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Emergency Medicine International

Ying Guo, Manyi Ren, Lili Ge, Chao Sun, Rui Li, Cheng'en Ma, Shujian Sui
We performed the current study to explore potential predictive value of serum Tumor Necrosis Factor- (TNF-) like weak inducer of apoptosis (TWEAK) concentrations for 28-day mortality in patients with sepsis. Adult septic patients (age≥18 years) admitted to a general ICU between November 2016 and October 2017 were consecutively included in our prospective observational study. TWEAK concentrations were detected in septic patients and healthy controls. Dynamic changes of TWEAK concentrations between 1st day and 3rd day of admission to ICU (ΔTWEAK concentrations) were also measured...
2019: Emergency Medicine International
Kiyohiro Oshima, Masato Murata, Makoto Aoki, Jun Nakajima, Yusuke Sawada, Yuta Isshiki, Yumi Ichikawa, Kazunori Fukushima, Shuichi Hagiwara, Hiroshi Hinohara
Purpose: To evaluate the effectiveness of intensive care for the elderly trauma patients aged 80 years and older. Methods: Trauma patients admitted to the intensive care unit (ICU) through the emergency room (ER) at our hospital between January 2013 and December 2016 were analyzed. Patients were divided into two groups: patients aged 80 and older (group E) and <80 years old (group Y). Clinical courses and the total treatment costs were compared between the two groups...
2018: Emergency Medicine International
Mehmet İz, Veysi Çeri
Aim: Attention Deficit Hyperactivity Disorder (ADHD) is a developmental disorder characterized by severe inattention, hyperactivity, and impulsivity. This research aims to determine the frequency of ADHD symptoms in children who were treated in emergency paediatric services due to unintentional injuries. Method: This study was carried out with children who were treated due to unintentional injuries in an Emergency Department. ADHD symptoms were evaluated using the DSM-IV-based Screening and Assessment Scale for Behavioural Disorders in Children and Adolescents...
2018: Emergency Medicine International
Çağdaş Yıldırım, Selçuk Coşkun, Şervan Gökhan, Gül Pamukçu Günaydın, Ayhan Özhasenekler, Uğur Özkula
The objective of this study was to verify the nasogastric tube position with neck ultrasound and subxiphoid ultrasound, by giving air-water mixture and auscultation and to compare the effectiveness of these methods with chest radiography. This is a single-center, prospective, single-blind study. Patients who were admitted to our emergency department and had an indication of nasogastric tube placement were included. Nasogastric tube localization was verified with neck ultrasound and subxiphoid ultrasound, by giving air-water mixture, auscultation, and direct radiography that was accepted as the 'gold standard technique'...
2018: Emergency Medicine International
Motoki Fujita, Yasutaka Oda, Kotaro Kaneda, Yoshikatsu Kawamura, Takashi Nakahara, Masaki Todani, Takeshi Yagi, Yasutaka Koga, Ryosuke Tsuruta
Background: The aim of this study was to identify practice differences in the treatment of carbon monoxide (CO) poisoning with or without hyperbaric oxygen (HBO2 ) therapy in Japan. Materials and Methods: Using an online survey website (Google form), we created a questionnaire and invited interested institutions to join the COP-J Study, a prospective observational study of CO poisoning in Japan. Results: Forty-eight (63%) of 76 institutions replied to the questionnaire...
2018: Emergency Medicine International
Dong Keon Lee, Seung Min Park, Yu Jin Kim, Choung Ah Lee, Won Jung Jeong, Gi Woon Kim, Dong Hyuk Shin, Young Hwan Lee
Background: In South Korea, the prehospital treatment of cardiac arrest is generally led by an emergency medical technician-paramedic (EMT-P), and defibrillation is delivered by the automatic external defibrillator (AED). This study aimed at examining the effects of direct medical guidance by an emergency physician through a video call that enabled prompt manual defibrillation. Methods: Two-hundred eighty-eight paramedics based in Gyeonggi Province were studied for four months, from July to November 2015...
2018: Emergency Medicine International
Neslihan Yucel, Tuba Ozturk Demir, Serdar Derya, Hakan Oguzturk, Murat Bicakcioglu, Funda Yetkin
Introduction: The aim was to identify risk factors that influence in-hospital mortality for patients with moderate-to-severe blunt multiple trauma (BMT) who survive initial resuscitation. Methods: The prospective study involved 195 adult patients with BMT who were admitted to a referral hospital's emergency department (ED) between May 1, 2015, and May 31, 2016. Results: Forty-three (22%) of the 195 patients died in hospital. Multivariate analysis identified low blood pH (odds ratio [OR] 6...
2018: Emergency Medicine International
Evan Yates, Roger Chirurgi, Frosso Adamakos, Rania Habal, Rajnish Jaiswal, Hossein Kalantari, Getaw Worku Hassen
Medical simulation is a widely used training modality that is particularly useful for procedures that are technically difficult or rare. The use of simulations for educational purposes has increased dramatically over the years, with most emergency medicine (EM) programs primarily using mannequin-based simulations to teach medical students and residents. As an alternative to using mannequin, we built a 3D printed models for practicing invasive procedures. Repeated simulations may help further increase comfort levels in performing an emergency department (ED) thoracotomy in particular, and perhaps this can be extrapolated to all invasive procedures...
2018: Emergency Medicine International
Nigel Champion, Sarah Hogan, Jeffery Flemming
Background and Objective: Though multiple studies have evaluated the prevalence of incidental findings identified by CTPA, none have done so with a focus on reproductive-age females with normal chest X-ray (CXR). Due to a comparatively lower breast radiation dose, the oft-recommended alternative to CTPA in this patient group is a V/Q scan. However, these are limited in their assessment of these alternate findings; therefore, it is of particular importance to evaluate the likelihood of these findings on CT in this patient group, which is the goal of this study...
2018: Emergency Medicine International
Yi-Fang Wu, Po-Chang Wang, Yi-Chuan Chen
Backgrounds: The objective of this study was to investigate the relationships among intention to leave, emergency physician clinical activities, work-family conflicts, and gender differences in emergency physicians (EPs). Methods: The survey instrument was a self-administered questionnaire containing basic demographic information and characteristics of clinical activities. The work-family conflicts were assessed by the Chinese version of the work-family conflict (WIF) scale...
2018: Emergency Medicine International
Francisco Martín-Rodríguez, José Luis Martín Conty, Verónica Casado Vicente, Pedro Arnillas Gómez, Alicia Mohedano-Moriano, Miguel Ángel Castro Villamor
Introduction: Certain professions, such as those related to emergency services, have usually been performed by men, progressively incorporating women into these professions. The main objective of our study was to determine, according to gender, how the use of level D biohazard personal protection equipment (PPE) affects emergency professionals during the performance of resuscitation. Materials and Methods: An uncontrolled quasi-experimental study was performed on 96 volunteers selected by means of random sampling stratified by gender...
2018: Emergency Medicine International
Ozlem Dikme, Ozgur Dikme
Cortisol is a steroid hormone released from the adrenal glands in response to stressful conditions. Elevated cortisol levels have been described in stress, but it is unclear whether these are associated with adverse outcomes. In this study, we assess whether cortisol levels drawn in patients presenting with dyspnea to the ED were a predictor of major adverse pulmonary event (MAPE). In 87 patients presenting with dyspnea to the ED, cortisol levels were determined. Patients were then assessed to determine the following MAPE: endotracheal intubation (ETI) in the ED, admission to the intensive care unit (ICU), and in-hospital all-cause mortality...
2018: Emergency Medicine International
Sohyun Park, Hui Jai Lee, Jonghwan Shin, Kyoung Min You, Se Jong Lee, Euigi Jung
Background: Activated charcoal is the most frequently and widely used oral decontaminating agent in emergency departments (EDs). However, there is some debate about its clinical benefits and risks. In Korea, activated charcoal with sorbitol was unavailable as of the mid-2015, and our hospital had been unable to use it from September 2015. This study examined the differences of clinical features and outcomes of patients during the periods charcoal was and was not available. Methods: We retrospectively reviewed the electronic medical records of patients who had visited an urban tertiary academic ED for oral drug poisoning between January 2013 and January 2017...
2018: Emergency Medicine International
Paibul Suriyawongpaisal, Pongsakorn Atiksawedparit, Samrit Srithamrongsawad, Thanita Thongtan
Background: Previous policy implementation in 2012 to incentivize private hospitals in Thailand, a country with universal health coverage, to provide free-of-charge emergency care using DRG-based payment resulted in an equity gap of access and copayment. To bridge the gap, strategic policies involving financial and legal interventions were implemented in 2017. This study aims to assess whether this new approach would be able to fill the gap. Methods: We analyzed an administrative dataset of over 20,206 patients visiting private hospital EDs from April 2017 to October 2017 requested for the preauthorization of access to emergency care in the first 72 hours free of charge...
2018: Emergency Medicine International
Yongsoon Choi, Jin Hui Paik, Ji Hye Kim, Seung Baik Han, Areum Durey
Objectives: Pseudomonas aeruginosa shows higher mortality rate compared to other bacterial infections and is susceptible to a limited number of antimicrobial agents. Considering inadequate empirical treatment of Pseudomonas bacteremia has been associated with increased mortality, it is important for emergency physicians to identify infections by P. aeruginosa . Methods: This was a single-center retrospective case-control study to investigate the clinical predictors of patients diagnosed as Pseudomonas bacteremia in the emergency department (ED) from June 2012 to December 2016...
2018: Emergency Medicine International
Fatma Sarac, Sevgi Buyukbese Sarsu, Selman Yeniocak, Kamil Sahin, Esma Yucetas, Dogan Yildirim, Macit Koldas, Ozlem Uzun
Objectives: Diagnosis of pediatric patients presenting to the Emergency Department with acute abdominal pain is not always easy. The purpose of this study was to investigate the effectiveness of irisin, a peptide hormone with reactivity shown in the appendix and neutrophils, in the differential diagnosis of pediatric patients with acute abdominal pain. Methods: 162 subjects consenting to participate, including 112 patients presenting to the Pediatric Emergency and Pediatric Surgery clinics with acute abdominal pain and 50 controls, were enrolled in the study...
2018: Emergency Medicine International
Zafer Dokumcu, Bade Toker Kurtmen, Emre Divarci, Petek Bayindir Tamay, Timur Kose, Murat Sezak, Geylani Ozok, Orkan Ergun, Ahmet Celik
Background: Decision-making for management may sometimes be difficult in acute appendicitis (AA). Various diagnostic scoring systems exist, but their sensitivity and specificity rates are far from ideal. In this study, the determination of the predictors and the effect of radiological data and developing a new scoring system were aimed. Methods: Medical records of patients who were hospitalized for AA between February 2012 and October 2016 were retrospectively reviewed...
2018: Emergency Medicine International
Tae-Hun Lee, Jae-Hyun Han, Ashish Ranjan Sharma, Young-A Choi, Dong Won Kim, Sang-Soo Lee, Moo-Eob Ahn
Due to an increase in traffic collisions, the demand for prehospital medical services is on the rise, even in low-resource countries where emergency ambulance services have not been previously provided. To build a sustainable and continuous prehospital ambulance operation model, it is necessary to consider the medical system and economic conditions of the corresponding country. In an attempt to construct a prehospital ambulance operation model that ensures continuous operation, a pilot "emergency patient transporting service from field to hospital" operation was established for approximately three months in Kinshasa, the capital of the DR Congo...
2018: Emergency Medicine International
Ting Xu Tan, Paula Buchanan, Erin Quattromani
Objective: To compare simulation task trainers (sim) with cadaver for teaching chest tube insertion to junior residents. Methods: Prospective study involving postgraduate year (PGY) one and two emergency medicine (EM) and PGY-1 surgery residents. Residents were randomized into sim or cadaver groups based on prior experience and trained using deliberate practice. Primary outcomes were confidence in placing a chest tube and ability to place a chest tube in a clinical setting during a seven-month follow-up period...
2018: Emergency Medicine International
Jongho Kim, Lyle Brewster, Sonja Maria, Jundong Moon
High-rise buildings present unique challenges to providing high-quality CPR. We investigated the effect of using a mechanical compressor and supraglottic airway on flow time and CPR quality in simulated cardiac arrests occurring within a high-rise building. Twelve teams of EMS providers performed CPR according to 4 scenarios: manual compression and ventilation through bag-valve-mask (MAB) or supraglottic airway (MAS); mechanical compression and ventilation through bag-valve-mask (MEB) or supraglottic airway (MES)...
2018: Emergency Medicine International
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