Pub Date : 2022-09-23DOI: 10.1177/10249079221125023
Yu On Li, O. Wong, S. Ko, Hing Man Ma, C. Lit, Yau Ngai Shih
Background: The video-optical intubation stylet (VS) is a slim, rigid but flexible intubating device that aids physicians to intubate patients, particularly with difficult airways. Objectives: The objective of this study was to compare the performance of emergency department doctors in using different intubating devices for intubation in an airway manikin simulating different difficult airway scenarios. Methods: Thirty emergency department doctors were recruited in a pilot study. Their performance of using traditional Macintosh laryngoscope, GlideScope®, Airtraq® and C-MAC® Video Stylet were compared in three situations: normal, restricted cervical motion and limited oral aperture. The time for intubation, first attempt success rate, failure rate, dental injury and the subjective ease of different devices by the participants were compared. Result: The mean intubation time by VS in each scenario was significantly shorter compared with other devices (Normal: 19.77s vs 24.67–28.19s, p = 0.014; Cervical restriction: 20.85 vs 26.17–31.26s, p = 0.008; Limited oral aperture:19.03 vs 29.35, p = 0.001). However, there was no significant difference in failure rate or first attempt success rate. The incidence of dental injury was significantly lower with VS than other laryngoscopes (p = 0.001, p < 0.05 and p < 0.05 in normal, cervical restriction and limited oral aperture scenarios, respectively). Moreover, participants appreciated that VS was the easiest device to intubate in each scenario. (p < 0.05 in all scenarios) Conclusion: The performance of VS was comparable to or even better than the commonly used laryngoscopes in the emergency department in airway management. When adequate training is provided, VS can be a potentially good alternative for tracheal intubation in different situations.
背景：视频光学插管管心针（VS）是一种细长、坚硬但灵活的插管设备，可帮助医生为患者插管，尤其是气道困难的患者。目的：本研究的目的是比较急诊科医生在模拟不同气道困难场景的气道模型中使用不同插管装置进行插管的表现。方法：在一项试点研究中招募了30名急诊科医生。比较了他们在三种情况下使用传统Macintosh喉镜、GlideScope®、Airtraq®和C-MAC®视频笔的性能：正常、受限的颈部运动和受限的口腔孔径。比较了参与者的插管时间、首次尝试成功率、失败率、牙齿损伤和不同器械的主观简易性。结果：与其他装置相比，VS在每种情况下的平均插管时间显著缩短（正常：19.77s VS 24.67-28.19s，p = 0.014；宫颈限制：20.85 vs 26.17–31.26秒，p = 0.008；有限口腔孔径：19.03 vs 29.35，p = 0.001）。然而，失败率或首次尝试成功率没有显著差异。VS的牙伤发生率明显低于其他喉镜（p = 0.001，p < 0.05和p < 在正常、宫颈受限和口腔受限情况下分别为0.05）。此外，参与者意识到VS在每种情况下都是最容易插管的设备。（p < 0.05）结论：VS在气道管理方面的表现与急诊科常用喉镜相当，甚至更好。当提供足够的训练时，VS可能是在不同情况下气管插管的一个潜在的好选择。
{"title":"A manikin study comparing the performance of traditional Macintosh laryngoscope, GlideScope®, Airtraq®, and video-optical intubation stylet in endotracheal intubation used by emergency doctors in simulated difficult airway intubation: A pilot study","authors":"Yu On Li, O. Wong, S. Ko, Hing Man Ma, C. Lit, Yau Ngai Shih","doi":"10.1177/10249079221125023","DOIUrl":"https://doi.org/10.1177/10249079221125023","url":null,"abstract":"Background: The video-optical intubation stylet (VS) is a slim, rigid but flexible intubating device that aids physicians to intubate patients, particularly with difficult airways. Objectives: The objective of this study was to compare the performance of emergency department doctors in using different intubating devices for intubation in an airway manikin simulating different difficult airway scenarios. Methods: Thirty emergency department doctors were recruited in a pilot study. Their performance of using traditional Macintosh laryngoscope, GlideScope®, Airtraq® and C-MAC® Video Stylet were compared in three situations: normal, restricted cervical motion and limited oral aperture. The time for intubation, first attempt success rate, failure rate, dental injury and the subjective ease of different devices by the participants were compared. Result: The mean intubation time by VS in each scenario was significantly shorter compared with other devices (Normal: 19.77s vs 24.67–28.19s, p = 0.014; Cervical restriction: 20.85 vs 26.17–31.26s, p = 0.008; Limited oral aperture:19.03 vs 29.35, p = 0.001). However, there was no significant difference in failure rate or first attempt success rate. The incidence of dental injury was significantly lower with VS than other laryngoscopes (p = 0.001, p < 0.05 and p < 0.05 in normal, cervical restriction and limited oral aperture scenarios, respectively). Moreover, participants appreciated that VS was the easiest device to intubate in each scenario. (p < 0.05 in all scenarios) Conclusion: The performance of VS was comparable to or even better than the commonly used laryngoscopes in the emergency department in airway management. When adequate training is provided, VS can be a potentially good alternative for tracheal intubation in different situations.","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":"30 1","pages":"179 - 188"},"PeriodicalIF":0.6,"publicationDate":"2022-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48263388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-20DOI: 10.1177/10249079221124754
A. Law, A. Kelly
Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). In this issue of HKJEM, Chen et al. examined the effectiveness of paediatric emergency medicine education in a nationwide survey involving 258 emergency residents and physicians in 43 teaching hospitals in Taiwan. Notably, the study reported a lack of confidence in paediatric resuscitation. Only 52.3% of the respondents felt confident enough to care for the acute paediatric resuscitation, possibly due to lack of exposure to paediatric critical patients. Also, more than half of the respondents felt their paediatric emergency case exposure was insufficient and would like more extended paediatric emergency training.1 That resonates with similar findings in other parts of the world, where a perception of a lack of paediatric case exposure was found among emergency medicine trainees.2,3 Perceptions of inadequacy of case exposure in other specialties like geriatrics, psychiatry and obstetrics were also reported.4–6 The cause could be multifaceted, including a deficiency in rotation opportunity, a lack of clear training objectives and structured experience in curriculum, and low caseload in some geographical regions. This situation is problematic as it has the potential to affect the quality of care and even the safety of certain groups of emergency department patients. Due to logistic reasons and time limitations, emergency medicine education administrators often cannot arrange for trainees to rotate to all the other specialties. For example, the current training curriculum of the Hong Kong College of Emergency Medicine7 does not require a compulsory rotation to paediatrics, geriatrics, psychiatry or obstetrics. In this regard, the exposure of a trainee in a particular patient group would be highly dependent on the case-load profile of the hospital he or she is being trained in. Worse still, the COVID-19 pandemic has aggravated this problem due to decrease patient volume and cancellation of training activities.8,9 To compensate for the inadequacy in training time in other specialties, one of the solutions would be enhancing emergency medicine training by ‘e-learning’. ‘E-learning’ or ‘electronic learning’ is often considered synonymously with ‘online learning’. This interpretation is overly simplistic. Pachler et al.10 defined e-Learning as ‘learning facilitated and supported through the use of information and communications technology, which may involve the use of computers, educational software, interactive whiteboards, digital camera, mobile devices, video-conferencing, virtual learning environment and online
{"title":"E-learning and virtual patient simulation in emergency medicine: New solutions for old problems","authors":"A. Law, A. Kelly","doi":"10.1177/10249079221124754","DOIUrl":"https://doi.org/10.1177/10249079221124754","url":null,"abstract":"Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). In this issue of HKJEM, Chen et al. examined the effectiveness of paediatric emergency medicine education in a nationwide survey involving 258 emergency residents and physicians in 43 teaching hospitals in Taiwan. Notably, the study reported a lack of confidence in paediatric resuscitation. Only 52.3% of the respondents felt confident enough to care for the acute paediatric resuscitation, possibly due to lack of exposure to paediatric critical patients. Also, more than half of the respondents felt their paediatric emergency case exposure was insufficient and would like more extended paediatric emergency training.1 That resonates with similar findings in other parts of the world, where a perception of a lack of paediatric case exposure was found among emergency medicine trainees.2,3 Perceptions of inadequacy of case exposure in other specialties like geriatrics, psychiatry and obstetrics were also reported.4–6 The cause could be multifaceted, including a deficiency in rotation opportunity, a lack of clear training objectives and structured experience in curriculum, and low caseload in some geographical regions. This situation is problematic as it has the potential to affect the quality of care and even the safety of certain groups of emergency department patients. Due to logistic reasons and time limitations, emergency medicine education administrators often cannot arrange for trainees to rotate to all the other specialties. For example, the current training curriculum of the Hong Kong College of Emergency Medicine7 does not require a compulsory rotation to paediatrics, geriatrics, psychiatry or obstetrics. In this regard, the exposure of a trainee in a particular patient group would be highly dependent on the case-load profile of the hospital he or she is being trained in. Worse still, the COVID-19 pandemic has aggravated this problem due to decrease patient volume and cancellation of training activities.8,9 To compensate for the inadequacy in training time in other specialties, one of the solutions would be enhancing emergency medicine training by ‘e-learning’. ‘E-learning’ or ‘electronic learning’ is often considered synonymously with ‘online learning’. This interpretation is overly simplistic. Pachler et al.10 defined e-Learning as ‘learning facilitated and supported through the use of information and communications technology, which may involve the use of computers, educational software, interactive whiteboards, digital camera, mobile devices, video-conferencing, virtual learning environment and online ","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":"29 1","pages":"335 - 337"},"PeriodicalIF":0.6,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41386237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-12DOI: 10.1177/10249079221116190
G. M. Y. Poon, Wing Yee Clara Wu, Rasha E. Buhumaid, E. Seow
{"title":"Her tale of three cities: Interview with three EM leaders","authors":"G. M. Y. Poon, Wing Yee Clara Wu, Rasha E. Buhumaid, E. Seow","doi":"10.1177/10249079221116190","DOIUrl":"https://doi.org/10.1177/10249079221116190","url":null,"abstract":"","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":"29 1","pages":"267 - 270"},"PeriodicalIF":0.6,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47231015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-08DOI: 10.1177/10249079221116197
R. Jahangiri
Study objective: To determine the effectiveness of intranasal topical application of tranexamic acid in reducing the need for anterior nasal packing and determine the number of episodes of rebleeding in adult patients presenting with spontaneous atraumatic anterior epistaxis. Methods: This study was a double-blind randomized trial conducted from September to November 2021 in the ENT emergency department, Khalili Hospital, Shiraz, Iran. Cotton pledgets soaked in either phenylephrine and lidocaine (con-trol group) or tranexamic acid with phenylephrine and lidocaine (intervention group) were inserted into the patients’ nostrils for 15 min. The primary outcome was the need for anterior nasal packing. The secondary outcomes were stay-ing in the ED for more than 2 h, needing electrical cauteriza-tion, and rebleeding within 24 h and 1 to 7 days of the first referral to the ED. The trial was registered with the Iranian Registry of Clinical Trials (IRCT20210403050815 N1). Results: A total of 240 patients (120 in each group) were enrolled in this study. Tranexamic acid was associated with a lower rate of need for anterior nasal packing (50.0% versus 64.2%; odds ratio (OR), 0.56; 95% confidence interval (CI): 0.33–0.94). There were no significant differences between the 2 groups in terms of the need for electrical cau-terization and the rate of rebleeding within 1 to 7 days. Tranexamic acid was associated with a lower rate of stay in the ED for more than 2 Study objective: Drugs in emergency medical service (EMS) cars are often exposed to temperature variations that could affect the stability of these drugs. We aimed to study the influence of real-life temperature exposure on the stability of 5 drugs onboard an EMS vehicle. Methods: Concentrations of active principles of 5 emergency drugs (amiodarone, rocuronium, fentanyl, succinylcholine, and epinephrine) aboard an EMS vehicle were analyzed every 3 months up to 1 year. The samples were compared to the same drugs stored for 1 year either at room temperature or in a refrigerator in the pharmacy. Succinylcholine was additionally analyzed once a week for 4 weeks after being taken out of the refrigerator. The dosage of the active principle was measured using high-pressure Q5 liquid chromatography coupled with ultravi-olet detection. Results: After the 12-month period, all drugs from the EMS car, except succinylcholine, presented concentrations still above 90% of the concentrations measured at the start of the project. Concentrations ranged from 96.3% to 103%. For succinylcholine at 12 months, the remaining concentration was 89%. Temperatures in the EMS car ranged from 13.9 C to 33.9 C (median, 22.8 C (interquartile range: 20.5 C–25.8 C)). Conclusion: In real-life conditions, amiodarone, rocuro-nium, fentanyl, succinylcholine, and epinephrine onboard an EMS vehicle did not suffer pharmacologically relevant degradation from temperature variations. All concentrations measured remained in the specification interval
{"title":"Reciprocal Abstracts","authors":"R. Jahangiri","doi":"10.1177/10249079221116197","DOIUrl":"https://doi.org/10.1177/10249079221116197","url":null,"abstract":"Study objective: To determine the effectiveness of intranasal topical application of tranexamic acid in reducing the need for anterior nasal packing and determine the number of episodes of rebleeding in adult patients presenting with spontaneous atraumatic anterior epistaxis. Methods: This study was a double-blind randomized trial conducted from September to November 2021 in the ENT emergency department, Khalili Hospital, Shiraz, Iran. Cotton pledgets soaked in either phenylephrine and lidocaine (con-trol group) or tranexamic acid with phenylephrine and lidocaine (intervention group) were inserted into the patients’ nostrils for 15 min. The primary outcome was the need for anterior nasal packing. The secondary outcomes were stay-ing in the ED for more than 2 h, needing electrical cauteriza-tion, and rebleeding within 24 h and 1 to 7 days of the first referral to the ED. The trial was registered with the Iranian Registry of Clinical Trials (IRCT20210403050815 N1). Results: A total of 240 patients (120 in each group) were enrolled in this study. Tranexamic acid was associated with a lower rate of need for anterior nasal packing (50.0% versus 64.2%; odds ratio (OR), 0.56; 95% confidence interval (CI): 0.33–0.94). There were no significant differences between the 2 groups in terms of the need for electrical cau-terization and the rate of rebleeding within 1 to 7 days. Tranexamic acid was associated with a lower rate of stay in the ED for more than 2 Study objective: Drugs in emergency medical service (EMS) cars are often exposed to temperature variations that could affect the stability of these drugs. We aimed to study the influence of real-life temperature exposure on the stability of 5 drugs onboard an EMS vehicle. Methods: Concentrations of active principles of 5 emergency drugs (amiodarone, rocuronium, fentanyl, succinylcholine, and epinephrine) aboard an EMS vehicle were analyzed every 3 months up to 1 year. The samples were compared to the same drugs stored for 1 year either at room temperature or in a refrigerator in the pharmacy. Succinylcholine was additionally analyzed once a week for 4 weeks after being taken out of the refrigerator. The dosage of the active principle was measured using high-pressure Q5 liquid chromatography coupled with ultravi-olet detection. Results: After the 12-month period, all drugs from the EMS car, except succinylcholine, presented concentrations still above 90% of the concentrations measured at the start of the project. Concentrations ranged from 96.3% to 103%. For succinylcholine at 12 months, the remaining concentration was 89%. Temperatures in the EMS car ranged from 13.9 C to 33.9 C (median, 22.8 C (interquartile range: 20.5 C–25.8 C)). Conclusion: In real-life conditions, amiodarone, rocuro-nium, fentanyl, succinylcholine, and epinephrine onboard an EMS vehicle did not suffer pharmacologically relevant degradation from temperature variations. All concentrations measured remained in the specification interval","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":"29 1","pages":"327 - 331"},"PeriodicalIF":0.6,"publicationDate":"2022-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48029580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-01DOI: 10.1177/10249079221111302
Daniel J Egan
both Study objective: Large doses of intramuscular (IM) naloxone are commonly used in out-of-hospital settings to reverse opioid toxicity; however, they are used less commonly in hospitals because of concerns about opioid withdrawal, particularly agitation. We aimed to determine the frequency of severe agitation following a single 1.6 mg IM naloxone dose. Methods : We undertook a prospective study of adult ( > 15 years) patients treated by an Australian state ambu-lance service with 1.6 mg IM administration of naloxone for respiratory depression (respiratory rate 1) within 1 hour of naloxone administration. Secondary outcomes were the proportion of presentations with acute opioid withdrawal (tachycardia [pulse rate > 100 beats/min], hypertension [systolic > 140 mm Hg], vomiting, agitation, seizure, myo-cardial infarction, arrhythmia, or pulmonary edema), and reversal of respiratory depression (respiratory rate > 10 and saturation > 92% or Glasgow Coma Scale score 15). Results : From October 2019 to July 2021, there were 197 presentations in 171 patients, with a median age of 41 years (range, 18–80 years); of the total patients, 119 were men (70%). The most common opioids were heroin (131 [66%], oxycodone 14 [7%], and morphine 11 [6%]). Severe agitation occurred in 14 presentations (7% [95% confidence interval {CI} 4% to 12%]). Opioid withdrawal occurred in 76 presentations (39% [95% CI 32% to 46%]), most commonly in the form of tachycardia (18%), Q7 mild agita-tion/anxiety (18%), and hypertension (14%). Three presentations (1.5%) received chemical Background and objective: The maintenance of sinus rhythm by means of antiarrhythmic drugs and/or upstream therapy to counter cardiac remodeling is fundamental to the management of atrial fibrillation (AF). This study aimed to analyze this approach and its appropriateness in the setting of hospital emergency departments. Methods: Secondary analysis of data from the Conclusions: Treatment to prevent the recurrence of AF is underprescribed in emergency departments. Increasing such prescription and ensuring the appropriateness of antiarrhythmic therapy prescribed are points emergency depart-ments can improve in the interest of better sinus rhythm maintenance. care hospital ED between January 7 and February 17, 2021. The inclusion criteria were as follows: (1) absence of pneumonia but presence of serious comorbidity and/or elevated biomarkers of inflammation and (2) pneumonia with or without elevated inflammatory markers but without respiratory insufficiency. The main outcome was need for an ED revisit with hospital admission and time from ED evaluation to hospitalization. Secondary outcomes were the number of COVID-A2R visits and the potential economic impact. Results: We included 278 patients with a median age of 57 years (57.9% men) and a median Charlson Comorbidity Index of 1. The median time since onset of symptoms was 7 days (interquartile range, 4–11 days). Pneumonia was diagnosed in 71.8%, and 64.7%
{"title":"Reciprocal Abstracts July 29(4)","authors":"Daniel J Egan","doi":"10.1177/10249079221111302","DOIUrl":"https://doi.org/10.1177/10249079221111302","url":null,"abstract":"both Study objective: Large doses of intramuscular (IM) naloxone are commonly used in out-of-hospital settings to reverse opioid toxicity; however, they are used less commonly in hospitals because of concerns about opioid withdrawal, particularly agitation. We aimed to determine the frequency of severe agitation following a single 1.6 mg IM naloxone dose. Methods : We undertook a prospective study of adult ( > 15 years) patients treated by an Australian state ambu-lance service with 1.6 mg IM administration of naloxone for respiratory depression (respiratory rate 1) within 1 hour of naloxone administration. Secondary outcomes were the proportion of presentations with acute opioid withdrawal (tachycardia [pulse rate > 100 beats/min], hypertension [systolic > 140 mm Hg], vomiting, agitation, seizure, myo-cardial infarction, arrhythmia, or pulmonary edema), and reversal of respiratory depression (respiratory rate > 10 and saturation > 92% or Glasgow Coma Scale score 15). Results : From October 2019 to July 2021, there were 197 presentations in 171 patients, with a median age of 41 years (range, 18–80 years); of the total patients, 119 were men (70%). The most common opioids were heroin (131 [66%], oxycodone 14 [7%], and morphine 11 [6%]). Severe agitation occurred in 14 presentations (7% [95% confidence interval {CI} 4% to 12%]). Opioid withdrawal occurred in 76 presentations (39% [95% CI 32% to 46%]), most commonly in the form of tachycardia (18%), Q7 mild agita-tion/anxiety (18%), and hypertension (14%). Three presentations (1.5%) received chemical Background and objective: The maintenance of sinus rhythm by means of antiarrhythmic drugs and/or upstream therapy to counter cardiac remodeling is fundamental to the management of atrial fibrillation (AF). This study aimed to analyze this approach and its appropriateness in the setting of hospital emergency departments. Methods: Secondary analysis of data from the Conclusions: Treatment to prevent the recurrence of AF is underprescribed in emergency departments. Increasing such prescription and ensuring the appropriateness of antiarrhythmic therapy prescribed are points emergency depart-ments can improve in the interest of better sinus rhythm maintenance. care hospital ED between January 7 and February 17, 2021. The inclusion criteria were as follows: (1) absence of pneumonia but presence of serious comorbidity and/or elevated biomarkers of inflammation and (2) pneumonia with or without elevated inflammatory markers but without respiratory insufficiency. The main outcome was need for an ED revisit with hospital admission and time from ED evaluation to hospitalization. Secondary outcomes were the number of COVID-A2R visits and the potential economic impact. Results: We included 278 patients with a median age of 57 years (57.9% men) and a median Charlson Comorbidity Index of 1. The median time since onset of symptoms was 7 days (interquartile range, 4–11 days). Pneumonia was diagnosed in 71.8%, and 64.7%","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":"29 1","pages":"260 - 264"},"PeriodicalIF":0.6,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49545393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-01DOI: 10.1177/10249079221100394
Axel YC Siu
{"title":"Asian Society for Emergency Medicine: Message from the President","authors":"Axel YC Siu","doi":"10.1177/10249079221100394","DOIUrl":"https://doi.org/10.1177/10249079221100394","url":null,"abstract":"","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":"29 1","pages":"201 - 202"},"PeriodicalIF":0.6,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48832826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-26DOI: 10.1177/10249079221106841
K. Cheung, C. Chan
Introduction: Tetrodotoxin poisoning is typically caused by puffer fish consumption. This study is to review its demographics, clinical presentations and management in Hong Kong. Method: Reported cases of tetrodotoxin poisoning to Hong Kong Poison Information Centre from October 2008 to March 2021 were included in the study. Information from electronic database was analysed. Results: Forty-two cases were included in this case series. The number of incidents of tetrodotoxin poisoning ranged from 0 to 5 per year, mostly in the winter months. Median ingestion-to-symptom and ingestion-to-door time was 2 and 6.5 h, respectively. 48% of puffer fish meal sharer was symptomatic and attended emergency department. 100% and 48% of all cases had neurological and cardiovascular/gastrointestinal symptoms, respectively. Fukuda and Tani clinical Grade 1 and 2 were the most common presentation. 17% required intensive care while most patients were managed safely in emergency department and/or emergency medicine ward. Conclusion: There are recurrent incidents of tetrodotoxin poisoning in Hong Kong. Public education is the key to prevent future outbreaks. Targeted history and enhanced availability of tetrodotoxin test would assist in its diagnoses.
{"title":"A 12-year retrospective review of tetrodotoxin poisoning in Hong Kong","authors":"K. Cheung, C. Chan","doi":"10.1177/10249079221106841","DOIUrl":"https://doi.org/10.1177/10249079221106841","url":null,"abstract":"Introduction: Tetrodotoxin poisoning is typically caused by puffer fish consumption. This study is to review its demographics, clinical presentations and management in Hong Kong. Method: Reported cases of tetrodotoxin poisoning to Hong Kong Poison Information Centre from October 2008 to March 2021 were included in the study. Information from electronic database was analysed. Results: Forty-two cases were included in this case series. The number of incidents of tetrodotoxin poisoning ranged from 0 to 5 per year, mostly in the winter months. Median ingestion-to-symptom and ingestion-to-door time was 2 and 6.5 h, respectively. 48% of puffer fish meal sharer was symptomatic and attended emergency department. 100% and 48% of all cases had neurological and cardiovascular/gastrointestinal symptoms, respectively. Fukuda and Tani clinical Grade 1 and 2 were the most common presentation. 17% required intensive care while most patients were managed safely in emergency department and/or emergency medicine ward. Conclusion: There are recurrent incidents of tetrodotoxin poisoning in Hong Kong. Public education is the key to prevent future outbreaks. Targeted history and enhanced availability of tetrodotoxin test would assist in its diagnoses.","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":"30 1","pages":"111 - 116"},"PeriodicalIF":0.6,"publicationDate":"2022-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42899896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 50-year-old man with history of type II diabetic mellitus attended the emergency department with persistent foreign body sensation after swallowing a drug pill. He also had mild odynophagia. Tracing his history, it was found that he had progressive dysphagia in previous 2 months. There was no coughing or choking immediately after swallowing the pill and speech quality was normal. He denied weight loss in last 6 months. On physical examination, no palpable mass or thyroid goiter was noted. Laboratory data were in acceptable range. A point-of-care ultrasound with a linear probe over the patient’s neck was done. Later, computed tomography was done for confirming the diagnosis.
{"title":"A man with difficulty dysphagia","authors":"Po-An Chen, Yu-Hsuan Lee, Chun-Yen Huang, Sheng-En Chu, Shyh-Shyong Sim, Jen-Tang Sun","doi":"10.1177/10249079221105725","DOIUrl":"https://doi.org/10.1177/10249079221105725","url":null,"abstract":"A 50-year-old man with history of type II diabetic mellitus attended the emergency department with persistent foreign body sensation after swallowing a drug pill. He also had mild odynophagia. Tracing his history, it was found that he had progressive dysphagia in previous 2 months. There was no coughing or choking immediately after swallowing the pill and speech quality was normal. He denied weight loss in last 6 months. On physical examination, no palpable mass or thyroid goiter was noted. Laboratory data were in acceptable range. A point-of-care ultrasound with a linear probe over the patient’s neck was done. Later, computed tomography was done for confirming the diagnosis.","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":"30 1","pages":"321 - 323"},"PeriodicalIF":0.6,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42148431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-16DOI: 10.1016/j.molcel.2022.05.036
For our 25th anniversary issue of Molecular Cell, we talk to one of our original board members, Dr. Susan M. Gasser, on the trajectory of her research in chromatin response to DNA repair, the concepts in the field, and technologies that influenced these discoveries. She also shares her thoughts on the evolution of Molecular Cell and what makes a "good" paper.
在《分子细胞》创刊25周年之际，我们采访了《分子细胞》最初的董事会成员之一苏珊-M-加瑟博士（Dr. Susan M. Gasser），她讲述了自己在染色质响应DNA修复方面的研究轨迹、该领域的概念以及影响这些发现的技术。她还分享了她对《分子细胞》发展的看法以及什么是 "好 "论文。
{"title":"Diving into chromatin organization and DNA repair: An interview with Dr. Susan M. Gasser.","authors":"","doi":"10.1016/j.molcel.2022.05.036","DOIUrl":"10.1016/j.molcel.2022.05.036","url":null,"abstract":"<p><p>For our 25th anniversary issue of Molecular Cell, we talk to one of our original board members, Dr. Susan M. Gasser, on the trajectory of her research in chromatin response to DNA repair, the concepts in the field, and technologies that influenced these discoveries. She also shares her thoughts on the evolution of Molecular Cell and what makes a \"good\" paper.</p>","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":"28 1","pages":"2170-2172"},"PeriodicalIF":16.0,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89829818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-01DOI: 10.1177/10249079221099636
{"title":"11th Asian Conference on Emergency Medicine (ACEM) 2021 Conference proceedings","authors":"","doi":"10.1177/10249079221099636","DOIUrl":"https://doi.org/10.1177/10249079221099636","url":null,"abstract":"","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":"29 1","pages":"2S - 87S"},"PeriodicalIF":0.6,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65716650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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