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Open Access Emergency Medicine: OAEM

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https://www.readbyqxmd.com/read/28331374/clinical-experience-and-skills-of-physicians-in-hospital-cardiac-arrest-teams-in-denmark-a-nationwide-study
#1
Kasper G Lauridsen, Anders S Schmidt, Philip Caap, Rasmus Aagaard, Bo Løfgren
BACKGROUND: The quality of in-hospital resuscitation is poor and may be affected by the clinical experience and cardiopulmonary resuscitation (CPR) training. This study aimed to investigate the clinical experience, self-perceived skills, CPR training and knowledge of the guidelines on when to abandon resuscitation among physicians of cardiac arrest teams. METHODS: We performed a nationwide cross-sectional study in Denmark. Telephone interviews were conducted with physicians in the cardiac arrest teams in public somatic hospitals using a structured questionnaire...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28260956/in-flight-medical-emergencies-during-airline-operations-a-survey-of-physicians-on-the-incidence-nature-and-available-medical-equipment
#2
Jochen Hinkelbein, Christopher Neuhaus, Lennert Böhm, Steffen Kalina, Stefan Braunecker
BACKGROUND: Data on the incidence of in-flight medical emergencies on-board civil aircraft are uncommon and rarely published. Such data could provide information regarding required medical equipment on-board aircraft and requisite training for cabin crew. The aim of the present study was to gather data on the incidences, nature, and medical equipment for in-flight medical emergencies by way of a survey of physician members of a German aerospace medical society. MATERIALS AND METHODS: Using unipark...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28223850/unusual-etiology-of-gastrointestinal-symptoms-the-case-of-jojoba-butter
#3
Michael R Minckler, Joseph Fisher, Rachel Bowers, Richard Amini
BACKGROUND: Jojoba butter is cyanogenic and has gained attention among herbal supplement consumers due to claims that it may aid in weight loss. Jojoba butter is extracted from the seeds of jojoba shrubs found in the Sonoran Desert. The seeds have long been recognized as inedible, however clinical symptoms following ingestion are not well documented. CASE REPORT: This report describes a patient who developed restlessness and gastrointestinal complaints following ingestion of homemade jojoba seed butter...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28176924/high-stakes-and-high-emotions-providing-safe-care-in-canadian-emergency-departments
#4
Samina Ali, Denise Thomson, Timothy A D Graham, Sean E Rickard, Antonia S Stang
BACKGROUND: The high-paced, unpredictable environment of the emergency department (ED) contributes to errors in patient safety. The ED setting becomes even more challenging when dealing with critically ill patients, particularly with children, where variations in size, weight, and form present practical difficulties in many aspects of care. In this commentary, we will explore the impact of the health care providers' emotional reactions while caring for critically ill patients, and how this can be interpreted and addressed as a patient safety issue...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28144169/the-forgotten-cause-of-stridor-in-the-emergency-department
#5
Tian-Tee Ng
Paradoxical Vocal Fold Movement Disorder is where the larynx exhibits paradoxical vocal cords closure during respiration, creating partial airway obstruction. Causes of vocal fold movement disorder are multifactorial, and patients describe tightness of throat, difficulty getting air in, have stridor, and do not respond to inhalers. We propose using transnasal laryngoscopy examination, which will show narrowing of vocal cords on inspiration, and The Pittsburgh Vocal Cord Dysfunction Index with a cutoff score of ≥4 to distinguish vocal fold movement disorder from asthma and other causes of stridor...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28144168/a-multicenter-prospective-randomized-study-comparing-the-efficacy-of-escalating-higher-biphasic-versus-low-biphasic-energy-defibrillations-in-patients-presenting-with-cardiac-arrest-in-the-in-hospital-environment
#6
Venkataraman Anantharaman, Seow Yian Tay, Peter George Manning, Swee Han Lim, Terrance Siang Jin Chua, Mohan Tiru, Rabind Antony Charles, Vidya Sudarshan
BACKGROUND: Biphasic defibrillation has been practiced worldwide for >15 years. Yet, consensus does not exist on the best energy levels for optimal outcomes when used in patients with ventricular fibrillation (VF)/pulseless ventricular tachycardia (VT). METHODS: This prospective, randomized, controlled trial of 235 adult cardiac arrest patients with VF/VT was conducted in the emergency and cardiology departments. One group received low-energy (LE) shocks at 150-150-150 J and the other escalating higher-energy (HE) shocks at 200-300-360 J...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28053558/high-fidelity-medical-simulation-training-improves-medical-students-knowledge-and-confidence-levels-in-septic-shock-resuscitation
#7
Veerapong Vattanavanit, Jarernporn Kawla-Ied, Rungsun Bhurayanontachai
BACKGROUND: Septic shock resuscitation bundles have poor compliance worldwide partly due to a lack of knowledge and clinical skills. High-fidelity simulation-based training is a new teaching technology in our faculty which may improve the performance of medical students in the resuscitation process. However, since the efficacy of this training method in our institute is limited, we organized an extra class for this evaluation. PURPOSE: The aim was to evaluate the effect on medical students' knowledge and confidence levels after the high-fidelity medical simulation training in septic shock management...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/27980438/acute-chest-pain-fast-track-at-the-emergency-department-who-was-misdiagnosed-for-acute-coronary-syndrome
#8
Thidathit Prachanukool, Kasamon Aramvanitch, Kittisak Sawanyawisuth, Yuwares Sitthichanbuncha
BACKGROUND: Acute coronary syndrome (ACS) is a commonly treated disease in the emergency department (ED). Acute chest pain is a common presenting symptom of ACS. Acute chest pain fast track (ACPFT) is a triage to cover patients presenting with chest pain with the aims of early detection and treatment for ACS. This study aimed to assess the quality of the ACPFT with the aim of improving the quality of care for ACS patients. METHODS: This study was conducted at the ED in Mahidol University, Bangkok, Thailand...
2016: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/27877069/risk-factors-and-mortality-associated-with-undertriage-at-a-level-i-safety-net-trauma-center-a-retrospective-study
#9
Chris Barsi, Peter Harris, Rich Menaik, Nicholas C Reis, Swapna Munnangi, Mikhail Elfond
PURPOSE: The primary objective of this study was to determine the risk factors associated with undertriage and the risk factors for mortality among the undertriaged patients at a level I safety-net trauma center. METHODS: A retrospective analysis was performed of all trauma patients who presented to a level I safety-net trauma center with an injury severity score >15 over a 2-year period (2013-2014). Univariate and multivariate regression analyses were used to determine the risk factors predictive of undertriage in major trauma patients (injury severity score >15) and of mortality in undertriaged patients...
2016: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/27843362/isolated-oculomotor-nerve-palsy-resulting-from-acute-traumatic-tentorial-subdural-hematoma
#10
Victoria Cui, Timur Kouliev
Acute subdural hematoma (SDH) resulting from head trauma is a potentially life-threatening condition that requires expedient diagnosis and intervention to ensure optimal patient outcomes. Rapidly expanding or large hematomas, elevated intracranial pressure, and associated complications of brain herniation are associated with high mortality rates and poor recovery of neurological function. However, smaller bleeds (clot thickness <10 mm) or hematomas occurring in infrequent locations, such as the tentorium cerebelli, may be difficult to recognize and patients may present with unusual or subtle signs and symptoms, including isolated cranial nerve palsies...
2016: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/27843361/pulmonary-embolism-new-treatments-for-an-old-problem
#11
REVIEW
John Ryan
Nonvitamin K antagonist oral anticoagulants, previously referred to as novel oral anticoagulants, have emerged in recent years as attractive treatment options for acute pulmonary embolism (PE). However, despite the widespread anticipation by physicians and the approval of rivaroxaban, apixaban, dabigatran, and more recently edoxaban, there is still some reluctance to choose these newer agents over conventional treatment with heparin/vitamin K antagonists. Acute PE puts a considerable strain on emergency departments, and medical staff rely on efficient diagnosis and risk assessment to manage the condition appropriately and economically...
2016: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/27822127/objective-triage-in-the-disaster-setting-will-children-and-expecting-mothers-be-treated-like-others
#12
Timur Kouliev
The study of disaster triage is made difficult by the complex emotional response of potentially lifesaving intervention that a triage officer must make basing decisions on a succinct and efficient algorithm. A survey of triage professionals in international settings was designed to identify possible emotionally led bias that affects objective decision making in identifying victims most likely to benefit from immediate life support intervention. This survey suggests a lack of correlation between triage priority and predictable clinical outcomes as predicted by the Revised Trauma Score tool...
2016: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/27703399/acute-chest-pain-after-bench-press-exercise-in-a-healthy-young-adult
#13
Janet A Smereck, Argyro Papafilippaki, Sawali Sudarshan
Bench press exercise, which involves repetitive lifting of weights to full arm extension while lying supine on a narrow bench, has been associated with complications ranging in acuity from simple pectoral muscle strain, to aortic and coronary artery dissection. A 39-year-old man, physically fit and previously asymptomatic, presented with acute chest pain following bench press exercise. Diagnostic evaluation led to the discovery of critical multivessel coronary occlusive disease, and subsequently, highly elevated levels of lipoprotein (a)...
2016: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/27660500/clinical-outcomes-of-3-year-experience-of-targeted-temperature-management-in-patients-with-out-of-hospital-cardiac-arrest-at-songklanagarind-hospital-in-southern-thailand-an-analysis-of-the-micu-ttm-registry
#14
Veerapong Vattanavanit, Rungsun Bhurayanontachai
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) is one of the leading causes of intensive care unit admission, which results in high hospital mortality. Targeted temperature management (TTM) was introduced several years ago and is considered to improve neurological and mortality outcomes. This management process was implemented in our hospital in 2012, which was expected to improve the standard of care in OHCA patients. PURPOSE: We aimed to report the clinical and mortality outcomes after TTM was introduced to our hospital in 2012...
2016: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/27660499/bilateral-acute-closed-angle-glaucoma-associated-with-the-discontinuation-of-escitalopram-a-case-report
#15
Sara AlQuorain, Sukayna Alfaraj, Mohammed Alshahrani
A 45-year-old woman presented to the Emergency Department complaining of severe headache for 3 hours duration associated with bilateral blurred vision, photophobia, and one attack of vomiting. Her clinical examination revealed normal vital signs and decrease in visual acuity with hazy cornea bilaterally. There were no signs of increased intracranial pressure and no neck rigidity or meningeal signs. The patient was diagnosed with bilateral acute closed angle glaucoma (AACG) with intraocular pressure of 60 mmHg in both eyes...
2016: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/27621675/meperidine-pethidine-versus-morphine-in-acute-pain-management-of-opioid-dependent-patients
#16
Hassan Solhi, Hossein Sanaei-Zadeh, Sadra Solhi, Mohammad Ali Azizi Nadian, Morteza Gharibi, Bahman Sadeghi Sedeh
The present study aimed to evaluate the effectiveness of morphine and meperidine (pethidine) as pain relief in opioid-dependent patients with acute pain. A total of 122 opioid-dependent patients with acute pain were included in the study. Their pain severity was assessed, using visual analog scale (VAS) scores ranging from 0 to 10. The patients randomly received intravenous morphine (up to 0.15 mg/kg) or meperidine (up to 1.5 mg/kg) for pain control by patient control analgesia (PCA) pump. The clinical opioid withdrawal scale (COWS) was employed for the assessment of withdrawal symptoms...
2016: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/27471415/asthma-related-emergency-department-use-current-perspectives
#17
REVIEW
Laurie H Johnson, Patricia Chambers, Judith W Dexheimer
Asthma is one of the most common chronic pediatric diseases. Patients with asthma often present to the emergency department for treatment for acute exacerbations. These patients may not have a primary care physician or primary care home, and thus are seeking care in the emergency department. Asthma care in the emergency department is multifaceted to treat asthma patients appropriately and provide quality care. National and international guidelines exist to help drive clinical care. Electronic and paper-based tools exist for both physicians and patients to help improve emergency, home, and preventive care...
2016: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/27307771/cardiopulmonary-laboratory-biomarkers-in-the-evaluation-of-acute-dyspnea
#18
REVIEW
Natalie R Stokes, Brett W Dietz, Jackson J Liang
Dyspnea is a common chief complaint in the emergency department, with over 4 million visits annually in the US. Establishing the correct diagnosis can be challenging, because the subjective sensation of dyspnea can result from a wide array of underlying pathology, including pulmonary, cardiac, neurologic, psychiatric, toxic, and metabolic disorders. Further, the presence of dyspnea is linked with increased mortality in a variety of conditions, and misdiagnosis of the cause of dyspnea leads to poor patient-level outcomes...
2016: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/27307770/early-recognition-of-intraventricular-hemorrhage-in-the-setting-of-thrombocytosis-in-the-emergency-department
#19
Marvinia Charles, Romy Fontoura, Gregory Sugalski
Thrombocytosis is frequently encountered as an incidental laboratory finding since isolated thrombocytosis is often asymptomatic. Even though thrombocytosis is benign and self-limiting in most cases, it can at times result in thrombosis or hemorrhage. The most common type of thrombocytosis is reactive (secondary) thrombocytosis and can be due to infections, trauma, surgery, or occult malignancy. Since thrombocytosis is a known risk factor for thrombosis, it is commonly a concern for ischemic stroke and myocardial infarction...
2016: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/27307769/interventions-to-reduce-the-risk-of-violence-toward-emergency-department-staff-current-approaches
#20
REVIEW
Nicola Ramacciati, Andrea Ceccagnoli, Beniamino Addey, Enrico Lumini, Laura Rasero
INTRODUCTION: The phenomenon of workplace violence in health care settings, and especially in the emergency department (ED), has assumed the dimensions of a real epidemic. Many studies highlight the need for methods to ensure the safety of staff and propose interventions to address the problem. AIM: The aim of this review was to propose a narrative of the current approaches to reduce workplace violence in the ED, with a particular focus on evaluating the effectiveness of emergency response programs...
2016: Open Access Emergency Medicine: OAEM
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