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Book ; Online ; E-Book: EKG teaching rounds

Tannenbaum, Lloyd / Bridwell, Rachel E. / Inman, Brannon L.

a case-based guide

2022

Author's details	Lloyd Tannenbaum, Rachel E. Bridwell, Brannon L. Inman
Keywords	Cardiology
Subject code	616.12
Language	English
Size	1 Online-Ressource (XII, 161 Seiten)
Publisher	Springer
Publishing place	Cham
Publishing country	Switzerland
Document type	Book ; Online ; E-Book
Remark	Zugriff für angemeldete ZB MED-Nutzerinnen und -Nutzer
HBZ-ID	HT030698777
ISBN	978-3-031-06028-1 ; 9783031060274 ; 3-031-06028-8 ; 303106027X
Database	ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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Article ; Online: Adrenal Emergencies.

Bridwell, Rachel E / April, Michael D

Emergency medicine clinics of North America

2023 Volume 41, Issue 4, Page(s) 795–808

Abstract: The adrenal glands drive physiologic homeostasis, with dysregulation in any direction causing multisystem dysfunction. Adrenal excess states include hyperaldosteronism which manifests with refractory hypertension and electrolyte abnormalities including ... ...

Abstract	The adrenal glands drive physiologic homeostasis, with dysregulation in any direction causing multisystem dysfunction. Adrenal excess states include hyperaldosteronism which manifests with refractory hypertension and electrolyte abnormalities including hypernatremia and hypokalemia. Paragangliomas including pheochromocytoma can cause multisystem end-organ dysfunction due to catecholaminergic storm, which require rapid blood pressure control with phentolamine and identification of lesions amenable to surgical resection. Adrenal insufficiency states in contrast can result in hypotension and decompensation refractory to vasopressor administration, requiring adrenal supplementation via hydrocortisone.
MeSH term(s)	Humans ; Emergencies ; Hyperaldosteronism ; Hydrocortisone ; Hypertension ; Hypotension
Chemical Substances	Hydrocortisone (WI4X0X7BPJ)
Language	English
Publishing date	2023-07-22
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	605637-4
ISSN	1558-0539 ; 0733-8627
ISSN (online)	1558-0539
ISSN	0733-8627
DOI	10.1016/j.emc.2023.06.006
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: High risk and low prevalence diseases: Acute mastoiditis.

Bridwell, Rachel E / Koyfman, Alex / Long, Brit

The American journal of emergency medicine

2024 Volume 79, Page(s) 63–69

Abstract: Introduction: Acute mastoiditis is a serious condition that carries with it a high rate of morbidity and mortality.: Objective: This review highlights the pearls and pitfalls of mastoiditis, including the presentation, diagnosis, and management in ... ...

Abstract	Introduction: Acute mastoiditis is a serious condition that carries with it a high rate of morbidity and mortality. Objective: This review highlights the pearls and pitfalls of mastoiditis, including the presentation, diagnosis, and management in the emergency department (ED) based on current evidence. Discussion: Acute mastoiditis most commonly affects pediatric patients and is a suppurative infection of the mastoid air cells. It is often associated with otitis media, and common bacteria include Streptococcus and Staphylococcus. History and examination may reveal tympanic membrane erythema, pinna protrusion, postauricular erythema, mastoid tenderness with palpation, external canal swelling, otorrhea, fever, and malaise. The disease should be suspected in those who fail treatment for otitis media and those who demonstrate the aforementioned abnormalities on examination and systemic symptoms. Laboratory analysis may reveal evidence of systemic inflammation, but a normal white blood cell count and other inflammatory markers should not be used to exclude the diagnosis. Computed tomography (CT) of the temporal bones with intravenous contrast is the recommended imaging modality if the clinician is unsure of the diagnosis. CT may also demonstrate complications. Treatment includes antibiotics such as ampicillin-sulbactam or ceftriaxone as well as otolaryngology consultation. Complications may include subperiosteal and intracranial abscess, deep neck abscess, facial nerve palsy, meningitis/encephalitis, venous sinus thrombosis, and seizures. Conclusions: An understanding of acute mastoiditis can assist emergency clinicians in diagnosing and managing this potentially deadly disease.
MeSH term(s)	Humans ; Child ; Mastoiditis/diagnosis ; Mastoiditis/epidemiology ; Mastoiditis/therapy ; Abscess/complications ; Prevalence ; Otitis Media/complications ; Acute Disease ; Erythema
Language	English
Publishing date	2024-02-07
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	605890-5
ISSN	1532-8171 ; 0735-6757
ISSN (online)	1532-8171
ISSN	0735-6757
DOI	10.1016/j.ajem.2024.02.009
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: In response: Considerations regarding compounding pharmacies and GLP-1 agonists.

Long, Brit / Pelletier, Jessica / Koyfman, Alex / Bridwell, Rachel E

The American journal of emergency medicine

2024

Language	English
Publishing date	2024-04-06
Publishing country	United States
Document type	Letter
ZDB-ID	605890-5
ISSN	1532-8171 ; 0735-6757
ISSN (online)	1532-8171
ISSN	0735-6757
DOI	10.1016/j.ajem.2024.03.037
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: GLP-1 agonists: A review for emergency clinicians.

Long, Brit / Pelletier, Jessica / Koyfman, Alex / Bridwell, Rachel E

The American journal of emergency medicine

2024 Volume 78, Page(s) 89–94

Abstract: Introduction: Glucagon-like peptide 1 (GLP-1) based therapies, including GLP-1 agonists, are currently in use for treatment of diabetes and obesity. However, several complications may occur with their use.: Objective: This narrative review provides a ...

Abstract	Introduction: Glucagon-like peptide 1 (GLP-1) based therapies, including GLP-1 agonists, are currently in use for treatment of diabetes and obesity. However, several complications may occur with their use. Objective: This narrative review provides a focused evaluation of GLP-1 agonist therapy and associated complications for emergency clinicians. Discussion: GLP-1 agonists potentiate insulin release and reduce gastric emptying and food intake. These agents have demonstrated significant improvements in glucose control in diabetics and weight loss in obese patients. The two most common agents include subcutaneous semaglutide (Ozempic, approved for type 2 diabetes, and Wegovy, approved for weight loss) and liraglutide (Saxenda, approved for weight loss, and Victoza, approved for type 2 diabetes), though an oral formulation of semaglutide is available (Rybelsus). While these drugs are associated with improved long-term outcomes, there are a variety of associated adverse events. The most common include gastrointestinal (GI) adverse events such as nausea, vomiting, diarrhea, and abdominal pain. Pancreatitis and biliary disease may also occur. Hypersensitivity including injection site reactions have been associated with use, with reports of anaphylaxis and other rashes. Renal adverse events are most commonly associated with severe GI losses. Hypoglycemia may occur when these agents are used with sulfonylureas or insulin. There is also an increased risk of diabetic retinopathy. Due to the current shortage and expense of these medications, many patients have attempted to obtain these medications from non-licensed and unregulated agents, which may be associated with increased risk of serious complications. Conclusions: An understanding of the indications for GLP-1 agonist use and associated adverse events can assist emergency clinicians.
MeSH term(s)	Humans ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/drug therapy ; Hypoglycemic Agents/adverse effects ; Glucagon-Like Peptide 1/therapeutic use ; Obesity ; Weight Loss ; Insulin/therapeutic use
Chemical Substances	Hypoglycemic Agents ; Glucagon-Like Peptide 1 (89750-14-1) ; Insulin
Language	English
Publishing date	2024-01-12
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	605890-5
ISSN	1532-8171 ; 0735-6757
ISSN (online)	1532-8171
ISSN	0735-6757
DOI	10.1016/j.ajem.2024.01.010
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Isolated Uvulitis in a Patient After Smoking Fentanyl.

Fappiano, Cayla / Inman, Brannon L / Bridwell, Rachel E

Cureus

2023 Volume 15, Issue 4, Page(s) e38109

Abstract: Isolated uvulitis is a rare but potentially devastating condition that can result in airway compromise. Etiologies include infection, trauma, allergy, primary angioedema, immunologic disorders, and inhalation injury. Uvulitis has been previously reported ...

Abstract	Isolated uvulitis is a rare but potentially devastating condition that can result in airway compromise. Etiologies include infection, trauma, allergy, primary angioedema, immunologic disorders, and inhalation injury. Uvulitis has been previously reported as a reaction to inhalation of cannabis, crack cocaine, and mephedrone. We present a case of isolated uvulitis with concerns for impending airway obstruction in a patient after smoking fentanyl. While a sore throat is a common chief complaint among ED patients, emergency providers should consider uvulitis within this deadly differential.
Language	English
Publishing date	2023-04-25
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.38109
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Analgesic Techniques for Managing Orthopedic Injuries: A Review for the Emergency Clinician.

Long, Brit / Bridwell, Rachel E / Gottlieb, Michael

The Journal of emergency medicine

2023 Volume 66, Issue 2, Page(s) 211–220

Abstract: Background: Orthopedic injuries are commonly managed in the emergency department (ED) setting. Fractures and dislocations may require reduction for proper management. There are a variety of analgesic and sedative strategies to provide patient comfort ... ...

Abstract	Background: Orthopedic injuries are commonly managed in the emergency department (ED) setting. Fractures and dislocations may require reduction for proper management. There are a variety of analgesic and sedative strategies to provide patient comfort during reduction. Objective: This narrative review evaluates hematoma block, intra-articular injection, intravenous regional analgesia (IVRA) (also known as the Bier block), and periosteal block for orthopedic analgesia in the ED setting. Discussion: Analgesia is an essential component of management of orthopedic injuries, particularly when reduction is necessary. Options in the ED setting include hematoma blocks, intra-articular injections, IVRA, and periosteal blocks, which provide adequate analgesia without procedural sedation or opioid administration. When used in isolation, these analgesic techniques decrease complications from sedation and the need for other medications, such as opioids, while decreasing ED length of stay. Emergency clinicians can also use these techniques as analgesic adjuncts. However, training in these techniques is recommended prior to routine use, particularly with IVRA. Conclusions: Knowledge of analgesic techniques for orthopedic procedures can assist clinicians in optimizing patient care.
MeSH term(s)	Humans ; Analgesics/therapeutic use ; Fractures, Bone/surgery ; Pain/drug therapy ; Anesthesia, Local ; Analgesics, Opioid/therapeutic use ; Hematoma ; Emergency Service, Hospital
Chemical Substances	Analgesics ; Analgesics, Opioid
Language	English
Publishing date	2023-10-07
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	605559-x
ISSN	0736-4679
ISSN	0736-4679
DOI	10.1016/j.jemermed.2023.10.010
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Hereditary Creutzfeldt-Jakob Disease: A Case Presentation of a Rare Stroke Mimic.

Bridwell, Rachel E / Barlow, Jessica A / Jacobson, Andrew R / Curell, Angela / Long, Brit

Cureus

2024 Volume 16, Issue 3, Page(s) e55559

Abstract: Acute ischemic cerebrovascular accident (CVA) is a time-sensitive emergent diagnosis, requiring rapid diagnosis and consideration of thrombolytic administration. However, a myriad of cerebrovascular mimics creates a diagnostic challenge. A rare CVA mimic ...

Abstract	Acute ischemic cerebrovascular accident (CVA) is a time-sensitive emergent diagnosis, requiring rapid diagnosis and consideration of thrombolytic administration. However, a myriad of cerebrovascular mimics creates a diagnostic challenge. A rare CVA mimic is Creutzfeldt-Jakob disease (CJD), a rapidly progressive fatal dementia due to protein misfolding. Magnetic resonance imaging (MRI) and neurology consultation for electroencephalogram (EEG) and specialized cerebrospinal fluid (CSF) studies are diagnostic while the patient is alive. All forms are fatal within months, and diagnosis can be confirmed on postmortem brain testing. While incredibly uncommon, emergency clinicians should consider this diagnosis in the proper patient to advocate for specialized CSF testing and potential palliative care consultation.
Language	English
Publishing date	2024-03-05
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.55559
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Facilitated Intubation: Time to Re-examine an Old Technique With Its Associated Risks Mitigated by New Technology.

Lowe, Joshua B / Yoo, Michael J / Patrick, John O / Bridwell, Rachel E

Cureus

2023 Volume 15, Issue 8, Page(s) e43364

Abstract: Background: Facilitated intubation (FI) refers to intubation performed using a sedative or anesthetic drug as an induction agent, without the use of a paralytic (neuromuscular blocking agent). In comparison, rapid sequence intubation (RSI) employs both ... ...

Abstract	Background: Facilitated intubation (FI) refers to intubation performed using a sedative or anesthetic drug as an induction agent, without the use of a paralytic (neuromuscular blocking agent). In comparison, rapid sequence intubation (RSI) employs both an induction agent and a paralytic drug. RSI has been seen to outperform FI in terms of first-pass success when performing direct laryngoscopy and was quickly adopted as the gold standard in all situations. Recently, ketamine-only intubation has been used in situations where there is distorted anatomy or apnea intolerance (physically and physiologically difficult airways) resulting in an increased risk of a can't intubate/can't oxygenate scenario or significant hypoxemia. Frequent and recurring national ketamine shortages have resulted in renewed interest in whether or not other forms of FI are feasible in an era where other factors that mitigate complictions in achieving first-pass success (video laryngoscopy, bougie use, semi-Fowler positioning) are commonly used. We present a case series with outcomes for profoundly hypoxic patients with coronavirus disease 2019 (COVID-19) (physiologically difficult airways) undergoing FI during a time of national ketamine shortage, using modern techniques and technology to maximize first-pass success and minimize peri-intubation complication. Methods: We included patients with COVID-19 pneumonia with pre-intubation oxygen saturations of less than 80% (significant hypoxemia) requiring intubation who presented to a tertiary care center in southern United States between August 25, 2021, and October 22, 2021. In this specific cohort, patients underwent endotracheal intubation with midazolam for induction without the use of paralytic agents. We used video-assisted laryngoscopy to increase the success of the first-pass attempt as well as placing the patients in a semi-Fowler position (head of bed elevation 30-45°) and bilevel positive pressure pre-oxygenation to minimize peri-intubation complications. Results: Our case series included 29 consecutive patients that met the inclusion criteria. The mean ± standard deviation (SD) age of the patients was 49.5±15.0 years. The mean±SD pre-intubation oxygenation of our cohort was 73.1±5.9%. All 29 intubations were successful on the first-pass attempt. Only one patient (3.4%) required a rescue paralytic to facilitate oral opening. Of note, 27/29 (93%) of the patients did not receive any immunizations (including partial) for COVID-19. There were no incidents of peri-intubation arrest (cardiac arrest within 30 minutes of induction) or aspiration. Conclusions: In 29 physiologically difficult patients with acute respiratory failure, in whom the physician determined that RSI posed a higher than normal risk, FI assisted by VL, semi-Fowler positioning, and bilevel positive pressure pre-oxygenation resulted in excellent successful first-pass intubation rates without any incidences of peri-intubation arrest or aspiration. While this cohort was small, our study reveals that FI with midazolam does not likely pose a higher risk than ketamine-only intubation and warrants further study.
Language	English
Publishing date	2023-08-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.43364
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: A Distal Femoral Salter-Harris IV Fracture Secondary to a Motocross Accident: A Case Report.

Van Nispen, Christiaan / Bridwell, Rachel E / Fernandes, Joel J / Long, Brit

Cureus

2023 Volume 15, Issue 5, Page(s) e38679

Abstract: High-grade physeal fractures, such as Salter-Harris types III, IV, and V fractures, are rare pediatric injuries observed disproportionately in teenage males. Such fractures are at high risk for complications such as growth retardation and arrest, ... ...

Abstract	High-grade physeal fractures, such as Salter-Harris types III, IV, and V fractures, are rare pediatric injuries observed disproportionately in teenage males. Such fractures are at high risk for complications such as growth retardation and arrest, arthrofibrosis, and post-traumatic arthritis. Consultation with the orthopedic specialist is imperative to ensure appropriate imaging, management, and potential transfer to a pediatric specialty hospital. The authors present a case of a 15-year-old male who sustained a Salter-Harris IV fracture of the distal femur extending from the intercondylar notch to the metadiaphysis from a motocross accident.
Language	English
Publishing date	2023-05-07
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.38679
Database	MEDical Literature Analysis and Retrieval System OnLINE

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