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BMC Emergency Medicine

Judith E van Zanden, Susanne Wagenaar, Jozine M Ter Maaten, Jan C Ter Maaten, Jack J M Ligtenberg
BACKGROUND: Pain management in the Emergency Department has often been described as inadequate, despite proven benefits of pain treatment protocols. The aim of this study was to investigate the effectiveness of our current pain protocol on pain score and patient satisfaction whilst taking the patients' wishes for analgesia into account. METHODS: We conducted a 10-day prospective observational study in the Emergency Department. Demographics, pain characteristics, Numeric Rating Scale pain scores and the desire for analgesics were noted upon arrival at the Emergency Department...
November 8, 2018: BMC Emergency Medicine
Pham Thi Ngoc Thao, Ton Thanh Tra, Nguyen Truong Son, Koji Wada
BACKGROUND: Sepsis and septic shock are common problems in intensive care units (ICUs). The mortality of patients with sepsis or septic shock is high. We investigated if reduction in the serum concentration of the cytokines tumor necrosis factor α, interleukin (IL)-6 and IL-10, and the rate of change in the IL-6 level at 24 h after ICU admission were survival predictors for patients with sepsis and septic shock in a Vietnamese population. METHODS: This was a prospective study conducted at an ICU in Cho Ray Hospital, Vietnam, from October 2014 to October 2016...
November 6, 2018: BMC Emergency Medicine
Karim Hajjar, Ralphe Bou Chebl, Mohammad Kanso, Gilbert Abou Dagher
BACKGROUND: Blunt abdominal trauma in the setting of polycystic kidney disease is still scantly described in the literature and management guidelines of such patients are not well-established. CASE PRESENTATION: The authors herein present a case of hypovolemic shock secondary to segmental renal artery bleed in a 75-year-old man with polycystic kidney disease after minimal blunt abdominal trauma, who underwent successful selective arterial embolization, and provide a thorough review of similar cases in the literature, while shedding the light on important considerations when dealing with such patients...
November 1, 2018: BMC Emergency Medicine
Samiha Jarrah, Mahfuz Judeh, Mohannad Eid AbuRuz
BACKGROUND: Out-of-hospital cardiac arrest is a major cause of mortality worldwide. When basic life support techniques are implemented quickly, the chance of survival is doubled. Therefore, this study evaluated public awareness, knowledge and attitudes towards basic life support in Jordan. METHODS: A descriptive, cross-sectional design with a convenience sample of 300 Jordanian adults aged over 18 years, recruited from three metropolitan areas in the northern, middle and southern regions...
October 29, 2018: BMC Emergency Medicine
Ardavan Khoshnood
Supplemental oxygen (O2 ) therapy in patients with chest pain has been a cornerstone in the treatment of suspected myocardial infarction (MI). Recent randomized controlled trials have, however, shown that supplemental O2 therapy has no positive nor negative effects on cardiovascular functions, mortality, morbidity or pain in normoxic patients with suspected MI and foremost patients with ST Elevation Myocardial Infarction (STEMI). O2 therapy in normoxic STEMI patients should therefore be omitted. More studies are needed in discussing hemodynamically unstable STEMI patients, as well as patients with non-STEMI, unstable angina and other emergency conditions...
October 20, 2018: BMC Emergency Medicine
Mary Matthews, Peter Richman, Scott Krall, Kimberly Leeson, K Tom Xu, Albert L Gest, Osbert Blow
BACKGROUND: Recurrent CT imaging is believed to significantly increase lifetime malignancy risk. We previously reported that high acuity, admitted trauma patients who received a whole-body CT in the emergency department (ED) had a history of prior CT imaging in 14% of cases. The primary objective of this study was to determine the CT imaging history for trauma patients who received a whole-body CT but were ultimately deemed safe for discharge directly home from the ED. METHODS: This was a retrospective cohort study conducted at an academic ED...
October 16, 2018: BMC Emergency Medicine
Mohammed-Najeeb Mahama, Ernest Kenu, Delia Akosua Bandoh, Ahmed Nuhu Zakariah
BACKGROUND: Every year, about 1.2 million people die through road traffic crashes worldwide. Majority of these deaths occur in Africa where most of their emergency medical services are underdeveloped. In 2004, Ghana established the National Ambulance Council to provide timely and efficient pre-hospital emergency medical care to the sick and injured. Pre-hospital emergency medical service is essential for accident victims since it has the potential of saving lives. The study sought to determine the relationship between pre-hospital trauma survival rate and response time to emergencies and factors associated to pre-hospital trauma survival  in Accra, Ghana...
October 3, 2018: BMC Emergency Medicine
George Mnatzaganian, Janet E Hiller, Jason Fletcher, Mark Putland, Cameron Knott, George Braitberg, Steve Begg, Melanie Bish
BACKGROUND: Socioeconomic inequalities in cardiovascular morbidity have been previously reported showing direct associations between socioeconomic disadvantage and worse health outcomes. However, disagreement remains regarding the strength of the direct associations. The main objective of this panel design was to inspect socioeconomic gradients in admission to a coronary care unit (CCU) or an intensive care unit (ICU) among adult patients presenting with non-traumatic chest pain in three acute-care public hospitals in Victoria, Australia, during 2009-2013...
September 29, 2018: BMC Emergency Medicine
Antonella Cotoia, Federico Franchi, Chiara De Fazio, Jean-Louis Vincent, Jacques Creteur, Fabio Silvio Taccone
BACKGROUND: Platelet variables, including platelet distribution width (PDW) and mean platelet volume (MPV), have been associated with outcome in critically ill patients. We evaluated these variables in patients after cardiac arrest (CA). METHODS: All adult CA patients admitted to the intensive care unit (ICU) over an 8-year period (2006-2014) and treated with targeted temperature management were included. We retrieved all data concerning CA characteristics as well as platelet count, PDW and MPV on the first 2 days of admission...
September 25, 2018: BMC Emergency Medicine
Omid Mehrpour, Ayob Akbari, Firoozeh Jahani, Alireza Amirabadizadeh, Elaheh Allahyari, Borhan Mansouri, Patrick C Ng
BACKGROUND: Acute poisoning is a common chief complaint leading to emergency department visits and hospital admissions in developing countries such as Iran. Data describing the epidemiology of different poisonings, characteristics of the clinical presentations, and the predictors of outcome are lacking. Such data can help develop more efficient preventative and management strategies to decrease morbidity and mortality related to these poisonings. This manuscript describes the epidemiology of acute poisoning among patients admitted to the intensive care unit (ICU) in Birjand, Iran...
September 19, 2018: 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
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