Open Access Emergency Medicine最新文献

{"title":"Shortening Door-to-Balloon Time: The Use of Ambulance versus Private Vehicle for Patients with ST-Segment Elevation Acute Myocardial Infarction.","authors":"Abdulrhman Saleh Alghamdi, Abdullah Alshibani, Meshary Binhotan, Meshal Alharbi, Saleh S Algarni, Mohammed Musaed Alzahrani, Abdulmalik Nasser Asiri, Faisal Faleh Alsulami, Kamal Ayoub, Abdullah Alabdali","doi":"10.2147/OAEM.S435446","DOIUrl":"https://doi.org/10.2147/OAEM.S435446","url":null,"abstract":"<p><strong>Purpose: </strong>Time is critical when dealing with acute myocardial infarction (AMI) patients in the Emergency Department (ED), as 90 min is crucial for overall health. Using non-EMS transportation for critical patients, such as patients with acute myocardial infarction, to a hospital might delay the rapid identification of the underlying medical disease and initiating definitive treatment. We aim to evaluate the association between the mode of transportation and the D2B time in patients presenting at the ED with AMI.</p><p><strong>Patients and methods: </strong>We conducted a retrospective cohort study with patients who presented at ED with AMI and underwent percutaneous coronary intervention (PCI). The participants were patients with confirmed AMI at the ED of King Abdullah Medical City (KAMC) from January 2019 to December 2019.</p><p><strong>Results: </strong>In total, 162 AMI patients were enrolled in the study and divided based on the method of transportation. Less than half (n=65, 40.1%) were transported with an ambulance and 97 (59.9%) patients with a private car. The door-to-balloon (D2B) time for the ambulance group was 93.6±38.31 minutes, and the private car group was 93.8±30.88 minutes.</p><p><strong>Conclusion: </strong>There was no statistical significance when comparing the D2B time between the private car group and the ambulance group (P = 0.1870). Finally, ambulance transport significantly shortened the time to first ED physician contact. However, it was not associated with shortened D2B time when compared to private vehicle transport.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10740716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032688","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":"Validity of TIMI Risk Score and HEART Score for Risk Assessment of Patients with Unstable Angina/Non-ST Elevation Myocardial Infarction Presented to an Emergency Department in Jordan.","authors":"Muhannad J Ababneh, Mahmoud Mustafa Smadi, Abdullah Al-Kasasbeh, Qutaiba Ali Jawarneh, Mohammad Nofal, Mohanad El-Bashir, Mohamad Ismail Jarrah, Liqaa A Raffee","doi":"10.2147/OAEM.S439423","DOIUrl":"https://doi.org/10.2147/OAEM.S439423","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the validity and predictability of thrombolysis in myocardial infarction (TIMI) risk and HEART scores in patients presenting to the emergency department (ED) with chest pain in Jordan (representative of the Middle East and North Africa Region, MENA).</p><p><strong>Patients and methods: </strong>Risk scores were calculated for 237 patients presenting to the ED with chest pain. Patients were followed-up prospectively for the need for percutaneous coronary intervention, major adverse cardiovascular events, and all-cause mortality, looking for correlation and accuracy between the predicted cardiovascular risk from TIMI risk score and HEART score and the clinical outcome.</p><p><strong>Results: </strong>Of the 237 patients, approximately 77% were diagnosed with unstable angina and 23% diagnosed with non-ST elevation myocardial infarction (NSTEMI). about two thirds of the study population were smokers and known to have hypertension and dyslipidaemia. In 50 patients, the primary outcome (need for percutaneous coronary intervention (PCI) and/or major adverse cardiovascular events (MACE) at days 14 and 40, all-cause mortality) was observed. Regarding the predictability of the TIMI score, a larger number of events were observed in the study population than predicted. Patients with TIMI scores of 3 to 5 have about a 5-8% higher event rate than predicted.</p><p><strong>Conclusion: </strong>Both TIMI and HEART risk scores were able to predict an elevated risk of major cardiovascular adverse events (MACE). The overall impression was that the TIMI risk score tended to underestimate risk in the study population.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10743701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032689","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":"Effects of the Hazardous Area Response Team Training Program on the Knowledge and Confidence in Operational Skills of Prehospital Emergency Medical Personnel in Thailand: A Quasi-Experimental Study.","authors":"Thongpitak Huabbangyang, Thanidtha Nomrabporn, Watcharan Chiraratchawarich, Rapeeporn Rojsaengroeng","doi":"10.2147/OAEM.S436054","DOIUrl":"10.2147/OAEM.S436054","url":null,"abstract":"<p><strong>Background: </strong>Hazardous areas are places emitting hazardous materials, terrorist- or war-related, which lead to public health risks in developed and developing countries globally. Hence, prehospital emergency medical personnel who work as frontliners should be trained.</p><p><strong>Patients and methods: </strong>Data via pretest, posttest, and questionnaire surveys regarding the HART's knowledge of and confidence in operational skills were collected using the 5-point Likert scale. The cohort included prehospital emergency medical personnel aged >18 years. The training program comprised lectures, practicals, and examinations and included three subcourses: emergency medicine in the chemical, biological, radiation, and nuclear hazardous area (EM-CBRN) course; Thailand Tactical Emergency Medical Service (TTEMS) course; and cooperation and preparation for disaster (CPD) course.</p><p><strong>Results: </strong>The HART's mean multiple choice question (MCQ) posttest knowledge score (12.80±3.11) was significantly higher (<i>p</i><0.001) than the mean pretest knowledge score (7.74±3.71) for the EM-CBRN course. The HART's mean MCQ posttest knowledge score (24.04±2.79) was significantly higher (<i>p</i><0.001) than the mean pretest knowledge score (14.34±3.92) for the TTEMS course. Further, the HART's mean MCQ posttest knowledge score (21.03±3.49) was significantly higher (<i>p</i><0.001) than the mean pretest knowledge score (14.40±5.08) for the CPD course. The HART's mean confidence in operational skill score for the EM-CBRN course was significantly higher (<i>p</i><0.001) after training (4.45±0.59) than before training (2.77±0.90). The HART's mean confidence in operational skill score for the TTEMS course was significantly higher (<i>p</i><0.001) after training (4.55±0.59) than before training (2.78±0.98). The HART's mean confidence in operational skill score for the CPD course was significantly higher (<i>p</i><0.001) after training (4.70±0.41) than before training (3.03±0.90).</p><p><strong>Conclusion: </strong>The HART training program significantly affected the HART's knowledge development and confidence in operational skills, particularly the frontline prehospital emergency medical personnel. Therefore, prehospital emergency medical personnel should undergo training, and learning activities must be developed to reinforce capacity and improve knowledge and confidence.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10729060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811717","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 Burden and Contributing Factors of Cardiogenic Pulmonary Edema Among Acute Heart Failure Patients Admitted to Tertiary Hospital, Eastern Ethiopia.","authors":"Natanim Degefu, Abera Jambo, Shambel Nigusse, Mesay Dechasa, Tigist Gashaw, Melaku Getachew","doi":"10.2147/OAEM.S436352","DOIUrl":"10.2147/OAEM.S436352","url":null,"abstract":"<p><strong>Background: </strong>Despite cardiogenic pulmonary edema is the most common phenotype of acute heart failure (AHF), studies on its burden and associated factors are limited. This study aimed to assess the burden and contributing factors of cardiogenic pulmonary edema in patients with acute heart failure admitted to a tertiary hospital in eastern Ethiopia.</p><p><strong>Patients and methods: </strong>An institution-based cross-sectional study was conducted on the medical records (n = 276) of patients with AHF between February 01, 2018, and January 31, 2023. A simple random sampling technique was used to select participants from the study population. Bivariable and multivariable logistic regression analyses were used to assess factors associated with the development of cardiogenic pulmonary edema. A P-value ≤0.05 was considered as statistically significant.</p><p><strong>Results: </strong>The prevalence of cardiogenic pulmonary edema was 47.8% in AHF patients. Rural residence (adjusted odds ratio (AOR),9.54), smoking (AOR,3.17), comorbidity (AOR,2.1), and underlying cardiovascular disease (ischemic heart disease, chronic rheumatic valvular heart disease, and hypertensive heart disease with AOR: 6.71, 8.47, and 12.07, respectively) were significantly associated with the development of cardiogenic pulmonary edema in patients with AHF.</p><p><strong>Conclusion: </strong>Nearly half of the patients with AHF had cardiogenic pulmonary edema. Being a rural dweller, cigarette smoking, comorbidities, and underlying cardiac illness were significantly associated with the development of cardiogenic pulmonary edema in patients with AHF.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10642536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107592472","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":"Outcome of Poisoning and Associated Factors Among Patients Admitted at Referral Hospitals in Northwest Ethiopia, 2022: A Multicenter Retrospective Study","authors":"Gashachew Bayleyegn Reda, Hailemichael Kindie Abate, Hidja Mustofa Mekonnen, Agerie Zerihun Gared, Zerko Wako Beko","doi":"10.2147/oaem.s414743","DOIUrl":"https://doi.org/10.2147/oaem.s414743","url":null,"abstract":"Background: Poisonings are the most common reason for visiting emergency departments and hospitals globally. Poisoning-related mortalities increase instantly, and it is a principal public health problem in Ethiopia. Hence, understanding the treatment outcome and identifying the associated factors is necessary to reduce poisoning-related mortality. Objective: To assess outcome of poisoning and associated factors among patients admitted to Referral Hospitals in Northwest Ethiopia, 2022. Methods: An institutional-based retrospective cross-sectional study was conducted in Western Amhara referral hospitals from June 2019 to May 2022. A total of 400 medical charts were reviewed. A stratified sampling technique was used. The data were entered into Epi Info version 7.2.1.0 and exported to SPSS version 25.0 software for analysis. Multivariable binary logistic regression analysis was used to determine factors associated with the outcome of poisoning. Results: The mortality rate of poisoning was 18% (95% CI: 14.4– 22.1). Being rural dwellers (AOR=2.65, 95% CI: 1.07– 6.63), being unconscious (AOR=4.86, 95% CI: 1.89– 12.48), not treated in triage area (AOR=4.64, 95% CI: 1.608– 13.407), transport by Bajaj (AOR=6.78, 95% CI: 1.86– 24.73), spo 2 < 95% (AOR=4.42, 95% CI: 1.19– 10.78), and stayed > 48 hours in the hospital (AOR=0.08, 95% CI: 0.02– 0.36) were significantly associated with a mortality of poisoning. Conclusion: The mortality rate from poisoning was considerably high. Residence, level of consciousness, treatment at the triage area, mode of arrival, Spo2, and prolonged hospital stay were significantly associated. All stakeholders should focus on planning and improving care for patients with poisoning. Improving ambulance service in rural areas and providing treatment at the triage area for all patients are recommended. Keywords: emergency departments, poisoning, referral hospital, treatment outcome","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135515796","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":"Factors Associated with Postintubation Hypotension Among Patients with Suspected Sepsis in Emergency Department","authors":"Panvilai Tangkulpanich, Chuenruthai Angkoontassaneeyarat, Thavinee Trainarongsakul, Chetsadakon Jenpanitpong","doi":"10.2147/oaem.s426822","DOIUrl":"https://doi.org/10.2147/oaem.s426822","url":null,"abstract":"Purpose: Postintubation hypotension (PIH) is a recognized complication that increases both in-hospital mortality and hospital length of stay. Sepsis is reportedly a factor associated with PIH. However, no study to date has examined which factors, including the intubation method, may be clinical predictors of PIH in patients with sepsis. This study aims to investigate factors associated with the occurrence of PIH in patients with suspected sepsis in emergency department. Patients and Methods: This retrospective cross-sectional study was performed over a 5-year period (January 2013–December 2017) and involved patients with suspected sepsis who underwent endotracheal intubation in the emergency department of Ramathibodi Hospital. The patients were divided into those with and without PIH, and factors associated with the occurrence of PIH were analyzed. PIH was defined as any recorded systolic blood pressure of < 90 mmHg within 60 minutes of intubation. Results: In total, 394 patients with suspected sepsis were included. PIH occurred in 106 patients (26.9%) and was associated with increased in-hospital mortality (43.00% in the PIH group vs 31.25% in the non-PIH group, P = 0.034). Multivariable logistic regression showed that the factors associated with PIH were an age of ≥ 61 years (adjusted odds ratio [aOR] 2.25; 95% confidence interval [CI] 1.14– 4.43; P = 0.019) and initial serum lactate concentration of > 4.4 mmol/L (aOR 2.00; 95% CI 1.16– 3.46; P = 0.013). Rapid sequence intubation and difference types of induction agents was unrelated to PIH. Conclusion: Monitoring the development of PIH in patients with sepsis is essential because of its correlation with higher in-hospital mortality. This is particularly critical for older individuals and those with severe infections and high initial lactate concentrations. Keywords: postintubation hypotension, sepsis, emergency department intubation","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135714184","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":"Impact of Different Treatments for Disseminated Intravascular Coagulation on Patients with or without Biliary Drainage for Severe Biliary Tract Infection","authors":"Makoto Kobayashi, Shun Takai, Kyohei Sakurai, Yoshimatsu Ehama","doi":"10.2147/oaem.s423097","DOIUrl":"https://doi.org/10.2147/oaem.s423097","url":null,"abstract":"Objective: Sepsis caused by severe acute cholangitis requires biliary drainage to decrease the intra-biliary pressure. Furthermore, several studies showed that anticoagulant treatment can improve the outcomes of patients with sepsis-associated disseminated intravascular coagulation (DIC). There were reports examining the efficacy of anti-DIC drugs in patients undergoing biliary drainage with sepsis-associated DIC, and no reports compared the efficacy of DIC treatments when no drainage is performed. In this study, the influence of antithrombin (AT) replacement therapy and recombinant thrombomodulin (rTM) preparations on the overall survival (OS) of patients with and without biliary drainage was analyzed. Patients and Methods: This retrospective cohort study in a single institution involved patients with sepsis-associated DIC caused by severe biliary tract infection. In total, 71 patients treated by either AT replacement therapy or rTM preparation were assessed for inclusion. The two groups were patients with biliary drainage (n = 45) and without drainage (n = 26). To assess the clinical efficacy of anti-DIC drugs in each group, the 60-day OS was determined through estimated survival analysis. Results: Focusing on the effects of different therapeutic agents for DIC, in the group of patients with biliary drainage, OS showed no difference between patients treated by rTM and AT. However, in patients without biliary drainage, the survival curves of patients treated with AT replacement were lower than those of patients with rTM preparation. Conclusion: This study revealed that the OS of patients without biliary drainage differed depending on the DIC therapeutic agent for sepsis-associated DIC caused by acute cholangitis. We would recommend the use of rTM preparation over AT replacement therapy for patients who cannot undergo biliary drainage. Keywords: sepsis, antithrombin, recombinant thrombomodulin, DIC treatment, acute cholangitis","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135765483","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 Clinical Value of Comprehensive Nursing Intervention in Preventing Severe Lymphopenia and Improving the Survival Rate Among Patients with Sepsis.","authors":"Lin Zhang,&nbsp;Chao Xu,&nbsp;Lin Bai,&nbsp;Lin Li,&nbsp;Jinyan Guo,&nbsp;Yanyi Li","doi":"10.2147/OAEM.S433980","DOIUrl":"10.2147/OAEM.S433980","url":null,"abstract":"<p><strong>Background: </strong>Intensive care unit (ICU) patients with sepsis who experience severe lymphopenia are at a higher risk of mortality, and they serve as a more accurate indicator of bacteremia compared to traditional infection markers.</p><p><strong>Aim: </strong>Our study aimed to examine the influence of severe lymphopenia on ICU mortality and outcomes in sepsis patients, while also evaluating the clinical significance of comprehensive nursing intervention in preventing severe lymphopenia.</p><p><strong>Methods: </strong>Patients with sepsis in the ICU at our hospital between January 2015 and January 2021 were split into a control group and a test group.The control group received regular nursing care, while the test group was provided with comprehensive nursing care in addition to the control group. The results encompassed mortality rates of 28 days, mortality rates of 1 year, and lengths of stay in the ICU.</p><p><strong>Results: </strong>Our attention was directed towards day 4 absolute lymphocyte counts, taking into account the receiver operating characteristic (ROC) outcome. Patients with severe lymphopenia were older, more patients with 2 above comorbidities, higher co-infection rates and SOFA score. In addition, patients with severe lymphopenia required longer days stay in ICU (<i>P</i><0.001), and presented with higher 28-day mortality (<i>P</i>=0.038) and 1-year mortality (<i>P</i>=0.004). Patients in control group have a higher incidence of severe lymphopenia (<i>P</i>=0.006), 28-day mortality (<i>P</i>=0.015) and 1-year mortality (<i>P</i>=0.019) compared with the test group.</p><p><strong>Conclusion: </strong>Comprehensive nursing intervention can prevent the occurrence of severe lymphopenia, improve patients satisfaction and reduce mortality.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/75/e9/oaem-15-393.PMC10599247.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54231528","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":"Perioperative Adverse Outcome and Its Predictors After Emergency Laparotomy Among Sigmoid Volvulus Patients: Retrospective Follow-Up Study.","authors":"Tilahun Deresse,&nbsp;Esubalew Tesfahun,&nbsp;Zenebe Abebe Gebreegziabher,&nbsp;Mandante Bogale,&nbsp;Dawit Alemayehu,&nbsp;Megbar Dessalegn,&nbsp;Tewodros Kifleyohans,&nbsp;George Eskandar","doi":"10.2147/OAEM.S430193","DOIUrl":"10.2147/OAEM.S430193","url":null,"abstract":"<p><strong>Background: </strong>Acute sigmoid volvulus is a surgical emergency with closed-loop obstruction of the colon that often requires emergency laparotomy, which is associated with a multitude of post-operative complications. Although sigmoid volvulus is the main cause of intestinal obstruction in Ethiopia, local studies of its management outcomes are limited.</p><p><strong>Objective: </strong>To assess the magnitude and predictors of adverse perioperative outcomes of emergency laparotomy for acute sigmoid volvulus in the Debre Markos Comprehensive Specialized Hospital (DMCSH), Amhara region, Ethiopia in 2023.</p><p><strong>Methods: </strong>This was a retrospective follow-up study. Descriptive statistics were used to measure perioperative outcomes and other study variables. Bivariable and multivariable logistic regression models were used to identify the predictors of adverse surgical outcomes. Associations were considered significant at p < 0.05 (95% confidence interval).</p><p><strong>Results: </strong>In total, 170 study participants were enrolled, with a response rate of 91.4%. Forty-nine patients (28.8%) developed perioperative adverse outcomes. Pneumonia (29 patients, 28.1%), surgical site infection (19 patients, 18.4%), and wound dehiscence (10 patients, 9.7%) were the most common complications. Pre-operative shock [AOR: 3.87 (95% CI: (1.22, 12.28))], pus or fecal matter contamination of the peritoneum [AOR: 4.43 (95% CI: (1.35, 14.47)], and a higher American Society of Anesthesiologists (ASA) score [AOR: 2.37 (95% CI: (1.05, 5.34))] were identified as predictors of perioperative adverse events.</p><p><strong>Conclusion: </strong>The perioperative adverse outcomes in this study were higher than those reported in Ethiopian national and global reports following emergency laparotomies. Hypotension at presentation, pus and/or fecal matter contamination of the peritoneum, and higher ASA scores are strong predictors of increased perioperative adverse outcomes. Therefore, healthcare providers and institutions involved in the delivery of emergency surgical care should emphasize the importance of early surgical intervention, adequate resuscitation, and patient monitoring to improve perioperative outcomes.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ef/e2/oaem-15-383.PMC10591608.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50159035","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":"Evaluating the Triage of Suspected COVID-19 Cases in Sudan's Emergency Settings: A Clinical Audit.","authors":"Bayan E Ibrahim,&nbsp;Rahba Osman El-Amin,&nbsp;Safia Tarig Adam Abdulla","doi":"10.2147/OAEM.S433240","DOIUrl":"10.2147/OAEM.S433240","url":null,"abstract":"<p><strong>Background: </strong>The inevitable coronavirus disease 2019 global pandemic has severely affected Sudan's fragile healthcare system. The authors share the experience of COVID-19 triage in the emergency departments of five public hospitals in Khartoum state, Sudan.</p><p><strong>Methods: </strong>A clinical audit was conducted in December 2020 using the Centers for Disease Control and Prevention Checklist and Monitoring Tool for Triage of Suspected COVID-19 Cases. The tool was categorised into 5 domains and 38 indicators.</p><p><strong>Results: </strong>Only three hospitals had hand hygiene stations in their triage areas: Ibrahim Malik, Omdurman, and Al-Nau. Omdurman Teaching Hospital was the sole hospital with a designated respiratory waiting area. At Al-Nau and Omdurman Hospitals, all respiratory symptomatic patients wore a facemask or alternative. Ibrahim Malik and Bahri Teaching Hospitals had 60% and 50% compliance, respectively, while none at El-Tamayouz Hospital did. No posters or job aids were present in donning and doffing areas. Heavy duty gloves were worn only at Ibrahim Malik (50%) and Omdurman (20%). 100% of staff wore closed-toe footwear at Ibrahim Malik and Omdurman, 75% at El-Tamayouz, 63% at Bahri, and none at Al-Nau.</p><p><strong>Conclusion: </strong>The healthcare facilities displayed significant shortcomings in preparedness and response to COVID-19, with variations across hospitals in infrastructure, human resources, and procedures. To better combat future outbreaks, systemic improvements and a focused approach on consistent staff training, standard triage algorithms, and adequate PPE availability are imperative.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b5/aa/oaem-15-373.PMC10590591.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693013","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}