scholarly journals 285 Improving the Identification of Symptomatic or Ruptured AAA in The Emergency Department

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
B Al-Khazaali
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Back Pain ◽  
Clinical Practice ◽  
Royal College ◽  
Screening Program ◽  
Standard Technique ◽  
Cycle Phase ◽  
Number Of Patients ◽  
Life Threatening

Abstract Background rAAA is a life-threatening emergency. Without early treatment, it can be fatal. Patient > 50 presented with abdominal/back pain &hypotension or collapse a diagnosis of rAAA should be considered. Aortic ultrasound is recommended as it is the standard technique used in clinical practice and the screening program. Objective The project aimed to determine the number of patients who were screened for rAAA according to Royal College of Emergency Medicine (RCEM) guidelines and increase the adherence in clinical practice in the emergency department. Method Retrospective baseline data were obtained for 40 patients >50 with abdominal/back pain, hypotension and collapse between 1st of November to 31st of December 2019. Re-auditing was conducted after the first intervention (phase one), which included informing colleagues about RCEM guidance via emails and paper forms to record the scans’ results. In August 2020, a final cycle (phase two) was performed after educational posters were put up in the department. Results Baseline showed that out of the 40 patients only 10% of them received the U/S scan. After phase one, the audit demonstrated an increase in screening to 42%, and in the final cycle, the percentage improved to 53%. Conclusions Routine screening of rAAA were minimal in the emergency department. As a result of the project, more patients received the U/S screening and adherence to RCEM guidelines improved.

scholarly journals Just the Facts: Risk stratifying non-traumatic back pain for spinal epidural abscess in the emergency department

CJEM ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 753-755
Author(s):  
Zoe Polsky ◽  
Shawn K. Dowling ◽  
W. Bradley Jacobs
Keyword(s):  
Emergency Department ◽  
Back Pain ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Thoracic Spinal ◽  
Life Threatening ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Whole Spine ◽  
Spinal Epidural

A 65-year-old male with a history of hypertension presents to the emergency department (ED) with new onset of non-traumatic back pain. The patient is investigated for life-threatening diagnoses and screened for “red flag symptoms,” including fever, neurologic abnormalities, bowel/bladder symptoms, and a history of injectiondrug use (IVDU). The patient is treated symptomatically and discharged home but represents to the ED three additional times, each time with new and progressive symptoms. At the time of admission, he is unable to ambulate, has perineal anesthesia, and 500 cc of urinary retention. Whole spine magnetic resonance imaging (MRI) confirms a thoracic spinal epidural abscess. This case, and many like it, prompts the questions: when should emergency physicians consider the diagnosis of a spinal epidural abscess, and what is the appropriate evaluation of these patients in the ED? (Figure 1).

scholarly journals Profil Kegawatdaruratan Pasien Berdasarkan Start Triage Scale di Instalasi Gawat Darurat RSUP Prof. Dr. R. D. Kandou Manado Periode Januari 2018 sampai Juli 2018

e-CliniC ◽  
2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Muhammad F. Bazmul ◽  
Eka Y. Lantang ◽  
Barry I. Kambey
Keyword(s):  
Emergency Department ◽  
Medical Records ◽  
Emergency Services ◽  
Descriptive Study ◽  
Emergency Case ◽  
Number Of Patients ◽  
Life Threatening

Abstract: Emergency Department provides first emergency services to patients with threats of death and disability in an integrated manner involving multi disciplines. Patients who come to the Emergency Department are always assessed as 3 priorities, namely priorities 1, 2 and 3. Priority 1 is case/disease with life-threatening emergency or severe emergency; Priority 2 is case/disease with mild emergency; and Priority 3 is non-emergency case/disease. This study was aimed to obtain the Triage profile of patients at Emergency Department of Prof. Dr. R. D. Kandou Hospital Manado. This was a retrospective descriptive study using patients’ medical records. Samples were all patients treated at the Emergency Department of Prof. Dr. R. D. Kandou Hospital from January 2018 until July 2018. The results showed that there were 19,229 patients as samples. Based on sex, most patients were male, meanwhile based on age most were 51-70 years, with the highest number of patients in March 2018. There were 6,913 patients (35.9%) in the orange or emergency category (Priority 2) and 6,130 patients (31.8%) in the yellow category (Priority 3). Conclusion: Based on the Start Triage in Emergency Department, the majority of patients were in Priority 2 category, followed by Priority 3 category.Keywords: Emergency Department, Start Triage Abstrak: Instalasi Gawat Darurat (IGD) memberikan pelayanan pertama yang bersifat emergency pada pasien dengan ancaman kematian dan kecacatan secara terpadu dengan melibatkan multi disiplin ilmu. Pasien yang datang di IGD selalu dinilai kegawatannya menja-di 3 prioritas, yaitu prioritas 1, 2, dan 3. Prioritas 1 yaitu kasus/penyakit dengan kegawat-daruratan yang mengancam jiwa atau gawat darurat berat. Prioritas 2 untuk kasus/penyakit dengan gawat darurat ringan. Prioritas 3 untuk kasus/penyakit yang bukan gawat darurat. Penelitian ini bertujuan untuk mengetahui profil skala Triase pasien yang masuk di IGD RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deskriptif-retrospektif, menggunakan data rekam medis pasien. Sampel penelitian ialah seluruh pasien yang dirawat di IGD RSUP Prof. Dr. R. D. Kandou Manado periode Januari 2018 sampai Juli 2018. Hasil penelitian mendapatkan data pasien yang masuk ke Ruang IGD RSUP Prof. Dr. R. D. Kandou Manado terhitung sejak Januari hingga Juli 2018 sebanyak 19.229 orang. Distribusi pasien terbanyak berdasarkan jenis kelamin ialah laki-laki, dan berdasarkan usia ialah 51-70 tahun, dengan jumlah pasien terbanyak pada bulan Maret 2018. Pasien IGD terbanyak ialah kategori jingga yaitu emergency (Prioritas 2) berjumlah 6.913 orang (35,9%) serta kategori kuning (Prioritas 3) berjumlah 6.130 orang (31,8%). Simpulan: Berdasarkan skala Triase di IGD, pasien terbanyak ialah Prioritas 2, disusul dengan Prioritas 3.Kata kunci : Instalasi Gawat Darurat, skala Triase

scholarly journals 845. Impact of the COVID-19 Pandemic on Routine HIV Screening in an Emergency Department

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S513-S513
Author(s):  
Elizabeth A Aguilera ◽  
Gilhen Rodriguez ◽  
Gabriela P Del Bianco ◽  
Gloria Heresi ◽  
James Murphy ◽  
...  
Keyword(s):  
Emergency Department ◽  
Screening Program ◽  
Medical Center ◽  
Hiv Infections ◽  
Hiv Screening ◽  
Opt Out ◽  
Number Of Patients ◽  
Confirmatory Tests ◽  
Routine Hiv Screening ◽  
The Impact

Abstract Background The Emergency Department (ED) at Memorial Hermann Hospital (MHH) - Texas Medical Center (TMC), Houston, Texas has a long established screening program targeted at detection of HIV infections. The impact of the COVID-19 pandemic on this screening program is unknown. Methods The Routine HIV screening program includes opt-out testing of all adults 18 years and older with Glasgow score > 9. HIV 4th generation Ag/Ab screening, with reflex to Gennius confirmatory tests are used. Pre-pandemic (March 2019 to February 2020) to Pandemic period (March 2020 to February 2021) intervals were compared. Results 72,929 patients visited MHH_ED during the pre-pandemic period and 57,128 in the pandemic period, a 22% decline. The number of patients tested for HIV pre-pandemic was 9433 and 6718 pandemic, a 29% decline. When the pandemic year was parsed into first and last 6 months interval and compared to similar intervals in the year pre pandemic, 39% followed by 16% declines in HIV testing were found. In total, 354 patients were HIV positives, 209, (59%) in the pre-pandemic and 145 (41%) in the pandemic period.The reduction in new HIV infections found was directly proportional to the decline in patients visiting the MHH-ED where the percent of patients HIV positive was constant across intervals (2.21% vs 2.26%). Demographic and outcome characteristics were constant across the compared intervals. Conclusion The COVID -19 pandemic reduced detection of new HIV infections by screening in direct proportion to the reduction in MHH-ED patient visits. The impact of COVID-19 pandemic decreased with duration of the pandemic. Disclosures All Authors: No reported disclosures

The Swine Flu Emergency Department: The Relationship Between Media Attention for the Swine Flu and Registrations in an Emergency Medicine Unit

2014 ◽  
Vol 29 (2) ◽  
pp. 141-145 ◽  
Author(s):  
Sara Nelissen ◽  
Kathleen Beullens ◽  
Marc Sabbe ◽  
Jan Van den Bulck
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Time Frame ◽  
Swine Flu ◽  
Publication Type ◽  
Media Report ◽  
Media Attention ◽  
Number Of Patients ◽  
Media Reports ◽  
The Relationship

AbstractIntroductionWhen the world is faced with a new potential pandemic outbreak, the media report heavily about it. Media are an important disseminator of health threat information. This study examined potential media effects during the 2009 outbreak of A/H1N1 influenza.HypothesisTo examine the relationship between media reports of the swine flu and self-registrations in an emergency department (ED) of a tertiary hospital in Flanders, Belgium.MethodsAll articles concerning swine flu published in seven Flemish newspapers were selected during the biggest flu peak in Belgium. This number was compared with the number of patients who presented themselves with a self-diagnosis of swine flu symptoms during the same time frame. The Pearson's correlation coefficient was selected to determine the relationship. The cross-correlation function determined the direction of this relationship.ResultsA strong correlation was found between the number of potential patients (n = 308) and the number of articles in the Flemish press (n = 1657). The number of patients was the leading indicator; increases in the volume of written press followed increases in the number of patients.ConclusionMedia reporting is extensive when a new infectious disease breaks out and intensifies when it is feared that pandemic levels are reached. This was also the case with the swine flu outbreak in Flanders. These findings suggest that a rise in the number of media reports follows a rise in the number of cases, rather than the reverse.NelissenS, BeullensK, SabbeM, Van den BulckJ. The Swine Flu Emergency Department: the relationship between media attention for the swine flu and registrations in an emergency medicine unit. Prehosp Disaster Med. 2014;29(2):1-5.

The Efficacy of Emergency Medicine Ward for the Management of Patients with Mental Disorders

2009 ◽  
Vol 16 (4) ◽  
pp. 217-223 ◽  
Author(s):  
CM Chan ◽  
MY Wong ◽  
SL Chan ◽  
MY Wan ◽  
YF Mo
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Mental Disorders ◽  
Length Of Stay ◽  
Admission Rate ◽  
Medical Ward ◽  
Attendance Rate ◽  
Number Of Patients ◽  
The Mean ◽  
Emergency Medicine Ward

Objective Patients with mental disorders are one of the target groups selected for management in the Emergency Medicine Ward (EMW) with the enrolment of psychiatric advanced practice nurses. This study aimed to determine whether the EMW can be efficiently used for the management of patients with mental disorders in terms of length of stay (LOS), admission rate, and re-attendance rate when compared with the medical ward. Methods This was a retrospective descriptive study. Patients with mental disorders were defined and recruited from the Princess Margaret Hospital during two selected study periods: pre-opening (pre-EMW) and post-opening (post-EMW) of the EMW. All emergency department records of patients with mental disorders within these two periods were reviewed and data of the selected samples were retrieved from different computer databases. Results The total number of patients with mental disorders was 565 in the pre-EMW period and 404 in the post-EMW period; 214 (37.9%) cases were admitted into the medical ward in the pre-EMW period while only 62 (15.3%) were admitted into the medical ward in the post-EMW period. The mean LOS in the pre-EMW period was 67.7 hours. For the post-EMW period, the mean LOS was 32.3 hours. The reduction in mean LOS was 35.4 hours, and 82% of the study patients treated in the EMW were discharged within 48 hours. Notably, 23.3% of the cases re-attended the emergency department after discharge from the medical ward, whereas only 8.8% of cases re-attended after discharge from the EMW. Conclusion Patients with mental disorders or related problems can be efficaciously managed in the EMW, as evidenced by a decrease in the length of stay, admission rate, and re-attendance rate.

scholarly journals The choice of the method of patients triage in the system of emergency medicine

2021 ◽  
Vol 22 (2) ◽  
pp. 17-24
Author(s):  
L. T. Mirvarisova ◽  
Kh. E. Anvarov
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Medical Care ◽  
Emergency Medical Care ◽  
Medical Care System ◽  
Emergency Medical ◽  
Number Of Patients ◽  
Care System

For the timely provision of a full-fledged volume of emergency medical care, it is necessary to triage patients admitted to the emergency department. The article highlights the tool for the prompt and adequate prioritization of the growing number of patients for the provision of emergency medical care, corresponding to the features of the emergency medical care system in Uzbekistan, during which the opinions of experts working in the emergency medicine system were actively accepted.

Life-threatening emergencies

2020 ◽  
pp. 43-65
Author(s):  
Jonathan P. Wyatt ◽  
Robert G. Taylor ◽  
Kerstin de Wit ◽  
Emily J. Hotton ◽  
Robin J. Illingworth ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Cardiac Arrest ◽  
Life Support ◽  
Central Venous Access ◽  
Advanced Life Support ◽  
Venous Access ◽  
Central Venous ◽  
Sick Patient ◽  
Life Threatening

This chapter in the Oxford Handbook of Emergency Medicine examines all aspects of life-threatening emergencies encountered in the emergency department (ED). It examines anaphylaxis and its treatment, as well as choking. It discusses cardiac arrest and its management, as well as in-hospital resuscitation and adult Basic and Advanced Life Support algorithm use, post-resuscitation care, and central venous access. It explores recognition of the sick patient, sepsis, and shock.

Cutaneous Disorders

2019 ◽  
pp. 119-126
Author(s):  
Fred Wu
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Correct Answer ◽  
Visual Cues ◽  
Age Groups ◽  
Stevens Johnson Syndrome ◽  
Pediatric Pathology ◽  
Johnson Syndrome ◽  
Common Skin ◽  
Life Threatening

Dermatology can be a challenging subject in emergency medicine. While most dermatologic complaints are benign, the clinician must be able to distinguish them from life-threatening conditions. This chapter reviews some of the most common skin disorders seen in the emergency department (ED), including adult and pediatric pathology. Patients typically present to the ED with a rash. Visual cues and the patient history are helpful in leading to the diagnosis. Knowing the distribution of common rashes and the age groups in which they typically occur can help the clinician reach the correct answer. These conditions range from an inconvenience, such as dermatitis, to the severe in the case of Stevens-Johnson syndrome.

scholarly journals Evaluation of the efficacy of Raktamokshana by cupping method in vatapradhana katigata-vata.

2021 ◽  
Vol 9 (02) ◽  
Author(s):  
Shivanand F. Kawane
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Practice ◽  
Side Effects ◽  
Low Back ◽  
Adverse Side Effects ◽  
Number Of Patients ◽  
Ayurvedic Treatment ◽  
Operative Measures

With the advancement of age, each individual suffering backache once in his lifetime. In the clinical practice maximum number of patients visiting a doctor have symptoms of Low Back Pain (LBP). Taking into consideration, the frequency of this ailment various modalities of treatment such as NSAIDs, steroids, physiotherapy and lastly operative measures are implied on patients which have its own drawback like having temporarily relief, adverse side-effects, costly affair etc. In case of Ayurvedic Treatment: snehana, swedana, basti karma, Agni karma & Raktamokshana need to be implemented. An effort has been made to establish the practice of Raktamokshana with cupping method. Raktamokshana is done by after prachhan karma and applying transparent vacuum cups to drain vitiated dosha along with the impure blood. It is very similar to Ghati Yantra explained in the classics that is the Sushruta Samhita. A single arm study was conducted on 10 patients of katigatavata and were treated with raktamokshana by cupping method. A significant relief was observed in the patients complains. So, it can be concluded that cupping method is an efficient modality for raktamokshana for patients suffering from Katigata-Vata.  

scholarly journals Intensity of hemorrhage following tonsillectomy

2012 ◽  
Vol 69 (6) ◽  
pp. 500-503 ◽  
Author(s):  
Dusanka Milosevic
Keyword(s):  
Blood Transfusion ◽  
Bleeding Event ◽  
Standard Technique ◽  
Grade Classification ◽  
Number Of Patients ◽  
Life Threatening ◽  
Grade 3 ◽  
Cold Dissection ◽  
Endotracheal Anesthesia

Background/Aim. Although post-tonsillectomy hemorrhage is one of the most frequent and potentially life-threatening complications, there is no generally accepted classification of post-operative bleeding intensity. The aim of this study was to evaluate the intensity of post-tonsillectomy hemorrhage according to the five-grade classification. Methods. A total of 408 consecutive patients, aged 2 to 54 years, undergoing elective tonsillectomy, with (n=261) or without (n=147) adenoidectomy, were included in this prospective study. Tonsillectomy was performed under general anesthesia using standard technique of cold dissection with a snare. Any bleeding event was recorded. The severity of post-operative hemorrhage was classified in five grades. Results. In 11 (2.70%) of the patients grade 1 hemorrhage following tonsillectomy occurred, 4 (0.98%) had grade 2 and 2 (0.49%) of the patients had grade 3 post-operative bleeding. Grades 4 and 5 were not recorded, and no patient received a blood transfusion. Conclusion. Post-tonsillectomy hemorrhage can be expected in a small number of patients undergoing tonsillectomy. Hemorrhage is mostly primary and rarely requires treatment under endotracheal anesthesia and blood transfusion.

Sign in / Sign up

Export Citation Format

Share Document