Open Access Emergency Medicine最新文献

{"title":"Interprofessional On-floor Education on Oxygen Therapy in COVID-19 Patients, Cardiac Arrest, and Procedural Sedation: Perception of Health-care Workers in Emergency Setting.","authors":"Munawar Farooq,&nbsp;Shabbir Ahmad,&nbsp;Faisal K Hanjra,&nbsp;Obaidullah Zafar,&nbsp;Khalid Bashir","doi":"10.2147/OAEM.S349656","DOIUrl":"https://doi.org/10.2147/OAEM.S349656","url":null,"abstract":"<p><strong>Objective: </strong>There is paucity of evidence for interprofessional education (IPE) conducted within the working environment of emergency departments (EDs). This study demonstrates favorable perception of on-floor IPE sessions conducted in a busy emergency department.</p><p><strong>Materials and methods: </strong>Between January and December 2020, IPE was conducted in EDs using low fidelity manikins and involved nurses, doctors, respiratory therapists, and medical students already present on floor. The three key areas were, taught cardiac arrest, escalating oxygen therapy for COVID-19 patients, and procedural sedation. Each session lasted 30 min, and feedback was obtained immediately after the session in both transcribed and written forms through scannable survey monkey links.</p><p><strong>Results: </strong>Forty-seven sessions were conducted covering the three topics for 141 participants. The majority of the participants benefited from on-floor IPE and preferred this approach in the future. Both participant and faculty recommended to have some protected time to maximize the learnings.</p><p><strong>Conclusion: </strong>IPE in the clinical environment is feasible, with careful planning it can enhance collaborative learning in the ED.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/19/32/oaem-14-535.PMC9531615.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33491652","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 Correlations of Human Atrial Natriuretic Peptide on Cardiac Function and Hemodynamics in Pediatric Septic Shock.","authors":"Arina Setyaningtyas,&nbsp;Soetjipto Soetjipto,&nbsp;Anang Endaryanto,&nbsp;Antonius Hocky Pudjiadi","doi":"10.2147/OAEM.S379543","DOIUrl":"https://doi.org/10.2147/OAEM.S379543","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to determine the correlations of human Atrial Natriuretic Peptide (ANP) on cardiac function and hemodynamics in pediatric septic shock.</p><p><strong>Patients and methods: </strong>We conducted an observational and prospective study on 30 children with septic shock. Measurement of the level of human atrial natriuretic peptide was determined in the serum of patients. Cardiac power (CP) is a cardiac function parameter measured with cardiac output (cardiovascular flow) and mean arterial (intravascular) pressure. Cardiac output and mean arterial pressure were monitored using pressure recording analytical methods (PRAM). Hemodynamic status was represented by a vasoactive inotropic score.</p><p><strong>Results: </strong>Thirty pediatric septic shock patients fulfilled the eligibility criteria. The human ANP level was not significantly different in pediatric septic shock on three days of examination. Cardiac power was significantly different in pediatric septic shock on three days of examination. There was a correlation between human ANP and cardiac power on day 3 and human ANP and VIS on day 2.</p><p><strong>Conclusion: </strong>There was a significant correlation between human ANP level and cardiac power on day 3 and ANP level and VIS on day 2. The cardiac power on day 3 and VIS on 48 hours can be alternatives to evaluate the hemodynamic status and cardiac function concerning human ANP in pediatric septic shock.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/50/ac/oaem-14-525.PMC9525027.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40390105","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 Management for Emergency Surgery in Pediatric Patients with COVID-19: Retrospective Observational Study.","authors":"Gezy Giwangkancana,&nbsp;Ezra Oktaliansah,&nbsp;Andi Ade W Ramlan,&nbsp;Arie Utariani,&nbsp;Putu Kurniyanta,&nbsp;Hasanul Arifin,&nbsp;Yunita Widyastuti,&nbsp;Astrid Pratiwi,&nbsp;Rusmin Syukur","doi":"10.2147/OAEM.S377201","DOIUrl":"https://doi.org/10.2147/OAEM.S377201","url":null,"abstract":"<p><strong>Background: </strong>The first wave of COVID-19 in 2020 created massive challenges in providing safe surgery for pediatric patients with COVID-19. Inevitably, emergency surgery and the unknown nature of the disease place a burden on the heavily challenged surgical services for pediatrics in a developing country. Lessons from the pandemic are important for future disaster planning.</p><p><strong>Aim: </strong>To describe the characteristics of pediatric surgical patients with COVID-19 undergoing emergency surgery during the first wave and its perioperative narrative in a developing country.</p><p><strong>Methods: </strong>The study was a multicenter retrospective descriptive study in eight Indonesian government-owned referral and teaching hospitals. The authors reviewed confirmed COVID-19 pediatric patients (≤18 years old) who underwent surgery. Institutional review board clearances were acquired, and data were evaluated in proportion and percentages. The writing of this paper follows the STROBE guidelines.</p><p><strong>Results: </strong>About 7791 pediatric surgical cases were collected, 73 matched the study criteria and 24 confirmed cases were found. Cases were more common in females (58.3%), who were above 12 years old (37.5%) and who were asymptomatic (62.5%). Laparotomy (33.3%), general anesthesia (90.4%) and intubation (80.8%) were common, while use of video laryngoscopy (40%) and rapid sequence intubation (28.8%) were rare. The mean length of stay was 12 ±13.3 days, and in-hospital mortality was 8.3%.</p><p><strong>Discussions: </strong>Lockdown and school closure were successful in protecting children, hence the low incidence of pediatric surgical cases with COVID-19 during the first wave. Many hospitals were unprepared to perform surgery for a droplet or airborne infectious disease, and COVID-19 testing was not available nationally in the early pandemic, hence the use of protective protection equipment  during these early pandemic times are often not efficient.</p><p><strong>Conclusion: </strong>The incidence of COVID-19 in pediatric surgical patients is low. The rapidity and availability of preoperative testing for a new emerging disease are essential in a pandemic.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d6/0e/oaem-14-515.PMC9509001.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40375742","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":"Evaluation of Essential and Emergency Surgery Provide in Primary Hospitals of Gedeo Zone and Sidama Region, South, Ethiopia, 2020.","authors":"Teshome Regasa,&nbsp;Abebayehu Zemedkun,&nbsp;Derartu Neme","doi":"10.2147/OAEM.S371509","DOIUrl":"https://doi.org/10.2147/OAEM.S371509","url":null,"abstract":"<p><strong>Background: </strong>Surgical services at level referral hospitals were an essential part of overall health care. The surgical uhservice was approximated to account for 11% of the worldwide load of disease, with a large percentage of that burden being uncovered in resource-constraint settings. Even though the surgery service is significant and growing across all economic sectors, the majority of resource-limited countries have been unable to provide essential surgical services.</p><p><strong>Objective: </strong>To investigate the capacity of essential and emergency surgical services in primary hospital facilities in the Gedeo zone and Sidama region.</p><p><strong>Methodology: </strong>In the Gedeo zone and Sidama region, a cross-sectional study was undertaken in eight district hospitals. By looking at four areas of data: infrastructure, human resources, interventions available, and equipment, a World Health Organization tool for conditional analysis was used to assess a health set-up competence to perform essential surgical and anesthetic procedures. The tool looked for eight different categories of healthcare giving 35 surgical procedures, and 67 different pieces of instruments.</p><p><strong>Results: </strong>This research found that 48.57% of the 35 essential interventions counted in the test, including cesarean section, were available at all hospitals. Prior to admission, each hospital reported a total of 53 beds, with an average travel distance of 28 kilometers. There were 189 healthcare providers in the eight facilities. According to the research, basic instruments were not always present at all of the sites.</p><p><strong>Conclusion: </strong>Infrastructure, health profession, service supply, and key instruments and supplies deficiencies reveal major inadequacies in hospitals' capacity to perform EESC and efficiently treat the growing surgical load of disease and damage in primary care.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/db/d6/oaem-14-507.PMC9507455.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33483438","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":"Optimal Management of Status Epilepticus in Children in the Emergency Setting: A Review of Recent Advances.","authors":"Shrouk Messahel, Louise Bracken, Richard Appleton","doi":"10.2147/OAEM.S293258","DOIUrl":"10.2147/OAEM.S293258","url":null,"abstract":"<p><p>Convulsive status epilepticus (CSE) is the most common neurological emergency in children and the second most common neurological emergency in adults. Mortality is low, but morbidity, including neuro-disability, learning difficulties, and a de-novo epilepsy, may be as high as 22%. The longer the duration of CSE, the more difficult it is to terminate, and the greater the risk of morbidity. Convulsive status epilepticus is usually managed using specific national or local algorithms. The first-line treatment is administered when a tonic-clonic or focal motor clonic seizure has lasted five minutes (impending or premonitory CSE). Second-line treatment is administered when the CSE has persisted after two doses of a first-line treatment (established CSE). Randomised clinical trial (RCT) evidence supports the use of benzodiazepines as a first-line treatment of which the most common are buccal or intra-nasal midazolam, rectal diazepam and intravenous lorazepam. Alternative drugs, for which there are considerably less RCT data, are intra-muscular midazolam and intravenous clonazepam. Up until 2019, phenobarbital and phenytoin (or fosphenytoin) were the preferred second-line treatments but with no good supporting RCT evidence. Robust RCT data are now available which has provided important information on second-line treatments, specifically phenytoin (or fosphenytoin), levetiracetam and sodium valproate. Lacosamide is an alternative second-line treatment but with no supporting RCT evidence. Current evidence indicates that first, buccal or intranasal midazolam or intravenous lorazepam are the most effective and the most patient and carer-friendly first-line anti-seizure medications to treat impending or premonitory CSE and second, that there is no difference in efficacy between levetiracetam, phenytoin (or fosphenytoin) or sodium valproate for the treatment of established CSE. Pragmatically, levetiracetam or sodium valproate are preferred to phenytoin (or fosphenytoin) because of their ease of administration and lack of serious adverse side-effects, including potentially fatal cardiac arrhythmias. Sodium valproate must be used with caution in children aged three and under because of the rare risk of hepatotoxicity and particularly if there is an underlying mitochondrial disorder.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2022-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c4/5c/oaem-14-491.PMC9491331.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33483442","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":"MONitoring Knockbacks in EmergencY (MONKEY) - An Audit of Disposition Outcomes in Emergency Patients with Rejected Admission Requests.","authors":"Wendell Zhang,&nbsp;Lee Yung Wong,&nbsp;Jasmine Liu,&nbsp;Soham Sarkar","doi":"10.2147/OAEM.S376419","DOIUrl":"https://doi.org/10.2147/OAEM.S376419","url":null,"abstract":"<p><strong>Background: </strong>Emergency Department (ED) clinicians commonly experience difficulties in referring patients to inpatient teams for hospital admission. There is limited literature reporting on patient outcomes following these complicated referrals, where ED requests for inpatient admission are rejected - which study investigators termed a \"knockback\".</p><p><strong>Purpose: </strong>To identify disposition outcomes and referral accuracy in ED patients whose admission referral was initially rejected. Secondary objectives were to identify additional patient, clinician and systemic factors associated with knockbacks.</p><p><strong>Selection and methodology: </strong>Emergency clinicians prospectively nominated a convenience sample of patients identified as having knockbacks over two time periods (Jan-Feb 2020 and Aug 2020 to Jan 2021) at a tertiary Australian ED. Data were analyzed with a mixed-methods approach and subsequent descriptive and thematic analyses were performed.</p><p><strong>Results: </strong>A total of 109 patients were identified as knockbacks. The referrals were warranted, with 89.0% of cases (n = 97) ultimately requiring a hospital admission. In 60.6% (n = 66) of the admissions, patients were admitted under the inpatient team initially referred to by the ED, suggesting referrals were generally accurate. The number of in-hospital units involved in the admission process and ED length of stay were positively correlated (0.409, p < 0.001). Patient factors associated with knockbacks include pre-existing chronic medical conditions and presenting acutely unwell. Analysis of clinicians' perspectives yielded recurring themes of disagreements over admission destination and diagnostic uncertainty.</p><p><strong>Conclusion: </strong>In this patient sample, emergency referrals for admission were mostly warranted and accurate. Knockbacks increase ED length of stay and may adversely affect patient care. Further focused discussion and clearer referral guidelines between ED clinicians and their inpatient colleagues are required.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2022-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9b/a6/oaem-14-481.PMC9448349.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33454887","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":"Do Non-COVID-19 Patients' Behaviour Towards Emergency Changed During the COVID-19 Outbreak? A Severity-Based Approach.","authors":"Julien Flament,&nbsp;Frederic Clarembeau,&nbsp;Charlotte Hayden,&nbsp;Nathan Scius,&nbsp;Maxime Regnier,&nbsp;Henri Thonon","doi":"10.2147/OAEM.S368254","DOIUrl":"https://doi.org/10.2147/OAEM.S368254","url":null,"abstract":"<p><strong>Objective: </strong>During the COVID-19 pandemic, the number of patients presenting to the emergency department (ED) declined. The main goal of this study was to compare and describe the non-COVID-19 patient's disease severity presentation during the pandemic with its pre-pandemic severity.</p><p><strong>Methods: </strong>We conducted a retrospective observational study. We selected two samples of visits: one during the first COVID-19 wave of 2020 (pandemic period, PP) and the other during the same months of 2019 (control period, CP). The primary endpoints were the comparison of severity and distribution of the Emergency Severity Index (ESI). Secondary endpoints were comparisons of specific patient characteristics (age, sex, length of the symptoms before the visits, spontaneous visits or not, return home or not).</p><p><strong>Results: </strong>The mean ESI of the visits during the PP (3.19) was statistically significantly lower (<i>P</i> = 0.001) than it was in the CP (3.43). These changes were more pronounced during the months of March (3.03 versus 3.33, <i>P</i> = 0.037) and April (2.96 versus 3.48, <i>P</i> < 0.001). The change in ESI was mainly due to an increase in the proportion of visits by patients with an ESI score of 3 (42% versus 28%, <i>P</i> < 0.001). There were no differences in the characteristics of patients except a decline in patients whose symptoms had a duration of more than 30 days (2% during PP versus 4% during CP, <i>P</i> = 0.03).</p><p><strong>Conclusion: </strong>The COVID-19 pandemic caused a change in the pattern of non-COVID-19 visits, with proportionally more severe presentations based on the ESI. To our knowledge, this is the first description of changes in behaviour in ED visits by specifically non-COVID-19 patients.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/59/4b/oaem-14-473.PMC9419907.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33446479","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":"Magnitude and Factors Associated with Ambulance Service Utilization Among Women Who Gave Birth at Public Health Institutions in Central Ethiopia.","authors":"Wondwosen Tolossa,&nbsp;Elias Teferi Bala,&nbsp;Mulugeta Mekuria,&nbsp;Meseret Ifa,&nbsp;Berhanu Senbeta Deriba,&nbsp;Adugna Dufera","doi":"10.2147/OAEM.S373700","DOIUrl":"https://doi.org/10.2147/OAEM.S373700","url":null,"abstract":"<p><strong>Background: </strong>Effective and well-organized ambulance services system forms the link between household and health facility for providing basic or comprehensive emergency obstetric care. Therefore, the establishment of a strong ambulance services network across the country based on evidences from local study is necessary for the improvement of ambulance service utilization among mothers who gave birth. This study aimed to assess magnitude and factors associated with ambulance service utilization among women who gave birth at public health institutions in central Ethiopia.</p><p><strong>Methods: </strong>A community-based cross-sectional study supplemented by a qualitative method was employed. Data were collected via face-to-face interview. A simple random sampling and purposive sampling techniques were used to select study participants. Bivariate and multivariable logistic regression analyses were done to identify factors associated with ambulance services utilization, and variables with a p-value <0.25 were entered in the multivariable logistic regression analysis. Adjusted odds ratio (AOR) with 95% CI and a P-value <0.05 were used to declare statistically significant associations.</p><p><strong>Results: </strong>Among study participants, only 214 (46%) utilized ambulance service. Mother who had no formal education (AOR=0.03, 95% CI [0.01, 0.07]), husband who completed primary school and above (AOR=7.03, 95% CI [1.83, 27.16]), rural residence (AOR=2.27, 95% CI [1.11, 4.65]), decision maker to get ambulance service (AOR=0.03, 95% CI [0.01, 0.07]), multigravida (AOR=4.8, 95% CI [2.48, 9.34]), having ambulance phone number (AOR=0.36, 95% CI [0.19, 0.68]), antenatal care attendance (AOR=0.07, 95% CI [0.04, 0.16]), and having discussion with health extension worker (AOR=0.14, 95% CI [0.084, 0.24]) were significantly associated with ambulance service utilization.</p><p><strong>Conclusion: </strong>The magnitude of ambulance service utilization was low. Hence, health sector should improve the awareness of pregnant mothers on benefit of ambulance utilization through provision of information. Health care providers should provide antenatal services for pregnant mothers as early as possible.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2022-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/af/3e/oaem-14-457.PMC9384968.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40430989","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":"Emergency Medical Care of People with Intellectual Disabilities: A Scoping Review.","authors":"Jana York,&nbsp;Yvonne Wechuli,&nbsp;Ute Karbach","doi":"10.2147/OAEM.S361676","DOIUrl":"https://doi.org/10.2147/OAEM.S361676","url":null,"abstract":"<p><strong>Purpose: </strong>The paper intends to do a scoping review of people with intellectual disabilities in emergency care where this group seems to face access barriers and discrimination. It analyses the conceptual and methodological framework for studies examining the former.</p><p><strong>Methods: </strong>A scoping review is conducted. The studies' quality is assessed via a checklist developed by the authors drawing on a compilation of common assessment tools for study quality.</p><p><strong>Results: </strong>Fourteen quantitative studies fulfil the inclusion criteria for further analysis. Summary measures are extracted. Results are synthesized with Andersen's Behavioral Model of Health Service Use. Studies employ a combination of variables attributable to different aspects of population characteristics and health behavior.</p><p><strong>Conclusion: </strong>Most studies seek to quantify or predict emergency care overuse by people with intellectual disabilities. Future studies should also take patients' poor health or treatment outcomes and their perspectives into account.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2d/e2/oaem-14-441.PMC9381009.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40721695","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":"Program of Uncontrolled Donation After Circulatory Death as Potential Solution to the Shortage of Organs: A Canadian Single-Center Retrospective Cohort Study.","authors":"Frederick D'Aragon,&nbsp;Olivier Lachance,&nbsp;Vincent Lafleur,&nbsp;Ivan Ortega-Deballon,&nbsp;Marie-Helene Masse,&nbsp;Gabrielle Trepanier,&nbsp;Daphnee Lamarche,&nbsp;Marie-Claude Battista","doi":"10.2147/OAEM.S361930","DOIUrl":"https://doi.org/10.2147/OAEM.S361930","url":null,"abstract":"<p><strong>Purpose: </strong>Worldwide, the number of patients waiting for organ transplantation exceeds the number of organs available. Program for uncontrolled donation after circulatory death (uDCD) implemented in Europe has resulted in a 10-15% expansion of the donor pool. We aimed to describe the number of patients eligible for an uDCD program in a regional tertiary care center.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study in a Canadian tertiary academic center located in a rural area including all adults who received cardiopulmonary resuscitation in 2016 and died in the emergency department (ED) or during their hospitalization. The primary outcome was the number of patients eligible for uDCD defined as aged between 18 and 60 years old whose collapse was witnessed and where the time between cardiac arrest to cardiopulmonary resuscitation and ED arrival was, respectively, less than 30 and 120 minutes. As a secondary outcome, we determined the number of patients eligible for controlled donation after circulatory death.</p><p><strong>Results: </strong>Of the 130 patients included, 84 did not return to spontaneous circulation. We identified 15 potential uDCD candidates, with a mean age of 46.6 (95% Confidence Interval [CI] 41.3 to 52) years. Twelve had an out-of-hospital cardiac arrest with a mean time between collapse and arrival to the ED of 43.2 (29.8 to 56.6) minutes. Among the 46 patients who died after a return of spontaneous circulation, 10 (21.7%) were eligible for organ donation after circulatory death.</p><p><strong>Conclusion: </strong>Implementing an uDCD program in a tertiary hospital covering a rural area could increase the number of donors.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2022-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e3/7e/oaem-14-413.PMC9362902.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40623152","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}