Open Access Emergency Medicine最新文献

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Utility of Common Bile Duct Identification on Biliary Ultrasound in Emergency Department Patients. 急诊科患者胆道超声胆总管识别的实用性
IF 1.5
Open Access Emergency Medicine Pub Date : 2024-08-28 eCollection Date: 2024-01-01 DOI: 10.2147/OAEM.S468678
Christopher Thom, Justin Yaworsky, Kevin Livingstone, David Han, Jakob Ottenhoff
{"title":"Utility of Common Bile Duct Identification on Biliary Ultrasound in Emergency Department Patients.","authors":"Christopher Thom, Justin Yaworsky, Kevin Livingstone, David Han, Jakob Ottenhoff","doi":"10.2147/OAEM.S468678","DOIUrl":"10.2147/OAEM.S468678","url":null,"abstract":"<p><strong>Background: </strong>Biliary ultrasound is often utilized in the evaluation of abdominal pain in the Emergency Department (ED). Common bile duct (CBD) identification is traditionally a standard component of the biliary ultrasound examination but can be challenging to perform for the novice sonographer. Previous work has demonstrated that CBD dilatation is rare in cases of cholecystitis with normal liver function tests (LFTs). We sought to assess the frequency of CBD dilatation in the subset of ED patients undergoing hepatobiliary ultrasound who have normal LFTs and an absence of gallstones or biliary sludge on ultrasound. We also performed an assessment of changes in CBD diameter by age and cholecystectomy status.</p><p><strong>Methods: </strong>This was a retrospective chart review at a single academic ED. Patients were enrolled in the study if they underwent a radiology performed (RP) hepatobiliary ultrasound within the 2 year study period. Records were reviewed for the presence of gallstones or sludge, CBD diameter, age, clinical indication for the ultrasound, and LFTs. Descriptive analyses were performed, and interobserver agreement among data abstractors was assessed by <i>K</i> analysis for the presence of CBD dilatation. The Mann-Whitney test was utilized to assess statistical significance in the comparison of differences between CBD diameters amongst age groups.</p><p><strong>Results: </strong>Of 1929 RP hepatobiliary ultrasounds performed in the study period, 312 were excluded and 1617 met inclusion criteria. Amongst these, there were 506 patients who had normal LFTs and an ultrasound with no stones or sludge. Ten patients within this group had a dilated CBD > 7 mm (1.98%, 95% CI of 1.08% to 3.6%). We also noted a statistically significant increase in CBD size in the older age cohort and in those individuals with a history of cholecystectomy.</p><p><strong>Conclusion: </strong>CBD dilation in ED patients who present with normal LFTs and an absence of gallstones and biliary sludge is rare. Physicians should be reassured that the routine identification of the CBD on ultrasound in this setting is of low yield and need not be pursued.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113213","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}
引用次数: 0
Effect of a Point-of-Care Ultrasound-Driven vs Standard Diagnostic Pathway on 24-Hour Hospital Stay in Emergency Department Patients with Dyspnea-Protocol for A Randomized Controlled Trial. 护理点超声与标准诊断路径对急诊科呼吸困难患者 24 小时住院时间的影响--随机对照试验方案。
IF 1.5
Open Access Emergency Medicine Pub Date : 2024-08-27 eCollection Date: 2024-01-01 DOI: 10.2147/OAEM.S454062
Stig Holm Ovesen, Søren Helbo Skaarup, Rasmus Aagaard, Hans Kirkegaard, Bo Løfgren, Michael Dan Arvig, Bo Martin Bibby, Stefan Posth, Christian B Laursen, Jesper Weile
{"title":"Effect of a Point-of-Care Ultrasound-Driven vs Standard Diagnostic Pathway on 24-Hour Hospital Stay in Emergency Department Patients with Dyspnea-Protocol for A Randomized Controlled Trial.","authors":"Stig Holm Ovesen, Søren Helbo Skaarup, Rasmus Aagaard, Hans Kirkegaard, Bo Løfgren, Michael Dan Arvig, Bo Martin Bibby, Stefan Posth, Christian B Laursen, Jesper Weile","doi":"10.2147/OAEM.S454062","DOIUrl":"10.2147/OAEM.S454062","url":null,"abstract":"<p><strong>Purpose: </strong>Point-of-care ultrasound (POCUS) helps emergency department (ED) physicians make prompt and appropriate decisions, but the optimal diagnostic integration and potential clinical benefits remain unclear. We describe the protocol and statistical analysis plan for a randomized controlled trial. The objective is to determine the effect of a POCUS-driven diagnostic pathway in adult dyspneic ED patients on the proportion of patients having a hospital stay of less than 24 hours when compared to the standard diagnostic pathway.</p><p><strong>Patients and methods: </strong>This is a multicenter, randomized, investigator-initiated, open-labeled, pragmatic, controlled trial. Adult ED patients with chief complaint dyspnea are eligible. Patients are randomized (1:1) to the POCUS-driven diagnostic pathway or standard diagnostic pathway, with 337 patients in each group. The primary outcome is the proportion of patients having a hospital stay (from ED arrival to hospital discharge) of less than 24 hours. Key secondary outcomes include hospital length-of-stay, 72-hour revisits, and 30-day hospital-free days.</p><p><strong>Conclusion: </strong>Sparse evidence exists for any clinical benefit from a POCUS-integrated diagnostic pathway. The results from this trial will help clarify the promising signals for POCUS to influence patient care among ED patients with dyspnea.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116955","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}
引用次数: 0
Accuracy of FAST-ED for Assessment Large Vessel Occlusion of Acute Ischemic Stroke in Emergency Department. FAST-ED 评估急诊科急性缺血性脑卒中大血管闭塞的准确性。
IF 1.5
Open Access Emergency Medicine Pub Date : 2024-08-22 eCollection Date: 2024-01-01 DOI: 10.2147/OAEM.S461177
Chatchanan Pornpanit, Punnaporn Loymai, Nattaphol Uransilp, Winchana Srivilaithon
{"title":"Accuracy of FAST-ED for Assessment Large Vessel Occlusion of Acute Ischemic Stroke in Emergency Department.","authors":"Chatchanan Pornpanit, Punnaporn Loymai, Nattaphol Uransilp, Winchana Srivilaithon","doi":"10.2147/OAEM.S461177","DOIUrl":"10.2147/OAEM.S461177","url":null,"abstract":"<p><strong>Background: </strong>Acute large vessel occlusion stroke (LVOS) requires swift and precise assessment for effective treatment. The Field Assessment Stroke Triage for Emergency Destination (FAST-ED) protocol shows promise for rapid LVOS evaluation but lacks extensive validation. This study aims to assess the accuracy of FAST-ED in predicting LVOS and compare its predictive capability with the National Institute of Health Stroke Scale (NIHSS).</p><p><strong>Methods: </strong>This prospective cross-sectional study was conducted at Thammasat University Hospital. Participants included those aged 18 years or older who presented with symptoms of acute stroke syndrome within 24 hours of onset. The study focused on comparing FAST-ED assessments by emergency department physicians with NIHSS evaluations by neurologists, followed by vascular imaging, which included brain multiphase CT angiography, MRI with MRA, and transcranial Doppler ultrasound combined with carotid Doppler ultrasound. Statistical analyses included the use of AuROC to assess the effectiveness of FAST-ED and to compare FAST-ED with NIHSS.</p><p><strong>Results: </strong>130 patients were included in the analysis, with 47 diagnosed with LVOS. No significant differences were found in most baseline characteristics between LVOS and non-LVOS groups, except for a higher prevalence of atrial fibrillation and lower systolic blood pressure in the LVOS group. The FAST-ED scale demonstrated a fair ability to predict LVOS with an AuROC of 0.79 (95% confidence interval (CI); 0.70, 0.87). A FAST-ED cut point of ≥4 showed improved specificity and likelihood ratio. Comparing FAST-ED≥4 with NIHSS≥6 revealed similar AuROC (0.74, 95% CI; 0.65, 0.82 and 0.72, 95% CI; 0.64, 0.80, respectively), with no significant statistical difference (p=0.661).</p><p><strong>Conclusion: </strong>FAST-ED scale, especially with a cut-off point of ≥4, exhibits fair overall accuracy in predicting LVOS in patients who presented with suspected acute stroke within 24 hours at the ED. This predictive capability is closely comparable to that of the NIHSS at a cut-off point of ≥6.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074230","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}
引用次数: 0
Prehospital Emergency Care: A Cross-Sectional Survey of First-Aid Preparedness Among Layperson First Responders in Northern Uganda. 院前急救:乌干达北部非专业急救人员急救准备情况横向调查。
IF 1.5
Open Access Emergency Medicine Pub Date : 2024-07-19 eCollection Date: 2024-01-01 DOI: 10.2147/OAEM.S464793
Keneth Opiro, Derrick Amone, Margret Sikoti, Amos Wokorach, Jerom Okot, Felix Bongomin
{"title":"Prehospital Emergency Care: A Cross-Sectional Survey of First-Aid Preparedness Among Layperson First Responders in Northern Uganda.","authors":"Keneth Opiro, Derrick Amone, Margret Sikoti, Amos Wokorach, Jerom Okot, Felix Bongomin","doi":"10.2147/OAEM.S464793","DOIUrl":"https://doi.org/10.2147/OAEM.S464793","url":null,"abstract":"<p><strong>Background: </strong>Uganda has a high incidence of road traffic accidents and high mortality rates, yet lacks a mature prehospital emergency care system. Our study addresses this gap by assessing the experiences, training, and confidence in providing first aid (FA) among diverse layperson first responders in Northern Uganda, expanding beyond previous research, which was limited to Central Uganda and specific occupational groups.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey among layperson first responders of various occupations in Gulu City, Acholi sub-region, Uganda. Data on socio-demographics, training, experiences, knowledge, and confidence in FA were collected.</p><p><strong>Results: </strong>We included 396 participants, of whom 81.6% (n=323) were male, 47.0.6% (n=186) were aged 21-30 years, 59.3% (n=235) had obtained a secondary level of education, 23.7% (n=94) were commercial motorcyclists, and 45.7% (n=181) had work experience of >5 years. The majority (85.4%, n=338) had witnessed acute illness/trauma. Accidents/bleeding were the most commonly witnessed cases (68.6%, n=232), followed by burn injuries (10.1%, n=34). Most participants (52.3%, n=207) had attended FA training. Only 20.5% (n=81) had obtained an above-average score (≥70%). The majority (67.9%, n=269) were confident in providing FA. Lack of knowledge and skills (61.4%, n=78), fear of taking health risks (18.9%, n=24), and legal implications (7.1%, n=9) were the major reasons for not being willing to confidently give FA. Factors associated with above-average knowledge were tertiary education and being confident in providing FA, while training in FA and prior experience in giving FA were associated with confidence in giving FA.</p><p><strong>Conclusion: </strong>In this study, laypeople in Northern Uganda exhibited a high level of FA training. However, low confidence in providing FA is attributed to inadequate knowledge, fear of health risks, and legal concerns. Therefore, future efforts should focus on assessing FA practices in diverse regions and promoting formal FA training.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11268844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761510","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}
引用次数: 0
Evaluating the Diagnostic Accuracy of the Alvarado Score and Abdominal Ultrasound for Acute Appendicitis: A Retrospective Single-Center Study. 评估阿尔瓦拉多评分和腹部超声对急性阑尾炎的诊断准确性:单中心回顾性研究
IF 1.5
Open Access Emergency Medicine Pub Date : 2024-07-06 eCollection Date: 2024-01-01 DOI: 10.2147/OAEM.S462013
Saleh Al-Wageeh, Qasem Abdulkarem Alyhari, Faisal Ahmed, Abdulfattah Altam, Gubran Alshehari, Mohamed Badheeb
{"title":"Evaluating the Diagnostic Accuracy of the Alvarado Score and Abdominal Ultrasound for Acute Appendicitis: A Retrospective Single-Center Study.","authors":"Saleh Al-Wageeh, Qasem Abdulkarem Alyhari, Faisal Ahmed, Abdulfattah Altam, Gubran Alshehari, Mohamed Badheeb","doi":"10.2147/OAEM.S462013","DOIUrl":"10.2147/OAEM.S462013","url":null,"abstract":"<p><strong>Background: </strong>Acute appendicitis is a complex diagnosis that often requires both clinical and radiological evaluation. Significant variations in diagnostic approaches are evident among clinicians and healthcare institutions. While certain guidelines advocate for risk stratification based on clinical characteristics, others emphasize the importance of pre-operative imaging. This study seeks to explore the accuracy of the Alvarado Score and abdominal ultrasound (AUS) in diagnosing acute appendicitis.</p><p><strong>Methods: </strong>Suspected cases of appendicitis admitted to Al-Thora Hospital in Ibb, Yemen, from Jan 2021 to July 2022 were evaluated. The demographics, clinical, and laboratory data were collected and analyzed. This study assessed Alvarado scores (calculated based on clinical evaluation and laboratory data) and pre-operative AUS findings, correlating them with post-operative and histopathology findings. The Alvarado scores and AUS sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were assessed using the ROC curve.</p><p><strong>Results: </strong>Out of 1021 cases of acute abdomen, 171 patients were suspected of appendicitis. Using AUS along with the Alvarado score, appendicitis was presumed in 137 patients who underwent appendectomy. 130 (94.9%) patients had positive intraoperative and histopathology findings while 7 (5.1%) had negative findings. The Alvarado Score had a sensitivity and specificity of 94.62% and 87.80% at cutoffs of 6, respectively [Area under the curve (AUC): 0.985; 95% confidence interval (CI), 0.954 to 0.998; p < 0.0001]. Abdominal US showed a sensitivity of 98.46% and specificity of 82.93% (AUC:0.907; 95% CI, 0.853 to 0.946; p < 0.0001).</p><p><strong>Conclusion: </strong>Alvarado's score and AUS exhibited high sensitivity and specificity in diagnosing acute appendicitis. The substantial accuracy and efficacy of both the Alvarado score and AUS support their utilization as primary investigative tools in resource-limited settings. This approach can help avoid unnecessary appendectomies and minimize the financial burden on patients.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11236940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591652","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}
引用次数: 0
The Relationship Between Acute Kidney Injury in Sepsis Patients and Coagulation Dysfunction and Prognosis. 败血症患者急性肾损伤与凝血功能障碍和预后的关系
IF 1.5
Open Access Emergency Medicine Pub Date : 2024-07-03 eCollection Date: 2024-01-01 DOI: 10.2147/OAEM.S453632
Zhenyi Wang, Shimin Dong, Yanjun Qin
{"title":"The Relationship Between Acute Kidney Injury in Sepsis Patients and Coagulation Dysfunction and Prognosis.","authors":"Zhenyi Wang, Shimin Dong, Yanjun Qin","doi":"10.2147/OAEM.S453632","DOIUrl":"10.2147/OAEM.S453632","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to investigate the relationship between ARF and coagulopathy in patients with sepsis and to explore the prognostic value of these conditions.</p><p><strong>Patients and methods: </strong>The data of 271 patients with sepsis-associated coagulopathy admitted from June 2021 to June 2022 were reviewed. The patients were divided into a survival group and a nonsurviving group according to patient prognosis. Independent sample t tests were utilized to compare laboratory parameters within 24 hours of admission, as well as the APACHE II and SOFA scores, between the two patient groups. According to the sepsis-associated coagulation dysfunction (SAC) grading criteria for grading, Spearman correlation analysis was used to study the relationship between blood creatinine and SAC grading and assignment scores, and receiver operating characteristic (ROC) curves and Cox's proportional risk regression model were used to explore the factors affecting the prognosis of SAC patients.</p><p><strong>Results: </strong>Spearman correlation analysis revealed strong associations between serum creatinine (Scr) concentration, SAC classification, and SAC score, with coefficients above 0.7. SAC classification outcomes varied significantly with severity: mild severity had a 77.6% survival rate versus 22.4% mortality; moderate severity had 21.5% survival versus 78.5% mortality; and severe cases had a 0.7% survival rate versus 99.3% mortality (P<0.01 for all). Multivariate analysis revealed significant predictors of outcome, including multiple organ dysfunction syndrome (MODS), with an OR of 2.070 (P=0.019); the SOFA score (OR=1.200, P<0.01); the international normalized ratio (INR) (OR=0.72, P=0.013); and the Scr level (OR=0.995, P<0.01). The areas under the ROC curves for the SOFA score, APACHE II score, and SAC classification were >0.8, all P < 0.05.</p><p><strong>Conclusion: </strong>In patients with sepsis, SAC grade 3 or a SAC score of 4 or higher is associated with poorer prognosis, and the interaction of acute kidney injury exacerbates the degree of SAC, consequently affecting prognosis.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11228537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560025","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}
引用次数: 0
Compassion Fatigue in Emergency Medicine: Current Perspectives 急诊医学中的同情疲劳:当前视角
IF 1.5
Open Access Emergency Medicine Pub Date : 2024-07-01 DOI: 10.2147/oaem.s418935
Donald Jeanmonod, Jennifer Irick, Adam Munday, Afopefoluwa Awosika, R. Jeanmonod
{"title":"Compassion Fatigue in Emergency Medicine: Current Perspectives","authors":"Donald Jeanmonod, Jennifer Irick, Adam Munday, Afopefoluwa Awosika, R. Jeanmonod","doi":"10.2147/oaem.s418935","DOIUrl":"https://doi.org/10.2147/oaem.s418935","url":null,"abstract":"","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141704252","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 Observational Study of Sexual Assaults in French Guiana During 2019–2020 2019-2020 年法属圭亚那性侵犯观察研究
IF 1.5
Open Access Emergency Medicine Pub Date : 2024-07-01 DOI: 10.2147/oaem.s451891
Victoire Menseau, Jeanne Charbonnier, Angélique Franchi, Sihem Ouar, Karim Hamiche, J. Pujo, Hatem Kallel, Mathieu Nacher, Alexis Fremery
{"title":"An Observational Study of Sexual Assaults in French Guiana During 2019–2020","authors":"Victoire Menseau, Jeanne Charbonnier, Angélique Franchi, Sihem Ouar, Karim Hamiche, J. Pujo, Hatem Kallel, Mathieu Nacher, Alexis Fremery","doi":"10.2147/oaem.s451891","DOIUrl":"https://doi.org/10.2147/oaem.s451891","url":null,"abstract":"","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141702438","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
Electrocardiographic Abnormalities in Patients with Hyperkalemia: A Retrospective Study in an Emergency Department in Colombia. 高钾血症患者的心电图异常:哥伦比亚一家急诊科的回顾性研究。
IF 1.5
Open Access Emergency Medicine Pub Date : 2024-06-25 eCollection Date: 2024-01-01 DOI: 10.2147/OAEM.S455159
Jaime A Quintero, Camilo A Medina, Federico Penagos, Jaime Andres Montesdeoca, Gildardo Antonio Orozco, Juan Saavedra-Castrillón, Julio Diez-Sepulveda
{"title":"Electrocardiographic Abnormalities in Patients with Hyperkalemia: A Retrospective Study in an Emergency Department in Colombia.","authors":"Jaime A Quintero, Camilo A Medina, Federico Penagos, Jaime Andres Montesdeoca, Gildardo Antonio Orozco, Juan Saavedra-Castrillón, Julio Diez-Sepulveda","doi":"10.2147/OAEM.S455159","DOIUrl":"10.2147/OAEM.S455159","url":null,"abstract":"<p><strong>Introduction: </strong>Hyperkalemia is a prevalent electrolyte disorder related to elevated serum potassium levels, resulting in diverse abnormal electrocardiographic findings and associated clinical signs and symptoms, often necessitating specific treatment. However, in some patients, these abnormal findings may not be present on the electrocardiogram even in elevated serum potassium levels. This study aims to identify electrocardiographic abnormalities related to the severity of hyperkalemia and the clinical outcomes in an emergency department in southwestern Colombia.</p><p><strong>Methodology: </strong>This is a retrospective cross-sectional descriptive study. We described the electrocardiographic findings, clinical characteristics, treatment, and outcomes related to the degrees of hyperkalemia. The potential association between the severity of hyperkalemia and electrocardiographic findings was evaluated.</p><p><strong>Results: </strong>A total of 494 patients were included. The median of the potassium level was 6.6 mEq/L. Abnormal electrocardiographic findings were reported in 61.5% of the cases. Mild and severe hyperkalemia groups reported abnormalities in 59.9% and 61.2%, respectively. The most common electrocardiography abnormalities were the peaked T wave 36.2%, followed by wide QRS 83 (16.8%). Only 1.4% of patients had adverse outcomes. The abnormal findings were registered in 61.5%. Mortality was 11.9%. The peaked T wave was the most common finding across different levels of hyperkalemia severity.</p><p><strong>Conclusion: </strong>High serum potassium levels are related with abnormal ECG. However, patients with different degrees of hyperkalemia could not describe abnormal ECG findings. In a high proportion of patients with renal chronic disease and hyperkalemia, the abnormalities in the ECG could be minimal or absent.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11215665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477644","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}
引用次数: 0
Seeking Care for Children with Intellectual and/or Developmental Disabilities in the Emergency Department: A Mixed Methods Systematic Review of Parents' Experiences and Information Needs. 在急诊科为智力和/或发育障碍儿童寻求护理:对家长经历和信息需求的混合方法系统回顾》(A Mixed Methods Systematic Review of Parents' Experiences and Information Needs.
IF 1.5
Open Access Emergency Medicine Pub Date : 2024-06-19 eCollection Date: 2024-01-01 DOI: 10.2147/OAEM.S450191
Sarah A Elliott, Sholeh Rahman, Shannon D Scott, Wiliam R Craig, Lisa Knisley, Kathleen Shearer, Lisa Hartling
{"title":"Seeking Care for Children with Intellectual and/or Developmental Disabilities in the Emergency Department: A Mixed Methods Systematic Review of Parents' Experiences and Information Needs.","authors":"Sarah A Elliott, Sholeh Rahman, Shannon D Scott, Wiliam R Craig, Lisa Knisley, Kathleen Shearer, Lisa Hartling","doi":"10.2147/OAEM.S450191","DOIUrl":"10.2147/OAEM.S450191","url":null,"abstract":"<p><p>The objective of this review was to explore parents' experiences and information needs regarding management of their child with an intellectual and/or developmental disability (IDD) in the emergency department (ED). We searched six electronic databases and grey literature to identify primary studies in English published since 2000. We synthesized quantitative and qualitative outcome data simultaneously using a convergent integrated approach and used a Mixed Methods Appraisal Tool (MMAT) to assess methodological quality of the included studies. Nine articles derived from seven studies were included (3 qualitative, 3 quantitative, 1 mixed method). Four main themes related to parents' self-reported experiences were identified: 1) appropriateness of the ED to manage and support their child; 2) acknowledgement/recognition of their child's IDD and incorporation of those considerations into overall care and management; 3) managing and navigating the ED environment; and 4) decision to disclose their child's condition when visiting the ED. Two articles provided data relevant to information needs, highlighting parents' desire to have resources supporting ED orientation and access to services within and outside of the ED setting. From the limited number of studies, it was evident that parents wanted better communication with healthcare providers and a greater understanding by ED staff around physical space settings needed to support their child. Resources supporting ED staff and parents to communicate effectively and work together can ensure that children with IDDs care needs are met. Further research into understanding parents' experiences and information needs related to managing a child with an IDD in the ED is needed to guide the development of effective resources.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11194008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443495","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}
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