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Emergency Medicine International

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https://www.readbyqxmd.com/read/28357139/effect-of-focused-bedside-ultrasonography-in-hypotensive-patients-on-the-clinical-decision-of-emergency-physicians
#1
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
https://www.readbyqxmd.com/read/28316839/tranexamic-acid-txa-in-trauma-patients-barriers-to-use-among-trauma-surgeons-and-emergency-physicians
#2
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
https://www.readbyqxmd.com/read/28265471/public-medical-preparedness-at-the-swiss-wrestling-and-alpine-games-2013-descriptive-analysis-of-1-533-patients-treated-at-the-largest-3-day-sporting-event-in-switzerland
#3
Simone Hostettler-Blunier, Nora Müller, Tobias Haltmeier, Andreas Hosner, Heinz Bähler, Frank Neff, Daniel Baumberger, Aristomenis Exadaktylos, Beat Schnüriger
Introduction. Medical preparedness at mass gatherings is challenging, as little is known about the optimal planning. Most studies and case reports are based on mass casualty incidents, so the results cannot be extrapolated to mass gatherings. Aim of this study was to evaluate the preclinical medical structure and the frequency of specific injuries and medical emergencies during the event. Methods. Retrospective analysis of a prospectively collected database. Three on-site medical assistance points were set up, completed by mobile teams, and coordinated by an on-site operational management team...
2017: Emergency Medicine International
https://www.readbyqxmd.com/read/28255457/the-epidemiology-of-hospital-referred-head-injury-in-ardabil-city
#4
Esmaeil Farzaneh, Ghasem Fattahzadeh-Ardalani, Vahid Abbasi, Fariba Kahnamouei-Aghdam, Behnam Molaei, Elham Iziy, Habib Ojaghi
Background and Purpose. Trauma is the leading cause of death for youth in developing countries. Given the prevalence of head trauma (HT) in society and its complication and burden, the epidemiologic study of head trauma is necessary and is the main aim of this study. Materials and Methods. This retrospective population-based survey describes the epidemiology of head injury in a defined population in Ardabil city. It includes all 204 patients with head injury referred to the University Hospital of Ardabil, Iran, during 2013-2014...
2017: Emergency Medicine International
https://www.readbyqxmd.com/read/28203462/adherence-to-follow-up-recommendations-by-triathlon-competitors-receiving-event-medical-care
#5
Jeremy D Joslin, Jarem B Lloyd, Nikoli Copeli, Derek R Cooney
Introduction. We sought to investigate triathlete adherence to recommendations for follow-up for participants who received event medical care. Methods. Participants of the 2011 Ironman Syracuse 70.3 (Syracuse, NY) who sought evaluation and care at the designated finish line medical tent were contacted by telephone approximately 3 months after the initial encounter to measure adherence with the recommendation to seek follow-up care after event. Results. Out of 750 race participants, 35 (4.6%) athletes received event medical care...
2017: Emergency Medicine International
https://www.readbyqxmd.com/read/27885343/qualitative-inquiry-into-challenges-experienced-by-registered-general-nurses-in-the-emergency-department-a-study-of-selected-hospitals-in-the-volta-region-of-ghana
#6
Confidence Alorse Atakro, Jerry Paul Ninnoni, Peter Adatara, Janet Gross, Michael Agbavor
Registered General Nurses (RGNs) play crucial roles in emergency departments (EDs). EDs in Ghana are primarily staffed by RGNs who have had no additional formal education in emergency care. Additionally, basic, master's, or doctoral level nursing education programs provide limited content on the complexities of emergency nursing. Nurses in EDs are affected by many challenges such as growing patient population, financial pressures, physical violence, verbal abuse, operational inefficiencies, overcrowding, and work overload...
2016: Emergency Medicine International
https://www.readbyqxmd.com/read/27656297/mandibular-fractures-admitted-to-the-emergency-department-data-analysis-from-a-swiss-level-one-trauma-centre
#7
Kemal Yildirgan, Edris Zahir, Siamak Sharafi, Sufian Ahmad, Benoit Schaller, Meret E Ricklin, Aristomenis K Exadaktylos
Mandibular fracture is a common occurrence in emergency medicine and belongs to the most frequent facial fractures. Historically road traffic injuries (RTIs) have played a prominent role as a cause for mandibular fractures. We extracted data from all patients between August 2012 and February 2015 with "lower jaw fracture" or "mandibular fracture" from the routine database from the emergency department. We conducted a descriptive analysis at a Swiss level one trauma centre. 144 patients were admitted with suspected mandibular fractures...
2016: Emergency Medicine International
https://www.readbyqxmd.com/read/27563467/trauma-simulation-training-increases-confidence-levels-in-prehospital-personnel-performing-life-saving-interventions-in-trauma-patients
#8
Christine M Van Dillen, Matthew R Tice, Archita D Patel, David A Meurer, Joseph A Tyndall, Marie Carmelle Elie, Jonathan J Shuster
Introduction. Limited evidence is available on simulation training of prehospital care providers, specifically the use of tourniquets and needle decompression. This study focused on whether the confidence level of prehospital personnel performing these skills improved through simulation training. Methods. Prehospital personnel from Alachua County Fire Rescue were enrolled in the study over a 2- to 3-week period based on their availability. Two scenarios were presented to them: a motorcycle crash resulting in a leg amputation requiring a tourniquet and an intoxicated patient with a stab wound, who experienced tension pneumothorax requiring needle decompression...
2016: Emergency Medicine International
https://www.readbyqxmd.com/read/27478642/revisits-within-48-hours-to-a-thai-emergency-department
#9
Jiraporn Sri-On, Adisak Nithimathachoke, Gregory Philip Tirrell, Sataporn Surawongwattana, Shan Woo Liu
Objective. Emergency department (ED) revisits are a common ED quality measure. This study was undertaken to ascertain the contributing factors of revisits within 48 hours to a Thai ED and to explore physician-related, illness-related, and patient-related factors behind those revisits. Methods. This study was a chart review from one tertiary care, urban Thai hospital from October 1, 2009, to September 31, 2010. We identified patients who returned to the ED within 48 hours for the same or related complaints after their initial discharge...
2016: Emergency Medicine International
https://www.readbyqxmd.com/read/27379186/disparities-in-survival-with-bystander-cpr-following-cardiopulmonary-arrest-based-on-neighborhood-characteristics
#10
Nina Thakkar Rivera, Shari L Kumar, Rohit K Bhandari, Sunil D Kumar
The American Heart Association reports the annual incidence of out-of-hospital cardiopulmonary arrests (OHCA) is greater than 300,000 with a survival rate of 9.5%. Bystander cardiopulmonary resuscitation (CPR) saves one life for every 30, with a 10% decrease in survival associated with every minute of delay in CPR initiation. Bystander CPR and training vary widely by region. We conducted a retrospective study of 320 persons who suffered OHCA in South Florida over 25 months. Increased survival, overall and with bystander CPR, was seen with increasing income (p = 0...
2016: Emergency Medicine International
https://www.readbyqxmd.com/read/27293895/direct-acting-oral-anticoagulants-practical-considerations-for-emergency-medicine-physicians
#11
REVIEW
W Frank Peacock, Zubaid Rafique, Adam J Singer
Nonvalvular atrial fibrillation- (NVAF-) related stroke and venous thromboembolism (VTE) are cardiovascular diseases associated with significant morbidity and economic burden. The historical standard treatment of VTE has been the administration of parenteral heparinoid until oral warfarin therapy attains a therapeutic international normalized ratio. Warfarin has been the most common medication for stroke prevention in NVAF. Warfarin use is complicated by a narrow therapeutic window, unpredictable dose response, numerous food and drug interactions, and requirements for frequent monitoring...
2016: Emergency Medicine International
https://www.readbyqxmd.com/read/27144028/coca-the-history-and-medical-significance-of-an-ancient-andean-tradition
#12
REVIEW
Amy Sue Biondich, Jeremy David Joslin
Coca leaf products are an integral part of the lives of the Andean peoples from both a cultural and traditional medicine perspective. Coca is also the whole plant from which cocaine is derived. Coca products are thought to be a panacea for health troubles in regions of South America. This review will examine the toxicology of whole coca and will also look at medicinal applications of this plant, past, present, and future.
2016: Emergency Medicine International
https://www.readbyqxmd.com/read/27144027/trainers-attitudes-towards-cardiopulmonary-resuscitation-current-care-guidelines-and-training
#13
M Mäkinen, M Castrén, J Nurmi, L Niemi-Murola
Objectives. Studies have shown that healthcare personnel hesitate to perform defibrillation due to individual or organisational attitudes. We aimed to assess trainers' attitudes towards cardiopulmonary resuscitation and defibrillation (CPR-D), Current Care Guidelines, and associated training. Methods. A questionnaire was distributed to CPR trainers attending seminars in Finland (N = 185) focusing on the updated national Current Care Guidelines 2011. The questions were answered using Likert scale (1 = totally disagree, 7 = totally agree)...
2016: Emergency Medicine International
https://www.readbyqxmd.com/read/27127654/use-of-the-vocera-communications-badge-improves-public-safety-response-times
#14
Jeremy D Joslin, David Goldberger, Loretta Johnson, D Paul Waltz
Objectives. Violence in the Emergency Department (ED) has been a long-standing issue complicated by deficiencies in staff training, ease of weapons access, and response availability of public safety officers. The Vocera Badge is being used by our staff to request public safety assistance in lieu of a formal phone call to the University Police Communications Center. We sought to learn if use of this technology improved officer response times to the ED. Methods. Mean response times were reviewed and descriptive statistics analyzed to determine if the use of the Vocera Badge improved public safety officer response times to the ED...
2016: Emergency Medicine International
https://www.readbyqxmd.com/read/27119024/reducing-time-to-first-on-scene-an-ambulance-community-first-responder-scheme
#15
Alan Campbell, Matt Ellington
The importance of early access to prehospital care has been demonstrated in many medical emergencies. This work aims to describe the potential time benefit of implementing a student Community First Responder scheme to support ambulance services in an inner-city setting in the United Kingdom. Twenty final and penultimate year medical students in the UK were trained in the "First Person on Scene" Business and Technology Education Council (BTEC) qualification. Over 12 months, they attended 89 emergency calls in an inner-city setting as Community First Responders (CFRs), alongside the West Midlands Ambulance Service, UK...
2016: Emergency Medicine International
https://www.readbyqxmd.com/read/27051533/paramedic-recognition-of-sepsis-in-the-prehospital-setting-a-prospective-observational-study
#16
Robert S Green, Andrew H Travers, Edward Cain, Samuel G Campbell, Jan L Jensen, David A Petrie, Mete Erdogan, Gredi Patrick, Ward Patrick
Background. Patients with sepsis benefit from early diagnosis and treatment. Accurate paramedic recognition of sepsis is important to initiate care promptly for patients who arrive by Emergency Medical Services. Methods. Prospective observational study of adult patients (age ≥ 16 years) transported by paramedics to the emergency department (ED) of a Canadian tertiary hospital. Paramedic identification of sepsis was assessed using a novel prehospital sepsis screening tool developed by the study team and compared to blind, independent documentation of ED diagnoses by attending emergency physicians (EPs)...
2016: Emergency Medicine International
https://www.readbyqxmd.com/read/26981282/routine-head-computed-tomography-for-patients-in-the-emergency-room-with-trauma-requires-both-thick-and-thin-slice-images
#17
Kazuhide Maetani, Jun Namiki, Shokei Matsumoto, Katsutoshi Matsunami, Atsushi Narumi, Toshimi Tsuneyoshi, Masanobu Kishikawa
Background. Images of head CT for the supratentorial compartment are sometimes recommended to be reconstructed with a thickness of 8-10 mm to achieve lesion conspicuity. However, additional images of a thin slice may not be routinely provided for patients with trauma in the emergency room (ER). We investigated the diagnostic sensitivity of a head CT, where axial images were 10 mm thick slices, in cases of linear skull fractures. Methods. Two trauma surgeons retrospectively reviewed head CT with 10 mm slices and skull X-rays of patients admitted to the ER that were diagnosed with a linear skull fracture...
2016: Emergency Medicine International
https://www.readbyqxmd.com/read/26953061/using-fresh-frozen-plasma-for-acute-airway-angioedema-to-prevent-intubation-in-the-emergency-department-a-retrospective-cohort-study
#18
Aya Saeb, Karen H Hagglund, Christine T Cigolle
Background. Angioedema (AE) is a common condition which can be complicated by laryngeal edema, having up to 40% mortality. Although sporadic case reports attest to the benefits of fresh frozen plasma (FFP) in treating severe acute bouts of AE, little evidence-based support for this practice is available at present. Study Objectives. To compare the frequency, duration of intubation, and length of intensive care unit (ICU) stay in patients with acute airway AE, with and without the use of FFP. Methods. A retrospective cohort study was conducted, investigating adults admitted to large community hospital ICU with a diagnosis of AE during the years of 2007-2012...
2016: Emergency Medicine International
https://www.readbyqxmd.com/read/26682070/new-insights-into-the-role-of-metformin-effects-on-serum-omentin-1-levels-in-acute-myocardial-infarction-cross-sectional-study
#19
Hayder M Alkuraishy, Ali I Al-Gareeb
Background. Serum omentin-1 level was low in the most types of ischemic heart disease compared to normal subjects; it also dependently correlated with coronary heart disease; thus, omentin-1 is regarded as a novel biomarker in IHD. Objective. The aim of the present study was to establish the links between omentin-1 and acute myocardial infarction in metformin patients. Subjects and Methods. A cross-sectional study was performed on eighty-five patients with type II DM and acute MI. They are divided as follows: Group I, 62 patients with type II DM who received metformin prior to onset of acute MI; Group II, 23 patients with type II DM who did not receive metformin prior to onset of acute MI; and Group III, 30 normal healthy controls...
2015: Emergency Medicine International
https://www.readbyqxmd.com/read/26649200/validation-of-egsys-score-in-prediction-of-cardiogenic-syncope
#20
Hamid Kariman, Sepideh Harati, Saeed Safari, Alireza Baratloo, Mehdi Pishgahi
Introduction. Evaluation of Guidelines in Syncope Study (EGSYS) is designed to differentiate between cardiac and noncardiac causes of syncope. The present study aimed to evaluate the accuracy of this predictive model. Methods. In this prospective cross-sectional study, screening performance characteristics of EGSYS-U (univariate) and EGSYS-M (multivariate) in prediction of cardiac syncope were calculated for syncope patients who were referred to the emergency department (ED). Results. 198 patients with mean age of 59...
2015: Emergency Medicine International
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