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Clinical and Experimental Emergency Medicine

Rachel Kadar, Daniel Rochford, Ellen Omi, Yalaunda Thomas, Kunal Patel, Erik Kulstad
Objective: To analyze the trends in demographics and outcomes of patients presenting with traumatic brain injury by performing a retrospective database review of the Illinois Department of Public Health (IDPH) Trauma Registry. Methods: We utilized the IDPH Trauma Registry to retrieve data on patients treated for traumatic brain injuries at our large, tertiary care hospital from 2004 to 2012, inclusive. From this data, logistic regression models were used to analyze and compare basic demographics such as age, sex, and clinical outcome...
April 8, 2019: Clinical and Experimental Emergency Medicine
Karalynn Otterness, Adam J Singer
Lacerations are a common reason for patients to seek medical attention, and are often acutely managed in the emergency department. Recent studies pertaining to closure techniques, sedation and analgesia, advances in wound care, and various other topics have been published, which may enhance our understanding of this injury and improve our management practices. This article will review pertinent studies published in the past few years relevant to laceration management. Understanding the current literature and appreciating which areas warrant further investigation will help us optimize outcomes for patients who sustain laceration injuries...
April 8, 2019: Clinical and Experimental Emergency Medicine
Holger Rupprecht, Katharina Gaab
Emergency physicians in the field are sometimes confronted with cases wherein patients cannot be intubated and ventilated. In some cases, cricothyrotomy, the method of choice for securing an emergency airway, may not have a successful outcome. We report a rare case of a 35-yearold male patient with avulsion of the larynx and a comminuted fracture of the jawbone, due to entrapment in a dung excavator. Prehospital tracheotomy was successfully performed. In cases with crush injuries to the larynx, anatomic structures, including the ligamentum conicum, are destroyed...
April 3, 2019: Clinical and Experimental Emergency Medicine
Byung Kook Lee, Kyung Woon Jeung, Dong Hun Lee, Yong Soo Cho, Yong Hun Jung
Comatose cardiac arrest patients frequently experience cardiogenic shock or recurrent arrest. Extracorporeal membrane oxygenation (ECMO) can be used to salvage patients with cardiogenic shock or cardiac arrest refractory to conventional therapies. However, in comatose cardiac arrest patients whose neurologic recovery is uncertain, the use of ECMO is restricted because it requires considerable financial and human resources. Amplitude-integrated electroencephalography is an easily applicable, real-time electroencephalography monitoring tool that has been increasingly used to monitor brain activity in comatose cardiac arrest patients...
April 3, 2019: Clinical and Experimental Emergency Medicine
Seul Ki Kim, Jin Hee Jung, Jin Hee Lee, Jae Yun Jung, Hyuksool Kwon, So Hyun Paek, Young Ho Kwak, Do Kyun Kim
Objective: The use of computed tomography (CT) in pediatric patients has decreased since the association between radiation and cancer risk has been reported. However, in adolescent patients being treated as adult patients, there has been a high incidence of CT use in emergency departments (EDs). Thus, this study aimed to evaluate the CT use in adolescent patients with complaints of headache or abdominal pain in the general and pediatric EDs of the same hospital. Methods: A retrospective chart review of patients aged 15 to 18 years, who presented with headache or abdominal pain at the general and pediatric EDs of Seoul National University Hospital from January 2010 to December 2014, was conducted...
February 20, 2019: Clinical and Experimental Emergency Medicine
Eunhye Cho, Sung Eun Lee, Eunjung Park, Hyuk-Hoon Kim, Ji Sook Lee, Sangchun Choi, Young Gi Min, Minjung Kathy Chae
Objective: Cerebral hemodynamic and metabolic changes may occur during the rewarming phase of targeted temperature management in post cardiac arrest patients. Yet, studies on different rewarming rates and patient outcomes are limited. This study aimed to investigate post cardiac arrest patients who were rewarmed with different rewarming rates after 24 hours of hypothermia and the association of these rates to the neurologic outcomes. Methods: This study retrospectively investigated post cardiac arrest patients treated with targeted temperature management and rewarmed with rewarming rates of 0...
February 20, 2019: Clinical and Experimental Emergency Medicine
Jong-Hak Park, Hanjin Cho, Sungwoo Moon, Ju-Hyun Song, Ju Young Kim, Yu-Sang Ahn
Objective: We evaluated the effect of rapid influenza diagnostic tests (RIDTs) on patient management in an emergency department for 3 years after 2009, and also identified factors associated with the choice of treatment for patients with influenza-like illnesses. Methods: The study period consisted of three influenza epidemic seasons. Patients older than 15 years who underwent RIDTs in the emergency department and were then discharged without admission were included...
February 20, 2019: Clinical and Experimental Emergency Medicine
Joonghee Kim, Kyuseok Kim, Heeyoung Lee, Soyeon Ahn
Objective: To investigate the epidemiology of sepsis in Korea and identify risk factors for death in sepsis. Methods: We conducted a longitudinal, population-based epidemiological study of sepsis in Korea from 2005 to 2012 using the National Health Insurance Service-National Sample Cohort, a population-based cohort representing 2.2% of the Korean population. The primary objective was to assess the incidence, mortality and cost of sepsis. The secondary objective was to identify the risk factors for death in sepsis...
February 20, 2019: Clinical and Experimental Emergency Medicine
Hwan Song, Hyung Gi Moon, Soo Hyun Kim
Objective: Community-acquired pneumonia (CAP) is a major cause of sepsis, and sepsis-related acute organ dysfunction affects patient mortality. Although the quick Sequential Organ Failure Assessment (qSOFA) is a new screening tool for patients with suspected infection, its predictive value for the mortality of patients with CAP has not been validated. Lactate concentration is a valuable biomarker for critically ill patients. Thus, we investigated the predictive value of qSOFA with lactate concentration for in-hospital mortality in patients with CAP in the emergency department (ED)...
February 20, 2019: Clinical and Experimental Emergency Medicine
Jeong Ho Park, Jung Hee Wee, Seung Pill Choi, Jae Hun Oh, Shin Cheol
Objective: Despite increased survival in patients with cardiac arrest, it remains difficult to determine patient prognosis at the early stage. This study evaluated the prognosis of cardiac arrest patients using brain injury, inflammation, cardiovascular ischemic events, and coagulation/fibrinolysis markers collected 24, 48, and 72 hours after return of spontaneous circulation (ROSC). Methods: From January 2011 to December 2016, we retrospectively observed patients who underwent therapeutic hypothermia...
February 20, 2019: Clinical and Experimental Emergency Medicine
Ou Jun Kwon, Suk Woo Lee, Mun Sun Jang, Sang Chul Kim, Ji Han Lee, Hoon Kim
Perihepatic capsulitis is associated with various diseases, such as Fitz-Hugh-Curtis syndrome, systemic lupus erythematosus, perforated cholecystitis, perforated hepatic abscess, and tuberculous peritonitis. Miliary tuberculosis is present in about 2% of all reported cases of tuberculosis and is characterized by the widespread millet-like hematogenous dissemination of Mycobacterium tuberculosis. We describe a 24-year-old virgin patient presenting with right upper quadrant and costovertebral angle pain. Diffuse perihepatic capsular enhancement was observed in abdominal computed tomography scans...
February 12, 2019: Clinical and Experimental Emergency Medicine
Jun Young Hong, Je Hyeok Oh
Objective: This study was conducted to determine why rescuers could maintain adequate chest compression depth for longer periods during conventional cardiopulmonary resuscitation (CPR). Methods: Various CPR parameters, including average compression depth (ACD), average compression rate, average ventilation time (AVT), and rescuers' heart rates were recorded in real-time when 20 health care providers performed 10 minutes of conventional CPR during a simulation experiment...
February 12, 2019: Clinical and Experimental Emergency Medicine
Miguel E Habeych, Pouria Moshayedi, Jon C Rittenberger, Scott R Gunn
A 34-year-old male was brought to the hospital with a chest gunshot wound. Pulseless upon arrival, blood pressure was absent for 10 minutes. A thoracotomy resulted in return of spontaneous circulation. On hospital day 5, with brainstem reflexes present, he was unresponsive to call or pain, exhibited generalized hyperreflexia and bilateral Babinskys. Median nerve somatosensory evoked potentials (mSSEPs) and brainstem auditory evoked potentials were obtained. International Federation of Clinical Neurophysiology recommendations for mSSEPs and brainstem auditory evoked potentials were followed...
February 12, 2019: Clinical and Experimental Emergency Medicine
Rohat Ak, Fatih Doğanay, Muharrem Doğan
No abstract text is available yet for this article.
February 12, 2019: Clinical and Experimental Emergency Medicine
Allen Zhi, Abbas Husain
No abstract text is available yet for this article.
March 2019: Clinical and Experimental Emergency Medicine
Kamal Kant Sahu, Ajay Kumar Mishra
No abstract text is available yet for this article.
March 2019: Clinical and Experimental Emergency Medicine
Kyung Su Kim, Gil Joon Suh, Kyuseok Kim, Woon Yong Kwon, Jonghwan Shin, You Hwan Jo, Jae Hyuk Lee, Huijai Lee
OBJECTIVE: To test the hypothesis that the quick Sepsis-related Organ Failure Assessment (qSOFA) score, derived from vital signs taken during triage and recommended by current sepsis guidelines for screening patients with infections for organ dysfunction, is not sensitive enough to predict the risk of mortality in emergency department (ED) sepsis patients. METHODS: Patients diagnosed with severe sepsis and septic shock using the old definition between May 2014 and April 2015 were retrospectively reviewed in three urban tertiary hospital EDs...
March 2019: Clinical and Experimental Emergency Medicine
Samir A Haydar, Tania D Strout, Alicia G Bond, Paul Kj Han
OBJECTIVE: Few reliable and valid prognostic tools are available to help emergency physicians identify patients who might benefit from early palliative approaches. We sought to determine if responses to a modified version of the surprise question, "Would you be surprised if this patient died in the next 30 days" could predict in-hospital mortality and resource utilization for hospitalized emergency department patients. METHODS: For this observational study, emergency physicians responded to the modified surprise question with each admission over a five-month study period...
March 2019: Clinical and Experimental Emergency Medicine
Laura Bonfanti, Antonio Annovi, Fabian Sanchis-Gomar, Carlotta Saccenti, Tiziana Meschi, Andrea Ticinesi, Gianfranco Cervellin
OBJECTIVE: Despite limited evidence, electrical cardioversion of acute-onset atrial fibrillation (AAF) is widely performed in the emergency department (ED). The aim of this study was to describe the effectiveness and safety of electrical cardioversion of AAF performed by emergency physicians in the ED. METHODS: All episodes of AAF electrically cardioverted in the ED were retrieved from the database for a 10-year period. Most patients not already receiving anticoagulants were given enoxaparin before the procedure (259/419)...
March 2019: Clinical and Experimental Emergency Medicine
Sion Jo, Jae Baek Lee, Youngho Jin, Taeoh Jeong, Jaechol Yoon, Boyoung Park
OBJECTIVE: The head-tilt/chin-lift (HT/CL) is a simple, routinely used maneuver to open the upper airway. Changes in the peak expiratory flow rate (PEFR) before and after the HT/CL maneuver have not been evaluated among conscious volunteers who are regarded as a control cohort. METHODS: Sixty healthy 20-year-old volunteers (30 males and 30 females) were enrolled. The supine position was defined as the position at which the ear-eye line was at a 10° angle to the horizontal...
March 2019: Clinical and Experimental Emergency Medicine
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