Open Access Emergency Medicine : OAEM最新文献

{"title":"Nitroglycerin Use in the Emergency Department: Current Perspectives.","authors":"Michael J Twiner,&nbsp;John Hennessy,&nbsp;Rachel Wein,&nbsp;Phillip D Levy","doi":"10.2147/OAEM.S340513","DOIUrl":"https://doi.org/10.2147/OAEM.S340513","url":null,"abstract":"<p><p>Nitroglycerin, a fast-acting vasodilator, is commonly used as a first-line agent for angina in the emergency department and to manage chest pain due to acute coronary syndromes. It is also a treatment option for other disease states such as acute heart failure, pulmonary edema, and aortic dissection. Nitroglycerin is converted to nitric oxide, a potent vasodilator, in the body, leading to venodilation at lower dosages and arteriodilation at higher dosages that results in both preload and afterload reduction, respectively. Although nitroglycerin has historically been administered as a sublingual tablet and/or spray, it is often given intravenously in the emergency department as this enables titration to effect with predictable pharmacokinetics. In this review article, we outline the indications, mechanism of action, contraindications, and adverse effects of nitroglycerin as well as review relevant literature and make general recommendations regarding the use of nitroglycerin in the emergency department.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":" ","pages":"327-333"},"PeriodicalIF":1.5,"publicationDate":"2022-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cf/3a/oaem-14-327.PMC9278720.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40515364","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":"Richter's Type Recurrent Indirect Inguinal Hernia, an Extremely Rare Occurrence: A Case Report.","authors":"Agegnehu Bayeh,&nbsp;Simachew Limenh","doi":"10.2147/OAEM.S363212","DOIUrl":"https://doi.org/10.2147/OAEM.S363212","url":null,"abstract":"<p><strong>Background: </strong>Richter's type recurrent indirect inguinal hernia remains to be an extremely rare entity reported scarcely. It may present with grave complications in the absence of symptoms and signs of intestinal obstruction. The aim of this study is to report a rare case of Richter's hernia after a previously repaired indirect inguinal hernia.</p><p><strong>Case presentation: </strong>A 31-year-old male farmer came up with complaints of colicky abdominal pain and two episodes of vomiting. He had a previous right inguinal surgery. A physical examination revealed a full abdomen with right inguinal tenderness and oblique surgical scar. Abdominal ultrasound showed a bowel segment entrapped in the deep inguinal ring of the inguinal canal. Right inguinal exploration was done, and the finding was a gangrenous Richter's type recurrent indirect inguinal hernia. The patient was discharged and improved on the seventh post-operative day after resection and anastomosis.</p><p><strong>Discussion: </strong>Richter's hernia is a rare form of hernia that occurs when the anti-mesenteric border of the bowel is partly trapped in a tight hernial ring. Its rarity, combined with the fact that it may present in the absence of typical symptoms and signs of intestinal obstruction and local physical findings, poses a diagnostic challenge which often end up with complications like gangrenous bowel at the time of diagnosis.</p><p><strong>Conclusion: </strong>Richter's hernia can occur in an extremely rare form as Richter's type recurrent indirect inguinal hernia. A high degree of suspicion, an early referral and timely imaging on the provider's side may prevent mortality and morbidity.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":" ","pages":"323-326"},"PeriodicalIF":1.5,"publicationDate":"2022-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f2/05/oaem-14-323.PMC9275495.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40605458","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":"Difficult Laryngoscopy Prediction Score for Intubation in Emergency Departments: A Retrospective Cohort Study.","authors":"Sorravit Savatmongkorngul,&nbsp;Panrikan Pitakwong,&nbsp;Pungkava Sricharoen,&nbsp;Chaiyaporn Yuksen,&nbsp;Chetsadakon Jenpanitpong,&nbsp;Sorawich Watcharakitpaisan","doi":"10.2147/OAEM.S372768","DOIUrl":"https://doi.org/10.2147/OAEM.S372768","url":null,"abstract":"<p><strong>Objective: </strong>Difficult laryngoscopy is associated with difficult intubation, an increasing number of endotracheal intubation attempts, and adverse events. Clinical prediction of difficult airways in an emergency setting was limited in sensitivity and specificity. This study developed a new model for predicting difficult laryngoscopy in the emergency department.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted using an exploratory model at the Emergency Medicine of Ramathibodi Hospital. The study was conducted from June 2018 to July 2020. The eligibility criteria were an age of ≥15 years who undergo intubation in the emergency department. Difficult laryngoscopy was defined as a Cormack-Lehane grade 3 and above. The predictive model and score were developed by multivariable logistic regression analysis.</p><p><strong>Results: </strong>A total of 617 patients met the eligibility criteria; 83 (13.45%) had difficult laryngoscopy. Five independent factors were predictive of difficult laryngoscopy. Significant factors were M: limited mouth opening, O: presence of obstructed airway, N: poor neck mobility, T: large tongue, and H: short hypo-mental distance. The difficult laryngoscopy score had an accuracy of 89%. A score of >4 increased the likelihood ratio of difficult laryngoscopy by 7.62 times.</p><p><strong>Conclusion: </strong>The MONTH Difficult Laryngoscopy Score of >4 was associated with difficult laryngoscopy.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":" ","pages":"311-322"},"PeriodicalIF":1.5,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/23/cc/oaem-14-311.PMC9250787.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40483951","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":"How Should We Approach Syncope in the Emergency Department? Current Perspectives.","authors":"Mustafa Emin Canakci,&nbsp;Omer Erdem Sevik,&nbsp;Nurdan Acar","doi":"10.2147/OAEM.S247023","DOIUrl":"https://doi.org/10.2147/OAEM.S247023","url":null,"abstract":"<p><p>Syncope is a clinical picture that can affect all age groups and has an important place in admissions to the emergency department. There is an important diagnostic challenge in cases where there are different clinical presentations and patients cannot express the situation clearly. Although the emergency department facilities for the diagnosis of syncope are limited, the diagnosis of many patients can be differentiated from life-threatening conditions with a detailed history and physical examination. High-risk patients should be identified and directed for definitive treatment by emergency medicine physicians. This review contains information about the management of the syncope patient in the emergency department.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":" ","pages":"299-309"},"PeriodicalIF":1.5,"publicationDate":"2022-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6d/9c/oaem-14-299.PMC9249662.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40585234","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":"Assessment of the Effects of the COVID-19 Lockdown on Trauma at AaBET Hospital in Addis Ababa, Ethiopia.","authors":"Ayalew Zewdie,&nbsp;Lielina Messele,&nbsp;Yared Boru,&nbsp;Tesfaye Abebe,&nbsp;Salsawit Tesfaye,&nbsp;Tsion Firew","doi":"10.2147/OAEM.S364192","DOIUrl":"https://doi.org/10.2147/OAEM.S364192","url":null,"abstract":"<p><strong>Introduction: </strong>A novel coronavirus disease (COVID-19) broke out in Wuhan, Hubei Province, China, in December 2019 that continues to pose major challenges to trauma care around the world. The objective of this study was to assess the effects of COVID-19 on the pattern of traumatic injuries and outcomes.</p><p><strong>Methodology: </strong>This retrospective, descriptive study was conducted over a three-month period at Addis Ababa Burn Emergency and Trauma (AaBET) Hospital, Addis Ababa, Ethiopia. It compared pre- and post-COVID-19 data from the hospital registry and reports. Specifically, data from March through May, 2019 (pre-COVID-19) were compared to data from March through May, 2020 (during COVID-19). The data were analyzed using SPSS 20.0. Descriptive analyses of the variables are reported as numbers and percentages.</p><p><strong>Results: </strong>There were a total of 5179 emergency visits during the study period, of which 2763 were trauma cases (53.4%). Among trauma cases, 1441 (52.1%) were attributable to road traffic injuries. During the COVID-19 period, 1901 patients were admitted, of which 1412 (74.3%) were trauma cases. Of the trauma cases during the COVID-19 period, 476 (33.7%) were attributable to road traffic injuries. There was a 42% decrease in emergency visits during the COVID-19 period. Although there was a 4.5% rise in trauma cases during the COVID-19, traffic injury-related trauma cases decreased by 50.7% during the same period. A significant increase in non-road traffic injury was noted during the lockdown period. These include interpersonal and domestic violence, and significant decreases were noted in multiple site injuries. Further, admissions were significantly decreased.</p><p><strong>Conclusion: </strong>During the period of lockdown, there was a significant decrease in road traffic injuries in AaBET hospital and an increase in non-road traffic injuries. Implementation of preventive measures will decrease road-traffic injury burden.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":" ","pages":"293-298"},"PeriodicalIF":1.5,"publicationDate":"2022-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/22/b5/oaem-14-293.PMC9241991.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40467791","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":"Global Ultrasound Check for the Critically Lll (GUCCI)-a New Systematized Protocol Unifying Point-of-Care Ultrasound in Critically Ill Patients Based on Clinical Presentation [Retraction].","authors":"","doi":"10.2147/OAEM.S378669","DOIUrl":"https://doi.org/10.2147/OAEM.S378669","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.2147/OAEM.S199137.].</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":" ","pages":"273-274"},"PeriodicalIF":1.5,"publicationDate":"2022-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f7/38/oaem-14-273.PMC9235825.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40410540","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":"Diagnosis and Management of Pediatric Ovarian Torsion in the Emergency Department: Current Insights.","authors":"Eric Scheier","doi":"10.2147/OAEM.S342725","DOIUrl":"https://doi.org/10.2147/OAEM.S342725","url":null,"abstract":"<p><p>Ovarian torsion is defined as twisting of the ovary around an axis consisting of its vascular pedicle, the infundibulopelvic ligament and the tubo-ovarian ligament, and can occur in females of any age. Torsion can be a result of ovarian mass causing asymmetry and subsequent torsion, or can be spontaneous. While ovarian torsion is a surgical emergency, early diagnosis and treatment can preserve ovarian viability even if necrosis is seen operatively. Presentation classically involves sudden onset severe abdominal pain and vomiting but diagnostic delay can follow subtler presentations. Diagnosis is most commonly based on sonographic findings, but advanced imaging such as CT or MRI may be required if sonography is not diagnostic. Treatment is surgical, with ovarian preservation preferred in almost all cases. In this review, I present the most recent evidence on epidemiology, diagnosis, and management of pediatric ovarian torsion, with a focus on point-of-care ultrasound for the emergency care provider.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":" ","pages":"283-291"},"PeriodicalIF":1.5,"publicationDate":"2022-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/39/da/oaem-14-283.PMC9236466.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40410541","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":"Factors Associated with Unscheduled Emergency Department Revisits in Children with Acute Lower Respiratory Tract Diseases.","authors":"Teeranai Sakulchit,&nbsp;Suphakorn Thepbamrung","doi":"10.2147/OAEM.S359505","DOIUrl":"https://doi.org/10.2147/OAEM.S359505","url":null,"abstract":"<p><strong>Purpose: </strong>To identify factors associated with unscheduled emergency department (ED) revisits within 72 hours in children with acute dyspnea from lower respiratory tract diseases.</p><p><strong>Patients and methods: </strong>This retrospective cohort study included pediatric patients (age group: one month to 15 years old) who visited the ED with acute lower respiratory tract diseases between January 1st, 2017 and February 28th, 2019. The medical records were reviewed and discharged patients were dichotomized into revisit and non-revisit groups, based on whether the patients needed a revisit or not. Baseline characteristics, vital signs, diagnosis, treatment, pediatrician consultation, ED length of stay, and primary doctor of both groups were compared. Univariate and multivariate analyses by logistic regression were used to determine the significant factors associated with the revisits.</p><p><strong>Results: </strong>Medical records of 918 eligible pediatric patients (1417 visits) were reviewed. Factors significantly associated with the revisits were history of asthma or current controller use (odds ratio [OR]: 3.08: 95% confidence interval [CI]: 1.86-5.1). Not prescribing systemic corticosteroids (<i>P</i> < 0.001), or prescribing them upon discharge without first dose in the ED (<i>P</i> = 0.022) were significantly associated with revisits.</p><p><strong>Conclusion: </strong>No prescription of systemic corticosteroids or prescription upon discharge, without an immediate dose at the ED, in children with history of asthma or current controller use were associated with revisits.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":" ","pages":"275-282"},"PeriodicalIF":1.5,"publicationDate":"2022-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/40/38/oaem-14-275.PMC9233495.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40405876","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":"Greek BLS Certified Providers' CPR Willingness and Skill Retention During the Pre-Vaccine Covid-19 Pandemic Period. A Survey of the Hellenic Society of Cardiology.","authors":"George Latsios,&nbsp;Andreas Synetos,&nbsp;Marianna Leopoulou,&nbsp;Evaggelia Stamatopoulou,&nbsp;Panagiotis Koukopoulos,&nbsp;Charalambos Parisis,&nbsp;Antonios Karanasos,&nbsp;Paraskevi Fragkou,&nbsp;Konstantinos Toutouzas,&nbsp;John Kanakakis,&nbsp;Kostas Tsioufis","doi":"10.2147/OAEM.S340567","DOIUrl":"https://doi.org/10.2147/OAEM.S340567","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to evaluate the level of established knowledge regarding cardiopulmonary resuscitation (CPR) during the pre-vaccine Covid-19 pandemic era of certified Basic Life Support (BLS) providers, as well as their attitude towards CPR and their willingness to provide CPR.</p><p><strong>Methods: </strong>Certified BLS providers from courses held in Athens, Greece, were asked to complete an electronic survey regarding their knowledge of and stance towards performing CPR on victims with confirmed or suspected Covid-19 infection. Their insight on BLS courses was also assessed. Answers were collected during June 2020.</p><p><strong>Results: </strong>Out of 5513 certified providers, 25.53% completed the survey. The majority (83.36%) would provide CPR to a cardiac arrest victim with possible or confirmed Covid-19 infection. Regarding the use of an automated external defibrillator, most respondents anticipated that it is equally safe as in the pre-Covid-19 period (58.24%). A more elementary level of education (p = 0.04) made rescuers more willing to provide CPR. Access to the European Resuscitation Council (ERC) or to the Greek National Public Health Organization (NPHO) guidelines was not correlated to the attitude towards resuscitation. Time since the last BLS seminar had no impact on the rescuers' attitude (p = 0.72). All responders agreed that training in CPR during Covid-19 remains necessary.</p><p><strong>Conclusion: </strong>Certified BLS providers maintained their willingness to perform CPR in cardiac arrest victims even during the pre-vaccine, dangerous Covid-19 pandemic period. Knowledge regarding Covid-19 CPR was satisfactory; however, continuous training, focused on the revised algorithms, was considered essential.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":" ","pages":"63-75"},"PeriodicalIF":1.5,"publicationDate":"2022-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/33/c3/oaem-14-63.PMC8860398.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39959421","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 Use of qSOFA, SOFA, and Ramathibodi Early Warning Score (REWS) to Predict Severe Complications in Hematologic Malignancy Patients.","authors":"Pungkava Sricharoen,&nbsp;Chaithawat Chueluecha,&nbsp;Chaiyaporn Yuksen,&nbsp;Chetsadakon Jenpanitpong","doi":"10.2147/OAEM.S345308","DOIUrl":"https://doi.org/10.2147/OAEM.S345308","url":null,"abstract":"<p><strong>Background: </strong>Sepsis causes high mortality in vulnerable groups such as hematologic malignancy (HM) patients. There are various early warning scores of sepsis, eg, qSOFA, SOFA, and Ramathibodi Early Warning Score (REWS). This study aimed to compare REWS, qSOFA, and SOFA in predicting severe complications in hematologic malignancy patients visiting ED.</p><p><strong>Methods: </strong>The study was conducted as a retrospective cohort study at the ED of Ramathibodi Hospital, Bangkok, Thailand. Adult HM patients suspected of sepsis and have visited ED between March 2016 and December 2019.</p><p><strong>Results: </strong>Among 124 patients in our cohort, 51 (41%) had serious complication in ED and 20 (16%) died within 28 days after admission. The AUROCs of SOFA and qSOFA indicate significantly higher predicting in serious complication in ED than REWS (SOFA, 0.81 [95% CI, 0.73-0.89], qSOFA, 0.73 [95% CI, 0.65-0.81], REWS, 0.62 [95% CI, 0.52-0.72] p=0.004) while the predicting in 28-day mortality is not statistically significantly different (SOFA, 0.73 [95% CI, 0.60-0.85], qSOFA, 0.69 [95% CI, 0.58-0.80], REWS, 0.60 [95% CI, 0.44-0.75] p=0.25).</p><p><strong>Conclusion: </strong>The SOFA score is highest in predicting severe complications among hematologic malignancy patients.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":" ","pages":"51-61"},"PeriodicalIF":1.5,"publicationDate":"2022-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/49/49/oaem-14-51.PMC8827160.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39620376","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}