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Emergency Medicine International

Francisco Martín-Rodríguez, José Luis Martín Conty, Verónica Casado Vicente, Pedro Arnillas Gómez, Alicia Mohedano-Moriano, Miguel Ángel Castro Villamor
Introduction: Certain professions, such as those related to emergency services, have usually been performed by men, progressively incorporating women into these professions. The main objective of our study was to determine, according to gender, how the use of level D biohazard personal protection equipment (PPE) affects emergency professionals during the performance of resuscitation. Materials and Methods: An uncontrolled quasi-experimental study was performed on 96 volunteers selected by means of random sampling stratified by gender...
2018: Emergency Medicine International
Ozlem Dikme, Ozgur Dikme
Cortisol is a steroid hormone released from the adrenal glands in response to stressful conditions. Elevated cortisol levels have been described in stress, but it is unclear whether these are associated with adverse outcomes. In this study, we assess whether cortisol levels drawn in patients presenting with dyspnea to the ED were a predictor of major adverse pulmonary event (MAPE). In 87 patients presenting with dyspnea to the ED, cortisol levels were determined. Patients were then assessed to determine the following MAPE: endotracheal intubation (ETI) in the ED, admission to the intensive care unit (ICU), and in-hospital all-cause mortality...
2018: Emergency Medicine International
Sohyun Park, Hui Jai Lee, Jonghwan Shin, Kyoung Min You, Se Jong Lee, Euigi Jung
Background: Activated charcoal is the most frequently and widely used oral decontaminating agent in emergency departments (EDs). However, there is some debate about its clinical benefits and risks. In Korea, activated charcoal with sorbitol was unavailable as of the mid-2015, and our hospital had been unable to use it from September 2015. This study examined the differences of clinical features and outcomes of patients during the periods charcoal was and was not available. Methods: We retrospectively reviewed the electronic medical records of patients who had visited an urban tertiary academic ED for oral drug poisoning between January 2013 and January 2017...
2018: Emergency Medicine International
Paibul Suriyawongpaisal, Pongsakorn Atiksawedparit, Samrit Srithamrongsawad, Thanita Thongtan
Background: Previous policy implementation in 2012 to incentivize private hospitals in Thailand, a country with universal health coverage, to provide free-of-charge emergency care using DRG-based payment resulted in an equity gap of access and copayment. To bridge the gap, strategic policies involving financial and legal interventions were implemented in 2017. This study aims to assess whether this new approach would be able to fill the gap. Methods: We analyzed an administrative dataset of over 20,206 patients visiting private hospital EDs from April 2017 to October 2017 requested for the preauthorization of access to emergency care in the first 72 hours free of charge...
2018: Emergency Medicine International
Yongsoon Choi, Jin Hui Paik, Ji Hye Kim, Seung Baik Han, Areum Durey
Objectives: Pseudomonas aeruginosa shows higher mortality rate compared to other bacterial infections and is susceptible to a limited number of antimicrobial agents. Considering inadequate empirical treatment of Pseudomonas bacteremia has been associated with increased mortality, it is important for emergency physicians to identify infections by P. aeruginosa . Methods: This was a single-center retrospective case-control study to investigate the clinical predictors of patients diagnosed as Pseudomonas bacteremia in the emergency department (ED) from June 2012 to December 2016...
2018: Emergency Medicine International
Fatma Sarac, Sevgi Buyukbese Sarsu, Selman Yeniocak, Kamil Sahin, Esma Yucetas, Dogan Yildirim, Macit Koldas, Ozlem Uzun
Objectives: Diagnosis of pediatric patients presenting to the Emergency Department with acute abdominal pain is not always easy. The purpose of this study was to investigate the effectiveness of irisin, a peptide hormone with reactivity shown in the appendix and neutrophils, in the differential diagnosis of pediatric patients with acute abdominal pain. Methods: 162 subjects consenting to participate, including 112 patients presenting to the Pediatric Emergency and Pediatric Surgery clinics with acute abdominal pain and 50 controls, were enrolled in the study...
2018: Emergency Medicine International
Zafer Dokumcu, Bade Toker Kurtmen, Emre Divarci, Petek Bayindir Tamay, Timur Kose, Murat Sezak, Geylani Ozok, Orkan Ergun, Ahmet Celik
Background: Decision-making for management may sometimes be difficult in acute appendicitis (AA). Various diagnostic scoring systems exist, but their sensitivity and specificity rates are far from ideal. In this study, the determination of the predictors and the effect of radiological data and developing a new scoring system were aimed. Methods: Medical records of patients who were hospitalized for AA between February 2012 and October 2016 were retrospectively reviewed...
2018: 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
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