Emergency Medicine – Open Journal最新文献

{"title":"Emergency Department Diagnosis and Management of Superior Vena Cava Syndrome Secondary to Hodgkin’s Lymphoma: Case Report and Limited Literature Review of Emergency Department Management","authors":"Paul R. Henning, Larry B. Mellick","doi":"10.17140/emoj-9-171","DOIUrl":"https://doi.org/10.17140/emoj-9-171","url":null,"abstract":"Superior vena cava (SVC) syndrome refers to the obstruction of blood through the SVC with limited case reports and literature reviews of its presentation and management. Here we discuss a 26-year-old male who presented with progressive chest pain and shortness of breath for 5-weeks. The exam showed facial and neck plethora and distension of the veins in the neck and chest wall. This case discusses SVC syndrome due to external compression by Hodgkin’s Lymphoma. The diagnostic approach and the clinical management of superior vena syndrome are reviewed.","PeriodicalId":125067,"journal":{"name":"Emergency Medicine – Open Journal","volume":"7 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139148043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thyrotoxic Periodic Paralysis after Surgery: A Case Report and Literature Review","authors":"Cécile Wouters, Melvin Willems, Annelies Mullens, Agnes Meersman","doi":"10.17140/emoj-9-172","DOIUrl":"https://doi.org/10.17140/emoj-9-172","url":null,"abstract":"Thyrotoxic periodic paralysis (TPP) is a rare but potentially life-threatening muscle disease in a thyrotoxic patient. Due to the lack of knowledge, the diagnosis is easily missed. Diagnosis of TPP is made by documentation of hypokalemia and hyperthyroidism in acute generalized muscle weakness. Hypokalemia is caused by an intracellular shift of potassium because of an increased Na-K-ATPase pump activity and the inhibition of the inward rectifying potassium (Kir) channels. The initial treatment aims to treat potentially life-threatening cardiac arrhythmias caused by severe hypokalemia. This can be done with potassium substitution and nonselective beta-blockers, being aware of the potential of rebound hyperkaliemia. Definitive treatment consists of avoiding triggers and correcting the hyperthyroid state with antithyroid drugs, radioactive iodine, or thyroidectomy. Once patients are, permanently euthyroid complete remission of the paralytic attacks usually occurs. We present a case of a 37-year-old male with diffuse muscle weakness after surgery. A new diagnosis of thyrotoxic periodic paralysis was made in the emergency department. This review summarizes the epidemiology, clinical manifestations, pathogenesis, diagnostics, and treatment of TPP.","PeriodicalId":125067,"journal":{"name":"Emergency Medicine – Open Journal","volume":" 28","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139144007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pre-Hospital Intervention to Alleviate Loneliness and Isolation in Older Adults","authors":"Yanithra Perera","doi":"10.17140/emoj-9-169","DOIUrl":"https://doi.org/10.17140/emoj-9-169","url":null,"abstract":"Aims The project’s objectives included determining how lonely older folks were in their pre-hospital environment and how much social contact they had. To gauge older individuals’ knowledge of regional programmes to combat isolation and loneliness. Letting elderly folks who could benefit from local services know that they are available. Using pre-hospital efforts to identify and treat patients who are lonely. Methods Thirty (30) patients were recruited whilst on 6 ambulance observer shifts in Berkshire, UK. The ambulance observer shifts took place between January 2023 to February 2023. The patients were asked a simple questionnaire on loneliness and social isolation. At the end of the questionnaire, all patients were offered information leaflets with local services and their contact details that they might find useful to alleviate loneliness and social isolation. Patients were also offered a follow-up telephone call to assess the impact of the intervention or if help was needed with getting in touch with the local services. Results Of the 30 patients interviewed, 15 were male and 15 were female. The youngest patient was 66-years-old and the oldest patient interviewed was 98. The average age was 80.4. Twelve (12) patients (40%) scored 7 and above on the question of ‘How lonely do you feel?’, with 10 being extremely lonely. Fifty percent (50%) of the patients saw their friends or families less than twice a week and 46.6% spoke to their friends and families less than twice a week. Several patients had not had a conversation with friends or family for several weeks, with one response being ‘over 3-months ago’. The vast majority (80%) of patients interviewed did not know that there were charities and local services in place to alleviate loneliness and social isolation. As part of the intervention, patients were offered information leaflets about local services available. These were printed on A4 paper or emailed to the patients if they preferred a digital copy. Conclusion Loneliness and social isolation is an epidemic on the rise amongst older adults, and their effects transcend not only mental wellbeing but physical health as well. Intervening in the pre-hospital setting is pivotal because pre-hospital practitioners are in a unique position to observe and assess patients in their own environment and gather firsth and evidence about the determinants of the patient’s health. The benefits will be multi-fold if we can help patients before they get admitted to hospitals. Apart from the economic benefits of reduced admissions, patients will not be unnecessarily admitted and put at risk of deconditioning or nosocomial infections. Most importantly, these interventions aim to improve the patient’s overall quality of life by enhancing their social connections and reducing loneliness.","PeriodicalId":125067,"journal":{"name":"Emergency Medicine – Open Journal","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123816386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recombinant Human Lactoferrin: An Opportunity to Treat the Neonatal and Adult Severe Sepsis","authors":"K. Petrak","doi":"10.17140/emoj-9-168","DOIUrl":"https://doi.org/10.17140/emoj-9-168","url":null,"abstract":"Lactoferrin, both human and bovine, acts against oxidative stress damage and has a range of beneficial activities such as antipathogenic, anti-cancer, anti-inflammatory, immunomodulatory, and deoxyribonucleic acid (DNA)-regulatory. In addition, clinical studies have shown human lactoferrin to attenuate inflammation and reduce mortality from neonatal and adult severe sepsis. However, the magnitude of the lactoferrin effect varies between studies. Given the demonstrated efficacy of recombinant human lactoferrin in sepsis, its lack of side effects, ease of administration, and relatively low cost, it is worth exploring whether the protein could be administered “preventively” as soon as the possibility of a patient’s condition progressing to severe sepsis is likely","PeriodicalId":125067,"journal":{"name":"Emergency Medicine – Open Journal","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115125419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Quantitative and Qualitative Investigation of Factors Associated with Caesarean Section Deliveries in Sri Lanka Assessing National Trends and Views of Local Healthcare Professionals in Colombo in 2015","authors":"Y. Perera","doi":"10.17140/emoj-9-166","DOIUrl":"https://doi.org/10.17140/emoj-9-166","url":null,"abstract":"Background A caesarean section (CS) is an operation to deliver a baby through incisions made to the mother’s abdominal wall and uterus, either before or after labor has started. An emergency CS is performed for certain medical indications such as placenta praevia or umbilical cord prolapse, and it most frequently occurs once labor has started. Elective CS are planned CS. They could be performed for non-medical reasons such as maternal request. Aim CS rates in Sri Lanka have been rising over the past decades. This study investigates reasons for the rise in CS rates through qualitative and quantitative analyses. Methods Qualitative data analysis involved interviews which were conducted in a teaching hospital in Colombo, Sri Lanka. Twenty (20) healthcare professionals in Obstetrics and Gynecology were interviewed. A semi-structured questionnaire, consisting of 15 opened and closed questions, was the basis for the interview. Quantitative analysis was performed on Demographic and Health Survey (DHS) data from 2006-2007. Variables included mother’s age, education level and residence. Chi-squared (χ2) and regression analysis using statistical package for the social sciences version (SPSS) was performed to determine if these variables were associated with CS. Results From qualitative analyses of the interviews, the main themes identified were the healthcare professionals’ views on causes of the rising CS rates, parties involved in the decision-making process, benefits and risks of elective CS and availability of support or alternative options. Quantitative analysis of DHS data showed variables such as residence, province, and education level were significantly associated with CS (p<0.01). Urban residences, living in Colombo and extremes in education levels had the greatest likelihood of a CS. Age, although statistically not significant, is clinically important as literature reviewed showed that CS tend to be more prevalent in extremes of age. Conclusion Analysis revealed the importance of factors associated with CS. Targeting areas that showed the greatest prevalence of CS is an effective strategy to address rising rates","PeriodicalId":125067,"journal":{"name":"Emergency Medicine – Open Journal","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133513287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of Anesthetic, Saline and Dry Needling Injections for Headache Patients","authors":"Danner Butler, L. Mellick, C. Clanton","doi":"10.17140/emoj-9-170","DOIUrl":"https://doi.org/10.17140/emoj-9-170","url":null,"abstract":"Objectives Earlier literature provided evidence of neck pain relief via cervical trigger point injections with anesthetic agents. However, recent evidence suggests that intramuscular or paraspinal cervical injections with local anesthetic may provide relief for various types of headaches and orofacial pain as well. The primary purpose of this systematic review was to determine whether a cohort of retrospective case studies and randomized controlled trials using paraspinal cervical or intramuscular anesthetic injections were associated with a decrease in headache and orofacial pain. Methods A systematic review of the literature was performed to observe the association between headache or orofacial pain relief and paraspinal cervical injections with various pain-relieving agents. Literature searches using the key terms “headaches”, “paraspinous cervical injections”, “neck/intramuscular injections” and “orofacial pain” were performed in PubMed, Google Scholar, and Scopus. We implemented the preferred reporting items for systematic reviews and meta-analyses (PRISMA) format for the systematic review. Results Initially, four hundred forty articles were located during the systematic review. Five total articles were selected for review and 435 were excluded because they did not meet search criteria. Another two relevant articles were found during manual searches within references of the systematic review. The seven studies included were retrospective case studies involving patients with headaches or orofacial pain who received paraspinal cervical or other intramuscular injections. A total of 841 patients’ data were tallied from the 7 articles and 683 of those patients received anesthetic injections. Significant pain relief due to intramuscular or paraspinal cervical injections was observed in 83.7% of the patients. Conclusion Our systematic review of association between headache or orofacial pain relief and paraspinal cervical injections with various pain-relieving agents demonstrated a frequency of headache and orofacial pain relief of 83.7%. Such a large percentage compared to a robust placebo study provides promising evidence that this treatment may have a therapeutic role in the management of headache and orofacial pain. Despite limitations faced in performing our systematic review, it seems quite clear that pain relief for these headache patients can be attributed to intramuscular anesthetic or dry needling injections. While larger prospective studies should be performed regarding specific location and anesthetic, our systematic review provides additional evidence that anesthetic intramuscular and dry needling injections provide pain relief intension-type headaches (TTH), migraine headaches, cervicogenic headache pain, and orofacial pain.","PeriodicalId":125067,"journal":{"name":"Emergency Medicine – Open Journal","volume":"87 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128284185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysing the Impact of Large Events on Local Emergency Departments","authors":"Yanithra Perera","doi":"10.17140/emoj-9-167","DOIUrl":"https://doi.org/10.17140/emoj-9-167","url":null,"abstract":"Every summer, Berkshire plays host to a large event that attracts over 100,000 attendees for a weekend of merrymaking.1 Hosting such a large group of attendees comes with several considerations, one of which is access to medical attention. The local hospital in Berkshire is a district general hospital which has approximately 1000 beds and serves a population of around 500,000 people. It has a well-established emergency department (ED). Attendances to EDs have been increasing annually. This is accompanied by increased pressures, waiting times and need for resources.2 When the population abruptly increases by 20%, measures need to be put in place to manage the demand on healthcare services to ensure that all patients receive safe and effective care both in hospital and pre-hospitally.","PeriodicalId":125067,"journal":{"name":"Emergency Medicine – Open Journal","volume":"150 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134325370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Complexity of Ambulance Missions on Shared Mental Models in Virtual Teams","authors":"B. Johnsen, G. Brattebø, Roar Espevik, S. Hystad, Øyvind Østerås, Live Vatsøy, J. Eid","doi":"10.17140/emoj-8-164","DOIUrl":"https://doi.org/10.17140/emoj-8-164","url":null,"abstract":"Background Empirical research on shared mental models (SMM) in virtual environments are almost non-existent. Pre-hospital emergencies presents an opportunity to examine team processes in virtual teams because the dispatcher is geographically separated from the ambulance and at the same time plays a significant role in coordinating, organizing, obtaining, evaluating, and conveying relevant information to the deployed ambulance. The present study aimed at mapping team behavior and cognition in critical real-life emergency medical missions based on the concept of SMM. Methods By investigating the frequencies of coordinating mechanisms and team competencies based on voice recordings from real-life missions, differences in team behavior between low and high-complexity missions were investigated. Results Lower frequencies of team competencies and coordinating mechanisms were found in high compared to low-complexity missions. The results showed a different profile in communication between high and low-complexity missions with more frequent use of both coordinating mechanisms and team competencies in low-complexity missions. Furthermore, the profiles revealed that SMM and closed loop communication were the only coordinating mechanism used, and leadership and team orientation were the only competencies exercised. Conclusion It was concluded that the lack of visual input of a team member during team interaction could lead to team process loss due to a breakdown of the team into sub-units. Potential improvement of team behavior is discussed within the SMM framework.","PeriodicalId":125067,"journal":{"name":"Emergency Medicine – Open Journal","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134630606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Airport Personnel and Coronavirus Disease-2019: A Seroprevalence Study in Taiwan","authors":"Chien-Chang Lee, Chih-Hung Wang, S. Hsu, Shih-Hung Liu, T. Lo, Yen-Hsing Liu, A. Papaila, Shan-Chwen Chang","doi":"10.17140/emoj-8-165","DOIUrl":"https://doi.org/10.17140/emoj-8-165","url":null,"abstract":"Introduction Many countries tried to lifted the travel restriction to revive their stagnant tourism-based economies. However, infection risks among airport personnel are incompletely understood. We therefore conducted this seroepidemiological study targeting airport personnel. Methods This cross-sectional study was conducted from October 20th, 2020 to February 28th, 2021 at the Taoyuan International Airport in Taiwan. All adults who worked at Taoyuan International Airport and were older than 20-years of age were eligible for participation. Serological tests were collected and study participants were asked to complete an online questionnaire which collected self reported data including demographic characteristics, occupation, exposure risk assessment, recent symptoms, and self-perceived risk of infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Continuous data were expressed with median and interquartile ranges; categorical data were expressed with counts and proportions. Results A total of 450 volunteers agreed to participate in the study. Most of the participants worked as ground crew (40.7%). Approximately 43.6% of participants did not feel any symptoms in the 3-months prior to serologic testing. Only 8 participants (1.8%) reported close contact with confirmed coronavirus disease-2019 (COVID-19) cases. Overall, none of the study participants had serologic confirmation of immunoglobulin G (IgG) antibodies against SARS-CoV-2. Conclusion The SARS-CoV-2 infection rate among airport personnel was low. This study demonstrates that a well-designed border control strategy may work and so that transmission of SARS-CoV-2 may be controllable.","PeriodicalId":125067,"journal":{"name":"Emergency Medicine – Open Journal","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131020230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prevalence of Pathologic Q Waves on Electrocardiograms of Pediatric Patients with Confirmed Hypertrophic Cardiomyopathy: A Systematic Review of the Literature","authors":"L. Mellick, K. Singhapakdi, C. Clanton, R. Waldrop","doi":"10.17140/emoj-8-163","DOIUrl":"https://doi.org/10.17140/emoj-8-163","url":null,"abstract":"Objectives The electrocardiogram (ECG) of patients with hypertrophic cardiomyopathy (HCM) ranges from normal to exhibiting evidence of ventricular hypertrophy, including pathologic Q waves and ST-T wave changes. Deep Q waves in the inferior and lateral leads are one of the classic ECG findings associated with HCM. The prevalence or frequency of this finding in pediatric HCM patients, however, is not well-established. Furthermore, other pediatric health conditions have also been associated with pathologic and non-pathologic Q waves and an awareness of those conditions is important to consider when Q waves are observed. The primary goal of this systematic review of the literature is to describe the prevalence of pathologic Q waves in the ECGs of pediatric patients with echocardiogram proven HCM. A secondary goal is to review other pediatric conditions that can present with pathologic and non-pathologic Q waves. Methods The databases PubMed, Web of Science, Scopus and cumulative index to nursing and allied health literature (CINAHL) were searched utilizing the preferred reporting items for systematic reviews and meta-analyses (PRISMA) format. The Rayyan systemic review software was used to screen articles for final review. The initial search (Search 1) consisted of the following terms: “dagger Q wave”, “dagger-like Q waves”, “dagger shape Q waves”. Subsequently, a broader search (Search 2) was conducted to determine if viable articles were omitted in the first search. This broader search strategy eliminated the term “HCM”. The authors then performed detailed review of the articles these two searches yielded, as well as a review of the references of these articles to find other relevant articles as well as produce a list of other pediatric conditions that may be associated with pathologic or nonpathologic Q waves. Results Of the articles found via the three searches, a total of nine English language articles that specifically addressed the prevalence of pathological Q waves in pediatric HCM patients were ultimately included in our systematic review. These nine articles described a total of 845 pediatric patients with HCM. Of these, 258 (30.5%) demonstrated pathological Q waves on their electrocardiograms. The range of percentages reported for pathological Q waves was 12.5 to 66.7%. Additionally, our review found fifteen different pediatric conditions reported to be associated with pathologic or non-pathologic Q waves. Conclusion Our systematic review confirmed that pathologic Q waves are a common and early electrocardiographic finding in children with HCM and may, in fact, be the only ECG finding. In addition, our review provided an extensive list of other pediatric diseases and conditions associated with pathologic or non-pathologic Q waves on the electrocardiogram.","PeriodicalId":125067,"journal":{"name":"Emergency Medicine – Open Journal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123620435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}