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Emergency Medicine International

Tae-Hun Lee, Jae-Hyun Han, Ashish Ranjan Sharma, Young-A Choi, Dong Won Kim, Sang-Soo Lee, Moo-Eob Ahn
Due to an increase in traffic collisions, the demand for prehospital medical services is on the rise, even in low-resource countries where emergency ambulance services have not been previously provided. To build a sustainable and continuous prehospital ambulance operation model, it is necessary to consider the medical system and economic conditions of the corresponding country. In an attempt to construct a prehospital ambulance operation model that ensures continuous operation, a pilot "emergency patient transporting service from field to hospital" operation was established for approximately three months in Kinshasa, the capital of the DR Congo...
2018: Emergency Medicine International
Ting Xu Tan, Paula Buchanan, Erin Quattromani
Objective: To compare simulation task trainers (sim) with cadaver for teaching chest tube insertion to junior residents. Methods: Prospective study involving postgraduate year (PGY) one and two emergency medicine (EM) and PGY-1 surgery residents. Residents were randomized into sim or cadaver groups based on prior experience and trained using deliberate practice. Primary outcomes were confidence in placing a chest tube and ability to place a chest tube in a clinical setting during a seven-month follow-up period...
2018: Emergency Medicine International
Jongho Kim, Lyle Brewster, Sonja Maria, Jundong Moon
High-rise buildings present unique challenges to providing high-quality CPR. We investigated the effect of using a mechanical compressor and supraglottic airway on flow time and CPR quality in simulated cardiac arrests occurring within a high-rise building. Twelve teams of EMS providers performed CPR according to 4 scenarios: manual compression and ventilation through bag-valve-mask (MAB) or supraglottic airway (MAS); mechanical compression and ventilation through bag-valve-mask (MEB) or supraglottic airway (MES)...
2018: Emergency Medicine International
Paibul Suriyawongpaisal, Samrit Srithamrongsawad, Pongsakorn Atiksawedparit, Khanisthar Phooseemungkun, Krongkan Bunchaiyai, Thanita Thongtan
Introduction: Financing health systems constitutes a key element of well-functioning healthcare system. Prior to 2015, two new financial arrangements (direct-pay and E-claim systems) were introduced on a voluntary basis which aimed to pool more financial resources and improve cash flow of prehospital care systems. The aims of this study were to (1) assess the effects of direct-pay system in terms of (a) timeliness of reimbursement to EMS agencies, (b) changes in clinical care processes, and (c) the outcomes of patient care as compared to previous system; (2) identify the reasons for or against EMS agencies to participate in direct-pay system mechanisms; (3) identify the emerging issues with potential to significantly further the advancement of EMS systems...
2018: Emergency Medicine International
Behcet Al, Mustafa Bogan, Suat Zengin, Mustafa Sabak, Seval Kul, M Murat Oktay, Hasan Bayram, Ertan Vuruskan
Objective: This study was designed to investigate the effects of Desert Dust Storms and Climatological Factors on Mortality and Morbidity of Cardiovascular Diseases admitted to emergency department in Gaziantep. Method: Hospital records, obtained between September 01, 2009 and January 31, 2014, from four state hospitals in Gaziantep, Turkey, were compared to meteorological and climatological data. Statistical analysis was performed by Statistical Package for the Social Science (SPSS) for windows version 24...
2018: 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
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