Open Access Emergency Medicine : OAEM最新文献_第6页

Characteristics of Medico-Legal Cases and Errors in Medico-Legal Reports at a Teaching Hospital in Saudi Arabia. 沙特阿拉伯某教学医院法医学案例特点及报告错误

IF 1.5

Open Access Emergency Medicine : OAEM Pub Date : 2021-12-02 eCollection Date: 2021-01-01 DOI: 10.2147/OAEM.S341893

Mohammed Madadin, Abdullah A Alqarzaie, Rashed S Alzahrani, Faisal F Alzahrani, Saleh M Alqarzea, Khalid M Alhajri, Mohammed A Al Jumaan

{"title":"Characteristics of Medico-Legal Cases and Errors in Medico-Legal Reports at a Teaching Hospital in Saudi Arabia.","authors":"Mohammed Madadin, Abdullah A Alqarzaie, Rashed S Alzahrani, Faisal F Alzahrani, Saleh M Alqarzea, Khalid M Alhajri, Mohammed A Al Jumaan","doi":"10.2147/OAEM.S341893","DOIUrl":"https://doi.org/10.2147/OAEM.S341893","url":null,"abstract":"Introduction: A medico-legal case (MLC) involves any injury or medical condition in which law enforcement agencies investigate and fix the responsibility regarding of an injury or medical condition. Incorrect or incomplete medico-legal reports (MLRs) may trigger a pause or delay in legal proceedings and patients' rights could be violated. The aim of this study is to describe the characteristics of MLCs and to identify errors in the MLRs.Materials and methods: This retrospective, descriptive study was conducted in a teaching hospital in the Eastern Province of Saudi Arabia. In total, 418 MLRs furnished during a 6-month period and reviewed for characteristics of MLCs and identification of errors.Results: A total of 418 MLRs were included in the present study. Fights or physical assault and battery formed the major proportion of MLCs amounting to 83% of MLCs. Blunt injury was the dominant type of injury in most of the cases (81.8%). In relation to errors in MLRs, no MLR in the present study were without errors.Conclusion: Fights or physical assault and battery formed the major proportion of MLCs. Multiple errors were identified in the MLRs furnished by the physicians. Writing MLRs must follow standardized guidelines as it has a bearing on legal proceedings and patients' rights. We recommend training for physicians in writing MLRs in the interest of proper administration of justice.","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":"13 ","pages":"521-526"},"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/90/d7/oaem-13-521.PMC8648094.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39704283","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: 5

Normal Saline Solution or Lactated Ringer's Solution to Enhance Lactate Clearance in Septic Patients After Initial Resuscitation in the ED: A Retrospective Cohort Trial. 一项回顾性队列试验:生理盐水或乳酸林格氏液增强败血症患者初次复苏后乳酸清除。

IF 1.5

Open Access Emergency Medicine : OAEM Pub Date : 2021-12-01 eCollection Date: 2021-01-01 DOI: 10.2147/OAEM.S340691

Thanya Limapichat, Krittapat Pattanapong

{"title":"Normal Saline Solution or Lactated Ringer's Solution to Enhance Lactate Clearance in Septic Patients After Initial Resuscitation in the ED: A Retrospective Cohort Trial.","authors":"Thanya Limapichat, Krittapat Pattanapong","doi":"10.2147/OAEM.S340691","DOIUrl":"https://doi.org/10.2147/OAEM.S340691","url":null,"abstract":"Objective: To compare the effect of isotonic crystalloid solutions between lactated Ringer's solution (LRS) and normal saline solution (NSS) on lactate clearance in septic patients at the emergency department (ED).Materials and methods: This study is a single-center retrospective chart review. The study enrolled patients older than 18 years with sepsis and initial serum lactate level >2 mg/dL in the ED. The primary outcome was to determine which isotonic solution was better for serum lactate clearance in septic patients. The secondary outcomes were serum creatinine change within 24 h and the 48-h survival rate after admission.Results: A total of 120 patients were enrolled with a median crystalloid volume administered in the ED of 1000 mL. Within 2 h of resuscitation, there was no difference in lactate clearance between the LRS and NSS groups with median values of 29.2% and 25%, respectively (P=0.839). The 48-h survival rate after admission did not differ between the LRS and NSS groups with median values of 90% and 86%, respectively. Both isotonic solutions increased serum creatinine levels within 24 h of treatment with median values of 0.3 for each group (P=0.647).Conclusion: Among septic patients in the ED treated with NSS or LRS, there was no difference in lactate clearance, serum creatinine change within 24 h, or 48-h survival. However, several factors were associated with increased lactate levels, such as older age and use of vasopressors and immunosuppressive agents.","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":"13 ","pages":"511-519"},"PeriodicalIF":1.5,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7a/ef/oaem-13-511.PMC8647759.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39704282","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: 4

Causal Effect Analysis of Demographic Concordance of Physician Trust and Respect in an Emergency Care Setting. 急诊医师信任与尊重人口学一致性的因果分析。

IF 1.5

Open Access Emergency Medicine : OAEM Pub Date : 2021-11-19 eCollection Date: 2021-01-01 DOI: 10.2147/OAEM.S334495

Amy F Ho, Yuan Zhou, Jessica J Kirby, Md Mamunur Rahman, Kathryn Tessitore, Yousef Abdel-Raziq, James P d'Etienne, Chet D Schrader, Hao Wang

{"title":"Causal Effect Analysis of Demographic Concordance of Physician Trust and Respect in an Emergency Care Setting.","authors":"Amy F Ho, Yuan Zhou, Jessica J Kirby, Md Mamunur Rahman, Kathryn Tessitore, Yousef Abdel-Raziq, James P d'Etienne, Chet D Schrader, Hao Wang","doi":"10.2147/OAEM.S334495","DOIUrl":"https://doi.org/10.2147/OAEM.S334495","url":null,"abstract":"Objective: Patient perceptions of physician trust and respect are important factors for patient satisfaction evaluations. However, perceptions are subjective by nature and can be affected by patient and physician demographic characteristics. We aim to determine the causal effect on patient-physician demographic concordance and patient perceptions of physician trust and respect in an emergency care setting.Methods: We performed a causal effect analysis in an observational study setting. A near-real-time patient satisfaction survey was sent via telephone to patients within 72 h of discharge from an emergency department (ED). Patient-trust-physician (PTP) and physician-show-respect (PSR) scores were measured. Patient and physician demographics (age, gender, race, and ethnicity) were matched. Causal effect was analyzed to determine the direct effect of patient-physician demographic concordance on PTP/PSR scores.Results: We enrolled 1815 patients. The treatment effect of patient-physician age concordance on PTP scores was -0.119 (p = 0.036). Other treatment effect of patient-physician demographic concordance on patient perception of physician trust and respect ranged from -0.02 to -0.2 (p > 0.05).Conclusion: Patient-physician age concordance may cause a negative effect on patient perception of physician trust. Otherwise, patient-physician demographic concordance has no effect on patient perceptions of physician trust and respect.","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":"13 ","pages":"503-509"},"PeriodicalIF":1.5,"publicationDate":"2021-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/26/26/oaem-13-503.PMC8610774.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39660005","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: 2

Successful Application of Extracorporeal Membrane Oxygenation in an Acute Tonsillitis Patient Complicated with Acute Respiratory Distress Syndrome: A Case Report. 体外膜氧合在急性扁桃体炎合并急性呼吸窘迫综合征中的成功应用1例。

IF 1.5

Open Access Emergency Medicine : OAEM Pub Date : 2021-11-18 eCollection Date: 2021-01-01 DOI: 10.2147/OAEM.S337568

Zhufeng Zhang, Dongmei Guo, Qi Ren

引用次数: 1

D-Dimer Tests in the Emergency Department: Current Insights. d -二聚体测试在急诊科:当前的见解。

IF 1.5

Open Access Emergency Medicine : OAEM Pub Date : 2021-11-11 eCollection Date: 2021-01-01 DOI: 10.2147/OAEM.S238696

Francesca Innocenti, Cristian Lazzari, Francesca Ricci, Elisa Paolucci, Ilya Agishev, Riccardo Pini

{"title":"D-Dimer Tests in the Emergency Department: Current Insights.","authors":"Francesca Innocenti, Cristian Lazzari, Francesca Ricci, Elisa Paolucci, Ilya Agishev, Riccardo Pini","doi":"10.2147/OAEM.S238696","DOIUrl":"https://doi.org/10.2147/OAEM.S238696","url":null,"abstract":"In the Emergency Medicine setting, D-dimer is currently employed in the diagnostic assessment of suspected venous thromboembolism and aortic syndrome. The nonspecific symptoms reported by patients, like chest pain, dyspnea or syncope, uncover a wide range of differential diagnosis, spanning from mild to life-threatening conditions. Therefore, we assumed the perspective of the Emergency Physician and, in this narrative review, we reported a brief presentation of the epidemiology of these symptoms and the characteristics of patients, in whom we could suspect the aforementioned pathologies. We also reported in which patients D-dimer gives useful information. In fact, when the probability of the disease is high, the D-dimer level is futile. On the contrary, given the low specificity of the test, when the probability of the disease is very low, a false-positive value of the D-dimer only increases the risk of overtesting. Patients with low to moderate probability really benefit from the D-dimer testing, in order to prevent the execution of expensive and potentially dangerous imaging tests. In the second part of the review, we focused on the prognostic value of the test in septic patients. The early prognostic stratification of septic patients remains a challenge for the Emergency Physician, in the absence of a definite biomarker or score to rely on. Therefore, we need several parameters for the early identification of patients at risk of an adverse prognosis and the D-dimer may play a role in this demanding task. SARS COVID-19 patients represent an emerging reality, where the role of the D-dimer for prognostic stratification could be relevant. In fact, in patients with severe forms of this disease, the D-dimer reaches very high values, which appear to parallel the course of respiratory failure. Whether the test may add useful information for the management of these patients remains to be determined.","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":"13 ","pages":"465-479"},"PeriodicalIF":1.5,"publicationDate":"2021-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f1/12/oaem-13-465.PMC8593515.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39637277","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: 5

Mortality Rate of Trauma Patients with ESI Triage Level 1-2 Who Underwent Computerized Tomography-PANSCAN versus Conventional Computerized Tomography Scan. ESI分类等级1-2的创伤患者行计算机断层扫描- panscan与常规计算机断层扫描的死亡率比较

IF 1.5

Open Access Emergency Medicine : OAEM Pub Date : 2021-10-18 eCollection Date: 2021-01-01 DOI: 10.2147/OAEM.S330294

Sorravit Savatmongkorngul, Chaiyaporn Yuksen, Wapee Maspol, Pungkava Sricharoen, Sirote Wongwaisayawan, Chetsadakon Jenpanitpong, Sorawich Watcharakitpaisan, Parama Kaninworapan, Konwachira Maijan

{"title":"Mortality Rate of Trauma Patients with ESI Triage Level 1-2 Who Underwent Computerized Tomography-PANSCAN versus Conventional Computerized Tomography Scan.","authors":"Sorravit Savatmongkorngul, Chaiyaporn Yuksen, Wapee Maspol, Pungkava Sricharoen, Sirote Wongwaisayawan, Chetsadakon Jenpanitpong, Sorawich Watcharakitpaisan, Parama Kaninworapan, Konwachira Maijan","doi":"10.2147/OAEM.S330294","DOIUrl":"https://doi.org/10.2147/OAEM.S330294","url":null,"abstract":"Objective: The treatment of severe trauma patients requires a fast and accurate method to diagnose life-threatening conditions. Computerized tomography (CT)-PANSCAN has been widely used for the last 20 years to diagnose many patients in critical condition. However, no research has been performed into the efficacy of CT-PANSCAN. This research aims to compare the mortality rate of trauma patients who underwent CT-PANSCAN versus conventional CT scan.Methods: This retrospective cohort study enrolled patients who were at triage ESI level 1-2 in the emergency department of Ramathibodi Hospital from January 2013 to December 2018 and analyzed the mortality rate between those who underwent CT-PANSCAN and conventional CT scan.Results: The study enrolled 123 trauma patients; 61 patients underwent CT-PANSCAN, whereas 62 patients underwent conventional CT scan. There were 1 and 7 patients who expired in the CT-PANSCAN and conventional CT scan groups, respectively. After multivariate regression analysis, the result revealed that patients who underwent CT-PANSCAN had a lower mortality rate (adjusted odds ratio = 0.023; p-value = 0.018; 95% CI 0.001-0.518).Conclusion: Undergoing a CT-PANSCAN can reduce the mortality rate in trauma patients, especially in ESI level 1, 2 traumatic patients, and CT-PANSCAN available facilities.","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":"13 ","pages":"457-463"},"PeriodicalIF":1.5,"publicationDate":"2021-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/75/65/oaem-13-457.PMC8536882.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39564091","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: 1

Rapid Intubation Sequence: 4-Year Experience in an Emergency Department. 快速插管程序:急诊科4年经验。

IF 1.5

Open Access Emergency Medicine : OAEM Pub Date : 2021-10-14 eCollection Date: 2021-01-01 DOI: 10.2147/OAEM.S321365

Ángela María Muñoz, Manuela Estrada, Jaime A Quintero, Mauricio Umaña

{"title":"Rapid Intubation Sequence: 4-Year Experience in an Emergency Department.","authors":"Ángela María Muñoz, Manuela Estrada, Jaime A Quintero, Mauricio Umaña","doi":"10.2147/OAEM.S321365","DOIUrl":"https://doi.org/10.2147/OAEM.S321365","url":null,"abstract":"Background: The rapid intubation sequence is advanced airway management that effectively ensures an adequate supply of oxygen in critically ill patients. The medical personnel in the emergency department performed this procedure.Objective: To describe the main characteristics of the rapid intubation sequence in an emergency department of a high complexity hospital.Methods: This is a descriptive, cross-sectional, retrospective study. We included all older patients with a rapid intubation sequence requirement in the emergency department from 2014 to 2017. We used central tendency measures for numerical variables and proportions for categorical variables.Results: A total of 401 patients were eligible for this analysis. The main indication for intubation was the Glasgow Coma Scale = <8 in 170 patients (42.4%), followed by hypoxemia in 142 patients (35.4%). In 36 patients, at least one complication occurred. RSI was performed in 54.4% by emergency physician. RSI was successful on the first attempt in 90.5%. Only 36 patients (9%) presented complications.Conclusion: In this study, we found that the rapid intubation sequence was not related to a high proportion of complications. Perhaps, this is attributed to the degree of medical training and the use of emergency department protocols in our hospital.","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":"13 ","pages":"449-455"},"PeriodicalIF":1.5,"publicationDate":"2021-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8e/42/oaem-13-449.PMC8524177.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39564090","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: 1

Complete Resolution of a Refractory Pyogenic Granuloma Following Topical Salt Treatment. 局部盐治疗后顽固性化脓性肉芽肿的完全解决。

IF 1.5

Open Access Emergency Medicine : OAEM Pub Date : 2021-10-05 eCollection Date: 2021-01-01 DOI: 10.2147/OAEM.S323793

Nouf Faihan Bin Rubaian

引用次数: 1

Chronic Contained Rupture of the Abdominal Aortic Aneurysm. 慢性腹内主动脉瘤破裂。

IF 1.5

Open Access Emergency Medicine : OAEM Pub Date : 2021-09-24 eCollection Date: 2021-01-01 DOI: 10.2147/OAEM.S327922

Nabil A Al-Zoubi, Mahmoud R Mahafdah, Omar Albawaih

{"title":"Chronic Contained Rupture of the Abdominal Aortic Aneurysm.","authors":"Nabil A Al-Zoubi, Mahmoud R Mahafdah, Omar Albawaih","doi":"10.2147/OAEM.S327922","DOIUrl":"https://doi.org/10.2147/OAEM.S327922","url":null,"abstract":"Background: The most lethal complication of the abdominal aortic aneurysm (AAA) is rupture (rAAA). A triad of abdominal or back pain, a pulsating mass in the abdomen, and decrease in blood pressure is mostly diagnostic. However, this presentation may not be complete due to either an impalpable aneurysm or atypical symptoms which leads to difficulties in diagnosis and delayed management. Chronic contained rupture of AAA (CCR-AAA) is a rare but well-recognized condition. Its diagnosis may be difficult because of the atypical and chronic nature of the symptoms. The aim of this study is to investigate the incidence and to highlight the importance of this less common presentation of rAAA.Methods: Patients who presented to King Abdullah University Hospital (KAUH) with infra-renal AAAs (elective and emergency) from January 2014 to April 2021 were prospectively collected. Patients with CCR-AAA were identified and evaluated in terms of demographic data, associated comorbidities, presentation, treatments, and outcomes.Results: A total number of 85 patients were admitted with an infra-renal AAA. Seventeen patients (20.0%) had rAAA, of them only 5 patients (29.4%) were diagnosed with CCR-AAA. CCR-AAAs represent 5.9% of cases with AAA. CCR-AAAs were all in men, with a mean age ± SD of 73.1±8.3. Two patients (40.0%) had abdominal pain, 2 patients (40.0%) had back pain and one patient (10.0%) had no symptoms at the time of diagnosis.Conclusion: CCR-AAA represents 5.9% of all AAA and 29.4% of rAAA. To prevent this potentially fatal condition, awareness is required especially in old males with abdominal or back pain.","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":"13 ","pages":"439-443"},"PeriodicalIF":1.5,"publicationDate":"2021-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a0/83/oaem-13-439.PMC8478337.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39475274","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: 1

Catastrophic Complications of Circumcision by Traditional Circumcisers. 传统包皮环切术的灾难性并发症。

IF 1.5

Open Access Emergency Medicine : OAEM Pub Date : 2021-09-21 eCollection Date: 2021-01-01 DOI: 10.2147/OAEM.S322683

Faisal Ahmed, Saleh Al-Wageeh, Saif Ghabisha, Ebrahim Al-Shami, Khalil Al-Naggar, Ghamdan Obaid, Ali Eslahi, Mohammed Alfaragi

引用次数: 3