F. Coccolini, F. Paratore, D. Tartaglia, C. Cremonini, G. Zocco, L. Cobuccio, M. Chiarugi
Numerous innovations have been aided by abdominal wall surgical repair. Abdominal wall surgery was drastically altered by synthetic materials. Tissue engineering was unquestionably first applied to biomaterials. The purpose of the present study is to compare different repeating approaches with rising tissue engineering complexity in repairing complex incisional hernia in emergency setting. Patients with complicated incisional hernia were prospectively included in the study and divided into 4 groups: DR (Direct Repair) group underwent direct reconstruction of the abdominal wall, BR (Biological mesh Repair) group underwent reconstruction of the abdominal wall with biological mesh (retro-muscular), BPR [Biological mesh and Platelet Enriched Plasma (PEP), gel] group underwent reconstruction of the abdominal wall with Biological mesh (retro-muscular) and PEP, BPSR (biological mesh, PEP gel and Bone Marrow Stem Cells) group underwent reconstruction of the abdominal wall with biological mesh (retromuscular), PEP and Bone Marrow Stem cells (BMSc). Forty patients were enrolled. Patients in the DR group experienced a higher rate of severe complication (p<0.05). Recurrence rates were 60% for DR patients, 20% for BM patients and 10% for the BM+PEP group (p<0.05). Median follow-up period was 64.6, 55.7 and 55.8 months (p<0.05). 7- and 30-days abdominal wall thickness is progressively increased by different techniques: BP, BP+PEP and BP+PEP+BMSc (p<0.05). No mortality was registered. Tissue engineering techniques in abdominal wall reconstruction showed promising results. They seem to reduce the recurrence rate without increasing complication one in complicated incisional abdominal wall hernia. Although many aspects are yet to be determined and standardized, it seems extremely important to continue research and experimentation in this field.
{"title":"Biological prosthesis, platelet enriched plasma and bone marrow stem cells in complicated incisional hernia reconstruction in emergency surgery: a prospective case control study","authors":"F. Coccolini, F. Paratore, D. Tartaglia, C. Cremonini, G. Zocco, L. Cobuccio, M. Chiarugi","doi":"10.4081/ecj.2023.11050","DOIUrl":"https://doi.org/10.4081/ecj.2023.11050","url":null,"abstract":"Numerous innovations have been aided by abdominal wall surgical repair. Abdominal wall surgery was drastically altered by synthetic materials. Tissue engineering was unquestionably first applied to biomaterials. The purpose of the present study is to compare different repeating approaches with rising tissue engineering complexity in repairing complex incisional hernia in emergency setting. Patients with complicated incisional hernia were prospectively included in the study and divided into 4 groups: DR (Direct Repair) group underwent direct reconstruction of the abdominal wall, BR (Biological mesh Repair) group underwent reconstruction of the abdominal wall with biological mesh (retro-muscular), BPR [Biological mesh and Platelet Enriched Plasma (PEP), gel] group underwent reconstruction of the abdominal wall with Biological mesh (retro-muscular) and PEP, BPSR (biological mesh, PEP gel and Bone Marrow Stem Cells) group underwent reconstruction of the abdominal wall with biological mesh (retromuscular), PEP and Bone Marrow Stem cells (BMSc). Forty patients were enrolled. Patients in the DR group experienced a higher rate of severe complication (p<0.05). Recurrence rates were 60% for DR patients, 20% for BM patients and 10% for the BM+PEP group (p<0.05). Median follow-up period was 64.6, 55.7 and 55.8 months (p<0.05). 7- and 30-days abdominal wall thickness is progressively increased by different techniques: BP, BP+PEP and BP+PEP+BMSc (p<0.05). No mortality was registered. Tissue engineering techniques in abdominal wall reconstruction showed promising results. They seem to reduce the recurrence rate without increasing complication one in complicated incisional abdominal wall hernia. Although many aspects are yet to be determined and standardized, it seems extremely important to continue research and experimentation in this field.","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47381649","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}
Rachel McLatchie, Sarah Wilson, Matthew Reed, Francoise Ticehurst, Kathryn Easterford, Salma Alawiye, Alicia Cowan, Aakash Gupta
Objectives: To understand why the diagnosis of AAS is missed in the ED, and to characterise the presenting features of cases in which a diagnosis of AAS was missed.
Methods: A retrospective case series cohort study was performed, identifying and analysing cases where AAS was misdiagnosed in three UK EDs between 1st January 2011 and 31st December 2020.
Results: 43 cases were included, 22 of which were type A aortic dissections. The most common incorrect presumed diagnoses made were acute coronary syndrome (28%), pulmonary embolism (12%) and ‘non-specific chest pain’ (12%). In 31 cases (72%) there was no evidence from the notes that the clinician had considered AAS in the differential diagnosis. In 10 cases (23%), AAS was considered, but the clinician was falsely reassured by atypical or resolved symptoms, clinical examination, or normal chest x-ray.
Conclusions: ED clinicians may miss AAS by not considering it as a possibility, being falsely reassured by atypical or resolved symptoms, or mistaking it for other more common conditions. Further prospective work is necessary to establish the role of diagnostic aids and biomarkers in UK EDs.
{"title":"Why do emergency department clinicians miss acute aortic syndrome? A case series and descriptive analysis","authors":"Rachel McLatchie, Sarah Wilson, Matthew Reed, Francoise Ticehurst, Kathryn Easterford, Salma Alawiye, Alicia Cowan, Aakash Gupta","doi":"10.4081/ecj.2023.11153","DOIUrl":"https://doi.org/10.4081/ecj.2023.11153","url":null,"abstract":"Objectives: To understand why the diagnosis of AAS is missed in the ED, and to characterise the presenting features of cases in which a diagnosis of AAS was missed.
 Methods: A retrospective case series cohort study was performed, identifying and analysing cases where AAS was misdiagnosed in three UK EDs between 1st January 2011 and 31st December 2020.
 Results: 43 cases were included, 22 of which were type A aortic dissections. The most common incorrect presumed diagnoses made were acute coronary syndrome (28%), pulmonary embolism (12%) and ‘non-specific chest pain’ (12%). In 31 cases (72%) there was no evidence from the notes that the clinician had considered AAS in the differential diagnosis. In 10 cases (23%), AAS was considered, but the clinician was falsely reassured by atypical or resolved symptoms, clinical examination, or normal chest x-ray.
 Conclusions: ED clinicians may miss AAS by not considering it as a possibility, being falsely reassured by atypical or resolved symptoms, or mistaking it for other more common conditions. Further prospective work is necessary to establish the role of diagnostic aids and biomarkers in UK EDs.","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":"333 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135627215","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 : 2023-01-20DOI: 10.35584/carejournal.v2i1.128
Suhendra Agung Wibowo, Ifa Nofalia
Strategi koping merupakan aspek utama bagi seseorang dalam menghadapi masalah. Demikian juga dalam menghadapi permasalahan kesehatan berupa tuberkulosis. Efek TB yang kompleks tidak hanya masalah fisik akan tetapi juga masalah psikis tentu akan membutuhkan strategi koping yang bagus. Strategi koping dipengaruhi oleh banyak hal, salah satunya adalah usia seseorang. Usia dapat menggambarkan kematangan seseorang yang penuh akan pengalaman. Hal ini tentunya dapat memberikan kekuatan tersendiri bagi seseorang dalam menghadapi stressor yang muncul. Tujuan penelitian ini adalah untuk mengetahui pengaruh usia terhadap strategi koping pada pasien TB Paru di kabupaten Jombang. Penelitian ini menggunakan metode observasional analitik dengan pendekatan crossectional. 150 responden menjadi responden dalam penelitian ini dan pemilihannya berdasarkan kriteria inklusi. Teknik pengambilan sampel adalah proportional random sampling. Variabel dalam penelitian ini terdiri dari variabel bebas yaitu usia dan variabel terikat yaitu strategi koping. Data dikumpulkan menggunakan kuesioner terstruktur dan dianalisis menggunakan SPSS. Hasil dari penelitian menunjukkan bahwa faktor usia memberikan efek signifikan terhadap strategi koping pada pasien TB Paru. Hal ini berarti bahwa usia menjadi dasar bagi seseorang dalam memilih strategi koping yang digunakan dalam menghadapi stressor, sehingga disarankan melakukan pendekatan berdasarkan tingkatan usia dalam melakukan asuhan keperawatan pada pasien TB Paru.
{"title":"Usia terhadap Strategi Koping Pasien TB Paru di Jombang berbasis Teori Health Belief Model","authors":"Suhendra Agung Wibowo, Ifa Nofalia","doi":"10.35584/carejournal.v2i1.128","DOIUrl":"https://doi.org/10.35584/carejournal.v2i1.128","url":null,"abstract":"Strategi koping merupakan aspek utama bagi seseorang dalam menghadapi masalah. Demikian juga dalam menghadapi permasalahan kesehatan berupa tuberkulosis. Efek TB yang kompleks tidak hanya masalah fisik akan tetapi juga masalah psikis tentu akan membutuhkan strategi koping yang bagus. Strategi koping dipengaruhi oleh banyak hal, salah satunya adalah usia seseorang. Usia dapat menggambarkan kematangan seseorang yang penuh akan pengalaman. Hal ini tentunya dapat memberikan kekuatan tersendiri bagi seseorang dalam menghadapi stressor yang muncul. Tujuan penelitian ini adalah untuk mengetahui pengaruh usia terhadap strategi koping pada pasien TB Paru di kabupaten Jombang. Penelitian ini menggunakan metode observasional analitik dengan pendekatan crossectional. 150 responden menjadi responden dalam penelitian ini dan pemilihannya berdasarkan kriteria inklusi. Teknik pengambilan sampel adalah proportional random sampling. Variabel dalam penelitian ini terdiri dari variabel bebas yaitu usia dan variabel terikat yaitu strategi koping. Data dikumpulkan menggunakan kuesioner terstruktur dan dianalisis menggunakan SPSS. Hasil dari penelitian menunjukkan bahwa faktor usia memberikan efek signifikan terhadap strategi koping pada pasien TB Paru. Hal ini berarti bahwa usia menjadi dasar bagi seseorang dalam memilih strategi koping yang digunakan dalam menghadapi stressor, sehingga disarankan melakukan pendekatan berdasarkan tingkatan usia dalam melakukan asuhan keperawatan pada pasien TB Paru.","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":"4 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87866813","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 : 2023-01-03DOI: 10.35584/carejournal.v2i1.127
D. Retnowati, Novia Nastasia Devi
Involusi atau pengerutan uterus merupakan suatu proses dimana uterus kembali kekondisi sebelum hamil. Pada ibu primipara kekuatan kontraksi uterus lebih tinggi dan teraba lebih keras, sedangkan pada ibu multipara kontraksi uterus berlangsung lebih lama sehingga dapat memberikan pengaruh terhadap proses involusi uterus. Tujuan penelitian mengetahui hubungan paritas terhadap penurunan Tinggi Fundus Uteri pada ibu postpartum di wilayah kerja Puskesmas Beji, Kecamatan Boyolangu, Kabupaten Tulungagung tahun 2018. Penelitian dilaksanakan tanggal 16 April-15 Mei 2018. Jenis penelitian observasional, dengan pendekatan cross sectional dan instrument penelitian berupa kuesioner dan observasi. Populasi penelitian semua ibu post partum di wilayah kerja Puskesmas Beji Kecamatan Boyolangu Kabupaten Tulungagung. Sampel diambil dengan teknik purposive sampling sejumlah 30 orang. Variabel independent paritas, variabel dependent penurunan tinggi fundus uteri. Data dianalisis dengan uji chi square. Hasil penelitian didapatkan sebagian besar dari responden adalah ibu multipara yaitu sebanyak 19 orang (63,4%) dan hampir seluruh responden penurunan TFU nya normal, yaitu sebanyak 28 orang (93,3%). Uji statistik chi square didapatkan P Value = 0,001 < 0,05 sehingga H1 diterima, yang berarti ada hubungan paritas terhadap penurunan Tinggi Fundus Uteri pada ibu postpartum di wilayah kerja Puskesmas Beji, Kecamatan Boyolangu, Kabupaten Tulungagung tahun 2018. Ibu yang usianya lebih tua dan sudah beberapa kali melahirkan banyak dipengaruhi oleh proses penuaan dimana mengalami perubahan metabolisme yaitu terjadi peningkatan jumlah lemak, penurunan otot, penurunan penyerapan lemak, protein, dan karbohidrat dan hal ini akan menghambat penurunan fundus uteri. Resiko yang terjadi pada kehamilan >5 kali seperti kontraksi uterus yang kurang maksimal
{"title":"Hubungan Paritas terhadap Penurunan Tinggi Fundus Uteri pada Ibu Post Partum di Wilayah Kerja Puskesmas Beji Kecamatan Boyolangu Kabupaten Tulungagung","authors":"D. Retnowati, Novia Nastasia Devi","doi":"10.35584/carejournal.v2i1.127","DOIUrl":"https://doi.org/10.35584/carejournal.v2i1.127","url":null,"abstract":"Involusi atau pengerutan uterus merupakan suatu proses dimana uterus kembali kekondisi sebelum hamil. Pada ibu primipara kekuatan kontraksi uterus lebih tinggi dan teraba lebih keras, sedangkan pada ibu multipara kontraksi uterus berlangsung lebih lama sehingga dapat memberikan pengaruh terhadap proses involusi uterus. Tujuan penelitian mengetahui hubungan paritas terhadap penurunan Tinggi Fundus Uteri pada ibu postpartum di wilayah kerja Puskesmas Beji, Kecamatan Boyolangu, Kabupaten Tulungagung tahun 2018. Penelitian dilaksanakan tanggal 16 April-15 Mei 2018. Jenis penelitian observasional, dengan pendekatan cross sectional dan instrument penelitian berupa kuesioner dan observasi. Populasi penelitian semua ibu post partum di wilayah kerja Puskesmas Beji Kecamatan Boyolangu Kabupaten Tulungagung. Sampel diambil dengan teknik purposive sampling sejumlah 30 orang. Variabel independent paritas, variabel dependent penurunan tinggi fundus uteri. Data dianalisis dengan uji chi square. Hasil penelitian didapatkan sebagian besar dari responden adalah ibu multipara yaitu sebanyak 19 orang (63,4%) dan hampir seluruh responden penurunan TFU nya normal, yaitu sebanyak 28 orang (93,3%). Uji statistik chi square didapatkan P Value = 0,001 < 0,05 sehingga H1 diterima, yang berarti ada hubungan paritas terhadap penurunan Tinggi Fundus Uteri pada ibu postpartum di wilayah kerja Puskesmas Beji, Kecamatan Boyolangu, Kabupaten Tulungagung tahun 2018. Ibu yang usianya lebih tua dan sudah beberapa kali melahirkan banyak dipengaruhi oleh proses penuaan dimana mengalami perubahan metabolisme yaitu terjadi peningkatan jumlah lemak, penurunan otot, penurunan penyerapan lemak, protein, dan karbohidrat dan hal ini akan menghambat penurunan fundus uteri. Resiko yang terjadi pada kehamilan >5 kali seperti kontraksi uterus yang kurang maksimal","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":"114 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80751680","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}
An 86-year-old nursing home woman with an indwelling urinary catheter presented to our emergency department for abdominal pain, nausea, hyporexia after nine days of stubborn constipation despite the use of laxatives, on a background of IV stage Chronic Kidney Disease (CKD), type 2 diabetes, hypothyroidism, and bed rest syndrome with chronic pain treated with fentanyl transdermal patch. Blood tests showed a worsening of renal function (creatinine 5.7 mg/dL, nv 0.6-1; azotemia 177 mg/dL, nv 10-50), and increased C reactive protein value (5 mg/dL, nv < 0.5). Glucose and serum electrolytes were normal. Abdomen X-ray was unremarkable, and PoCUS excluded hydronephrosis and bladder globe. The urine drainage bag was purple with smelly urine.
{"title":"What is happening in that urinary catheter bag?","authors":"V. Antoci, Valentina Ferrari, Alessandro Dacrema","doi":"10.4081/ecj.2022.10990","DOIUrl":"https://doi.org/10.4081/ecj.2022.10990","url":null,"abstract":"An 86-year-old nursing home woman with an indwelling urinary catheter presented to our emergency department for abdominal pain, nausea, hyporexia after nine days of stubborn constipation despite the use of laxatives, on a background of IV stage Chronic Kidney Disease (CKD), type 2 diabetes, hypothyroidism, and bed rest syndrome with chronic pain treated with fentanyl transdermal patch. Blood tests showed a worsening of renal function (creatinine 5.7 mg/dL, nv 0.6-1; azotemia 177 mg/dL, nv 10-50), and increased C reactive protein value (5 mg/dL, nv < 0.5). Glucose and serum electrolytes were normal. Abdomen X-ray was unremarkable, and PoCUS excluded hydronephrosis and bladder globe. The urine drainage bag was purple with smelly urine.","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44337240","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}
Acute pancreatitis is a common presentation in Emergency Department. Elevated amylase and lipase level are one of the three important criteria to diagnose acute pancreatitis. Out of amylase and lipase, the latter is considered more specific for acute pancreatitis. We report a case of acute pancreatitis with a normal lipase level. On review of published literature on acute pancreatitis with normal lipase levels, 23 such case reports were retrieved. A brief review of all these cases including the case presented here had unknown etiology in 50% of cases followed by alcohol and gall stone. Pain abdomen was the commonest presentation followed by vomiting. The normal discharge could be done in 71% of cases and 17% of patients were non-survivors. Hence, normal lipase cannot rule out acute pancreatitis on its own. A typical presentation of acute pancreatitis needs radiological work up like an Ultrasound abdomen or CT scan with IV contrast (if not contraindicated) before refuting its possibility.
{"title":"Normal lipase acute pancreatitis: A case report and brief review of literature","authors":"O. Sanjeev, Ratender K. Singh, T. Ghatak","doi":"10.4081/ecj.2022.10788","DOIUrl":"https://doi.org/10.4081/ecj.2022.10788","url":null,"abstract":"Acute pancreatitis is a common presentation in Emergency Department. Elevated amylase and lipase level are one of the three important criteria to diagnose acute pancreatitis. Out of amylase and lipase, the latter is considered more specific for acute pancreatitis. We report a case of acute pancreatitis with a normal lipase level. On review of published literature on acute pancreatitis with normal lipase levels, 23 such case reports were retrieved. A brief review of all these cases including the case presented here had unknown etiology in 50% of cases followed by alcohol and gall stone. Pain abdomen was the commonest presentation followed by vomiting. The normal discharge could be done in 71% of cases and 17% of patients were non-survivors. Hence, normal lipase cannot rule out acute pancreatitis on its own. A typical presentation of acute pancreatitis needs radiological work up like an Ultrasound abdomen or CT scan with IV contrast (if not contraindicated) before refuting its possibility.","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45262055","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}
To reveal the ability of Red cell Distribution Width (RDW) to predict short-term mortality in geriatric patients presenting to the emergency department with acute heart failure and compare the results with pro B-type Natriuretic Peptide (pro-BNP). This prospective cohort study was conducted to evaluate the data of patients admitted to the emergency department between August 15th, 2021, and November 15th, 2021. The study population enrolled volunteers aged 65 years and over, who presented with acute heart failure signs and symptoms. Demographics, vital parameters, and laboratory parameters were noted. A total of 424 patients were included in the study. The 30 day-mortality rate of the study cohort was 14.4%. Older age, active malignancy, RDW, C-reactive protein, blood urea nitrogen, and pro-BNP were early independent predictors of short-term mortality. pro-BNP was a better predictor than RDW with a greater area under the curve value (0.841 versus 0.752, p=0.045, DeLong equality test). The created multivariate regression model was able to detect the risk of shortterm mortality with high accuracy (area under the curve: 0.943, accuracy: 0.936, sensitivity: 98.1, specificity: 67.2, p<0.001). Initial RDW and pro-BNP were significantly higher in the mortality group among the geriatric patients with acute decompensated heart failure presenting to the emergency department, and pro- BNP was found to be a better predictor of mortality than RDW. RDW presents as a promising hematological marker that aids in the prognosticating short-term mortality in this patient population.
{"title":"RDW and pro-BNP in predicting short-term mortality in geriatric patients presenting to the emergency department with acute decompensated heart failure","authors":"S. Özdemir, A. Özkan","doi":"10.4081/ecj.2022.10747","DOIUrl":"https://doi.org/10.4081/ecj.2022.10747","url":null,"abstract":"To reveal the ability of Red cell Distribution Width (RDW) to predict short-term mortality in geriatric patients presenting to the emergency department with acute heart failure and compare the results with pro B-type Natriuretic Peptide (pro-BNP). This prospective cohort study was conducted to evaluate the data of patients admitted to the emergency department between August 15th, 2021, and November 15th, 2021. The study population enrolled volunteers aged 65 years and over, who presented with acute heart failure signs and symptoms. Demographics, vital parameters, and laboratory parameters were noted. A total of 424 patients were included in the study. The 30 day-mortality rate of the study cohort was 14.4%. Older age, active malignancy, RDW, C-reactive protein, blood urea nitrogen, and pro-BNP were early independent predictors of short-term mortality. pro-BNP was a better predictor than RDW with a greater area under the curve value (0.841 versus 0.752, p=0.045, DeLong equality test). The created multivariate regression model was able to detect the risk of shortterm mortality with high accuracy (area under the curve: 0.943, accuracy: 0.936, sensitivity: 98.1, specificity: 67.2, p<0.001). Initial RDW and pro-BNP were significantly higher in the mortality group among the geriatric patients with acute decompensated heart failure presenting to the emergency department, and pro- BNP was found to be a better predictor of mortality than RDW. RDW presents as a promising hematological marker that aids in the prognosticating short-term mortality in this patient population.","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45160556","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}
F. Yılmaz, Yasar Tekin, Nazmi Toprak, Mehmet Berk Eyı̇nç, E. Arslan
Pulmonary Embolism (PE), when complicated by cardiac arrest, is almost always fatal despite all resuscitative efforts. However, a more favorable is possible when PE is rapidly identified as the cause of cardiac arrest and pulmonary circulation is quickly re-established by specific therapy. A 54-year-old woman was brought to the Emergency Department (ED) by 112 emergency ambulance service with the complaint of shortness of breath that had started 2 hours ago. She developed cardiac arrest while being physical examined 2 minutes after admission, and Cardiopulmonary Resuscitation (CPR) was immediately begun. Massive PE was considered the most likely diagnosis in the light of her history, physical examined, and bedside ultrasonography findings; thus, recombinant tissue Plasminogen Activator (r-tPA) was administered during CPR. The second CPR attempt achieved return of spontaneous circulation within 5 minutes. She was treated at intensive care unit for 32 days and discharged from the hospital with complete recovery.
{"title":"A case of massive pulmonary embolism causing cardiac arrest managed with successful systemic thrombolytic in the emergency department","authors":"F. Yılmaz, Yasar Tekin, Nazmi Toprak, Mehmet Berk Eyı̇nç, E. Arslan","doi":"10.4081/ecj.2022.10827","DOIUrl":"https://doi.org/10.4081/ecj.2022.10827","url":null,"abstract":"Pulmonary Embolism (PE), when complicated by cardiac arrest, is almost always fatal despite all resuscitative efforts. However, a more favorable is possible when PE is rapidly identified as the cause of cardiac arrest and pulmonary circulation is quickly re-established by specific therapy. A 54-year-old woman was brought to the Emergency Department (ED) by 112 emergency ambulance service with the complaint of shortness of breath that had started 2 hours ago. She developed cardiac arrest while being physical examined 2 minutes after admission, and Cardiopulmonary Resuscitation (CPR) was immediately begun. Massive PE was considered the most likely diagnosis in the light of her history, physical examined, and bedside ultrasonography findings; thus, recombinant tissue Plasminogen Activator (r-tPA) was administered during CPR. The second CPR attempt achieved return of spontaneous circulation within 5 minutes. She was treated at intensive care unit for 32 days and discharged from the hospital with complete recovery.","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42195905","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}
Nazer Shabrandi, Mohamad Iraj Bagheri-Saweh, B. Nouri, S. Valiee
Emergency department (ED) triage in hospitals is part of their emergency structure carried out by nurses in emergency units. There have not been many studies available on nurses' performance in triage based on the emergency severity index (ESI). This present study aimed to investigate the nurses’ performance in triage with regard to the emergency severity index and its relation to clinical outcome measures in the emergency department. This was a cross-sectional study. The hospitalization record of 600 patients who arrived at the emergency department of Sanandaj Social Security Hospital was randomly assessed based on the accuracy of triage performed by nurses. The data analysis procedure was done by employing STATA software version 12, as well as Fisher's exact test, independent t-test, and one-way ANOVA. Findings of the study revealed that nurses’ overall performance in triage showed that 82.67% of nurses had perfect triage accuracy, 12.17% had low-level triage accuracy and 5.17% had high-level triage accuracy. There was an association between nurses' performance in triage with the disposition of patients (p=0.029) and length of stay (p=0.009). Results of the study highlighted the importance of theoretical and practical triage training courses for nurses and provided a foundation for identifying effective factors for decreasing the length of stay and disposition of patients in emergency care units.
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Not available for the section "Images in Emergency".
“紧急情况下的图像”部分不可用。
{"title":"Eye and headache: Not always an inseparable association","authors":"Erika Poggiali, Chiara Morini, Vincenzo Murelli","doi":"10.4081/ecj.2022.10775","DOIUrl":"https://doi.org/10.4081/ecj.2022.10775","url":null,"abstract":"Not available for the section \"Images in Emergency\".","PeriodicalId":51984,"journal":{"name":"Emergency Care Journal","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46062085","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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