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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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 : 2022-06-01DOI: 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":null,"pages":null},"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}
Pub Date : 2022-05-23DOI: 10.1177/10249079221096920
F. Chirico, G. Nucera, M. Leiter
Keywords: Burnout syndrome;burnout measure;emergency healthcare workers;Maslach Burnout Inventory;occupational health EN Burnout syndrome burnout measure emergency healthcare workers Maslach Burnout Inventory occupational health 325 326 2 08/25/22 20220901 NES 220901 Dear Editor in Chief, We have appreciated the paper by Zakaria et al. showing a high prevalence of burnout syndrome (BOS) among emergency healthcare workers (HCWs) in Malaysia during COVID-19 pandemic.[1] This finding is certainly in line with the literature as high levels of stress, fear, anxiety, depression, sleep disturbances, and post-traumatic stress disorders among emergency and frontline HCWs during the COVID-19 have resulted in high levels of BOS and turnover intention.[2] However, the instrument (i.e. the "Burnout Questionnaire Form") used by Zakaria et al. for measuring BOS raises some concerns. Burnout syndrome, burnout measure, emergency healthcare workers, Maslach Burnout Inventory, occupational health This latter focuses on six "Areas of Worklife" (AWS) and could be used in combination with the MBI for conducting among HCWs analyses of association between their burnout profile and job-related factors. [Extracted from the article] Copyright of Hong Kong Journal of Emergency Medicine is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
关键词：倦怠综合征；倦怠测度；急救医护人员；Maslach燃尽库存；职业健康EN倦怠综合征倦怠测量急救医护人员Maslach倦怠量表职业健康325 326 2 08/25/2220220901 NES 220901尊敬的主编，我们感谢Zakaria等人的论文。该论文显示，在新冠肺炎大流行期间，马来西亚急救医护人员（HCW）中倦怠综合征（BOS）的发病率很高。[1] 这一发现当然与文献一致，因为新冠肺炎期间，急诊和一线医务人员中高水平的压力、恐惧、焦虑、抑郁、睡眠障碍和创伤后应激障碍导致了高水平的BOS和离职意图。[2] 然而，Zakaria等人用于测量BOS的工具（即“倦怠调查表”）引起了一些担忧。倦怠综合征、倦怠测量、急救医护人员、Maslach倦怠量表、职业健康。后者侧重于六个“工作生活领域”（AWS），可与MBI结合使用，在HCW中分析其倦怠状况与工作相关因素之间的关联。【摘自文章】《香港急诊医学杂志》版权归Sage Publications股份有限公司所有，未经版权持有人明确书面许可，其内容不得复制或通过电子邮件发送到多个网站或发布到listserv。但是，用户可以打印、下载或通过电子邮件发送文章供个人使用。这可能会被删节。对复印件的准确性不作任何保证。用户应参考材料的原始发布版本以获取完整信息。（版权适用于所有人。）
{"title":"Measuring burnout syndrome requires reliable and standardized measures","authors":"F. Chirico, G. Nucera, M. Leiter","doi":"10.1177/10249079221096920","DOIUrl":"https://doi.org/10.1177/10249079221096920","url":null,"abstract":"Keywords: Burnout syndrome;burnout measure;emergency healthcare workers;Maslach Burnout Inventory;occupational health EN Burnout syndrome burnout measure emergency healthcare workers Maslach Burnout Inventory occupational health 325 326 2 08/25/22 20220901 NES 220901 Dear Editor in Chief, We have appreciated the paper by Zakaria et al. showing a high prevalence of burnout syndrome (BOS) among emergency healthcare workers (HCWs) in Malaysia during COVID-19 pandemic.[1] This finding is certainly in line with the literature as high levels of stress, fear, anxiety, depression, sleep disturbances, and post-traumatic stress disorders among emergency and frontline HCWs during the COVID-19 have resulted in high levels of BOS and turnover intention.[2] However, the instrument (i.e. the \"Burnout Questionnaire Form\") used by Zakaria et al. for measuring BOS raises some concerns. Burnout syndrome, burnout measure, emergency healthcare workers, Maslach Burnout Inventory, occupational health This latter focuses on six \"Areas of Worklife\" (AWS) and could be used in combination with the MBI for conducting among HCWs analyses of association between their burnout profile and job-related factors. [Extracted from the article] Copyright of Hong Kong Journal of Emergency Medicine is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47624495","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 : 2022-05-13DOI: 10.1177/10249079221096918
Y. Yip, Christopher Pak-To Lee, J. Cheung
We recently read an interesting study which demonstrated that self-inflating resuscitation bag (SIRB) lacking expiratory valve has unreliable performance in oxygen delivery during spontaneous breathing mimicked by mechanical lung simulator. It was postulated that the absence of an expiratory valve and the resulting air entrainment via the exhaust port accounts for the poor oxygen delivery performance. The current disposable SIRB in-use in our institutions (Med-Rescuer Disposable BVM Resuscitator 4000, BLS Systems Limited, ON, Canada) has a duckbill valve but no expiratory valve. Safety concerns regarding its oxygen delivery performance during spontaneous breathing were raised, as this SIRB was commonly used to preoxygenate critically ill patient with potentially transmissible respiratory infection (e.g. COVID-19) before tracheal intubation. We therefore performed an experiment on this SIRB using one of us as a healthy volunteer. Our small experiment demonstrated that air entrainment could occur via the exhaust port and affect oxygen delivery performance. Our experiment also demonstrated that attaching a positive end-expiratory pressure (PEEP) valve to the exhaust port improves the oxygen delivery performance. The findings of this experiment were sent to the relevant department of our institutions for safety consideration.
我们最近阅读了一项有趣的研究，该研究表明，在机械肺模拟器模拟的自发呼吸过程中，缺乏呼气阀的自充气复苏袋(SIRB)的供氧性能不可靠。据推测，没有呼气阀和由此产生的空气夹带通过排气口说明了氧气输送性能差。目前在我们的机构中使用的一次性SIRB (Med-Rescuer一次性BVM复苏器4000,BLS Systems Limited, ON, Canada)有一个鸭嘴阀，但没有呼气阀。由于该SIRB通常用于气管插管前对具有潜在传染性呼吸道感染(例如COVID-19)的危重患者进行预充氧，因此提出了其在自主呼吸过程中供氧性能的安全性问题。因此，我们对这个SIRB进行了一个实验，使用我们中的一个作为健康志愿者。我们的小型实验表明，空气夹带可以通过排气口发生，并影响氧气输送性能。我们的实验还表明，在排气口安装呼气末正压(PEEP)阀可以改善氧气输送性能。本实验结果已发送给我们机构的相关部门进行安全考虑。
{"title":"Raising the awareness for insufficient oxygen delivery from self-inflating resuscitation bags lacking expiratory valve during preoxygenation","authors":"Y. Yip, Christopher Pak-To Lee, J. Cheung","doi":"10.1177/10249079221096918","DOIUrl":"https://doi.org/10.1177/10249079221096918","url":null,"abstract":"We recently read an interesting study which demonstrated that self-inflating resuscitation bag (SIRB) lacking expiratory valve has unreliable performance in oxygen delivery during spontaneous breathing mimicked by mechanical lung simulator. It was postulated that the absence of an expiratory valve and the resulting air entrainment via the exhaust port accounts for the poor oxygen delivery performance. The current disposable SIRB in-use in our institutions (Med-Rescuer Disposable BVM Resuscitator 4000, BLS Systems Limited, ON, Canada) has a duckbill valve but no expiratory valve. Safety concerns regarding its oxygen delivery performance during spontaneous breathing were raised, as this SIRB was commonly used to preoxygenate critically ill patient with potentially transmissible respiratory infection (e.g. COVID-19) before tracheal intubation. We therefore performed an experiment on this SIRB using one of us as a healthy volunteer. Our small experiment demonstrated that air entrainment could occur via the exhaust port and affect oxygen delivery performance. Our experiment also demonstrated that attaching a positive end-expiratory pressure (PEEP) valve to the exhaust port improves the oxygen delivery performance. The findings of this experiment were sent to the relevant department of our institutions for safety consideration.","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46678954","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：