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Article
Peer Reviewed

Adult Male with Traumatic Eye Pain and Swelling

Clinical Practice and Cases in Emergency Medicine, Volume 2, Issue 2 (2018)

Creative Commons 'BY' version 4.0 license

Article
Peer Reviewed

Point-of-care Ultrasound Diagnosis of an Atypical Acute Aortic Dissection

Clinical Practice and Cases in Emergency Medicine, Volume 2, Issue 4 (2018)

Aortic dissections have a vast array of clinical presentations that rarely follow traditional teachings. Dissections are rapidly fatal conditions requiring immediate diagnosis and treatment to reduce morbidity and mortality. We present a case of an acute aortic dissection presenting as abrupt onset, atraumatic leg pain with absent distal extremity pulses. The prompt use of point-of-care ultrasound detected an intimal flap within the abdominal aorta allowing immediate surgical consultation and intervention.

Cover page: Point-of-care Ultrasound Diagnosis of an Atypical Acute Aortic Dissection

Article
Peer Reviewed

Point-of-care Ultrasound Diagnosis of Acute Abdominal Aortic Occlusion

Clinical Practice and Cases in Emergency Medicine, Volume 4, Issue 1 (2020)

Acute aortic occlusion is an emergent vascular condition not encountered routinely. Given its varied presentations, including neurovascular deficits and mimicking an acute abdomen, the diagnosis is often delayed causing increased morbidity and mortality. We present a case of acute abdominal aortic occlusion masquerading as sudden onset lower extremity pain and weakness in an 86-year-old female requiring emergent thrombectomy. This is only the second case report to discuss the use of point-of-care ultrasound to expedite diagnosis and management.1

Cover page: Point-of-care Ultrasound Diagnosis of Acute Abdominal Aortic Occlusion

Article

Acute Epiglottitis Secondary to the Severe Acute Respiratory Syndrome Coronavirus 2: A Case Report

Clinical Practice and Cases in Emergency Medicine, Volume 7, Issue 3 (2023)

Introduction: Acute epiglottis is a rapidly progressive, potentially life-threatening infection causing inflammation of the epiglottis and adjacent supraglottic structures.1-2 Since the introduction of the Haemophilus influenzae vaccine, the incidence of pediatric cases has decreased dramatically while adult instances have increased.1-4 Likewise, the etiology has changed considerably with the increasing prevalence of other causative bacterial and viral pathogens.1-4

Case Report: We present a novel case of acute epiglottis secondary to infection with the severe acute respiratory syndrome coronavirus 2. This case report highlights the changing landscape of epiglottitis and the importance of airway assessment.

Conclusion: Present-day epiglottitis differs greatly from our traditional understanding. Numerous etiologies beyond Haemophilus influenzae now afflict adults predominately. As a clinically significant, novel complication of coronavirus disease 2019, acute epiglottitis is a life-threatening airway emergency. Emergency physicians must maintain a high index of suspicion, especially given the evolving clinical landscape. Early airway assessment with nasopharyngolaryngoscopic is critical.

1 supplemental video

Cover page: Acute Epiglottitis Secondary to the Severe Acute Respiratory Syndrome Coronavirus 2: A Case Report

Article

(O-A1) Point-of-care Ocular Ultrasound vs Ophthalmoscopy for the Evaluation of Acute Visual Complaints in the Emergency Department

Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, Volume 25, Issue 1.1 (2024)

Article
Peer Reviewed

Diagnostic Accuracy of a Handheld Ultrasound vs a Cart-based Model: A Randomized Clinical Trial

Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, Volume 25, Issue 2 (2024)

Introduction: Numerous studies have demonstrated the accuracy of point-of-care ultrasound (POCUS). Portable, handheld devices have expanded the clinical scope of POCUS at a fraction of the cost of traditional, cart-based models. There is a paucity of data assessing the diagnostic accuracy of portable devices. Our objective in this study was to compare the diagnostic accuracy of a portable device with a cart-based model.

Methods: This was an institutional review board-approved, observational, prospective, randomized clinical trial (NCT05196776) of a convenience sample of adult patients who presented to a university-based health system. Patients who required a cardiac, lung, renal, aorta, or biliary POCUS were randomized to a portable device or to a cart-based model. We hypothesized that the cart-based model would have a 90% diagnostic accuracy vs 70% for the handheld device. To detect a 20% difference, the sample size was calculated to be 98, with 49 patients randomized to each arm. We used standard 2x2 tables to calculate test characteristics with 95% conﬁdence intervals (CI).

Results: A total of 110 patients were enrolled, with 56 patients randomized to the cart-based model and 54 to the handheld device. The sensitivity, speciﬁcity, and diagnostic accuracy of the cart-based vs handheld were 77.8% (40–97.2) vs 92.9% (66.1–99.8), 91.5% (79.6–97.6) vs 92.3% (79.1–98.4%), and 89.3% (78.1–96) vs 92.5% (81.8–97.9), respectively.

Conclusion: The diagnostic accuracy of a portable, handheld device is similar to that of a cart-based model.

Cover page: Diagnostic Accuracy of a Handheld Ultrasound vs a Cart-based Model: A Randomized Clinical Trial

Article
Peer Reviewed

Toward a neutrino-limited dark matter search with crystalline xenon

LBL Publications (2024)

Experiments searching for weakly interacting massive particle dark matter are now detecting background events from solar neutrino-electron scattering. However, the dominant radioactive background in state-of-the-art experiments such as LZ and XENONnT is beta decays from radon contamination. In spite of careful detector material screening, radon progenitor atoms are ubiquitous and long-lived, and radon is extremely soluble in liquid xenon. We propose a change of phase and demonstrate that crystalline xenon offers more than a factor ×500 exclusion against radon ingress, compared with the liquid state. This level of radon exclusion would allow crystallized versions of existing experiments to probe spin-independent cross sections near 10-47 cm2 in roughly 11 years, as opposed to the 35 years required otherwise.