Open Access Emergency Medicine最新文献

{"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}

{"title":"Deadly Injuries Sustained From a Hyena Attack: The Importance of Timely Diagnosis and Treatment - A Case Report.","authors":"Abdullahi Ahmed Ahmed, Ismail Gedi Ibrahim, Ismail Mohamoud Abdullahi, Abdihakim Artan Abdi, Mohamed Dahir Omar, Abdulkadir Ahmed Mohamed","doi":"10.2147/OAEM.S509826","DOIUrl":"10.2147/OAEM.S509826","url":null,"abstract":"<p><p>Animal bites represent a significant global public health concern, with hyena attacks being rare but highly destructive. This report details the case of a 22-year-old male who was attacked by a hyena while herding camels in rural Qardho, Somalia. The attack resulted in traumatic amputation of both testicles and the penis, finger loss, extensive muscle damage, and a jawbone fracture. The patient initially received local care and was subsequently transferred to Mogadishu for advanced treatment. Key interventions included wound closure, tracheotomy, broad-spectrum antibiotics, and tetanus prophylaxis. This case highlights the complexities of managing severe trauma in resource-limited settings and underscores the necessity of timely, multidisciplinary care. Long-term rehabilitation, along with psychological support, are essential components of the patient's recovery. Furthermore, the case emphasizes the importance of trauma prevention strategies and ensuring access to specialized medical care in remote regions.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"17 ","pages":"121-127"},"PeriodicalIF":1.5,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494084","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":"Ketamine Versus Haloperidol/Lorazepam/Diphenhydramine Combination Treatment for Management of Acute Agitation in the Emergency Department.","authors":"Nicole Sunshine, Jenny Martinez, Alexandra Bazan, William R Wolowich, Tony Zitek","doi":"10.2147/OAEM.S486208","DOIUrl":"10.2147/OAEM.S486208","url":null,"abstract":"<p><strong>Purpose: </strong>Appropriate use and timing of agents for chemical management of patient agitation is critical for the safety of patients and providers. Ketamine may have a preferable safety profile in acutely agitated patients, especially those with an unknown medication history given that it does not carry the same cardiovascular and respiratory risks as other sedative agents currently used in practice. This study aimed to evaluate subsequent chemical sedation requirements and the incidence of adverse events following the use of ketamine for agitation as compared to combination antipsychotic/sedative use in the ED.</p><p><strong>Methods: </strong>This was a retrospective, single-center, observational cohort study of 102 adult patients who received chemical sedation for agitation/aggression/combative behavior from January 2018 to December 2023 at the Mount Sinai Medical Center Emergency Department. Patients who received at least one dose of ketamine (n = 51) were compared to patients who received at least one dose of the B52 combination (diphenhydramine (Benadryl) 25 mg, haloperidol (Haldol) 5 mg, and lorazepam (Ativan) 2 mg) (n = 51) for management of aggression. The primary endpoint was restricted mean survival time (RMST) to next sedative given. Secondary endpoints included the number of additional sedatives needed, adverse events, and length of stay.</p><p><strong>Results: </strong>The use of ketamine was associated with patients requiring additional sedation both more often and sooner than patients who received the B52 combination (RMST to next sedative: 2.1 hours ketamine vs 4 hours B52; <i>p</i> = 0.032, median additional doses: 3 doses ketamine group vs 0 doses B52 group; <i>p</i> < 0.00).</p><p><strong>Conclusion: </strong>In agitated patients within the ED, the administration of ketamine demonstrated inadequate duration of sedation and increased need for supplemental sedative use compared to B52.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"17 ","pages":"113-120"},"PeriodicalIF":1.5,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469540","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":"Are Saudi Radiological Sciences Students Prepared for Emergencies? Exploring Knowledge, and Attitudes Towards Basic Life Support and Cardiopulmonary Resuscitation.","authors":"Khalid M Alshamrani, Alaa A Alkhayyat, Rimaz N Arif, Adnan A S Alahmadi, Shrooq T Aldahery, Walaa M Alsharif, Abdulaziz A Qurashi","doi":"10.2147/OAEM.S507046","DOIUrl":"10.2147/OAEM.S507046","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to evaluate the preparedness of Saudi radiological sciences students for emergencies by assessing their awareness of cardiac arrest evaluation criteria, knowledge of Cardiopulmonary Resuscitation (CPR) and defibrillators, and attitudes towards performing CPR.</p><p><strong>Methods: </strong>A cross-sectional descriptive study was conducted among students from the radiological sciences program at three Saudi universities. Using a well-established questionnaire, the study employed non-probability convenient sampling. Descriptive statistics were generated, and chi-square test examined associations between categorical variables and Basic Life Support (BLS) training status.</p><p><strong>Results: </strong>Out of 367 students contacted, 261 participated (71.1% response rate). BLS training markedly enhances knowledge of the correct chest compression rate, with 50.9% of trained students demonstrating accurate understanding compared to 27.5% of untrained students (P < 0.0001). A significant correlation was found between BLS training and the ability to perform cardiac massage during cardiac arrest and respiratory standstill, with 44.1% of students demonstrating this knowledge (P < 0.0001). Notably, 80.8% of students without BLS training lacked knowledge of cardiac massage, compared to only 30.4% of those with training. Additionally, 30.6% of students were familiar with defibrillators, and 44.1% knew AED locations (P = 0.0007). Hesitation to perform CPR was mainly due to fear of mistakes (53.6%) and harm concerns (31.1%).</p><p><strong>Conclusion: </strong>Our findings reveal significant gaps in knowledge, confidence, and preparedness for cardiac emergencies among Saudi radiological sciences students, with only 41.4% having completed BLS training. These results highlight the urgent need for comprehensive BLS education to.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"17 ","pages":"91-103"},"PeriodicalIF":1.5,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434077","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":"An Effective Triage Education Method for Triage Nurses: An Overview and Update.","authors":"Sofia-Chrysovalantou Zagalioti, Mairi Ziaka, Aristomenis Exadaktylos, Barbara Fyntanidou","doi":"10.2147/OAEM.S498085","DOIUrl":"10.2147/OAEM.S498085","url":null,"abstract":"<p><strong>Background: </strong>Accurate decision-making in triage largely determines the amount of time required for a patient to be evaluated and treated while in the emergency department. Nursing staff worldwide have similar learning characteristics with similar working hours and common goals, despite the fact that different triage scales are used globally. The aim of this mini review is to present the different educational methods and identify the most effective for triage training of triage nurses.</p><p><strong>Materials and methods: </strong>We screened studies concerning triage education for nurses in Emergency Department, in databases including PubMed, CENTRAL and CINAHL. From November 12, 2023 to February 15, 2024, databases were searched for relevant literature. \"Triage education\" OR \"triage training\" AND \"emergency nurses\" OR \"triage nurses\" were the MeSH terms.</p><p><strong>Results: </strong>There are various educational methods, including traditional, web-based, audiovisual, simulation-based, blended learning, and other specialized approaches. Almost all of the studies that are currently available demonstrate how effectively an educational intervention might improve nurses' comprehension of triage. Except for one, every study concluded that the educational intervention significantly improved nurses' triage knowledge. Comparing the included studies is challenging due to their heterogeneity, and applying the results in practice requires caution.</p><p><strong>Conclusion: </strong>The majority of studies reported that educational interventions effectively increased nurses' triage knowledge. Blended learning in conjunction with refresher courses enhanced triage-related knowledge and decision-making; however, additional research is required to ascertain whether this approach is superior to the others and whether these improvements will last.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"17 ","pages":"105-112"},"PeriodicalIF":1.5,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434074","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":"A Case of Cutaneous Leishmaniasis Presenting to the Emergency Department.","authors":"Anne Gordon, Adrienne N Malik","doi":"10.2147/OAEM.S499748","DOIUrl":"10.2147/OAEM.S499748","url":null,"abstract":"<p><p>In this case, we describe a case of cutaneous leishmaniasis, a protozoan disease not typically found in the United States, that presented to our emergency department (ED). The diagnosis was confirmed by the Center for Disease Control and Prevention (CDC) through a polymerase chain reaction (PCR) sample from the presenting skin lesion. The patient was a 43-year-old woman with history of a bite by an unknown organism while traveling by foot through Panama. She presented with a large, ulcerated lesion on her lower left shin. She was admitted on suspicion of leishmaniasis, and physicians of several specialties initiated a broad laboratory workup, collected wound cultures, prescribed antibiotics, and surgically repaired the lesion. The rapid recognition of leishmaniasis allowed for the patient to begin treatment before the definitive diagnosis returned, emphasizing the importance of knowledge of worldwide diseases and their presenting features for the ED physician.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"17 ","pages":"85-89"},"PeriodicalIF":1.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399949","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 [Letter].","authors":"Sari Luthfiyah, Triwiyanto Triwiyanto, Mohammed Ismath","doi":"10.2147/OAEM.S502924","DOIUrl":"10.2147/OAEM.S502924","url":null,"abstract":"","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"17 ","pages":"65-66"},"PeriodicalIF":1.5,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383758","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":"Anemia, Hyperglycemia, and Reduced Left Ventricular Ejection Fraction Improve the GRACE Score's Predictability for In-hospital Mortality in Acute Coronary Syndrome; Single-Centre Cross-Sectional Study.","authors":"Iswandy Janetputra Turu' Allo, Miftah Pramudyo, Mohammad Rizki Akbar","doi":"10.2147/OAEM.S493878","DOIUrl":"10.2147/OAEM.S493878","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigates the predictive value of incorporating anemia, hyperglycemia, and left ventricular ejection fraction (LVEF) into the Global Registry of Acute Coronary Events (GRACE) score for in-hospital mortality in Acute Coronary Syndrome (ACS).</p><p><strong>Patients and methods: </strong>We conducted a single-center, cross-sectional study involving 634 ACS patients admitted to Dr. Hasan Sadikin General Hospital between 2021 and 2023. Anemia was defined as hemoglobin <13 g/dL in men and <12 g/dL in women, while hyperglycemia was indicated with random blood glucose (RBG) ≥200 mg/dL at admission. Patients with LVEF <50% were classified as having reduced LVEF. The primary outcome was in-hospital mortality. Model goodness-of-fit was assessed using R² and the Hosmer-Lemeshow's test. The predictive accuracy of the GRACE score alone and combined with these parameters were evaluated through receiver operating characteristic curve analysis, an area under the curve (AUC), and concordance (C)-statistics. Reclassification improvement was quantified using continuous net reclassification improvement (cNRI) and integrated discrimination improvement (IDI).</p><p><strong>Results: </strong>Among 634 patients (mean age 58.10±11.08 years old; 80.3% male), anemia, hyperglycemia, and reduced LVEF were observed in 197 (31.1%), 123 (19.4%), and 364 (57.4%) patients, respectively. The in-hospital mortality rate was 6.6%. Regression analysis identified nine predictors of mortality, with anemia, hyperglycemia, and reduced LVEF confirmed as independent predictors. The GRACE score showed an AUC of 0.839 (95% confidence interval/CI 0.77-0.0.90). Incorporating anemia, hyperglycemia, and reduced LVEF increased the AUC to 0.862 (95% CI 0.81-0.91), enhancing predictive accuracy (p = 0.590). Combining these variables yielded an NRI of 0.075 (p = 0.070) and an IDI of 0.035 (p = 0.029).</p><p><strong>Conclusion: </strong>Incorporating anemia, hyperglycemia, and reduced LVEF into the GRACE score improves its predictive capacity for in-hospital mortality in ACS patients. The modified GRACE score offers a more robust risk stratification tool for clinical practice and decision-making.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"17 ","pages":"67-83"},"PeriodicalIF":1.5,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383745","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}