The American journal of emergency medicine
Audio Summaries

Acute kidney injury secondary to Djenkol bean ingestion

Sep 22, 2026

This case report investigates the occurrence of acute kidney injury and hematuria in a 10-year-old male following the ingestion of djenkol beans, a nephrotoxic food known to cause "djenkolism" in Southeast Asia. The authors aim to highlight the potential risks associated with djenkol bean consumption, particularly in non-endemic regions like the United States, and document the clinical management and recovery of the patient. This report is significant as it represents the first documented case of djenkolism in the U.S.

Contrast agent substitution or corticosteroid premedication: association with emergency department throughput

Sep 22, 2026

The authors aimed to evaluate the operational efficiency of contrast agent substitution versus corticosteroid premedication in emergency department patients with prior mild allergic-like reactions to iodinated contrast media. Their findings indicated that contrast agent substitution significantly reduced the time from CT order entry to examination start and ED discharge compared to corticosteroid premedication, with no breakthrough allergic reactions occurring in the substitution group.

The 2026 Surviving Sepsis Campaign Guidelines: The dissenting opinion

Sep 21, 2026

The authors aim to critique the 2026 Surviving Sepsis Campaign Guidelines, arguing that they have deviated from optimal care for sepsis and septic shock by enforcing rigid "bundles" that dictate standard practices rather than supporting evidence-based decision-making. They provide a dissenting opinion on the most controversial recommendations and suggest alternative approaches for clinicians to move beyond the current protocolized care model.

Severe atomoxetine overdose presenting with status epilepticus and wide-complex ventricular tachycardia

Sep 18, 2026

This case report investigates the severe effects of atomoxetine overdose, specifically addressing the neurological and cardiovascular complications that can arise from high doses. The authors detail the presentation of a 21-year-old woman who experienced status epilepticus, metabolic acidosis, and wide-complex ventricular tachycardia following a massive overdose, highlighting critical management strategies such as airway protection and sodium bicarbonate therapy. The findings underscore the potential for life-threatening toxicity in severe atomoxetine overdoses and the importance of prompt medical intervention.

Bedside predictors of left ventricular systolic dysfunction in children with suspected infection undergoing cardiac ultrasound

Sep 18, 2026

The authors aimed to identify bedside markers commonly used in pediatric sepsis assessments that are associated with reduced left ventricular systolic function in children with suspected infections undergoing cardiac ultrasound. Their study found that systolic hypotension and prolonged capillary refill time were significantly associated with reduced left ventricular function, while tachycardia, altered mental status, and high-risk conditions were not. These findings suggest that specific bedside markers may aid in the early evaluation of myocardial dysfunction in this patient population.

Emergency department disposition and hospital-based resource utilization for skin and soft tissue infections

Sep 18, 2026

The authors investigate how emergency department (ED) disposition decisions for skin and soft tissue infections (SSTIs) relate to hospital-based resource utilization, aiming to identify factors that predict the need for more intensive care. They found that certain demographics and clinical factors, such as older age and the presence of diabetes or systemic inflammatory response syndrome, were associated with higher odds of requiring extensive hospital care, while specific treatment approaches like incision and drainage were linked to lower odds. The study suggests that optimizing outpatient management for selected patients could reduce unnecessary hospitalizations and improve follow-up care for those at higher risk.

After the scan: Timing of first analgesia relative to CT initiation in adult trauma patients

Sep 17, 2026

The authors aimed to investigate the timing of the first analgesia administration relative to the initiation of CT scans in adult trauma patients and its association with trauma activation levels and the scope of CT imaging. Their findings revealed that 44.1% of patients received analgesia after CT initiation, with higher trauma activation levels and pan-scan imaging being significantly linked to this delay. This study highlights the need to examine the timing of analgesia delivery in conjunction with trauma imaging practices.

Artificial intelligence in emergency medicine education: A narrative review

Sep 17, 2026

This narrative review investigates the role of artificial intelligence (AI) in emergency medicine education, aiming to synthesize existing literature on its applications, benefits, limitations, and future directions. The authors highlight the potential of AI tools to enhance educational strategies while also addressing critical concerns such as the impact on critical thinking, faculty training, content accuracy, and equitable access. Ultimately, they emphasize the need for clinician educators to balance the advantages of AI with its limitations to ensure effective and safe integration into medical education.

Prehospital management of pain associated with acute complications of Sickle Cell Disease: a preliminary nationwide cross-sectional study

Sep 16, 2026

The authors aimed to investigate the epidemiology of emergency medical services (EMS) encounters for complications related to sickle cell disease (SCD) and to evaluate the factors influencing the administration of analgesia for SCD-related pain. Their findings revealed that while longer patient contact times were associated with higher rates of analgesia administration, overall pain management was inadequate, highlighting the need for improved protocols in EMS for treating SCD-related pain.

Hypomagnesemia and 30-day mortality in the emergency department: A large-scale propensity-matched analysis

Sep 16, 2026

The authors aimed to investigate the incidence and mortality associated with hypomagnesemia (HM) in emergency department patients using a national database. Their analysis revealed that patients with HM had a significantly higher risk of 30-day mortality compared to those with normal magnesium levels, particularly among individuals with certain comorbidities such as hypertension and diabetes. The study highlights the importance of recognizing and addressing hypomagnesemia in the emergency setting due to its association with increased mortality risk.