A. Kotera, H. Irie, T. Ando, S. Iwashita, J. Taniguchi, S. Kasaoka, Y. Kinoshita
A We present the case of a patient who sustained a vertebral artery injury due to a stab wound to the neck. The 76-year-old male injured himself with a rake at a slippery sea-shore location. He was transferred to the nearest hospital in the late afternoon, and a left vertebral artery injury was suspected on plain and contrast-enhanced CT. After sunset on the same day, he was transferred to our institution for endovascular treatment. Because available time of emergency helicopter service in Japan is limited to daylight hours, he was transferred by ambulance, which took nearly 2.5h. During the transfer medical staff held his head to prevent additional injuries due to unexpected rolling or bouncing in the ambulance. Fortunately no harmful event occurred, and he was successfully treated. Although endovascular treatment is available at a limited number of institutions, patients with a suspected vertebral artery injury should be transferred to such an institution. If the transfer distance is long, examinations for the injury should be minimized and transfer by helicopter should be considered as early as possible. If a helicopter is not available, care should be taken to minimize the stress experienced by the patient and medical staff during the transfer.
{"title":"A case of vertebral artery injury caused by a stab wound to the neck who was long time transported by an ambulance","authors":"A. Kotera, H. Irie, T. Ando, S. Iwashita, J. Taniguchi, S. Kasaoka, Y. Kinoshita","doi":"10.3893/JJAAM.25.50","DOIUrl":"https://doi.org/10.3893/JJAAM.25.50","url":null,"abstract":"A We present the case of a patient who sustained a vertebral artery injury due to a stab wound to the neck. The 76-year-old male injured himself with a rake at a slippery sea-shore location. He was transferred to the nearest hospital in the late afternoon, and a left vertebral artery injury was suspected on plain and contrast-enhanced CT. After sunset on the same day, he was transferred to our institution for endovascular treatment. Because available time of emergency helicopter service in Japan is limited to daylight hours, he was transferred by ambulance, which took nearly 2.5h. During the transfer medical staff held his head to prevent additional injuries due to unexpected rolling or bouncing in the ambulance. Fortunately no harmful event occurred, and he was successfully treated. Although endovascular treatment is available at a limited number of institutions, patients with a suspected vertebral artery injury should be transferred to such an institution. If the transfer distance is long, examinations for the injury should be minimized and transfer by helicopter should be considered as early as possible. If a helicopter is not available, care should be taken to minimize the stress experienced by the patient and medical staff during the transfer.","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"33 4 1","pages":"50-56"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79229239","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}
Hiroaki Izumida, J. Sasaki, K. Tajima, Masaru Suzuki, Seitarou Fujishima, K. Ogawa, S. Hori
Epistaxis is a common pathological condition. Although many patients visit the emergency department complaining of epistaxis, epistaxis is typically treated by otolaryngologists. At Keio University Hospital, emergency physicians care for all epistaxis patients transported by ambulance and otolaryngologists are consulted as needed. The aim of the present study was to examine the characteristics of patients with non-traumatic epistaxis, especially difficult-to-control bleeding and patients in shock, and to further clarify the role of emergency physicians in the first-line management of epistaxis. We identified patients transported by ambulance to Keio University Hospital for the treatment of non-traumatic epistaxis between January and October 2012 and collected the patients ’ clinical records retrospec-tively. As a result, 208 patients with non-traumatic epistaxis were identified. Elderly and male patients were predom-inant. Most of the patients (170 patients, 81.9%) had placed a call for emergency service at night between 17:00 to 8:00, and the transportation time ranged from 3 to 55 minutes (median, 20 minutes). Otolaryngologists were consulted in 31 cases (14.9%) because of difficult-to-control bleeding. In this group, patients had a tendency to be tak-ing anticoagulant and/or antiplatelet medications vs. p = Nine patients were shock. the emergency department within 24 hours because of a relapse of epistaxis. In conclu-sion, the relatively low rate of otolaryngologist consultations and the low rate of return visits suggest that the involvement of emergency physicians in first-line care for epistaxis is safe and efficient for the patients. Moreover, the involvement of both emergency physicians and otolaryngologist specialists enabled the safe treatment of patients who were in shock.
{"title":"Epistaxis cared by emergency physicians in emergency department","authors":"Hiroaki Izumida, J. Sasaki, K. Tajima, Masaru Suzuki, Seitarou Fujishima, K. Ogawa, S. Hori","doi":"10.3893/JJAAM.25.93","DOIUrl":"https://doi.org/10.3893/JJAAM.25.93","url":null,"abstract":"Epistaxis is a common pathological condition. Although many patients visit the emergency department complaining of epistaxis, epistaxis is typically treated by otolaryngologists. At Keio University Hospital, emergency physicians care for all epistaxis patients transported by ambulance and otolaryngologists are consulted as needed. The aim of the present study was to examine the characteristics of patients with non-traumatic epistaxis, especially difficult-to-control bleeding and patients in shock, and to further clarify the role of emergency physicians in the first-line management of epistaxis. We identified patients transported by ambulance to Keio University Hospital for the treatment of non-traumatic epistaxis between January and October 2012 and collected the patients ’ clinical records retrospec-tively. As a result, 208 patients with non-traumatic epistaxis were identified. Elderly and male patients were predom-inant. Most of the patients (170 patients, 81.9%) had placed a call for emergency service at night between 17:00 to 8:00, and the transportation time ranged from 3 to 55 minutes (median, 20 minutes). Otolaryngologists were consulted in 31 cases (14.9%) because of difficult-to-control bleeding. In this group, patients had a tendency to be tak-ing anticoagulant and/or antiplatelet medications vs. p = Nine patients were shock. the emergency department within 24 hours because of a relapse of epistaxis. In conclu-sion, the relatively low rate of otolaryngologist consultations and the low rate of return visits suggest that the involvement of emergency physicians in first-line care for epistaxis is safe and efficient for the patients. Moreover, the involvement of both emergency physicians and otolaryngologist specialists enabled the safe treatment of patients who were in shock.","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"7 1","pages":"93-101"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87832999","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}
Takehiko Kasai, Shuji Uemura, T. Narita, Toshihiro Tawara, Hiroyuki Okamoto, Y. Takeyama, E. Narimatsu
{"title":"Study of efficacy and safety of needle thoracostomy at the second intercostal space in the midclavicular line and ?fth intercostal space in the anterior axillary line by using computed tomography scans in Japanese patients","authors":"Takehiko Kasai, Shuji Uemura, T. Narita, Toshihiro Tawara, Hiroyuki Okamoto, Y. Takeyama, E. Narimatsu","doi":"10.3893/JJAAM.25.703","DOIUrl":"https://doi.org/10.3893/JJAAM.25.703","url":null,"abstract":"","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"106 1","pages":"703-709"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87862793","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}
Keiko Kurosawa, K. Ishii, Sanshi Tanabe, Tatsunori Nakashima, Takayuki Noguchi
A A 46-year-old woman with generalized convulsions following sudden loss of consciousness was transferred to the nearest hospital. Urgent coronary angiography was performed on suspicion of acute myocardial infarction. Intra-aor-tic balloon pumping was started to treat an unstable circulation. Cardiopulmonary arrest (CPA) occurred during ex-amination and cardiopulmonary resuscitation was started. The electrocardiographic diagnosis was ventricular fibril-lation. The coronary lesion was intact, but an aortic valve stenosis was indicated. A pump oxygenator was conveyed from our hospital by specialized medical staff in an ambulance-type emergency response vehicle to the nearest hospital. The patient immediately recovered to regular sinus rhythm after introduction of a percutaneous cardiopulmonary support system (PCPS). An aortic valve replacement was performed at our hospital. The post-operative clinical course was uneventful and almost full recovery was achieved. We consider that an ambulance-type emergency response vehicle is very effective, both in conveyance of specialized large-sized medical equipment and dispatch of a specialized medical team. Routine preparation and construction of an investment framework are important for a de-vice carrying special large-sized apparatus in vehicles, a fellow passenger’s appointment, etc. (JJAAM. 2014; 25: 319-24)
{"title":"A patient with cardiogenic cardiac arrest who returned to society following percutaneous cardiopulmonary support delivered by ambulance-type emergency response vehicle: A case report","authors":"Keiko Kurosawa, K. Ishii, Sanshi Tanabe, Tatsunori Nakashima, Takayuki Noguchi","doi":"10.3893/JJAAM.25.319","DOIUrl":"https://doi.org/10.3893/JJAAM.25.319","url":null,"abstract":"A A 46-year-old woman with generalized convulsions following sudden loss of consciousness was transferred to the nearest hospital. Urgent coronary angiography was performed on suspicion of acute myocardial infarction. Intra-aor-tic balloon pumping was started to treat an unstable circulation. Cardiopulmonary arrest (CPA) occurred during ex-amination and cardiopulmonary resuscitation was started. The electrocardiographic diagnosis was ventricular fibril-lation. The coronary lesion was intact, but an aortic valve stenosis was indicated. A pump oxygenator was conveyed from our hospital by specialized medical staff in an ambulance-type emergency response vehicle to the nearest hospital. The patient immediately recovered to regular sinus rhythm after introduction of a percutaneous cardiopulmonary support system (PCPS). An aortic valve replacement was performed at our hospital. The post-operative clinical course was uneventful and almost full recovery was achieved. We consider that an ambulance-type emergency response vehicle is very effective, both in conveyance of specialized large-sized medical equipment and dispatch of a specialized medical team. Routine preparation and construction of an investment framework are important for a de-vice carrying special large-sized apparatus in vehicles, a fellow passenger’s appointment, etc. (JJAAM. 2014; 25: 319-24)","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"60 1","pages":"319-324"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73924976","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}
T. Yunoki, M. Nishimoto, Hirotada Kittaka, Y. Kitamura, A. Sugie, H. Kobata, H. Akimoto
{"title":"A case of isolated dissection of the superior mesenteric artery due to blunt trauma","authors":"T. Yunoki, M. Nishimoto, Hirotada Kittaka, Y. Kitamura, A. Sugie, H. Kobata, H. Akimoto","doi":"10.3893/JJAAM.25.723","DOIUrl":"https://doi.org/10.3893/JJAAM.25.723","url":null,"abstract":"","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"2 1","pages":"723-728"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88546735","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}
Naoko Tachizawa, Hiroki Tajima, T. Sagawa, A. Tanaka, S. Furui, H. Takikawa, T. Sakamoto
{"title":"Six cases with small bowel anisakiasis developed bowel obstruction and successfully diagnosed with abdominal CT scanning","authors":"Naoko Tachizawa, Hiroki Tajima, T. Sagawa, A. Tanaka, S. Furui, H. Takikawa, T. Sakamoto","doi":"10.3893/JJAAM.25.113","DOIUrl":"https://doi.org/10.3893/JJAAM.25.113","url":null,"abstract":"","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"28 1","pages":"113-118"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85720459","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}
M. Onodera, Y. Fujino, Y. Inoue, S. Kikuchi, S. Endo
{"title":"Treatment outcomes of patients with non-variceal upper gastrointestinal bleeding in emergency and critical care center","authors":"M. Onodera, Y. Fujino, Y. Inoue, S. Kikuchi, S. Endo","doi":"10.3893/JJAAM.25.1","DOIUrl":"https://doi.org/10.3893/JJAAM.25.1","url":null,"abstract":"","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"12 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81986810","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}
Keitaro Suzuki, M. Shinozaki, A. Kaji, Atsuhiro Kurihara, E. Nishino
{"title":"Spontaneous multiple cholesterol crystal embolisms accompanied by abdominal pain and paraplegia:a case report","authors":"Keitaro Suzuki, M. Shinozaki, A. Kaji, Atsuhiro Kurihara, E. Nishino","doi":"10.3893/JJAAM.25.839","DOIUrl":"https://doi.org/10.3893/JJAAM.25.839","url":null,"abstract":"","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"60 1","pages":"839-845"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82014208","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}
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