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BMC Emergency Medicine

Miriam Luginbühl, Timo Junker, Dagmar I Keller
BACKGROUND: Smuggling of illegal drugs by hiding them inside one's own body, also called body packing, is a worldwide phenomenon. Cocaine is the most frequently transported drug. Body packing is a potentially lethal practice. The most serious complications of body packing are gastrointestinal obstruction or perforation and drug toxicity due to packet leakage or rupture. CASE PRESENTATION: A 30-year-old confirmed body packer was brought to our emergency department from jail because of agitation and mydriasis...
September 4, 2018: BMC Emergency Medicine
Daniel Kornhall, Robert Näslund, Cecilia Klingberg, Regina Schiborr, Mikael Gellerfors
BACKGROUND: Physician-staffed helicopter emergency services (HEMS) can provide benefit through the delivery of specialist competence and equipment to the prehospital scene and through expedient transport of critically ill patients to specialist care. This paper describes the integration of such a system in a rural Swedish county. METHODS: This is a retrospective database study recording the outcomes of every emergency call centre dispatch request as well as the clinical and operational data from all completed missions during this service's first year in operation...
August 29, 2018: BMC Emergency Medicine
Nolan Mann, Kellen Welch, Andrew Martin, Michael Subichin, Katherine Wietecha, Lauren E Birmingham, Tiffany D Marchand, Richard L George
BACKGROUND: Falls are a common cause of hospitalization, morbidity, and mortality among the elderly in the United States. Evidence-based imaging recommendations for evaluation of delayed intracranial hemorrhage (DICH) are not generally agreed upon. The purpose of this project was to evaluate the incidence of DICH detected by head computer tomography (CT) among an elderly population on pre-injury anticoagulant or antiplatelet (ACAP) therapy. METHODS: Data from a Level 1 Trauma Center trauma registry was used to assess the incidence of DICH in an elderly population of patients (≥65 years) who sustained a minor fall while on pre-injury ACAP medications...
August 24, 2018: BMC Emergency Medicine
Charles Morin, Jacques Choukroun, Jean-Christophe Callahan
BACKGROUND: Primary care patients are often cited as a cause of Emergency Department overcrowding (ED). The aim of this study was to evaluate a physician led redirection procedure of selected patients towards an out of hours general practice (OHGP) in an Emergency Department with 55,000 admissions per year. METHODS: Observational monocentric study over a period of 2 months. Every patient redirected to the OHGP was included and subsequently contacted by telephone to answer a standardized questionnaire, in order to measure: Redirection rate over the entire period and during weekdays or weekends/holiday Rate of redirected patients who went to the OHGP Rate of redirected patients who consulted in an ED in the next 72 h for the same reason Redirected patients' satisfaction rate RESULTS: During the study period 9551 patients presented to the ED, of which 288 were redirected towards the OHGP (3%)...
August 22, 2018: BMC Emergency Medicine
Christian B Mogensen, Helene Skjøt-Arkil, Annmarie T Lassen, Isik S Johansen, Ming Chen, Poul Petersen, Karen V Andersen, Svend Ellermann-Eriksen, Jørn M Møller, Marc Ludwig, David Fuglsang-Damgaard, Finn Nielsen, Dan B Petersen, Ulrich S Jensen, Flemming S Rosenvinge
BACKGROUND: Multiresistant bacteria (MRB) is an increasing problem. Early identification of patients with MRB is mandatory to avoid transmission and to target the antibiotic treatment. The emergency department (ED) is a key player in the early identification of patients who are colonized with MRB. There is currently sparse knowledge of both prevalence and risk factors for colonization with MRSA, ESBL, VRE, CPE and CD in acutely admitted patients in Western European countries including Denmark...
August 20, 2018: BMC Emergency Medicine
Natalie Baier, Karsten Roth, Susanne Felgner, Cornelia Henschke
BACKGROUND: The association between burnout and patient safety has been analyzed in many studies for nurses, physicians, and residents. However, studies concerning prehospital emergency medical services (EMS) workers are limited, although they are particularly under risk for emotional stress. This study aims to descriptively analyze the overall degree of burnout among EMS-workers, and potential adverse events that might harm patients as well as the relationship between burnout and perceived safety outcomes for EMS-workers in Germany...
August 20, 2018: BMC Emergency Medicine
Waheeb Nasr Naser, Huda Ba Saleem
BACKGROUND: Medical professionals together with other first responder teams are the first to attend an emergency or disaster. Knowledge and training in emergency and disaster preparedness are important in responding effectively. This study aims to assess the current knowledge, attitude and training in emergency and disaster preparedness among Yemeni health professionals. METHOD: A descriptive, cross-sectional, non-probability based study was conducted in Yemen using self-reported on-line and paper surveys in 2017...
August 6, 2018: BMC Emergency Medicine
Nadir Ijaz, Matthew Strehlow, N Ewen Wang, Elizabeth Pirrotta, Areeba Tariq, Naseeruddin Mahmood, Swaminatha Mahadevan
BACKGROUND: There is little data describing pediatric emergencies in resource-poor countries, such as Pakistan. We studied the demographics, management, and outcomes of patients presenting to the highest-volume, public, pediatric emergency department (ED) in Karachi, Pakistan. METHODS: In this prospective, observational study, we approached all patients presenting to the 50-bed ED during 28 12-h study periods over four consecutive weeks (July 2013). Participants' chief complaints and medical care were documented...
August 3, 2018: BMC Emergency Medicine
Roland C Merchant, Tao Liu, Melissa A Clark, Michael P Carey
BACKGROUND: Although this has not been fully studied, videos and pictorial brochures might be equivalent methods of delivering HIV/AIDS and HIV testing information to emergency departments (ED) patients. It also is not known how well or for how long such knowledge is retained, if this information should be tailored according to patient health literacy, and if retention of this knowledge impacts future HIV testing behavior. METHODS: We will conduct a multi-site, randomized, controlled, longitudinal trial among 600 English- and 600 Spanish-speaking 18-64-year-old ED patients to investigate these questions...
July 9, 2018: BMC Emergency Medicine
Rayan El Sibai, Rana Bachir, Mazen El Sayed
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is increasingly used in resuscitation of critically ill patients with documented improved survival. Few studies describe ECMO use in cardiogenic shock. This study examines ECMO use and identifies variables associated with mortality in patients treated for cardiogenic shock in US hospitals. METHODS: A retrospective observational study of the US Nationwide Emergency Department Sample (NEDS) database of 2013 was conducted...
July 4, 2018: BMC Emergency Medicine
Warren M Perry, Rubayet Hossain, Richard A Taylor
BACKGROUND: The use of big data and machine learning within clinical decision support systems (CDSSs) has the potential to transform medicine through better prognosis, diagnosis and automation of tasks. Real-time application of machine learning algorithms, however, is dependent on data being present and entered prior to, or at the point of, CDSS deployment. Our aim was to determine the feasibility of automating CDSSs within electronic health records (EHRs) by investigating the timing, data categorization, and completeness of documentation of their individual components of two common Clinical Decision Rules (CDRs) in the Emergency Department...
July 3, 2018: BMC Emergency Medicine
Igor Jeroukhimov, Itay Wiser, Yehuda Hershkovitz, Zahar Shapira, Kobi Peleg, Ricardo Alfici, Adi Givon, Boris Kessel
BACKGROUND: Management of stable patients with abdominal stab wound remains controversial, particularly for those with no clear indications for explorative laparotomy. We evaluated the risk of intra-abdominal injury in stab wound victims concomitantly stabbed in other anatomical body areas. METHODS: We performed a retrospective cohort study of patients with abdominal stab wounds recorded in the Israeli National Trauma Registry from January 1st, 1997, to December 31st, 2013...
June 27, 2018: BMC Emergency Medicine
Anna S M Dobbe, Renate Stolmeijer, Jan C Ter Maaten, Jack J M Ligtenberg
BACKGROUND: Liberal use of oxygen in an emergency situation is common. Today, most health care professionals do not adjust the amount of oxygen given when a saturation of 100% or a PaO2 which exceeds the normal range is reached- which may result in hyperoxia. There is increasing evidence for the toxic effects of hyperoxia. Therefore, it seems justified to aim for normoxia when giving oxygen. This study evaluates whether it is feasible to aim for normoxia when giving oxygen therapy to patients at the emergency department (ED)...
June 26, 2018: BMC Emergency Medicine
David Fitzpatrick, Douglas Maxwell, Alan Craigie
BACKGROUND: Poor communication during patient handover is recognised internationally as a root cause of a significant proportion of preventable deaths. Data used in handover is not always easily recorded using ambulance based tablets, particularly in time-critical cases. Paramedics have therefore developed pragmatic workarounds (writing on gloves or scrap paper) to record these data. However, such practices can conflict with policy, data recorded can be variable, easily lost and negatively impact on handover quality...
June 25, 2018: BMC Emergency Medicine
Mohamed Amine Msolli, Kaouther Beltaief, Wahid Bouida, Nahla Jerbi, Mohamed Habib Grissa, Hamdi Boubaker, Riadh Boukef, Semir Nouira
BACKGROUND: The aim of this study is to test the diagnostic value of baseline and early change of C-reactive protein (CRP) concentrations, evaluated separately or in combination with the modified Alvarado score (MAS), in patients with clinically suspected acute appendicitis. METHODS: This is a prospective observational study including all patients presenting to the emergency department with an equivocal diagnosis of acute appendicitis. After inclusion, clinical and demographic data are recorded and blood samples were taken at baseline and 3 h after for serum CRP measurements (3 h CRP)...
May 24, 2018: BMC Emergency Medicine
Abel Negussie, Andarge Getie, Elias Manaye, Tamrat Tekle
BACKGROUND: Traumatic injuries continue to be an important cause of morbidity and mortality in the developing world. Despite the high burden of injury in Ethiopia, the occurrence and health impact have not received due attention. The aim of the study was to assess the prevalence and outcome of injury among patients visiting the Emergency Department (ED) of Yirgalem General Hospital, southern Ethiopia. METHODS: A facility-based prospective cross sectional study was conducted from March, 27 - April, 30/2017...
May 22, 2018: BMC Emergency Medicine
Damien Di Rocco, Mathieu Pasquier, Eric Albrecht, Pierre-Nicolas Carron, Fabrice Dami
BACKGROUND: Helicopter emergency medical services (HEMS) are popular rescue systems despite inconsistent evidence in the scientific literature to support their use for primary interventions, as well as for inter-facility transfer (IFT). There is little research about IFT by HEMS, hence questions remain about the appropriateness of this method of transport. The aim of this study was to describe a case-mix of operational and medical characteristics for IFT activity of a sole HEMS base, and identify indicators of over-triage...
May 16, 2018: BMC Emergency Medicine
Muna Al Jalaf, Hanan Fadali, Rasha Alanee, Firas Najjar, Zulfa Al Deesi, Rania M Seliem, Eric J Nilles
BACKGROUND: Since the 1990s, community-associated methicillin resistant staphylococcus aureus (CA-MRSA) has emerged as an important global cause of skin and soft tissue infections. Little is known about the epidemiology of this pathogen in the Middle East. METHODS: We conducted a prospective observational study in a single large teaching hospital in Dubai to identify the incidence of community-acquired methicillin resistant staphylococcus aureus (MRSA) among ambulatory patients presenting with purulent skin and soft tissue infections...
May 15, 2018: BMC Emergency Medicine
Liliana Pinto, Adriana Lein, Raquel Mahoque, David W Wright, Scott M Sasser, Catherine A Staton
BACKGROUND: In Mozambique, and other low-income countries (LICs), there is little information on the burden of child maltreatment (CM). Emergency care services (ECS) play an important role in recognizing, treating, and intervening in situations of CM. We aim to identify knowledge, attitudes, and practices regarding CM among health care providers in ECS at Mavalane General Hospital in Maputo, Mozambique. METHODS: This exploratory cross-sectional study evaluates the knowledge, attitudes, and practices of health care providers to diagnose and treat cases of CM...
May 9, 2018: BMC Emergency Medicine
Paul I Musey, John A Lee, Cassandra A Hall, Jeffrey A Kline
BACKGROUND: Approximately 80% of patients presenting to emergency departments (ED) with chest pain do not have any true cardiopulmonary emergency such as acute coronary syndrome (ACS). However, psychological contributors such as anxiety are thought to be present in up to 58%, but often remain undiagnosed leading to chronic chest pain and ED recidivism. METHODS: To evaluate ED provider beliefs and their usual practices regarding the approach and disposition of patients with low risk chest pain associated with anxiety, we constructed a 22-item survey using a modified Delphi technique...
March 14, 2018: BMC Emergency Medicine
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