{"title":"Postintensive care syndrome family: A comprehensive review","authors":"Kasumi Shirasaki, Toru Hifumi, Nobuto Nakanishi, Nobuyuki Nosaka, Kyohei Miyamoto, Miyuki H. Komachi, Junpei Haruna, Shigeaki Inoue, Norio Otani","doi":"10.1002/ams2.939","DOIUrl":"https://doi.org/10.1002/ams2.939","url":null,"abstract":"<p>Families of critically ill patients are predisposed to tremendous burdens when their relatives are admitted to the intensive care unit (ICU). Postintensive care syndrome family (PICS-F) can be described as a devastated life, encompassing psychological, physical, and socioeconomical burdens that begin with the emotional impact experienced by the family when the patient is admitted to the ICU. PICS-F was primarily proposed as a clinically significant psychological impairment, but it needs to be extended beyond the psychological impairment of the family to include physical and socioeconomical impairments in the future. The prevalence of physiological problems including depression, anxiety and post-traumatic syndrome is 20–40%, and that of non-physiological problems including fatigue is 15% at 6 months after the ICU stay. Assessment of PICS-F was frequently conducted at 3- or 6-month points, although the beginning of the evaluation was based on different assessment points among each of the studies. Families of ICU patients need to be given and understand accurate information, such as the patient's diagnosis, planned care, and prognosis. Prevention of PICS-F requires a continuous bundle of multifaceted and/or multidisciplinary interventions including providing a family information leaflet, ICU diary, communication facilitators, supportive grief care, and follow-up, for the patient and families from during the ICU stay to after discharge from the ICU. This is the first comprehensive review of PICS-F to address the concept, risk factors, assessment tools, prevalence, and management to prevent PICS-F to facilitate acute care physicians' understanding of PICS-F.</p>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.939","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140104330","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}
Yoshihiro Aoki, Rustan Arrieta, Grace Joy B. Aquino, Chris Smith, Lourdes C. Agosto
{"title":"Very mild bilateral ptosis following snakebite","authors":"Yoshihiro Aoki, Rustan Arrieta, Grace Joy B. Aquino, Chris Smith, Lourdes C. Agosto","doi":"10.1002/ams2.935","DOIUrl":"https://doi.org/10.1002/ams2.935","url":null,"abstract":"<p>A 22-year-old male construction worker in Eastern Samar, Philippines, was bitten on his right leg by a black and yellow snake in the coastal area. Despite receiving a local remedy, he was later brought to the emergency department. Twelve hours post-bite, careful examination revealed mild bilateral ptosis, with the patient struggling to keep his eyes open, especially during upward gaze (Figure 1A). The bite site showed mild swelling, tenderness, and two fang marks. Although the snake responsible was not conclusively identified, based on the geographical distribution, snake description, and clinical signs, <i>Naja samarensis</i> envenomation was suspected. Intravenous administration of Purified Cobra Antivenom (Research Institute for Tropical Medicine)<span><sup>1</sup></span> significantly improved eye-opening ability within 30 min: the patient could open his eyes fully and sustain eye-opening (Figure 1B).</p><p>Although the literature reports a limited number of cases, <i>Naja samarensis</i>, Samar cobra, is a WHO category I venomous snake in the Philippines.<span><sup>2</sup></span> Often, snakebite envenomation diagnosis depends on clinical observations due to limited diagnostic tools.<span><sup>3</sup></span> As demonstrated in our image of the probable <i>Naja samarensis</i> case, detection of bilateral ptosis is crucial in recognizing neurological snakebite envenomation. This sign is vital to identify neurotoxic envenomation from various snakes globally, including exotic species.</p><p>The authors declare no conflicts of interest.</p><p>Approval of the research protocol: N/A.</p><p>Informed Consent: Informed consent was obtained by the patient.</p><p>Registry and the Registration No. of the study/trial: N/A.</p><p>Animal studies: N/A.</p>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.935","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140104331","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":"Accuracy of rapid blood coagulation testing device FibCare® in a tertiary emergency department","authors":"Yutaka Mihara, Kenta Komoriya, Kei Hagiwara, Yasuhito Hatanaka, Keita Shibahashi, Mayu Hikone, Kazuhiro Sugiyama","doi":"10.1002/ams2.934","DOIUrl":"10.1002/ams2.934","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>FibCare<sup>®</sup> is a novel point-of-care testing device enabling prompt evaluation of fibrinogen levels. This study aimed to investigate the accuracy of FibCare<sup>®</sup> at a tertiary emergency department.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Blood specimens obtained at a tertiary emergency medical center between October 1, 2021, and April 30, 2023, were evaluated. The correlation between the fibrinogen levels assessed via FibCare<sup>®</sup> and those via the Clauss method was evaluated using the Spearman's test. The discrepancy between the two measurement methods was assessed according to fibrinogen level and diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 177 specimens from 147 patients were eligible for the analysis. The median age of the patients was 49 years, and 109 (61.6%) were men. The two measurements had statistically significant but moderate correlation (<i>p</i> < 0.001, <i>ρ</i> = 0.76). FibCare<sup>®</sup> missed 14 out of 35 cases from patients with hypofibrinogenemia (fibrinogen ≤150 mg/dL assessed by the Clauss method). The discrepancy between the two measurements was significantly greater in specimens with lower fibrinogen levels and those obtained from patients following trauma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>FibCare<sup>®</sup>, a novel point-of-care testing device, can be compatible with the Clauss method. However, clinicians should be aware of the risk that FibCare<sup>®</sup> may underestimate fibrinogen reduction, especially in severe cases and trauma cases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10916673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140048531","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":"Ultrasound-guided femoral nerve block versus fascia iliaca compartment block for femoral fractures in emergency department: A randomized controlled trial","authors":"Mohammad Rezaei Zadeh Rukerd, Lida Erfaniparsa, Mitra Movahedi, Hanieh Mirkamali, Seyed Danial Alizadeh, Mehran Ilaghi, Amirreza Sadeghifar, Saeed Barazandehpoor, Morteza Hashemian, Pouria Pourzand, Amirhossein Mirafzal","doi":"10.1002/ams2.936","DOIUrl":"10.1002/ams2.936","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Femoral fractures are one of the most debilitating injuries presenting to the emergency departments (EDs). The pain caused by these fractures is typically managed with opioids and adjunctive regional analgesia. These approaches are often associated with adverse side effects. Thus, appropriate alternative methods should be thoroughly investigated. To evaluate ultrasound-guided femoral nerve block (FNB) with ultrasound-guided fascia iliaca compartment block (FICB) in femoral fractures, to determine which provides better analgesia and less opioid requirement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was a randomized clinical trial performed on adult patients presenting to the ED within 3 h of isolated femoral fracture with initial numerical pain rating scale (NRS-0) score of more than 5. The patients were randomized to receive FNB or FICB. The outcomes were block success rates, pain at 20 (NRS-20) and 60 (NRS-60) min after the end of the procedures, as well as the number and total dose of fentanyl administration during ED stay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty-seven patients were recruited (40 FNB and 47 FICB). Success rates were 82.5% in FNB and 83.0% in FICB group, with no significant difference between the groups. NRS-20, NRS-60, the number of patients who received supplemental fentanyl, and the total dose of administered fentanyl were significantly lower following FNB. However, the length of the procedure was significantly lower in the FICB group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Both FNB and FICB are effective in pain reduction for fractures of femur, but FNB provides more pain relief and less need for supplemental fentanyl.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10916633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140048532","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":"Gigantic angina bullosa haemorrhagica in the oropharynx","authors":"Yuki Okubo, Mitsuhiro Matsuo, Takateru Ihara","doi":"10.1002/ams2.930","DOIUrl":"https://doi.org/10.1002/ams2.930","url":null,"abstract":"<p>A 66-year-old woman presented to the emergency department with sudden throat tightness. The patient was uncomfortable and could not speak. No pain, dysphagia, drooling, labored breathing, or snoring were noted, and she had an unremarkable medical and allergic history. Oral examination revealed a 4-cm bloody blister in the middle of the soft palate (Figure 1A). Blood examination revealed no coagulopathy or anemia.</p><p>The patient was diagnosed with angina bullosa haemorrhagica (ABH). Puncture drainage was suggested to prevent airway obstruction. Preparation for airway management, including cricothyrotomy, was performed. However, the patient's blister spontaneously ruptured, and symptoms disappeared. A shallow ulcer formed at the post-rupture site (Figure 1B).</p><p>ABH was first reported by Badham in 1967 as the rapid formation of a bloody blister on the oral mucosa.<span><sup>1</sup></span> Its diagnosis relies on the patient's clinical symptoms. Most cases of ABH are 1–2 cm in diameter, and no reports are found on a similar size to our case.<span><sup>2, 3</sup></span> Most are resolved without treatment, but several cases of airway obstruction have been reported, one of which required puncture drainage to secure the airway.<span><sup>4, 5</sup></span> Therefore, airway obstruction should be considered when large ABH in the oropharynx or severe symptoms are present.</p><p>The authors have no financial relationships relevant to this article.</p><p>Approval of the research protocol: N/A.</p><p>Informed consent: Consent was obtained from the patient in the form of British Medical Journal.</p><p>Registry and the registration no. of the study/trial: N/A.</p><p>Animal studies: N/A.</p>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.930","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139915680","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}
Hiroshi Ito, Youhei Nakamura, Yuki Togami, Shinya Onishi, Shunichiro Nakao, Hiroshi Ogura, Jun Oda
{"title":"Relationship between extravascular leakage and clinical outcome on computed tomography of isolated traumatic brain injury","authors":"Hiroshi Ito, Youhei Nakamura, Yuki Togami, Shinya Onishi, Shunichiro Nakao, Hiroshi Ogura, Jun Oda","doi":"10.1002/ams2.931","DOIUrl":"https://doi.org/10.1002/ams2.931","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study investigated whether contrast extravasation on computed tomography (CT) angiography in patients with traumatic brain injury (TBI) is associated with death or surgical procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients over 18 years old, directly brought in by ambulance with an isolated head injury and confirmed to have acute intracranial hemorrhage on a CT scan upon admission between 2010 and 2020, were included. The primary outcome was mortality, and the secondary outcome was neurosurgical procedures performed from admission to discharge from the intensive care unit. Multivariable logistic regression analyses were performed to evaluate the association between these outcomes and contrast extravasation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis included 188 patients with a median age of 65 years, 123 men (65.4%), 34 deaths (18.1%), and 91 surgeries (48.4%). Among the 66 patients with contrast extravasation, 22 (33.3%) died and 47 (71.2%) required surgery. Among the 122 patients with no contrast extravasation, 12 (9.8%) died, and 44 (36.1%) required surgery. The presence or absence of extravascular leakage was associated with death (odds ratio, 3.6 [95% CI: 1.2–12.2]) and surgery (odds ratio, 7.6 [95% CI: 2.5–22.7]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Contrast extravasation was associated with mortality and performance of surgery in patients with an isolated head injury.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.931","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139915679","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":"Post-intensive care syndrome: Recent advances and future directions","authors":"Shigeaki Inoue, Nobuto Nakanishi, Fumimasa Amaya, Yoshihisa Fujinami, Junji Hatakeyama, Toru Hifumi, Yuki Iida, Daisuke Kawakami, Yusuke Kawai, Yutaka Kondo, Keibun Liu, Kensuke Nakamura, Takeshi Nishida, Hidenori Sumita, Shunsuke Taito, Shunsuke Takaki, Norihiko Tsuboi, Takeshi Unoki, Yasuyo Yoshino, Osamu Nishida","doi":"10.1002/ams2.929","DOIUrl":"https://doi.org/10.1002/ams2.929","url":null,"abstract":"<p>Post-intensive care syndrome comprises physical, cognitive, and mental impairments in patients treated in an intensive care unit (ICU). It occurs either during the ICU stay or following ICU discharge and is related to the patients' long-term prognosis. The same concept also applies to pediatric patients, and it can greatly affect the mental status of family members. In the 10 years since post-intensive care syndrome was first proposed, research has greatly expanded. Here, we summarize the recent evidence on post-intensive care syndrome regarding its pathophysiology, epidemiology, assessment, risk factors, prevention, and treatments. We highlight new topics, future directions, and strategies to overcome post-intensive care syndrome among people treated in an ICU. Clinical and basic research are still needed to elucidate the mechanistic insights and to discover therapeutic targets and new interventions for post-intensive care syndrome.</p>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.929","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139915681","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":"Postmortem diagnosis of gestational psittacosis: A case report","authors":"Takashi Miyauchi, Yutaro Hirata, Shinya Fukuda","doi":"10.1002/ams2.932","DOIUrl":"https://doi.org/10.1002/ams2.932","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gestational psittacosis is one of the causes of unanticipated maternal death but has been difficult to diagnose early in clinical practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 28-year-old woman who was 7 months pregnant experienced flu-like symptoms, which deteriorated. She was brought to our hospital in shock, and the fetus was nonviable. The patient was diagnosed with pneumonia and septic shock and administered meropenem. Despite aggressive resuscitation, she died 7 h after symptom onset. After obtaining consent from the patient's family, the autopsy was done to identify the cause of death. Microscopically, there was intervillous neutrophil accumulation in the placenta. Genetic analysis detected the <i>Chlamydia psittaci</i> gene in several organs, including placenta.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Gestational psittacosis should be considered for a pregnant woman with flu-like symptoms. Moreover, unanticipated death of a pregnant woman might warrant a detailed autopsy to reveal the cause of death.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.932","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139750095","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":"A case of repeated Kounis syndrome after anaphylactic shock: A note for disease management","authors":"Satoshi Kawaguchi, Tatsuki Kuroshima, Ryo Namba, Hiroki Satou, Riku Kashiwagi, Ai Abe, Motoi Okada","doi":"10.1002/ams2.908","DOIUrl":"https://doi.org/10.1002/ams2.908","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Kounis syndrome (KS) is an underdiagnosed disease. The management of the disease remains elusive because of its infrequency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 78-year-old man with anaphylactic shock was admitted to our hospital 2 h after multiple bee stings. After recovering from an anaphylactic reaction, he presented with chest pain with ST elevation. We diagnosed him with KS. After a continuous intravenous infusion of vasodilators, his chest pain and ST elevation improved. However, chest pain with ST-segment elevation recurred the next day. Coronary angiography revealed severe stenosis in the middle left anterior descending coronary artery, and drug-eluting stents were implanted. The patient was discharged on foot after treatment for heart failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>KS, in which anaphylaxis and acute coronary syndrome occur simultaneously, can recur repeatedly after an initial anaphylactic reaction; however, it could be delayed or it could present simultaneously with the anaphylactic reaction. Therefore, long-term observation is important.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.908","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139682919","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}