The American journal of emergency medicine
Audio Summaries

Status epilepticus in patients with known epilepsy presenting to the emergency department: Predictors and mortality risk

Jun 23, 2026

This study aimed to determine the incidence of status epilepticus (SE) and its predictors among patients with known epilepsy presenting to emergency departments in Malaysia, as well as its association with in-hospital mortality. The findings revealed that 22.8% of the 521 patients experienced SE, which was significantly linked to a higher mortality risk, particularly in older patients and those with metabolic abnormalities or central nervous system infections. These results highlight the need for early risk assessment and monitoring in this vulnerable population.

Vascular Eagle syndrome presenting with expanding cervical hematoma and acute ischemic stroke causing impending airway compromise

Jun 22, 2026

This case report investigates the rare and severe manifestations of vascular Eagle syndrome, specifically how it can lead to expanding cervical hematoma and acute ischemic stroke, resulting in airway compromise. The authors emphasize the importance of early recognition and multidisciplinary intervention in managing such complex presentations, as demonstrated by the successful treatment of a 26-year-old female patient who experienced these life-threatening complications.

Acute urinary retention presenting as inferior pseudo-STEMI: A case report

Jun 22, 2026

The authors aim to highlight a case where acute urinary retention led to inferior ST-segment elevation on an electrocardiogram, mimicking a myocardial infarction, without the typical signs of sympathetic activation. They present a 73-year-old man with massive bladder distension who experienced ST-segment changes that resolved following catheterization, suggesting that mechanical factors rather than hemodynamic changes may be responsible for such electrocardiographic alterations. This case emphasizes the need for emergency physicians to consider bladder distension as a potential cause of reversible ST-segment elevation.

Oncoptysis as the primary presentation of metastatic melanoma: A case report

Jun 19, 2026

This case report explores the rare presentation of oncoptysis in an 88-year-old female patient with metastatic melanoma, who presented with cough and hemoptysis. The authors aim to highlight the significance of considering malignancy in the differential diagnosis of hemoptysis, especially in patients with a history of melanoma, and to contribute to the limited literature on oncoptysis as a manifestation of pulmonary metastases. The findings underscore the need for careful diagnostic evaluation and palliative care strategies in such cases.

Patterns of emergency department visits for suicidal attempts associated with toxic ingestion: A retrospective cross-sectional study

Jun 19, 2026

This study investigates the patterns of emergency department visits for intentional self-poisoning due to toxic ingestion in Israel, focusing on the substances involved and their clinical outcomes. The authors found that polypharmacy, particularly with CNS-acting agents, was common and associated with more severe clinical presentations, highlighting the importance of early toxicology consultation in managing these cases. The findings emphasize the role of medical toxicologists in both treatment and preventive strategies for patients at risk of self-harm.

A case of hidradenitis suppurativa complicated by necrotizing soft tissue infection

Jun 19, 2026

The authors aim to highlight the challenges of diagnosing necrotizing soft tissue infection (NSTI) in patients with hidradenitis suppurativa (HS), as the condition can present with subtle or nonspecific symptoms that may be mistaken for less severe issues. They present a case of a 28-year-old man with HS who exhibited rapid progression of symptoms, ultimately leading to a diagnosis of NSTI that required emergent surgical intervention. The findings emphasize the need for heightened awareness and frequent reassessment in similar cases to ensure timely diagnosis and treatment.

Lumbar paraspinal compartment syndrome with concomitant rhabdomyolysis and multifidus necrosis

Jun 19, 2026

The authors investigate the challenges in diagnosing acute lumbar paraspinal compartment syndrome, particularly in cases that may initially appear as benign muscle strain. They present a case of a 29-year-old male who developed severe pain and rhabdomyolysis after a football game, ultimately requiring surgical intervention that revealed multifidus necrosis. This case underscores the importance of recognizing critical symptoms such as disproportionate pain and unexplained rhabdomyolysis to prevent serious complications.

Frailty stratification in the emergency department using the triage frailty and comorbidity tool

Jun 19, 2026

The authors aimed to evaluate the effectiveness of the Triage Frailty and Comorbidity (TFC) Tool for frailty stratification in low-acuity patients within the Emergency Department (ED). Their multicentre observational study found that incorporating the TFC Tool into routine triage reduced waiting times for medical evaluation and was associated with higher rates of hospitalisation among TFC-positive patients. This suggests that the TFC Tool can enhance the identification and management of frail patients without compromising triage efficiency.

Association between bedside medical toxicology consultation and hospital triage and resource utilization for poisoned patients

Jun 18, 2026

The authors aimed to investigate the impact of bedside medical toxicology consultations on hospital triage, resource utilization, and management outcomes for poisoned patients. Their study found that such consultations were associated with a higher likelihood of managing patients in the emergency department without admission, increased ICU admissions for more severe cases, greater use of targeted therapies, and similar or shorter lengths of stay across care levels. These results suggest that integrating medical toxicology services could improve the management of poisoned patients and optimize hospital resource use.

A case of orbital compartment syndrome caused by orbital abscess in an immunocompetent pediatric patient

Jun 18, 2026

This case report investigates the development of orbital compartment syndrome in an immunocompetent pediatric patient due to an orbital abscess resulting from asymptomatic sinusitis. The authors emphasize the critical need for timely assessment of intraocular pressures and prompt intervention in patients with orbital infections to prevent permanent visual impairment. The successful management of the patient's condition underscores the importance of recognizing and addressing complications associated with orbital cellulitis.