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Awake tracheostomy in a patient with acute upper airway obstruction: an emergency application of an elective percutaneous procedure. 急性上呼吸道阻塞患者的苏醒式气管造口术：选择性经皮手术的紧急应用。

IF 1.5

Open Access Emergency Medicine Pub Date : 2019-07-24 eCollection Date: 2019-01-01 DOI: 10.2147/OAEM.S201079

Pierluigi Fusco, Angela Iuorio, Mirco Della Valle, Fausto Ferraro

{"title":"Awake tracheostomy in a patient with acute upper airway obstruction: an emergency application of an elective percutaneous procedure.","authors":"Pierluigi Fusco, Angela Iuorio, Mirco Della Valle, Fausto Ferraro","doi":"10.2147/OAEM.S201079","DOIUrl":"10.2147/OAEM.S201079","url":null,"abstract":"<p><p>Since its introduction in 1985 with Ciaglia, percutaneous tracheostomy (PT) was contraindicated in emergency settings and obesity. However, several case series in the last 20 years have documented the use of PT in life-threatening airway emergencies. We present a case of severe acute airway obstruction in a 66-year-old woman successfully treated with a placement of an awake PT. The woman's glottic obstruction was caused by a recurrent laryngeal neoplasia and revealed by nasoendoscopy. This acute condition required a serious effort from the patient to oxygenate and therefore prevented orotracheal intubation as well as the use of any supraglottic device and/or sedation. Blood aspiration after a first attempt to make a quick access to the tracheal lumen with an emergency cricothyroidotomy, and difficulties in the exact identification of tumor infiltration, led us to perform an awake tracheostomy. Due to elevated risk of airway bleeding, we started with a surgical approach to better identify anatomical structures. After the correct inter-tracheal ring space identification, sudden worsening of clinical symptoms required that we complete the procedure quickly with the aid of a Ciaglia Blue Rhino™-Cook (CBR) tracheostomy kit. At the tracheostomy tube placement, the patient quickly resolved her dyspnea and physiological breathing was restored.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"11 ","pages":"167-170"},"PeriodicalIF":1.5,"publicationDate":"2019-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/68/e2/oaem-11-167.PMC6661998.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41215569","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

High-fidelity medical simulation training improves medical students’ knowledge and confidence levels in septic shock resuscitation 高保真医学模拟训练提高了医学生对感染性休克复苏的认识和信心水平

IF 1.5

Open Access Emergency Medicine Pub Date : 2016-12-22 DOI: 10.2147/OAEM.S122525

Veerapong Vattanavanit, Jarernporn Kawla-Ied, R. Bhurayanontachai

{"title":"High-fidelity medical simulation training improves medical students’ knowledge and confidence levels in septic shock resuscitation","authors":"Veerapong Vattanavanit, Jarernporn Kawla-Ied, R. Bhurayanontachai","doi":"10.2147/OAEM.S122525","DOIUrl":"https://doi.org/10.2147/OAEM.S122525","url":null,"abstract":"Background Septic shock resuscitation bundles have poor compliance worldwide partly due to a lack of knowledge and clinical skills. High-fidelity simulation-based training is a new teaching technology in our faculty which may improve the performance of medical students in the resuscitation process. However, since the efficacy of this training method in our institute is limited, we organized an extra class for this evaluation. Purpose The aim was to evaluate the effect on medical students’ knowledge and confidence levels after the high-fidelity medical simulation training in septic shock management. Methods A retrospective study was performed in sixth year medical students during an internal medicine rotation between November 2015 and March 2016. The simulation class was a 2-hour session of a septic shock management scenario and post-training debriefing. Knowledge assessment was determined by a five-question pre-test and post-test examination. At the end of the class, the students completed their confidence evaluation questionnaire. Results Of the 79 medical students, the mean percentage score ± standard deviation (SD) of the post-test examination was statistically significantly higher than the pre-test (66.83%±19.7% vs 47.59%±19.7%, p<0.001). In addition, the student mean percentage confidence level ± SD in management of septic shock was significantly better after the simulation class (68.10%±12.2% vs 51.64%±13.1%, p<0.001). They also strongly suggested applying this simulation class to the current curriculum. Conclusion High-fidelity medical simulation improved the students’ knowledge and confidence in septic shock resuscitation. This simulation class should be included in the curriculum of the sixth year medical students in our institute.","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"9 1","pages":"1 - 7"},"PeriodicalIF":1.5,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAEM.S122525","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68412300","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: 13

Acute chest pain after bench press exercise in a healthy young adult 健康青年卧推运动后急性胸痛

IF 1.5

Open Access Emergency Medicine Pub Date : 2016-09-22 DOI: 10.2147/OAEM.S114310

Janet A. Smereck, Argyro Papafilippaki, Sawali Sudarshan

引用次数: 1

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