Advanced journal of emergency medicine最新文献

{"title":"Application Effect of Limited Fluid Resuscitation in Emergency Patients with Multiple Trauma Complicated with Shock","authors":"Biao Wang, Jian-qing Qiu, Wenhao Lin, Wei Han","doi":"10.18686/AEM.V10I1.183","DOIUrl":"https://doi.org/10.18686/AEM.V10I1.183","url":null,"abstract":"This article explores the methods and effects of limited fluid resuscitation in the treatment of hemorrhagic shock caused by multiple trauma, which is common in clinic. 80 patients with multiple trauma complicated with shock were randomly selected from the emergency department of our hospital and divided into the observation group and the control group, with 40 members in each group. Patients in the observation group were treated with limited fluid resuscitation, while those in the control group were treated with aggressive fluid resuscitation. By comparing the therapeutic effects of the two groups, it is concluded that the therapeutic effect of the observation group is significantly better than that of the control group. Therefore, adopting limited fluid resuscitation in the clinical treatment of patients with multiple trauma complicated with shock can realize faster recovery, as well as protect patients’ coagulation function, effectively reducing complications and mortality. Moreover, it can also reduce the injury of trauma perfusion to the body, ensuring the recovery of patients.","PeriodicalId":94293,"journal":{"name":"Advanced journal of emergency medicine","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84772408","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":"Discussion on the Effect of Introducing Clinical Pharmacists to Guide Clinical Medication in ICU","authors":"Dalai Wuyun","doi":"10.18686/AEM.V10I1.186","DOIUrl":"https://doi.org/10.18686/AEM.V10I1.186","url":null,"abstract":"Objective: to investigate the effect of clinical pharmacists in ICU. Methods: 108 ICU patients from January 2018 to March 2020 were divided into the control group and the observation group, with 54 cases in each group. The control group used the previous medication route, while the observation group introduced clinical pharmacists to guide clinical medication. The infection rate and adverse reaction rate of the two groups were compared. Results: the infection rate of the observation group was 3.70%, and that of the control group was 14.81%, which was significantly lower than that of the control group (P<0.05). The adverse reaction rate of the observation group was 5.56%, and that of the control group was 18.52%, which was significantly lower than that of the control group (P<0.05). Conclusion: the introduction of clinical pharmacists to guide clinical medication in ICU can effectively control the infection, and reduce various adverse reactions during drug use, so as to realize the scientific and standardized use of drugs, and improve the efficiency and safety of drug use.","PeriodicalId":94293,"journal":{"name":"Advanced journal of emergency medicine","volume":"84 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80379832","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":"Relationship between Ambulatory Pulse Pressure, Pulse Pressure Index and Coronary Artery Disease in Patients with Hypertension","authors":"Jiajuan Chen, Yunjie Wei, Zhen Gao, Haijun Xu, Hezhong Zhu","doi":"10.18686/AEM.V10I1.187","DOIUrl":"https://doi.org/10.18686/AEM.V10I1.187","url":null,"abstract":"Objective: To analyze the relationship between ambulatory pulse pressure, pulse pressure index, and coronary artery disease in patients with hypertension. Methods: From February 2018 to February 2019, a group of 100 patients with hypertension (control group) and a group of 100 patients with hypertension and coronary artery disease (experimental group) were selected to monitor and analyze dynamic pulse pressure and pulse pressure indicators. Results: In terms of clinical indicators, values of NPPI, 24hPP and 24hPPI in the experimental group were significantly higher than those in the control group. P < 0.05 indicates that there is statistical value in the data difference. Conclusion: In the clinical diagnosis of hypertension patients, ambulatory pulse pressure, pulse pressure index are highly correlated with the risk of coronary artery disease. Therefore, researchers should actively pay attention to the relevant indicators of patients to lay a solid foundation for the effective protection of patients’ health.","PeriodicalId":94293,"journal":{"name":"Advanced journal of emergency medicine","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90727016","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":"Application of Microscrew Implant Anchorage in Orthodontics","authors":"H. Wong","doi":"10.18686/AEM.V10I1.188","DOIUrl":"https://doi.org/10.18686/AEM.V10I1.188","url":null,"abstract":"Objective: To study the value of microscrew implant anchorage in orthodontic treatment. Methods: A total of 80 cases received orthodontic treatment in recent two years were selected and divided into experimental group and control group based on their received orthodontic measures, each group contains 40 cases. The control group was treated with general orthodontic treatment plan, while the study group received microscrew implant anchorage for the treatment. The clinical conditions of the two groups were counted and observed. Results: After different treatments, the effect of the study group was significantly better than that of the control group. All the indicators (including the improvement of molar displacement, incisor inclination angle and incisor convex distance) were available. In addition, there are obvious differences between the two groups in the occurrence of adverse reactions including inflammatory reaction, soft tissue edema and discomfort. Conclusion: In oral clinic, microscrew implant anchorage can achieve ideal curative effect for those who need orthodontics. Besides, its safety is relatively high, which is worth popularizing widely.","PeriodicalId":94293,"journal":{"name":"Advanced journal of emergency medicine","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81189771","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 Impact of Deep Brain Stimulation on the Cognitive Ability of Patients with Parkinson Disease","authors":"Kuo Liu","doi":"10.18686/aem.v9i3.172","DOIUrl":"https://doi.org/10.18686/aem.v9i3.172","url":null,"abstract":"Deep Brain Stimulation, especially STN-DBS, is one of the most prevalent treatments for the Parkinson’s Disease. Previous researches already showed its positive effects on the general conditions of the patients but lack evaluation of its influence on the cognitive ability of the patients. A comparison in the effect of DBS and surgical lesioning procedures can determine DBS’s influence on the quality of life and confirm whether it is the most optimal treatment. This proposal reviewed previous researches about the influence of STN-DBS and proposed a study on its influence of patients’ cognitive ability.","PeriodicalId":94293,"journal":{"name":"Advanced journal of emergency medicine","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88393871","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":"Sample Size Calculation Guide - Part 5: How to calculate the sample size for a superiority clinical trial","authors":"","doi":"10.22114/ajem.v0i0.255","DOIUrl":"https://doi.org/10.22114/ajem.v0i0.255","url":null,"abstract":"In the previous educational articles, we explained how to calculate the sample size for a rate or a single proportion, for an independent cohort study, for an independent case-control study, and for a diagnostic test accuracy study. In this article, we explain how to calculate the sample size for a superiority clinical trial.","PeriodicalId":94293,"journal":{"name":"Advanced journal of emergency medicine","volume":"162 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73939677","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":"Auto-amputation of an Entire Foot with Ankle in a Diabetic Patient","authors":"Utsav Anand Mani, Danish Ansari, F. Bhot, Elizabeth Sada, Rajesh Ursekar","doi":"10.22114/ajem.v0i0.245","DOIUrl":"https://doi.org/10.22114/ajem.v0i0.245","url":null,"abstract":"A 62-year-old male came to emergency department (ED) with a complaint of “separation of foot” during sleep at night. He noticed he lost his foot while getting up from bed to go to toilet at midnight. Upon arrival in ED, his blood pressure was 218/96 mmHg and random blood sugar 556mg/dl. The patient had large ketone bodies in urine. He was a known case of diabetes and hypertension for many years. He was on homeopathic medications for his diabetes, hypertension and diabetic foot. He refused any form of invasive treatment and hospitalization. The patient was adamant on not getting admitted and wanted to continue his homeopathic medications as before. He only wanted his leg stump covered with a dressing after which he was discharged.","PeriodicalId":94293,"journal":{"name":"Advanced journal of emergency medicine","volume":"6 1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74725056","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":"ED Assembly: Introducing a Simple Method of Bringing Emergency Department Staff Together to Facilitate Improvement; A Report of a Real Experience","authors":"","doi":"10.22114/ajem.v0i0.212","DOIUrl":"https://doi.org/10.22114/ajem.v0i0.212","url":null,"abstract":"Introduction: The emergency department (ED) at Ashford and St Peter’s Hospitals NHS Foundation Trust (ASPH) is a medium size department which sees around 260–300 patients per day. As a result of sustained demand, we continue to struggle to meet the four hour waiting target and face similar challenges of those of ED’s nationally. Working in a busy ED is challenging and demanding. specific challenges around communication and risks arise directly from the unique contextual demands of the ED environment. Objective: Aim being to improve the productivity of the ED team and find a mechanism to create a more supportive and enjoyable working environment within the department. Method: Our clinical leadership started looking for answer to improve communication among team members and to create a platform where there was no hierarchy and all team members could be directly involved in problem solving. With the support of the quality improvement (QI) team, ED assembly was born. The assembly is a simple method of regularly bringing together staff to facilitate improvement and better team working. It is a platform for effective communication and innovation, in which there is no hierarchy and everyone is encouraged to contribute. Results: The assembly runs to a routine; every other Wednesday at 11am, the team come together for just half an hour. The agenda is set by the team in advance and everyone is encouraged to contribute their ideas and items they wish to contribute to others. Here are some examples of the quality improvement initiatives that have been born out of ED assembly: ED board rounds, coding information, overdose proforma, timely completion of standard investigations, access to fracture clinic appointments, nil-by-mouth communication, safety huddles, patient safety and sepsis, inclusive improvement, adoption of the ED assembly model by other teams and etc. Conclusion: ED assembly has supported many small but effective QI initiatives and regular communications support timely feedback on progress and update on plan-do-study-act (PDSA) cycles, resulting in changes in the everyday practice and improved pathways of patient care.","PeriodicalId":94293,"journal":{"name":"Advanced journal of emergency medicine","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89931759","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 34-year-old Pregnant Woman with Chickenpox Re-infection","authors":"Somayeh Karimi, Sepideh Babaniamansour, Ehsan Aliniagerdroudbari","doi":"10.22114/ajem.v0i0.163","DOIUrl":"https://doi.org/10.22114/ajem.v0i0.163","url":null,"abstract":"A 34-year-old pregnant woman was referred to our emergency ward, complaining of intensification of skin lesions which had started six days earlier. Initially, vesicular lesions had started from head and face accompanied by fever which turn to generalized pustular lesions expanded to the whole body within four days (figure 1). By investigating the patient's personal contact history, we found that same symptoms were detected in her 9-year-old child 19 days prior to admission which was diagnosed as chickenpox. The patient also had mentioned previous history of chicken pox infection at her age of seven. She was ill but not toxic and was conscious with a blood pressure of 98/59 mmHg, respiratory rate of 18 breaths per minute, heart rate of 100 beats per minute and oral temperature of 37.2 °C in physical examination. She didn't have respiratory distress, dyspnea, meningism symptoms (Kernig Sign, Brudzinksi, and Nuchal Rigidity), ataxia or sensory defect and her all other physical examinations were normal. Upon diagnosis of chickenpox, intravenous (IV) acyclovir 750 mg three times a day and also IV clindamycin 900 mg TDS in combination with IV fluid were administered and finally the patient was admitted in Infectious diseases ward.","PeriodicalId":94293,"journal":{"name":"Advanced journal of emergency medicine","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83032617","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 Role of Ultrasonography in Patients Referring to the Emergency Department with Acute Abdominal Pain.","authors":"Ali Abdolrazaghnejad,&nbsp;Ali Rajabpour-Sanati,&nbsp;Hojjat Rastegari-Najafabadi,&nbsp;Maryam Ziaei,&nbsp;Abdolghader Pakniyat","doi":"10.22114/ajem.v0i0.152","DOIUrl":"https://doi.org/10.22114/ajem.v0i0.152","url":null,"abstract":"<p><strong>Context: </strong>Acute abdominal pain is a common clinical problem in emergency and non-emergency cases accounting for 5 to 10% of all referrals to the emergency department. Studies have indicated that these widely differentiated diagnoses are common to these complaints. Considering the high prevalence of this complaint in the patients and the wide range of its differential diagnosis, this review study was designed and evaluated aiming at investigating the causes of acute abdominal pain with a focus on assessing the position of ultrasound as a diagnostic tool in the emergency department.</p><p><strong>Evidence acquisition: </strong>This article was conducted as a narrative review of selected articles from 2005 through 2019. By comparing them, a comprehensive review of ultrasound role was conducted in patients with acute abdominal pain referring to the emergency department.</p><p><strong>Results: </strong>In this review study, we attempted to use the articles of the clinical approach, the required laboratory tests, the disadvantages and advantages of each imaging technique, the differential diagnosis for acute abdominal pain according to the location of the pain, and the position of ultrasound as a diagnostic aid tool. Eventually, the proposed protrusion will be considered in dealing with a patient with acute abdominal pain.</p><p><strong>Conclusion: </strong>Regarding the wide range of causes providing multiple differential diagnosis, as well as the limited time of the health team in the emergency department for diagnostic and therapeutic measures, particularly in time-sensitive clinical conditions, ultrasound offered by emergency medicine specialists as a diagnostic aid is considered to improve the overall diagnosis and treatment of patients, thereby reducing complications.</p>","PeriodicalId":94293,"journal":{"name":"Advanced journal of emergency medicine","volume":"3 4","pages":"e43"},"PeriodicalIF":0.0,"publicationDate":"2019-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6789065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41224635","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}