful of ground cinnamon -- has led to a surge in calls to poison control centers with reports of spice-induced choking and aspiration, according to a new report.

Ricin Deadly, but Not an Effective WMD

It may have been a preferred tool of Soviet hit men, but ricin generally flops as a weapon of mass destruction, several bioterrorism experts told 木瓜直播.

ECG for Eyes Sorts Strokes from Vertigo

A device described as an ECG for the eye accurately distinguishes stroke from other causes of dizziness in the emergency department, a small proof-of-concept study showed.

Is Pot Smoking a Stroke Trigger?

HONOLULU -- Middle age stroke patients were twice as likely to be pot smokers than healthy middle age controls, researchers found.

Surgery Boosts Outcomes in Esophageal Cancer

SAN FRANCISCO -- Surgery after chemoradiotherapy increased overall and disease-free survival compared with chemoradiotherapy alone in advanced esophageal cancer treatment, researchers reported here.

Painful Speed Bumps? Could Be Appendicitis

Diagnostic uncertainty surrounding appendicitis could turn into a small bump in the road, according to a study showing a high correlation between appendicitis and pain on driving over speed bumps on the way to the hospital.

AHA: No Excess Bleeding Risk with Dabigatran

LOS ANGELES -- Patients starting dabigatran (Pradaxa) did not have a higher risk of bleeding compared with new users of warfarin, according to a postmarketing data review by the FDA.

Fainting in PE Signals High Risk

ATLANTA -- Patients with pulmonary embolism brought to emergency rooms because they had passed out tended to have the most ominous risk factors for poor outcomes, a researcher said here.

Readers: Who Really Benefits from Spanking?

Although a majority of our readers don't think childhood spanking causes mental illness in adulthood, many of them noted that the topic is more complex than a simple "Yes" and "No" survey.

Tattoos Replace Bracelets for Medical Alerts

PHILADELPHIA -- As more people with diabetes replace their medical alert bracelets with tattooed warnings, there might be a need for a standard design and body location, a researcher here said.

Cheney's Heart Makes Him a Million Dollar Man

Keeping former Vice President Dick Cheney's heart beating probably will cost the healthcare system at least a million dollars, cardiac transplantation experts told 木瓜直播.

Follow the Money: Pain, Policy, and Profit

When the Federation of State Medical Boards decided it needed to put a model guideline for opioid use into a book, it reached out and touched the makers of opioid drugs to make it happen.

In Cocaine Users Think About Levamisole

HOUSTON -- Half of a group of cocaine users tested positive for levamisole, a potentially hazardous veterinary drug that cocaine dealers often use to prepare street product, investigators reported here.

ER Presentation Not the End for Colon Cancer Patients

SAN FRANCISCO -- Curative therapy is still a possibility, even if a colon cancer patient is seen for the first time in the emergency department with acute symptoms, researchers said here.

Ski Helmets Not Best for Sledding

To protect kids' noggins before setting them on toboggans parents should ditch ski helmets for hockey or cycling ones, results of a study suggest.

FDA Panel Split Over Inhaled Antipsychotic

WASHINGTON -- An FDA advisory panel punted on the question of approval for an inhaled version of the antipsychotic drug loxapine (Adasuve) to treat agitation in bipolar and schizophrenic patients, despite the risk for respiratory side effects.

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