Hong Kong Journal of Emergency Medicine最新文献

{"title":"Reciprocal Abstracts July 2023","authors":"Tomoyoshi Tamura, Akina, Haiden, Jo Yoshizawa, Takashi Tagami, N. Glaser, Leah, Tzimenatos, Michael J. Stoner, Kathleen M. Brown, J. Mcmanemy, J. Schunk, A. Rewers, Jonathan E. Bennett","doi":"10.1177/10249079231178409","DOIUrl":"https://doi.org/10.1177/10249079231178409","url":null,"abstract":"Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). African Journal of Emergency Medicine","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":"30 1","pages":"261 - 265"},"PeriodicalIF":0.6,"publicationDate":"2023-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46402219","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":"External validation of the Oakland score to assess safe hospital discharge among adult patients with acute lower gastrointestinal bleeding in an accident and emergency department in Hong Kong","authors":"Ho Yin Fong","doi":"10.1177/10249079231175434","DOIUrl":"https://doi.org/10.1177/10249079231175434","url":null,"abstract":"To externally validate the use of the Oakland score in identification of low-risk lower gastrointestinal bleeding patients who can be safely managed without hospitalisation in an accident and emergency department in Hong Kong. This single-centre retrospective cohort study included adult patients who attended the accident and emergency department for lower gastrointestinal bleeding and were subsequently admitted to hospital from 1 January 2020 to 31 December 2020. Safe discharge was defined as absence of all of the following adverse outcomes after hospital presentation: blood transfusion; therapeutic colonoscopy, mesenteric embolisation, or laparotomy for bleeding; in-hospital death (all causes); and readmission with subsequent lower gastrointestinal bleeding within 28 days. The sensitivities, specificities and area under the receiver-operating characteristic curve of the Oakland score were calculated. Among 376 patients who were included in this study, 114 (30.3%) of them experienced one or more adverse outcomes. The area under the receiver-operating characteristic curve for safe discharge was 0.88 (95% confidence interval, 0.84–0.91). Using an Oakland score threshold of ⩽8 points as in the original derivation study can achieve 100% sensitivity (95% confidence interval, 96.8%–100%) and 7.3% specificity (95% confidence interval, 4.4%–11.1%) for safe discharge. When the Oakland score threshold was extended to ⩽11 points, a much greater proportion of low-risk patients could be identified, with 97.4% sensitivity (95% confidence interval, 92.5%–99.5%) and 32.8% specificity (95% confidence interval, 27.2%–38.9%) for safe discharge. The Oakland score performed well in identification of lower gastrointestinal bleeding patients who were at low risk of experiencing adverse outcomes and could thus be safely managed without hospitalisation. Extension of the Oakland score threshold to ⩽11 points can allow identification of a greater proportion of low-risk patients while sensitivity is reasonably maintained.","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44281247","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":"Trauma patient management: Evolution and challenges","authors":"K. Lee, Chi-wai Chau","doi":"10.1177/10249079231174868","DOIUrl":"https://doi.org/10.1177/10249079231174868","url":null,"abstract":"Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). In the past 3 years, the COVID-19 pandemic has influenced every corner of the world and every aspect of patient treatment and management. The care of trauma patients was undoubtedly affected as it was one of the most frequently encountered and important conditions. Globally, researchers have examined the impact of COVID-19 on trauma patient care, trauma networks, and how the system evolved after the pandemic. Even during the crisis, efforts have ceaselessly been put in to discover new evidence, techniques, and devices for better trauma patient management. Researchers and studies of the current issue have also highlighted and addressed a few crucial areas. Sephton et al.1 conducted a study focused on the mechanism and diagnoses of injuries in a major trauma network in the United Kingdom during the lockdown in early 2020. They found a dramatic reduction in all emergency orthopedic referrals and the total number of operations performed. A similar phenomenon was observed in a city in China by Yang and Lu2; there was a reduction in the volume of trauma patients throughout the trauma system. Wickramarachchi et al.3 reported a setting with a dual site for delivering COVID19-free trauma service and retaining the COVID-19 trauma service separately. The mode produced a significant gain in medical bed capacity, with 100% of the trauma patients under the care and emergency operations not having developed COVID-19. Hong Kong has also used a similar system in some clusters. COVID-19 and non–COVID-19-related cases, including trauma patients, were bundled to be managed in different hospitals. Experience gained during COVID-19 for managing trauma patients and networking during the pandemic is invaluable. In the past years, there has been increasing awareness of the important role of metabolic derangements in traumarelated morbidities and mortality. Coagulopathy, hypothermia, and acidosis have been quoted as the “lethal triad” in trauma. Trauma-induced coagulopathy (TIC) is one of the most critical factors contributing to poor outcomes. TIC is present in approximately 24%–34% of hospitalized patients with trauma.4,5 Maegele6 addressed that advances and modern coagulopathy management emphasize goal-oriented and individualized care, which are guided by point-of-care viscoelastic assays. Early identification followed by aggressive management is of utmost importance.6 Evidence and recommendations are established to guide the use of various treatment options for TIC, which include tranexamic acid, fresh-frozen plasma, cryoprecipi","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":"30 1","pages":"201 - 202"},"PeriodicalIF":0.6,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48009671","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":"Knowledge and training preference of standard first aid among undergraduates in Hong Kong: A cross-sectional survey","authors":"Sze Nok Ng, Lok Kan Tang, Chi Kei Leung, Chung Yi Cheng, Mei Shan Cheung, Yuet Yee Lam, Leong Ching Yeung, Yung Ting Tse, Wing Han Tai, P. Chau","doi":"10.1177/10249079211050148","DOIUrl":"https://doi.org/10.1177/10249079211050148","url":null,"abstract":"Introduction: The study aimed to assess the level of standard first aid knowledge among Hong Kong undergraduates and identify the associated factors, and to examine their attitudes, training preferences and obstacles in first aid training. Methods: This cross-sectional study employed a structured online questionnaire covering demographic data, first aid knowledge assessment and attitude evaluation. Participants were recruited by convenience sampling from August to October 2020. Inclusion criteria included full-time undergraduates studying for the first degree in Hong Kong and receiving primary and secondary education in Hong Kong. To contrast undergraduates studying medical and non-medical degrees, a set ratio of 1:1 was employed, and estimated proportions were weighted according to the ratio of medical and non-medical undergraduates in the population. Unweighted data were used in logistic regressions. Results: Among 385 respondents, the weighted proportion of good knowledge of standard first aid was 15.2% (95% confidence interval (CI): 11.6%–18.8%) and that of good attitudes towards standard first aid was 71.3% (95% CI: 66.8%–75.8%). Holding valid or expired standard first aid certificates (valid: odds ratio (OR) = 9.897, p < 0.001; expired: OR = 4.816, p < 0.001) and studying medical-related degrees (OR = 3.693, p < 0.001) were shown by multiple logistic regression to be associated with good knowledge of standard first aid. Only being a current or past member of first aid cadet teams was associated with a greater likelihood of having good attitudes towards first aid (OR = 2.336, p = 0.047). Respondents proposed standard first aid training should take form of credit-bearing or non-credit-bearing courses in university curriculum, and academic workload should be taken into account when designing training schemes. Conclusion: The proportion of undergraduates in Hong Kong with good first aid knowledge was unsatisfactory, but the counterpart with a good attitude was encouraging. Standard first aid training should be proactively provided to all the local undergraduates, regardless of their enrollment in medical- or non-medical-related degrees.","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":"30 1","pages":"172 - 178"},"PeriodicalIF":0.6,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44097393","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":"Reciprocal Abstracts HKJEM May 2023","authors":"","doi":"10.1177/10249079231166211","DOIUrl":"https://doi.org/10.1177/10249079231166211","url":null,"abstract":"","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":"30 1","pages":"196 - 198"},"PeriodicalIF":0.6,"publicationDate":"2023-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44824901","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":"Comparison of distance education and in-person education in procedural sedation and analgesia: A randomized controlled trial","authors":"Shinya Takeuchi, T. Norii, Marisa Rivera, Y. Homma","doi":"10.1177/10249079231166331","DOIUrl":"https://doi.org/10.1177/10249079231166331","url":null,"abstract":"Despite the increasing demand for procedural sedation and analgesia training, the number of available instructors remains limited. The aim of this study is to compare distance education with in-person learning for knowledge acquisition and participant satisfaction in procedural sedation and analgesia education. We conducted a randomized controlled trial comparing distance education with in-person learning in Japan on three occasions. Twenty participants per course were randomly divided into five groups with stratification by year of graduation. The groups were randomized to either a distance education group or an in-person group. We conducted pre- and post-testing of procedural sedation and analgesia knowledge and surveyed participants’ perceptions by using a scale ranging from 0 (not enough) to 100 (enough). Our primary outcomes were knowledge acquisition and the quality of discussion. We included 48 healthcare professionals in the analysis. Forty-one participants (83.6%) were men and the median years of experience was 5 (interquartile range: 3–9). Both groups had similar knowledge acquisition with the pre-test and post-test score difference and reported similar scores on the quality of discussion with the exception of the clarity of audio quality (93 vs 100, p = 0.017). In a randomized trial of distance versus in-person learning for the sedation course, we did not observe statistically significant differences in knowledge acquisition and participant satisfaction between the two groups except for audio quality for the case discussion. Further efforts to improve quality for distance learning in procedural sedation and analgesia education are needed.","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43806549","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":"Resuscitation: Bread and butter in emergency medicine","authors":"R.K.M. Cheung, R. Cocks","doi":"10.1177/10249079231165947","DOIUrl":"https://doi.org/10.1177/10249079231165947","url":null,"abstract":"","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":"30 1","pages":"137 - 138"},"PeriodicalIF":0.6,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65716880","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":"Reciprocal Abstracts September 2023","authors":"L. Westafer, Erica Jessen, Michael Zampi, E. Boccio, S. D. Casey, P. Lindenauer, D. Vinson","doi":"10.1177/10249079231191866","DOIUrl":"https://doi.org/10.1177/10249079231191866","url":null,"abstract":"STUDY OBJECTIVE\u0000Although recommended by professional society guidelines, outpatient management of low-risk pulmonary embolism (PE) from emergency departments (EDs) in the US remains uncommon. The objective of this study was to identify barriers and facilitators to the outpatient management of PE from the ED using implementation science methodology.\u0000\u0000\u0000METHODS\u0000We conducted semistructured interviews with a purposeful sample of emergency physicians using maximum variation sampling, aiming to recruit physicians with diverse practice patterns regarding the management of low-risk PE. We developed an interview guide using the implementation science frameworks-the Consolidated Framework for Implementation Research and the Theoretical Domains Framework. Interviews were recorded, transcribed, and analyzed in an iterative process.\u0000\u0000\u0000RESULTS\u0000We interviewed 26 emergency physicians from 11 hospital systems, and the participants were diverse with regard to years in practice, practice setting, and engagement with outpatient management of PE. Although outer setting determinants, such as medicolegal climate, follow-up, and insurance status were universal, our participants revealed that the importance of these determinants were moderated by individual-level and inner setting determinants. Prominent themes included belief in consequences, belief in capabilities, and institutional support and culture. Inertia of clinical practice and complexity of the process were important subthemes.\u0000\u0000\u0000CONCLUSION\u0000In this qualitative study, clinicians reported common barriers and facilitators that initially focused on outer setting and external barriers but centered on clinician beliefs, fear, and local culture. Efforts to increase outpatient treatment of select patients with acute PE should be informed by these barriers and facilitators, which are aligned with the deimplementation theory.","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":"30 1","pages":"326 - 328"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49503562","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":"Hong Kong poison information centre: Annual report 2020","authors":"T. Chow, C. Chan, Sze Hong Ng, M. Tse","doi":"10.1177/10249079221127611","DOIUrl":"https://doi.org/10.1177/10249079221127611","url":null,"abstract":"Background: The Hong Kong Poison Information Centre has provided consultation service to healthcare professionals and collected epidemiological data on poisoning in Hong Kong since 2005. Objective: To analyse and report the poisoning data of Hong Kong Poison Information Centre in 2020 during the COVID-19 pandemic. Methods: A retrospective review of all poisoning cases recorded in the Poison Information and Clinical Management System of Hong Kong Poison Information Centre in 2020. Results: A total of 3633 poisoning cases were analysed. Compared to 2019 (pre-COVID era), there was a reduction of ~10% of total poisoning cases recorded (383 cases), with a majority (> 90%) of reduction from poisoning cases with no clinical effect (353 cases). A greater proportion of reduction was observed among the children (0–12 years), patients with general unintentional poisoning, poisoning due to therapeutic error and food poisoning. An increased number of cases was noted from abusive use, adverse herb/proprietary Chinese medicine reaction and poisoning related to household bleaches. Teenage (13–19 years) poisoning seemed to be unaffected by the COVID-19 pandemic and the previously observed increasing trend continued (up to 11.8% of total poisoning cases this year). Despite a total reduction in poisoning cases recorded, the number of deaths increased by 37% from 35 in 2019 to 48 in 2020 (mortality rate 1.5%). A total of seven interesting cases were discussed. Conclusion: This 15th annual report provides updated epidemiological information on poisoning patterns in Hong Kong during the COVID-19 pandemic. It also highlighted important changes and possible effects of the COVID-19 pandemic on poisoning in Hong Kong in comparison with our previous reports.","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":"30 1","pages":"117 - 130"},"PeriodicalIF":0.6,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42343059","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":"Reciprocal Abstracts March 2023","authors":"","doi":"10.1177/10249079231152382","DOIUrl":"https://doi.org/10.1177/10249079231152382","url":null,"abstract":"","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":"30 1","pages":"131 - 133"},"PeriodicalIF":0.6,"publicationDate":"2023-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45546960","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}