SPECIAL CONTRIBUTIONS

International Emergency Medicine: A Review

of the Literature From 2010
Miriam Aschkenasy, MD, MPH, Kris Arnold, MD, MPH, Mark Foran, MD, MPH, Suzanne Lippert, MD,
MS, Erika D. Schroeder, MD, MPH, Karina Bertsch, MSW, and Adam C. Levine, MD, MPH,
on behalf of the International Emergency Medicine Literature Review Group

Abstract
The International Emergency Medicine (IEM) Literature Review aims to highlight and disseminate
high-quality global EM research in the fields of EM development, disaster and humanitarian response,
and emergency care in resource-limited settings. For this review, we conducted a Medline search for
articles published between January 1 and December 31, 2010, using a set of international and EM search
terms and a manual search of journals that have produced large numbers of IEM articles for past
reviews. This search produced 6,936 articles, which were divided among 20 reviewers who screened
them using established inclusion and exclusion criteria to select articles relevant to the field of IEM.
Two-hundred articles were selected by at least one reviewer and approved by an editor for scoring.
Two independent reviewers using a standardized and predetermined set of criteria then scored each of
the 200 articles. The 27 top-scoring articles were chosen for full review. The articles this year trended
toward evidence-based research for treatment and care options in resource-limited settings, with an
emphasis on childhood illness and obstetric care. These articles represent examples of high-quality inter-
national emergency research that is currently ongoing in high-, middle-, and low-income countries alike.
This article is not intended to serve as a systematic review or clinical guideline but is instead meant to
be a selection of current high-quality IEM literature, with the hope that it will foster further growth in
the field, highlight evidence-based practice, and encourage discourse.
ACADEMIC EMERGENCY MEDICINE 2011; 18:872–879 ª 2011 by the Society for Academic Emergency
Medicine

T
he International Emergency Medicine (IEM) resource-limited settings. The goals of the review are to
Literature Review, now in its sixth year, began as illustrate best practices, stimulate additional research,
an effort to summarize and categorize the grow- and promote further professionalization of the field of
ing field of IEM. The current mission of the review is to IEM. This task becomes more challenging every year, as
highlight and disseminate high-quality global EM the field of IEM continues to grow exponentially, and the
research in the fields of EM development, disaster and body of IEM literature being produced has evolved from
humanitarian response, and emergency care in a pond to a sea.
As we wade through this body of work, we find that
From the Department of Emergency Medicine, Cambridge
the boundaries of IEM itself have expanded. In the past
Hospital (MA), Cambridge, MA; Harvard Humanitarian Initia-
several years, new issues such as pandemic influenza,1
tive (MA, MF, ACL), Cambridge, MA; ArLac Health Services
the growth of EM as a specialty throughout the world,
(KA), Boston, MA; the Department of Emergency Medicine,
and increasing access to digital resources have pro-
Brigham and Women’s Hospital (MF), Boston, MA; the Divi-
vided new and fertile ground for a discussion on what
sion of Emergency Medicine, Stanford University (SL), Palo
constitutes ‘‘international emergency medicine.’’2 Using
Alto, CA; the Department of Emergency Medicine, George
our overall mission and goals as a guide, this year we
Washington University (EDS), Washington, DC; and the
refined the screening criteria and limited the search to
Department of Emergency Medicine, Rhode Island Hospital
original research and review articles. In addition, we
(KB, ACL), Providence, RI.
created a standardized point system to grade each arti-
Received April 26, 2011; accepted April 28, 2011.
cle that passed the initial screening process. Thousands
The authors declare that they have no conflict of interest with
of articles presented themselves in the initial searches,
regards to the publication of this work. No external funding was
and through our screening and scoring processes, we
provided for this literature review.
chose 27 individual articles for full review.
Supervising Editor: Mark Hauswald, MD.
For the first time this year, we also undertook
Address for correspondence and reprints: Miriam Aschkenasy,
a search of the gray literature. Gray literature
MD, MPH; e-mail: maschkemd@hotmail.com.
has been defined as any material not produced by an

ISSN 1069-6563 ª 2011 by the Society for Academic Emergency Medicine

872 PII ISSN 1069-6563583 doi: 10.1111/j.1553-2712.2011.01129.x
ACADEMIC EMERGENCY MEDICINE • August 2011, Vol. 18, No. 8
organization whose primary function is publication and
includes theses, technical reports, white papers, news-
letters, slide presentations, government documents, and
private and nonprofit organization reports.3 Content in
the gray literature domain has grown much more rap-
idly than the body of material available through formal
publishing services. The concept of gray literature was
developed around finding information of value to
researchers in items such as unpublished research
reports and similar, more structured publications. In
addition, what constitutes gray literature has been
expanding rapidly with the growth of internet use and
on-line information sources, such as conference pro-
ceedings, blogs, video postings, and social networking
sites. These expanding sources of potentially useful
information place an increasing burden on the user to
perform due diligence regarding the source and validity
of posted information he or she may wish to use. With
the widening scope of gray literature has come increas-
ing discussion regarding assessment of validity of the
information presented. While we did not feel that any
articles from the gray literature search met our criteria
for inclusion in the 2010 review, we anticipate that this
may change in the coming years.
While this year’s review spans the field of IEM, it is
by no means a comprehensive review of the existing
IEM literature, nor is it meant to be used as a clinical
guideline. Rather, it is meant to provide the IEM practi-
tioner and researcher with insight into the current field
of work and generate opportunities for new learning
and research.
METHODS
Each year, the editorial board for the IEM Literature
Review Group produces a procedure manual that out-
lines in detail the methodology for its search, screening,
scoring, and reviewing processes.4 As a review article,
no prior ethical or institutional review board approval
was sought for this article. None of the authors or
reviewers reported any conflict of interest. Although
reviewers and editors were not blinded to the authors
of the articles included in the review or their affilia-
tions, in all cases both reviewers and editors recused
themselves from scoring or reviewing any articles in
which they may have been directly or indirectly
involved.
The initial search was conducted in two periods, the
first from January 1 to August 31, 2010, and the second
from September 1 to December 31, 2010. We used Pub-
Med to search Medline for original research or review
articles that contained at least one ‘‘international’’
search term and one ‘‘emergency medicine’’ search
term. The EM search terms included emergency medi-
cine, refugees, emergency treatment, relief work, rescue
work, acute disease, humanitarian, critical illness, war,
pre-hospital, conflict, triage, disasters, multiple trauma,
injuries, internally displaced persons, and emergency
medical services. The international search terms
included world health, developing countries, interna-
tional, global, tropical medicine, third world, middle
income countries, and low income countries. A manual
search of journals that previously have published a
• www.aemj.org 873
significant number of IEM articles that were included in
our prior reviews was also performed. This year, the
following journals were included in the manual search:
Academic Emergency Medicine, Annals of Emergency
Medicine, Bulletin of the World Health Organization,
Emergency Medicine Journal, and Prehospital and
Disaster Medicine.
This year, we limited our search to articles published
in English, Spanish, French, Japanese, Chinese (Manda-
rin), German, and Dutch based on the linguistic capac-
ity of our reviewers and editors. All studies were
limited to human subjects only, and news articles and
letters were excluded.
The total number of articles produced by our Pub-
Med search for 2010 was 4,615, including 4,476 English,
40 German, 32 Japanese, 31 French, 28 Spanish, 5 Chi-
nese, and 3 Dutch. The total number of articles pro-
duced by our manual search for 2010 was 2,321. The
6,936 articles produced by these two searches were
divided up amongst 20 reviewers for initial screening
based on their relevance to the field on IEM. Two-hun-
dred articles were deemed appropriate by at least one
reviewer and approved by his or her editor for formal
scoring of their overall quality and importance.
Once selected for scoring, the full-text article was
obtained and categorized as either an original research
or a review article. Each article was then scored by two
separate reviewers using a grading scale that ranged
from 0 to 25 (Table 1). All articles with a score differ-
ence between reviewers that was greater than one stan-
dard deviation above the median score difference were
rescored by an editor. The new score was then used as
the official score for the article. Overall, 27 articles had
a score of 21 or greater and were chosen for formal
review. These articles were then distributed to review-
ers who produced summaries and critiques of the
articles, which were edited by their individual editors.
This year, we also introduced a new ‘‘gray literature
search,’’ the goal of which was to identify new IEM
research conducted by government agencies, local or
international nongovernment organizations, or other
entities that may not have been published in an indexed
journal. A search of the Internet for documents related
to the underlying mission of the review was undertaken
using phrases constructed from our mission statement.
Trial searches were performed using ‘‘advanced
search’’ mode in different search engines: Google,
Lycos, Dogpiles, AltaVista, and MetaCrawler. Struc-
tured collections of gray literature were also reviewed
for relevant publications (Table 2). Google advanced
search was chosen as seeming to have the most adapt-
able input interface and results management. Search
string combinations were then constructed combining
elements of the mission statement as they might appear
within either titles or bodies of documents. The search
structure was limited to Adobe Portable Document File
(.pdf) file types to capture more formalized documents.
A set of exclusion terms was constructed to eliminate
formal publishing and cataloging services, including the
National Library of Medicine, PubMed, and commercial
publishers. Searches of items from the title and short
excerpts presented in the results led to further related
documents. The gray literature search did not uncover
874 Aschkenasy et al. • IEM: REVIEW OF THE LITERATURE 2010

Table 1
Review Scoring Criteria

Original Articles Points Review Articles Points

Clarity Clearly stated study 2 Clearly stated purpose for review 2
hypothesis or purpose
Sufficient background provided 1 Sufficient background provided 1
Understandable to nonprofessional 1 Understandable to nonprofessional 1
Clear language used 1 Clear language, appropriate 1
throughout article use of tables and figures
Design Controlled trial or RCT 2 Formal systematic review or meta-analysis 1–2
Little or no bias in 1 Study selection clear 1
selection of subjects and reproducible
Adequate blinding 1 Articles selected by at 1
of study subjects least 2 blinded authors
Correct statistical 1 Data aggregated and ⁄ or 1
tests used for analysis analyzed appropriately
Ethics Approved by international IRB 2 Authors provide an unbiased assessment of the data 4
Approved by local 1
IRB ⁄ local ethical review
Written ⁄ verbal consent 1 Authors state whether they 1
obtained from subjects have conflicts of interest
Procedures comply with 1
local standard of care
Importance Results are generalizable 2 Results are generalizable 2
to a variety of settings to a variety of settings
Results are clinically significant 1 Results are clinically significant 1
Addresses an important 1 Addresses an important 1
global health topic global health topic
Topic is clearly relevant to IEM 1 Topic is clearly relevant to IEM 1
Impact Recommendations 2 Recommendations can 2
can be applied in LMICs be applied in LMICs
The proposed intervention 1 The proposed recommendations 1
is cost-effective are cost-effective
Study results are likely 1 Study results are likely 1
to change practice to change practice
Study results likely to 1 Study results likely to 1
stimulate further research stimulate further research

IEM = international emergency medicine; IRB = institutional review board; LMIC = low- and middle-income country; RCT =
randomized controlled trial.

any IEM original research studies or formal literature found in Data Supplement S1 (available as supporting
reviews; therefore, no findings from the gray literature information in the online version of this paper).
search were included in this year’s review.
DISCUSSION
RESULTS
The articles selected for the 2010 review show a clear
The articles chosen for final review are listed in Table 3 5–31 emphasis on the development of new evidence-based,
and categorized as EM development, humanitarian and low-cost interventions for low- and middle-income
disaster response, or emergency care in resource-lim- countries (LMICs), as well as the effects of humanitar-
ited settings. An annotated bibliography, including final ian disasters on health. They cover many diverse
summary and critical analysis of each article, can be fields within development, disaster and humanitarian
response, and health care in resource-limited settings,
with a focus on prevention, treatment, and training and
Table 2 education. There is also a predominance of articles
Grey Literature Database Resources related to children’s health and to the health of
pregnant women and newborns.
New York http://www.nyam.org/
Academy of library/online-resources/ Emergency Care in Resource-limited Settings
Medicine Library grey-literature-report/ By far the largest number of articles could be catego-
GreyNet http://www.greynet.org/
GreySource greysourceindex.html
rized as evidence-based EM practice in resource-limited
OpenDOAR from http://www.opendoar.org/ settings, in particular, practices relating to pediatric
U. of Nottingham, EM. Geduld et al.5 validated the Broselow tape as the
England best estimate for children’s weight in Western Cape,
South Africa. Kabra et al.6 looked at evidence-based
ACADEMIC EMERGENCY MEDICINE • August 2011, Vol. 18, No. 8 • www.aemj.org 875

Table 3
Top 27 International EM Articles of 2010

Category First Author, Reference Title Journal

Emergency care Geduld5 Validation of weight estimation Emergency Medicine
in resource-limited by age and length based methods in the Journal
settings Western Cape, South Africa population.
Kabra6 Antibiotics for community-acquired Cochrane Database
pneumonia in children.
7
Bouyou-Akotet Efficacy and safety of a new Wien Klin Wochenschr
pediatric artesumate-mefloquine drug
formulation for the treatment of
uncomplicated falciparum malaria
in Gabon.
Pilger8 Household-wide ivermectin Bulletin of the World
treatment for head lice in an Health Organization
impoverished community: randomized
observer-blinded controlled trial.
Munos9 The effect of oral rehydration solution International Journal
and recommended home fluids on of Epidemiology
diarrhea mortality.
Allen10 Probiotics for treating acute Cochrane Database
infectious diarrhoea.
Rabbani11 Green banana-supplemented Tropical Medicine &
diet in the home management International Health
of acute and prolonged diarrhea in
children: a community-based
trial in rural Bangladesh.
Levine12 Ultrasound assessment of Academic Emergency
severe dehydration in children Medicine
with diarrhea and vomiting.
Ghimire13 Community-based interventions Bulletin of the World
for diarrhoeal diseases and Health Organization
acute respiratory infections in Nepal.
Brooks14 Influenza is a major contributor Pediatric Infectious
to childhood pneumonia in Disease Journal
a tropical developing country.
Winikoff15 Treatment of post-partum haemorrhage Lancet Infectious
with sublingual misoprostol Diseases
versus oxytocin in women not
exposed to oxytocin during labour: a
double-blind, randomized, non-inferiority trial.
Blum16 Treatment of post-partum haemorrhage Lancet Infectious Diseases
with sublingual misoprostol versus
oxytocin in women receiving prophylactic
oxytocin: a double-blind, randomized,
non-inferiority trial.
Barros17 Global report on preterm birth and stillbirth. BMC Pregnancy
and Childbirth
Mwansa-Kambafwile18 Antenatal steroids in preterm International Journal of
labour for the prevention of neonatal Epidemiology
deaths due to complications of preterm birth.
Disaster and Feikin19 Mortality and health among Bulletin of the World
humanitarian internally displaced persons. Health Organization
20
response Donaldson Injury burden during an insurgency: The Journal of Trauma
the untold trauma of infrastructure
breakdown in Baghdad, Iraq.
Berger21 An intervention for reducing secondary International Journal
traumatization and improving professional of Nursing Studies
self-efficacy in well baby clinic
nurses following war and terror: a
random control group trial.
Zraly22 Don’t let the suffering make you Social Science & Medicine
fade away: an ethnographic study of
resilience among survivors of genocide-rape
in southern Rwanda.
Walker23 British military experience Journal of the Royal Army
of pre-hospital paediatric Medical Corps
trauma in Afghanistan.
Sadewasser24 Defining a standard medication Emergency Medicine
kit for prehospital and retrieval physicians: Journal
a comprehensive review.
876 Aschkenasy et al. • IEM: REVIEW OF THE LITERATURE 2010

Table 3
(Continued)

Category First Author, Reference Title Journal

Emergency Schmucker25 Road traffic crashes in developing countries. Unfallchirurg
medicine Ranney26 A novel ED-based sexual assault centre Emergency Medicine
development in western Kenya: description of patients Journal
and analysis of treatment patterns.
Alam27 Partner notification for sexually BMC Public Health
transmitted infections in developing
countries: a systematic review.
Corbett28 Provider-initiated symptom screening Bulletin of the World
for tuberculosis in Zimbabwe: diagnostic value Health Organization
and the effect of HIV status.
Nakahara29 Exploring referral systems for injured Health Policy and Planning
patients in low-income countries:
a case study from Cambodia.
van Lonkhuijzen30 A systematic review of the effectiveness British Journal of Obstetrics
of training in emergency obstetric care in and Gynecology
low-resource environments.
Carlo31 High mortality rates for very low Pediatrics
birth weight infants in developing countries
despite training.

antibiotic use in community-acquired pneumonia in
children, while Bouyou-Akotet et al.7 demonstrated that
a pediatric artesunate-mefloquine formulation was effi-
cacious, safe, and well-tolerated for treatment of
malaria in African children. Finally, Pilger et al.8 were
able to show that treating the entire household with
ivermectin lengthened the amount of time free from
head lice infestation in children.
Acute diarrhea was also well researched in the past
year. Several studies looked at treatment options
including Munos et al.,9 who conducted a systematic
review of the effects of oral rehydration solution and
recommended home fluids on diarrhea-associated
mortality; Allen et al.,10 who looked at probiotics as
having a safe and beneficial role in the treatment of
acute infectious diarrhea; and Rabbani et al.,11 who
demonstrated that green banana is effective in
decreasing the duration of illness in both acute and
prolonged diarrhea for children being treated at home.
Levine et al.12 used ultrasound measurement of the
aorta-to-inferior vena cava ratio as an adjunct in the
diagnosis of severe dehydration in children with diar-
rhea in a resource-limited setting. Respiratory illness
in children was also well represented in our review.
Ghimire et al.13 reviewed a successful community-
based intervention in Nepal that employed community
health worker volunteers to diagnose, treat, and
appropriately refer patients to health care facilities to
combat acute diarrheal and respiratory illnesses and
the effect of those interventions on child mortality.
Brooks et al.14 looked at the influence of influenza as a
significant contributor to childhood pneumonia in a
tropical setting.
Another clear area of IEM research in 2010 was
related to pregnancy. Winikoff et al.15 demonstrated
that misoprostol is a reasonable alternative for post-
partum hemorrhage when oxytocin is not available.
Blum et al.16 conducted a double-blinded, randomized
trial showing that sublingual misoprostol is equivalent
to oxytocin in the setting of postpartum bleeding in
women who have been prophylactically exposed to
oxytocin during the third stage of labor. Barros
et al.17 reviewed the effectiveness of current interven-
tions related to preterm birth and stillbirth and
Mwansa-Kambafwile et al.18 reviewed the effective-
ness of antenatal steroids for reducing mortality in
preterm labor neonates.
Humanitarian and Disaster Response
Several strong studies emerged in the area of humani-
tarian and disaster response, which looked at the
effects of population displacement, war, and trauma on
health. Feikin et al.19 researched internally displaced
persons as a result of the 2009 Kenyan postelection vio-
lence and found that they were at greater risk for death
due to HIV and for hospital admission for childhood ill-
ness. Donaldson et al.20 conducted a cross-sectional
household survey assessing the increased injury burden
within the war-affected Baghdad Governorate of
central Iraq. The postconflict setting was evaluated by
Berger and Gelkopf,21 showing that improved clinical
and psychosocial training among well-baby clinic
nurses working in regions exposed to war and
terror decreased secondary traumatization. Zraly and
Nyirazinyoye22 evaluated the expression of resilience in
two different postgenocide support groups in Rwanda.
The final two papers in this category both looked at air
medical services in the emergency setting. Walker
et al.23 reported on a prehospital helicopter-borne
response team deployed in Afghanistan, while Sade-
wasser et al.24 reviewed an Australian air medical ser-
vice to provide a standardized, evidence-based list of
essential prehospital medications needed for response.
EM Development
As shown by the articles included in this year’s review,
development of the specialty is becoming more focused
on diseases with high burdens of morbidity and mortal-
ity, such as road traffic accidents, HIV, tuberculosis,
and sexually transmitted infections (STIs). Road traffic
accidents in resource-limited settings cause a large
burden of disability and require multidisciplinary efforts
ACADEMIC EMERGENCY MEDICINE • August 2011, Vol. 18, No. 8
to effectively address the problem. This was reviewed
in detail by Schmucker et al.25 Ranney et al.26 looked at
an ED-based sexual assault assessment and treatment
center in Kenya that was able to provide high rates of
HIV prophylaxis, STI treatment, and emergency contra-
ception without the addition of significant external
resources, while Alam et al.27 reviewed STI partner
notification and discussion of barriers to notification in
developing countries. Corbett et al.28 showed that pro-
vider screening for tuberculosis, based on symptoms
alone, could safely identify patients at very low risk for
tuberculosis infection—limiting the need for testing,
even among individuals who are HIV positive.
The effect of both EM training and referral systems
were represented in this year’s article selections as
well. Nakahara et al.29 evaluated referral systems for
traumatically injured patients in Cambodia. Two stud-
ies investigated obstetric training programs and
demonstrated the importance of focused research that
looks at all aspects of care in resource-limited settings.
Van Lonkhuijzen et al.,30 looking at graduate-trained
health professionals and excluding traditional birth
attendants, showed training programs in emergency
obstetric care may improve quality of care and overall
outcomes. Further research on this issue by Carlo
et al.,31 however, seemed to show that training courses
in neonatal care for birth attendants did not decrease
the mortality of very-low-birth-weight infants in the
developing world.
Gray Literature
Finally, while we did not include any articles obtained
from the gray literature search, the growing digital
field of informal publication is worth discussing. The
vast amount of information available on the Internet
includes much that may be useful to persons inter-
ested in the various aspects of IEM. Many reports of
projects currently in process or recently completed
offer insights for which there currently is no good
forum for exchange among colleagues. Searching for
such information is currently a tedious process
requiring multiple searches with variations on search
strings in an attempt to capture the varied ways in
which a concept may be expressed, in either the title
or the text of available documents. Searching through
and reading documents from the gray literature offers
an opportunity to develop a good sense of the spec-
trum of international emergency medical care from
local conditions to global policy, as well as opportuni-
ties for involvement in the process of improving
global emergency medical care.
CONCLUSIONS
International emergency medicine is an ever-changing
and fast-growing field. As the specialty expands, the
relevant body of work has increased exponentially in
the past few years. Choosing 27 articles from the
existing pool of qualified articles was a daunting task.
These articles were chosen to represent examples of
both high-quality and high-impact international emer-
gency medicine research currently being conducted in
• www.aemj.org 877
nearly every part of the world. It is by no means an
exhaustive list of articles, nor is it meant to be.
Rather, it is a sampling of the current literature,
which we hope will foster further growth in the field,
highlight evidence-based practice and encourage
global discourse.
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APPENDIX A
The International Emergency Medicine Literature
Review Group consisted of David Anthony, MD, MPH
(NY Presbyterian ⁄ Columbia ⁄ Cornell, New York, New
York, NY); Kris Arnold, MD, MPH (ArLac Health
Services, Boston, MA); Miriam Aschkenasy, MD, MPH
(Department of Emergency Medicine, Cambridge
Hospital, Cambridge, MA; and Harvard Humanitarian
Initiative, Cambridge, MA); Joseph Becker, MD
(Division of Emergency Medicine, Stanford University,
Palo Alto, CA); Torben Kim Becker, MD (University of
Heidelberg, Heidelberg, Germany); Jennifer Chan, MD,
MPH (Department of Emergency Medicine, Northwest-
ern Memorial Hospital, Chicago, IL); Herbert C. Duber,
MD, MPH (Tufts University School of Medicine, Boston,
MA; and Department of Emergency Medicine, Baystate
Medical Center, Springfield, MA); Mark Foran, MD,
MPH (Harvard Humanitarian Initiative, Cambridge,
MA; Department of Emergency Medicine, Brigham and
Women’s Hospital, Boston, MA); Elizabeth Goldberg,
MD (Department of Emergency Medicine, Rhode Island
Hospital, Providence RI); Cheryl Lynn Horton, MD
(Department of Emergency Medicine, Brigham and
Women’s Hospital, Boston, MA); Gabrielle Jacquet, MD
(Denver Health Med Center, Denver, CO); Joshua Jau-
regui, MD (Department of Emergency Medicine, Rhode
Island Hospital, Providence RI); Sandeep Johar, DO,
MS (Hartford Hospital, Hartford, CT); Aditi Joshi, MD,
MSc (Department of Emergency Medicine, Jersey City
Medical Center, Jersey City, NJ); Sampsa Kiuru, MD,
FACEM (S. Carelia Central Hospital, Lappeenranta,
Finland); Adam Levine, MD, MPH (Harvard Humanitar-
ian Initiative, Cambridge, MA; Department of Emer-
gency Medicine, Rhode Island Hospital, Providence RI);
Xiaoguang Li, MD (Shanghai United Family Hospital,
China); Suzanne Lippert, MD, MS (Division of Emer-
gency Medicine, Stanford University, Palo Alto, CA);
Kevin Lunney, MD, PhD (Department of Emergency
Medicine, UCSF Fresno, Fresno, CA); Dan Millikan,
MD (Providence Regional Medical Center, Everett,
WA); Terrence Mulligan, DO, MPH (Department
of Emergency Medicine, University of Maryland
School of Medicine, Baltimore, MD); Takashi Nagata,
ACADEMIC EMERGENCY MEDICINE • August 2011, Vol. 18, No. 8
MD (Department of Emergency Medicine, Kyushu Uni-
versity Hospital, Japan); Theresa Nguyen, MD (Christi-
ana Care Health System, Newark, DE); Usha
Periyanayagam, MD, MPH, MS (Department of
Emergency Medicine, Northwestern Memorial Hospital,
Chicago, IL); Kimberly Pringle, MD (Department of
Emergency Medicine, Rhode Island Hospital, Provi-
dence RI); Stephanie Rosborough, MD, MPH (Harvard
Humanitarian Initiative, Cambridge, MA; and Depart-
ment of Emergency Medicine, Brigham and Women’s
Hospital, Boston, MA); Erika D. Schroeder, MD, MPH
(Department of Emergency Medicine, George Washing-
ton University, Washington DC); Timothy Tan, MD
(Department of Emergency Medicine, Brigham and
Women’s Hospital, Boston, MA); Charles Washington,
MD, MPH (Department of Emergency Medicine,
University of New Mexico Hospital, Albuquerque, NM);
• www.aemj.org 879
Ambrose H. Wong, MD (Department of Emergency
Medicine, NYU Langone Medical Center ⁄ Bellevue
Hospital Center, New York, NY); and Meghan Wood,
MD (Harbor-UCLA Medical Center, Torrance, CA).
Supporting Information
The following supporting information is available in
the online version of this paper:
Data Supplement S1. Emergency Care in Resource-
Limited Settings.
The document is in PDF format.
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