Scholarly Journal of Emergency Medicine and Critical Care最新文献

{"title":"Is there a Change in Clinical Practice in the Imaging of Thoraco-Lumbar Vertebral Injuries? - A Shift in Paradigm to CT Imaging as an Interim Measure","authors":"Chowdhury Debkumar","doi":"10.36959/592/392","DOIUrl":"https://doi.org/10.36959/592/392","url":null,"abstract":"unless in the context of the multiply injured patient, is likely to be plain radiograph. In the context of the polytrauma patient CT would include imaging of the vertebrae with MPR. As we know magnetic resonance imaging is the gold standard imaging in the diagnosis of spinal cord injury with specific focus on ligamentous, soft tissue and intervertebral disc prolapse. In the context of trauma leading to cauda equina syndrome (CES) MRI is the gold standard imaging modality of choice. the","PeriodicalId":422263,"journal":{"name":"Scholarly Journal of Emergency Medicine and Critical Care","volume":"75 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115004160","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":"Disruption and Rapid Recovery of Emergency Ophthalmic Services Amidst the COVID Pandemic: An English Teaching Hospital Experience","authors":"J. Muhammed, Joganathan Varajini, H. ZaidiFarhan","doi":"10.36959/592/389","DOIUrl":"https://doi.org/10.36959/592/389","url":null,"abstract":"Purpose: To share our experience of emergency ophthalmic services at a major Tier 2 emergency department in the UK National Health Service, including; emergency department attendances in eye casualty, urgent intravitreal injection services and emergency ophthalmic surgery during the COVID pandemic. We also share our experience of urgent cataract and adnexal surgery work during and after the easing of COVID pandemic restrictions. Methods: Using electronic patient records (EPR) we analysed data for emergency eye clinic attendances and surgical work over a 12 week period during the COVID pandemic from March until May 2020. Emergency surgical work and emergency eye clinic attendance numbers, including type of diagnoses seen were analysed and compared to pre-COVID months. Furthermore, we analysed the data after gradual resumption of routine elective cataract and adnexal surgery from June 2020 onwards. Results: A 73% reduction in patient attendances in the emergency eye clinic and six-fold reduction in surgical work in comparison to the previous year was observed during the height of the pandemic. Our recovery phase elective surgical work demonstrates a 55% and 62% reduction in cataract and adnexal surgical volume respectively, in comparison to preCOVID numbers. Conclusion: At the height of the COVID pandemic we witnessed a significant drop in emergency eye attendances and a complete cessation of elective eye surgery. Investment in Telephone Triage allowed > 70% of emergency patients to be managed without attendance to hospital. It was safe to restart urgent surgery almost immediately after lockdown finished. Check for updates Citation: Jawad M, Joganathan V, Zaidi FH (2020) Disruption and Rapid Recovery of Emergency Ophthalmic Services Amidst the COVID Pandemic: An English Teaching Hospital Experience. Sch J Emerg Med Crit Care 4(1):90-95 Jawad et al. Sch J Emerg Med Crit Care 2020, 4(1):90-95 Open Access | Page 91 | had to make adjustments to our HEES at the door triage. All patients are asked to clean their hands with alcohol gel on arrival and asked to wear a surgical mask to cover the mouth and nose. Patients are asked screening questions and have their body temperature recorded. Any patients suspected of having COVID are redirected to an isolated area in the hospital for further assessment. Those subsequently found to be infected with COVID are examined and managed in a separate ‘hot’ area of the hospital. Patients with no suspicion of COVID infection were either seen on arrival or allocated an appointment in the HEES clinic at a later date depending on urgency. This was in order to minimise the number of patients in the department and adhere to social distancing rules. All staff with patient face to face interaction were required to undergo ‘fit testing’ for personal protective equipment (PPE) face masks. Doctors and other staff who were seeing patients were provided with face masks, disposable gloves and aprons, and protective eye goggles. Slit","PeriodicalId":422263,"journal":{"name":"Scholarly Journal of Emergency Medicine and Critical Care","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126566834","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 Complete Blood Count Modified Results in Patients with Complicated Colorectal Cancer","authors":"Constantin Georgiana Bianca, Firescu D, Voicu D, Ș. Cristina, Rebegea Laura, Manole Corina Pălivan, Mihailov R, Ștefănescu B, Bîrlă Rodica, Constantinoiu S","doi":"10.36959/592/387","DOIUrl":"https://doi.org/10.36959/592/387","url":null,"abstract":"Introduction: Among the factors on which the long-term survival of patients with colorectal cancer depends, the biological status at admission is essential and it is well reflected by a simple, routine analysis: The complete blood count (CBC). The link between the values of the hemoleukogram parameters and the diagnosis of colorectal cancers, but also between the changes in the hemoleukogram and the prognosis of patients with colorectal cancer is well documented in the literature. The aim of this study is to show the link between CBC changes at admission and the survival of patients with complicated colorectal cancer. Patients and methods: We conducted a retrospective study that included 431 patients admitted and operated in emergency for complicated colorectal cancer, in the Surgery II Clinic of the Clinical Emergency County Hospital “St. Ap. Andrei” from Galati between 2008-2017. We made statistical correlations between the 4 types of emergency operations (external derivations, Hartmann, internal derivations and resections with anastomosis) and CBC changes, as well as a survival analysis depending on the presence of these changes. Results: The presence of anemia at admission is statistically significant correlated with the practice of emergency colostomies and the presence of leukocytosis is correlated with Hartmann operations. In our study, only the anemia was a negative prognostic factor for the long-term survival of patients with complicated colorectal cancer. Conclusions: The complete blood count is a routine, simple, cost-effective laboratory test that can be a very useful tool in assessing the prognosis of patients with complicated colorectal cancer. as well as a survival analysis depending on the presence of these changes.","PeriodicalId":422263,"journal":{"name":"Scholarly Journal of Emergency Medicine and Critical Care","volume":"210 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115761277","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":"Laboratory Markers and Mortality in Novel Coronavirus Disease 2019 (COVID-19): A Systematic Review and Meta-Analysis","authors":"Davis Joshua, Geffe Shane, Hana Gina, T. Connor","doi":"10.36959/592/391","DOIUrl":"https://doi.org/10.36959/592/391","url":null,"abstract":"Background: Novel coronavirus disease 2019 (COVID-19) is associated with high mortality. Many laboratory values have been suggested to predict patients at risk for a poor outcome in COVID-19.The objective of this project was to systematically review and meta-analyze all laboratory markers associated with prognosis of mortality in patients with COVID-19. Methods: We searched OVID Medline, SCOPUS, MedRxIv, preprints.org, and Centers for Disease Control databases from November 2019 to April 10, 2020 for articles on laboratory values and mortality in COVID-19 and updated the search July 20, 2020. Teams of 2 independent reviewers reviewed titles and abstracts for studies that reported mortality and laboratory values and subsequently abstracted relevant data. Results: Our initial search identified 6,973 articles and a total of 96 articles (30 articles from first search and 66 from updated search) on 72 laboratory values were included. Many laboratory values were associated with mortality, but those most associated with mortality included lymphopenia (OR 0.30, 95% CI 0.24-0.36), thrombocytopenia (OR 0.46, 95% CI 0.35-0.60), elevated lactate dehydrogenase (OR 7.32, 95% CI 5.19-10.33), and ferritinemia (OR 5.19, 95% CI 3.07-8.62). All cardiac markers were associated with mortality, with troponin being the least associated. A low PaO2:FiO2 ratio was also associated with mortality (OR 0.13, 95% CI -0.06-0.28). Heterogeneity was high and risk of bias was moderate. Conclusions: This meta-analysis identified many laboratory abnormalities associated with mortality in COVID-19, though was limited by heterogeneity. Laboratory markers previously identified as associated with a poor prognosis in COVID-19 were confirmed to be those most associated with mortality in this large meta-analysis.","PeriodicalId":422263,"journal":{"name":"Scholarly Journal of Emergency Medicine and Critical Care","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129150081","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":"Covid-19 Treatment: A Narrative Review of the Research and Evidence Thus Far","authors":"Rahim SM Zubair, Connolly Derek L, Rajasekaran Arvind B, Sharma Vinoda","doi":"10.36959/592/390","DOIUrl":"https://doi.org/10.36959/592/390","url":null,"abstract":"The emergence of the novel SARS-CoV-2 virus has led to an unprecedented global pandemic with a high degree of morbidity and mortality. Treatment regimens around the world have been varied both in their drug combinations and the levels of evidence behind them. Drugs that have been used for other immune modulating purposes are being re-trialled to try to combat this disease, with data showing far from conclusive results. We will examine the most common treatment strategies, including the rationale and evidence behind their","PeriodicalId":422263,"journal":{"name":"Scholarly Journal of Emergency Medicine and Critical Care","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123601931","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 Case of Repetitive Consciousness Disturbance with Hypercapnia due to Nonconvulsive Status Epilepticus in Klippel-Feil Syndrome","authors":"Nagasawa Hiroki, Dotare Taishi, Takeuchi Ikuto, Jitsuiki Kei, Madokoro Shunsuke, Takahashi Norihito, Ohsaka Hiromichi, Ishikawa Kouhei, Omori Kazuhiko, Y. Youichi","doi":"10.36959/592/383","DOIUrl":"https://doi.org/10.36959/592/383","url":null,"abstract":"A 59-year-old female complained palpitation in the morning. She was found in unconsciousness by her family and transported to our department. Her past history was she had torticollis, unilateral renal agenesis and dextrocardia since her birth. She had limited range of motion of bilateral brachiums and left hand dysesthesia due to torticollis since over 50-years-old. On arrival, she was in coma state with severe hypoxia and hypercapnia. Initially, she underwent diagnosis of status epileptic and/or over dose inducing coma, acute lung failure and liver dysfunction.","PeriodicalId":422263,"journal":{"name":"Scholarly Journal of Emergency Medicine and Critical Care","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128799527","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":"Cancer Pain at the Emergency Department and its Approach","authors":"Hernández-Porras B Carolina, Maruri Daniela Benítez, Ñamendys-Silva Silvio, Sánchez Ricardo Plancarte","doi":"10.36959/592/382","DOIUrl":"https://doi.org/10.36959/592/382","url":null,"abstract":"Introduction: Pain is reported to be a chief complaint in emergency departments (ED), however, few studies have examined pain management in the ED, and fewer in oncologic patients. Objective: The purpose of this study was to determine the prevalence of pain complaints in the ED in cancer patients at an oncologic center. Methods: We conducted a retrospective study in which we analyzed the consecutive, nonrandomized records of patients who arrived at the ED of the National Cancer Institute of Mexico, during the period from January 2015 to March 2015. Results: Of 2676 patients, 30.7% complained of pain at the ED. Visceral pain was the most frequent type of pain (55.5%), followed by somatic pain (27.4%). The mean VAS score of background pain was 6 (RIC 4-8), while for break through cancer pain (BTCP) the mean was 8 (RIC 7-10). In 92.2% of patients referred to a pain clinic office, an opioid was prescribed. Morphine, followed by tramadol and buprenorphine were the most frequent opioids prescribed. Conclusion: This is the first study that identifies types of pain, intensity and treatment in cancer population at an ED. Recognizing pain as a prevalent problem, may be helpful to implement preventive measures or treat pain opportunely and appropriately in cancer patients. We suggest prospectively long-term studies to properly evaluate the impact of a pain clinic office in an ED at an Oncologic Center.","PeriodicalId":422263,"journal":{"name":"Scholarly Journal of Emergency Medicine and Critical Care","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127416875","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":"Type II Myocardial Infarction and Stress Cardiomyopathy Secondary to Inhaled Foreign Body (Garden Pea)","authors":"Brown-Schmidt Sarah, M. Craig","doi":"10.36959/592/394","DOIUrl":"https://doi.org/10.36959/592/394","url":null,"abstract":"","PeriodicalId":422263,"journal":{"name":"Scholarly Journal of Emergency Medicine and Critical Care","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130286165","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":"Effects of ELF-EMF Treatment on Depression","authors":"Cheong Issac","doi":"10.36959/592/393","DOIUrl":"https://doi.org/10.36959/592/393","url":null,"abstract":"","PeriodicalId":422263,"journal":{"name":"Scholarly Journal of Emergency Medicine and Critical Care","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129361211","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}