Open Access Emergency Medicine最新文献

{"title":"First Results of Our Local Practice Guide Used During the Late Phase of Resuscitation in Patients with Refractory VF in Out of Hospital Cardiac Arrest.","authors":"Cornelis Slagt, Sander M J Van Kuijk, Jörgen Bruhn, Geert Jan Van Geffen, Lars Mommers","doi":"10.2147/OAEM.S510483","DOIUrl":"10.2147/OAEM.S510483","url":null,"abstract":"<p><strong>Objective: </strong>Treatment of refractory ventricular fibrillation (rVF) is a clinical challenge. If rVF is still present after standard advanced life support (ALS) guideline care, including amiodaron administration, other therapeutic options might be necessary. Based on the available evidence and expertise, our Helicopter Emergency Medical Service (HEMS) team developed a local practice guide for the prolonged resuscitation of patients in rVF and implemented this as standard HEMS care in March 2022.</p><p><strong>Methods: </strong>This database study contains all patients treated with our local practice guide during out of hospital cardiac arrest (OHCA) with rVF beyond the fifth regular ALS shock-block. This local practice HEMS treatment algorithm consisted of, among others, cessation of epinephrine and alternating administration of esmolol and norepinephrine combined with enoximone. Data were derived from the HEMS database and the treating hospitals. Primary outcome was the return of spontaneous circulation. Secondary outcome was defined as survival to hospital discharge and cerebral performance. This outcome was compared to the literature to analyze for inferiority of treatment.</p><p><strong>Results: </strong>In a 21-month period, HEMS was 761 times deployed for OHCA. Nineteen patients were treated with the local practice guide, nine patients (47%) were admitted to hospital with return of spontaneous circulation. Median resuscitation time was 22min. Hospital survival with good neurology was achieved in 42% vs 17% as expected. Exact Clopper-Pearson and logistic regression analysis revealed non-inferiority of the local practice guide. Withholding epinephrine was achieved in 84% of patients. A total of 79% and 90% of patients received esmolol and norepinephrine/enoximone mixture, respectively. Alternative defibrillation positions were indicated in 18 patients but applied in only 6 (33%).</p><p><strong>Conclusion: </strong>In patients with persisting VF despite prolonged advanced life support care, a multifaceted bundle of care approach shows promising results and warrants further research. Alternative drug administrations were found to be substantially easier to achieve compared to alternative defibrillation positions.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"17 ","pages":"203-213"},"PeriodicalIF":1.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroanesthesia Management in Pediatric with Traumatic Brain Injury Due to Gunshot Wound.","authors":"Andy Nugroho, Dewi Yulianti Bisri, Iwan Abdul Rachman, Radian Ahmad Halimi","doi":"10.2147/OAEM.S494418","DOIUrl":"10.2147/OAEM.S494418","url":null,"abstract":"<p><p>Traumatic brain injury (TBI) in the pediatric population is a major cause of morbidity and mortality. Between various etiologies of TBI, gunshot wounds occupy a unique characteristic and apprehensive place. We report a clinical case of a TBI due to a gunshot wound in Indonesia. A 4-year-old girl complained of a painful head and vomiting after sustaining a gunshot wound to the head. The patient was presented with a pediatric Glasgow Coma Scale (pGCS) score of E3V4M5 and was hemodynamically stable Multislice computerized tomography (MSCT) revealed a bullet lodged in the left temporal lobe, a subdural hematoma in the left frontoparietal-temporooccipital, an intracranial hemorrhage in the left temporoparietal region, and a midline shift to the right by 0.7 cm. The patient underwent craniotomy for subdural hematoma evacuation and bullet evacuation. Stable hemodynamics and brain relaxation conditions were achieved during surgery. Postoperative recovery in the pediatric intensive care unit (PICU) was uneventful, and the patient was discharged with improved neurological status (pGCS E4V5M6) without complications. The case highlights the successful management of a pediatric patient with traumatic brain injury due to a gunshot wound through a multidisciplinary and tailored approach focusing on hemodynamic stability, intracranial pressure management, early posttraumatic seizure, and infection prophylaxis to ensure a positive outcome. Given the scarcity of reported cases in low- and middle-income settings, this report provides valuable insights into the optimal management of pediatric gunshot-related TBIs.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"17 ","pages":"195-201"},"PeriodicalIF":1.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Obesity on Orthopedic Injury and Fracture Patterns in Motor Vehicle Accidents.","authors":"Jonathan P Japa, Alina Shats, Philip Zitser, Nisha Lakhi","doi":"10.2147/OAEM.S490123","DOIUrl":"10.2147/OAEM.S490123","url":null,"abstract":"<p><strong>Purpose: </strong>Obese trauma patients face a higher risk of mortality, prolonged ICU stays, and more complications than non-obese patients. However, some studies suggest that obesity might provide protective benefits in high-impact trauma situations through the \"cushion effect\". This study will examine whether obesity influences fracture occurrence, injury severity, and clinical outcomes in motor vehicle accidents (MVA).</p><p><strong>Methods: </strong>A retrospective study of 555 adult patients who presented to a Level 1 Trauma Center following a MVA from 2010-2022. Patients with a Body Mass Index (BMI) greater than or equal to 30 kg/m² were categorized as obese (178 patients, 32.6%), and those with a BMI less than 30 kg/m² were classified as non-obese (377 patients, 67.4%). Incidence of bone fractures and injury severity were compared between both groups using injury severity score (ISS) and abbreviated injury scale (AIS). For variables significant on univariate analysis, binary logistic regression models were used to control age, gender, restraint use, and airbag deployment.</p><p><strong>Results: </strong>The mean number of fractures (0.62 vs 0.46, p=0.096) and ISS (4.55 vs 4.51, p=0.703) were similar between the obese and non-obese groups. However, obese patients were more likely to experience upper extremity fractures (7.3% vs 3.4%, p=0.045) and lower extremity fractures (7.3% vs 2.7%, p =0.01), particularly fractures of the tibia/fibula (5.6% vs 1.6%, p=0.008). No significant differences were found in the incidence of head, thoracolumbar, or pelvic fractures between the two groups. After controlling for age, gender, restraint use, and airbag deployment, obesity remained an independent predictor of lower extremity fracture (aOR) 2.62 (95% CI: 1.01-6.56), p = 0.04).</p><p><strong>Conclusion: </strong>Obesity is an independent predictor of lower extremity fractures following a MVA. Clinicians should acknowledge potential differences in fracture occurrence and patterns between obese and non-obese patients during triage.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"17 ","pages":"185-193"},"PeriodicalIF":1.5,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed Diagnosis and Outcomes in Acute Aortic Dissection: A 10-Year Single-Center Retrospective Study.","authors":"Suluck Kanoksirirat, Adisak Nithimathachoke","doi":"10.2147/OAEM.S496279","DOIUrl":"https://doi.org/10.2147/OAEM.S496279","url":null,"abstract":"<p><strong>Introduction: </strong>Acute aortic dissection is a rare and life-threatening condition with highly variable clinical presentations, often resulting in atypical symptoms and initial misdiagnosis. This study aimed to investigate clinical presentations and explore the associations between clinical characteristics, delayed diagnosis, and in-hospital mortality among patients with acute aortic dissection.</p><p><strong>Methods: </strong>A retrospective chart review was performed on patients presenting with acute aortic dissection at an urban academic emergency department in Thailand between January 1, 2011, and December 31, 2020. Baseline characteristics, clinical presentations, imaging findings, delayed diagnosis (>4 h from first emergency department contact), and in-hospital mortality rates were analyzed.</p><p><strong>Results: </strong>The study included 103 patient charts, predominately men (71 patients), with a median age of 71 years (interquartile range of 58-78 years). Abdominal pain (36.9%) and thoracic pain (24.3%) were the most common presenting symptoms. Dyspnea (11.7%), altered consciousness (4.9%), and syncope (4.9%) were the three main painless presenting atypical symptoms. Atypical presentations were not significantly associated with delayed diagnosis, which occurred in 27.2% of cases. Normotension, a history of coronary artery disease, and pleural effusion were associated with delayed diagnosis. Abnormal chest films were major risk factors for in-hospital mortality, observed in 22.3% of patients with acute aortic dissection, whereas delayed diagnosis was not directly related to such mortality.</p><p><strong>Conclusion: </strong>The incidence of acute aortic dissection in the urban Thai population was 32.4 per 100,000 patient-years, with a range of clinical presentations. A high index of suspicion for AAD is crucial for timely diagnosis, even in patients with atypical symptoms and seemingly normal vital signs. Careful interpretation of chest radiographs is essential as abnormal chest X-ray findings are associated with a poorer prognosis.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"17 ","pages":"173-183"},"PeriodicalIF":1.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12075430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using an in-situ Simulation Model to Identify Deviations from Guideline-Based Management of Pediatric Status Epilepticus in Community Emergency Departments.","authors":"Eliza T Firn, Rinat Jonas, Laurie M Douglass, Barbara M Walsh","doi":"10.2147/OAEM.S507770","DOIUrl":"https://doi.org/10.2147/OAEM.S507770","url":null,"abstract":"<p><strong>Background: </strong>Children with epilepsy are often presented to Community Emergency Departments (CEDs) for acute treatment of status epilepticus (SE). Timely medical management is imperative to prevent morbidity and mortality, and adherence to evidence-based guidelines improves outcomes for high stakes/low frequency events. Barriers to guideline adherent management in the CED setting are understudied; in-situ simulation (ISS) can be used to identify gaps in care for events such as pediatric SE.</p><p><strong>Objective: </strong>The primary objective was to assess for deviations from evidence-based guidelines in the management of pediatric SE. A secondary objective was to explore potential barriers to practice within the evidence-based guidelines.</p><p><strong>Methods: </strong>We conducted a prospective observational ISS pilot study examining representative CED teams caring for a simulated child in SE. The primary outcome was overall adherence to the pediatric SE guidelines as measured by 12 metrics: 5 non-pharmacologic (for example: delays in vital sign assessment, failure to time seizure) and 7 pharmacologic (for example: incorrect benzodiazepine dose, delay in benzodiazepine administration or escalation to antiseizure medication). Additional metrics including provider knowledge (recognition of status epilepticus) and resources (antiseizure medications stocked) were analyzed as process measures. We enrolled 4 interprofessional teams at 4 participating ED sites.</p><p><strong>Results: </strong>Overall, 0 of the 4 teams adhered to all 12 metrics. A barrier to timely administration of benzodiazepines for two of the sites came from attempting IV access repeatedly. No team referenced an up-to-date treatment algorithm based on current evidence-based guidelines.</p><p><strong>Conclusion: </strong>Standardized ISS scenarios identified variability in adherence to the pediatric SE guideline across a pilot sample of local CEDs. Barriers to guideline-adherent care occurred at both individual and systems levels. The study was limited in scope to 4 pilot sites.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"17 ","pages":"165-171"},"PeriodicalIF":1.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing Unnecessary Venous Blood Gas (VBG) Testing in the Emergency Department Through Targeted Education.","authors":"Kelly Mullins, Kate Urie, Kate Wallis, Brendan Morrissey, Sam Freeman, Christina M Trambas, Hamed Akhlaghi","doi":"10.2147/OAEM.S505114","DOIUrl":"https://doi.org/10.2147/OAEM.S505114","url":null,"abstract":"<p><strong>Objective: </strong>Our objective was to evaluate the amount of unnecessary Venous Blood Gas (VBG) tests initiated in the Emergency Department (ED) and to assess the effectiveness of clinical intervention, such as education, in reducing VBG tests.</p><p><strong>Methods: </strong>497 consecutive patients were selected between 1 August and 30 September 2019. For Phase 1, 10 volunteer nurses were randomly assigned to 50 cases each and assessed whether they would perform a VBG. A brief educational intervention was then implemented regarding specific clinical indications to perform VBGs. After the education, they were asked the same questions. For Phase 2, the entire ED team was subjected to intervention and education (Phase 2). A monthly prospective audit of VBG testing numbers in St Vincent's Melbourne Emergency Department was compared from March 2022 to December 2022.</p><p><strong>Results: </strong>The phase 1 educational intervention saw a significant reduction in unnecessary VBG of 24% (p-value < 0.001, odd ratio of 15.8 [confidence interval (CI): 8.5-29.1]). During Phase two, a sustained reduction in absolute VBG testing in the ED was observed of 33.7% (9% adjusted reduction). This simple intervention would save around $22,000 in our ED based on an annual presentation of ~50,000.</p><p><strong>Conclusion: </strong>Our study highlights the importance of education to support the \"Choosing wisely\" campaign to reduce VBG testing in EDs. By reducing the number of VBGs, we not only limit unnecessary tests for our patients, but also reduce the cost associated with frequent and unnecessary blood gas analysis.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"17 ","pages":"157-163"},"PeriodicalIF":1.5,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical Presentation of Kikuchi-Fujimoto Disease: Diagnostic Challenges in a Case of Persistent Cervical Lymphadenopathy with Acute Onset Quadriplegia.","authors":"Abdullahi Ahmed Ahmed, Ismail Mohamoud Abdullahi, Ismail Gedi Ibrahim","doi":"10.2147/OAEM.S507693","DOIUrl":"10.2147/OAEM.S507693","url":null,"abstract":"<p><p>Kikuchi-Fujimoto disease (KFD), is rare, self-limiting disorder with necrotizing lymphadenitis as its hallmark, can be difficult to diagnose because it may have multiple nonspecific features. The study presented here describes the rare type of KFD that occurred in a young male patient suffering from quadriplegia and who was wrongly diagnosed as having tuberculous lymphadenitis, which is a common cause of lymphadenopathy in tuberculosis-endemic area. A 19-year-old man had presented with two week history of fever, quadriplegia, and cervical lymphadenopathy. On physical examination revealed cervical lymphadenopathy. A laceration procedure was performed to address the lymphadenopathy. The patient was treated with anti-tubercular medication for 11 days. Currently, his urinary and bowel functions are stable, and he is fully conscious, alert, and oriented to time, place, and person. Histopathology showed classical changes in histiocytic necrotizing lymphadenitis in the lymph nodes with no evidence of either tuberculosis or neoplasm. This KFD case is particularly glaring in terms of the obstacles it presented in making a diagnosis due to its endemicity of tuberculosis. The case actually had a complicated clinical picture with KFD's initial presentation of quadriplegia. Hence, the list of differential diagnosis should include KFD as one of the uncommon causes. Timely recognition and appropriate management of KFD can prevent unnecessary treatments and improve patient outcomes.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"17 ","pages":"151-155"},"PeriodicalIF":1.5,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traffic Patterns and Emergency Medical Services Prenotification Transport Estimates in Trauma Activations [Response to Letter].","authors":"Sophia Gorgens, Eric N Klein, Matthew A Bank, Daniel Jafari","doi":"10.2147/OAEM.S520503","DOIUrl":"https://doi.org/10.2147/OAEM.S520503","url":null,"abstract":"","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"17 ","pages":"149-150"},"PeriodicalIF":1.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prevalence and Management of Aerodigestive Foreign Bodies at Rwanda Military Hospital: A Six-years Retrospective Study.","authors":"John Bukuru, Agape Ngirinshuti, Pascale Ange Kamanda, Wilson Kananga, Charity Murungi Mukomeza, Olivier Sibomana","doi":"10.2147/OAEM.S493458","DOIUrl":"10.2147/OAEM.S493458","url":null,"abstract":"<p><strong>Background: </strong>Aerodigestive foreign bodies are common issue especially in children, who often place objects in their mouths, leading to inhalation or ingestion. Despite global data on this issue, no comprehensive study has been conducted in Rwanda. This study aimed to assess the prevalence, demographic factors, clinical presentations, diagnostic and management techniques of aerodigestive foreign bodies at Rwanda Military Hospital (RMH).</p><p><strong>Methods: </strong>This retrospective study reviewed patient records from ENT department of RMH over the period of six years, from January 2017 to December 2022. Data on aerodigestive foreign bodies were extracted from operating room archives and OpenClinic hospital online system, then compiled in Excel spreadsheet, and descriptively analyzed using and SPSS 23.</p><p><strong>Results: </strong>Among 39,240 patients who consulted the ENT department over the six years, 290 (0.74%) cases of aerodigestive foreign bodies were identified, with male-to-female ratio of 1.34:1. The highest incidence was in children aged 1-3 years (49.66%). Inorganic foreign bodies, especially coins (35.17%), were more common than organic ones. Clinical presentations varied, with 46.21% of cases being asymptomatic, and others showing drooling (17.93%) and dysphagia (9.66%). Chest X-rays were the most frequently used diagnostic tool (49.66%). Esophagoscopy was the primary management method for esophageal cases (45.52%), with bronchoscopy (13.10%) and forceps (34.14%) used for bronchial and nasal cases, respectively.</p><p><strong>Conclusion: </strong>Aerodigestive foreign bodies, particularly coins, are prevalent in Rwanda, especially among young children and males. This highlights the need for targeted preventive strategies and educational programs to reduce incidence and improve management.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"17 ","pages":"137-147"},"PeriodicalIF":1.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous Spinal Epidural Hematoma Under Rivaroxaban and Clopidogrel: A Case Report and Literature Review.","authors":"Bruno Schoenmaekers, Imad Derraz, Nadim Tahhan, Pierre Metrailler","doi":"10.2147/OAEM.S489072","DOIUrl":"10.2147/OAEM.S489072","url":null,"abstract":"<p><p>Spontaneous spinal epidural hematoma (SSEH) is a rare pathology with potentially severe consequences for the patient. Given its uncommon incidence and frequent atypical presentation, SSEH can easily be misdiagnosed. The association between anticoagulation or antiplatelet therapy and SSEH has been described in multiple case reports and literature reviews. We present a case of a 61-year-old man on anticoagulation and antiplatelet therapy (Rivaroxaban and Clopidogrel respectively), diagnosed with spinal SSEH with good recovery after laminectomy and hematoma evacuation. However, treatment guidelines for SSEH are difficult to find and there is no clear strategy about management of anticoagulation and antiplatelet therapy. The aim of this report is to highlight the importance of rapid diagnosis and surgical therapy in selected cases and to give an insight on the anticoagulation and antiplatelet management in these patients and their prognosis.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"17 ","pages":"129-135"},"PeriodicalIF":1.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}