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Emergency Medicine International

Nicholas Black, Jon W Schrock
Background: Skin and soft tissue infections are common presenting complaints for Emergency Department (ED) patients. Although they are common, there remain no definitive guidelines on decisions of admission for these patients. Objectives: To determine the influence of demographic and clinical information of those presenting with skin and soft tissue infection(s) (SSTI) on both disposition and treatment failure. Methods: We prospectively enrolled adults with SSTI seen at a large urban ED...
2018: Emergency Medicine International
Yuko Ono, Takeyasu Kakamu, Hiroaki Kikuchi, Yusuke Mori, Yui Watanabe, Kazuaki Shinohara
The aim of this study was to determine complication rates and possible risk factors of expert-performed endotracheal intubation (ETI) in patients with trauma, in both the prehospital setting and the emergency department. We also investigated how the occurrence of ETI-related complications affected the survival of trauma patients. This single-center retrospective observational study included all injured patients who underwent anesthesiologist-performed ETI from 2007 to 2017. ETI-related complications were defined as hypoxemia, unrecognized esophageal intubation, regurgitation, cardiac arrest, ETI failure rescued by emergency surgical airway, dental trauma, cuff leak, and mainstem bronchus intubation...
2018: Emergency Medicine International
A Abdulkarim, A Juhdi, P Coffey, Lily Edelson
Background: The Irish Equestrian industry provides over 12,500 full time job equivalents contributing in excess of €454 million to the Irish economy annually. For such an important industry there is a paucity of information relating to equestrian injuries. Aims: The aim of this study was to determine the demographics, characteristics, and outcomes of equestrian related injuries presenting to the emergency department of a regional trauma centre in Ireland over the course of one year...
2018: Emergency Medicine International
Elham Peidaee, Fereshte Sheybani, HamidReza Naderi, Nasrin Khosravi, Mehdi Jabbari Nooghabi
The profile of febrile encephalopathy varies based on different demographic and geographical characteristics of the study population. This retrospective, cross-sectional study was conducted to evaluate the etiological spectrum of febrile encephalopathy in hospitalized adult patients. A total of 293 patients with the mean age of 49.7 ± 23 were evaluated of whom 77.1% presented with encephalopathy syndrome. The most common diagnosis in patients with clinical syndromes suggestive of central nervous system (CNS) infection was sepsis associated encephalopathy (SAE) (22...
2018: Emergency Medicine International
Jae Hee Lee, Koo Young Jung, Yoon Hee Choi
Several abbreviated versions of the Alcohol Use Disorders Identification Test (AUDIT) have been developed for use in high-volume clinical situations such as emergency departments. In this study, we developed a new abbreviated version of AUDIT called the Screening Tool for At-risk Drinking (STAD) for young and middle-aged adults, consisting of two questions that reflect the structure of the AUDIT questionnaire using data from the Korea National Health and Nutrition Examination Survey (KNHANES). To derive the abbreviated test considering AUDIT item structure, we performed confirmatory factor analysis on the 10 AUDIT questions in the Korea National Health and Nutrition Examination Survey (KNHANES) IV...
2018: Emergency Medicine International
Francis M Sakita, Hendry R Sawe, Victor Mwafongo, Juma A Mfinanga, Michael S Runyon, Brittany L Murray
Background: Abdominal pain in children can represent benign conditions or life-threatening emergencies. Aetiologies of paediatric abdominal pain vary geographically and have not been studied in acute care settings in East Africa. This study describes the clinical profiles and outcomes of children presenting with undifferentiated abdominal pain to the Emergency Department of Muhimbili National Hospital (ED-MNH). Methods: This was a prospective cohort study of children below 18 years of age presenting to the ED-MNH with abdominal pain...
2018: Emergency Medicine International
Fareen Zaver, Keith Boniface, Benjamin Wachira, Grace Wanjiku, Hamid Shokoohi
Background: While ultrasound (US) use for internal jugular central venous catheter (CVC) placement is standard of care in North America, most developing countries have not adopted this practice. Previous surveys of North American physicians have identified lack of training and equipment availability as the most important barriers to the use of US. Objective: We sought to identify perceived barriers to the use of US to guide CVC insertion in a resource-constrained environment...
2018: Emergency Medicine International
Shalini Pooransingh, L K Teja Boppana, Isaac Dialsingh
Objectives: To review the modified Canadian Triage and Acuity Scale used in an accident and emergency department in Trinidad and Tobago. Design and Methods: A cross-sectional study was carried out. Times from assignment of triage category to being seen by a physician were collected from the patient notes on the days of presentation and compared to the reference standards. Times from decision to admit to obtaining a bed were also recorded. Results: 200 patients were included in the study...
2018: Emergency Medicine International
Feride Mehmetoğlu
Aim: This retrospective case series was designed to evaluate the clinical experience of pediatric patients who had ingested water absorbent beads (WABs) and review the relevant literature. Materials and Methods: A retrospective chart analysis of 21 children who were admitted to the emergency service or outpatient clinic with complaints of swallowing WABs during a 10-year period was performed. The patients were divided into two groups: 6 patients who were hospitalized and 15 patients who were observed as outpatients for groups 1 and 2, respectively...
2018: Emergency Medicine International
Seyed Hamid Hosseinikia, Shekufeh Zarei, Majid Najafi Kalyani, Sepideh Tahamtan
Background and Purpose: Workplace violence is a global phenomenon and violation of human rights affects the people's self-esteem and quality of work and causes inequality, discrimination, disorder, and conflict at work. The present study was carried out aiming at determining the workplace violence against the prehospital emergency medical technicians (PEMTs) in three provinces of Fars, Kohgiluyeh and Boyer-Ahmad, and Bushehr, Iran. Materials and Methods: This was a cross-sectional multicenter study in which 206 PEMTs from Fars, Bushehr, and Kohgiluyeh and Boyer-Ahmad provinces participated...
2018: Emergency Medicine International
Anna Abelsson, Lillemor Lindwall, Björn-Ove Suserud, Ingrid Rystedt
Introduction: We focus on trauma care conducted in the context of a simulated traumatic event. This is in this study defined as a four-meter fall onto a hard surface, resulting in severe injuries to extremities in the form of bilateral open femur fractures, an open tibia fracture, and a closed pelvic fracture, all fractures bleeding extensively. Methods: The simulated trauma care competence of 63 ambulance nurses in prehospital emergency care was quantitatively evaluated along with their perception of their sufficiency...
2018: Emergency Medicine International
A Pourmand, U Dimbil, A Drake, H Shokoohi
Radiological imaging plays an essential role in the evaluation of a patient with suspected small bowel obstruction (SBO). In a few studies, point-of-care ultrasound (POCUS) has been utilized as a primary imaging modality in patients with suspected SBO. POCUS has been shown to be an accurate tool in the diagnosis of SBO with multiple research studies noting a consistent high sensitivity with a range of 94-100% and specificity of 81-100%. Specific sonographic findings that increase the likelihood of SBO include dilatation of small bowel loops > 25 mm, altered intestinal peristalsis, increased thickness of the bowel wall, and intraperitoneal fluid accumulation...
2018: Emergency Medicine International
M Rehfeldt, A Slagman, B A Leidel, M Möckel, T Lindner
Background: Traumatic Pneumothorax (PTX) is a potentially life-threatening injury. It requires a fast and accurate diagnosis and treatment, but diagnostic tools are limited. A new point-of-care device (PneumoScan) based on micropower impulse radar (MIR) promises to diagnose a PTX within seconds. In this study, we compare standard diagnostics with PneumoScan during shock-trauma-room management. Patients and Methods: Patients with blunt or penetrating chest trauma were consecutively included in the study...
2018: Emergency Medicine International
Suleyman Serdar Tasci, Cemil Kavalci, Afsin Emre Kayipmaz
Background and Purpose: In this study, we aimed to evaluate the relationship between pneumonia and meteorological parameters (temperature, humidity, precipitation, airborne particles, sulfur dioxide (SO2 ), carbon monoxide (CO), nitrogen dioxide (NO2 ), nitrite oxide (NO), and nitric oxide (NOX)) in patients with the diagnosis of pneumonia in the emergency department. Methods: Our study was performed retrospectively with patients over 65 years of age who were diagnosed with pneumonia...
2018: Emergency Medicine International
Brian A Ferguson, Hugh W Shoff, Jennifer E McGowan, Martin R Huecker
Objective: Sleep deprivation decreases work performance and predisposes workers to deleterious health outcomes. We sought to evaluate sleep hygiene and fatigue among emergency physicians. Methods: In March-June 2016, physicians and residents at an academic emergency medicine program were invited to complete a survey evaluating sleep and alertness. Results: Six attending physicians and 26 residents completed the survey. Among six personal priorities, sleep ranked fourth behind family, work, and leisure...
2018: Emergency Medicine International
Ahmad Khobrani, Nirali H Patel, Richard L George, Neil L McNinch, Rami A Ahmed
Trauma is a leading cause of morbidity and mortality in infants and children worldwide. Trauma education is one of the most commonly reported deficiencies in pediatric emergency medicine (PEM) training. In this study, we describe the creation of a pediatric trauma boot camp in which trainees' basic knowledge, level of confidence, teamwork, and communication skills are assessed. The primary goal of this pilot study was to create a simulation-based pediatric trauma curriculum for PEM fellows and emergency medicine residents utilizing Kern's curricular conceptual framework...
2018: Emergency Medicine International
Majed A Refaai, Truptesh H Kothari, Shana Straub, Jacob Falcon, Ravi Sarode, Joshua N Goldstein, Andres Brainsky, Laurel Omert, Martin L Lee, Truman J Milling
INTRODUCTION: To investigate the impact of a 4-factor prothrombin complex concentrate (4F-PCC [Beriplex®/Kcentra®]) versus plasma on "time to procedure" in patients with acute/severe gastrointestinal bleeding requiring rapid vitamin K antagonist (VKA) reversal prior to invasive procedure. METHODS: A post hoc analysis of two phase III trials of 4F-PCC versus plasma in patients with acute/severe gastrointestinal bleeding. The treatment arms were compared for study treatment volume, infusion times, and time from start of study treatment to procedure...
2017: Emergency Medicine International
Mohammed Al Ghobain, Turki Aldrees, Abdullah Alenezi, Saleh Alqaryan, Dana Aldabeeb, Najed Alotaibi, Abdulrahman Aldhabib, Shaker Alghalibi, Sami Alharethy
Introduction. Middle East respiratory syndrome (MERS) outbreaks have had a considerable negative impact on health systems in Saudi Arabia. We aimed to study the psychological impact of a Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak on emergency room resident physicians (ERRPs). Methods. We assessed the MERS-related psychological impact and concerns of ERRPs using a self-report questionnaire. Results. The majority (91%) of the ERRPs agreed that their work put them at risk of infection, but most (65%) did not agree that they should not be looking after patients infected with MERS...
2017: Emergency Medicine International
M Ikbal Sasmaz, Faruk Gungor, Ramazan Guven, K Can Akyol, Nalan Kozaci, Mustafa Kesapli
We assessed the effect of focused point of care ultrasound (POCUS) used for critical nontraumatic hypotensive patients presenting to the emergency department of our hospital on the clinical decisions of the physicians and whether it led to the modification of the treatment modality. This prospective clinical study was conducted at the Emergency Department of Antalya Training and Research Hospital. Nontraumatic patients aged 18 and older who presented to our emergency department and whose systolic blood pressure was <100 mmHg or shock index (heart rate/systolic blood pressure) was >1 were included in the study...
2017: Emergency Medicine International
Abdulaziz Alburaih
Objective. Tranexamic Acid (TXA) is currently the only drug with prospective clinical evidence supporting its use in bleeding trauma patients. We sought to better understand the barriers preventing its use and elicit suggestions to further its use in trauma patients in the state of Maryland. Methods . This is a cross-sectional study. Results . The overall response rate was 38%. Half of all participants reported being familiar with the CRASH-2 trial and MATTERs study. Half reported being aware of TXA as part of their institution's massive transfusion protocol...
2017: Emergency Medicine International
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