急诊医学(英文)最新文献

{"title":"Assessment of Weight and Health in the Emergency Department: A Cross-Sectional Study","authors":"M. Ryan","doi":"10.4236/ojem.2022.102012","DOIUrl":"https://doi.org/10.4236/ojem.2022.102012","url":null,"abstract":"Introduction: The prevalence of obesity and obesity-related diseases contin-ues to rise. A key aspect of prevention and treatment of these disorders re-quires clear communication about weight and health between patients and healthcare providers. Objective: We sought to examine the prevalence rate of obesity and associated comorbid illnesses in an emergency department (ED) population. A second aim was to assess patients’ perceptions of their weight and their overall health. Methods: This is a cross-sectional study performed in an academic tertiary-care center using a representative sample of patients (≥18 yr) who presented to the ED. Pregnant patients, patients who were medically unstable, cognitively impaired or who were unable or unwilling to provide informed consent were excluded. Anthropometric measurements were taken which include BMI (the ratio of a patient’s weight and height expressed as kg/m 2 ) and waist circumference. In addition, the prevalence rates of all enrolled patients who 1) feel their health is affecting their weight and 2) who have had or recall discussions about their health and weight with their provider were examined by using a two-question validated survey. Results: The overall prevalence rate of obesity in this study was 38.6%. Only 71.8% (95% CI, 63.2% - 80.6%) of overweight patients (BMI = 25.0 - 29.9) and 28.4% (95% CI, 21.6% - 35.2%) of obese patients (BMI ≥ 30.0) believe their present weight is damaging to their health. Further, only 15.5% (95% CI, 8.5% - 22.6%) and 59.4% (95% CI, 53% - 67%) of","PeriodicalId":57857,"journal":{"name":"急诊医学(英文)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70627938","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":"Usefulness of Contrast-Enhanced CT on Arrival in Colonic Diverticular Bleeding","authors":"M. Kishimoto, K. Maejima, T. Muroya, K. Kajino, H. Ikegawa, Y. Kuwagata","doi":"10.4236/ojem.2022.103013","DOIUrl":"https://doi.org/10.4236/ojem.2022.103013","url":null,"abstract":"Contrast-enhanced computed tomography (CT) and colonoscopy are very useful for the diagnosis and treatment of colonic diverticular bleeding. However, the timing of CT has been reported in few cases. The aim of this study was to demonstrate the usefulness of contrast-enhanced CT on arrival in colonic diverticular bleeding. We conducted a review of the data of patients that were diagnosed with colonic diverticular bleeding between July 2010 and December 2021. Eighty-two patients (51 males, 31 females, average age 69.1 years) were admitted with diagnosis of colonic diverticular bleeding after under-going contrast-enhanced CT. We retrospectively investigated the relationship between the initial diagnosis by contrast-enhanced CT on arrival at the hospital and the results of endoscopic identification. Contrast-enhanced CT showed extravasation of contrast medium in 30 cases. The time from the onset of bloody stool to the implementation of contrast-enhanced CT was significantly shorter in cases with extravasation images in the CT (average 7.9 hours) than in cases without extravasation images in the CT (average 15.3 hours). The identification rate of diverticular bleeding sites with colonoscopy was significantly higher in cases with extravasation images in the CT (83%) than in cases without extravasation images in the CT (36.5%). The final treatment methods were endoscopic hemostasis in 46 cases, medical treatment alone in 26 cases, transcatheter arterial embolization (TAE) in 8 cases, and surgery in 2 cases. For patients suspected of colonic diverticular bleeding, performing contrast-enhanced CT early and estimating the bleeding site before colonoscopy may lead to the success of endoscopic hemostasis. To identify and treat successfully colonic diverticular bleeding by colonoscopy, the early use of contrast-enhanced CT before colonoscopy is highly recommended.","PeriodicalId":57857,"journal":{"name":"急诊医学(英文)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70627950","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":"Cardiopulmonary Resuscitation Induced Consciousness—A Case Report from United Arab Emirates","authors":"Y. Abboud, Sreya Varanasi","doi":"10.4236/ojem.2022.102007","DOIUrl":"https://doi.org/10.4236/ojem.2022.102007","url":null,"abstract":"","PeriodicalId":57857,"journal":{"name":"急诊医学(英文)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70628206","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":"Upper Extremities Injuries in Children Attending Pediatric Emergency Department-SFH, Riyadh-Saudi","authors":"Elsharif. A. Bazie, T. H. Aldraye, F. M. Alharbi, A. S. Albalawi","doi":"10.4236/ojem.2022.101001","DOIUrl":"https://doi.org/10.4236/ojem.2022.101001","url":null,"abstract":"","PeriodicalId":57857,"journal":{"name":"急诊医学(英文)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70627691","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":"Out of Sight, Out of Mind, Right? Not in COVID-19 Shock or Anaerobic and Exhaustive Shock versus Septic Shock Dilemma That Means to Live or Die. Emergency Attention and a Necessity of Trials","authors":"L. Zanella","doi":"10.4236/ojem.2022.101003","DOIUrl":"https://doi.org/10.4236/ojem.2022.101003","url":null,"abstract":"Background: COVID-19 brought challenges that did not end after a two-year pandemic. From more straightforward changes in habits to studying to understand the enigmatic parasite-host relationship, we can better manage the patient infected with SARS-CoV-2 even with a vaccine full of doubts and antivirals that do not correctly cover the viral period. SARS-CoV-2 brought the chronic inflammation now called “The Long COVID-19 Syndrome” (LCS), something still little talked about, but we already see deaths due to non-identification of this inflammatory syndrome that can lead to shock. Theory: LCS Shock is due to a long period of metabolic stress, reflecting the shift from inflammation to oxidative stress and innate immunity, and does not respond to antimicrobials, as its main component is inflammatory, although there may be conjoined bacterial translocation. Thus, we are losing patients to a new syndrome confused with sepsis and septic shock. While septic shock (SS) responds to antimicrobials, Inflammatory Shock (ISc) does not respond to antimicrobials alone, requiring high doses of corticosteroids. Review: This study shows that we need to differentiate SS and ISC, as the treatment is different. The review shows that Lactate, LDH and the presence of new/recent cardiac changes and bradycardia in the face of a status where there should be tachycardia as the usual response can differ ISC from SS. Maybe the main responsible for high LDH is Warburg Effect. Conclusion: We have a dilemma that requires clinical studies that routinely match high doses of corticosteroids (until there is something better to be done) and bring How to cite this paper: D’Elia Zanella, L.G.F. de A.B. (2022) Out of Sight, Out of Mind, Right? Not in COVID-19 Shock or Anaerobic and Exhaustive Shock versus Septic Shock Dilemma That Means to Live or Die. Emergency Attention and a Necessity of Trials. Open Journal of Emergency Medicine, 10, 19-47. https://doi.org/10.4236/ojem.2022.101003 Received: December 12, 2021 Accepted: February 21, 2022 Published: February 24, 2022 Copyright © 2022 by author(s) and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/","PeriodicalId":57857,"journal":{"name":"急诊医学(英文)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70628128","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 Case of Two Cardiac Arrests in a Pregnant Woman with Severe Covid-19 Pneumonia","authors":"R. Ibadov, H. Alimova, G. Voitova, S. Ibragimov","doi":"10.4236/ojem.2022.104015","DOIUrl":"https://doi.org/10.4236/ojem.2022.104015","url":null,"abstract":"Background: COVID-19 pneumonia increases the risk for pregnant women and the fetuses that often require intensive therapy. In addition to obvious therapeutic targets, ICU staff has to control the psycho-emotional conditions of COVID-19 patients, e.g. intensive care unit syndrome and post-intensive care syndrome. Case presentation: Patient M., Uzbek, 24 years old, gravida 1 (27 weeks) was admitted to the Maternity Department of Zangiota hospital on 19.07.2021 with the diagnosis of extremely severe COVID-19 pneumonia and respiratory failure with psychomotor agitation. On day 4 her general condition deteriorated due to the progression of pneumonia and involvement of abdominal organs associated with 27-week pregnancy. On that day the fetus had no signs of life, and the caesarean delivery was performed; the child was stillborn. For the next two weeks the patient had been in medical coma due to the progression of respiratory and multi-organ failure. The patient had two separate cardiac arrests. Cardio-pulmonary resuscitation was successful. By day 20, the dynamics of her cardiac activity has been completely restored. The brain function restored to 15 on the Glasgow Coma Scale. Conclusion: Special measures of prevention and treatment of multi-organ failure, intensive care unit syndrome and post-intensive care syndrome should be taken in an ICU for pregnant women with COVID-19 pneumonia.","PeriodicalId":57857,"journal":{"name":"急诊医学(英文)","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70628003","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":"Waiting Times and Length of Stay of Trauma Patients in a Botswana Referral Hospital Emergency Department","authors":"Keatlaretse Siamisang, K. Mokute, Bonolo Mhaladi, J. Tlhakanelo","doi":"10.4236/ojem.2022.101005","DOIUrl":"https://doi.org/10.4236/ojem.2022.101005","url":null,"abstract":"Background: Mortality and morbidity due to trauma are a significant public health challenge. There is paucity of data on the waiting times and length of stay (LOS) of trauma patients in emergency departments in Botswana. The aim of this study was to determine the Emergency Department (ED) waiting times and LOS of trauma patients at Princess Marina Hospital in Gaborone, Botswana. Methods: This was a retrospective medical records review of waiting times (time from triage to review by ED medical officer) and LOS (time from triage to disposition from the emergency department). The waiting times for the different assigned acuities were assessed against the South African Triage System (SATS) standards. All trauma patients seen from 19/11/2018 to 18/12/2018 were included in the study. Prolonged length of stay was defined as duration > 6 hours. Categorical data was summarized with frequencies while numeric data was summarized with medians and interquartile ranges. Results: A total of 187 trauma patients’ files were analyzed. Of these, 72 (38.5%) were females. The median waiting time was 3.8 hours and the maximum was 19.2 hours. The median length of stay (LOS) was 8.8 hours with a maximum of 37.2 hours. Only 53 (28.3%) of the participants had a LOS of less than 6 hours. None of the emergent patients were seen immediately. Only 5 (4.0%) of the very urgent patients were seen within the target of 10 minutes. Finally, and investigate possible solutions to this public health challenge.","PeriodicalId":57857,"journal":{"name":"急诊医学(英文)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70628340","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":"Management and Outcome of Acute Subdural Hematoma in Gabriel Touré Hospital","authors":"Y. Sogoba, D. Kanikomo, Quenum Kisito, M. Diallo, B. Dembélé, B. Sogoba, Djènè Kourouma, I. B. Koumaré, S. Diallo, Hamidou Almeimoune, M. Mangane, T. Diop, O. Coulibaly, M. Diarra, M. Dama, O. Diallo, Y. Maiga, D. Diango","doi":"10.4236/ojem.2022.101004","DOIUrl":"https://doi.org/10.4236/ojem.2022.101004","url":null,"abstract":"Background: Traumatic Brain Injury (TBI) is a major health problem worldwide. It is the main cause of trauma mortality. Acute subdural hematoma (ASDH) has a reputation for being the most serious of all posttraumatic head injuries. Its frequency is estimated to be 1% to 5% of all head injuries and 22% of severe head injuries. The aim of this study was to assess the epidemiological, clinical and prognosis aspects of ASDH in our department. Material and Methods: This prospective study, from January to December 2019, included 57 patients admitted to the Gabriel Touré Teaching Hospital for ASDH. Patients underwent detailed clinical and radiological evaluation and ASDH was diagnosed by non-contrast computed tomography (CT) scan. Functional outcome was evaluated 6 months after injury by Glasgow Outcome Scale. Results: During the study period, 662 patients were admitted for TBI including 57 (8.61%) cases of ASDH. The mean age was 34 years with extremes of 2 and 77 years. There was a male predominance with 52 (91.2%). The main cause of trauma was motor vehicle accidents in 38 (66.6%) patients. According to the Glasgow coma scale (GCS), 33 (57.9%) patients were classified mild (Table 2). The thickness of the hematoma was more than 1 cm in 13 (22.8%) patients and less than 1 cm in 44 (77%) patients. Surgical treatment was performed in 13 (22.8%) patients. The outcome was favorable in 30 (52.6%) patients and the mortality rate was 33.3%. Conclusion: ASDH reHow to cite this paper: Sogoba, Y., Kanikomo, D., Kisito, Q.K.J.M., Diallo, M., Dembélé, B., Sogoba, B., Kourouma, D., Koumaré, I.B., Diallo, S.H., Almeimoune, H., Mangané, M., Diop, T.M., Coulibaly, O., Diarra, M.S., Dama, M., Diallo, O., Maiga, Y. and Diango, D.M. (2022) Management and Outcome of Acute Subdural Hematoma in Gabriel Touré Hospital. Open Journal of Emergency Medicine, 10, 48-53. https://doi.org/10.4236/ojem.2022.101004 Received: February 4, 2022 Accepted: March 15, 2022 Published: March 18, 2022 Copyright © 2022 by author(s) and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/ Open Access","PeriodicalId":57857,"journal":{"name":"急诊医学(英文)","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70628324","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":"The Professional Profile and the Physical Therapy Service in the Emergency Units in the State of São Paulo","authors":"Mariel Patricio Oliveira Junior, C. C. Silva, Sabrina M. Cunha, A. Cruz, Paulo E. J. Campos, G. Maia, L. Azeredo, M. V. M. Pinto, Eliza Macedo","doi":"10.4236/ojem.2021.94015","DOIUrl":"https://doi.org/10.4236/ojem.2021.94015","url":null,"abstract":"The emergency room is the entrance door of hospitals for patients who are in risk of life, and the role of the physiotherapist in this area is recognized as a qualified member of the team, helping to reduce the rate and time of orotracheal intubation, judicious use of invasive mechanical ventilation (MV) and non-invasive ventilation (NIV). The objective was to know the profile and performance of physical therapists in the emergency departments of hospitals in the state of Sao Paulo. Conducted through a semi-structured questionnaire covering personal and professional aspects, and analyzed and described in percentage form. Thirty-six questionnaires were analyzed, and it was observed that 92% provide emergency care, but only 25% work exclusively. Among the main reasons for admission to this sector are: acute respiratory failure (44%) and decreased level of consciousness (36.1%). Regarding the physiotherapeutic resources used in the emergency department, 97.2% make use of NIV, followed by monitoring of MV parameters (94.4%) and modification of parameters (94.4%). We also found that the average time of MV in this sector is 3 to 21 days (50%), and that 33% believe there is delay between indication and installation of NIV. The physiotherapist has much to contribute in emergency units, however, he must be trained through the search for technical and scientific knowledge, thus contributing to the consolidation of this area of expertise.","PeriodicalId":57857,"journal":{"name":"急诊医学(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45967299","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":"Improved Resuscitation Method for Choking Victims","authors":"P. Raghuprasad","doi":"10.4236/ojem.2021.94014","DOIUrl":"https://doi.org/10.4236/ojem.2021.94014","url":null,"abstract":"Abdominal thrust, popularized by Henry Heimlich in 1975 is the standard resuscitation method for victims of choking. When properly applied, this procedure can and has saved many lives over the years, but the process itself is somewhat difficult to perform. The main reason for this difficulty is the need to reach around the trunk of the victim and then apply sufficient force to generate enough pressure upwards to the diaphragm, to be able to dislodge the food bolus (or foreign body) out of the larynx. This is compounded by the size of the average American, especially when they are overweight or obese, thus the ability to reach the front of the abdomen and then the prospect of actually trying to lift the victim up through brute force is a challenge for most people. Some difficulties are inherent in the emotionally charged and panicky situations in which such resuscitation measures take place. Some scientists have advocated the use of mechanical devices to apply thrust to the abdomen. However, the lack of availability of such assisting devices at home and even in restaurants is a distinct issue. Damage to the xiphisternum or internal organs by excessive force is also an issue, so much so, most authorities recommend a post-resuscitation check up of all victims at a hospital or clinic. The procedure(s) described in this report is much simpler in execution, while being almost effortless, and applicable to victims of any size. It also exploits the objects that are likely to be present where such choking accidents occur, the restaurants and dining rooms, while also taking advantage of the earth’s gravity to dislodge the offending food bolus. If such objects are not available, an alternate method using the rescuer’s free forearm to support the victim’s weight, while keeping him/her folded over is also described.","PeriodicalId":57857,"journal":{"name":"急诊医学(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48995092","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}