Emergency Medicine
Audio Summaries

Repeat 9-1-1 Calls and Clinical Outcomes of Children After Non-Transport by Emergency Medical Services

The authors aimed to determine the rate of repeat 9-1-1 calls and subsequent transport to the emergency department within 72 hours for children not transported by emergency medical services (EMS). They found that only 1% of these children had a repeat call resulting in transport, with rare occurrences of hospitalization and death, suggesting that pediatric non-transport protocols may be safe and effective. Additionally, certain demographic and clinical factors were associated with the likelihood of repeat calls and transport.

Acute kidney injury secondary to Djenkol bean ingestion

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

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.

Enhancing Far-Forward Resuscitation: A Quantitative Laboratory Analysis of Blood Warmer Devices Used in Austere Environments

The authors aimed to identify the most effective blood warming devices for far-forward trauma resuscitation in austere environments, as hypothermia can worsen outcomes in injured patients. They conducted a comparative analysis of six portable blood warmers under varying pressure conditions, finding that the MWarmer consistently maintained optimal warming performance, while the Quantum device, despite achieving the fastest time-to-one-unit, showed significant performance decline under increased pressure. Overall, the study highlights the MWarmer as the most suitable option for maintaining both thermal performance and flow in critical situations.

The 2026 Surviving Sepsis Campaign Guidelines: The dissenting opinion

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

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.

Quantifying the impact of prehospital arterial line insertion on scene time

The authors aimed to investigate the impact of prehospital arterial line insertion on scene time and its potential implications for patient transport to definitive care. Their systematic review of four studies found a consistent association between arterial line insertion and increased scene time, ranging from 4 to 34.4 minutes, but noted that the clinical significance of this delay remains unclear and may vary depending on the context.

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

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.

A Causal Model for Prehospital Blood Transfusion and Mortality in Traumatic Hemorrhagic Shock

The authors aim to develop a causal model that links prehospital blood transfusion (PBT) to mortality outcomes in patients with traumatic hemorrhagic shock (THS), addressing the need for strong scientific evidence in this area. The model identifies various pathways, including mediators and confounders, that may influence patient survival and is designed to guide future research and implementation strategies for PBT in emergency medical services.

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

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.