M. Cascio, B. Barcella, G. Zaccaria, I. Piazza, CoSMEU group
Dear Editor, As part of the board of CoSMEU – the Italian association of Emergency Medicine (EM) residents – we are looking with great concern at the current situation of the Emergency Departments (ED) and EM in our country,1 and we would like to share our point of view and experience. [...]
{"title":"Italian Emergency Medicine residents’ perspectives","authors":"M. Cascio, B. Barcella, G. Zaccaria, I. Piazza, CoSMEU group","doi":"10.4081/ecj.2022.10870","DOIUrl":"https://doi.org/10.4081/ecj.2022.10870","url":null,"abstract":"Dear Editor, As part of the board of CoSMEU – the Italian association of Emergency Medicine (EM) residents – we are looking with great concern at the current situation of the Emergency Departments (ED) and EM in our country,1 and we would like to share our point of view and experience. [...]","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46855234","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}
I. Casagranda, M. Gola, A. Bellone, D. Coen, A. Brambilla, G. Guiddo, C. Paolillo, R. Lerza, S. Capolongo, S. Boeri
The COVID 19 outbreak dramatically highlighted the inadequacy of the Emergency Department (ED) settings in dealing with events that can acutely affect a wide range of population. The immediate urgency to create strictly distinct pathways became also a strategic aspect for reducing possible sources of contagion inside the hospital.1 This need has often clashed with inadequate structural conditions of the hospital: in fact, the rigidity of many EDs is due to the hospital typology and its localization (affected by functional program);2,3 and it prevents them from being quickly adapted to new needs in the case of maxi-emergencies.4 In several recent international projects, the presence of a multifunctional space and/or a buffer area guarantees different scenarios in relation to the healthcare/emergency needs.5 [...]
{"title":"Challenges of the next generation hospitals: Rethinking the Emergency Department","authors":"I. Casagranda, M. Gola, A. Bellone, D. Coen, A. Brambilla, G. Guiddo, C. Paolillo, R. Lerza, S. Capolongo, S. Boeri","doi":"10.4081/ecj.2022.10840","DOIUrl":"https://doi.org/10.4081/ecj.2022.10840","url":null,"abstract":"The COVID 19 outbreak dramatically highlighted the inadequacy of the Emergency Department (ED) settings in dealing with events that can acutely affect a wide range of population. The immediate urgency to create strictly distinct pathways became also a strategic aspect for reducing possible sources of contagion inside the hospital.1 This need has often clashed with inadequate structural conditions of the hospital: in fact, the rigidity of many EDs is due to the hospital typology and its localization (affected by functional program);2,3 and it prevents them from being quickly adapted to new needs in the case of maxi-emergencies.4 In several recent international projects, the presence of a multifunctional space and/or a buffer area guarantees different scenarios in relation to the healthcare/emergency needs.5 [...]","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45749029","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}
G. Borio, Gianluca Semeraro, Emanuela Manzo, P. Maffi, M. Etteri
Delayed Splenic Rupture (DSR) is a rare but well-known manifestation of Blunt Splenic Injury (BSI), which most commonly occurs following a car accident, a fall from a great height, or a direct blow to the left thorax or abdomen. If the history of trauma is remote or unknown, the diagnosis can be difficult or missed, and a high index of suspicion is not warranted. Regardless of the time and mechanism of the inciting event, DSR should be considered in the differential diagnosis of an acute surgical abdomen. We present a case of DSR in an 81-year-old woman caused by a remote minor blunt abdominal trauma four weeks prior to her admission to our emergency department for acute abdominal pain and hemorrhagic shock (ATLS CLASS III). Starting with this case report, we conducted a literature review on the subject in order to raise awareness, knowledge, and understanding of DSR among emergency clinicians.
{"title":"Delayed splenic rupture after a minor blunt trauma: A case report and literature review","authors":"G. Borio, Gianluca Semeraro, Emanuela Manzo, P. Maffi, M. Etteri","doi":"10.4081/ecj.2022.10822","DOIUrl":"https://doi.org/10.4081/ecj.2022.10822","url":null,"abstract":"Delayed Splenic Rupture (DSR) is a rare but well-known manifestation of Blunt Splenic Injury (BSI), which most commonly occurs following a car accident, a fall from a great height, or a direct blow to the left thorax or abdomen. If the history of trauma is remote or unknown, the diagnosis can be difficult or missed, and a high index of suspicion is not warranted. Regardless of the time and mechanism of the inciting event, DSR should be considered in the differential diagnosis of an acute surgical abdomen. We present a case of DSR in an 81-year-old woman caused by a remote minor blunt abdominal trauma four weeks prior to her admission to our emergency department for acute abdominal pain and hemorrhagic shock (ATLS CLASS III). Starting with this case report, we conducted a literature review on the subject in order to raise awareness, knowledge, and understanding of DSR among emergency clinicians.","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44681098","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}
Pub Date : 2022-08-26DOI: 10.35584/carejournal.v1i2.93
Mayta Sari Dwianggimawati
Latar Belakang: Tingginya kasus penyakit hipertensi di Indonesia terus mengalami peningkatan. Penderita hipertensi yang tidak mendapat pengobatan yang memadai, akan berdampak terjadinya penyakit kerusakan pada ginjal (gagal ginjal), penyakit jantung koroner, penyakit otak (stroke) dan kematian. Peningkatan pengetahuan dan kesadaran masyarakat terhadap hipertensi dapat dilakukan dengan memberikan promosi kesehatan dengan metode audiovisual. Tujuan dari penelitian ini adalah untuk mengetahui efektifitas edukasi kesehatan berbasis audiovisual terhadap perubahan pengetahuan tentang diet rendah garam penderita hipertensi. Metode: Rancangan penelitian ini adalah Pra-eksperimental dengan desain one group pretest-posttest. Populasi sebanyak 60 orang anggota prolanis yang aktif pada kegiatan prolanis wilayah Puskesmas Adan-Adan Kabupaten Kediri. Dengan teknik Accidental Sampling didapatkan 30 orang responden yang bersedia menjadi sampel. Pengambilan data dilakukan selama satu bulan, dengan memberikan perlakuan audivosual diet rendah garam dilanjutkan pengisian kuesioner terstruktur. Analisis data menggunakan uji Wilcoxon signed rank test. Hasil: Berdasarkan hasil analisa diketahui bahwa terdapat efektifitas audiovisual diet rendah garam sebagai edukasi kesehatan terhadap perubahan pengetahuan tentang diet rendah garam penderita hipertensi (ρ-value=0,00
背景:印度尼西亚高血压发病率不断上升。高血压患者如果没有得到适当的治疗，将会导致肾脏疾病、冠心病、脑疾病和死亡。增加公众对高血压的认识和认识可以通过视听方法促进健康。本研究的目的是确定以视听为基础的健康教育对高血压低盐饮食知识改变的有效性。方法:这项研究的设计是一组预试验设计。大约有60名普罗兰尼斯特成员活跃在普斯马斯阿丹摄政地区。通过采样技术，我们得到了30名愿意做样本的受访者。数据检索持续一个月，提供低盐饮食的优待，然后进行结构问卷调查。使用Wilcoxon signed rank测试的数据分析。结果:根据分析结果发现有视听的有效性,低盐饮食变化的影响健康低盐饮食的知识教育作为高血压患者(ρ-value = 0,00 < a = 0。05)。结论:有效的视听效果有助于提高对低盐饮食的认识。卫生工作者可以通过视听媒体促进健康促进工作，让公众意识到经常进行健康检查和保持盐的摄入量，并提高控制血压的低盐饮食的知识。
{"title":"Efektifitas Edukasi Kesehatan Berbasis Audiovisual terhadap Perubahan Pengetahuan Tentang Diet Rendah Garam pada Penderita Hipertensi","authors":"Mayta Sari Dwianggimawati","doi":"10.35584/carejournal.v1i2.93","DOIUrl":"https://doi.org/10.35584/carejournal.v1i2.93","url":null,"abstract":"Latar Belakang: Tingginya kasus penyakit hipertensi di Indonesia terus mengalami peningkatan. Penderita hipertensi yang tidak mendapat pengobatan yang memadai, akan berdampak terjadinya penyakit kerusakan pada ginjal (gagal ginjal), penyakit jantung koroner, penyakit otak (stroke) dan kematian. Peningkatan pengetahuan dan kesadaran masyarakat terhadap hipertensi dapat dilakukan dengan memberikan promosi kesehatan dengan metode audiovisual. Tujuan dari penelitian ini adalah untuk mengetahui efektifitas edukasi kesehatan berbasis audiovisual terhadap perubahan pengetahuan tentang diet rendah garam penderita hipertensi. \u0000Metode: Rancangan penelitian ini adalah Pra-eksperimental dengan desain one group pretest-posttest. Populasi sebanyak 60 orang anggota prolanis yang aktif pada kegiatan prolanis wilayah Puskesmas Adan-Adan Kabupaten Kediri. Dengan teknik Accidental Sampling didapatkan 30 orang responden yang bersedia menjadi sampel. Pengambilan data dilakukan selama satu bulan, dengan memberikan perlakuan audivosual diet rendah garam dilanjutkan pengisian kuesioner terstruktur. Analisis data menggunakan uji Wilcoxon signed rank test. \u0000Hasil: Berdasarkan hasil analisa diketahui bahwa terdapat efektifitas audiovisual diet rendah garam sebagai edukasi kesehatan terhadap perubahan pengetahuan tentang diet rendah garam penderita hipertensi (ρ-value=0,00<a=0,05). \u0000Simpulan: Pemberian audiovisual efektif dalam peningkatan pengetahuan responden tentang diet rendah garam. Tenaga kesehatan dapat meningkatkan upaya promosi kesehatan menggunakan media audiovisual agar masyarakat memiliki kesadaran untuk selalu memeriksakan kesehatan dan menjaga asupan makanan yang mengandung garam serta meningkatkan pengetahuan dalam melakukan diet rendah garam sebagai upaya mengontrol tekanan darahnya.","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":"40 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81641412","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}
Tekanan darah merupakan ukuran yang dapat menentukan seberapa kuat jantung memompa darah ke seluruh tubuh. Tekanan darah sendiri dapat dipengaruhi oleh beberapa faktor, seperti gaya hidup seseorang, usia, aktivitas yang dijalani, hingga emosi yang tengah dirasakan. Bahkan, tekanan darah dapat ditentukan dari jenis kelamin dan peningkatan seiring bertambahnya usia.. Jika pengukuran tekanan darah tidak dilakukan dengan benar, bisa salah diagnosis sebagai hipertensi. Tujuan dari penelitian ini adalah untuk mengetahui gambaran hasil pengukuran tekanan darah klien di Desa Sambitan Kecamatan Pakel Kabupaten Tulungagung dalam posisi duduk dan berbaring. Populasi dalam penelitian ini adalah 77 klien yang berdomisili di , Desa Sambitan, Kecamatan Pakel, Kabupaten Tulungagung. Sampel untuk penelitian ini termasuk 30 pasien. Metode analisis data yang digunakan adalah uji statistik “Paired T Test”. Hasil penelitian ini menunjukkan bahwa pengukuran tekanan darah pada posisi duduk menunjukkan nilai sistolik rata-rata 127 mmHg dan nilai diastolik 78 mmHg, dan pengukuran tekanan darah pada posisi berbaring menunjukkan nilai sistolik rata-rata 125 mmHg dan nilai diastolik. 75 mmHg. Dari hasil analisis diperoleh p(0,000)<α(0,05), maka Ho ditolak dan H1 diterima. Yang artinya "ada perbedaan hasil pengukuran tekanan darah antara posisi klien duduk dengan berbaring di Desa Sambitan Kecamatan Pakel Kabupaten Tulungagung".Kesimpulannya terdapat perbedaan hasil pengukuran tekanan darah antara posisi duduk dengan berbaring. Hasil pengukuran tekanan darah posisi berbaring lebih rendah dari pada posisi duduk
{"title":"Gambaran Hasil Pengukuran Tekanan Darah Antara Posisi Klien Duduk dengan Berbaring di Desa Sambitan Kecamatan Pakel Kabupaten Tulungagung","authors":"Wiwid Yuliastuti, Dwi Prastyo, Salsabilla Aurellia","doi":"10.35584/carejournal.v1i2.91","DOIUrl":"https://doi.org/10.35584/carejournal.v1i2.91","url":null,"abstract":"Tekanan darah merupakan ukuran yang dapat menentukan seberapa kuat jantung memompa darah ke seluruh tubuh. Tekanan darah sendiri dapat dipengaruhi oleh beberapa faktor, seperti gaya hidup seseorang, usia, aktivitas yang dijalani, hingga emosi yang tengah dirasakan. Bahkan, tekanan darah dapat ditentukan dari jenis kelamin dan peningkatan seiring bertambahnya usia.. Jika pengukuran tekanan darah tidak dilakukan dengan benar, bisa salah diagnosis sebagai hipertensi. Tujuan dari penelitian ini adalah untuk mengetahui gambaran hasil pengukuran tekanan darah klien di Desa Sambitan Kecamatan Pakel Kabupaten Tulungagung dalam posisi duduk dan berbaring. Populasi dalam penelitian ini adalah 77 klien yang berdomisili di , Desa Sambitan, Kecamatan Pakel, Kabupaten Tulungagung. Sampel untuk penelitian ini termasuk 30 pasien. Metode analisis data yang digunakan adalah uji statistik “Paired T Test”. Hasil penelitian ini menunjukkan bahwa pengukuran tekanan darah pada posisi duduk menunjukkan nilai sistolik rata-rata 127 mmHg dan nilai diastolik 78 mmHg, dan pengukuran tekanan darah pada posisi berbaring menunjukkan nilai sistolik rata-rata 125 mmHg dan nilai diastolik. 75 mmHg. Dari hasil analisis diperoleh p(0,000)<α(0,05), maka Ho ditolak dan H1 diterima. Yang artinya \"ada perbedaan hasil pengukuran tekanan darah antara posisi klien duduk dengan berbaring di Desa Sambitan Kecamatan Pakel Kabupaten Tulungagung\".Kesimpulannya terdapat perbedaan hasil pengukuran tekanan darah antara posisi duduk dengan berbaring. Hasil pengukuran tekanan darah posisi berbaring lebih rendah dari pada posisi duduk","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":"54 3 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79953450","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}
Pub Date : 2022-08-24DOI: 10.35584/carejournal.v1i2.85
Zulkifli B. Pomalango, Herlina Jusuf
Stroke merupakan penyakit yang serangannya secara tiba-tiba. Informasi melalui penyuluhan kesehatan tentang gejala stroke sangat diperlukan oleh keluarga dalam mengatasi pasien stroke di pre hospital, sehingga pasien segara mendapatkan penanganan yang tepat. Penelitian ini bertujuan untuk mengetahui pengetahuan keluarga tentang stroke, tanda, gejala serta faktor risikonya pada individu yang berisiko terkena stroke, menilai program penyuluhan kesehatan terhadap pengetahuan keluarga merawat pasien yang beresiko. Metode penelitian yakni Studi eksperimen semu, untuk menilai pengetahuan sebelum dan sesudah diberikan penyuluhan kepada keluarga yang memiliki pasien berisiko terkena stroke. Penyuluhan akan dilaksanakan secara tatap muka selama 4 menit oleh peneliti menggunakan media dan hand-out singkat. Penilaian dilakukan dengan pemberian kuesioner. Penelitian akan dilaksanakan di Wilayah Kerja Puskesmas Kota Selatan dan Puskesmas Kabila. Kegiatan ini dilaksanakn oleh 2 orang dosen, yang akan dilaksanakan selama ±2 bulan. Hasil yang ditargetkan dalam penelitian ini yakni adanya sistem pemberdayaan keluarga dalam mengoptimalkan penanganan manajemen pre hospital pada pasien stroke, yang saat ini penelitian sudah masuk pada tindak lanjut memberikan penyuluhan kesehatan kepada keluarga yang memiliki anggota keluarga beresiko mengalami stroke. Hasi penelitian didapatkan pengetahuan keluarga tentang stroke, tanda, gejala serta faktor risikonya pada individu yang berisiko terkena stroke, menilai program penyuluhan kesehatan signifikan dapat meningkatkan pengetahuan keluarga merawat pasien yang beresiko stroke.
{"title":"Pengaruh Pendidikan Kesehatan pada Pengetahuan Keluarga tentang Gejala dan Pencegahan Resiko Stroke","authors":"Zulkifli B. Pomalango, Herlina Jusuf","doi":"10.35584/carejournal.v1i2.85","DOIUrl":"https://doi.org/10.35584/carejournal.v1i2.85","url":null,"abstract":"\u0000 \u0000 \u0000 \u0000Stroke merupakan penyakit yang serangannya secara tiba-tiba. Informasi melalui penyuluhan kesehatan tentang gejala stroke sangat diperlukan oleh keluarga dalam mengatasi pasien stroke di pre hospital, sehingga pasien segara mendapatkan penanganan yang tepat. Penelitian ini bertujuan untuk mengetahui pengetahuan keluarga tentang stroke, tanda, gejala serta faktor risikonya pada individu yang berisiko terkena stroke, menilai program penyuluhan kesehatan terhadap pengetahuan keluarga merawat pasien yang beresiko. Metode penelitian yakni Studi eksperimen semu, untuk menilai pengetahuan sebelum dan sesudah diberikan penyuluhan kepada keluarga yang memiliki pasien berisiko terkena stroke. Penyuluhan akan dilaksanakan secara tatap muka selama 4 menit oleh peneliti menggunakan media dan hand-out singkat. Penilaian dilakukan dengan pemberian kuesioner. Penelitian akan dilaksanakan di Wilayah Kerja Puskesmas Kota Selatan dan Puskesmas Kabila. Kegiatan ini dilaksanakn oleh 2 orang dosen, yang akan dilaksanakan selama ±2 bulan. \u0000Hasil yang ditargetkan dalam penelitian ini yakni adanya sistem pemberdayaan keluarga dalam mengoptimalkan penanganan manajemen pre hospital pada pasien stroke, yang saat ini penelitian sudah masuk pada tindak lanjut memberikan penyuluhan kesehatan kepada keluarga yang memiliki anggota keluarga beresiko mengalami stroke. Hasi penelitian didapatkan pengetahuan keluarga tentang stroke, tanda, gejala serta faktor risikonya pada individu yang berisiko terkena stroke, menilai program penyuluhan kesehatan signifikan dapat meningkatkan pengetahuan keluarga merawat pasien yang beresiko stroke. \u0000 \u0000 \u0000 \u0000 \u0000 ","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":"225 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75786165","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}
Dear Editors, The deep, ongoing crisis of Emergency Medicine (EM) is, sadly, a well-recognised problem of the Italian National Health Care System. As beautifully outlined in the editorial by Coen et al.,1 the systematic disruption of Public Health Care, with progressively more significant cuts to the number of hospital beds and to primary care and community services has irreversibly changed the quality of care we can provide to our patients. [...]
{"title":"Community Emergency Medicine: the right care, at the right time, in the right place","authors":"C. Sorlini","doi":"10.4081/ecj.2022.10595","DOIUrl":"https://doi.org/10.4081/ecj.2022.10595","url":null,"abstract":"Dear Editors, \u0000The deep, ongoing crisis of Emergency Medicine (EM) is, sadly, a well-recognised problem of the Italian National Health Care System. \u0000As beautifully outlined in the editorial by Coen et al.,1 the systematic disruption of Public Health Care, with progressively more significant cuts to the number of hospital beds and to primary care and community services has irreversibly changed the quality of care we can provide to our patients. [...]","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45316073","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}
C. Zattera, Simona Luly, A. Cipriano, Grazia Maria Luisa Rizzelli, N. Cecconi, Massimo Santini
We report an interesting clinical case of Acquired Haemophilia A (AHA) after a probable Loxosceles rufescens spider bite in a 73- year-old woman, admitted to an Emergency Department (ED) of Central Italy during April 2019. AHA is a rare disease, whose acute clinical manifestations are not widely known by most ED physicians; its prompt recognition and treatment are crucial to avoid fatal bleeding. In particular, the development of AHA after a violin spider bite (another rare and poorly characterized clinical condition) has never been described. Therefore, our case report could provide useful insight into the understanding and treatment of such unusual and possibly life-threatening conditions.
{"title":"An unexpected turn of events: A rare case of Acquired Haemophilia A after a violin spider bite","authors":"C. Zattera, Simona Luly, A. Cipriano, Grazia Maria Luisa Rizzelli, N. Cecconi, Massimo Santini","doi":"10.4081/ecj.2022.10457","DOIUrl":"https://doi.org/10.4081/ecj.2022.10457","url":null,"abstract":"We report an interesting clinical case of Acquired Haemophilia A (AHA) after a probable Loxosceles rufescens spider bite in a 73- year-old woman, admitted to an Emergency Department (ED) of Central Italy during April 2019. AHA is a rare disease, whose acute clinical manifestations are not widely known by most ED physicians; its prompt recognition and treatment are crucial to avoid fatal bleeding. In particular, the development of AHA after a violin spider bite (another rare and poorly characterized clinical condition) has never been described. Therefore, our case report could provide useful insight into the understanding and treatment of such unusual and possibly life-threatening conditions.","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46597684","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}
Kartik Akkihal, Edy C. Adams, S. Khan, Faraz Jafri, J. Taboada, Thomas Varkey
Patients often present to the emergency department with nonspecific complaints of lumbar back pain. Because of the nature of the emergency department, the lack of knowledge or time on the part of providers, and the high levels of quick decision making, unnecessary imaging studies are often ordered to provide care for the patient’s emotional and perceived physical needs. This narrative review will present a hypothetical typical standardized case of a patient presenting with lower back pain, examine the current evidence and recommendations from the major ruling bodies in internal medicine, neurology, neurosurgery, and radiology, evaluate the major statements released by the Choosing Wisely campaign, and finally, present a new diagnostic decision tree for the management of lumbar back pain.
{"title":"Evidence-based imaging for the management of lower back pain in the emergency department: A narrative review","authors":"Kartik Akkihal, Edy C. Adams, S. Khan, Faraz Jafri, J. Taboada, Thomas Varkey","doi":"10.4081/ecj.2022.10413","DOIUrl":"https://doi.org/10.4081/ecj.2022.10413","url":null,"abstract":"Patients often present to the emergency department with nonspecific complaints of lumbar back pain. Because of the nature of the emergency department, the lack of knowledge or time on the part of providers, and the high levels of quick decision making, unnecessary imaging studies are often ordered to provide care for the patient’s emotional and perceived physical needs. This narrative review will present a hypothetical typical standardized case of a patient presenting with lower back pain, examine the current evidence and recommendations from the major ruling bodies in internal medicine, neurology, neurosurgery, and radiology, evaluate the major statements released by the Choosing Wisely campaign, and finally, present a new diagnostic decision tree for the management of lumbar back pain.","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42477085","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}
A 73-year-old man affected by hyperuricemia, dyslipidaemia and hypothyroidism presented to the emergency room with a 3-month history of fever, exertional dyspnea, progressive asthenia, and painless not itchy skin lesions. Physical exam showed purplish papules and plaques affecting any area of his body, and a slight bilateral oedema of his legs. Laboratory studies revealed a severe macrocytic anaemia (haemoglobin 4.8 g/dL, mean cell volume 119 fL) and thrombocytopenia (34,000/mm3) with hyperferritinemia (1894 ng/mL, normal value <400) and increased serum B12 (1412 pg/mL, normal value 197-771), associated with ESR 71 mm/h (normal value 1-15), CRP 139 mg/L (normal value <6), and procalcitonin 1.05 ng/mL (normal value <0.5).
{"title":"Anaemia, thrombocytopenia and skin lesions","authors":"Erika Poggiali, Giorgio Orofino, J. Peccatori","doi":"10.4081/ecj.2022.10498","DOIUrl":"https://doi.org/10.4081/ecj.2022.10498","url":null,"abstract":"A 73-year-old man affected by hyperuricemia, dyslipidaemia and hypothyroidism presented to the emergency room with a 3-month history of fever, exertional dyspnea, progressive asthenia, and painless not itchy skin lesions. Physical exam showed purplish papules and plaques affecting any area of his body, and a slight bilateral oedema of his legs. Laboratory studies revealed a severe macrocytic anaemia (haemoglobin 4.8 g/dL, mean cell volume 119 fL) and thrombocytopenia (34,000/mm3) with hyperferritinemia (1894 ng/mL, normal value <400) and increased serum B12 (1412 pg/mL, normal value 197-771), associated with ESR 71 mm/h (normal value 1-15), CRP 139 mg/L (normal value <6), and procalcitonin 1.05 ng/mL (normal value <0.5).","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45165867","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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