Open Access Emergency Medicine : OAEM最新文献

{"title":"Ischemic Stroke Following <i>Calloselasma rhodostoma</i> Snakebite: A Rare Case Report.","authors":"Rizaldy Taslim Pinzon,&nbsp;Radian Adhiputra Antonius,&nbsp;Vanessa Veronica","doi":"10.2147/OAEM.S352865","DOIUrl":"https://doi.org/10.2147/OAEM.S352865","url":null,"abstract":"<p><strong>Background: </strong>Ischemic stroke following a snakebite is a rare case. Snake venom consists of multiple components which can cause various symptoms and consequences. We report a case of ischemic stroke following <i>Calloselasma rhodostoma</i> snakebite, and this study was the first to report a case of ischemic stroke after snakebite in Indonesia.</p><p><strong>Case presentation: </strong>A 72-year-old Mongoloid male presented with a history of snakebite one day before hospital admission with a swollen right lower leg with no history of hypertension, diabetes mellitus, or heart disease. The patient was conscious. His temperature was 36.5°C, pulse rate was 90 beats per minute, respiration rate was 30 breaths per minute, and blood pressure was 162/109 mmHg. The neurological examination showed left-side weakness and headache, with blood laboratory results showing prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT), leucocytosis, thrombocytopenia, and low haemoglobin. A computerized tomogram (CT) scan of the brain was taken, which revealed a sign of infarct in the pericallosal of the right lateral periventricular anterior horn.</p><p><strong>Conclusion: </strong>Although ischemic stroke following a snakebite is uncommon, it must be considered and monitored.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":" ","pages":"35-39"},"PeriodicalIF":1.5,"publicationDate":"2022-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/58/1a/oaem-14-35.PMC8818974.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39904574","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":"High Altitude Pulmonary Edema in a Healthy Pediatric Patient Traveling from Denver to Breckenridge.","authors":"Matthew Adamo,&nbsp;Kayla E Prokopakis,&nbsp;Todd Bolotin","doi":"10.2147/OAEM.S334485","DOIUrl":"https://doi.org/10.2147/OAEM.S334485","url":null,"abstract":"<p><p>A healthy 11-year-old boy presented with headache, nausea, and cough to a clinic at 2926 meters of altitude one day after ascending from his home altitude of 1578 meters. The patient had made multiple trips to the same altitude without any symptoms or sequelae throughout his childhood. Physical examination was significant for rales, tachycardia, and pulse oximetry level of 86% on room air. Radiographic evaluation with plain films revealed patchy alveolar opacities throughout the right lung. He received treatment with dexamethasone and high-flow face mask supplemental oxygen. In less than two hours, his rales had resolved, and his oxygen saturation had dramatically improved. He was discharged back to his native altitude and was at his baseline later the same day. High altitude pulmonary edema is a rare occurrence in children, but it is exceedingly rare for a healthy child with no history of pulmonary hypertension ascending only 1348 meters.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":" ","pages":"1-4"},"PeriodicalIF":1.5,"publicationDate":"2022-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/09/f0/oaem-14-1.PMC8742613.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39812092","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":"Measures of Emergency Department Crowding, a Systematic Review. How to Make Sense of a Long List.","authors":"Samer Badr,&nbsp;Andrew Nyce,&nbsp;Taha Awan,&nbsp;Dennise Cortes,&nbsp;Cyrus Mowdawalla,&nbsp;Jean-Sebastien Rachoin","doi":"10.2147/OAEM.S338079","DOIUrl":"https://doi.org/10.2147/OAEM.S338079","url":null,"abstract":"<p><p>Emergency department (ED) crowding, a common and serious phenomenon in many countries, lacks standardized definition and measurement methods. This systematic review critically analyzes the most commonly studied ED crowding measures. We followed the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. We searched PubMed/Medline Database for all studies published in English from January 1st, 1990, until December 1st, 2020. We used the National Institute of Health (NIH) Quality Assessment Tool to grade the included studies. The initial search yielded 2293 titles and abstracts, of whom we thoroughly reviewed 109 studies, then, after adding seven additional, included 90 in the final analysis. We excluded simple surveys, reviews, opinions, case reports, and letters to the editors. We included relevant papers published in English from 1990 to 2020. We did not grade any study as poor and graded 18 as fair and 72 as good. Most studies were conducted in the USA. The most studied crowding measures were the ED occupancy, the ED length of stay, and the ED volume. The most heterogeneous crowding measures were the boarding time and number of boarders. Except for the National ED Overcrowding Scale (NEDOCS) and the Emergency Department Work Index (EDWIN) scores, the studied measures are easy to calculate and communicate. Quality of care was the most studied outcome. The EDWIN and NEDOCS had no studies with the outcome mortality. The ED length of stay had no studies with the outcome perception of care. ED crowding was often associated with worse outcomes: higher mortality in 45% of the studies, worse quality of care in 75%, and a worse perception of care in 100%. The ED occupancy, ED volume, and ED length of stay are easy to measure, calculate and communicate, are homogenous in their definition, and were the most studied measures.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":" ","pages":"5-14"},"PeriodicalIF":1.5,"publicationDate":"2022-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/aa/5d/oaem-14-5.PMC8742612.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39812094","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":"Practice Patterns and Assessment of Needs for Pediatric Pain Management in Alberta Emergency Departments.","authors":"Neta Bar Am,&nbsp;Jennifer Thull-Freedman,&nbsp;Samina Ali","doi":"10.2147/OAEM.S337900","DOIUrl":"https://doi.org/10.2147/OAEM.S337900","url":null,"abstract":"<p><strong>Purpose: </strong>Many rural and community emergency departments (EDs) experience barriers to providing optimal pain care to children. In preparation for a quality improvement initiative, our team conducted a provincial pediatric pain management practice and needs assessment.</p><p><strong>Methods: </strong>An online survey was sent to ED administrators and educators from March to May 2017. Themes included pain assessment, pain and distress management strategies, available resources, education, barriers to care, and opportunities for improvement.</p><p><strong>Results: </strong>Forty-five respondents, from 31 EDs representing all five geographic health zones in Alberta, completed the survey. Use of a pain assessment tool was reported at 93.5% (29/31 sites) of the sites. Topical anesthesia was employed \"most of the time\" before suturing at 67% (18/27) of sites, versus 15% (4/27) before blood work or IV insertion. Eighty-one percent (22/27) of sites reported physically restraining children for procedures \"often\", while 37% (10/27) reported use of comfort positioning \"often\". Digital distraction devices were available at 37% (10/27) of sites. Reported challenges included lack of resources (33.3%, 12/36), staff education/knowledge (33.3%, 12/36), and absent policies/poor policy adherence (25.0%, 9/36). Opportunities for improvement included staff member education (73.5%, 25/34) and more resources (58.8%, 20/34). Respondents rated their site's overall ability to manage children's pain as 50/100 [IQR:21,61].</p><p><strong>Conclusion: </strong>General EDs report providing suboptimal children's pain care, with use of physical restraint for medical procedures, and under-utilization of evidence-based, inexpensive treatment options. There are many gaps in children's pain care in rural and community EDs which could be addressed through collaborative quality improvement initiatives.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":"13 ","pages":"587-594"},"PeriodicalIF":1.5,"publicationDate":"2021-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/67/95/oaem-13-587.PMC8714010.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39668382","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":"Survival Rates and Factors Related to the Survival of Traffic Accident Patients Transported by Emergency Medical Services.","authors":"Thongpitak Huabbangyang,&nbsp;Rossakorn Klaiaungthong,&nbsp;Duangsamorn Jansanga,&nbsp;Airada Aintharasongkho,&nbsp;Tunwaporn Hanlakorn,&nbsp;Ratchanee Sakcharoen,&nbsp;Anucha Kamsom,&nbsp;Tavachai Soion","doi":"10.2147/OAEM.S344705","DOIUrl":"https://doi.org/10.2147/OAEM.S344705","url":null,"abstract":"<p><strong>Background: </strong>Traffic accident patients place a tremendous burden on health care services because they require substantial, rapid, and effective evaluation, management, and treatment by emergency medical services (EMS) to decrease morbidity and mortality rates. This study investigated the 1-month survival rate and factors related to the survival of traffic accident patients managed by EMS.</p><p><strong>Patients and methods: </strong>We retrospectively analyzed data of traffic accident patients serviced by the Surgico Medical Ambulance and Rescue Team (SMART) at Vajira Hospital, Bangkok, from January 1, 2018, to December 31, 2020. The data were collected from EMS patient care reports recorded using the emergency medical triage protocol as well as the criteria-based dispatch response codes in Thailand. Survival data at 1 month were obtained from electronic medical records.</p><p><strong>Results: </strong>Of the 340 traffic accident patients who fulfilled the study criteria, 314 (92.35%) were alive at 1 month. A multivariable analysis using multiple logistic regression identified prehospital level of consciousness, airway management, and cardiopulmonary resuscitation as factors associated with survival. Unresponsive patients had a lower survival rate than responsive patients (adjusted odds ratio [OR_adj] = 0.16, 95% confidence interval [CI]: 0.05-0.56, p = 0.004). Prehospital airway management and cardiopulmonary resuscitation reduced the survival rate by 0.30 and 0.10 times, respectively (OR_adj = 0.30, 95% CI: 0.09-0.97, p = 0.045 and OR_adj = 0.10, 95% CI: 0.02-0.47, p = 0.004, respectively).</p><p><strong>Conclusion: </strong>Traffic accident patients had a high survival rate at 1 month. We identified three factors regarding EMS treatment which were related to increased survival: a prehospital responsive level of consciousness, no prehospital airway management, and no prehospital cardiopulmonary resuscitation. Therefore, the development of standard guidelines for the management of traffic accident patients by EMS is crucial to increase the survival rate of traffic accident patients.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":"13 ","pages":"575-586"},"PeriodicalIF":1.5,"publicationDate":"2021-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/42/3f/oaem-13-575.PMC8694573.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39763759","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":"Epidemiology of Knife Injuries at Ain Shams University Hospital Emergency Department from 2018 to 2019: A Cross-Sectional Study.","authors":"Manar M Ellaban,&nbsp;Eman Afifi,&nbsp;Moustafa El Houssinie,&nbsp;Jon Mark Hirshon,&nbsp;Mohamed El-Shinawi,&nbsp;Maged El-Setouhy","doi":"10.2147/OAEM.S338245","DOIUrl":"https://doi.org/10.2147/OAEM.S338245","url":null,"abstract":"<p><strong>Purpose: </strong>For knife-related injuries (KRI), a comprehensive understanding of the incidence, mechanism, and pattern of injury is required for the development of prevention strategies. Unfortunately, reliable data on knife-related injuries are difficult to obtain. In Egypt, there is no national routine surveillance system for all knife injuries. The aim was to examine the epidemiologic characteristics of knife-related injuries at the Ain Shams University Hospital (ASUH) emergency department (ED).</p><p><strong>Patients and methods: </strong>A cross-sectional study was conducted on 140 patients who presented with knife injuries at the ASUH ED. Data collection was done during a randomly selected period of seven days each month from October 2018 to September 2019. The sociodemographic characteristics, injury-related variables, and outcomes of the injury were recorded on a structured worksheet.</p><p><strong>Results: </strong>Knife-related injuries represented 22.9% of all injury cases that presented to the ED. Majority of the knife-related injuries (87.86%) were accidental, 7.9% were assault, and 4.3% were self-inflicted. Home was the most reported place of injury. Most of the victims were discharged from the ED (87.1%), and 84.3% recovered completely. The mean hospital stay was 3.6 ± 1.3 days.</p><p><strong>Conclusion: </strong>Majority of the knife-related injuries were accidental, and the most common pattern was isolated chest injury with contusions. Cases that were not severe and had favorable prognosis (ie, complete recovery) comprised the largest proportion. Recommendations include development of a surveillance system may result in the effective control and prevention of this growing problem of knife-related injuries.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":"13 ","pages":"561-567"},"PeriodicalIF":1.5,"publicationDate":"2021-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/76/58/oaem-13-561.PMC8702981.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39785363","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 Duration of Intercostal Chest Drainage in Patients with Primary Spontaneous Pneumothorax and the Role of Pulmonary Rehabilitation.","authors":"Puthachad Namwaing,&nbsp;Seksan Chaisuksant,&nbsp;Rakfan Sawadpanich,&nbsp;Thitima Anukunananchai,&nbsp;Akkaranee Timinkul,&nbsp;Waraporn Sakaew,&nbsp;Bundit Sawunyavisuth,&nbsp;Watchara Boonsawat,&nbsp;Sittichai Khamsai,&nbsp;Kittisak Sawanyawisuth","doi":"10.2147/OAEM.S336637","DOIUrl":"https://doi.org/10.2147/OAEM.S336637","url":null,"abstract":"<p><strong>Purpose: </strong>Primary spontaneous pneumothorax (PSP) is an urgent/emergency condition. Treatment with intercostal chest drainage (ICD) is necessary, particularly in symptomatic patients or those with tension. A previous study found that systematic breathing exercise significantly reduced ICD duration when compared with controls. This study aimed to evaluate if pulmonary rehabilitation can reduce the duration of ICD treatment in patients with PSP.</p><p><strong>Patients and methods: </strong>This was a retrospective study of patients diagnosed with PSP treated with ICD. Duration of ICD treatment was recorded from patients' medical charts. Factors associated with ICD duration were calculated using linear regression analysis.</p><p><strong>Results: </strong>There were 66 patients who met the study criteria, with average (SD) age and body mass index of 31.68 (13.53) years and 20.94 (2.72) kg/m². The majority of the patients were male (72.73%), and average (SD) duration of ICD treatment was 9.90 (7.83) days. Three factors remained in the final model: body mass index, systolic blood pressure, and recurrent PSP. Two factors were independently associated with longer ICD duration: systolic blood pressure and recurrent PSP, with adjusted coefficients of 0.21 (p value 0.041) and 7.69 (p value 0.039), respectively. Pulmonary rehabilitation was not included in the final model.</p><p><strong>Conclusion: </strong>Patients with a history of recurrent PSP or high systolic blood pressure at presentation may require longer ICD duration. Pulmonary rehabilitation was not associated with the duration of ICD treatment.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":"13 ","pages":"569-573"},"PeriodicalIF":1.5,"publicationDate":"2021-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0a/ab/oaem-13-569.PMC8687673.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39836904","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":"Why Do Not Physicians Attend Hospital Cardiopulmonary Resuscitation Training?","authors":"Kasper G Lauridsen,&nbsp;Rikke Højbjerg,&nbsp;Anders S Schmidt,&nbsp;Bo Løfgren","doi":"10.2147/OAEM.S332739","DOIUrl":"https://doi.org/10.2147/OAEM.S332739","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiopulmonary resuscitation (CPR) training is mandatory in most hospitals. Despite this, some hospital staff do not attend CPR training on a regular basis, but the barriers to training attendance are sparsely investigated. This study aimed to investigate CPR course attendance, barriers to participation, and possible initiatives to increase CPR course attendance.</p><p><strong>Methods: </strong>Physicians from one university hospital and one regional hospital in the Central Denmark Region were included. Questionnaires were handed out at daily staff meetings at departments of internal medicine and surgery.</p><p><strong>Results: </strong>In total, 233 physicians responded (response rate: 92%, male: 54%). Overall, 32% of physicians had not attended CPR training at the hospital. Mean (±standard deviation) time since the last CPR course participation was 17 (±3) months. Frequent barriers to attending courses included not knowing when courses are conducted (70%) and where to sign up for training (45%). The majority (60%) of physicians responded that the reason why they prioritize course participation is to be professionally updated. In contrast, 16% stated that they had sufficient CPR skills and therefore CPR training was unnecessary. Physicians stated that the following factors would improve CPR training participation: an annual day protected (no clinical work) for course attendance (72%), use of short booster sessions (49%), shorter courses combined with e-learning (51%) and shorter courses held over 2 days (46%).</p><p><strong>Conclusion: </strong>One-third of physicians did not attend hospital CPR training at two Danish hospitals. Several barriers to course participation exist, of which course registration seems to be a crucial factor. Alternative CPR training methods may help improve training participation.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":"13 ","pages":"543-551"},"PeriodicalIF":1.5,"publicationDate":"2021-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/80/2e/oaem-13-543.PMC8685550.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39836902","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":"Cervical Fracture During COVID-19 Pandemic Era: A Case Series.","authors":"Pamudji Utomo,&nbsp;R Andhi Prijosedjati,&nbsp;Ricat Hinaywan Malik","doi":"10.2147/OAEM.S319748","DOIUrl":"https://doi.org/10.2147/OAEM.S319748","url":null,"abstract":"<p><strong>Background: </strong>Cervical fractures are potentially serious and can have fatal consequences if not treated properly. Correct diagnosis and classification of injury is the first step in determining the most appropriate treatment. Cervical fractures will have an impact on the patient's work, and COVID-19 is a challenge in the hospital to treat a cervical fracture. This study aims to discuss the case of patients with cervical fractures that have undergone surgical treatment in the COVID-19 pandemic.</p><p><strong>Case presentation: </strong>Two cases of emergency patients with cervical injury treated at the hospital in the acute setting of the COVID-19 pandemic. All these patients experienced delayed timing to arrive in the emergency department of Prof. Dr. R. Soeharso Orthopedic Hospital. Neurological outcome was assessed before being discharged after surgery and a 3-month follow-up post-surgery.</p><p><strong>Results: </strong>Laminectomy and posterior stabilization and fusion (PSF) were performed immediately after diagnosis was established in both patients. Physical rehabilitation was performed. In a 3-month follow-up, both patients' neurological functions improved.</p><p><strong>Conclusion: </strong>Clinical outcomes of cervical injury patients can be affected by some factors, for example, timing to diagnosis, timing to traction application, timing to surgery, and timing to rehabilitation. Depending on the institution, weekend days can also affect the delay of the COVID-19 PCR swab. MRI schedule and patient optimal condition can also affect the timing to surgery. The immediate diagnosis and prompt treatment are needed to make a better outcome, especially better neurological status.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":"13 ","pages":"535-542"},"PeriodicalIF":1.5,"publicationDate":"2021-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e8/eb/oaem-13-535.PMC8665776.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39815439","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":"Nasal Packing in the Emergency Department: A Practical Review for Emergency Providers.","authors":"Quincy K Tran,&nbsp;Jeremy Barnett,&nbsp;Francis O'Connell,&nbsp;Brian D'Anza,&nbsp;Ali Pourmand","doi":"10.2147/OAEM.S247017","DOIUrl":"https://doi.org/10.2147/OAEM.S247017","url":null,"abstract":"<p><p>We performed a narrative review of epistaxis management in the emergency department. First, we examined the pathophysiology, the current types of treatment that are available to emergency clinicians. When nasal packing is indicated, we examined the efficacy of nasal packing in addition to other topical treatment such as tranexamic acid and the evidence of prophylactic antibiotics. We detailed current studies involving tranexamic acid and prophylactic antibiotics for nasal packing. Finally, we introduced an epistaxis clinical care pathway, based on current evidence, to aid emergency clinicians with their clinical decision-making processes.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":"13 ","pages":"527-533"},"PeriodicalIF":1.5,"publicationDate":"2021-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/df/0e/oaem-13-527.PMC8648098.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39704284","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}