Hong Kong Journal of Emergency Medicine最新文献

{"title":"Application of the National Early Warning Score in patients with suspected COVID‐19 in Korea","authors":"Seonghye Park, C. Youn, Hyo Joon Kim, S. Kim, Sanghyun Park, H. Bang","doi":"10.1002/hkj2.12016","DOIUrl":"https://doi.org/10.1002/hkj2.12016","url":null,"abstract":"Coronavirus disease 2019 (COVID‐19) infection has a wide range of severity, ranging from asymptomatic infection to severe respiratory distress and multiple organ dysfunction. To optimize the utilization of limited resources, a system is needed to rapidly classify the patients requiring monitoring and urgent intervention. The purpose of this study was to determine whether the National Early Warning Score (NEWS) at admission is a useful prediction tool for in‐hospital mortality in patients who visited the emergency department (ED) and required isolation during the COVID‐19 pandemic.This study was conducted in adults aged 19 years or older who visited the ED and were preemptively isolated due to fever or respiratory symptoms from January 2021 to December 2021. The NEWS was calculated at the time of ED admission. The primary outcome was all‐cause in‐hospital mortality.Of the 6304 patients included in the study, 5759 survived and 545 died in the hospital. The NEWS was higher in non‐survivors (6.1 ± 4.2) than in survivors (2.8 ± 2.5). When the NEWS was examined as a continuous variable, the adjusted odds ratio for in‐hospital mortality was 1.176 (95% CI, 1.12–1.23). The area under the curve (AUC) of NEWS for predicting in‐hospital mortality was 0.756 (95% CI, 0.734–0.778).The NEWS at ED admission was associated with in‐hospital mortality in preemptively isolated patients during the COVID‐19 pandemic. The use of NEWS in patients with suspected COVID‐19 infection would help predict the severity and prognosis of patients.","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140221459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of body mass index on abdominal injuries in motorcycle crashes in South Korea","authors":"Yonghun Gwak, Dae Kon Kim, Joo Jeong, You Hwan Jo, Dong Keon Lee, S. Park, Yeongho Choi, Yu Jin Kim","doi":"10.1002/hkj2.12014","DOIUrl":"https://doi.org/10.1002/hkj2.12014","url":null,"abstract":"Motorcyclists face a higher risk of severe morbidity and mortality compared to automobile passengers. This study aimed to determine the injury characteristics of motorcyclists according to their body mass index (BMI).A retrospective observational cross‐sectional study was conducted using data from the Emergency Department‐based Injury In‐depth Surveillance (EDIIS) registry. Motorcycle riders aged 18 or older who were injured and admitted to study hospitals between 2019 and 2020 were included. Patients were divided into three groups based on BMI cutoffs of 18.5 and 25 kg/m2: the low, optimal, and high BMI groups. The primary outcome was anatomical injury location according to the abbreviated injury scale. The secondary outcomes were the surgery and intensive care unit admission rate, and the 48‐h and 30‐day in‐hospital mortality. Multivariable logistic regression analysis was performed to assess the impact of BMI on outcomes.Among 1280 patients, the low and high BMI groups had higher risk of abdominal injuries (AIS ≥ 2) than the optimal BMI group, with adjusted odds ratios of 2.82 (95% CI 1.41–5.63) and 1.61 (95% CI 1.17–2.21), respectively. Only the low BMI group had a significant association with severe abdominal injury (AIS ≥ 3), with an adjusted odds ratio of 3.11 (95% CI 1.31–7.39). No significant association was found between BMI and surgery, ICU admission, or mortality.The low BMI group was more likely to have an abdominal injury (AIS score ≥2 or AIS score ≥3) during motorcycle injuries. BMI was not associated with surgery, ICU admission, or mortality.","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140230914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new page for the Hong Kong journal of emergency medicine","authors":"K. Hung, Rex Pui Kin Lam, C. Lui","doi":"10.1002/hkj2.12012","DOIUrl":"https://doi.org/10.1002/hkj2.12012","url":null,"abstract":"","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139961146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of joint commission international standard combined with 6S management mode in the management of emergency medical equipment","authors":"Jing He, Yanhong Cang, Chunhong Wei, Hui Wang, Yan Xu, Yan Han","doi":"10.1002/hkj2.12009","DOIUrl":"https://doi.org/10.1002/hkj2.12009","url":null,"abstract":"The medical instruments used in the emergency department have a wide coverage and prominent importance. The study was aimed to observe the effect of joint commission international (JCI) standard combined with 6S management mode in emergency medical equipment.Medical equipment and nursing staff in the emergency department of our hospital were the subjects of the research. We compared the management status (standard placement, good cleaning, good maintenance, complete records) of medical equipment after the application of JCI standard combined with 6S management mode was compared with that before the application. Working time associated with medical equipment, equipment repair ratio, nurses' satisfaction with medical equipment use and management were also compared.After the application of JCI standard combined with 6S management mode, the proportion of instances meeting standards for placement, cleaning, maintenance, and record‐keeping was higher than before the application (p < 0.05), the time of instrument acquisition was significantly lower than before the application (p < 0.001), the proportion of instrument repair was lower than before application (p < 0.05), and the proportion of nurses satisfied with the use and management of the instrument was higher than before (p < 0.05). There was no statistical difference in instrument cleaning time, instrument maintenance time and environmental management time after the application of JCI standard combined with 6S management mode compared with before application (p > 0.05).JCI standard combined with 6S management mode can standardize the use of emergency medical instruments, reduce the risk of instrument damage, increase work efficiency, improve nurses' satisfaction with medical instrument management, and are therefore worthy of clinical application.","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139791511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of joint commission international standard combined with 6S management mode in the management of emergency medical equipment","authors":"Jing He, Yanhong Cang, Chunhong Wei, Hui Wang, Yan Xu, Yan Han","doi":"10.1002/hkj2.12009","DOIUrl":"https://doi.org/10.1002/hkj2.12009","url":null,"abstract":"The medical instruments used in the emergency department have a wide coverage and prominent importance. The study was aimed to observe the effect of joint commission international (JCI) standard combined with 6S management mode in emergency medical equipment.Medical equipment and nursing staff in the emergency department of our hospital were the subjects of the research. We compared the management status (standard placement, good cleaning, good maintenance, complete records) of medical equipment after the application of JCI standard combined with 6S management mode was compared with that before the application. Working time associated with medical equipment, equipment repair ratio, nurses' satisfaction with medical equipment use and management were also compared.After the application of JCI standard combined with 6S management mode, the proportion of instances meeting standards for placement, cleaning, maintenance, and record‐keeping was higher than before the application (p < 0.05), the time of instrument acquisition was significantly lower than before the application (p < 0.001), the proportion of instrument repair was lower than before application (p < 0.05), and the proportion of nurses satisfied with the use and management of the instrument was higher than before (p < 0.05). There was no statistical difference in instrument cleaning time, instrument maintenance time and environmental management time after the application of JCI standard combined with 6S management mode compared with before application (p > 0.05).JCI standard combined with 6S management mode can standardize the use of emergency medical instruments, reduce the risk of instrument damage, increase work efficiency, improve nurses' satisfaction with medical instrument management, and are therefore worthy of clinical application.","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139851061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood pressure immediately after return of spontaneous circulation is associated with increased survival on admission following out‐of‐hospital cardiac arrest","authors":"Seung Wook Kim, Hee Eun Kim, You Hwan Jo, Yu Jin Kim, S. Park, Yong Won Kim, Dong Keon Lee, Dong-Hyun Jang","doi":"10.1002/hkj2.12013","DOIUrl":"https://doi.org/10.1002/hkj2.12013","url":null,"abstract":"In patients with out‐of‐hospital cardiac arrest (OHCA), low blood pressure after return of spontaneous circulation (ROSC) can be a sign of hemodynamic instability. We aimed to investigate whether systolic blood pressure (SBP) measured immediately after ROSC is associated with survival on admission.Patients with ROSC after OHCA between 2015 and 2018 were included. The primary outcome was survival on admission. Included patients were divided into three groups based on the SBP measured at the time of ROSC: group 1 (SBP ≤90 mmHg), group 2 (SBP 90–120 mmHg), and group 3 (SBP >120 mmHg). Multivariable logistic regression was used to investigate the relationship between the groups by SBP and outcomes.In the final analysis, 519 patients were included. In the restrictive cubic spline curve, the probability of achieving survival on admission increased gradually from low SBP to approximately 120–130 mmHg, then plateaued at a higher SBP. In the multivariable logistic regression analysis, group 1 was independently associated with decreased survival on admission compared to group 2. There was no significant difference between groups 2 and 3.Low blood pressure (SBP ≤90 mmHg) at the time of ROSC was independently associated with a lower likelihood of survival on admission in patients with non‐traumatic OHCA. However, high blood pressure (SBP >120 mmHg) was not associated with a higher likelihood of survival. These suggest that low blood pressure measured in the prehospital phase can serve as an indicator predicting the poor short‐term prognosis of patients.","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140464600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"February 2024 global research highlights","authors":"","doi":"10.1002/hkj2.12011","DOIUrl":"https://doi.org/10.1002/hkj2.12011","url":null,"abstract":"","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140465401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burnout in emergency department personnel—A continuing concern post pandemic","authors":"Mei Ling Tan, J. Pek, Shiu Hong Wong","doi":"10.1002/hkj2.12008","DOIUrl":"https://doi.org/10.1002/hkj2.12008","url":null,"abstract":"High incidences of burnout has been reported amongst emergency department (ED) personnel during the COVID‐19 pandemic. Emerging from the pandemic, organisational support for psychological health may dwindle and become secondary to economic priorities. We aimed to ascertain the level of burnout within ED staff at our hospital, identify professional groups, which were more vulnerable and domains, which contributed most towards burnout.We conducted a cross‐sectional study approximately 8 months after major moves to remove COVID‐19 restrictions in Singapore. Data was collected via a self‐administered survey employing the Copenhagen Burnout Inventory (CBI). Demographics, occupational details, work satisfaction and motivation to stay in the job were also collected and analysed.A total of 115 ED staff participated. Overall CBI score was 62.3 ± 22.0. Scores for personal, work‐related and client burnout were 64.9 ± 23.2, 61.6 ± 23.1 and 60.4 ± 26.1, respectively. A total of 44.5% had to take medical leave because of burnout. Nurses had higher overall CBI scores than doctors (67.5 ± 20.5 vs. 54.6 ± 23.0, p = 0.01). Those who were satisfied with their present job had lower overall CBI scores compared to those not satisfied (42.7 ± 17.9 vs. 84.0 ± 14.4, p < 0.001). Overall CBI scores were also lower in those motivated compared with those not motivated to continue in their current job (50.1 ± 16.3 vs. 79.0 ± 15.1, p < 0.001).ED staff continue to record high rates of burnout as we transit out of the pandemic. Accompanying rates of medical leave and low levels of motivation to remain in the job are serious occupational health concerns. Factors contributing to burnout in at risk groups such as nurses should be further analysed. High mean CBI scores in the personal and work domains indicate that related factors contribute most towards burnout and interventions should be focused accordingly.","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139605398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and mortality prediction of patients admitted to the Hong Kong East Cluster intensive care units in the COVID‐19 fifth wave","authors":"MY Man, SM Lam, Syj Yu, Jya Chan, MY Lee, H. Shum, WW Yan","doi":"10.1002/hkj2.12007","DOIUrl":"https://doi.org/10.1002/hkj2.12007","url":null,"abstract":"COVID‐19 has been threatening global public health since 2019. To address the overwhelming caseload, several tools were developed to predict prognosis and aid triage of critically ill patients for intensive care. Currently, there is a lack of local data on the validity of such tools.The objective of this study is to identify the predictors of intensive care unit (ICU) mortality in COVID‐19 patients in Hong Kong and externally validate the different scoring systems.A retrospective cohort analysis of patients admitted to the HKEC ICUs from 1 January 2022 to 30 April 2022 was performed. We collected data on patient demographics, vaccination status, laboratory parameters, and clinical outcomes including need for organ support and mortality. Clinical severities were estimated by Sequential Organ Failure Score, 4C Mortality Score, COVID‐Gram score, and Acute Physiology and Chronic Health Evaluation (APACHE) IV score based on the original studies. Comparison between individual scoring systems' performance on hospital mortality was conducted and summarized.In these four months, 137 patients with COVID‐19 admitted to ICUs of Ruttonjee Hospital and Pamela Youde Nethersole Eastern Hospital were recruited. 64 patients (46.7%) were admitted for COVID‐19 related respiratory failure, among which mortality was 66.7%. The overall hospital and ICU mortality were 21.9% and 13.1%, respectively. Invasive mechanical ventilation (IMV) (OR 3.221, p 0.034), high flow nasal cannula (HFNC) oxygen therapy (OR 3.107, p 0.039), and higher APACHE IV score (OR 1.043, p < 0.001) were independent predictors of hospital mortality using multivariate analysis. The scoring systems had good performance in mortality prediction in our population. The APACHE IV score (AUROC 0.79, 95% CI 0.698–0.894) and 4C Mortality Score (AUROC 0.751, 95% CI 0.657–0.844) outperformed other scoring systems in predicting hospital mortality.In patients with COVID‐19, the use of IMV or HFNC and APACHE IV score were independent risk factors for hospital mortality. The APACHE IV and the 4C Mortality Score were most useful in our population for predicting ICU and hospital mortality.","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139624278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HKJEM November 2023 Reciprocal Abstracts","authors":"","doi":"10.1177/10249079231202132","DOIUrl":"https://doi.org/10.1177/10249079231202132","url":null,"abstract":"Free accessAbstractFirst published online October 9, 2023HKJEM November 2023 Reciprocal AbstractsOnlineFirsthttps://doi.org/10.1177/10249079231202132","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135095532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}