The American journal of emergency medicine
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Clinical selection of point-of-care EEG for seizure or altered mental status in a pediatric emergency department

Aug 8, 2026

The authors aimed to evaluate the clinical factors influencing the use of point-of-care electroencephalography (pocEEG) in children presenting with seizures or altered mental status in a pediatric emergency department. Their findings indicate that pocEEG is more frequently utilized in cases of prolonged seizures and reduced Glasgow Coma Scale eye-opening response, suggesting its potential role in guiding treatment decisions for nonconvulsive status epilepticus. The study highlights the need for further prospective research to assess the impact of pocEEG on management strategies for these patients.

Paramedic perspectives on prehospital buprenorphine: A qualitative case study of implementation in emergency medical services

Aug 8, 2026

The authors aimed to explore paramedics' perspectives on the early implementation of a prehospital buprenorphine program for opioid use disorder within Emergency Medical Services. Through qualitative interviews, they identified key themes such as the perceived value of buprenorphine, clinician comfort, and operational barriers that influence the program's uptake. The findings suggest that while prehospital buprenorphine is feasible and well-received, successful implementation depends more on addressing logistical and systemic challenges than on clinical complexities.

When dyspnea replaces chest pain: Age-dependent symptom profiles in ACS and non-ACS patients undergoing coronary angiography

Aug 7, 2026

The authors investigated how age affects symptom presentation in patients undergoing coronary angiography, specifically whether older adults increasingly present with dyspnea instead of the typical chest pain associated with acute coronary syndrome (ACS). Their findings reveal a significant shift toward dyspnea-containing presentations with advancing age, occurring in both ACS and non-ACS patients, highlighting the need for careful evaluation of dyspnea as a high-risk symptom in older individuals. This suggests that dyspnea should be recognized as a critical indicator of potential coronary disease, rather than merely an atypical symptom in this demographic.

Successful dispatcher-assisted CPR and outcomes after out-of-hospital cardiac arrest: an age-specific nationwide study

Aug 6, 2026

This study investigates the effectiveness of successful dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) on survival outcomes after out-of-hospital cardiac arrest (OHCA) in both adult and pediatric populations. The authors found that successful DA-CPR significantly increased the odds of survival to hospital discharge for both age groups, with no evidence suggesting that age modifies this association.

Non-A, non-B aortic arch dissection with atypical presentation, ambiguous CTA findings, and therapeutic dilemma

Aug 6, 2026

The authors aim to address the diagnostic and therapeutic challenges associated with acute aortic syndrome (AAS) when presented with atypical clinical features and ambiguous imaging findings. They report a case of a 50-year-old woman with subtle CTA abnormalities that led to differing interpretations among specialists, ultimately managed conservatively with serial imaging. This highlights the importance of maintaining a high suspicion for AAS in atypical presentations and the role of multidisciplinary approaches in guiding diagnosis and treatment.

Concurrent cardiocerebral infarction in the emergency department: A case series from a tertiary care centre in South India

Aug 6, 2026

This study investigates the outcomes of patients presenting with concurrent cardiocerebral infarction (CCI) in a South Indian emergency department, aiming to understand the impact of delayed presentation and treatment eligibility on in-hospital mortality. The authors found a high mortality rate of 73% among the 11 patients studied, with most presenting beyond established therapeutic windows for both acute ischemic stroke and acute myocardial infarction. The findings highlight the need for early recognition and coordinated management strategies to improve outcomes in this complex condition.

Initial atropine dose of 0.5 mg versus 1 mg in unstable bradycardia: A propensity score-matched retrospective cohort study

Aug 6, 2026

The authors aimed to determine the optimal initial intravenous atropine dose for treating unstable bradycardia, comparing 0.5 mg and 1.0 mg doses. Their study found that the 1.0 mg dose resulted in higher first-dose success rates and reduced need for additional treatments compared to the 0.5 mg dose. These findings suggest that a 1.0 mg dose may be more effective in managing unstable bradycardia, warranting further investigation through prospective multicenter studies.

Rapid catastrophic neurologic deterioration following large Lumboperitoneal shunt adjustment in a patient with IIH

Aug 6, 2026

The authors aim to highlight the potential for rapid neurologic deterioration following adjustments to lumboperitoneal (LP) shunts in patients with idiopathic intracranial hypertension (IIH). They present a case of fatal cerebral and cerebellar herniation after a large shunt valve adjustment, emphasizing the need for emergency physicians to maintain a high index of suspicion for neurologic complications, even when initial imaging appears normal. The study underscores the importance of understanding LP shunt failure complications in emergency settings.

No-flow duration and outcomes in adult blunt traumatic out-of-hospital cardiac arrest

Aug 5, 2026

This study aimed to investigate the relationship between no-flow duration and outcomes in adults experiencing witnessed out-of-hospital cardiac arrest (OHCA) due to blunt trauma. The findings revealed that the threshold for a chance of achieving a favorable neurological outcome within 30 days was effectively zero minutes, while the threshold for survival was approximately six minutes, highlighting the extremely poor prognosis associated with prolonged no-flow durations in this population.

Re-designing emergency medicine physician staffing to augment emergency department capacity: A combined waterfall schedule and modified physician-in-triage model

Aug 5, 2026

The authors aimed to assess whether a combined physician waterfall schedule (PWS) and modified physician-in-triage (PIT) model could reduce the rate of patients leaving without being seen (LWBS) in a crowded emergency department (ED). Their study found that this intervention significantly decreased LWBS from 6.5% to 4.7%, while also maintaining patient safety and experience, despite an increase in patient boarding. This approach presents a practical solution to enhance ED capacity and efficiency.