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Use of procedural ultrasound for the insertion of peripheral intravenous catheters: A nationwide survey in acute care departments in Belgium. 使用程序超声置入外周静脉导管:在比利时急症护理部门的一项全国性调查。
Acute Medicine Pub Date : 2023-01-01 DOI: 10.52964/AMJA.0931
Florence Dupriez, Cedric Smets, Hannelore Raemen, Marie Van Laer, Martin Hachez
{"title":"Use of procedural ultrasound for the insertion of peripheral intravenous catheters: A nationwide survey in acute care departments in Belgium.","authors":"Florence Dupriez,&nbsp;Cedric Smets,&nbsp;Hannelore Raemen,&nbsp;Marie Van Laer,&nbsp;Martin Hachez","doi":"10.52964/AMJA.0931","DOIUrl":"https://doi.org/10.52964/AMJA.0931","url":null,"abstract":"<p><strong>Purpose: </strong>Assessment of ultrasound use for peripheral intravenous cannulation among acute care nurses and physicians.</p><p><strong>Methods: </strong>Over a population of 17,437, the calculated sample size of respondents required was 376.</p><p><strong>Results: </strong>A total of 388 health professionals; 249 (64.2%) physicians and 139 (35.8%) nurses completed the entire questionnaire. 166 (45.2%) used ultrasound for intravenous cannulation. A statistically significant difference favored physicians' ultrasound use (p<0.001). Respondents with less than 10 years of clinical practice used ultrasound significantly more (p<0.001). The main reported obstacle among users was the lack of time.</p><p><strong>Conclusion: </strong>This survey revealed the gap between the current recommendations for ultrasound use for peripheral intravenous cannulation and the actual practices. Efforts should be made to develop specific training using ultrasound.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"22 1","pages":"33-38"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9284051","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}
引用次数: 0
Point of care ultrasound: Current and future directions for Acute Medicine. 护理点超声:急性医学的当前和未来方向。
Acute Medicine Pub Date : 2023-01-01 DOI: 10.52964/AMJA.0939
S Biart, F Stanley, L Rahman, H Jones, N Smallwood
{"title":"Point of care ultrasound: Current and future directions for Acute Medicine.","authors":"S Biart,&nbsp;F Stanley,&nbsp;L Rahman,&nbsp;H Jones,&nbsp;N Smallwood","doi":"10.52964/AMJA.0939","DOIUrl":"https://doi.org/10.52964/AMJA.0939","url":null,"abstract":"<p><p>Point of care ultrasound (POCUS) represents an exciting tool for current and future acute care practitioners. POCUS has come a long way in a short space of time and its widespread implementation may well be one of the biggest changes seen in acute medicine across the next decade. This narrative review explores the increasing evidence base for the accuracy of POCUS use in various acute scenarios, whilst also addressing current gaps in the evidence and areas for potential future POCUS development.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"22 2","pages":"83-90"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9624692","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}
引用次数: 0
Bilateral orbital myositis in a patient with rheumatoid arthritis on treatment with tofacitinib: a report and review of literature. 一名接受托法替尼治疗的类风湿关节炎患者的双侧眼眶肌炎：一份报告和文献综述。
Acute Medicine Pub Date : 2023-01-01
G Brambilla, N Nair, Y Osman, S Akram
{"title":"Bilateral orbital myositis in a patient with rheumatoid arthritis on treatment with tofacitinib: a report and review of literature.","authors":"G Brambilla, N Nair, Y Osman, S Akram","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Orbital myositis is a rare inflammatory condition affecting the extraocular muscles of the eyes. It has also been linked to systemic autoimmune diseases. We present a case of orbital myositis in a 57-year-old male undergoing treatment for rheumatoid arthritis (RA) with tofacitinib, a Janus kinase inhibitor (JAK). Prompt administration of intravenous steroids led to rapid symptom improvement. To date, only six published cases have documented the association between RA and orbital myositis. This is the first description of orbital myositis occurring during treatment with the anti-inflammatory drug tofacitinib, an increasingly used disease-modifying anti-rheumatic drug (DMARD). We review the literature and emphasize the importance of ongoing vigilance regarding adverse events linked to tofacitinib.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"22 4","pages":"258-260"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571574","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}
引用次数: 0
Correspondence - Further reflections of the role of artificial intelligence in acute medicine. 通信 - 进一步思考人工智能在急症医学中的作用。
Acute Medicine Pub Date : 2023-01-01
S Sreenivasan, M Monaghan
{"title":"Correspondence - Further reflections of the role of artificial intelligence in acute medicine.","authors":"S Sreenivasan, M Monaghan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We read with great interest the article \"Artificial Intelligence: its Future and Impact on Acute Medicine\". Regarding the historical perspective on artificial intelligence (AI) origins, we believe the role of John von Neumann (1903-1957) also deserves emphasis.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"22 4","pages":"264"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571575","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}
引用次数: 0
Acute coronary syndrome after initiation of amoxicillin/clavulanate. 阿莫西林/克拉维酸起始治疗后急性冠脉综合征。
Acute Medicine Pub Date : 2023-01-01 DOI: 10.52964/AMJA.0933
Jacopo Davide Giamello, Chiara Bertone, Gabriele Sobrero, Letizia Barutta, Giulia Paglietta, Luigi Losardo, Giuseppe Lauria
{"title":"Acute coronary syndrome after initiation of amoxicillin/clavulanate.","authors":"Jacopo Davide Giamello,&nbsp;Chiara Bertone,&nbsp;Gabriele Sobrero,&nbsp;Letizia Barutta,&nbsp;Giulia Paglietta,&nbsp;Luigi Losardo,&nbsp;Giuseppe Lauria","doi":"10.52964/AMJA.0933","DOIUrl":"https://doi.org/10.52964/AMJA.0933","url":null,"abstract":"<p><p>We report the case of a 54 year old man referred to the Emergency Department for rapid onset of an itchy rash and oppressive epigastric pain after assumption of amoxicillin/clavulanate. Electrocardiogram aand laboratory findings were consistent with acute coronaty syndrome. After coronary angiography, diagnosis of type II Kounis syndrome was made.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"22 1","pages":"47-49"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9284050","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}
引用次数: 0
An Unusual Case of a Primary Hyperparathyroidism Mimic. 一个罕见的原发性甲状旁腺功能亢进症模拟病例
Acute Medicine Pub Date : 2023-01-01
T Wynn, H Marath, A Brahma, V Rajagopal
{"title":"An Unusual Case of a Primary Hyperparathyroidism Mimic.","authors":"T Wynn, H Marath, A Brahma, V Rajagopal","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 32-year-old lady with a history of bulimia nervosa was noted to have a raised adjusted calcium of 2.94mmol/L associated with high parathyroid hormone (PTH) 17.2pmol/L. On review, she had an apparent hypercalcaemia for at least three years, and also had a chronic, severe alkalosis with a bicarbonate up to 81.9mEQ/L. Ionised calcium during that time had actually been low, down to 1.03mmol/L. This case highlights the effects of alkalosis on calcium, as more albumin is available for binding to ionised calcium. This results in a low ionised calcium, which triggers PTH release and overall leads to raised adjusted calcium levels. Clinicians may misdiagnose a similar patient with primary hyperparathyroidism and treatment would cause worsening of true hypocalcaemia.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"22 4","pages":"261-263"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571567","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}
引用次数: 0
The incidence and mortality of neutropenic fever in hematologic patients did not change during the SARS-CoV2 pandemic. 在 SARS-CoV2 大流行期间，血液病患者中性粒细胞减少性发热的发病率和死亡率没有变化。
Acute Medicine Pub Date : 2023-01-01
M Brabrand, M Brabrand, S B Bogh, M Fløjstrup, H Frederiksen
{"title":"The incidence and mortality of neutropenic fever in hematologic patients did not change during the SARS-CoV2 pandemic.","authors":"M Brabrand, M Brabrand, S B Bogh, M Fløjstrup, H Frederiksen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>During the current SARS-CoV2 pandemic, fear of nosocomial infection could keep neutropenic patients from contacting the healthcare system with infection. We analyzed nationwide hospital contacts for neutropenic fever during the first seven weeks of the Danish shelter at home order. Using national registers, we extracted data on all unplanned hospital contacts due to neutropenic fever. We included 311 admissions, 13-30 per week, and found no difference between 2017-2019 and 2020. The incidence rate ratio varied between 0.68 and 1.11 with no effect on mortality. Thus, our data indicate that Danish neutropenic patients are admitted with fever, even during a pandemic.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"22 4","pages":"201-203"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571624","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}
引用次数: 0
Quantitative assessment of the relationship between body mass index and risk of pulmonary embolism: a retrospective case-control study. 体重指数与肺栓塞风险关系的定量评估:一项回顾性病例对照研究。
Acute Medicine Pub Date : 2023-01-01 DOI: 10.52964/AMJA.0937
I Le Jeune, R Hubbard
{"title":"Quantitative assessment of the relationship between body mass index and risk of pulmonary embolism: a retrospective case-control study.","authors":"I Le Jeune,&nbsp;R Hubbard","doi":"10.52964/AMJA.0937","DOIUrl":"https://doi.org/10.52964/AMJA.0937","url":null,"abstract":"<p><p>In the context of a significant increase in obesity rates, quantifying the relationship between body mass index (BMI) and risk of pulmonary embolism (PE) is an essential component of accurate clinical risk assessment. This observational study is the first to explore this association by clinician-defined cause of the PE. We demonstrate that the association between BMI and PE is driven by patients with otherwise 'unprovoked' PE where there is a strong positive correlation with odds ratios equivalent to well-recognised major risk factors such as cancer, pregnancy and surgery. We make a case for the inclusion of BMI in risk-prediction tools.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"22 2","pages":"67-71"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9621788","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}
引用次数: 0
Emergency admissions' diagnoses and risk of in-hospital death according to the primary ICD-10 chapter assigned at discharge and the National Early Warning Score on admission. 根据出院时分配的ICD-10主要章节和入院时的国家预警评分，急诊入院的诊断和住院死亡风险。
Acute Medicine Pub Date : 2023-01-01
M Holland, A Dannatt, J Kellett, D Green
{"title":"Emergency admissions' diagnoses and risk of in-hospital death according to the primary ICD-10 chapter assigned at discharge and the National Early Warning Score on admission.","authors":"M Holland,&nbsp;A Dannatt,&nbsp;J Kellett,&nbsp;D Green","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The relationship between diagnosis, illness severity, and mortality risk for unselected emergency admissions is poorly defined.</p><p><strong>Aim: </strong>To define primary ICD-10 diagnostic chapters at discharge, admission illness severity by the National Early Warning Score, and in-hospital mortality for all unselected emergency admissions.</p><p><strong>Method: </strong>Retrospective, observational, cohort study of 122,259 unselected, adult emergency admissions to Salford Royal Hospital between 2014 and 2022.</p><p><strong>Results: </strong>In-hospital mortality was 4.3% but most patients had an ICD-10 chapter associated with a lower risk of death. 60% of in-hospital deaths were in four chapters, infections, circulatory and respiratory diseases, or neoplasms. An admission NEWS ≥3 was associated with earlier mortality and an eight-fold increased risk of in-hospital mortality. 45% of all in-hospital deaths occurred in patients with an admission NEWS <3.</p><p><strong>Conclusion: </strong>Mortality in emergency hospital admissions is associated with illness severity and four diagnostic chapters. NEWS should not be the only arbiter of hospital admission, as for certain diagnostic chapters the risk of death is high even if vital signs on presentation are normal.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"22 3","pages":"113-119"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41132993","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}
引用次数: 0
Becoming the medical registrar: a qualitative study of a professional transition as a transformative learning event. 成为医疗注册员：将职业转变作为一项变革性学习活动的定性研究。
Acute Medicine Pub Date : 2023-01-01
Z Ferguson, R Selman
{"title":"Becoming the medical registrar: a qualitative study of a professional transition as a transformative learning event.","authors":"Z Ferguson,&nbsp;R Selman","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The medical registrar is a daunting role to take on for the first time. While studies have explored how preparedness can be improved through simulation, less has been written about how doctors learn to be registrars through clinical practice.</p><p><strong>Method: </strong>Doctors working as medical registrars were invited to participate in semi-structured interviews. The qualitative data collected underwent thematic analysis.</p><p><strong>Results: </strong>The clinical environment was considered fertile ground for transformative experiential learning, but opportunities for debriefing and guided reflection were rare. Participants felt they needed additional support from supervisors after difficult experiences and mistakes, but this support was not always forthcoming.</p><p><strong>Conclusion: </strong>Acute physicians involved in supervising new medical registrars must facilitate meaningful independent practice to encourage the next generation of medical generalists.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"22 3","pages":"144-149"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41153366","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}
引用次数: 0
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