Articles

Emergency medical service systems in Sri Lanka: problems of the past, challenges of the future

The concept of emergency medical services (EMS) is new to Sri Lanka. This article describes the development, delivery, and future ideas for EMS in Sri Lanka. Sri Lanka also faces frequent natural hazards that ...

Authors: Kelum Wimalaratne, Jeong IL Lee, Kang Hyun Lee, Hee Young Lee, Jung Hun Lee and In Hye Kang

Stercoral colitis mimicking appendicitis

Stercoral colitis is an inflammatory process involving the colonic wall related to fecal impaction. This rare condition is associated with high morbidity-mortality.

Authors: Abdelghafour Elkoundi, Mustapha Bensghir and Charki Haimeur

Implementation strategies for procedural sedation and analgesia in the emergency department

Implementing procedural sedation and analgesia in the emergency department is still is a challenge on an international scale. Here, we describe the Dutch setting of emergency medicine and explain the strategie...

Authors: Maybritt I. Kuypers, Frans B. Plötz and Francis Mencl

Blood product transfusion in emergency department patients: a case-control study of practice patterns and impact on outcome

Blood product transfusion occurs in a significant percentage of intensive care unit (ICU) patients. Pulmonary complications, such as acute respiratory distress syndrome (ARDS), occurring in the setting of tran...

Authors: Alexander Beyer, Ryan Rees, Christopher Palmer, Brian T. Wessman and Brian M. Fuller

How to manage tension gastrothorax: a case report of tension gastrothorax with multiple trauma due to traumatic diaphragmatic rupture

Tension gastrothorax is a kind of obstructive shock with prolapse and distention of the stomach into the thoracic cavity. Progressive gastric distension leads to mediastinal shift, reduced venous return, decre...

Authors: Naofumi Bunya, Keigo Sawamoto, Shuji Uemura, Takashi Toyohara, Yukino Mori, Ryoko Kyan, Kei Miyata, Hideto Irifune, Keisuke Harada and Eichi Narimatsu

Hyperkalemia masked by pseudo-stemi infarct pattern and cardiac arrest

Hyperkalemia is a common electrolyte abnormality and has well-recognized early electrocardiographic manifestations including PR prolongation and symmetric T wave peaking. With severe increase in serum potassiu...

Authors: Shareez Peerbhai, Luke Masha, Adrian DaSilva-DeAbreu and Abhijeet Dhoble

Operational demands on pre-hospital emergency care for burn injuries in a middle-income setting: a study in the Western Cape, South Africa

Burns occur disproportionately within low-socioeconomic populations. The Western Cape Province of South Africa represents a middle-income setting with a high rate of burns, few specialists and few burn centres...

Authors: Rachel L. Allgaier, Lucie Laflamme and Lee A. Wallis

The effectiveness of rapid sequence intubation (RSI) versus non-RSI in emergency department: an analysis of multicenter prospective observational study

Although rapid sequence intubation (RSI) is the method of choice in emergency department (ED) airway management, data to support the use of RSI remain scarce. We sought to compare the effectiveness of airway m...

Authors: Masashi Okubo, Koichiro Gibo, Yusuke Hagiwara, Yukiko Nakayama and Kohei Hasegawa

Intravenous enalaprilat for treatment of acute hypertensive heart failure in the emergency department

Afterload reduction with bolus enalaprilat is used by some for management of acute hypertensive heart failure (HF) but existing data on the safety and effectiveness of this practice are limited. The purpose of...

Authors: Syed Imran Ayaz, Craig M. Sharkey, Gregory M. Kwiatkowski, Suprat Saely Wilson, Reba S. John, Rosa Tolomello, Arushi Mahajan, Scott Millis and Phillip D. Levy

Funding global emergency medicine research—from seed grants to NIH support

Funding for global health has grown significantly over the past two decades. Numerous funding opportunities for international development and research work exist; however, they can be difficult to navigate. Th...

Authors: Bhakti Hansoti, Adam Levine, Latha Ganti, Rockefeller Oteng, Taylor DesRosiers, Payal Modi and Jeremy Brown

The readiness of emergency and trauma care in low- and middle-income countries: a cross-sectional descriptive study of 42 public hospitals in Albania

Traumatic injuries have become a substantial but neglected epidemic in low- and middle-income countries (LMICs), but emergency rooms (ERs) in these countries are often staffed with healthcare providers who hav...

Authors: Rifat Latifi, Jayleen K. L. Gunn, John A. Stroster, Edmond Zaimi, Fatos Olldashi, Agron Dogjani, Mihal Kerci, Xheladin Draçini, Julian Kuçani, Zhaneta Shatri, Agim Kociraj, Arian Boci and Ross I. Donaldson

Creating a contemporary clerkship curriculum: the flipped classroom model in emergency medicine

The teaching modality of “flipping the classroom” has garnered recent attention in medical education. In this model, the lecture and homework components are reversed. The flipped classroom lends itself to more...

Authors: Edward K. Lew

Antibiotic prophylaxis for oral lacerations: our emergency department’s experience

The purpose of this study was to examine the emergency physician (EP) practice of prescribing prophylactic antibiotics for patients with oral lacerations. A secondary outcome measure was the infection rate of ...

Authors: Suzanne Lilley Katsetos, Roxanne Nagurka, Jaclyn Caffrey, Steven E. Keller and Tiffany Murano

Bifrontal brain abscesses secondary to orbital cellulitis and sinusitis extension

Intracranial abscesses are rare and life-threatening conditions that typically originate from direct extension from nearby structures, hematogenous dissemination or following penetrating cerebral trauma or neu...

Authors: David Traficante, Alexander Riss and Steven Hochman

A rare case of multiple spinal epidural abscesses and cauda equina syndrome presenting to the emergency department following acupuncture

Acupuncture is a form of traditional Chinese medicine being increasingly used as complementary therapy in many countries. It is relatively safe and rarely associated with deep infections.

Authors: Jing Jing Chan and Jen Jen Oh

Usefulness of hospital emergency department records to explore access to injury care in Nepal

Injuries are a major public health problem worldwide. Despite increasing morbidity and mortality from injuries in Nepal, it is not recognised in the government’s policy and programmes and few population-based ...

Authors: Santosh Bhatta, Puspa Raj Pant and Julie Mytton

Emergency medicine in Nepal: present practice and direction for future

Emergency medicine is one of the youngest recognized specialties in Nepal, and its growth in clinical practice and academic development has been challenging. In this paper, we reviewed the current state of eme...

Authors: Nishant Raj Pandey

Knowledge about systemic inflammatory response syndrome and sepsis: a survey among Dutch emergency department nurses

Sepsis has a high mortality. Early recognition and timely treatment are essential for patient survival. The aim of this study is to examine the factors that influence the knowledge and recognition of systemic ...

Authors: L. C. van den Hengel, T. Visseren, P. E. Meima-Cramer, P. P. M. Rood and S. C. E. Schuit

Unusual side effect of cannabis use: acute abdomen due to duodenal perforation

The chronic use of synthetic cannabinoids (SCs) which has become an increasingly prevalent problem can rarely cause gastric and duodenal ulcer because of their effects on gastric secretion and emptying.

Authors: Sevgi Buyukbese Sarsu

Implementation of the Canadian Emergency Department Triage and Acuity Scale (CTAS) in an Urgent Care Center in Saudi Arabia

The objectives of the study is to review and assess the implementation of the applied modified five-level triage and acuity scale triage system in AL-Yarmook Urgent Care Center (UCC), King Abdulaziz Residentia...

Authors: Abdullah Arafat, Ali Al-Farhan and Hiba Abu Khalil

An innovative safe anesthesia and analgesia package for emergency pediatric procedures and surgeries when no anesthetist is available

Adequate pain control through sedation and anesthesia for emergency procedures is a crucial aspect of pediatric emergency care. Resources for administering such anesthesia are extremely limited in many low-inc...

Authors: Kevin R. Schwartz, Karla Fredricks, Zaid Al Tawil, Taylor Kandler, Stella A. Odenyo, Javan Imbamba, Brett D. Nelson and Thomas F. Burke

A retrospective comparison of helicopter transport versus ground transport in patients with severe sepsis and septic shock

Helicopter emergency medical services (HEMS) extend the reach of a tertiary care center significantly. However, its role in septic patients is unclear. Our study was performed to clarify the role of HEMS in se...

Authors: Rahul Kashyap, Peter W. Anderson, Abhay Vakil, Christopher S. Russi and Rodrigo Cartin-Ceba

Diving accidents: a cohort study from the Netherlands

Diving is, besides professional reasons, an increasingly popular leisure activity. Whilst statistically compared to other sports safe, diving accidents can result in serious complications. In order to treat th...

Authors: J. W. Smithuis, E. Gips, T. P. van Rees Vellinga and M. I. Gaakeer

“Floating shoulder” injuries

“Floating shoulder” is a rare injury complex resulting from high-energy blunt force trauma to the shoulder, resulting in scapulothoracic dissociation. It is commonly associated with catastrophic neurovascular ...

Authors: Kenneth Heng

The hyperdense basilar artery sign: a case of locked-in syndrome

Locked-in syndrome, although a notoriously famous clinical entity, the rarity of the condition coupled with the variability of clinical features on acute presentation represents a potential diagnostic pitfall ...

Authors: Lasanthi Aryasinghe, Yasmin Kazim, Hamza F. Obeid and Husnain Hashim

Case-based discussion: an unusual manifestation of diaphragmatic hernia mimicking pneumothorax in an adult male

Diaphragmatic hernia is an important cause of emergency hospital admission associated with significant morbidity. It usually results from congenital defect or rupture in the diaphragm due to trauma. Prompt and...

Authors: Pradeep Kumar Vyas, Chintamani Godbole, Susheel Kumar Bindroo, Rajiv S. Mathur, Bharathi Akula and Nilesh Doctor

Predictors of early progression to severe sepsis or shock among emergency department patients with nonsevere sepsis

Progression from nonsevere sepsis—i.e., sepsis without organ failure or shock—to severe sepsis or shock among emergency department (ED) patients has been associated with significant mortality. Early recognitio...

Authors: Andre L. Holder, Namita Gupta, Elizabeth Lulaj, Miriam Furgiuele, Idaly Hidalgo, Michael P. Jones, Tiphany Jolly, Paul Gennis and Adrienne Birnbaum

Adaptive leadership curriculum for Indian paramedic trainees

Paramedic trainees in developing countries face complex and chaotic clinical environments that demand effective leadership, communication, and teamwork. Providers must rely on non-technical skills (NTS) to man...

Authors: Aditya Mantha, Nathaniel L. Coggins, Aditya Mahadevan, Rebecca N. Strehlow, Matthew C. Strehlow and S.V. Mahadevan

Ultrasonographic assessment of inferior vena cava/abdominal aorta diameter index: a new approach of assessing hypovolemic shock class 1

We designed this study to expand the usage of ultrasound to detect early occurrence of hypovolemia. We explore the potential use of inferior vena cava (IVC) and abdominal aorta (AA) diameter index (IVC:AA) mea...

Authors: Nik Hisamuddin NA Rahman, Rashidi Ahmad, Meera Mohaideen Kareem and Mohammad Iqhbal Mohammed

Point-of-care capillary HbA1c measurement in the emergency department: a useful tool to detect unrecognized and uncontrolled diabetes

Inpatient hyperglycaemia and diabetes mellitus (DM) are common and are associated with an increased risk of complications and mortality. The severity of hyperglycaemia determines the rate of complications in p...

Authors: Fernando Gomez-Peralta, Cristina Abreu, Leonor Andreu-Urioste, Ana Cristina Antolí, Carmen Rico-Fontsaré, David Martín-Fernández, Rosa Resina-Rufes, Juan Jesús Pérez-García, Ángela Negrete-Muñoz, Daniel Muñoz-Álvarez and Guillermo E. Umpierrez

Analysis of trauma admission data at an urban hospital in Maputo, Mozambique

Trauma is a major public health concern. Worldwide, injuries resulted in 4.8 million deaths in 2013, an increase of 11 % since 1990. The majority of deaths from trauma in low-and middle-income countries occur ...

Authors: Cátia Luciana Abdulfattáhe Taibo, Troy D. Moon, Orvalho A. Joaquim, Carlos R. Machado, Amina Merchant, Kelly McQueen, Mohsin Sidat and Elena Folgosa

Survey of student perception of medical education environment among emergency medicine residents of an academic medical centre in Northern India

The specialty of emergency medicine is in its infancy state in the long history of the Indian health sciences education system. Little analytical published data is available at the moment in India regarding th...

Authors: Sushant Chhabra, Asit Misra, Sumiyah Shah and Tamorish Kole

Increased analgesia administration in emergency medicine after implementation of revised guidelines

The most common complaint of patients attending the emergency department (ED) is pain, caused by different diseases. Yet the treatment of pain at the ED is suboptimal, and oligoanalgesia remains common. The ob...

Authors: Geesje Van Woerden, Crispijn L. Van Den Brand, Cornelis F. Den Hartog, Floris J. Idenburg, Diana C. Grootendorst and M. Christien Van Der Linden

Ultrasound-guided “short” midline catheters for difficult venous access in the emergency department: a retrospective analysis

Acutely ill patients admitted to the emergency department (ED) constantly require at least one fast and reliable peripheral intravenous (PIV) access. In many conditions (morbid obesity, underweight state, chro...

Authors: Giancarlo Scoppettuolo, Mauro Pittiruti, Sara Pitoni, Laura Dolcetti, Alessandro Emoli, Alessandro Mitidieri, Ivano Migliorini and Maria Giuseppina Annetta

Cross-cultural challenges in assessing medical professionalism among emergency physicians in a Middle Eastern Country (Bahrain): feasibility and psychometric properties of multisource feedback

Multisource feedback (MSF) is an evaluation tool whereby surveys assessing physicians are administered among medical peers and colleagues. Such evaluations provide physicians with non-biased valuations of both...

Authors: Ahmed Al Ansari, Ahmed Al Meer, Mooza Althawadi, Deyari Henari and Khalid Al Khalifa

Validation of the modified Japanese Triage and Acuity Scale-based triage system emphasizing the physiologic variables or mechanism of injuries

The Canadian Triage and Acuity Scale is a valid triage system. The system was translated and implemented in the Japanese emergency departments (EDs) from 2012. This system was named the Japanese Triage and Acu...

Authors: Hiraku Funakoshi, Takashi Shiga, Yosuke Homma, Yoshiyuki Nakashima, Jin Takahashi, Hiroshi Kamura and Masatomi Ikusaka

Factors affecting communication in emergency departments: doctors and nurses’ perceptions of communication in a trilingual ED in Hong Kong

This study investigates clinicians’ views of clinician-patient and clinician-clinician communication, including key factors that prevent clinicians from achieving successful communication in a large, high-pres...

Authors: Jack K.H. Pun, Christian M. I. M. Matthiessen, Kristen A. Murray and Diana Slade

A study of the workforce in emergency medicine in Israel 2012: what has changed in the last decade?

In 2003, we published a study on the Israeli workforce in emergency medicine (EM). We repeated the study in 2012 to assess changes in the workforce that have occurred in the interval decade.

Authors: Michael J. Drescher, Zev Wimpfheimer, Aziz Darawsha, Ryan Sullivan, Aviva Goral and Limor Aharonson-Daniel

Self-referrals in the emergency department: reasons why patients attend the emergency department without consulting a general practitioner first—a questionnaire study

To influence self-referral, it is crucial to know a patient’s motives to directly visit the emergency department (ED). The goal of this study is to examine motives for self-referral to the ED and compare these...

Authors: Nicole Kraaijvanger, Douwe Rijpsma, Henk van Leeuwen and Michael Edwards

Academic affairs and global health: how global health electives can accelerate progress towards ACGME milestones

Global health electives (GHEs) have become a standard offering in many residency programs. Residency electives should aid residents in achieving outcomes in the Accreditation Council for Graduate Medical Educa...

Authors: Alison Schroth Hayward, Gabrielle A. Jacquet, Tracy Sanson, Hani Mowafi and Bhakti Hansoti

Is my patient fit to be discharged? – A numerical answer to a difficult question

Authors: Pragya Mallick, Balaji Natarajan, Jassica Adaikalanadhan, Tausif A Thangalvadi and Parivalavan Rajavelu

Validating the fever protocol – Acute undifferentiated febrile illness in the ED

Authors: Sivaraj Durairaj, Parivalavan Rajavelu and Tausif Thangalvadi

Ketofol versus fentofol as induction agents for endotracheal intubation in emergency room

Authors: Vijay Shankar Manickam and Prakash Mohanasundaram

Validation of the HEART score in Indian population

Authors: Balaji Natarajan, Pragya Mallick, Tausif A Thangalvadi and Parivalavan Rajavelu

Incidence and risk factors of acute coronary syndrome in younger age groups

Authors: Abhishek Sharma, Yasser Chomayil, Firoz Abdul Karim and Venugopalan Poovathum Parambil

Isoprenaline in complete heart block patients during ambulance transport

Authors: Taraknath Taraphdhar and Sreekanth Reddy Basireddy

Epidemiology of illnesses encountered during a marathon race – an EMS perspective

Authors: Yusra Fatima, Amaan Ahmed, Sohail Abdullah and Imran Shareef

Inter hospital transfer or centralized ambulance number – what is the need of hour?

Authors: Kaveri Bharati, Taraknath Taraphdhar and Sunil Choudhary

Fatal trauma: death anlysis from September 2011 to December 2013, at Fortis hospital, Noida, India

Authors: Rinkey Ahuja, Keshav Singh, Rizwan Gani and Dina Shah;

A study to assess the factors associated with severity of road traffic injuries in the emergency medicine department in rural India

Authors: Jeedhu Radha