Acute Medicine & Surgery最新文献

{"title":"Positive emotions for promoting quality improvement of extracorporeal membrane oxygenation therapy for COVID-19: In situ interprofessional simulation","authors":"Osamu Nomura,&nbsp;Arisa Aoyagi,&nbsp;Jin Irie,&nbsp;Takeshi Goto,&nbsp;Kana Sugiyama,&nbsp;Hiroyuki Hanada,&nbsp;Yoshiya Ishizawa","doi":"10.1002/ams2.70002","DOIUrl":"https://doi.org/10.1002/ams2.70002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The requirement during the COVID-19 pandemic to provide extracorporeal membrane oxygenation (ECMO) treatment regardless of experience caused high levels of anxiety among healthcare professionals. The aim of the present study was to evaluate the effectiveness of an in situ interprofessional simulation training conducted to improve readiness and preparedness for ECMO management of patients with COVID-19 at a non-high-volume ECMO centre.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Three emergency physicians, three clinical engineers and two nurses attended the 3-h simulation held at Hirosaki University Hospital in December 2021, during the COVID-19 pandemic. The training comprised a 30-min briefing, a 1-h ECMO circuit change session, a 1-h in-hospital transfer simulation for CT and a 30-min debriefing. Before and after the training, participants completed an online survey of their emotions, based on the Japanese version of the Medical Emotion Scale (J-MES). Related-samples Wilcoxon signed rank test was used to assess potential changes in emotional responses before and after the simulation, and <i>p</i> &lt; 0.05 was considered to indicate significance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants' positive deactivating emotions increased from a median of 3.3 (range, 2.0–4.5) before the simulation to 4.0 (range, 2.5–5.0) after the simulation (<i>p</i> = 0.02), which indicates favourable performance according to the control value theory of educational psychology. There was no statistically significant change in other emotional categories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Participants' positive deactivating emotions increased significantly following an in situ ECMO simulation training, which indicates the efficacy of the training for improving the quality of ECMO management in patients with COVID-19.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"11 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.70002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142045336","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}

{"title":"Clinical features and risk factors for delayed rupture of traumatic cerebral aneurysm: A case series","authors":"Masataka Sugii,&nbsp;Kazuhiro Okada,&nbsp;Shimpei Ikeda,&nbsp;Yoshiaki Hara,&nbsp;Shoji Yokobori","doi":"10.1002/ams2.70000","DOIUrl":"10.1002/ams2.70000","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Traumatic cerebral aneurysms (TA) are a subset of traumatic cerebrovascular injury (TCVI). Misdiagnosis of TA can be fatal. To investigate factors that predict TA formation and the optimal timing for searching, we present four suspected cases of delayed TA rupture during hospitalization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>Medical records of head injury cases to have delayed TA rupture during hospitalization between April 2021 and March 2022 were retrospectively reviewed. Of the four patients included, only one met the TCVI screening criteria. All the patients had acute subdural hematoma (ASDH) on arrival; two had delayed expansion of the traumatic subarachnoid hemorrhage (tSAH) on repeat imaging. All the patients received anticoagulants. Ruptured TA occurred between days 5 and 11. Three patients died during hospitalization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>It is advisable to suspect TA when imaging studies show ASDH on admission and intracranial hematoma expansion during hospitalization. We suggest TA screening around day 5.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"11 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11339465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142034944","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}

{"title":"Interaction of a caffeine overdose with clinical doses of contraceptive ethinyl estradiol in a young woman","authors":"Koichiro Adachi,&nbsp;Maki Murata,&nbsp;Akiyoshi Inada,&nbsp;Takeyori Morimoto,&nbsp;Makiko Shimizu,&nbsp;Satoru Beppu,&nbsp;Hiroshi Yamazaki","doi":"10.1002/ams2.985","DOIUrl":"https://doi.org/10.1002/ams2.985","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The overdose of caffeine, a cytochrome P450 1A2 probe, in young women has become a problem. The aim of this study was to evaluate possible drug interactions between intentionally overdosed caffeine (12 g) and oral contraceptive doses of ethinyl estradiol prescribed to a young woman in a suicide attempt.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The serum concentrations of caffeine in the patient and the time-dependent ethinyl estradiol inhibition of caffeine oxidation in vitro were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The serum concentration of caffeine 4 h after overdose was 136 μg/mL; from the data obtained between 4 and 28 h after overdose, the half-life was estimated to be 33 h, which is many times larger than the normal value. Prescribed ethinyl estradiol prolonged caffeine elimination in vivo and inhibited paraxanthine formation, as evidenced by the low serum concentrations. In human liver microsomes, ethinyl estradiol (50 nM) inhibited half of caffeine <i>N</i>_<i>3</i>-demethylation. Pre-incubation of human liver microsomes with ethinyl estradiol resulted in a powerful time-dependent inhibitory effect on caffeine <i>N</i>_<i>3</i>-demethylation in human liver microsomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These results suggest that a prescription history of contraceptives at clinical doses may have a strong effect on the pharmacokinetics of overdosed caffeine in young women, resulting in dangerous drug interactions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"11 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.985","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141967897","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}

{"title":"Establishment of a swine experimental model of non-occlusive mesenteric ischemia: Combining induced hemorrhagic shock and vasopressor administration","authors":"Yasutaka Tanaka,&nbsp;Yosuke Matsumura,&nbsp;Makoto Aoki,&nbsp;Yosuke Hayashi,&nbsp;Yoshimitsu Izawa,&nbsp;Kazuhiro Endo,&nbsp;Takashi Mato","doi":"10.1002/ams2.982","DOIUrl":"10.1002/ams2.982","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Non-occlusive mesenteric ischemia (NOMI) is associated with high mortality rates, but definitive treatments have not yet been established. Although experimental animal models are worthwhile, reproducible models that reflect the pathophysiology of NOMI have not been developed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We combined risk factors for NOMI, comprising hemorrhagic shock, systemic vasopressor infusion, and local vasopressor infusion from the superior mesenteric artery (SMA) in swine under maintained anesthesia. Experiment 1 involved full-intensity (40%) phlebotomy and systemic vasopressor (norepinephrine and epinephrine). Experiment 2 involved full-intensity (40%) phlebotomy, systemic norepinephrine, and local vasopressor infusion into the SMA. Experiment 3 involved moderate (27%) phlebotomy, systemic norepinephrine infusion, and local epinephrine infusion. We evaluated serum lactate levels, intestinal serosa color, computed tomography (CT) angiography, and pathological findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After inducing hemorrhage, systemic vasopressor alone and in combination with local vasopressin or norepinephrine infusion did not induce ischemic color changes in the intestine. The combination of systemic norepinephrine and local epinephrine (0.5 μg/kg/min) after moderate (27% blood loss) hemorrhage induced gross color change, pathological destruction, and elevation of serum lactate. Patent flow in the SMA was confirmed on CT angiography.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We established a swine NOMI model with systemic norepinephrine infusion and local epinephrine with moderate hemorrhagic shock.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"11 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11263749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750837","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}

{"title":"Effectiveness of pelvic circumferential compression device for lower body trauma: Insights from a Japan Trauma Data Bank retrospective study","authors":"Shohei Ono,&nbsp;Satoshi Miyata,&nbsp;Hiroaki Suzuki,&nbsp;Keiki Shimizu","doi":"10.1002/ams2.983","DOIUrl":"10.1002/ams2.983","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Pelvic ring fractures (PRFs) due to high-energy trauma often result in severe bleeding and high mortality. Pelvic circumferential compression devices (PCCD) are widely used to stabilize PRF and decrease bleeding. However, evidence supporting their effectiveness is still inconclusive.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted an observational study using the Japan Trauma Data Bank (JTDB) from 2019 to 2021. Patients with blunt lower body trauma aged 15 years or older were included. We used propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) to evaluate the association of PCCD and mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 74,393 patients in the database, 235 PCCD group and 23,429 control group were analyzed. After PSM, 231 patients in both groups were enrolled. Crude analysis indicated significantly higher in-hospital mortality in the PCCD group (odds ratio (OR) = 3.8 [95% CI = 2.51–5.75]). However, PSM and IPTW analysis indicated that PCCD was associated with decreased in-hospital mortality (PSM: OR = 0.79 [0.43–1.42]; IPTW: OR = 0.73 [0.62–0.86]). In a subgroup analysis of the IPTW analysis, PCCD fitting resulted in increased in-hospital mortality in the group without PRF (OR = 2.08 [1.91–2.27]), a decrease in stable PRF (OR = 0.74 [0.6–0.91]), and a further decrease in unstable PRF (OR = 0.18 [0.12–0.27]). Additional factors, such as a fall from a height, a fall downstairs, and pre-hospital PCCD placement also influenced the treatment effect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The present, large, registry-based study found that PCCD reduced mortality in patients with a lower body injury, especially those with an unstable PRF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"11 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11263733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750836","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}

{"title":"Successful use of methylene blue for catecholamine-refractory vasoplegic shock due to metformin intoxication: A case report and literature review","authors":"Yuji Takahashi,&nbsp;Hidehiko Nakano,&nbsp;Maiko Motoki,&nbsp;Yuji Wakimoto,&nbsp;Daisuke Ikechi,&nbsp;Yasuaki Koyama,&nbsp;Hideki Hashimoto","doi":"10.1002/ams2.981","DOIUrl":"10.1002/ams2.981","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Severe metformin intoxication can lead to lactic acidosis and vasoplegic shock, for which the optimal management strategy remains uncertain, especially in cases of severe circulatory collapse.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 45-year-old diabetic woman on metformin therapy presented with impaired consciousness and seizures. She had experienced a cardiac arrest and undergone extracorporeal cardiopulmonary resuscitation. Blood gas analysis showed severe lactic acidosis. A 71-g metformin packet was found at the patient's home, suggesting an overdose. Despite extracorporeal support and blood purification, severe lactic acidosis and hypotension persisted. Methylene blue was administered 32 h from the onset, which improved her metabolic and circulatory status. We examined her blood sample throughout the case to check the transition of metformin blood concentration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Methylene blue may be beneficial for severe metformin toxicity, regardless of the blood concentration of metformin and the time since intoxication. However, further research is needed to establish its optimal use and effectiveness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"11 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11247704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141618984","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}

{"title":"Extracorporeal membrane oxygenation-facilitated palliative radiotherapy for severe airway obstruction due to lung cancer: A case report","authors":"Hitoshi Mori,&nbsp;Masahiro Kashiura,&nbsp;Yuya Yoshimura,&nbsp;Yuki Yamahata,&nbsp;Tomohisa Tokura,&nbsp;Tatsuya Nodagashira,&nbsp;Akihide Konn,&nbsp;Takashi Moriya","doi":"10.1002/ams2.980","DOIUrl":"10.1002/ams2.980","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The use of venovenous extracorporeal membrane oxygenation (VV-ECMO), particularly during radiotherapy, for severe malignant central airway obstruction has rarely been reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 47-year-old female presented to our emergency department with severe respiratory distress. Given her medical history, she was initially diagnosed with asthma. Despite initial treatment, which included intubation, her condition deteriorated, necessitating VV-ECMO. Computed tomography performed following the initiation of VV-ECMO revealed extensive lung cancer involving both bronchial types. Radiotherapy while on VV-ECMO led to a significant reduction in tumor size, allowing for the weaning of ECMO support and successful extubation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Malignant central airway obstruction is life-threatening. Our case demonstrates the efficacy of combining VV-ECMO with radiotherapy when conventional therapies fail. Further research is necessary to validate and explore this novel approach's implications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"11 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11246608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141615666","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}

{"title":"Seizure occurrences among hypoglycemic patients in the emergency department","authors":"Seigo Urushidani,&nbsp;Mao Tanabe,&nbsp;Kwangsoo Baek,&nbsp;Koki Miyaguchi,&nbsp;Tetsunori Ikegami","doi":"10.1002/ams2.979","DOIUrl":"10.1002/ams2.979","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Symptomatic hypoglycemia is a common problem in the emergency department (ED). However, without appropriate recognition and management, hypoglycemia remains a potentially fatal condition. The cause of sudden death associated with hypoglycemia might be attributed to cardiac arrhythmias and hypoxia with seizures. Despite advances in diabetes mellitus management and social background, the frequency and characteristics of patients with hypoglycemia-related seizures have remained unknown. Hence, our study aimed to investigate the frequency and characteristics of patients with hypoglycemia presenting with seizures in the ED.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective observational study was conducted in a single tertiary care center. Patient information was retrieved from the final diagnostic records in the ED. We reviewed all medical records and included patients with symptomatic hypoglycemia aged 16 years or older. The primary outcome was the frequency of seizures in patients with hypoglycemia. We also compared the initial blood sugar levels of the patients with and without seizures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included a total of 380 patients (median age, 72 years, IQR 64–80 years; median initial blood sugar, 34 mg/dL, IQR 24–46; 62.9% male). Nineteen of 380 patients (5.0%) had seizures. Although 16 of the 19 patients had diabetes mellitus, none of the 19 patients had a history of epilepsy. The initial blood sugar levels of the patients with and without seizures were not significantly different (<i>p</i> = 0.97).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Approximately 5% of the patients with hypoglycemia presented with seizures. Blood glucose levels of hypoglycemic patients with and without seizures did not differ.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"11 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11223063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141533279","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}

{"title":"The timing of death in burn patients","authors":"Kazuhiro Yoneda,&nbsp;Akinori Osuka,&nbsp;Shinya Ohnishi,&nbsp;Hiroshi Matsuura,&nbsp;Jun Oda","doi":"10.1002/ams2.970","DOIUrl":"10.1002/ams2.970","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>When treating burn patients, some patients die in the chronic phase, even if they overcome the acute phase of the burn. To elucidate the timing of death and its underlying causes among burn patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients evaluated were admitted to our burn center between January 2015, and December 2019. Patient information, time, and cause of death were retrospectively collected from their medical records.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 342 admitted patients, 49 died. The time of death was as follows: within 24 h (<i>n</i> = 9), within 3 days (<i>n</i> = 7), within 1 week (<i>n</i> = 5), within 2 weeks (<i>n</i> = 4), within 3 weeks (<i>n</i> = 3), within 30 days (<i>n</i> = 6), within 60 days (<i>n</i> = 5), and after 60 days (<i>n</i> = 9). The causes of death within 3 days were hypoxic encephalopathy, extensive burns (&gt;80%), severe heat stroke, and acute coronary syndrome. The causes of death after 3 days were sepsis, pneumonia, intestinal ischemia, pancreatitis, and worsening of chronic diseases. The mortality rate was similar for patients ≥65 years of age and those with a burn area of ≥20%, with both groups showing a particularly poor prognosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The timing of death in hospitalized burn patients showed a bimodal distribution as approximately 40% of patients who survived the resuscitation period died after 30 days. Elderly patients were at particularly high risk for mortality. In burn care, treatment planning should consider not only the short-term but also the long-term prognosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"11 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11211089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141465502","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}

{"title":"Guidance for clinical practice using emergency and point-of-care ultrasonography","authors":"Toru Kameda,&nbsp;Hiromoto Ishii,&nbsp;Seiro Oya,&nbsp;Kenichi Katabami,&nbsp;Takamitsu Kodama,&nbsp;Makoto Sera,&nbsp;Hirokazu Takei,&nbsp;Hayato Taniguchi,&nbsp;Shunichiro Nakao,&nbsp;Hiraku Funakoshi,&nbsp;Satoshi Yamaga,&nbsp;Satomi Senoo,&nbsp;Akio Kimura","doi":"10.1002/ams2.974","DOIUrl":"10.1002/ams2.974","url":null,"abstract":"<p>Owing to the miniaturization of diagnostic ultrasound scanners and their spread of their bedside use, ultrasonography has been actively utilized in emergency situations. Ultrasonography performed by medical personnel with focused approaches at the bedside for clinical decision-making and improving the quality of invasive procedures is now called point-of-care ultrasonography (POCUS). The concept of POCUS has spread worldwide; however, in Japan, formal clinical guidance concerning POCUS is lacking, except for the application of focused assessment with sonography for trauma (FAST) and ultrasound-guided central venous cannulation. The Committee for the Promotion of POCUS in the Japanese Association for Acute Medicine (JAAM) has often discussed improving the quality of acute care using POCUS, and the “Clinical Guidance for Emergency and Point-of-Care Ultrasonography” was finally established with the endorsement of JAAM. The background, targets for acute care physicians, rationale based on published articles, and integrated application were mentioned in this guidance. The core points include the fundamental principles of ultrasound, airway, chest, cardiac, abdominal, and deep venous ultrasound, ultrasound-guided procedures, and the usage of ultrasound based on symptoms. Additional points, which are currently being considered as potential core points in the future, have also been widely mentioned. This guidance describes the overview and future direction of ultrasonography for acute care physicians and can be utilized for emergency ultrasound education. We hope this guidance will contribute to the effective use of ultrasonography in acute care settings in Japan.</p>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"11 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11201855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141454602","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}