Discover the most talked about and latest scientific content & concepts.

Journal: Academic emergency medicine : official journal of the Society for Academic Emergency Medicine



Case reports have described a syndrome of cyclic vomiting associated with chronic marijuana use, termed cannabinoid hyperemesis syndrome. The primary objective was to determine the prevalence of patients presenting with cyclic vomiting before and after the liberalization of medical marijuana in Colorado in 2009. The secondary objective was to describe the odds of marijuana use among cyclic vomiting visits in these same time periods.

Concepts: Chemotherapy, Tetrahydrocannabinol, Cannabis, Cannabinoid, Recreational drug use, Cannabis sativa, Nabilone, Legality of cannabis by country


Treatment guidelines for acute pulmonary embolism (PE) recommend risk stratifying patients to assess PE severity, as those at higher risk should be considered for therapy in addition to standard anticoagulation to prevent right ventricular (RV) failure, which can cause hemodynamic collapse. The hypothesis was that 12-lead electrocardiography (ECG) can aid in this determination. The objective of this study was to measure the prognostic value of specific ECG findings (the Daniel score, which includes heart rate > 100 beats/min, presence of the S1Q3T3 pattern, incomplete and complete right bundle branch block [RBBB], and T-wave inversion in leads V1-V4, plus ST elevation in lead aVR and atrial fibrillation suggestive of RV strain from acute pulmonary hypertension), in patients with acute PE.

Concepts: Cardiology, Heart, Atrial fibrillation, Pulmonary embolism, Cardiac electrophysiology, Thrombus, Pulmonary artery, Ventricular fibrillation


The use of alcohol-based hand sanitizers has recently become widespread. To the authors' knowledge, no previous study has examined whether application of ethanol-based hand sanitizers by the person operating a common breathalyzer machine will affect the accuracy of the readings. This was a prospective study investigating whether the use of hand sanitizer applied according to manufacturer’s recommendations (Group I), applied improperly at standard doses (Group II), or applied improperly at high doses (Group III) had an effect on breathalyzer readings of individuals who had not ingested alcohol.

Concepts: Alcohol, Ethanol, Antiseptic, Disinfectant, Intoxication, Breathalyzer, Hand sanitizer, Disinfectants



Delirium is frequently missed in older emergency department (ED) patients. Brief (<2 minutes) delirium assessments have been validated for the ED, but some ED health care providers may consider them to be cumbersome. The Richmond Agitation Sedation Scale (RASS) is an observational scale that quantifies level of consciousness and takes less than 10 seconds to perform. The authors sought to explore the diagnostic accuracy of the RASS for delirium in older ED patients.

Concepts: Health care, Health care provider, Healthcare, Hospital, Illness, Psychometrics, Performance, Sedation


Measuring the QT interval on an electrocardiogram (ECG) is integral to risk assessment of Torsade de Pointes (TdP). This study aimed to investigate the accuracy of the ½ RR rule as a risk assessment tool for drug-induced TdP, comparing it to the QT nomogram, Bazett’s corrected QT (QTcB), and Fridericia’s corrected QT (QTcF).

Concepts: Cardiology, Cardiac electrophysiology, QT interval, Integral, Risk assessment, Interval


Indwelling urinary catheters (IUCs) are placed frequently in older adults (age ≥ 65 years) in the emergency department (ED) and carry significant risks. The authors developed, implemented, and assessed a novel clinical protocol to assist ED providers with appropriate indications for placement, reassessment, and removal of IUCs in elders in the ED.

Concepts: Death, Clinical trial protocol, Catheter, Urinary catheterization, Dublin


We evaluated the efficacy of topical application of the injectable form of tranexamic acid (TXA) compared with anterior nasal packing (ANP) for the treatment of epistaxis in patients taking antiplatelet drugs (Aspirin, Clopidegrol or both) who presented to the emergency department (ED).

Concepts: Pharmacology, Myocardial infarction, Randomized controlled trial, Clopidogrel, Antiplatelet drug, Aspirin, Route of administration, Antiplatelet drugs


The Palliative Care and Rapid Emergency Screening (P-CaRES) Project is an initiative intended to improve access to palliative care (PC) among emergency department (ED) patients with life-limiting illness by facilitating early referral for inpatient PC consultations. In the previous two phases of this project, we derived and validated a novel PC screening tool. This paper reports on the third and final pre-implementation phase.

Concepts: Cancer, Hospital