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Open Access Emergency Medicine: OAEM

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https://www.readbyqxmd.com/read/28919828/jugular-bulb-oxygen-saturation-correlates-with-full-outline-of-responsiveness-score-in-severe-traumatic-brain-injury-patients
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/28794660/a-renal-colic-fast-track-pathway-to-improve-waiting-times-and-outcomes-for-patients-presenting-to-the-emergency-department
#4
Omar Al Kadhi, Kate Manley, Madhavi Natarajan, Valmiki Lutchmedial, Abbi Forsyth, Kate Tabrett, Jonathan Betteridge, William Finch, Heinrich Hollis
INTRODUCTION: Renal colic is commonly encountered in the emergency department (ED). We validated a fast track renal colic (FTRC) initiative to decrease patient waiting times and streamline patient flow. METHOD: The FTRC pathway was devised according to the National Institute for Health and Care Excellence clinical summary criteria for the management of patients with suspected renal colic. ED triage nurses use the pathway to identify patients with likely renal colic suitable for fast track to analgesia, investigation and management...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28740438/availability-and-use-of-hemostatic-agents-in-prehospital-trauma-patients-in-pennsylvania-translation-from-the-military-to-the-civilian-setting
#5
Adam Sigal, Anthony Martin, Adrian Ong
OBJECTIVE: To understand the translation of one innovation in trauma care from the military to the civilian setting, the adoption of topical hemostatic agents in the Emergency Medical Services (EMS) community and in Trauma Centers in Pennsylvania. METHOD: We utilized an anonymous electronic survey of EMS Agency Administrative Officers and Trauma Center Coordinators. RESULTS: We received responses from 23% (93/402) Advanced Life Support and Air Medical agencies in the State...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28435334/bispectral-index-value-correlates-with-glasgow-coma-scale-in-traumatic-brain-injury-patients
#6
Tjokorda Gde Agung Senapathi, Made Wiryana, I Gusti Ngurah Mahaalit Aribawa, Christopher Ryalino
BACKGROUND: Accuracy of consciousness level assessment is very important. It may determine and influence further clinical decisions, thus influences patients' outcomes. The widest method in determining the level of awareness is the Glasgow Coma Scale (GCS). Despite its common use, GCS scores obtained by one clinician may differ from others depending on their interpretations and past experience. One of the tools used to assess the level of consciousness objectively is bispectral index (BIS)...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28331374/clinical-experience-and-skills-of-physicians-in-hospital-cardiac-arrest-teams-in-denmark-a-nationwide-study
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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