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Clinical and Experimental Emergency Medicine

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https://www.readbyqxmd.com/read/29973037/pediatric-food-impaction-detected-through-point-of-care-ultrasonography
#1
Takaaki Mori, Takateru Ihara, Yusuke Hagiwara
A previously healthy 1-year-old boy suddenly began coughing while eating a dried sweet potato. Because he continued gagging after vomiting a piece of the dried sweet potato, his mother brought him to our emergency room. Upon arrival, despite normal pulmonary findings, he was drooling and gagging. Ultrasonography was performed because food impaction at the upper esophagus was suspected based on his medical history and physical examination, and results showed that a linear hyperechoic lesion was obstructing the posterior esophageal wall...
June 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29973036/validation-and-proposal-for-cut-off-values-of-an-abbreviated-version-of-the-alcohol-use-disorder-identification-test-using-the-korean-national-health-and-nutrition-examination-survey
#2
Jae Hee Lee, Kyoung Ae Kong, Duk Hee Lee, Yoon Hee Choi, Koo Young Jung
Objective: Several abbreviated versions of the Alcohol Use Disorder Identification Test (AUDIT) have been developed and are widely used in clinical settings. In this study, we provide evidence supporting the use of abbreviated versions of AUDIT by comparing the utility of various abbreviated versions and determining cut-off values for the population of South Korea. Methods: Data were obtained from the 4th to 6th Korean National Health and Nutrition Examination Surveys...
June 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29973035/diagnostic-performance-of-brain-computed-tomography-to-detect-facial-bone-fractures
#3
Duk Ho Kim, Yoon Hee Choi, Seong Jong Yun, Sun Hwa Lee
Objective: Most patients with head trauma require brain computed tomography (CT) in the emergency department. However, the requirement for facial CT remains controversial. The aim of this study was to evaluate the diagnostic value of brain CT alone for detection of facial fractures and its ability to determine the requirement for additional facial CT. Methods: This retrospective multicenter study was conducted in two tertiary hospitals in Seoul, Republic of Korea, between January 2014 and December 2015...
June 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29973034/radial-access-for-percutaneous-coronary-procedure-relationship-between-operator-expertise-and-complications
#4
Simona Susanu, Marco Angelillis, Cristina Giannini, Rossella Binella, Anna Matteoni, Rita Bellucci, Sandro Balestri, Nicola Ferrara, Federico Falchi, Giuliano Micheletti, Anna Sonia Petronio
Objective: The aim of this study was to investigate (1) whether the learning curve of new catheterization laboratory operators increases the incidence of complications of transradial access during percutaneous coronary interventions and (2) whether manual compression with a two-step approach is safe and efficient for radial access hemostasis. Methods: We performed a prospective study with all consecutive patients who underwent a coronary diagnostic or intervention procedure with radial access...
June 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29973033/injury-pyramid-of-unintentional-injuries-according-to-sex-and-age-in-south-korea
#5
Ajung Kim, Hyunjong Song, Namsoo Park, Sangchun Choi, Joonpil Cho
Objective: The injury-related disease burden in South Korea is relatively high compared to that in other nations. This study was conducted to identify the scale and causes of injury by severity, using an injury pyramid and analyzing the sex and age-dependent differences and the basic demographic characteristics. Methods: Unintentional injury was estimated for each group after classifying injury-related deaths, hospitalizations, and outpatient department (OPD) visits based on their severity...
June 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29973032/usefulness-of-delta-neutrophil-index-for-early-prediction-of-overt-disseminated-intravascular-coagulopathy-in-patients-with-venomous-snakebite
#6
Yong Sung Cha, Kang Hyun Lee, Seok Jeong Lee, Ho Chul Kwon, Jong Wook Lee, Hyung Il Kim, Oh Hyun Kim, Kyoung-Chul Cha, Hyun Kim, Sung Oh Hwang
Objective: Clinically, consumptive coagulopathy, such as disseminated intravascular coagulopathy (DIC), is the most important among the common venomous snakebite complications owing to the serious hemorrhage risk associated with this condition. We evaluated the predictive value of the delta neutrophil index (DNI)-a new indicator for immature granulocytes-for DIC diagnosis. Methods: This retrospective observational study consecutively assessed adult patients with venomous snakebites for over 51 months...
June 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29973031/usefulness-of-ultrasonography-for-the-evaluation-of-catheter-misplacement-and-complications-after-central-venous-catheterization
#7
Yong In Kim, Ji Ho Ryu, Mun Ki Min, Maeng Real Park, Soon Chang Park, Seok Ran Yeom, Sang Kyoon Han, Sung Wook Park, Seong Hwa Lee
Objective: To assess whether ultrasonographic examination compared to chest radiography (CXR) is effective for evaluating complications after central venous catheterization. Methods: We performed a prospective observational study. Immediately after central venous catheter insertion, we asked the radiologic department to perform a portable CXR scan. A junior and senior medical resident each performed ultrasonographic evaluation of the position of the catheter tip and complications such as pneumothorax and pleural effusion (hemothorax)...
June 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29706060/variability-of-extracorporeal-cardiopulmonary-resuscitation-utilization-for-refractory-adult-out-of-hospital-cardiac-arrest-an-international-survey-study
#8
Patrick J Coppler, Benjamin S Abella, Clifton W Callaway, Minjung Kathy Chae, Seung Pill Choi, Jonathan Elmer, Won Young Kim, Young-Min Kim, Michael Kurz, Joo Suk Oh, Joshua C Reynolds, Jon C Rittenberger, Kelly N Sawyer, Chun Song Youn, Byung Kook Lee, David F Gaieski
Objective: A growing interest in extracorporeal cardiopulmonary resuscitation (ECPR) as a rescue strategy for refractory adult out-of-hospital cardiac arrest (OHCA) currently exists. This study aims to determine current standards of care and practice variation for ECPR patients in the USA and Korea. Methods: In December 2015, we surveyed centers from the Korean Hypothermia Network (KORHN) Investigators and the US National Post-Arrest Research Consortium (NPARC) on current targeted temperature management and ECPR practices...
June 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29706057/monomorphic-ventricular-tachycardia-due-to-protease-inhibitor-intoxication-by-atazanavir
#9
Byunghyun Kim, Kyung Su Kim
Atazanavir is a protease inhibitor approved for use in combination with other antiretroviral drugs for the treatment of human immunodeficiency virus infection. Atazanavir and other protease inhibitors can sometimes induce corrected QT prolongation and ventricular arrhythmia. A 40-year-old man with no comorbidities, except human immunodeficiency virus 1 infection, presented with palpitations 3 days after an overdose of 150 caps of atazanavir, with suicidal intent. His initial electrocardiogram showed monomorphic ventricular tachycardia, and hyperbilirubinemia was observed in his initial blood test...
June 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29706056/changes-in-medical-care-due-to-the-absence-of-internal-medicine-physicians-in-emergency-departments
#10
Kyoung Ho Kim, Jang Young Lee, Won Suk Lee, Won Young Sung, Sang Won Seo
Objective: Especially in emergency departments (EDs), a lack of internal medicine (IM) residents in charge causes difficulties in medical care and ED overcrowding. Thus, protocols without IM residents in EDs is needed. This study aimed to investigate changes in medical care when emergency medicine residents replaced the roles of IM residents. Methods: This study was conducted at a single-site ED of a university medical center. The study group contained patients admitted to the IM department between September and December 2015, during which IM residents were absent in the ED...
June 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29706055/hemoglobin-concentration-is-associated-with-neurologic-outcome-after-cardiac-arrest-in-patients-treated-with-targeted-temperature-management
#11
Daesung Kim, Soo Hyun Kim, Kyu Nam Park, Sang Hoon Oh, Young Min Kim, Chun Song Youn
Objective: The objective of this study was to test the hypothesis that hemoglobin concentration after return of spontaneous circulation (ROSC) is associated with neurologic outcome after cardiac arrest in patients treated with targeted temperature management. Methods: We studied consecutive adult patients with out-of-hospital cardiac arrest treated with targeted temperature management between January 2009 and December 2015. We quantified the association between post ROSC hemoglobin concentrations and good neurologic outcome (defined as Cerebral Performance Category of 1 and 2) at hospital discharge using multivariate logistic regression analysis...
April 30, 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29706054/heparin-free-extracorporeal-membrane-oxygenation-in-a-patient-with-severe-pulmonary-contusions-and-bronchial-disruption
#12
Kyoung Min Ryu, Sung Wook Chang
Pulmonary contusion complicated with endobronchial hemorrhage is potentially life-threatening, particularly in patients with tracheobronchial tree disruption and severe airway bleeding after blunt trauma, and pose a high mortality risk. In such cases, extracorporeal membrane oxygenation (ECMO) can be used as a salvage treatment modality. However, the use of ECMO for moribund trauma patients with respiratory failure may be limited for several reasons, such as intractable bleeding. In this case report, we describe a patient with severe bilateral pulmonary contusions with tracheobronchial tree disruption that was successfully treated using heparin-free venovenous ECMO...
April 30, 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29706053/night-shift-preparation-performance-and-perception-are-there-differences-between-emergency-medicine-nurses-residents-and-faculty
#13
John R Richards, Taylor L Stayton, Jason A Wells, Aman K Parikh, Erik G Laurin
Objective: Determine differences between faculty, residents, and nurses regarding night shift preparation, performance, recovery, and perception of emotional and physical health effects. Methods: Survey study performed at an urban university medical center emergency department with an accredited residency program in emergency medicine. Results: Forty-seven faculty, 37 residents, and 90 nurses completed the survey. There was no difference in use of physical sleep aids between groups, except nurses utilized blackout curtains more (69%) than residents (60%) and faculty (45%)...
April 30, 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29618195/inter-rater-variability-in-the-interpretation-of-the-head-impulse-test-results
#14
Alexander Cuculiza Henriksen, Peter Hallas
No abstract text is available yet for this article.
March 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29618194/quality-improvement-activity-for-improving-pain-management-in-acute-extremity-injuries-in-the-emergency-department
#15
Hyung Lan Chang, Jin Hee Jung, Young Ho Kwak, Do Kyun Kim, Jin Hee Lee, Jae Yun Jung, Hyuksool Kwon, So Hyun Paek, Joong Wan Park, Jonghwan Shin
OBJECTIVE: The aim of this study was to investigate the effectiveness of a quality improvement activity for pain management in patients with extremity injury in the emergency department (ED). METHODS: This was a retrospective interventional study. The patient group consisted of those at least 19 years of age who visited the ED and were diagnosed with International Classification of Diseases codes S40-S99 (extremity injuries). The quality improvement activity consisted of three measures: a survey regarding activities, education, and the triage nurse's pain assessment, including change of pain documentation on electronic medical records...
March 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29618193/a-novel-method-to-cease-traumatic-urethral-bleeding
#16
Hamed Akhavizadegan
Urethral bleeding due to trauma is a well-studied and often self-limiting condition. However, existing evidence regarding effective management of massive hemorrhage is limited. Intermittent penile compression and continuous perineal pressure are methods commonly used to control urethral bleeding. Nevertheless, these methods are not mentioned in the literature as specific treatment for this condition, and are rather learned by physicians via word of mouth. Sometimes these methods are ineffective and difficult for the patient to tolerate...
March 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29618192/incidence-and-characteristics-of-major-bleeding-among-rivaroxaban-users-with-renal-disease-and-nonvalvular-atrial-fibrillation
#17
Manesh R Patel, W Frank Peacock, Sally Tamayo, Nicholas Sicignano, Kathleen P Hopf, Zhong Yuan
OBJECTIVE: Patients with nonvalvular atrial fibrillation (AF) and renal disease (RD) who receive anticoagulation therapy appear to be at greater risk of major bleeding (MB) than AF patients without RD. As observed in past studies, anticoagulants are frequently withheld from AF patients with RD due to concerns regarding bleeding. The objective of this study was to evaluate the incidence and pattern of MB in those with RD, as compared to those without RD, in a population of rivaroxaban users with nonvalvular AF...
March 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29618191/delayed-massive-hemothorax-requiring-surgery-after-blunt-thoracic-trauma-over-a-5-year-period-complicating-rib-fracture-with-sharp-edge-associated-with-diaphragm-injury
#18
Sung Wook Chang, Kyoung Min Ryu, Jae-Wook Ryu
Delayed massive hemothorax requiring surgery is relatively uncommon and can potentially be life-threatening. Here, we aimed to describe the nature and cause of delayed massive hemothorax requiring immediate surgery. Over 5 years, 1,278 consecutive patients were admitted after blunt trauma. Delayed hemothorax is defined as presenting with a follow-up chest radiograph and computed tomography showing blunting or effusion. A massive hemothorax is defined as blood drainage >1,500 mL after closed thoracostomy and continuous bleeding at 200 mL/hr for at least four hours...
March 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29618190/pre-hospital-i-gel-blind-intubation-for-trauma-a-simulation-study
#19
Jae Guk Kim, Wonhee Kim, Gu Hyun Kang, Yong Soo Jang, Hyun Young Choi, Hyeongtae Kim, Minji Kim
OBJECTIVE: This study aimed to evaluate the efficacy of i-gel blind intubation (IGI) as a rescue device for definitive airway management in ground intubation for pre-hospital trauma patients. METHODS: A prospective randomized crossover study was conducted with 18 paramedics to examine intubation performance of two blind intubation techniques through a supraglottic airway devices (IGI and laryngeal mask airway Fastrach), compared with use of a Macintosh laryngoscope (MCL)...
March 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29618189/cervical-collar-makes-difficult-airway-a-simulation-study-using-the-lemon-criteria
#20
Moonsu Yuk, Woonhyung Yeo, Kangeui Lee, Jungin Ko, Taejin Park
OBJECTIVE: Endotracheal intubation is extremely difficult to perform in patients wearing a cervical collar for a head and neck injury. Therefore, we analyzed actual measurements using the look externally, evaluate 3-3-2, Mallampati score, obstruction, and neck mobility (LEMON) criteria before and after cervical collar application to investigate the causes of a difficult airway. METHODS: This simulation study was performed in 76 healthy volunteers. We measured the mouth opening, modified Mallampati classification, and neck extension before and after cervical collar application...
March 2018: Clinical and Experimental Emergency Medicine
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