Journals International Journal of Emerg...

International Journal of Emergency Medicine
Hari Prasad, Nagasubramanyam Vempalli, Naman Agrawal, U N Ajun, Ajmal Salam, Soumya Subhra Datta, Ashutosh Singhal, Nishant Ranjan, P P Shabeeba Sherin, G Sundareshan
BACKGROUND: Blood gas analysis is integral to assessing emergency department (ED) patients with acute respiratory or metabolic disease. Arterial blood gas (ABG) is the gold standard for oxygenation, ventilation, and acid-base status but is painful to obtain. Peripheral venous blood gas (VBG) is a valuable alternative as it is less painful and easy to collect. The comparability of ABG and VBG was studied in various conditions. But in hypotension, previous findings were inconsistent. So, we studied the correlation and agreement between ABG and VBG in hypotensive patients...
March 10, 2023: International Journal of Emergency Medicine
Aya Fukuhara, Seiko Fushimi, Masatoshi Nakata, Jumpei Takamatsu
BACKGROUND: Pasteurella multocida-related sepsis can cause purpura fulminans (PF), a rare thrombotic disorder that often presents acutely and is potentially fatal. As a consequence of disseminated intravascular coagulation, this hematological emergency originates from micro-thrombotic occlusion of peripheral blood vessels and resulting circulatory failure. Thus far, no studies have reported the use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) for saving lives in patients with worsening respiratory and circulatory failure...
March 9, 2023: International Journal of Emergency Medicine
Anuja Premawardhena, Shamila De Silva, Megha Rajapaksha, Vishaka Ratnamalala, Jemimah Nallarajah, Gamini Galappatthy
BACKGROUND: Cardiac disease remains a dominant if not the most important cause of morbidity and mortality in patients with thalassaemia, particularly in those with thalassaemia major. Myocardial infarction and coronary artery disease however are rarely reported. CASE PRESENTATIONS: Three older patients with three distinct thalassaemia syndromes presented with acute coronary syndrome. Two were heavily transfused whilst the other was a minimally transfused patient...
March 9, 2023: International Journal of Emergency Medicine
Aimi Ohya, Makoto Ohtake, Yusuke Kawamura, Taisuke Akimoto, Masayuki Iwashita, Tetsuya Yamamoto, Ichiro Takeuchi
BACKGROUND: Subarachnoid hemorrhage and thyroid storm are similar in their clinical symptomatology, and diagnosis of these conditions, when they occur simultaneously, is difficult. Here, we report a rare case of concurrent subarachnoid hemorrhage and thyroid storm we encountered at our hospital. CASE PRESENTATION: The patient was a 52-year-old woman. While bathing at home, the patient experienced a sudden disturbance of consciousness and was brought to our hospital...
March 1, 2023: International Journal of Emergency Medicine
David N Baden, Martijn H Roetman, Tom Boeije, Nieke Mullaart, Ralph Boden, Roderick M Houwert, Marilyn Heng, Rolf H H Groenwold, Olivier A J van der Meijden
BACKGROUND: Biomechanical reduction techniques for shoulder dislocations have demonstrated high reduction success rates with a limited pain experience for the patient. We postulated that the combination of biomechanical reduction techniques with the shortest length of stay would also have the lowest pain experience and the highest first reduction success rate. METHODS: A randomized multicenter clinical trial was performed to compare different biomechanical reduction techniques in treating anterior shoulder dislocations without the use of invasive pain relief...
February 24, 2023: International Journal of Emergency Medicine
Giorgio Berlot, Ariella Tomasini, Silvia Zanchi, Edoardo Moro, Maurizio Pinamonti, Sara Mohamed, Eleonora de Bellis
The Waterhouse-Friderichsen syndrome represents a critical condition characterized by a septic shock associated with a disseminated intravascular coagulation causing the plugging of the microvascular network virtually all organs and systems, including the skin, the kidneys, the liver, and adrenal glands; the mortality rate is elevated, and survivors often must undergo multiple limb amputations. Here, we describe the uncommon case of an asplenic patient who developed this syndrome after a superficial wound caused by a dog bite causing an initial infection due to Capnocytophaga canimorsus that is part of the normal oral microbiome of pets...
February 23, 2023: International Journal of Emergency Medicine
Ramu Kharel, Ghan B Thapa, Tamara Voor, Samriddha R Pant, Samir K Adhikari, Bimal S Bist, Pryanka Relan, Timmy Lin, Derek Lubetkin, Giovanna Deluca, Olita Shilpakar, Sanu K Shrestha, Yagya R Pokharel, Santosh Paudel, Ajay S Thapa, Yogendra M Shakya, Achyut R Karki, Nishant Dhakal, Adam R Aluisio
BACKGROUND: In 2021, the Nepal national emergency care system's assessment (ECSA) identified 39 activities and 11 facility-specific goals to improve care. To support implementation of the ECSA facility-based goals, this pilot study used the World Health Organization's (WHO) Hospital Emergency Unit Assessment Tool (HEAT) to evaluate key functions of emergency care at tertiary hospitals in Kathmandu, Nepal. METHODS: This cross-sectional study used the standardized HEAT assessment tool...
February 23, 2023: International Journal of Emergency Medicine
Chanokporn Puchongmart, Phetsinee Boonmee, Supawich Jirathanavichai, Nutthida Phanprasert, Netiporn Thirawattanasoot, Thawonrat Dorongthom, Apichaya Monsomboon, Nattakarn Praphruetkit, Onlak Ruangsomboon
BACKGROUND: The COVID-19 pandemic has caused over 6 million deaths worldwide. The elderly accounted for a large proportion of patients with their mortality rate largely higher than the non-elderly. However, limited studies have explored clinical factors associated with poor clinical outcomes in this important population. Therefore, this study aimed to determine factors independently associated with adverse clinical outcomes among COVID-19 elderly patients. METHODS: We conducted a multicenter observational study at five emergency departments (EDs) in Thailand...
February 22, 2023: International Journal of Emergency Medicine
Thongpitak Huabbangyang, Rossakorn Klaiangthong, Agasak Silakoon, Suttida Sretimongkol, Sutasinee Sangpakdee, Manit Khiaolueang, Pattama Seancha, Tontrakan Nuansamlee, Anucha Kamsom, Ratree Chaisorn
BACKGROUND: During the coronavirus disease 2019 (COVID-19) pandemic, the format of patients with out-of-hospital cardiac arrest (OHCA) management was modified. Therefore, this study compared the response time and survival at the scene of patients with OHCA managed by emergency medical services (EMS) before and during the COVID-19 pandemic in Thailand. METHODS: This retrospective, observational study used EMS patient care reports to collect data on adult patients with OHCA coded with cardiac arrest...
February 20, 2023: International Journal of Emergency Medicine
Xue Bi May Na, Swee Min Kathleen Khoo
BACKGROUND: This case report presents the case of a man with no known coagulopathy or preceding trauma, who spontaneously developed a spinal epidural hematoma (SEH). This is an uncommon condition which can have variable presentations including hemiparesis mimicking stroke, resulting in the potential for misdiagnosis and inappropriate treatment. CASE PRESENTATION: A 28-year-old Chinese male with no past medical history presented with sudden onset neck pain associated with bilateral upper limbs and right lower limb subjective numbness but intact motor function...
February 20, 2023: International Journal of Emergency Medicine
Ryosuke Shimai, Shohei Ouchi, Tetsuro Miyazaki, Koji Hirabayashi, Hiroshi Abe, Kosuke Yabe, Midori Kakihara, Masaaki Maki, Hiroyuki Isogai, Takeshi Wada, Dai Ozaki, Yuki Yasuda, Fuminori Odagiri, Kazuhisa Takamura, Kenji Yaginuma, Ken Yokoyama, Takashi Tokano, Tohru Minamino
BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) requires a large amount of economic and human resources. The presence of bystander cardiopulmonary resuscitation (CPR) was focused on selecting appropriate V-A ECMO candidates. RESULT: This study retrospectively enrolled 39 patients with V-A ECMO due to out-of-hospital cardiac arrest (CA) between January 2010 and March 2019. The introduction criteria of V-A ECMO included the following: (1) < 75 years old, (2) CA on arrival, (3) < 40 min from CA to hospital arrival, (4) shockable rhythm, and (5) good activity of daily living (ADL)...
February 17, 2023: International Journal of Emergency Medicine
Takahito Miyake, Hideshi Okada, Norihide Kanda, Yosuke Mizuno, Kodai Suzuki, Tomoaki Doi, Takahiro Yoshida, Shozo Yoshida, Shinji Ogura
BACKGROUND: Spinal ankylosing disorders (SADs) refer to a group of conditions resulting in spontaneous or postsurgical ossification and fusion of the spinal segments. The spine becomes increasingly susceptible to injury over time such that even low-energy trauma can cause a spinal injury. We report two cases of SADs, associated with massive thoracic hemorrhage. CASE PRESENTATION: The first patient was an 85-year-old male, who suffered from a vehicular crash. He was diagnosed with a fracture of the first lumbar vertebra, accompanied by SADs...
February 16, 2023: International Journal of Emergency Medicine
M Christien Van Der Linden, Merel Van Loon-Van Gaalen, John R Richards, Geesje Van Woerden, Naomi Van Der Linden
BACKGROUND: During a 6-year period, several process changes were introduced at the emergency department (ED) to decrease crowding, such as the implementation of a general practitioner cooperative (GPC) and additional medical staff during peak hours. In this study, we assessed the effects of these process changes on three crowding measures: patients' length of stay (LOS), the modified National ED OverCrowding Score (mNEDOCS), and exit block while taking into account changing external circumstances, such as the COVID-19 pandemic and centralization of acute care...
February 15, 2023: International Journal of Emergency Medicine
Sergiy Golovko, Rostislav Gybalo, Igor Lurin, Igor Taraban, Artem Kobirnichenko, Vitalii Ganiuk, Maksym Gorobeiko, Andrii Dinets
BACKGROUND: The current war in Ukraine is associated with frequent applications of multiple-launch rocket systems and cruise missiles as well as other various high-energy weapons to cause severe injuries in military personnel including abdomen wounds, vascular injury, and limb amputations as well as genitourinary trauma. The aim of this report is to demonstrate a case of successful penile salvage by restoring its function in a combat patient with gunshot genitourinary trauma in conditions of an interrupted supply of medical equipment...
February 3, 2023: International Journal of Emergency Medicine
Shreya Kolluri, Rohan K Mangal, Thor S Stead, Latha Ganti
This is a clinical image submission depicting hemithorax white-out due to massive pleural effusion.
January 23, 2023: International Journal of Emergency Medicine
Nattakarn Praphruetkit, Natyada Boonchana, Apichaya Monsomboon, Onlak Ruangsomboon
BACKGROUND: High-flow nasal cannula has been a promising initial respiratory support measure for patients with acute hypoxemic respiratory failure (AHRF) in the emergency department (ED). However, delayed detection of HFNC failure is associated with increased mortality. The ROX index is a tool that can help predict HFNC success. Nonetheless, its utility in ED patients is limited, and no studies have compared it with the HACOR scale, another tool that may be as accurate in predicting HFNC failure...
January 10, 2023: International Journal of Emergency Medicine
Yogendra Amatya, Frances M Russell, Suraj Rijal, Sunil Adhikari, Benjamin Nti, Darlene R House
BACKGROUND: Lung ultrasound (LUS) is an effective tool for diagnosing pneumonia; however, this has not been well studied in resource-limited settings where pneumonia is the leading cause of death in children under 5 years of age. OBJECTIVE: The objective of this study was to evaluate the diagnostic accuracy of bedside LUS for diagnosis of pneumonia in children presenting to an emergency department (ED) in a resource-limited setting. METHODS: This was a prospective cross-sectional study of children presenting to an ED with respiratory complaints conducted in Nepal...
January 9, 2023: International Journal of Emergency Medicine
Aleq Jaffery, Herman Morchel, Jessica Poon
BACKGROUND: Subarachnoid hemorrhage (SAH) is a diagnosis that emergency physicians must have a high index of suspicion for. Many common chief complaints such as headache, nausea, altered mental status, and even syncope may alert clinicians to the possibility of a SAH. CASE PRESENTATION: The authors present an unusual case of SAH in a patient presenting with acute dyskinesia and altered mental status, which has seldom been documented as the presenting feature of SAH, as well as the diagnostic pitfalls encountered in assessing this patient...
January 5, 2023: International Journal of Emergency Medicine
Atsuhito Tanaka, Ji Young Huh, Takamasa Yamamoto, Ken Washio, Koichi Ariyoshi
BACKGROUND: Gastrointestinal attacks are frequent symptoms in patients diagnosed with hereditary angioedema (HAE). Cases of self-limited bowel intussusception and unneeded exploratory laparotomy due to lack of knowledge about HAE have been reported. Furthermore, after the introduction of C1-esterase inhibitor (C1-INH) concentrate, the recommended medication for HAE attacks, treatment has become typically medical in nature. We share a rare case where operative exploration was indicated to resolve a mechanical small bowel obstruction secondary to an HAE attack...
December 30, 2022: International Journal of Emergency Medicine
Carlo Pegani, Giovanni Buttignon, Annarita Tullio, Marcello Naccarato, Paolo Manganotti, Serena Rakar, Enrico Fabris, Federico Nadalin, Vincenzo Mione, Gian Luigi Gigli, Simone Lorenzut, Leonardo Spedicato, Paolo Passadore, Daniela Pavan, Cristina Lutman, Manila Andrian, Massimo Borelli, Stefano Novello, Rita Belfiore, Chiara Daneluzzi, Gianfranco Sinagra, Alberto Peratoner
The COVID-19 global pandemic has changed considerably the way time-sensitive disorders are treated. Home isolation, people's fear of contracting the virus and hospital reorganisation have led to a significant decrease in contacts between citizens and the healthcare system, with an expected decrease in calls to the Emergency Medical Services (EMS) of the Friuli-Venezia Giulia (FVG) region. However, mortality in clinical emergencies like acute ST-elevation myocardial infarction (STEMI), stroke and out-of-hospital cardiopulmonary arrest (OHCA) remained high...
December 29, 2022: International Journal of Emergency Medicine
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