Pub Date : 2025-10-29DOI: 10.1016/j.annemergmed.2025.05.012
Megan A. Rech PharmD, MS, Michael Gottlieb MD
{"title":"Calcium Channel Blockers Should Be Preferentially Used to Treat Atrial Fibrillation with Rapid Ventricular Response","authors":"Megan A. Rech PharmD, MS, Michael Gottlieb MD","doi":"10.1016/j.annemergmed.2025.05.012","DOIUrl":"10.1016/j.annemergmed.2025.05.012","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"87 1","pages":"Pages 79-81"},"PeriodicalIF":5.0,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145382810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-27DOI: 10.1016/j.annemergmed.2025.09.026
Michael Gottlieb,Stephany Nuñez Cruz,Amanda Apato
{"title":"Efficacy and Safety of Levetiracetam in Pediatric Status Epilepticus.","authors":"Michael Gottlieb,Stephany Nuñez Cruz,Amanda Apato","doi":"10.1016/j.annemergmed.2025.09.026","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.09.026","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"3 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145370632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-25DOI: 10.1016/j.annemergmed.2025.09.023
Richard C Dart
{"title":"Snake Antivenom Reactions: A New Finding and Continued Controversy.","authors":"Richard C Dart","doi":"10.1016/j.annemergmed.2025.09.023","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.09.023","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"28 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145357849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-25DOI: 10.1016/j.annemergmed.2025.09.027
Caitlin R. Ryus MD, MPH , Gail D’Onofrio MD, MS , Turner Canty MPH , Michael V. Pantalon PhD , Robert Heimer PhD , Kathryn Hawk MD, MHS
{"title":"Self-Reported Readiness-to-Change Alcohol Use in Emergency Department Patients With Alcohol Use Disorder Is Associated With Linkage to Treatment","authors":"Caitlin R. Ryus MD, MPH , Gail D’Onofrio MD, MS , Turner Canty MPH , Michael V. Pantalon PhD , Robert Heimer PhD , Kathryn Hawk MD, MHS","doi":"10.1016/j.annemergmed.2025.09.027","DOIUrl":"10.1016/j.annemergmed.2025.09.027","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"87 2","pages":"Pages 275-277"},"PeriodicalIF":5.0,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145357850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-23DOI: 10.1016/j.annemergmed.2025.09.020
Lily W Zhou,Vanessa Dizonno,Jennifer Mandzia,Mohammed A Almekhlafi,Fouzi Bala,Ibrahim Alhabli,Maria Karina Villaluna,Princess King-Azote,Namali Ratnaweera,Stephen C Van Gaal,Laura K Wilson,Brett R Graham,Luciano A Sposato,Dylan Blacquiere,Mark I Boulos,Brian H Buck,Celine Odier,Kanjana S Perera,Aleksandra Pikula,Aleksander Tkach,George Medvedev,Michael D Hill,Thalia S Field,
STUDY OBJECTIVECerebral venous thrombosis symptom onset can be insidious and without focal deficits. We performed a planned analysis of care-seeking patterns prior to diagnosis in a Canadian randomized trial examining treatment and prognosis of cerebral venous thrombosis and its companion prospective observational registry to examine whether time to diagnosis or multiple health care encounters prior to diagnosis were associated with 180-day outcomes.METHODSAdults within 14 days of diagnosis of a new symptomatic cerebral venous thrombosis were included. We examined timing from symptom onset to diagnosis and the number of health care encounters for cerebral venous thrombosis symptoms prior to diagnosis. We explored associations between multiple care encounters prior to diagnosis with patient demographics, baseline clinical and radiologic features, and 180-day outcomes.RESULTSOf 102 patients (median age 45 [interquartile range {IQR} 31.0 to 61.0] years, 68.6% women), 40 (39%) had multiple health care encounters for their cerebral venous thrombosis symptoms prior to diagnosis. The median time from symptom onset to diagnosis was 4 (IQR 1 to 8) days. Women had a longer time from symptom onset to diagnosis compared with men (median 5 days [IQR 2 to 8 days] versus 2 days [IQR 1 to 4.5 days]), difference 3 days, 95% confidence interval [CI] 1 to 5 days) and were almost twice as likely as men to have had multiple health care encounters prior to diagnosis (46% versus 25%, difference 21%, 95% CI, 2 to 40). Time from symptom onset to diagnosis and number of health care encounters prior to diagnosis were not associated with adverse 180-day outcomes.CONCLUSIONWomen were more likely to have multiple health care encounters prior to cerebral venous thrombosis diagnosis. However, this was not associated with worse outcomes.
{"title":"Multiple Health Care Encounters Prior to Diagnosis of Cerebral Venous Thrombosis.","authors":"Lily W Zhou,Vanessa Dizonno,Jennifer Mandzia,Mohammed A Almekhlafi,Fouzi Bala,Ibrahim Alhabli,Maria Karina Villaluna,Princess King-Azote,Namali Ratnaweera,Stephen C Van Gaal,Laura K Wilson,Brett R Graham,Luciano A Sposato,Dylan Blacquiere,Mark I Boulos,Brian H Buck,Celine Odier,Kanjana S Perera,Aleksandra Pikula,Aleksander Tkach,George Medvedev,Michael D Hill,Thalia S Field, ","doi":"10.1016/j.annemergmed.2025.09.020","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.09.020","url":null,"abstract":"STUDY OBJECTIVECerebral venous thrombosis symptom onset can be insidious and without focal deficits. We performed a planned analysis of care-seeking patterns prior to diagnosis in a Canadian randomized trial examining treatment and prognosis of cerebral venous thrombosis and its companion prospective observational registry to examine whether time to diagnosis or multiple health care encounters prior to diagnosis were associated with 180-day outcomes.METHODSAdults within 14 days of diagnosis of a new symptomatic cerebral venous thrombosis were included. We examined timing from symptom onset to diagnosis and the number of health care encounters for cerebral venous thrombosis symptoms prior to diagnosis. We explored associations between multiple care encounters prior to diagnosis with patient demographics, baseline clinical and radiologic features, and 180-day outcomes.RESULTSOf 102 patients (median age 45 [interquartile range {IQR} 31.0 to 61.0] years, 68.6% women), 40 (39%) had multiple health care encounters for their cerebral venous thrombosis symptoms prior to diagnosis. The median time from symptom onset to diagnosis was 4 (IQR 1 to 8) days. Women had a longer time from symptom onset to diagnosis compared with men (median 5 days [IQR 2 to 8 days] versus 2 days [IQR 1 to 4.5 days]), difference 3 days, 95% confidence interval [CI] 1 to 5 days) and were almost twice as likely as men to have had multiple health care encounters prior to diagnosis (46% versus 25%, difference 21%, 95% CI, 2 to 40). Time from symptom onset to diagnosis and number of health care encounters prior to diagnosis were not associated with adverse 180-day outcomes.CONCLUSIONWomen were more likely to have multiple health care encounters prior to cerebral venous thrombosis diagnosis. However, this was not associated with worse outcomes.","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"58 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145351702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-17DOI: 10.1016/S0196-0644(25)01257-0
{"title":"Information for Readers","authors":"","doi":"10.1016/S0196-0644(25)01257-0","DOIUrl":"10.1016/S0196-0644(25)01257-0","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"86 5","pages":"Page A10"},"PeriodicalIF":5.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145327181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
STUDY OBJECTIVETo compare the efficacy and safety of subcutaneous versus intranasal ketamine in controlling pain following acute musculoskeletal trauma.METHODSWe conducted a randomized, double-blinded, double-dummy prospective study, including adult participants aged 18 to 65 years, presenting to the emergency department (ED) for acute musculoskeletal trauma with moderate to severe pain. Participants were randomly assigned to receive either 20 mg subcutaneous or intranasal ketamine. Our primary outcome was the reduction in the numerical rating scale (NRS) at 30 minutes, with additional measures at 5, 10, 15, 60, 90, and 120 minutes. Other secondary outcomes were the percentage of patients with a NRS score of less than 3 at the end of the protocol, adverse events, and the need for additional pain medications.RESULTSWe enrolled 599 patients in the subcutaneous group and 595 in the intranasal group. At 30 minutes, the mean NRS decrease from baseline was -3.70 (1.88) in the subcutaneous group and -4.42 (2.15) in the intranasal group, yielding a mean difference of -0.72 (95% confidence interval -0.95 to -0.48). Although statistically significant, this difference, as well as those observed at all other time points, remained below the 1.3 NRS threshold for clinical importance. There was no difference in secondary outcomes except more minor adverse events in the subcutaneous group.CONCLUSIONFor patients presenting to the ED with acute musculoskeletal trauma, we found no clinically important differences in pain reduction between ketamine 20 mg, subcutaneous and ketamine 20 mg, intranasal.
{"title":"Intranasal Versus Subcutaneous Ketamine for the Treatment of Acute Traumatic Pain in the Emergency Department: A Randomized Clinical Trial.","authors":"Randa Dhaoui,Cyrine Kouraichi,Marwa Toumia,Khaoula Bel Haj Ali,Adel Sekma,Rahma Jaballah,Hajer Yaakoubi,Lotfi Boukadida,Kaouthar Beltaief,Zied Mezgar,Mariem Khrouf,Amira Sghaier,Nahla Jerbi,Imen Zemni,Wahid Bouida,Mohamed Habib Grissa,Jamel Saad,Hamdi Boubaker,Riadh Boukef,Mohamed Amine Msolli,Semir Nouira","doi":"10.1016/j.annemergmed.2025.09.019","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.09.019","url":null,"abstract":"STUDY OBJECTIVETo compare the efficacy and safety of subcutaneous versus intranasal ketamine in controlling pain following acute musculoskeletal trauma.METHODSWe conducted a randomized, double-blinded, double-dummy prospective study, including adult participants aged 18 to 65 years, presenting to the emergency department (ED) for acute musculoskeletal trauma with moderate to severe pain. Participants were randomly assigned to receive either 20 mg subcutaneous or intranasal ketamine. Our primary outcome was the reduction in the numerical rating scale (NRS) at 30 minutes, with additional measures at 5, 10, 15, 60, 90, and 120 minutes. Other secondary outcomes were the percentage of patients with a NRS score of less than 3 at the end of the protocol, adverse events, and the need for additional pain medications.RESULTSWe enrolled 599 patients in the subcutaneous group and 595 in the intranasal group. At 30 minutes, the mean NRS decrease from baseline was -3.70 (1.88) in the subcutaneous group and -4.42 (2.15) in the intranasal group, yielding a mean difference of -0.72 (95% confidence interval -0.95 to -0.48). Although statistically significant, this difference, as well as those observed at all other time points, remained below the 1.3 NRS threshold for clinical importance. There was no difference in secondary outcomes except more minor adverse events in the subcutaneous group.CONCLUSIONFor patients presenting to the ED with acute musculoskeletal trauma, we found no clinically important differences in pain reduction between ketamine 20 mg, subcutaneous and ketamine 20 mg, intranasal.","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"1 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145311483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-17DOI: 10.1016/j.annemergmed.2025.09.017
{"title":"Global Research Highlights","authors":"","doi":"10.1016/j.annemergmed.2025.09.017","DOIUrl":"10.1016/j.annemergmed.2025.09.017","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"86 5","pages":"Pages 453-455"},"PeriodicalIF":5.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145327183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-17DOI: 10.1016/j.annemergmed.2025.06.001
James S. Ford MD, MAS, Joseph Morrison BS, Joshua P. Le BS, Atul Malhotra MD, Shamim Nemati PhD, Gabriel Wardi MD, MPH
{"title":"","authors":"James S. Ford MD, MAS, Joseph Morrison BS, Joshua P. Le BS, Atul Malhotra MD, Shamim Nemati PhD, Gabriel Wardi MD, MPH","doi":"10.1016/j.annemergmed.2025.06.001","DOIUrl":"10.1016/j.annemergmed.2025.06.001","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"86 5","pages":"Pages 560-561"},"PeriodicalIF":5.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145327179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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