Journals International Journal of Emerg...

International Journal of Emergency Medicine
Eva V Zadorozny, Tyler Weigel, Samuel M Galvagno, Christian Martin-Gill, Joshua B Brown, Francis X Guyette
BACKGROUND: Traumatic shock is the leading cause of preventable death with most patients dying within the first six hours from arriving to the hospital. This underscores the importance of prehospital interventions, and growing evidence suggests prehospital transfusion improves survival. Optimizing transfusion triggers in the prehospital setting is key to improving outcomes for patients in hemorrhagic shock. Our objective was to identify factors associated with early in-hospital transfusion requirements available to prehospital clinicians in the field to develop a simple algorithm for prehospital transfusion, particularly for patients with occult shock...
June 19, 2024: International Journal of Emergency Medicine
Soo Yeon Kang, Ik Joon Jo, Sejin Heo, Hansol Chang, Guntak Lee, Jong Eun Park, Taerim Kim, Se Uk Lee, Min Ji Kim, Hee Yoon
BACKGROUND: Many cases of deep vein thrombosis (DVT) are diagnosed in the emergency department, and abbreviated lower extremity venous point-of-care ultrasound (POCUS) has already shown an accuracy comparable to that of specialists. This study aimed to identify the learning curve necessary for emergency medicine (EM) residents to achieve expertise-level accuracy in diagnosing DVT through a 3-point lower extremity venous POCUS. METHODS: This prospective study was conducted at an emergency department between May 2021 and October 2022...
June 17, 2024: International Journal of Emergency Medicine
João P M Bidart, Regis G Rosa, Marina Bessel, Luana G Pedrotti, Luciano Z Goldani
BACKGROUND: Sepsis remains a worldwide major cause of hospitalization, mortality, and morbidity. To enhance the identification of patients with suspected sepsis at high risk of mortality and adverse outcomes in the emergency department (ED), the use of mortality predictors is relevant. This study aims to establish whether quick sofa (qSOFA) and the severity criteria applied in patients with suspicion of sepsis in a monitored ED are in fact predictors of mortality. METHODS: We performed a retrospective cohort study among adult patients with suspicion of sepsis at the ED of a tertiary care hospital in Brazil between January 1st, 2019 and December 31, 2020...
June 17, 2024: International Journal of Emergency Medicine
Salva Ameena M S, Vempalli Nagasubramanyam, Anand Sharma, Nidhi Kaeley, Bharat Bhushan Bhardwaj, Poonam Arora, Althaf Assis, Takshak Shankar, Hari Prasad, Mukund Rajta, Ashwani Pundir
BACKGROUND: The World Health Organization (WHO) reports that Asia and Africa have the highest Chronic Liver Disease (CLD) mortality rate. Cirrhosis, responsible for 22.2 fatalities per 100,000 people, is India's 10th most common cause of mortality. The increasing prevalence of chronic liver disease necessitates a study to identify predictive factors for patients who visit the emergency department. Identifying elements that enhance the predictive value of mortality in unstable patients with CLD complications is important in emergency departments...
June 13, 2024: International Journal of Emergency Medicine
Shuji Uemura, Ryuichi Nakayama, Masayuki Koyama, Yukiko Taguchi, Naofumi Bunya, Keigo Sawamoto, Hirofumi Ohnishi, Eichi Narimatsu
BACKGROUND: Falls among older individuals contribute significantly to the rise in ambulance transport use. To recognize the importance of future countermeasures, we estimated the projected number and percentage of fall-related emergency medical service (EMS) calls. METHODS: We examined the sex, age group, and location of falls among patients aged ≥ 65 years who contacted emergency services in Sapporo City from 2013 to 2021. Annual fall-related calls per population subgroup were calculated, and trends were analyzed...
June 11, 2024: International Journal of Emergency Medicine
Matthew Oliver, Andrew Coggins, Natalie Kruit, Brian Burns, Brian Plunkett, Steve Morgan, Tim J Southwood, Richard Totaro, Paul Forrest, Saartje Berendsen Russell, Ruaidhri Carey, Mark Dennis
Refractory out-of-hospital cardiac arrest (OHCA) has a very poor prognosis, with survival rates at around 10%. Extracorporeal membrane oxygenation (ECMO) for patients in refractory arrest, known as ECPR, aims to provide perfusion to the patient whilst the underlying cause of arrest can be addressed. ECPR use has increased substantially, with varying survival rates to hospital discharge. The best outcomes for ECPR occur when the time from cardiac arrest to implementation of ECPR is minimised. To reduce this time, systems must be in place to identify the correct patient, expedite transfer to hospital, facilitate rapid cannulation and ECMO circuit flows...
June 10, 2024: International Journal of Emergency Medicine
Adam J Singer, Neena S Abraham, Latha Ganti, W Frank Peacock, Janaé Dark, Hajirah Ishaq, Ana Negrete, Brandon Mount, James Neuenschwander
This manuscript is a consensus document of an expert panel on the Evaluation and Treatment of Gastrointestinal Bleeding in Patients Taking Anticoagulants Presenting to the Emergency Department, sponsored by the American College of Emergency Physicians.
May 31, 2024: International Journal of Emergency Medicine
Thana Harhara, Rasha Buhumaid, Leen Oyoun Alsoud, Halah Ibrahim
BACKGROUND: Emergency medicine (EM) physicians routinely care for patients with serious life-limiting illnesses. Educating EM residents to have general skills and competencies in palliative medicine is a global priority. The purpose of this study was to describe the current status of palliative and end-of-life education in EM residency programs in the United Arab Emirates (UAE) and to identify barriers and opportunities to inculcating palliative care (PC) instruction into EM training in a non-Western setting...
May 23, 2024: International Journal of Emergency Medicine
Lavinia Gentile, Martina Scaramella, Giuseppe Liotta, Andrea Magrini, Maria Franca Mulas, Giuseppe Quintavalle, Leonardo Palombi
BACKGROUND: Delayed discharge from hospital to home or other care institutions is a significant problem and has been investigated in the international scientific literature for many years. Behind this condition is a health care system based on a hospital-centered concept characterized by a lack of territorial health and social welfare services. This phenomenon causes two different problems: an excessive length of hospital stay, resulting in slow turnover of bed utilization; and overcrowding in emergency rooms (ERs)...
May 23, 2024: International Journal of Emergency Medicine
Welawat Tienpratarn, Chaiyaporn Yuksen, Joseph Daniel Pauly, Diana Vu, Anisa Noiwong Benbourenane, Nuttamon Sangskul
BACKGROUND: Cellulitis is defined as a bacterial infection of the skin and subcutaneous tissue that can cause multiple complications, such as sepsis and necrotizing fasciitis. In extreme cases, it may lead to multiorgan failure and death. We sought to analyze the clinical factors that contribute to the development of complicated disease, including demographics, clinical presentation, initial vital signs, and laboratory studies. METHODS: Our study is a retrospective cohort study carried out in a university-based tertiary care hospital in Bangkok, Thailand...
May 22, 2024: International Journal of Emergency Medicine
Gabrielle Trepanier, Viviane Falardeau, Gurpreet Sohi, Veronique Richard
OBJECTIVE: The skills of coping with stress and pressure within emergency medicine are conveyed informally and inconsistently throughout residency training. This study aims to identify key psychological competencies used by elite athletes in high-pressure situations, which can be integrated into a formal curriculum to support emergency medicine residents' performance in high acuity settings. DESIGN: We conducted a scoping review spanning 20 years to identify the relevant psychological competencies used by elite athletes (Olympic or World level) to perform under pressure...
May 21, 2024: International Journal of Emergency Medicine
Michael von Rhein, Aziz Chaouch, Vivian Oros, Sergio Manzano, Gianluca Gualco, Marc Sidler, Ursula Laasner, Michelle Dey, Julia Dratva, Michelle Seiler
PURPOSE: The COVID-19 pandemic was associated with a decrease in emergency department (ED) visits. However, contradictory, and sparse data regarding children could not yet answer the question, how pediatric ED utilization evolved throughout the pandemic. Our objectives were to investigate the impact of the pandemic in three language regions of Switzerland by analyzing trends over time, describe regional differences, and address implications for future healthcare. METHODS: We conducted a retrospective, longitudinal cohort study at three Swiss tertiary pediatric EDs (March 1st, 2018-February 28th, 2022), analyzing the numbers of ED visits (including patients` age, triage categories, and urgent vs...
May 16, 2024: International Journal of Emergency Medicine
Ani Arzoumanian, Anya Agopian, Marine Hovhannisyan, Sharon Chekijian, Aline Baghdassarian
BACKGROUND: Emergency medical services (EMS) are paramount to boosting health indices in lower-middle income countries (LMICs); however, lack of uniform data collection and analysis hinders system improvement efforts. In the present study, we describe patterns of EMS utilization in the Republic of Armenia and provide key insight into the quality of digital data collection methods. RESULTS: For calls logged in the capital city, Yerevan, the majority had at least one missing field...
May 16, 2024: International Journal of Emergency Medicine
Sarah Shiba, Jan Van Keer
BACKGROUND: Pulmonary embolism is a common and potentially fatal condition. Exogenous estrogens in contraceptives are associated with an increased risk of venous thrombo-embolism. However, discontinuation of a combined oral contraceptive can lead to severe withdrawal bleeding in an anticoagulated patient. CASE PRESENTATION: We report a case of a 47-year-old female who presented to the emergency room with a two-day history of worsening shortness of breath and chest pain...
May 13, 2024: International Journal of Emergency Medicine
Said Kortli, Hery Andrianjafy
Boerhaave's syndrome, also known as spontaneous esophageal rupture, is a rare but life-threatening condition characterized by a tear in the esophagus. It is most commonly caused by a sudden increase in intraesophageal pressure, often due to severe vomiting or retching.Early diagnosis of Boerhaave's syndrome is crucial for improving patient outcomes. The classic triad of symptoms includes severe chest pain, vomiting, and subcutaneous emphysema (air under the skin). However, not all patients present with this triad, and the diagnosis can be challenging, especially in patients without the typical symptoms...
May 8, 2024: International Journal of Emergency Medicine
Målfrid Asheim Nummedal, Sarah Elizabeth King, Oddvar Uleberg, Sindre Andre Pedersen, Lars Petter Bjørnsen
BACKGROUND: Emergency department (ED) crowding is a common healthcare issue with multiple causes. One important knowledge area is understanding where patients arrived from and what care they received prior to ED admission. This information could be used to inform strategies to provide care for low acuity patients outside of the hospital and reduce unnecessary ED admissions. The aim of this scoping review was to provide a comprehensive overview of global published research examining the acute care trajectory of all ED patients...
May 3, 2024: International Journal of Emergency Medicine
Ichiro Hirayama, Yoshito Kamijo, Hiroko Abe, Minaho Nonaka, Tetsuhiro Yano, Mitsuru Ishii, Yoshiteru Tominaga
BACKGROUND: Guanfacine is an alpha-2 adrenergic agonist that decreases norepinephrine release and sympathetic outflow. With the increased use of guanfacine for attention-deficit hyperactivity disorder (ADHD), reports of guanfacine poisoning have also risen. CASE PRESENTATION: A 15-year-old male (height: 170 cm, weight: 48 kg), who was taking 2 mg/day of guanfacine for ADHD, was brought to our emergency department after ingesting 40 tablets of guanfacine due to poor exam results...
April 26, 2024: International Journal of Emergency Medicine
Mitsutoshi Okuda, Atsushi Morizane, Sunao Asaba, Saika Tsurui, Ryutaro Tsuno, Mariko Hatakenaka, Tomoko Sugimura, Yuichi Saisaka
BACKGROUND: Widespread vaccinations have significantly decreased the number of tetanus cases in developed countries. Today, most cases of tetanus affect the elderly and those with inadequate immunization in developed countries such as Japan. As vaccinations were believed to be nearly 100% effective in preventing tetanus, tetanus in young, immunized individuals were considered unlikely. However, unexpected tetanus infection has been reported in young adequately immunized individuals. CASE: We herein describe a 20-year-old immunized female who visited our emergency department with trismus and painful muscle spasms that started after receiving a puncture wound to her right foot...
April 24, 2024: International Journal of Emergency Medicine
Sarah Almuammar, Wijdan Alhowig
BACKGROUND: Domestic violence, including violence against women, is a global public health concern with significant implications for women's health and well-being. Despite its prevalence, healthcare providers often face barriers when reporting cases of domestic violence. This study aims to estimate the prevalence of reporting domestic violence against women by physicians and to explore the barriers to reporting. METHODS: This cross-sectional study was conducted at King Abdulaziz University Hospital in Saudi Arabia...
April 24, 2024: International Journal of Emergency Medicine
Paul Peng, Alex F Manini
BACKGROUND: Capnography is a quantitative and reliable method of determining the ventilatory status of patients. We describe the test characteristics of capnography obtained during Emergency Department triage for screening acidemia. RESULTS: We performed an observational, pilot study of adult patients presenting to Emergency Department (ED) triage. The primary outcome was acidemia, as determined by the basic metabolic panel and/or blood gas during the ED visit. Secondary outcomes include comparison of estimated and measured respiratory rates (RR), relationships between end-tidal CO2 (EtCO2 ) and venous partial pressure of CO2 , admission disposition, in-hospital mortality during admission, and capnogram waveform analysis...
April 22, 2024: International Journal of Emergency Medicine
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