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International Journal of Emergency Medicine

Syed Imran Ayaz, Craig M Sharkey, Gregory M Kwiatkowski, Suprat Saely Wilson, Reba S John, Rosa Tolomello, Arushi Mahajan, Scott Millis, Phillip D Levy
BACKGROUND: Afterload reduction with bolus enalaprilat is used by some for management of acute hypertensive heart failure (HF) but existing data on the safety and effectiveness of this practice are limited. The purpose of this study was to evaluate the clinical effects of bolus enalaprilat when administered to patients with acute hypertensive heart failure. FINDINGS: We performed an IRB-approved retrospective cohort study of patients who presented to the emergency department of a large urban academic hospital...
December 2016: International Journal of Emergency Medicine
Bhakti Hansoti, Adam Levine, Latha Ganti, Rockefeller Oteng, Taylor DesRosiers, Payal Modi, Jeremy Brown
BACKGROUND: Funding for global health has grown significantly over the past two decades. Numerous funding opportunities for international development and research work exist; however, they can be difficult to navigate. The 2013 Academic Emergency Medicine consensus conference on global health and emergency care identified the need to strengthen global emergency care research funding, solidify existing funding streams, and expand funding sources. RESULTS: This piece focuses on the various federal funding opportunities available to support emergency physicians conducting international research from seed funding to large institutional grants...
December 2016: International Journal of Emergency Medicine
Rifat Latifi, Jayleen K L Gunn, John A Stroster, Edmond Zaimi, Fatos Olldashi, Agron Dogjani, Mihal Kerci, Xheladin Draçini, Julian Kuçani, Zhaneta Shatri, Agim Kociraj, Arian Boci, Ross I Donaldson
BACKGROUND: Traumatic injuries have become a substantial but neglected epidemic in low- and middle-income countries (LMICs), but emergency rooms (ERs) in these countries are often staffed with healthcare providers who have minimal emergency training and experience. The aim of this paper was to describe the specialized training, available interventions, and the patient management strategies in the ERs in Albanian public hospitals. METHODS: A cross-sectional descriptive study of 42 ERs in the Republic of Albania between September 5, 2014, and December 29, 2014 was performed...
December 2016: International Journal of Emergency Medicine
Edward K Lew
BACKGROUND: The teaching modality of "flipping the classroom" has garnered recent attention in medical education. In this model, the lecture and homework components are reversed. The flipped classroom lends itself to more interaction in "class" and theoretically improved clinical decision-making. Data is lacking for this model for students in emergency medicine clerkships. We trialed the flipped classroom in our fourth-year student clerkship. Our aim was to learn student and faculty facilitator perceptions of the experience, as it has not been done previously in this setting...
December 2016: International Journal of Emergency Medicine
Suzanne Lilley Katsetos, Roxanne Nagurka, Jaclyn Caffrey, Steven E Keller, Tiffany Murano
BACKGROUND: The purpose of this study was to examine the emergency physician (EP) practice of prescribing prophylactic antibiotics for patients with oral lacerations. A secondary outcome measure was the infection rate of those who were or were not prescribed antibiotics. METHODS: The study was a retrospective chart review of 323 patients who presented to a large urban emergency department (ED) between January 1, 2012 and December 31, 2012 with an oral laceration...
December 2016: International Journal of Emergency Medicine
David Traficante, Alexander Riss, Steven Hochman
BACKGROUND: Intracranial abscesses are rare and life-threatening conditions that typically originate from direct extension from nearby structures, hematogenous dissemination or following penetrating cerebral trauma or neurosurgery. FINDINGS: A 36-year-old male presented to our emergency department with complaints of left eye swelling, headache and drowsiness. On physical exam, the patient was febrile and his left upper eyelid was markedly swollen with fluctuance and drainage...
December 2016: International Journal of Emergency Medicine
Jing Jing Chan, Jen Jen Oh
BACKGROUND: Acupuncture is a form of traditional Chinese medicine being increasingly used as complementary therapy in many countries. It is relatively safe and rarely associated with deep infections. CASE PRESENTATION: In this case report, we describe a middle-aged Chinese patient who presented acutely to our emergency department with cauda equina syndrome secondary to acupuncture-related epidural abscesses, which were treated with surgical decompression and intravenous antibiotics...
December 2016: International Journal of Emergency Medicine
Santosh Bhatta, Puspa Raj Pant, Julie Mytton
BACKGROUND: Injuries are a major public health problem worldwide. Despite increasing morbidity and mortality from injuries in Nepal, it is not recognised in the government's policy and programmes and few population-based studies have been published. This study describes the usefulness of hospital emergency department records to explore access to injury care in Nepal. METHODS: A retrospective ED-based study was conducted at a governmental hospital in Nepal to review the routinely collected data for 1 year (1 January 2010 to 31 December 2010)...
December 2016: International Journal of Emergency Medicine
Nishant Raj Pandey
Emergency medicine is one of the youngest recognized specialties in Nepal, and its growth in clinical practice and academic development has been challenging. In this paper, we reviewed the current state of emergency medicine in Nepal based on review of the literature, personal observations and experience, and interviews with many Nepali and foreign emergency physicians. Most hospitals in Nepal have adopted a multi-specialist approach, where emergency room physicians are primarily general practitioners/family physicians or house officers...
December 2016: International Journal of Emergency Medicine
L C van den Hengel, T Visseren, P E Meima-Cramer, P P M Rood, S C E Schuit
BACKGROUND: Sepsis has a high mortality. Early recognition and timely treatment are essential for patient survival. The aim of this study is to examine the factors that influence the knowledge and recognition of systemic inflammatory response syndrome (SIRS) criteria and sepsis by emergency department (ED) nurses. METHODS: A prospective, multi-center study including 216 ED nurses from 11 hospitals and academic medical centers in The Netherlands was conducted in 2013...
December 2016: International Journal of Emergency Medicine
Sevgi Buyukbese Sarsu
BACKGROUND: The chronic use of synthetic cannabinoids (SCs) which has become an increasingly prevalent problem can rarely cause gastric and duodenal ulcer because of their effects on gastric secretion and emptying. Since peptic ulcer disease (PUD) is a rarely seen entity in patients who consult to the emergency service with complaints of abdominal pain, most of the physicians do not suspect of this clinical diagnosis. Perforation is a mortal complication of PUD, and early diagnosis and emergency surgery are life-saving procedures...
December 2016: International Journal of Emergency Medicine
Abdullah Arafat, Ali Al-Farhan, Hiba Abu Khalil
OBJECTIVES: The objectives of the study is to review and assess the implementation of the applied modified five-level triage and acuity scale triage system in AL-Yarmook Urgent Care Center (UCC), King Abdulaziz Residential City, Riyadh, Saudi Arabia. METHOD: An observational cross-sectional study was conducted, where a data collection sheet was designed and distributed to triage nurses. The data collection was done during the triage process and was directly observed by the co-investigator...
December 2016: International Journal of Emergency Medicine
Kevin R Schwartz, Karla Fredricks, Zaid Al Tawil, Taylor Kandler, Stella A Odenyo, Javan Imbamba, Brett D Nelson, Thomas F Burke
BACKGROUND: Adequate pain control through sedation and anesthesia for emergency procedures is a crucial aspect of pediatric emergency care. Resources for administering such anesthesia are extremely limited in many low-income settings. METHODS: Non-anesthetist providers in Western Kenya were trained in the use of a ketamine-based sedation and anesthesia package for non-anesthetists, Every Second Matters for Mothers and Babies-Ketamine™ (ESM-Ketamine). Data on use and safety of this package for emergent and urgent pediatric procedures was collected...
December 2016: International Journal of Emergency Medicine
Rahul Kashyap, Peter W Anderson, Abhay Vakil, Christopher S Russi, Rodrigo Cartin-Ceba
BACKGROUND: Helicopter emergency medical services (HEMS) extend the reach of a tertiary care center significantly. However, its role in septic patients is unclear. Our study was performed to clarify the role of HEMS in severe sepsis and septic shock. METHODS: This is a single-center retrospective cohort study. This study was performed at Mayo Clinic, Rochester, MN, in years 2007-2009. This study included a total of 181 consecutive adult patients admitted to the medical intensive care unit meeting criteria for severe sepsis or septic shock within 24 h of admission and transported from an acute care facility by a helicopter or ground ambulance...
December 2016: International Journal of Emergency Medicine
J W Smithuis, E Gips, T P van Rees Vellinga, M I Gaakeer
BACKGROUND: Diving is, besides professional reasons, an increasingly popular leisure activity. Whilst statistically compared to other sports safe, diving accidents can result in serious complications. In order to treat this specific patient category adequately, early diagnosis is important. In this study, we explore various medical aspects of diving accidents. By sharing our experiences, we intend to create awareness and enhance urgent medical care for this specific category of patients...
December 2016: International Journal of Emergency Medicine
Kenneth Heng
"Floating shoulder" is a rare injury complex resulting from high-energy blunt force trauma to the shoulder, resulting in scapulothoracic dissociation. It is commonly associated with catastrophic neurovascular injury. Two cases of motorcyclists with floating shoulder injuries are described.
December 2016: International Journal of Emergency Medicine
Lasanthi Aryasinghe, Yasmin Kazim, Hamza F Obeid, Husnain Hashim
BACKGROUND: Locked-in syndrome, although a notoriously famous clinical entity, the rarity of the condition coupled with the variability of clinical features on acute presentation represents a potential diagnostic pitfall for the emergency physician. CASE: A previously healthy 25-year-old female was brought to our Emergency Department after being found unresponsive. On examination, she was conscious and alert with a Glasgow Coma Score of 9; on neurological examination, the patient was quadriplegic and unable to speak but was able to move her eyes and blink...
December 2016: International Journal of Emergency Medicine
Pradeep Kumar Vyas, Chintamani Godbole, Susheel Kumar Bindroo, Rajiv S Mathur, Bharathi Akula, Nilesh Doctor
Diaphragmatic hernia is an important cause of emergency hospital admission associated with significant morbidity. It usually results from congenital defect or rupture in the diaphragm due to trauma. Prompt and appropriate diagnosis is necessary in patients with this condition, as surgical intervention by either abdominal or thoracic approach may be necessary. Here, we report a case of left-sided diaphragmatic hernia presenting with sudden onset of breathlessness, respiratory distress and left-sided chest pain radiating to the abdomen, mimicking pneumothorax, treated successfully with surgical intervention...
December 2016: International Journal of Emergency Medicine
Andre L Holder, Namita Gupta, Elizabeth Lulaj, Miriam Furgiuele, Idaly Hidalgo, Michael P Jones, Tiphany Jolly, Paul Gennis, Adrienne Birnbaum
BACKGROUND: Progression from nonsevere sepsis-i.e., sepsis without organ failure or shock-to severe sepsis or shock among emergency department (ED) patients has been associated with significant mortality. Early recognition in the ED of those who progress to severe sepsis or shock during their hospital course may improve patient outcomes. We sought to identify clinical, demographic, and laboratory parameters that predict progression to severe sepsis, septic shock, or death within 96 h of ED triage among patients with initial presentation of nonsevere sepsis...
December 2016: International Journal of Emergency Medicine
Aditya Mantha, Nathaniel L Coggins, Aditya Mahadevan, Rebecca N Strehlow, Matthew C Strehlow, S V Mahadevan
BACKGROUND: Paramedic trainees in developing countries face complex and chaotic clinical environments that demand effective leadership, communication, and teamwork. Providers must rely on non-technical skills (NTS) to manage bystanders and attendees, collaborate with other emergency professionals, and safely and appropriately treat patients. The authors designed a NTS curriculum for paramedic trainees focused on adaptive leadership, teamwork, and communication skills critical to the Indian prehospital environment...
December 2016: International Journal of Emergency Medicine
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