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Open Access Emergency Medicine: OAEM

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https://www.readbyqxmd.com/read/29942165/acute-pulmonary-edema-induced-by-non-ionic-low-osmolar-radiographic-contrast-media
#1
Laurence Pincet, Gabriele Lecca
Background: Non-cardiogenic pulmonary edema (NCPE) after intravenous (iv) administration of non-ionic radiocontrast media (RCM) is a rare but life-threatening complication. In a context of emergency, its diagnosis is difficult. Case report: We report the case of a 55-year-old woman who developed an acute pulmonary edema following iv infusion of non-ionic, low-osmolar RCM during abdominal CT scan. She needed a 24-hour hospitalization in intensive care unit for an acute hypoxemic dyspnea...
2018: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29942164/extended-glasgow-outcome-scale-correlates-with-bispectral-index-in-traumatic-brain-injury-patients-who-underwent-craniotomy
#2
Tjokorda Gde Bagus Mahadewa, Tjokorda Gde Agung Senapathi, Made Wiryana, I Gusti Ngurah Mahaalit Aribawa, Ketut Yudi Arparitna, Christopher Ryalino
Background: Assessing consciousness in traumatic brain injury is important because it also determines the treatment option, which will influence patients' outcome. A tool used to objectively assess consciousness level is the bispectral index (BIS) monitor, which was originally designed to monitor the depth of anesthesia. Glasgow Outcome Scale-Extended (GOS-E) provides a measuring tool to assess traumatic brain injury (TBI) outcome. The goal of this study was to assess the correlation between GOS-E scores with BIS values in patients with TBI who underwent craniotomy...
2018: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29942163/elaborated-plan-for-incoming-surgical-emergency-management-in-sub-saharan-africa
#3
REVIEW
Olivier Kubwimana
Background: Globally, there has been an increase in injuries as a major cause of death. This burden is mainly due to an increase in road traffic injuries, and it poses an enormous burden in low- and middle-income countries. Musculoskeletal and head injuries are the most prevalent ones, which has led to an overcrowding of traumatic surgical emergencies. Methodology: An unrestricted search was done in different research databases for articles published in English between January 2005 and November 2017 focusing on traumatic surgical emergencies...
2018: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29872354/ultrasound-guided-central-venous-catheter-placement-in-the-emergency-department-experience-in-a-hospital-in-bogot%C3%A3-colombia
#4
German Devia Jaramillo, Jenny Torres Castillo, Freddy Lozano, Angélica Ramírez
Introduction: The use of central venous catheters (CVCs) in the emergency room (ER) is a valuable tool for the comprehensive management of critically ill patients; however, the positioning of these devices is not free of complications. Currently, the use of ultrasound is considered a useful and safe tool to carry out these procedures, but in Colombia, the number of emergency departments providing this tool is scarce and there is no literature describing the experience in our country. Objective: The objective of this study was to describe the experience regarding placement of ultrasound-guided CVCs by emergency physicians in an institution in Bogotá, as well as the associated complications...
2018: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29805271/strategies-for-improving-outcomes-in-the-acute-management-of-ischemic-stroke-in-rural-emergency-departments-a-quality-improvement-initiative-in-the-stroke-belt
#5
Edward C Jauch, David Y Huang, Allison J Gardner, Julie L Blum
Background: The timely evaluation and initiation of treatment for acute ischemic stroke (AIS) is critical to optimal patient outcomes. However, clinical practice often falls short of guideline-established goals. Hospitals in rural regions of the USA, and notably those in the Stroke Belt, are particularly challenged to meet timing goals since the vast majority of primary stroke centers (PSCs) are concentrated in urban academic institutions. Methods: Between May 2015 and May 2017, emergency department (ED) teams from 5 non-PSC hospitals in the Stroke Belt participated in a quality improvement (QI) initiative...
2018: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29750057/medical-issues-in-flight-and-updating-the-emergency-medical-kit
#6
REVIEW
Mohamud A Verjee, Robert Crone, Grigory Ostrovskiy
Airline travel is more affordable than ever and likely safer than ever too. Within half a day, a passenger can be on the other side of the world. However, medical care in-flight has been an issue for those with medical conditions and for those who fall sick during a journey. While airlines have the advice of multiple recognized organizations on needs and standards of care, in-flight emergencies occur at various levels. An emergency medical kit (EMK) together with trained cabin crew can be very effective at resolving the minor problems that arise and reducing the risk of escalation...
2018: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29719423/reduction-in-laboratory-turnaround-time-decreases-emergency-room-length-of-stay
#7
Nitin Kaushik, Victor S Khangulov, Matthew O'Hara, Ramy Arnaout
Objective: Laboratory tests are an important contributor to treatment decisions in the emergency department (ED). Rapid turnaround of laboratory tests can optimize ED throughout by reducing the length of stay (LOS) and improving patient outcomes. Despite evidence supporting the effect of shorter turnaround time (TAT) on LOS and outcomes, there is still a lack of large retrospective studies examining these associations. Here, we evaluated the effect of a reduction in laboratory TAT on ED LOS using retrospective analysis of Electronic Health Records (EHR)...
2018: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29416381/all-guns-blazing-management-and-survival-of-massive-valproic-acid-overdose-case-report-and-literature-review
#8
Shaikha Al Jawder, Eiman AlJishi, Shaikhah Al-Otaibi, Mohammed S Al-Shahrani
A 51-year-old woman, who intentionally ingested a massive dose of ~60 g of valproic acid which she was using as a mood stabilizer for bipolar affective disorder, presented within 30 minutes of ingestion to the emergency department. The patient was asymptomatic and was immediately started on decontamination therapy with activated charcoal (AC). Drug serum levels, liver functions, and ammonia levels were tested and followed up during treatment. Due to the massive ingestion and continuous rise in serum drug levels, the patient received regular multiple doses of AC, as well as l-carnitine for liver protection...
2018: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29343993/management-of-disseminated-intravascular-coagulation-current-insights-on-antithrombin-and-thrombomodulin-treatments
#9
REVIEW
Mineji Hayakawa
Sepsis and septic shock are frequently complicated by disseminated intravascular coagulation (DIC), which decreases the survival rate of patients with sepsis. In the past, large international randomized controlled trials (RCTs) using physiological anticoagulants for sepsis-induced DIC were not performed; however, RCTs have been conducted for sepsis and/or septic shock. In these trials, physiological anticoagulants did not show any beneficial effects compared with placebo for the treatment of sepsis and/or septic shock...
2018: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29302196/when-good-times-go-bad-managing-legal-high-complications-in-the-emergency-department
#10
REVIEW
Charles R Caffrey, Patrick M Lank
Patients can use numerous drugs that exist outside of existing regulatory statutes in order to get "legal highs." Legal psychoactive substances represent a challenge to the emergency medicine physician due to the sheer number of available agents, their multiple toxidromes and presentations, their escaping traditional methods of analysis, and the reluctance of patients to divulge their use of these agents. This paper endeavors to cover a wide variety of "legal highs," or uncontrolled psychoactive substances that may have abuse potential and may result in serious toxicity...
2018: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29302195/can-base-excess-and-anion-gap-predict-lactate-level-in-diagnosis-of-septic-shock
#11
Werapon Pongmanee, Veerapong Vattanavanit
Background: Lactate measurement is the key component in septic shock identification and resuscitation. However, point-of-care lactate testing is not widely used due to the lack of access to nearby test equipment. Biomarkers such as serum lactate, anion gap (AG), and base excess (BE) are used in determining shock in patients with seemingly normal vital signs. Purpose: We aimed to determine if these biomarkers can be used interchangeably in patients with septic shock in the emergency setting...
2018: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29184452/violence-toward-health-workers-in-bahrain-defense-force-royal-medical-services-emergency-department
#12
Faisal Rafeea, Ahmed Al Ansari, Ehab M Abbas, Khalifa Elmusharaf, Mohamed S Abu Zeid
Background: Employees working in emergency departments (EDs) in hospital settings are disproportionately affected by workplace violence as compared to those working in other departments. Such violence results in minor or major injury to these workers. In other cases, it leads to physical disability, reduced job performance, and eventually a nonconducive working environment for these workers. Materials and methods: A cross-sectional exploratory questionnaire was used to collect data used for the examination of the incidents of violence in the workplace...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29158694/the-art-of-removing-nasal-foreign-bodies
#13
Tian-Tee Ng, Michael Nasserallah
Objective: The removal of nasal foreign bodies (NFBs) can be a difficult task for the inexperienced physician, and the more unsuccessful attempts are made, the more difficult the extraction becomes. We have formulated this simple "four-step" approach to improve success, especially on the first try. Methods: A retrospective review of cases requiring NFB removal, seen by one registrar from 2012 to 2016 at Frankston Hospital, was performed. Results: From 2012 to 2016, 93 patients were referred, of whom 65 were confirmed to have NFBs...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29123431/comparative-quality-measures-of-emergency-care-an-outcome-cockpit-proposal-to-survey-clinical-processes-in-real-life
#14
Susanne Burgemeister, Alexander Kutz, Antoinette Conca, Thomas Holler, Sebastian Haubitz, Andreas Huber, Ulrich Buergi, Beat Mueller, Philipp Schuetz
Background: Benchmarking of real-life quality of care may improve evaluation and comparability of emergency department (ED) care. We investigated process management variables for important medical diagnoses in a large, well-defined cohort of ED patients and studied predictors for low quality of care. Methods: We prospectively included consecutive medical patients with main diagnoses of community-acquired pneumonia, urinary tract infection (UTI), myocardial infarction (MI), acute heart failure, deep vein thrombosis, and COPD exacerbation and followed them for 30 days...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29066937/empirical-research-on-the-utility-of-a-preparation-manual-for-a-disaster-medical-response-drill
#15
Takao Arai, Shoichi Ohta, Masaki Onishi, Miyu Taniguchi, Junya Tsurukiri, Kenichiro Kumasaka, Katsuhiro Nagata, Kensuke Suzuki, Ken Harigae, Tetsuo Yukioka
PURPOSE: It is difficult for emergency physicians to plan and execute a disaster medical response drill while conducting their daily work activities. Readily available drill preparation manuals are therefore essential, alongside assessment methods to ensure quality. Here, we propose email text analysis as a manual assessment method, and investigate its validity. METHODS: The preparation status of two similar large-scale disaster medical response drills were compared...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29066936/automated-external-defibrillation-training-on-the-left-or-the-right-side-a-randomized-simulation-study
#16
Mathilde Stærk, Henrik Bødtker, Kasper G Lauridsen, Bo Løfgren
BACKGROUND: Correct placement of the left automated external defibrillator (AED) electrode is rarely achieved. AED electrode placement is predominantly illustrated and trained with the rescuer sitting on the right side of the patient. Placement of the AED electrodes from the left side of the patient may result in a better overview of and access to the left lateral side of the thorax. This study aimed to investigate if training in automated external defibrillation on the left side compared to the right side of a manikin improves left AED electrode placement...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29033616/nationwide-trends-of-clinical-characteristics-and-economic-burden-of-emergency-department-visits-due-to-acute-ischemic-stroke
#17
Mark Stuntz, Katsiaryna Busko, Shumaila Irshad, Taylor Paige, Veranika Razhkova, Tim Coan
We aimed to provide estimates of the volume and associated charges of acute ischemic stroke (AIS) visits in the US, as well as to assess predictors of patient disposition following an emergency department (ED) visit for AIS. Our study was conducted using the 2010-2013 data from the Nationwide Emergency Department Sample. We identified adult visits with AIS as the primary diagnosis. A generalized linear model was used to calculate mean charges per visit after adjusting for covariates. Multinomial logistic regression was used to assess predictors of patient disposition following an ED visit for AIS...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28919828/jugular-bulb-oxygen-saturation-correlates-with-full-outline-of-responsiveness-score-in-severe-traumatic-brain-injury-patients
#18
Tjokorda Gde Agung Senapathi, Made Wiryana, Ketut Sinardja, Ketut Wibawa Nada, Ida Bagus Krisna Jaya Sutawan, Christopher Ryalino, Aloysius Alphonso
BACKGROUND: Maintaining brain oxygenation status is the main goal of treatment in severe traumatic brain injury (TBI). Jugular venous oxygen saturation (SjvO2) monitoring is a technique to estimate global balance between cerebral oxygen supply and its metabolic requirement. Full Outline of Responsiveness (FOUR) score, a new consciousness measurement scoring, is expected to become an alternative for Glasgow Coma Scale (GCS) in evaluating neurologic status of patients with severe traumatic head injury, especially for those under mechanical ventilation...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28919827/is-a-mechanical-assist-device-better-than-manual-chest-compression-a-randomized-controlled-trial
#19
Chaiyaporn Yuksen, Thidathit Prachanukool, Kasamon Aramvanitch, Nuttamon Thongwichit, Kittisak Sawanyawisuth, Yuwares Sittichanbuncha
BACKGROUND: Chest compression quality is a determinant of survival from sudden cardiac arrest. The CPR RsQ Assist Device (CPR RAD) is a new cardiopulmonary resuscitation device for chest compression. It is operated manually but it does not pull up on the chest on the up stroke. The aim of this study was to compare the CPR RAD with standard manual compression in terms of chest compression quality in a manikin model. METHODS: Participants were randomly assigned to either the device or manual chest compression group...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28794661/focused-assessment-with-sonography-for-trauma-current-perspectives
#20
REVIEW
Sorravit Savatmongkorngul, Sirote Wongwaisayawan, Rathachai Kaewlai
Focused assessment with sonography for trauma (FAST) is a part of resuscitation of trauma patients recommended by international panel consensus. The purpose of FAST is to identify free fluid, which necessarily means blood in acute trauma patients. In this article, the authors focused on various aspects of FAST in the emergency department, prehospital care, pediatric setting, training and general pearls/pitfalls. Detailed techniques and interpretation of FAST are beyond the scope of this article.
2017: Open Access Emergency Medicine: OAEM
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