N. Capsoni, D. Privitera, C. Airoldi, S. Gheda, A. Mazzone, Gianluca Terranova, Filippo Galbiati, A. Bellone
{"title":"Evaluation of PaCO2 trend in COVID-19 patients undergoing helmet CPAP in the emergency department","authors":"N. Capsoni, D. Privitera, C. Airoldi, S. Gheda, A. Mazzone, Gianluca Terranova, Filippo Galbiati, A. Bellone","doi":"10.4081/ecj.2023.11274","DOIUrl":"https://doi.org/10.4081/ecj.2023.11274","url":null,"abstract":"The use of continuous positive airway pressure (CPAP) in COVID-19 hypoxemic respiratory failure (h-ARF) under a strict protocol has been described to be highly efficient. However, early prediction of failure is crucial to avoid delayed intubation. Lower PaCO2 values may represent a higher inspiratory effort and, therefore, may help identify patients at greatest risk of CPAP failure. Aim of this study was to observe the PaCO2 trend of COVID-19 patients with h-ARF before and after the initial treatment with helmet-CPAP. A case series study was conducted from November 2020 to March 2021. All adult patients with h-ARF secondary to COVID-19 treated with helmet-CPAP and eligible for endotracheal intubation were observed. Of a total of 54 patients, 32 (59.3%) underwent intubation. Seven (12.9%) patients died in the ETI group, and none in the non-ETI group. Median PaO2/FiO2 ratio on admission was 91mmHg [IQR 68-185] vs. 104mmHg [IQR 85-215] (p=0.137) in the ETI e non-ETI group, respectively. No differences were found either for PaCO2 values on admission (31.5mmHg [IQR 27-35] vs. 29.3mmHg [IQR 27.7-40]) and for PaCO2 variations after 120 minutes of CPAP (+2.38mmHg ± 3.65 vs. +2.73mmHg ± 3.96). Changes in PaCO2 values were observed during an initial helmet-CPAP trial, but no differences were found in those undergoing endotracheal intubation as compared to the others.","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70156937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sri Winarni, Ignata Yuliati, Elisabet Setyaningrum Kiswantari
{"title":"Tekanan Parsial Oksigen (PO2) Pasien Pneumonia Covid-19 dengan Komorbid dan tanpa Komorbid","authors":"Sri Winarni, Ignata Yuliati, Elisabet Setyaningrum Kiswantari","doi":"10.35584/carejournal.v2i2.136","DOIUrl":"https://doi.org/10.35584/carejournal.v2i2.136","url":null,"abstract":"Covid-19 disebabkan oleh virus yang pada umumnya menyerang sistem saluran pernapasan sehingga menghambat proses pertukaran gas di alveoli yang mengakibatkan tekanan parsial O2 menurun. Nilai tekanan parsial O2 pasien pneumonia Covid-19 harus dipantau ketat, melalui pemeriksaan analisa gas darah, HB, pemeriksaan D. Dimer. Tujuan penelitian ini adalah mengidentifikasi ilai tekanan parsial oksigen darah arteri (PO2) pada pasien Pneumonia Covid-19 yang belum memakai alat bantu nafas mekanik yang memiliki komorbid dan tanpa komorbid. Desain penelitian yang digunakan adalah deskriptif dengan polpulasi seluruh pasien pneumonia covid-19 di ruang isolasi RS swasta di Surabaya yang sesuai dengan kriteria inklusi. Penelitian ini menggunakan tehnik Non Probability Sampling dengan menarik semua anggota populasi untuk dijadikan sampel yaitu 141 responden. Data dikumpulkan melalui observasi dokumen rekam medis pasien, didapatkan 141 responden, 59,6% respnden mengalami pneumonia covid 19 dengan komorbid, dan 40,4% mengalami peneumonia covid 19 tanpa komorbid. Berdasarkan penelitian ini dapat disimpulkan bahwa nilai tekanan parsial oksigen pada pasien pneumonia covid-19 dapat dipengaruhi oleh beberapa faktor. Hasil penelitian ini dapat dijadikan masukan bagi manajemen Rumah sakit sebagai salah satu acuan untuk membuat pedoman dan sebagai upaya preventif pencegahan gagal napas pada pasien pneumonia covid-19 harus dilakukan pemeriksaan analisa gas darah, HB, D.dimer sehingga pasien dapat segera mendapatkan penanganan yang tepat.","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":"57 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87823630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nafis Vural, Murat Duyan, Ali Sarıdaş, E. Ertaş, A. Kalkan
{"title":"The predictive value of inflammatory biomarkers in the detection of multiple sclerosis attacks","authors":"Nafis Vural, Murat Duyan, Ali Sarıdaş, E. Ertaş, A. Kalkan","doi":"10.4081/ecj.2023.11314","DOIUrl":"https://doi.org/10.4081/ecj.2023.11314","url":null,"abstract":"Multiple sclerosis (MS) is the most prevalent immune-mediated inflammatory demyelinating central nervous system disorder, with a diverse set of clinical signs and symptoms. This study aimed to investigate the diagnostic values of the monocyte/lymphocyte ratio (MLR), red cell distribution width/lymphocyte ratio (RLR), and systemic immune-inflammation index (SII) in detecting multiple sclerosis attacks in patients with Relapsing-remitting MS (RRMS) presenting to the emergency department (ED). This retrospective observational study was conducted among patients with RRMS presenting to the ED of a third-level hospital. The laboratory parameters of 165 patients were compared during the attack and non-attack periods. The paired t-test statistic was used to compare means of inflammatory biomarker measurements between attack and non-attack groups. The neutrophil/lymphocyte ratio (NLR), MLR, RLR, and SII mean of the patients in the MS attack periods were higher than those in the non-attack period. The mean difference of NLR, MLR, RLR, and SII between both groups was 5.40±7.25, 0.37±0.43, 7.77±11.61, 1469.19±1978.88, respectively (p<0.001). In ROC analysis, NLR, RLR, MLR, and SII had excellent diagnostic power in detecting MS relapse (AUC: 0.87, 0.81, 0.86, and 0.87, respectively). According to our findings, SII, MLR, NLR, and RLR may be beneficial in confirming the diagnosis of attack in patients with RRMS.","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46584623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A narrative review on palliative care in the emergency department: dealing with the uncertainty of death","authors":"L. Porta, Eugenia Mauri","doi":"10.4081/ecj.2023.11308","DOIUrl":"https://doi.org/10.4081/ecj.2023.11308","url":null,"abstract":"In the last decades emergency physicians have observed a steep increase in the emergency department (ED) admissions of palliative care patients who rely on the hospital for symptoms’ relief and management of acute exacerbations of their chronic disease. Previous studies have suggested that palliative care interventions in the ED could prevent unnecessary admissions and reduce both the length of hospitalization and costs. However, emergency medicine physicians might have limited specialistic education and resources to provide a correct management of palliative care patients and avoid futile interventions. Thus, we aim in this narrative review to provide the reader with an introduction on the principles that should guide the emergency physician in a correct approach to palliative care patients in the ED. We will explain how to deal with the intrinsic prognostic uncertainty of palliative care patients by implementing a correct ethical approach which encompasses the understanding of both appropriateness and futility of intervention; furthermore, we will present practical tools such as scores and trials.","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48504615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sun, alcohol, and skin lesions","authors":"Erika Poggiali, A. Vercelli","doi":"10.4081/ecj.2023.11294","DOIUrl":"https://doi.org/10.4081/ecj.2023.11294","url":null,"abstract":"A 65-year-old man presented to the emergency room with blistered not itching skin lesions on the dorsal surface of both hands, which developed recurrently after exposure to sun and solved spontaneously with scarring. The patient had a history of hypertension, diabetes mellitus type 2 and hypercholesterolemia. His medications included ramipril, metformin, simvastatin, and acetylsalicylic acid. He denied smoke, but he used to consume a large amount of alcohol (1 Lt of red wine daily). His body mass index was 29 (overweight). Blood exams revealed: altered glucose metabolism (fasting and post-prandial blood glucose, respectively 172 mg/dL and 267 mg/dL), macrocytosis (mean cell volume 100.6 fL), increased transaminases (AST 62 U/L and ALT 79 U/L, normal value 10-37) and gamma-glutamyl transferase (GGT 255 U/L, normal value 7-40), and an iron assessment as follows: serum ferritin 2234 ng/mL, transferrin saturation 40%, serum iron 138 mcg/dL. Hepatitis C, hepatitis B, and HIV were excluded. Autoimmune screening was negative. Point of care ultrasound documented a grade 3 liver steatosis.","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43388720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prashin Rostami Zolghadri, J. García Cañete, Bernadette Pfang, Juan Carlos Hernández Clemente
{"title":"The importance of concord between nations for scientific progress in cardiopulmonary resuscitation. A literature review","authors":"Prashin Rostami Zolghadri, J. García Cañete, Bernadette Pfang, Juan Carlos Hernández Clemente","doi":"10.4081/ecj.2023.11317","DOIUrl":"https://doi.org/10.4081/ecj.2023.11317","url":null,"abstract":"Conflict between nations harms, not only its direct victims, but often the next generations. History teaches us that concord and international cooperation favors the progress of science, especially medicine, while wars and violence provoked by different religious, ideological, political, and sociocultural contexts hinder scientific research, to the detriment of humanity. The objective of this article is to recall some notable figures in the history of cardiopulmonary resuscitation (CPR), focusing on the negative consequences of ideological persecution for the science of CPR.","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42319484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hubungan Pengetahuan Keluarga tentang Tanaman Obat Keluarga Daun Mimba untuk Diabetes Mellitus dengan Perilaku Penggunaan Daun Mimba sebagai Pengobatan","authors":"Anis Murniati, Angga Miftakhul Nizar, Evi Tunjung Fitriani, Indah Rohmawati, Ratna Kholidati","doi":"10.35584/carejournal.v2i2.137","DOIUrl":"https://doi.org/10.35584/carejournal.v2i2.137","url":null,"abstract":"Tanaman Obat Keluarga (TOGA) merupakan tanaman yang ditanam di rumah dengan khasiat obat. TOGA tersebut pada dasarnya adalah tanaman yang ditanam di pekarangan sekitar rumah dan dapat digunakan sebagai tanaman obat. Tidak jarang TOGA hanya berfungsi sebagai tanaman hias saja tanpa dimanfaatkan sebagai tanaman obat. Hal tersebut terjadi karena berbagai alasan diantaranya takut mengkonsumsi atau kurang mengetahui khasiat dari toga yang ada salah satunya tentang khasiat beberapa TOGA yang dapat digunakan sebagai obat diabetes mellitus (DM) yaitu daun mimba. Oleh karena itu peneliti tertarik meneliti tentang pengetahuan keluarga tentang manfaat TOGA daun mimba yang berkhasiat untuk DM dengan perilaku dalam pemanfaatan TOGA daun mimba sebagai obat. Desain penelitian menggunakan cross sectional. Sampel penelitian adalah anggota keluarga yang berperan aktif dalam memberikan perawatan sehari-hari pada keluarganya yang memiliki DM berjumlah 42 responden. Teknik yang digunakan adalah purposive Sampling. Analisa data menggunakan SPSS dengan spearman correlation. Hasil penelitian dari 42 responden, sebagian besar mempunyai pengetahuan kurang yaitu sebanyak 27 responden (64%) dan sebagian besar dari responden tidak memanfaatkan TOGA untuk pengobatan yaitu sebanyak 24 responden (57%).. Hasil SPSS didapatkan P = 0,000 dan <; α = 0,05 menunjukkan bahwa pengetahuan mempengaruhi perilaku keluarga. Sebagai saran untuk meningkatkan perilaku pemanfaatan TOGA daun mimba untuk anggota keluarga dengan DM, maka perlu dilakukan penyuluhan pada masyarakat tentang khasiat dan dosis tepat yang bisa digunakan supaya mendapatkan khasiat yang maksimal","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":"15 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77353622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yitno Yitno, Surtini Surtini, F. Farida, Eny Masruroh
{"title":"Hubungan Self Efficacy dengan Pelaksanaan Asuhan Keperawatan di Ruang Rawat Inap Puskesmas Pagerwojo Kecamatan Pagerwojo Tulungagung","authors":"Yitno Yitno, Surtini Surtini, F. Farida, Eny Masruroh","doi":"10.35584/carejournal.v2i2.138","DOIUrl":"https://doi.org/10.35584/carejournal.v2i2.138","url":null,"abstract":"Asuhan dalam pelayanan keperawatan merupakan bagian dari kegiatan yang harus dikerjakan oleh perawat setelah memberikan tindakan keperawatan kepada pasien yang memuat semua informasi yang dibutuhkan untuk menentukan pengkajian sampai mengevaluasi tindakan keperawatan, yang disusun secara sistematis, valid dan dapat dipertanggung jawabkan secara moral dan hukum. Pelaksanaan asuhan keperawatan tidak hanya bisa dicapai jika perawat mempunyai kemampuan dan motivasi saja, tetapi juga harus memiliki Self Efficacy. Tujuan penelitian ini adalah menganalisis hubungan self efficacy dengan pelaksanaan asuhan keperawatan di ruang rawat inap Puskesmas Pagerwojo Kecamatan Pagerwojo Tulungagung Tahun 2016. Desain penelitian adalah Analitik korelasional dengan metode “Cross Sectional”. Populasi dalam penelitian ini adalah semua perawat yang bekerja di ruang rawat inap Puskesmas Pagerwojo, Kecamatan Pagerwojo. Penelitian ini menggunakan Tehnik Total Sampling dan diuji dengan spearman rhank (rho).Penelitian ini dilakukan di ruang rawat inap Puskesmas Pagerwojo, Kecamatan Pagerwojo Tulungagung pada tanggal 20 April 2016. Hasil penelitian menunjukkan bahwa dari total 20 responden yang bekerja di ruang rawat inap Puskesmas Pagerwojo hampir seluruhnya responden yaitu 17 orang (85%) memiliki self efficacy yang tinggi dan sebagian besar responden yaitu sebanyak 12 (60%) dalam pelaksanaan asuhan keperawatan memiliki kategori yang baik. Hasil analisa dengan menggunakan uji statistik Spearman Rho didapatkan nilai p= 0,020 dimana α = 0,05 atau p<α dengan demikian H0 ditolak dan H1 diterima. Berdasarkan hasil diatas dapat disimpulkan bahwa self efficacy perawat mempunyai pengaruh yang signifikan terhadap pelaksanaan asuhan keperawatan di Puskesmas Pagerwojo. Hal ini membuktikan bahwa salah satu faktor yang mempengaruhi pelaksanaan asuhan keperawatan adalah self efficacy.","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89873383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
La Ode, Abdul F 1a, Mulyadi, Haderiah, Farida, Kata Kunci, Gangguan pendengaran Kebisingan
{"title":"Faktor Risiko Gangguan Pendengaran pada Pekerja PT PLN Punagaya Kabupaten Jeneponto","authors":"La Ode, Abdul F 1a, Mulyadi, Haderiah, Farida, Kata Kunci, Gangguan pendengaran Kebisingan","doi":"10.35584/carejournal.v2i2.133","DOIUrl":"https://doi.org/10.35584/carejournal.v2i2.133","url":null,"abstract":"\u0000 \u0000 \u0000 \u0000Bidang industri selalu diikuti oleh penggunaan peralatan yang modern dan canggih dari penggunaan peralatan tersebut dapat berdampak positif, yaitu mempercepat proses produksi sehingga mempersingkat waktu dalam proses pekerjaan. Gangguan pendengaran atau Noise Induce Hearing Loss merupakan gangguan pendengaran yang timbul akibat paparan bising yang secara berulang dan dalam waktu yang lama bisa menahun setelah bekerja lebih dari 5 tahun. \u0000Penelitian kali ini bertujuan untuk mengetahui faktor resiko gangguan pendengaran pada pekerja PT PLN Persero punagaya yang didasarkan diameter pengukuran kebisingan dan pengukuran pendengaran. Jenis penelitian yang digunakan adalah penelitian analitik menggunakan rancangan penelitian cross sectional. Jumlah sampel dalam penelitian ini adalah 36 pekerja yang dianalisis menggunakan uji statistik berupa uji pearson correlation \u0000Hasil dari penelitian ini menjelaskan bahwa ada hubungan antara intensitas kebisingan dengan gangguan pendengaran pekerja dengan nilai p= 0,000, ada hubungan antara lama kerja responden dengan gangguan pendengaran pada pekerja dengan nilai p= 0,000, ada hubungan antara masa kerja responden dengan gangguan pendengaran pada pekerja dengan nilai p=0,048, ada hubungan antara penggunaan alat pelindung diri dengan gangguan pendengaran pekerja dengan nilai p=0.020. \u0000Berdasarkan hasil tersebut dapat disimpulkan bahwa terdapat hubungan antara kebisingan, lama kerja, masa kerja dan APT dengan gangguan pendengaran. Diharapkan pihak perusahaan mengatur rotasi kerja, memberi selang waktu dan melakukan pembuatan poster sebagai bentuk pengawasan terhadap penggunaan alat pelindung telinga pada pekerja. \u0000 \u0000 \u0000 \u0000","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":"445 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78257599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"CEU 2023 Florence: an appointment with the future of the emergency system","authors":"L. Ghiadoni","doi":"10.4081/ecj.2023.11330","DOIUrl":"https://doi.org/10.4081/ecj.2023.11330","url":null,"abstract":"The Academy of Emergency Medicine and Care is one of the more than 20 scientific societies promoting the 3rd National Congress of Emergency/Urgency (CEU2023), planned in Florence from March 30th to April 1st.1 \u0000This will be a fundamental appointment for update on all clinical and organizing aspects of the Italian emergency system. More that 2500 people will participated to the CEU2023 meeting and courses with the possibility to attend more than 50 sessions with approximately 500 national and international speakers. This organization will ensure elevate quality of updating for specific themes by covering the point of view of hospital and pre-hospital medical doctors and nurses, emergency medicine trainees, but other professionals (drivers, rescuers, technicians, and volunteers). [...]","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49144873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}