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A Pilot Study of Inhaled Low-dose Methoxyflurane to Support Cunningham Reduction of Anterior Shoulder Dislocation 吸入低剂量甲氧基氟醚支持肩关节前脱位Cunningham复位术的初步研究
IF 0.2 Q4 EMERGENCY MEDICINE Pub Date : 2022-12-09 DOI: 10.4274/eajem.galenos.2022.03206
Samuel Campbell, H. Wiemer, Ryan Fitzpatrick, C. Carriere, S. Teed, P. Hico, A. Snook
Aim: The Cunningham method allows for the reduction of anterior shoulder dislocations (ASD) without procedural sedation and analgesia (PSA) in some patients. This pilot study evaluates the feasibility of investigating whether the administration of inhaled methoxyflurane (I-MEOF) increases the success rate of Cunningham reduction of ASD. Materials and Methods: Twenty patients with uncomplicated ASD underwent reduction attempts using the Cunningham method supported by I-MEOF analgesia (Cunningham/I-MEOF). Outcomes included the success rate without the requirement for PSA, emergency department length of stay (LOS), and operator and patient satisfaction. Results: Of the patients enrolled. 80% were male, median age was 38.6 years (range 18-71) and 55% were the first dislocations. 35% (8/20 patients) were successfully reduced using Cunningham/I-MEOF. The remainder of patients proceeded to successful closed reduction under PSA. 60% of operators reported good to excellent satisfaction with the process. Operators identified the primary cause of failed initial reduction attempts as inadequate muscle relaxation. 80% of patients reported good to excellent satisfaction. Patients whose initial reduction attempt with Cunningham/I-MEOF was successful had an average LOS of 149 min, compared with 216 min for those who proceeded to reduction under PSA. Conclusion: Success with ASD reduction by the Cunningham technique was marginally increased with the use of I-MEOF, although 65% of patients still required PSA to facilitate reduction. Both providers and patients found the process generally satisfactory, suggesting that early administration of analgesia is appreciated.
目的:Cunningham方法可以在不使用镇静和镇痛(PSA)的情况下复位一些患者的前肩脱位(ASD)。本初步研究评估了吸入甲氧基氟醚(I-MEOF)是否能提高ASD坎宁安减法成功率的可行性。材料与方法:20例无并发症ASD患者采用Cunningham方法配合I-MEOF镇痛(Cunningham/I-MEOF)进行复位尝试。结果包括不需要PSA的成功率,急诊科住院时间(LOS),以及操作者和患者的满意度。结果:入组患者中。80%为男性,中位年龄38.6岁(18-71岁),55%为首次脱位。35%(8/20)患者使用Cunningham/I-MEOF成功复位。其余患者在PSA下进行了成功的闭合复位。60%的操作人员对该过程表示满意或非常满意。术者认为最初复位失败的主要原因是肌肉放松不足。80%的患者报告了良好到极好的满意度。Cunningham/I-MEOF初始复位成功的患者平均LOS为149分钟,而PSA下继续复位的患者平均LOS为216分钟。结论:使用I-MEOF, Cunningham技术减少ASD的成功率略有增加,尽管65%的患者仍然需要PSA来促进减少。提供者和患者都认为这个过程总体上令人满意,这表明早期镇痛是值得赞赏的。
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引用次数: 0
Mesenteric Cyst in a Child with Abdominal Pain: A Perspective from Emergency Department Attendance 肠系膜囊肿儿童腹痛:从急诊就诊的角度
IF 0.2 Q4 EMERGENCY MEDICINE Pub Date : 2022-12-09 DOI: 10.4274/eajem.galenos.2022.81905
Sarah Mohammed Bin Hariz, Ahmed Hasan AlZaabi, Ghazy Habeeb Lutf, B. Tesfayohannes, Ayesha Almemari
Mesenteric cysts are rare benign intra-abdominal pediatric lesions. It has a variable clinical presentation from an asymptomatic mass to an acute abdomen that appears in the omentum or mesentery of the gastrointestinal tract. Abdominal ultrasound and complete surgical resection are the modality of choice for diagnosis and treatment. Here, we present 15 months old boy who presented to the emergency department with constipation and abdominal pain and was found to have a huge mesenteric cyst that was excised surgically
肠系膜囊肿是一种罕见的良性腹腔内儿童病变。从无症状肿块到出现在胃肠道网膜或肠系膜的急腹症,其临床表现各不相同。腹部超声和完全手术切除是诊断和治疗的首选方式。在这里,我们介绍一个15个月大的男孩,他因便秘和腹痛到急诊科就诊,并被发现有一个巨大的肠系膜囊肿,该囊肿是通过手术切除的
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引用次数: 1
Retrospective Analysis of Bicycle Accidents at a Referral Pediatric Emergency Department: Mechanisms, Outcomes and Perspectives 转诊儿科急诊科自行车事故的回顾性分析:机制、结果和展望
IF 0.2 Q4 EMERGENCY MEDICINE Pub Date : 2022-12-09 DOI: 10.4274/eajem.galenos.2022.79446
L. Akcan Yıldız, A. Tagiyev, Ö. Tekşam
Aim: We investigated the characteristics of patients involved in bicycle accidents, along with the mechanisms of accidents and clinical outcomes in children. Our secondary aim was to assess the characteristics of patients with serious clinical consequences, such as traumatic brain injury (TBI) and permanent neurological sequelae. Materials and Methods: Children admitted to the pediatric emergency department of a tertiary referral hospital during a four-year period due to bicycle accidents were included. The mechanism of the accident was classified into two groups; high-energy trauma and low-energy trauma. Statistical analyses were performed to recognize injury patterns and clinical outcomes associated with the mechanism of the accident. Results: Three hundred-sixty children were included. Two of the injured patients were using a bicycle helmet. Twenty-nine patients (8.1%) required surgery. Fourteen patients had clinically important TBI. Eighteen patients had handlebar trauma to the abdomen. Eight patients had permanent neurological sequelae (vision loss in three, hearing loss in three, spasticity and hemiparesis in two patients) and two patients had finger amputations. Abrasions/soft tissue injuries, scalp fractures, maxillofacial fractures and TBI were also significantly more common types of injury in high-energy trauma. Conclusion: Although the recommendation of using helmets while riding was made two decades ago, the rate of helmet use is still very low in our country. In this retrospective cohort with low rate and no obligatory regulation of helmet use, high-energy bicycle accidents have caused significant clinical outcomes, including maxillofacial-scalp fractures, TBI, permanent sensory (visual and hearing) or motor (spasticity and hemiparesis) disability.
目的:我们调查了自行车事故患者的特点,以及儿童事故的机制和临床结果。我们的次要目的是评估具有严重临床后果的患者的特征,如创伤性脑损伤(TBI)和永久性神经后遗症。材料和方法:纳入四年内因自行车事故入住三级转诊医院儿科急诊科的儿童。事故机理分为两类;高能创伤和低能创伤。进行了统计分析,以识别与事故机制相关的损伤模式和临床结果。结果:360名儿童被纳入研究。其中两名受伤的病人正在使用自行车头盔。29名患者(8.1%)需要手术治疗。14名患者有临床重要的TBI。18名患者腹部有把手外伤。8名患者有永久性神经后遗症(3名患者视力下降,3名患者听力下降,2名患者痉挛和偏瘫),2名病人手指截肢。在高能创伤中,磨损/软组织损伤、头皮骨折、颌面部骨折和TBI也是更常见的损伤类型。结论:尽管20年前就提出了骑行时使用头盔的建议,但我国的头盔使用率仍然很低。在这个对头盔使用率低且没有强制性规定的回顾性队列中,高能自行车事故已导致显著的临床结果,包括颌面部头皮骨折、TBI、永久性感觉(视觉和听觉)或运动(痉挛和偏瘫)残疾。
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引用次数: 1
A COVID-19 Patient Presenting with Acute Hepatitis 1例新冠肺炎患者急性肝炎
IF 0.2 Q4 EMERGENCY MEDICINE Pub Date : 2022-12-09 DOI: 10.4274/eajem.galenos.2021.38247
M. Kaya, Simge Fidan Sarı
A 55-year-old male patient presented to our outpatient clinic with complaints of dark urine and fatigue. The laboratory parameters were as follows: alanine aminotransferase 821 IU/L, aspartate aminotransferase 1042 IU/L, alkaline phosphatase 412 IU/L gamma-glutamyl transferase 268 IU/L and the complete urinalysis revealed hematuria, while other laboratory parameters were normal. The patient's abdominal ultrasonography (USG) and Doppler USG showed no pathological finding. Hepatitis and the other serologies were negative. The patient, who did not exhibit any symptoms of Coronavirus disease-2019 (COVID-19) initially, exhibited bilateral opacities in the middle zones on chest X-ray taken after the development of fever and dyspnea on the third day of hospitalization. The computed tomography scan revealed segmental consolidation across the subpleural regions, mostly in the middle zones, and was evaluated to be consistent with COVID-19. COVID-19 treatment was planned for the patient whose nasopharyngeal swab tested positive for severe acute respiratory syndrome-Coronavirus-2.
一名55岁男性病人到我们门诊就诊,主诉尿色深和疲劳。实验室参数:丙氨酸转氨酶821 IU/L,天冬氨酸转氨酶1042 IU/L,碱性磷酸酶412 IU/L -谷氨酰转移酶268 IU/L,全尿分析血尿,其他实验室参数正常。腹部超声及多普勒超声未见病理改变。肝炎及其他血清学均为阴性。患者最初未表现出任何冠状病毒病(COVID-19)的症状,但在住院第3天出现发烧和呼吸困难后,胸部x线显示双侧中部混浊。计算机断层扫描显示横跨胸膜下区域的节段性实变,主要在中间区域,并被评估为与COVID-19一致。计划对鼻咽拭子检测为严重急性呼吸综合征-冠状病毒2型阳性的患者进行COVID-19治疗。
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引用次数: 1
Religious Coping in the Parents of Critically Ill Children 危重儿童父母的宗教应对
IF 0.2 Q4 EMERGENCY MEDICINE Pub Date : 2022-12-09 DOI: 10.4274/eajem.galenos.2022.29052
H. Çaksen
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引用次数: 0
COVID-19 Pandemic-are the Biggest Challenge Yet? 新冠肺炎大流行是迄今为止最大的挑战吗?
IF 0.2 Q4 EMERGENCY MEDICINE Pub Date : 2022-12-09 DOI: 10.4274/eajem.galenos.2021.03016
Burak Katipoğlu, M. Jaguszewski, M. Pruc, Dorota Sagan, L. Szarpak
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引用次数: 1
Is the Hospital Anxiety and Depression Scale a Useful Tool for Evaluating Suicide Patients in Emergency Department? A Crosssectional Study 医院焦虑抑郁量表是评估急诊科自杀患者的有效工具吗?横断面研究
IF 0.2 Q4 EMERGENCY MEDICINE Pub Date : 2022-09-14 DOI: 10.4274/eajem.galenos.2021.26504
Volkan Çelebi, Adeviyye Karaca, R. Güven, M. N. Bozdemir, Mustafa Keşaplı, B. Kulaksızoğlu
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引用次数: 0
Effects of Atmospheric Changes on Spontaneous Pneumothorax 大气变化对自发性胸腔积液的影响
IF 0.2 Q4 EMERGENCY MEDICINE Pub Date : 2022-09-14 DOI: 10.4274/eajem.galenos.2021.68725
M. Haberal, E. Akar, Özlem Şengören Dikiş, Muharrem Özkaya, M. Ay, H. Kaya, Melih Yüksel
Aim: Inconsistent results were reported in studies on the relationship between pneumothorax and meteorological condition. We investigated whether meteorological variables increase the incidence of pneumothorax application in a region of Turkey with intense southwestern winds. Materials and Methods: The study was conducted retrospectively using the hospital records of patients diagnosed with spontaneous pneumothorax (SP) at the emergency department or thoracic surgery outpatient clinics between January 2016 and December 2018. The admissions were grouped according to the month and seasons. Meteorological data, including daily mean temperatures (°C), atmospheric pressure (millibars), moisture (%), and wind (m/s), were obtained from the local meteorological directorate. The meteorological data on the days with and without SP were compared. Results: ‎ Total 264 patients diagnosed as pneumothorax included to this study. Of the patients, 27 (10.2%) were female, and 237 (89.8%) were male. The mean age was 36.71±17.95 years (between 18-92). Of these patients, 185 (70.0%) had primary SP, while 79 (29.9%) had secondary SP (SSP). During the study period, lower atmospheric pressure, humidity and higher °C were detected in July, August and September (<0.05). SSP was significantly higher in August and September (p<0.05). While southwestern winds were recorded on 703 days (74.5%), there were 214 days (22.7%) without such winds. Regarding the daily number of pneumothorax patient admissions, there was no statistically significant relationship between southwestern winds and SP. Conclusion: SSP was significantly higher in August and September because of lower atmospheric pressure, humidity and higher °C.
目的:气胸与气象条件关系的研究结果不一致。我们调查了气象变量是否会增加气胸在土耳其西南强风地区的发病率。材料与方法:回顾性分析2016年1月至2018年12月在急诊科或胸外科门诊诊断为自发性气胸(SP)的患者的医院记录。招生是根据月份和季节进行分组的。气象数据,包括日平均气温(°C)、大气压(毫巴)、湿度(%)和风(m/s),从当地气象局获得。比较了有无SP日的气象资料。结果:本研究共纳入264例诊断为气胸的患者。其中女性27例(10.2%),男性237例(89.8%)。平均年龄36.71±17.95岁(18 ~ 92岁)。其中185例(70.0%)为原发性SP, 79例(29.9%)为继发性SP (SSP)。研究期间,7月、8月和9月的气压、湿度和气温均较低(<0.05)。8月和9月SSP显著升高(p<0.05)。西南风有703天(74.5%),无西南风有214天(22.7%)。在每日气胸入院数方面,西南风与SP无统计学意义相关。结论:8、9月份气压、湿度较低,气温较高,SSP较高。
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引用次数: 0
HACOR Score in Predicting Non-invasive Ventilation Failure in Acute Decompensated Heart Failure and AECOAD Patients HACOR评分预测急性失代偿性心力衰竭和AECOAD患者无创通气衰竭的价值
IF 0.2 Q4 EMERGENCY MEDICINE Pub Date : 2022-09-14 DOI: 10.4274/eajem.galenos.2022.09734
Yong Hup Teh, Mohd Zahir Amin Mohd Nazri, Abdul Muhaimin Noor Azhar, Rabiha Mohd Alip
Aim: To compare the diagnostic accuracy of HACOR score in predicting non-invasive ventilation (NIV) failure among acute exacerbation of chronic obstructive airway disease and acute decompensated heart failure patients, and study the correlation of HACOR score with a length of stay and hospital mortality rate. Materials and Methods: A prospective observational study was conducted in the Emergency Department of Hospital Melaka. We enrolled patients who presented with acute respiratory distress and started them with NIV. The efficacy of the HACOR score is evaluated at several interval time points, before NIV initiation, 1 h, 2 h post NIV initiation. Results: HACOR score is much lower in NIV success subgroups and 100% NIV failure rate for the HACOR score more than 7 at 1 h and 2 h of NIV. With a cut-off value of more than 5 in 1 h of NIV, the diagnostic power is 86.27% with a sensitivity of 62.50% and specificity of 90.70%. While at 2 h of NIV the HACOR score of more than 5, its diagnostic power is 87.50% a sensitivity of 50% and specificity of 95%. In 0-2 hours of NIV, area under the curve for predicting NIV failure was 0.788, 0.868 and 0.925, respectively. Conclusion: The HACOR has good diagnostic accuracy when it is assessed at 1-2 h of NIV. It is convenient to use it to assess the efficacy of NIV especially for heart failure patients. However, HACOR score was a weak predictor of mortality in our study. The length of hospital stay was also found to be longer for those who failed to respond to NIV in our study.
目的:比较HACOR评分在预测慢性阻塞性气道疾病急性加重期和急性失代偿期心力衰竭患者无创通气(NIV)衰竭中的诊断准确性,并研究HACOR积分与住院时间和住院死亡率的相关性。材料与方法:在马六甲医院急诊科进行前瞻性观察研究。我们招募了出现急性呼吸窘迫的患者,并开始使用NIV。HACOR评分的疗效在NIV开始前、NIV开始后1小时、2小时的几个间隔时间点进行评估。结果:HACOR评分在NIV成功亚组中要低得多,在NIV 1小时和2小时HACOR得分超过7时,NIV失败率为100%。NIV 1 h的临界值大于5,诊断能力为86.27%,敏感性为62.50%,特异性为90.70%。而NIV 2 h的HACOR评分大于5,其诊断能力为87.50%,敏感性为50%,特异性为95%。在NIV的0-2小时内,预测NIV失败的曲线下面积分别为0.788、0.868和0.925。结论:HACOR在NIV后1~2h时具有良好的诊断准确性。用它来评估NIV的疗效是很方便的,尤其是对心力衰竭患者。然而,在我们的研究中,HACOR评分对死亡率的预测作用较弱。在我们的研究中,对NIV没有反应的患者住院时间也更长。
{"title":"HACOR Score in Predicting Non-invasive Ventilation Failure in Acute Decompensated Heart Failure and AECOAD Patients","authors":"Yong Hup Teh, Mohd Zahir Amin Mohd Nazri, Abdul Muhaimin Noor Azhar, Rabiha Mohd Alip","doi":"10.4274/eajem.galenos.2022.09734","DOIUrl":"https://doi.org/10.4274/eajem.galenos.2022.09734","url":null,"abstract":"Aim: To compare the diagnostic accuracy of HACOR score in predicting non-invasive ventilation (NIV) failure among acute exacerbation of chronic obstructive airway disease and acute decompensated heart failure patients, and study the correlation of HACOR score with a length of stay and hospital mortality rate. Materials and Methods: A prospective observational study was conducted in the Emergency Department of Hospital Melaka. We enrolled patients who presented with acute respiratory distress and started them with NIV. The efficacy of the HACOR score is evaluated at several interval time points, before NIV initiation, 1 h, 2 h post NIV initiation. Results: HACOR score is much lower in NIV success subgroups and 100% NIV failure rate for the HACOR score more than 7 at 1 h and 2 h of NIV. With a cut-off value of more than 5 in 1 h of NIV, the diagnostic power is 86.27% with a sensitivity of 62.50% and specificity of 90.70%. While at 2 h of NIV the HACOR score of more than 5, its diagnostic power is 87.50% a sensitivity of 50% and specificity of 95%. In 0-2 hours of NIV, area under the curve for predicting NIV failure was 0.788, 0.868 and 0.925, respectively. Conclusion: The HACOR has good diagnostic accuracy when it is assessed at 1-2 h of NIV. It is convenient to use it to assess the efficacy of NIV especially for heart failure patients. However, HACOR score was a weak predictor of mortality in our study. The length of hospital stay was also found to be longer for those who failed to respond to NIV in our study.","PeriodicalId":11814,"journal":{"name":"Eurasian Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47633583","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}
引用次数: 0
The Effect of Severe Pain on Transmyocardial Repolarization Parameters in Renal Colic Patients 剧烈疼痛对肾绞痛患者心肌复极参数的影响
IF 0.2 Q4 EMERGENCY MEDICINE Pub Date : 2022-09-14 DOI: 10.4274/eajem.galenos.2020.42275
M. Tandoğan, E. Emektar, Seda Dağar, Yücel Yüzbaşıoğlu, Handan Özen Olcay, Tuba Şafak, Y. Katırcı, Y. Çevik
{"title":"The Effect of Severe Pain on Transmyocardial Repolarization Parameters in Renal Colic Patients","authors":"M. Tandoğan, E. Emektar, Seda Dağar, Yücel Yüzbaşıoğlu, Handan Özen Olcay, Tuba Şafak, Y. Katırcı, Y. Çevik","doi":"10.4274/eajem.galenos.2020.42275","DOIUrl":"https://doi.org/10.4274/eajem.galenos.2020.42275","url":null,"abstract":"","PeriodicalId":11814,"journal":{"name":"Eurasian Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47261930","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}
引用次数: 0
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Eurasian Journal of Emergency Medicine
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