Patient satisfaction, needs, and preferences concerning information dispensation at the emergency department: a cross-sectional observational study
AbstractBackgroundPatient satisfaction is an important indicator of emergency care quality and has been associated with information dispensation at the emergency department (ED). Optimal information dispensation could improve patient experience and expectations. Knowing what kind of information patients want to receive and the preferred way of information dispensation are essential to optimize information delivery at the ED. The purpose of this cross-sectional observational study was to evaluate patient satisfaction concerning information dispensation (including general, medical, and practical information), the need for ad...
Source: International Journal of Emergency Medicine - January 24, 2022 Category: Emergency Medicine Source Type: research

Self-efficacy beliefs and expectations during an Emergency Medicine Clerkship
This study aims to evaluate the expectations, opinions, and self-efficacy beliefs of medical students during a 4-week mandatory EM clerkship.MethodsThis study used a prospective longitudinal design with quantitative and qualitative survey methods. It includes final year medical students of the 2015 –2016 academic year. Voluntary de-identified pre- and post-clerkship surveys included 25 statements. The post-clerkship survey included two open-ended questions asking participants to identify the best and worst three aspects of EM clerkship. Responses were analysed to determine themes or commonal ities in participant comm...
Source: International Journal of Emergency Medicine - January 22, 2022 Category: Emergency Medicine Source Type: research

COVID-19 masquerading as a non-convulsive status epilepticus
AbstractSince the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), more and more atypical presentations of COVID-19 are being reported. Here, we present and discuss non-convulsive status epilepticus (NCSE) as presenting symptom of SARS-CoV-2 infection at the Emergency Department. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - January 21, 2022 Category: Emergency Medicine Source Type: research

Development of a remote learning educational model for international Emergency Medicine trainees in the era of COVID-19
ConclusionsInternational remote education in LMICs poses a unique set of challenges to medical educators. Residents in our study reported high satisfaction with the curriculum, but there is a lack of clarity regarding how a remote curriculum may impact academic and clinical performance. Future studies are needed to further evaluate the efficacy and academic and clinical implications of remote medical education in LMICs. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - January 6, 2022 Category: Emergency Medicine Source Type: research

Tenecteplase vs. alteplase for acute ischemic stroke: a systematic review
ConclusionsThe available evidence suggests that tenecteplase appears to be a better thrombolytic agent for acute ischemic stroke when compared to alteplase. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - January 4, 2022 Category: Emergency Medicine Source Type: research

Emergency medicine in Brazil: historical perspective, current status, and future challenges
ConclusionAlthough EM in Brazil has accomplished key steps toward its development, there are several obstacles before it becomes a solid medical specialty. Its continuous development will depend on special attention to key challenges involving recognition, reliability, and research. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - December 22, 2021 Category: Emergency Medicine Source Type: research

Keywords reflecting sepsis presentation based on mode of emergency department arrival: a retrospective cross-sectional study
AbstractBackgroundCurrent sepsis screening tools are predominantly based on vital signs. However, patients with serious infections frequently present with normal vital signs and there has been an increased interest to include other variables such as symptoms in screening tools to detect sepsis. The majority of patients with sepsis arrive to the emergency department by emergency medical services. Our hypothesis was that the presentation of sepsis, including symptoms, may differ between patients arriving to the emergency department by emergency medical services and patients arriving by other means. This information is of int...
Source: International Journal of Emergency Medicine - December 20, 2021 Category: Emergency Medicine Source Type: research

Bioresorbable plate fracture after cranioplasty caused by head injury: a pediatric case
ConclusionIt has been reported that the durability of bioresorbable plates is no less than that of titanium plates. We experienced a relatively rare case in which bioabsorbable plate used for bone fixation was damaged due to head trauma. After craniotomy or cranioplasty using bioresorbable plates, special attention should be paid to head trauma that involves bone flap sinking force and side bending stress. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - December 20, 2021 Category: Emergency Medicine Source Type: research

Point of tangency between coronavirus disease and endothelial injury
(Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - December 20, 2021 Category: Emergency Medicine Source Type: research

A fatal case of traumatic brain injury with severe coagulopathy due to Rhabdophis tigrinus (yamakagashi) bites: a case report
ConclusionIn this case of a yamakagashi bite with active bleeding due to trauma, early administration of yamakagashi antivenom should be considered to control coagulopathy. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - December 20, 2021 Category: Emergency Medicine Source Type: research

Spontaneous globe subluxation: a case report and review of the literature
ConclusionsIn addition to causing distress and severe anxiety, SGS poses numerous immediate as well as long-term complications. Traction of the optic nerve and retinal vasculature may potentially cause retinal venous congestion and loss of visual acuity with potential vision loss. In the absence of known risk factors or disease processes, orbital imaging and serological studies for thyroid ophthalmopathy should be considered. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - December 18, 2021 Category: Emergency Medicine Source Type: research

Incidence and prevalence of violence toward health care workers in emergency departments: a multicenter cross-sectional survey
AbstractBackgroundWorkplace violence and abuse in the emergency department (ED) has increasingly become a serious and alarming phenomenon worldwide where health care professionals are more prone to violence compared with other specialties.AimsWe aimed to estimate prevalence, and types of work place violence made against health care workers (HCW) in emergency departments of Arabian Gulf area.MethodsWe performed a descriptive cross-sectional study at several emergency departments in Saudi Arabia and United Arab Emirates wherein a previously validated questionnaire was distributed among health care workers. The survey consist...
Source: International Journal of Emergency Medicine - December 14, 2021 Category: Emergency Medicine Source Type: research

Feasibility and efficacy of text messaging to promote care among trauma patients screened for HIV at an urban emergency department in Tanzania
AbstractBackgroundDue to the high prevalence of human immunodeficiency virus (HIV) in Tanzania, provider-initiated HIV testing for patients attending any health care setting is recommended. However, follow-up and linkage to care by those tested remain poor. We determined the feasibility and efficacy of text messaging to promote follow-up among otherwise healthy trauma patients who underwent provider-initiated HIV testing and counseling at an emergency department (ED) in Tanzania.Material and methodsThis randomized controlled trial (RCT) was conducted at Muhimbili National Hospital (MNH) ED between September 2019 and Februa...
Source: International Journal of Emergency Medicine - December 14, 2021 Category: Emergency Medicine Source Type: research

Pediatric tizanidine toxicity reversed with naloxone: a case report
ConclusionsThis case report provides further evidence regarding the use of naloxone as a viable antidote for centrally acting α-2 receptor agonists and presents additional epidemiologic data on childhood tizanidine poisoning. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - December 14, 2021 Category: Emergency Medicine Source Type: research

Case report: “an unexpected origin of coma in a young adult”
We report a peculiar case of acute non-traumatic coma due to neuromuscular hypoventilation syndrome caused by a non-traumatic spinal cord injury (NTSCI). A 21-year-old patient presented to the emergency room complaining of sudden onset weakness in his lower limbs and shortness of breath. While in the ER, he briefly became comatose and labs revealed an acute respiratory acidosis. Detailed neurologic examination ultimately revealed upper motor neuron signs and quadriplegia. He was ultimately diagnosed with a non-traumatic spinal cord injury, in particular, a cervical transverse myelitis which had caused acute diaphragmatic w...
Source: International Journal of Emergency Medicine - November 27, 2021 Category: Emergency Medicine Source Type: research

Frequency of alterations in qSOFA, SIRS, MEWS and NEWS scores during the emergency department stay in infectious patients: a prospective study
ConclusionAfter ED arrival, alterations in qSOFA, SIRS, MEWS and/or NEWS score are present in almost half of patients with suspected infection. The most contributing vital sign to these alterations was the respiratory rate. One in 6 –15 patients displayed an abnormal clinical rule score after a normal initial score. Clinicians should be aware of the frequency of these alterations in clinical rule scores, as clinical rules are widely used for diagnosis and/or prognosis and the optimal moment of assessing them is unknown. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - November 27, 2021 Category: Emergency Medicine Source Type: research

Urosepsis secondary to ureterosciatic hernia corrected with ureteral stent placement: a case report and literature review
ConclusionsAlthough ureterosciatic hernia is a rare disorder, it is associated with serious complications including urinary tract infection with sepsis, which may warrant urgent corrective procedure to relieve the structural obstruction. Treatment may be conservative or surgical, though treatment with ureteral stent placement may be a favorable approach in elderly patients with multiple comorbidities presenting with urosepsis. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - November 6, 2021 Category: Emergency Medicine Source Type: research

Prevalence of hepatopancreatic injury and clinical outcomes in patients with COVID-19 in USA
ConclusionCOVID-19 can cause liver injury. Mortality, disease severity, and hospital length of stay are increased in COVID-19 patients with hepatopancreatic injury.Graphical Abstract (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - November 6, 2021 Category: Emergency Medicine Source Type: research

Mental health-related visits in a pediatric emergency department during the COVID-19 pandemic
AbstractWe aimed to describe the epidemiology of all pediatric emergency department visits (focusing on mental health-related visits versus total visits) at the University Children ’s Hospital of Nice (France) from 1 January to 31 December 2020 (year of the COVID-19 pandemic) and to compare it with the earlier 3-year period. The increase in mental health-related visits (44.2%) that we observed, while total visits decreased (30.0%), suggests an impact of the pandemic on child ren’s and adolescents’ mental health. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - November 4, 2021 Category: Emergency Medicine Source Type: research

Emergency department point-of-care ultrasound for upper extremity deep venous thrombosis ED POCUS for upper extremity DVT
ConclusionThe use of point-of-care ultrasonography of the upper limb venous system can prove invaluable as a rapid, non-invasive technique to facilitate expedient diagnosis of and early intervention for UEDVT in the emergency department. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - November 4, 2021 Category: Emergency Medicine Source Type: research

A peculiar case of psychosis: anti-NMDAr encephalitis
ConclusionsAnti-NMDAr encephalitis can be the culprit behind a new-onset of psychosis in pregnancy. Early diagnosis and treatment are crucial. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - November 4, 2021 Category: Emergency Medicine Source Type: research

Correction to: Case report: appendicitis induced Staphylococcus aureus and Klebsiella pneumoniae bacteremia in a young healthy male
(Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - November 1, 2021 Category: Emergency Medicine Source Type: research

The use of a formative OSCE to prepare emergency medicine residents for summative OSCEs: a mixed-methods cohort study
ConclusionsParticipation in multiple formative OSCEs was beneficial in preparing residents for the summative OSCE. The formative OSCE was useful in familiarising residents with the examination, giving them an opportunity to perform in near-examination conditions, and providing feedback to residents and faculty about their progress. Our findings may support the implementation of formative OSCEs in other training programmes to prepare learners for high-stake summative OSCEs. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - October 1, 2021 Category: Emergency Medicine Source Type: research

Interhospital transfer of COVID-19 patients treated with high-flow nasal oxygen therapy
AbstractAt the start of the COVID-19 pandemic, early intubation was recommended on the basis of worldwide observations of severe hypoxemia. However, some patients were ultimately able to benefit from high-flow nasal cannula (HFNC) and thus avoid intubation. During the “second wave” (September to December 2020 in France), some emergency departments implemented HFNC in patients with severe COVID-19. The question then arose regarding the transfer of these most serious patients to intensive care units (ICU) and of the respiratory modalities to be used during this transfer. To assess the feasibility of interhospital...
Source: International Journal of Emergency Medicine - September 26, 2021 Category: Emergency Medicine Source Type: research

Spontaneous spinal epidural hematoma: a case report
ConclusionIn patients with no risk factors related to spinal epidural hematoma, symptoms of bilateral lower limb weakness must be investigated carefully because this condition may occur spontaneously. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - September 25, 2021 Category: Emergency Medicine Source Type: research

Impact of a binary triage system and structural reorganization of emergency department on health care workers exposed to suspected COVID-19 patients —a single-centre analysis
ConclusionA binary triage system based on severity and infectivity and supported with structural reorganization can be effective in reducing HCWs COVID-19 exposure. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - September 23, 2021 Category: Emergency Medicine Source Type: research

Language diversity and challenges to communication in Indian emergency departments
ConclusionsThis study is the first to document the impact of language diversity and communication barriers in Indian EDs. The results highlight the need for effective strategies to improve communication between the multiple languages spoken by clinicians and patients. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - September 22, 2021 Category: Emergency Medicine Source Type: research

A rare case of persistent air leak: beware of all the tubes
ConclusionsVigilant monitoring of patients requiring mechanical ventilation is necessary. For the evaluation of the cause of air leak, algorithmic approach will help in correctly identifying the abnormality. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - September 22, 2021 Category: Emergency Medicine Source Type: research

Early diagnosis and critical management of wound botulism in the emergency department: a single center experience and literature review
ConclusionsEmergency physicians should remain vigilant about early recognition of wound botulism, especially in patients who inject drugs. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - September 22, 2021 Category: Emergency Medicine Source Type: research

Successful treatment of severe electrolyte imbalance-induced cardiac arrest caused by adrenal tuberculosis with ECMO in the ED
ConclusionsECMO has won the opportunity for the diagnosis and treatment of this young patient who suffered from a rare cause of cardiac arrest and finally achieved a good prognosis. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - September 20, 2021 Category: Emergency Medicine Source Type: research

Public attitudes towards cardiopulmonary resuscitation training and performance in Singapore
ConclusionsThe survey results show that most participants in Singapore are keen to perform conventional CPR for a member of the public and can help to target future CPR training accordingly. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - September 15, 2021 Category: Emergency Medicine Source Type: research

Postmortem diagnosis of pulmonary tumor thrombotic microangiopathy with rapid exacerbation in a patient with gastric cancer: a case report
ConclusionsIn patients with carcinoma of unknown primary site and pulmonary hypertension with pulmonary embolism ruled out by CT, emergency physicians and intensivists must consider the possibility of PTTM, which represents an oncologic emergency, and initiate chemotherapy administration as soon as possible. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - September 15, 2021 Category: Emergency Medicine Source Type: research

Recurrent acute pancreatitis during a ketogenic diet —a case report and literature review
ConclusionThis case indicates that the ketogenic diet could lower the threshold for acute pancreatitis, and that an episodic stressor may trigger an acute attack in the absence of traditional risk factors. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - September 15, 2021 Category: Emergency Medicine Source Type: research

Multisystem inflammatory syndrome in children (MIS-C): a mini-review
AbstractMultisystem inflammatory syndrome in children (MIS-C) is a novel, life-threatening hyperinflammatory condition that develops in children a few weeks after infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). This disease has created a diagnostic challenge due to overlap with Kawasaki disease (KD) and KD shock syndrome. The majority of patients with MIS-C present with the involvement of at least four organ systems, and all have evidence of a marked inflammatory state. Most patients show an increase in the level of at least four inflammatory markers (C-reactive protein, neutrophil count, ferri...
Source: International Journal of Emergency Medicine - September 10, 2021 Category: Emergency Medicine Source Type: research

A big white dot after CPR
ConclusionThis case reminds us to consider neurologic causes of cardiac arrest. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - September 10, 2021 Category: Emergency Medicine Source Type: research

When disasters strike the emergency department: a case series and narrative review
ConclusionsHospitals and their EDs are at-risk for crises and their potential escalation to hospital disasters. Emerging risks due to climate-related emergencies, infectious disease outbreaks, terrorism, and cyberattacks pose particular threats. If a hospital is not prepared for IHCDs, it undermines the capacity of administration and staff to safeguard the safety of patients. Therefore, hospitals and their EDs must check and where necessary enhance their preparedness for these contingencies. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - September 9, 2021 Category: Emergency Medicine Source Type: research

Impact of an end-of-fourth-year emergency medicine bootcamp
ConclusionsParticipation in an EM bootcamp increases self-confidence at the start of residency among EM-matched residents. EM bootcamps and other specialty-specific courses at the end of medical school may ease the transition from student to clinician and may improve clinical knowledge and procedural skills. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - September 3, 2021 Category: Emergency Medicine Source Type: research

A survey study of the psychological impact of COVID-19 pandemic on physician parents
(Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - August 30, 2021 Category: Emergency Medicine Source Type: research

A young woman presented with massive pulmonary embolism with inferior vena cava thrombus as a complication of nephrotic syndrome: a case report
AbstractNephrotic syndrome (NS) was first described in 1827 as the presence of proteinuria of ≥ 3.5 g/24 h, hypoalbuminemia
Source: International Journal of Emergency Medicine - August 23, 2021 Category: Emergency Medicine Source Type: research

Rapid sequence intubation: a survey of current practice in the South African pre-hospital setting
ConclusionThe practice of safe and effective pre-hospital RSI, performed by non-physician providers or ECPs, relies on comprehensive implementation and adherence to all the components of the minimum standards. Although there is largely an apparent alignment with the minimum standards, recurrent revision of practice needs to occur to ensure alignment with recommendations. Additionally, some areas may benefit from further research to improve current practice. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - August 17, 2021 Category: Emergency Medicine Source Type: research

A focused, longitudinal analysis of cannabinoid hyperemesis syndrome symptomatology
(Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - July 29, 2021 Category: Emergency Medicine Source Type: research

Hereditary angioedema
AbstractA 14-year-old African American female presented to the emergency department with spontaneous, sudden-onset lip swelling for 1 h. On examination, there was significant water-bag edema of the upper lip extending to the philtrum and premaxilla. Nasopharyngeal laryngoscopy revealed a patent airway without edema. She was initiated on intravenous dexamethasone, famotidine, and diphenhydramine, after which her edema improved but did not resolve. She was subsequently transferred to a local pediatric hospital and upon further testing she was found to have a C1 esterase inhibitor de novo gene mutation. Angioedema causes loca...
Source: International Journal of Emergency Medicine - July 29, 2021 Category: Emergency Medicine Source Type: research

Adolescent and young adult stress and coping during COVID-19: the utility of a pediatric emergency department screener
ConclusionsWhile patients typically present to PEDs for a somatic complaint, screening their psychosocial and emotional states may reveal underlying mental health concerns that require intervention and at times, assistance from social workers. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - July 27, 2021 Category: Emergency Medicine Source Type: research

Feasible and effective use of a simulation-based curriculum for post-graduate emergency medicine trainees in India to improve learner self-efficacy, knowledge, and skills
AbstractBackgroundPediatric emergency medicine training is in its infancy in India. Simulation provides an educational avenue to equip trainees with the skills to improve pediatric care. We hypothesized that a simulation-based curriculum can improve Indian post-graduate emergency medicine (EM) trainees ’ self-efficacy, knowledge, and skills in pediatric care.MethodsWe designed a simulation-based curriculum for management of common pediatric emergencies including sepsis, trauma, and respiratory illness and pediatric-specific procedures including vascular access and airway skills. Training included didactics, procedura...
Source: International Journal of Emergency Medicine - July 27, 2021 Category: Emergency Medicine Source Type: research

Spontaneous giant rectus sheath hematoma in patients with COVID-19: two case reports and literature review
ConclusionsThese two reports and literature review demonstrate the need of active surveillance for possible hemorrhagic complications in patients with COVID-19 infection. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - July 23, 2021 Category: Emergency Medicine Source Type: research

Microbiological findings in emergency department patients with sepsis identified by the Sepsis-3 criteria: a single-center prospective population-based cohort study
ConclusionPatients identified with sepsis by SOFA score were more often blood culture-positive. Gram-positive pathogens, pulmonary tract infections,Streptococcus pneumoniae, and polymicrobial infections were also more common among SOFA patients. Polymicrobial infection,Staphylococcus aureus, and a group of other organisms were independently associated with an increased risk of death. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - July 23, 2021 Category: Emergency Medicine Source Type: research

Prehospital time of suspected stroke patients treated by emergency medical service: a nationwide study in Thailand
ConclusionPrehospital time from EMS call to hospital was approximately 30 min which was mainly utilized for traveling from the ambulance parking to the scene and transporting patients from the scene to hospitals. Even though only 48% of the services had RT ≤ 8 min, 95% of them had the scene time ≤ 15 min. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - July 19, 2021 Category: Emergency Medicine Source Type: research

Diagnostic delay of acute mitral regurgitation during the coronavirus disease 2019 pandemic: a case report
ConclusionsIn COVID-19 pandemic, anchoring bias suspecting COVID-19 among febrile patients becomes a strong heuristic factor. A thorough history and physical examination is still important in febrile patients presenting with dyspnea to ensure the correct diagnosis of acute mitral regurgitation. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - July 19, 2021 Category: Emergency Medicine Source Type: research

Case report: appendicitis induced Staphylococcus aureus and Klebsiella pneumoniae bacteremia in a young healthy male
ConclusionsAlthough rare, appendicitis can causeStaphylococcus aureus andKlebsiella pneumoniae bacteremia with extensive implications for workup and antibiotic management. Our case stresses the importance of obtaining cultures in patients with suspicion of bacteremia given its consequences for clinical management. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - July 19, 2021 Category: Emergency Medicine Source Type: research

Personal protective equipment and doffing procedures in out-of-hospital practice: assessment with a contamination simulation
ConclusionResults of this study converge towards the selection of surgical gowns over other types of PPE gowns, which met both contamination criteria as well as staff appreciation in this context. Specific attention should be paid to the legs and abdomino-pelvic areas. Additional protection such as protective trousers or aprons could be added. (Source: International Journal of Emergency Medicine)
Source: International Journal of Emergency Medicine - July 13, 2021 Category: Emergency Medicine Source Type: research