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Charles J. Gerardo

Professor of Emergency Medicine
Emergency Medicine
Box 3096 Med Ctr, Durham, NC 27710
Box 3096 DUMC, Durham, NC 27710

Selected Publications


Capacity of community health centers to treat snakebite envenoming in indigenous territories of the Brazilian Amazon.

Journal Article Toxicon · April 2024 INTRODUCTION: The deaths from and morbidities associated with snakebites - amputations, loss of function in the limb, visible scarring or tissue damage - have a vast economic, social, and psychological impact on indigenous communities in the Brazilian Amaz ... Full text Link to item Cite

Scaling up antivenom for snakebite envenoming in the Brazilian Amazon: a cost-effectiveness analysis.

Journal Article Lancet Reg Health Am · January 2024 BACKGROUND: Snakebite envenoming (SBE) affects nearly three million people yearly, causing up to 180,000 deaths and 400,000 cases of permanent disability. Brazil's state of Amazonas is a global hotspot for SBE, with one of the highest annual incidence rate ... Full text Link to item Cite

Development and validation of a minimum requirements checklist for snakebite envenoming treatment in the Brazilian Amazonia.

Journal Article PLoS Negl Trop Dis · January 2024 BACKGROUND: Currently, antivenoms are the only specific treatment available for snakebite envenoming. In Brazil, over 30% of patients cannot access antivenom within its critical care window. Researchers have therefore proposed decentralizing to community h ... Full text Link to item Cite

Antivenom access impacts severity of Brazilian snakebite envenoming: A geographic information system analysis.

Journal Article PLoS Negl Trop Dis · June 2023 BACKGROUND: Snakebite envenoming (SBE) is a neglected tropical disease capable of causing both significant disability and death. The burden of SBE is especially high in low- and middle-income countries. The aim of this study was to perform a geospatial ana ... Full text Link to item Cite

River dataset as a potential fluvial transportation network for healthcare access in the Amazon region.

Journal Article Sci Data · April 6, 2023 Remote areas, such as the Amazon Forest, face unique geographical challenges of transportation-based access to health services. As transportation to healthcare in most of the Amazon Forest is only possible by rivers routes, any travel time and travel dista ... Full text Link to item Cite

"Two Cultures in Favor of a Dying Patient": Experiences of Health Care Professionals Providing Snakebite Care to Indigenous Peoples in the Brazilian Amazon.

Journal Article Toxins (Basel) · March 3, 2023 In the Brazilian Amazon, deaths and disabilities from snakebite envenomations (SBEs) are a major and neglected problem for the indigenous population. However, minimal research has been conducted on how indigenous peoples access and utilize the health syste ... Full text Link to item Cite

Perspectives on snakebite envenoming care needs across different sociocultural contexts and health systems: A comparative qualitative analysis among US and Brazilian health providers.

Journal Article Toxicon X · March 2023 With the advancements in therapeutics and available treatment options, almost all deaths and permanent disabilities from snakebite envenoming (SBE) are preventable. The challenge lies in implementing these evidence-based treatments and practices across dif ... Full text Link to item Cite

Snakebite envenoming in Brazilian children: clinical aspects, management and outcomes.

Journal Article J Trop Pediatr · February 6, 2023 Snakebite envenoming is currently considered a neglected tropical disease, which affects over 5 million people worldwide, and causes almost 150 000 deaths every year, as well as severe injuries, amputations and other sequelae. Snakebite envenoming in child ... Full text Link to item Cite

A global core outcome measurement set for snakebite clinical trials.

Journal Article Lancet Glob Health · February 2023 Snakebite clinical trials have often used heterogeneous outcome measures and there is an urgent need for standardisation. A globally representative group of key stakeholders came together to reach consensus on a globally relevant set of core outcome measur ... Full text Link to item Cite

The BRAVO Clinical Study Protocol: Oral Varespladib for Inhibition of Secretory Phospholipase A2 in the Treatment of Snakebite Envenoming.

Journal Article Toxins (Basel) · December 28, 2022 INTRODUCTION: Snakebite is an urgent, unmet global medical need causing significant morbidity and mortality worldwide. Varespladib is a potent inhibitor of venom secretory phospholipase A2 (sPLA2) that can be administered orally via its prodrug, varespladi ... Full text Link to item Cite

Mapping of clinical management resources for snakebites and other animal envenomings in the Brazilian Amazon.

Journal Article Toxicon X · December 2022 Snakebite envenomings (SBEs) and other envenomings triggered by venomous animals (VAEs) represent a significant disease burden in Brazil, with 29,152 SBEs reported in 2021 alone with nearly half of those occurring in the remote Brazilian Amazon. In 2021, B ... Full text Link to item Cite

A systematic review and meta-analysis of clinical signs, symptoms, and imaging findings in patients with suspected renal colic.

Journal Article J Am Coll Emerg Physicians Open · December 2022 STUDY OBJECTIVE: The objective of this study was to conduct a systematic review and meta-analysis of the diagnostic accuracy of the clinical signs, symptoms, laboratory investigations, and imaging modalities commonly used in patients with clinically suspec ... Full text Link to item Cite

Pregnancy outcomes after snakebite envenomations: A retrospective cohort in the Brazilian Amazonia.

Journal Article PLoS Negl Trop Dis · December 2022 Snakebite envenomations (SBEs) in pregnant women can result in adverse maternal or neonatal effects, such as abortion, placental abruption, preterm labor, fetal malformations, and maternal, fetal or neonatal deaths. Despite the high incidence of SBEs in th ... Full text Link to item Cite

Delayed Recognition of Severe Systemic Envenomation after Copperhead Bite: A Case Report.

Journal Article Clin Pract Cases Emerg Med · August 2022 INTRODUCTION: We report a case of severe systemic copperhead, Agkistrodon contortrix, envenomation that resulted in long-term sequelae. CASE REPORT: A 72-year-old man presented to the emergency department after suffering a copperhead snakebite. He develope ... Full text Link to item Cite

Antivenom Does Not Cause Snakebite Complications, Withholding It Does.

Journal Article The American surgeon · June 2022 We read with interest the retrospective chart review "Crotalidae Polyvalent Immune Fab and Cost-Effective Management of Hospital Admission for Snakebites" by Bowden, et al. The efficacy of US snake antivenoms has been well established for decades. A random ... Full text Cite

Validation of a Culturally Relevant Snakebite Envenomation Clinical Practice Guideline in Brazil.

Journal Article Toxins (Basel) · May 28, 2022 Snakebite envenoming (SBE) is a neglected tropical disease with significant global morbidity and mortality. Even when antivenom is available in low-resource areas, health workers do not receive adequate training to manage SBEs. This study aims to develop a ... Full text Link to item Cite

Capacity of community health centers to treat snakebite envenoming in indigenous territories of the Brazilian Amazon.

Journal Article Toxicon · April 2024 INTRODUCTION: The deaths from and morbidities associated with snakebites - amputations, loss of function in the limb, visible scarring or tissue damage - have a vast economic, social, and psychological impact on indigenous communities in the Brazilian Amaz ... Full text Link to item Cite

Scaling up antivenom for snakebite envenoming in the Brazilian Amazon: a cost-effectiveness analysis.

Journal Article Lancet Reg Health Am · January 2024 BACKGROUND: Snakebite envenoming (SBE) affects nearly three million people yearly, causing up to 180,000 deaths and 400,000 cases of permanent disability. Brazil's state of Amazonas is a global hotspot for SBE, with one of the highest annual incidence rate ... Full text Link to item Cite

Development and validation of a minimum requirements checklist for snakebite envenoming treatment in the Brazilian Amazonia.

Journal Article PLoS Negl Trop Dis · January 2024 BACKGROUND: Currently, antivenoms are the only specific treatment available for snakebite envenoming. In Brazil, over 30% of patients cannot access antivenom within its critical care window. Researchers have therefore proposed decentralizing to community h ... Full text Link to item Cite

Antivenom access impacts severity of Brazilian snakebite envenoming: A geographic information system analysis.

Journal Article PLoS Negl Trop Dis · June 2023 BACKGROUND: Snakebite envenoming (SBE) is a neglected tropical disease capable of causing both significant disability and death. The burden of SBE is especially high in low- and middle-income countries. The aim of this study was to perform a geospatial ana ... Full text Link to item Cite

River dataset as a potential fluvial transportation network for healthcare access in the Amazon region.

Journal Article Sci Data · April 6, 2023 Remote areas, such as the Amazon Forest, face unique geographical challenges of transportation-based access to health services. As transportation to healthcare in most of the Amazon Forest is only possible by rivers routes, any travel time and travel dista ... Full text Link to item Cite

"Two Cultures in Favor of a Dying Patient": Experiences of Health Care Professionals Providing Snakebite Care to Indigenous Peoples in the Brazilian Amazon.

Journal Article Toxins (Basel) · March 3, 2023 In the Brazilian Amazon, deaths and disabilities from snakebite envenomations (SBEs) are a major and neglected problem for the indigenous population. However, minimal research has been conducted on how indigenous peoples access and utilize the health syste ... Full text Link to item Cite

Perspectives on snakebite envenoming care needs across different sociocultural contexts and health systems: A comparative qualitative analysis among US and Brazilian health providers.

Journal Article Toxicon X · March 2023 With the advancements in therapeutics and available treatment options, almost all deaths and permanent disabilities from snakebite envenoming (SBE) are preventable. The challenge lies in implementing these evidence-based treatments and practices across dif ... Full text Link to item Cite

Snakebite envenoming in Brazilian children: clinical aspects, management and outcomes.

Journal Article J Trop Pediatr · February 6, 2023 Snakebite envenoming is currently considered a neglected tropical disease, which affects over 5 million people worldwide, and causes almost 150 000 deaths every year, as well as severe injuries, amputations and other sequelae. Snakebite envenoming in child ... Full text Link to item Cite

A global core outcome measurement set for snakebite clinical trials.

Journal Article Lancet Glob Health · February 2023 Snakebite clinical trials have often used heterogeneous outcome measures and there is an urgent need for standardisation. A globally representative group of key stakeholders came together to reach consensus on a globally relevant set of core outcome measur ... Full text Link to item Cite

The BRAVO Clinical Study Protocol: Oral Varespladib for Inhibition of Secretory Phospholipase A2 in the Treatment of Snakebite Envenoming.

Journal Article Toxins (Basel) · December 28, 2022 INTRODUCTION: Snakebite is an urgent, unmet global medical need causing significant morbidity and mortality worldwide. Varespladib is a potent inhibitor of venom secretory phospholipase A2 (sPLA2) that can be administered orally via its prodrug, varespladi ... Full text Link to item Cite

Mapping of clinical management resources for snakebites and other animal envenomings in the Brazilian Amazon.

Journal Article Toxicon X · December 2022 Snakebite envenomings (SBEs) and other envenomings triggered by venomous animals (VAEs) represent a significant disease burden in Brazil, with 29,152 SBEs reported in 2021 alone with nearly half of those occurring in the remote Brazilian Amazon. In 2021, B ... Full text Link to item Cite

A systematic review and meta-analysis of clinical signs, symptoms, and imaging findings in patients with suspected renal colic.

Journal Article J Am Coll Emerg Physicians Open · December 2022 STUDY OBJECTIVE: The objective of this study was to conduct a systematic review and meta-analysis of the diagnostic accuracy of the clinical signs, symptoms, laboratory investigations, and imaging modalities commonly used in patients with clinically suspec ... Full text Link to item Cite

Pregnancy outcomes after snakebite envenomations: A retrospective cohort in the Brazilian Amazonia.

Journal Article PLoS Negl Trop Dis · December 2022 Snakebite envenomations (SBEs) in pregnant women can result in adverse maternal or neonatal effects, such as abortion, placental abruption, preterm labor, fetal malformations, and maternal, fetal or neonatal deaths. Despite the high incidence of SBEs in th ... Full text Link to item Cite

Delayed Recognition of Severe Systemic Envenomation after Copperhead Bite: A Case Report.

Journal Article Clin Pract Cases Emerg Med · August 2022 INTRODUCTION: We report a case of severe systemic copperhead, Agkistrodon contortrix, envenomation that resulted in long-term sequelae. CASE REPORT: A 72-year-old man presented to the emergency department after suffering a copperhead snakebite. He develope ... Full text Link to item Cite

Antivenom Does Not Cause Snakebite Complications, Withholding It Does.

Journal Article The American surgeon · June 2022 We read with interest the retrospective chart review "Crotalidae Polyvalent Immune Fab and Cost-Effective Management of Hospital Admission for Snakebites" by Bowden, et al. The efficacy of US snake antivenoms has been well established for decades. A random ... Full text Cite

Validation of a Culturally Relevant Snakebite Envenomation Clinical Practice Guideline in Brazil.

Journal Article Toxins (Basel) · May 28, 2022 Snakebite envenoming (SBE) is a neglected tropical disease with significant global morbidity and mortality. Even when antivenom is available in low-resource areas, health workers do not receive adequate training to manage SBEs. This study aims to develop a ... Full text Link to item Cite

Control of venom-induced tissue injury in copperhead snakebite patients: a post hoc sub-group analysis of a clinical trial comparing F(ab')2 to Fab antivenom.

Journal Article Clin Toxicol (Phila) · April 2022 INTRODUCTION: Fab antivenom (FabAV) halts progression of tissue injury and improves recovery in copperhead snakebite. It is unknown if F(ab')2AV does as well. The objective of this study was to compare control of tissue injury in copperhead snakebite patie ... Full text Link to item Cite

Patient-level interventions to reduce alcohol-related harms in low- and middle-income countries: A systematic review and meta-summary.

Journal Article PLoS Med · April 2022 BACKGROUND: Disease and disability from alcohol use disproportionately impact people in low- and middle-income countries (LMICs). While varied interventions have been shown to reduce alcohol use in high-income countries, their efficacy in LMICs has not bee ... Full text Link to item Cite

BITES study: A qualitative analysis among emergency medicine physicians on snake envenomation management practices.

Journal Article PLoS One · 2022 INTRODUCTION: Antivenom is currently considered standard treatment across the full spectrum of severity for snake envenomation in the United States. Although safe and effective antivenoms exist, their use in clinical practice is not universal. OBJECTIVE: T ... Full text Link to item Cite

Contextualizing the Impact of Snakebite Envenoming on Patients: A Qualitative Content Analysis of Patient-Specific Functional Scale Activities Using the International Classification of Functioning, Disability and Health.

Journal Article Int J Environ Res Public Health · September 12, 2021 To categorize the Patient-specific Functional Scale (PSFS) activities in snakebite envenoming (SBE) using the International Classification of Function (ICF) model in order to describe the impact of SBE on patients' activities and daily lives and to develop ... Full text Link to item Cite

Clinical Policy: Critical Issues in the Management of Adult Patients Presenting to the Emergency Department With Community-Acquired Pneumonia

Journal Article Annals of Emergency Medicine · January 1, 2021 This clinical policy from the American College of Emergency Physicians is a revision of the 2009 “Clinical Policy: Critical Issues in the Management of Adult Patients Presenting to the Emergency Department With Community-Acquired Pneumonia.” A writing subc ... Full text Cite

Association of a Network of Immunologic Response and Clinical Features With the Functional Recovery From Crotalinae Snakebite Envenoming.

Journal Article Front Immunol · 2021 BACKGROUND: The immunologic pathways activated during snakebite envenoming (SBE) are poorly described, and their association with recovery is unclear. The immunologic response in SBE could inform a prognostic model to predict recovery. The purpose of this ... Full text Open Access Link to item Cite

Alcohol stigma as it relates to drinking behaviors and perceptions of drink drivers: A mixed method study in Moshi, Tanzania.

Journal Article Alcohol · November 2020 BACKGROUND: Alcohol is a leading risk factor for road traffic injury in low- and middle-income countries, such as Tanzania. This research seeks to explore the drinking patterns, perceptions, and stigma of drink driving behavior of injury patients at Kilima ... Full text Link to item Cite

Clinical Policy: Critical Issues Related to Opioids in Adult Patients Presenting to the Emergency Department

Journal Article Annals of Emergency Medicine · September 1, 2020 This clinical policy from the American College of Emergency Physicians addresses key issues in opioid management in adult patients presenting to the emergency department. A writing subcommittee conducted a systematic review of the literature to derive evid ... Full text Cite

Testing for HIV infection in the emergency departments of 2 hospitals in the Southeastern United States

Journal Article JACEP Open · August 1, 2020 Background: In 2006, the Centers for Disease Control and Prevention (CDC) recommended non-targeted, opt-out HIV screening in all healthcare settings, including emergency departments (EDs). Multiple HIV testing programs have been implemented in EDs across t ... Full text Cite

In reply to Dr. Shah and Dr. Beuhler.

Journal Article Clin Toxicol (Phila) · March 2020 Full text Link to item Cite

Patterns of Emergency Care for Possible Acute Coronary Syndrome Among Patients with Chest Pain or Shortness of Breath at a Tanzanian Referral Hospital.

Journal Article Glob Heart · February 6, 2020 BACKGROUND: Acute coronary syndrome (ACS) is thought to be a rare diagnosis in sub-Saharan Africa, but little is known about diagnostic practices for patients with possible ACS symptoms in the region. OBJECTIVE: To describe current care practices for patie ... Full text Open Access Link to item Cite

Recovery from Copperhead Snake Envenomation: Role of Age, Sex, Bite Location, Severity, and Treatment.

Conference J Med Toxicol · January 2020 INTRODUCTION: Few data exist to understand the recovery phase of pit viper envenomation. A recently published placebo-controlled clinical trial affords this opportunity. The purpose of this study is to examine the time course of recovery from copperhead sn ... Full text Link to item Cite

Injury patients' perceptions of drink-driving: A qualitative assessment of drink-driving behavior in Moshi, Tanzania.

Journal Article PLoS One · 2020 BACKGROUND: Globally, about 2.3 billion people are current alcohol drinkers, and 283 million have an alcohol use disorder. Alcohol use while driving is a major contributor to road traffic injuries (RTI). We need to understand the culture and perception of ... Full text Link to item Cite

An analysis of emergency care delays experienced by traumatic brain injury patients presenting to a regional referral hospital in a low-income country.

Journal Article PLoS One · 2020 BACKGROUND: Trauma is a leading cause of death and disability worldwide. In low- and middle-income countries (LMICs), trauma patients have a higher risk of experiencing delays to care due to limited hospital resources and difficulties in reaching a health ... Full text Open Access Link to item Cite

Antivenom accessibility impacts mortality and severity of Brazilian snake envenomation: a geospatial information systems analysis

Journal Article · 2020 Background In 2017, the World Health Organization declared the snakebite envenomation as a neglected tropical disease. Annually, snakebite envenomation causes approximately 400,000 permanent disabilities and 95,000 deaths worldwide. People with th ... Full text Cite

Physician Perceptions Impacting Snake Envenomation Treatment

Conference ANNALS OF EMERGENCY MEDICINE · 2020 Cite

Validity and reliability of telephone administration of the patient-specific functional scale for the assessment of recovery from snakebite envenomation.

Journal Article PLoS Negl Trop Dis · December 2019 OBJECTIVES: Although more than 1.8 million people survive snakebite envenomation each year, their recovery is understudied. Obtaining long-term follow-up is challenging in both high- and low-resource settings. The Patient-Specific Functional Scale (PSFS) i ... Full text Open Access Link to item Cite

Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Acute Headache.

Journal Article Ann Emerg Med · October 2019 This clinical policy from the American College of Emergency Physicians addressed key issues in the evaluation and management of adult patients presenting to the emergency department with acute headache. A writing subcommittee conducted a systematic review ... Full text Link to item Cite

Response to carpenter and colleagues.

Journal Article Clin Toxicol (Phila) · July 2019 Full text Link to item Cite

Antivenom Treatment Is Associated with Fewer Patients using Opioids after Copperhead Envenomation.

Journal Article West J Emerg Med · May 2019 INTRODUCTION: Copperhead envenomation causes local tissue destruction, leading people to seek treatment for the pain and swelling. First-line treatment for the pain is opioid medications. There is rising concern that an initial opioid prescription from the ... Full text Link to item Cite

Does This Patient Have a Severe Snake Envenomation?: The Rational Clinical Examination Systematic Review.

Journal Article JAMA Surg · April 1, 2019 IMPORTANCE: Venomous snakebite severity ranges from an asymptomatic dry bite to severe envenomation and death. The clinical evaluation aids in prognosis and is essential to determine the risks and potential benefits of antivenom treatment. OBJECTIVES: To i ... Full text Link to item Cite

Early administration of Fab antivenom resulted in faster limb recovery in copperhead snake envenomation patients.

Journal Article Clinical toxicology (Philadelphia, Pa.) · January 2019 BackgroundNo previous research has studied whether early snake antivenom administration leads to better clinical outcomes than late antivenom administration in North American pit viper envenomation.MethodsA secondary analysis of data from ... Full text Cite

The validity, reliability and minimal clinically important difference of the patient specific functional scale in snake envenomation.

Journal Article PLoS One · 2019 OBJECTIVE: Valid, reliable, and clinically relevant outcome measures are necessary in clinical studies of snake envenomation. The aim of this study was to evaluate the psychometric (validity and reliability) and clinimetric (minimal clinically important di ... Full text Link to item Cite

Adverse Events in the Efficacy of Crotalidae Polyvalent Immune Fab Antivenom vs Placebo in Recovery from Copperhead Snakebite Trial.

Journal Article South Med J · December 2018 OBJECTIVE: To compare the incidence of hypersensitivity reactions following copperhead envenomation treated with Fab antivenom (FabAV) or placebo. METHODS: Patients with copperhead snakebites received treatment and follow-up in a prospective, randomized, d ... Full text Link to item Cite

Clinical Policy: Critical Issues in the Evaluation and Management of Emergency Department Patients With Suspected Non-ST-Elevation Acute Coronary Syndromes.

Journal Article Ann Emerg Med · November 2018 This clinical policy from the American College of Emergency Physicians addresses key issues in the evaluation and management of patients with suspected non-ST-elevation acute coronary syndromes. A writing subcommittee conducted a systematic review of the l ... Full text Link to item Cite

NHAMCS Validation of Emergency Severity Index as an Indicator of Emergency Department Resource Utilization.

Journal Article West J Emerg Med · September 2018 INTRODUCTION: Triage systems play a vital role in emergency department (ED) operations and can determine how well a given ED serves its local population. We sought to describe ED utilization patterns for different triage levels using the National Hospital ... Full text Link to item Cite

Injury prevalence and safety habits of boda boda drivers in Moshi, Tanzania: A mixed methods study.

Journal Article PLoS One · 2018 BACKGROUND: Traffic crashes are a major cause of global morbidity and mortality disproportionately affecting low- and middle-income countries (LMICs). Motorcycle taxi (boda boda) drivers are particularly vulnerable because they are exposed to traffic risks ... Full text Link to item Cite

In reply.

Journal Article Ann Emerg Med · December 2017 Full text Link to item Cite

In reply.

Journal Article Ann Emerg Med · December 2017 Full text Link to item Cite

Correction: Correction to 'Clinical Policy: Procedural Sedation and Analgesia in the Emergency Department' [Annals of Emergency Medicine 63 (2014) 247-258.e18].

Journal Article Ann Emerg Med · November 2017 Due to a miscommunication during the process of transferring this manuscript from our editorial team to Production, the Members of the American College of Emergency Physicians Clinical Policies Committee (Oversight Committee) were not properly indexed in P ... Full text Link to item Cite

Correction: Correction to 'Clinical Policy: Critical Issues in the Evaluation of Adult Patients With Suspected Transient Ischemic Attack in the Emergency Department' [Annals of Emergency Medicine 68 (2016) 354-370.e29].

Journal Article Ann Emerg Med · November 2017 Due to a miscommunication during the process of transferring this manuscript from our editorial team to Production, the Members of the American College of Emergency Physicians Clinical Policies Committee (Oversight Committee) were not properly indexed in P ... Full text Link to item Cite

Correction: Correction to 'Clinical Policy for Well-Appearing Infants and Children Younger Than 2 Years of Age Presenting to the Emergency Department With Fever' [Annals of Emergency Medicine 67 (2016) 625-639.e13].

Journal Article Ann Emerg Med · November 2017 Due to a miscommunication during the process of transferring this manuscript from our editorial team to Production, the Members of the American College of Emergency Physicians Clinical Policies Committee (Oversight Committee) were not properly indexed in P ... Full text Link to item Cite

Correction: Correction to 'Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients With Suspected Acute Nontraumatic Thoracic Aortic Dissection' [Annals of Emergency Medicine 65 (2015) 32-42.e12].

Journal Article Ann Emerg Med · November 2017 Due to a miscommunication during the process of transferring this manuscript from our editorial team to Production, the Members of the American College of Emergency Physicians Clinical Policies Committee (Oversight Committee) were not properly indexed in P ... Full text Link to item Cite

Correction: Correction to 'Clinical Policy: Use of Intravenous Tissue Plasminogen Activator for the Management of Acute Ischemic Stroke in the Emergency Department' [Annals of Emergency Medicine 66 (2015) 322-333.e31].

Journal Article Ann Emerg Med · November 2017 Due to a miscommunication during the process of transferring this manuscript from our editorial team to Production, the Members of the American College of Emergency Physicians Clinical Policies Committee (Oversight Committee) were not properly indexed in P ... Full text Link to item Cite

Correction: Correction to 'Clinical Policy: Critical Issues in the Initial Evaluation and Management of Patients Presenting to the Emergency Department in Early Pregnancy' [Annals of Emergency Medicine 69 (2017) 241-250.e20].

Journal Article Ann Emerg Med · November 2017 Due to a miscommunication during the process of transferring this manuscript from our editorial team to Production, the Members of the American College of Emergency Physicians Clinical Policies Committee (Oversight Committee) were not properly indexed in P ... Full text Link to item Cite

Correction: Correction to 'Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Acute Carbon Monoxide Poisoning' [Annals of Emergency Medicine 69 (2017) 98-107.e6].

Journal Article Ann Emerg Med · November 2017 Due to a miscommunication during the process of transferring this manuscript from our editorial team to Production, the Members of the American College of Emergency Physicians Clinical Policies Committee (Oversight Committee) were not properly indexed in P ... Full text Link to item Cite

The Efficacy of Crotalidae Polyvalent Immune Fab (Ovine) Antivenom Versus Placebo Plus Optional Rescue Therapy on Recovery From Copperhead Snake Envenomation: A Randomized, Double-Blind, Placebo-Controlled, Clinical Trial.

Journal Article Ann Emerg Med · August 2017 STUDY OBJECTIVE: Copperhead snake (Agkistrodon contortrix) envenomation causes limb injury resulting in pain and disability. It is not known whether antivenom administration improves limb function. We determine whether administration of antivenom improves ... Full text Link to item Cite

Mortality-Associated Characteristics of Patients with Traumatic Brain Injury at the University Teaching Hospital of Kigali, Rwanda.

Journal Article World Neurosurg · June 2017 OBJECTIVE: Traumatic brain injury (TBI) is a leading cause of death and disability. Patients with TBI in low and middle-income countries have worse outcomes than patients in high-income countries. We evaluated important clinical indicators associated with ... Full text Link to item Cite

A prospective registry evaluating the epidemiology and clinical care of traumatic brain injury patients presenting to a regional referral hospital in Moshi, Tanzania: challenges and the way forward.

Journal Article Int J Inj Contr Saf Promot · March 2017 Traumatic brain injury (TBI) is the most common cause of death and disability globally disproportionately affecting low- and middle-income countries where increasing injury rates are compounded by limited quality care. The objective of this study is to des ... Full text Link to item Cite

Coagulation parameters in copperhead compared to other Crotalinae envenomation: secondary analysis of the F(ab')2 versus Fab antivenom trial.

Journal Article Clin Toxicol (Phila) · February 2017 CONTEXT: Coagulation derangements in copperhead envenomation are considered less severe than other crotaline envenomations, resulting in recommendations to limit both coagulation testing and antivenom treatment. A prospective, blinded, multicenter, randomi ... Full text Link to item Cite

Quality of the Development of Traumatic Brain Injury Clinical Practice Guidelines: A Systematic Review.

Journal Article PLoS One · 2016 Traumatic brain injury (TBI) is a leading cause of death worldwide and is increasing exponentially particularly in low and middle income countries (LMIC). To inform the development of a standard Clinical Practice Guideline (CPG) for the acute management of ... Full text Link to item Cite

Marked Hypofibrinogenemia and Gastrointestinal Bleeding After Copperhead (Agkistrodon contortrix) Envenomation.

Journal Article Wilderness Environ Med · December 2015 Compared with other crotaline envenomations, copperhead envenomations have historically been reported as having less severe hematologic venom effects and rarely hemorrhage. We report a case of clinically significant gastrointestinal bleeding after a copper ... Full text Link to item Cite

Prospective study of recovery from copperhead snake envenomation: an observational study.

Journal Article BMC Emerg Med · May 15, 2015 BACKGROUND: Although much is known about signs, symptoms, and management in the acute phase of crotaline snake envenomation, little is known about signs, symptoms, function, and quality of life during the recovery phase. The purpose of this observational p ... Full text Link to item Cite

Copperhead Envenomation Resulting in a Rare Case of Hand Compartment Syndrome and Subsequent Fasciotomy.

Journal Article Plast Reconstr Surg Glob Open · May 2015 Copperhead bites account for nearly 40% of all snakebites in the United States. Although common, these bites are rarely severe, and most are treated with supportive care and antivenom. We describe the first reported case of a copperhead envenomation result ... Full text Link to item Cite

Ethical considerations in design of a study to evaluate a US Food and Drug Administration-approved indication: antivenom versus placebo for copperhead envenomation.

Journal Article Clin Trials · October 2014 BACKGROUND: In 2000, the US Food and Drug Administration approved CroFab(®) Crotalidae Polyvalent Immune Fab, ovine (FabAV), which had received orphan drug designation, for use in patients with minimal to moderate North American crotaline envenomations inc ... Full text Link to item Cite

Clinical policy: procedural sedation and analgesia in the emergency department.

Journal Article Ann Emerg Med · February 2014 This clinical policy from the American College of Emergency Physicians is the revision of a 2005 clinical policy evaluating critical questions related to procedural sedation in the emergency department.1 A writing subcommittee reviewed the literature to de ... Full text Link to item Cite

Time to Antivenom Administration in Snakebite

Conference ANNALS OF EMERGENCY MEDICINE · October 1, 2013 Link to item Cite

Analysis of traumatic injuries presenting to a referral hospital emergency department in Moshi, Tanzania.

Journal Article Int J Emerg Med · June 8, 2012 BACKGROUND: Injuries represent a significant and growing public health concern in the developing world, yet their impact on patients and the emergency health-care system in the countries of East Africa has received limited attention. This study evaluates t ... Full text Open Access Link to item Cite

Does this patient have a severe upper gastrointestinal bleed?

Journal Article JAMA · March 14, 2012 CONTEXT: Emergency physicians must determine both the location and the severity of acute gastrointestinal bleeding (GIB) to optimize the diagnostic and therapeutic approaches. OBJECTIVES: To identify the historical features, symptoms, signs, bedside maneuv ... Full text Link to item Cite

Dental visits to a North Carolina emergency department: a painful problem.

Journal Article N C Med J · 2012 BACKGROUND: Emergency departments (EDs) act as the safety net and alternative care site for patients without insurance who have dental pain. METHODS: We conducted a retrospective chart review of visits to an urban teaching hospital ED over a 12-month perio ... Link to item Cite

An observation unit may help improve an institution's Press Ganey satisfaction score.

Journal Article Crit Pathw Cardiol · June 2011 BACKGROUND: : Hospitals measure patient satisfaction through Press Ganey (PG) surveys. The impact of an emergency department observation unit (EDOU) on patient satisfaction has not been reported to date. We hypothesize that an EDOU has a positive impact on ... Full text Link to item Cite

The rapid impact on mortality rates of a dedicated care team including trauma and emergency physicians at an academic medical center.

Journal Article J Emerg Med · May 2011 BACKGROUND: Trauma center designation can result in improved patient outcomes after injuries. Whereas the presence of trauma teams has been associated with improved trauma patient outcomes, the specific components, including the role of emergency medicine ... Full text Link to item Cite

Off-service resident education in the emergency department: outline of a national standardized curriculum.

Journal Article Acad Emerg Med · December 2009 Although many residency programs mandate at least one rotation in emergency medicine (EM), to the best of our knowledge, a standardized curriculum for emergency department (ED) rotations for "off-service" residents has not been developed. As a result, the ... Full text Link to item Cite

328: Long-Term Limb Function Outcomes Following Copperhead Snakebite

Conference Annals of Emergency Medicine · October 2008 Full text Cite

Forced versus minimal intravenous hydration in the management of acute renal colic: a randomized trial.

Journal Article J Endourol · October 2006 BACKGROUND AND PURPOSE: The management of acute renal colic is a problem commonly encountered by both urologists and emergency medicine physicians. The classic approach to managing uncomplicated acute renal colic involves hydration, along with imaging and ... Full text Link to item Cite

Initial experience with Crotalidae polyvalent immune Fab (ovine) antivenom in the treatment of copperhead snakebite.

Journal Article Ann Emerg Med · February 2004 STUDY OBJECTIVE: Crotalidae polyvalent immune Fab (ovine) (CroFab; FabAV) effectively treats patients bitten by rattlesnakes. The copperhead snake (Agkistrodon contortrix) caused 37% of venomous snakebites reported to US poison centers in 2001 and is the m ... Full text Link to item Cite