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Emergency medications

Felipe P Andrade, Roberto Montoro, Renan Oliveira, Gabriela Loures, Luana Flessak, Roberta Gross, Camille Donnabella, Andrea Puchnick, Lisa Suzuki, Rodrigo Regacini
OBJECTIVES: 1) To verify clinical signs correlated with appropriate cranial computed tomography scan indications and changes in the therapeutic approach in pediatric minor head trauma scenarios. 2) To estimate the radiation exposure of computed tomography scans with low dose protocols in the context of trauma and the additional associated risk. METHODS: Investigators reviewed the medical records of all children with minor head trauma, which was defined as a Glasgow coma scale ≥13 at the time of admission to the emergency room, who underwent computed tomography scans during the years of 2013 and 2014...
October 1, 2016: Clinics
Carlos Walter Sobrado, Lucas Faraco Sobrado
Introduction: Acute severe colitis is a potentially lethal medical emergency and, even today, its treatment remains a challenge for clinicians and surgeons. Intravenous corticoid therapy, which was introduced into the therapeutic arsenal in the 1950s, continues to be the first-line treatment and, for patients who are refractory to this, the rescue therapy may consist of clinical measures or emergency colectomy. Objective: To evaluate the indications for and results from drug rescue therapy (cyclosporine, infliximab and tacrolimus), and to suggest a practical guide for clinical approaches...
July 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Emily McNicholas, Ahmed H Abdelhafiz
Unexplained fever and confusion is a common reason for emergency medical admission. When this occurs in the context of new urinary incontinence, a urinary tract infection may be considered to be the most likely cause. However it is also important to consider spinal pathology when this combination of symptoms arises. We present a case of a retropharygeal collection presenting in a patient with this combination of symptoms.
2016: Acute Medicine
Richard Conway, Sean Cournane, Declan Byrne, Deirdre O'Riordan, Seamus Coveney, Bernard Silke
BACKGROUND: Deprivation increases admission rates; the specific effect of deprivation with regard to weekend admissions is unknown. METHODS: We calculated annual weekend admission rates for each small area population unit and related these to quintiles of Deprivation Index from 2002-2014. Univariate and multivariable risk estimates were calculated using truncated Poisson regression. RESULTS: There were 30,794 weekend admissions in 16,665 patients...
2016: Acute Medicine
I-Shiang Tzeng, Su-Hsun Liu, Kuan-Fu Chen, Chin-Chieh Wu, Jih-Chang Chen
To reduce patient boarding time at the emergency department (ED) and to improve the overall quality of the emergent care system in Taiwan, the Minister of Health and Welfare of Taiwan (MOHW) piloted the Grading Responsible Hospitals for Acute Care (GRHAC) audit program in 2007-2009.The aim of the study was to evaluate the impact of the GRHAC audit program on the identification and management of acute myocardial infarction (AMI)-associated ED visits by describing and comparing the incidence of AMI-associated ED visits before (2003-2007), during (2007-2009), and after (2009-2012) the initial audit program implementation...
October 2016: Medicine (Baltimore)
Christopher S Evans, Katherine M Hunld, Tony Rosen, Timothy F Platts-Mills
OBJECTIVES: To estimate the proportion of visits to U.S. emergency departments (EDs) in which a diagnosis of elder abuse is reached using two nationally representative datasets. DESIGN: Retrospective cross-sectional analysis. SETTING: U.S. ED visits recorded in the 2012 Nationwide Emergency Department Sample (NEDS) or the 2011 National Hospital Ambulatory Medical Care Survey (NHAMCS). PARTICIPANTS: All ED visits of individuals aged 60 and older...
October 18, 2016: Journal of the American Geriatrics Society
Soo Won Ko, Jong Seok Lee, Han Sung Choi, Young Gwan Ko, Hoon Pyo Hong
The use of high-pressure air instruments has become more common. Consequently, there have been a number of cases of orbital emphysema caused by contact with high-pressure air. In this case, a 62-year-old male patient visited an emergency medical center after his left eye was shot by an air compressor gun that was used to wash cars. Lacerations were observed in the upper and lower eyelids of his left eye. Radiological examinations revealed orbital emphysema, optic nerve transection, pneumocephalus, and subcutaneous emphysema in the face, neck, shoulder, and mediastinum...
September 2016: Clin Exp Emerg Med
Myeong-Il Cha, Gi Woon Kim, Chu Hyun Kim, Minhong Choa, Dai Hai Choi, Inbyung Kim, Soon Joo Wang, In Sool Yoo, Han Deok Yoon, Kang Hyun Lee, Suck Ju Cho, Tag Heo, Eun Seog Hong
OBJECTIVE: To investigate and document the disaster medical response during the Gyeongju Mauna Ocean Resort gymnasium collapse on February 17, 2014. METHODS: Official records of each institution were verified to select the study population. All the medical records and emergency medical service run sheets were reviewed by an emergency physician. Personal or telephonic interviews were conducted, without a separate questionnaire, if the institutions or agencies crucial to disaster response did not have official records or if information from different institutions was inconsistent...
September 2016: Clin Exp Emerg Med
Mun Ki Min, Seok Ran Yeom, Ji Ho Ryu, Yong In Kim, Maeng Real Park, Sang Kyoon Han, Seong Hwa Lee, Sung Wook Park, Soon Chang Park
OBJECTIVE: We compared training using a voice advisory manikin (VAM) with an instructor-led (IL) course in terms of acquisition of initial cardiopulmonary resuscitation (CPR) skills, as defined by the 2010 resuscitation guidelines. METHODS: This study was a randomized, controlled, blinded, parallel-group trial. We recruited 82 first-year emergency medical technician students and distributed them randomly into two groups: the IL group (n=41) and the VAM group (n=37)...
September 2016: Clin Exp Emerg Med
Adam J Singer, Henry C Thode, W Frank Peacock
OBJECTIVE: Introduction of target specific anticoagulants and recent guidelines encourage outpatient management of low risk patients with venous thromboembolism. We describe hospital admission rates over time for patients presenting to US emergency departments (EDs) with deep vein thrombosis (DVT) and pulmonary embolism (PE) and estimate the proportion of low-risk PE patients who could potentially be managed as outpatients. METHODS: We performed a structured analysis of the National Hospital Ambulatory Medical Care Survey (a nationally representative weighted sampling of US ED visits) database for the years 2006-2010 including all adult patients with a primary diagnosis of DVT or PE...
September 2016: Clin Exp Emerg Med
Brendan Michael Fitzpatrick, Michael Eugene Mullins
OBJECTIVE: To evaluate intravenous lidocaine's safety and efficacy as an analgesic agent in the treatment of a variety of painful conditions presenting to the emergency department. METHODS: This case series identified seventeen patients who received lidocaine over a six month period and recorded demographic data, amount of lidocaine administered, the amount of opioid medication administered before and after lidocaine, pre- and post-lidocaine pain scores, and any qualitative descriptors of the patient's pain recorded in the record...
June 2016: Clin Exp Emerg Med
Byoung-Joon Oh, Yong-Gyun Im, Eunjung Park, Young-Gi Min, Sang-Cheon Choi
OBJECTIVE: The effect of induced hypothermia on severe acute carbon monoxide (CO) poisoning remains to be addressed further. We investigated the effect of induced hypothermia on severe acute CO poisoning. METHODS: Retrospective chart review was conducted for patients who diagnosed as severe acute CO poisoning in emergency department and underwent induced hypothermia from May 2013 to May 2014. Hospital courses with critical medication and major laboratory results were investigated through the chart review...
June 2016: Clin Exp Emerg Med
Choung Ah Lee, Joon Pil Cho, Sang Cheon Choi, Hyuk Hoon Kim, Ju Ok Park
OBJECTIVE: Discharge against medical advice (DAMA) from the emergency department (ED) accounts for 0.1% to 2.7% of all ED discharges. DAMA carries a risk of increased mortality and readmissions. Our aim was to investigate the general characteristics of DAMA patients and the differences between them and non-DAMA patients. METHODS: We reviewed data collected by the National Emergency Medical Center between 2010 and 2011. Subjects were categorized into 2 groups, namely, the DAMA group and the non-DAMA group...
June 2016: Clin Exp Emerg Med
Jae Hyun Kwon, Chang Hwan Sohn, Jae Ho Lee, Bum Jin Oh
OBJECTIVE: The supply of emergency medicine (EM) specialists has not been able to meet demand in the past decade. This study comparatively analyzed clinical findings to provide fundamental data to inform efficient utilization of a limited number of EM specialists. METHODS: This retrospective study included 54,204 patients who visited the emergency department of a tertiary care medical center from March 1 to December 31, 2012. The experimental specialist-supervised (SS) group included patients supervised by an EM specialist, while the control specialist-on-call (SOC) group included patients attended by a senior resident of EM with an EM specialist on call...
March 2016: Clin Exp Emerg Med
Tae Nyoung Chung, Sun Wook Kim, Je Sung You, Hyun Soo Chung
OBJECTIVE: Tube thoracostomy (TT) is a commonly performed intensive care procedure. Simulator training may be a good alternative method for TT training, compared with conventional methods such as apprenticeship and animal skills laboratory. However, there is insufficient evidence supporting use of a simulator. The aim of this study is to determine whether training with medical simulator is associated with faster TT process, compared to conventional training without simulator. METHODS: This is a simulation study...
March 2016: Clin Exp Emerg Med
Taerim Kim, Shin Ahn, Chang Hwan Sohn, Dong Woo Seo, Won Young Kim
OBJECTIVE: Reversible cerebral vasoconstriction syndrome (RCVS) is an underestimated cause of thunderclap headache that shares many characteristics with subarachnoid hemorrhage (SAH). This fact makes the two easily confused by emergency physicians. This study evaluated the clinical manifestations, radiological features, and outcomes of patients with RCVS. METHODS: The electronic medical records of 18 patients meeting the diagnostic criteria of RCVS at our emergency department between January 2013 and December 2014 were retrospectively reviewed...
December 2015: Clin Exp Emerg Med
Francis Mawanda, Robert B Wallace, Kimberly McCoy, Thad E Abrams
INTRODUCTION: Emerging evidence indicates associations between extra-central nervous system (CNS) bacterial infections and an increased risk for dementia; however, epidemiological evidence is still very limited. METHODS: This study involved a retrospective cohort of a national sample of US veterans (N = 417,172) aged ≥56 years. Extended Cox proportional hazard models adjusted for demographic characteristics and medical and psychiatric comorbidities determined the associations between systemic and localized extra-CNS bacterial infections occurring >2 years before the initial dementia diagnosis and the risk for dementia...
2016: Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring
Maryam Maddineshat, Alan H Rosenstein, Arash Akaberi, Mahbubeh Tabatabaeichehr
Introduction: Disruptive behaviors cause many problems in the workplace, especially in the emergency department (ED).This study was conducted to assess the physician's and nurse's perspective toward disruptive behaviors in the emergency department. Methods: In this cross-sectional study a total of 45 physicians and 110 nurses working in the emergency department of five general hospitals in Bojnurd participated. Data were collected using a translated, changed, and validated questionnaire (25 item). The collected data were analyzed by SPSS ver...
September 2016: Journal of Caring Sciences
Kaname Uno, Katsunori Iijima, Yasuhiko Abe, Tomoyuki Koike, Yasushi Takahashi, Nobuyuki Ara, Tooru Shimosegawa
PURPOSE: Endoscopic diagnosis of gastric cancer (GC) that emerges after eradication of Helicobacter pylori may be affected by unique morphological changes. Using comprehensive endoscopic imaging, which can reveal biological alterations in gastric mucosa after eradication, previous studies demonstrated that Congo red chromoendoscopy (CRE) might clearly show an acid non-secretory area (ANA) with malignant potential, while autofluorescence imaging (AFI) without drug injection or dyeing may achieve early detection or prediction of GC...
September 2016: Journal of Gastric Cancer
Husam R Kayyali, Anastasia Luniova, Ahmed Abdelmoity
Background. Approximately, one-third of patients with epilepsy are refractory to pharmacological treatment which mandates extensive medical care and imposes significant economic burden on patients and their societies. This study intends to assess the impact of the treatment with ketogenic diet (KD) on reducing seizure-related emergency room visits and hospitalizations in children with refractory epilepsy. Methods. This is a retrospective review of children treated with the KD in one tertiary center. We compared a 12 months' period prior to KD with 12 months after the diet was started in regard to the number of emergency department (ED) visits, hospitalizations, and hospital days as well as their associated charges...
2016: Epilepsy Research and Treatment
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