RebelEM

JUNE 22, 2023

Background: The COVID-19 pandemic has been the focus of massive research efforts over the last three years. Our understanding of the disease and effective treatments to reduce mortality have progressed rapidly during this time. However, the medical community is only just starting to understand long-COVID (WHO Definition: the continuation or development of new symptoms 3 months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least 2 months with no other explanation).

Outcomes 123

Outcomes Research Documentation/Coding Wellness 123

Emergency Medicine Journal

JUNE 22, 2023

Background Tools proposed to triage ED acuity in suspected COVID-19 were derived and validated in higher income settings during early waves of the pandemic. We estimated the accuracy of seven risk-stratification tools recommended to predict severe illness in the Western Cape, South Africa. Methods An observational cohort study using routinely collected data from EDs across the Western Cape, from 27 August 2020 to 11 March 2022, was conducted to assess the performance of the PRIEST (Pandemic Resp

Outcomes 98

Outcomes 98

Emergency Live

JUNE 22, 2023

The medical term spondylolisthesis refers to a pathological condition characterised by a slow but progressive and constant displacement of a vertebra with respect to the vertebra underneath The post Spondylolisthesis: what is it? appeared first on Emergency Live.

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97

Science Based Medicine

JUNE 22, 2023

USA Track & Field is endorsing a kinesiology tape that is claimed to improve cell oxygenation. The post Can Kinesiology Tape Increase Oxygen Delivery and Improve Sports Performance? first appeared on Science-Based Medicine.

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EMDocs

JUNE 22, 2023

Author: Taylor Webb, MD (Emergency Medicine Resident, University of Mississippi Medical Center) // Reviewed by: Brit Long, MD (@long_brit) I am a third year Emergency Medicine chief resident at the University of Mississippi Medical Center (UMMC) and want to share one of my experiences to all medical residents and providers. Remember that while mistakes in resuscitation are often dissected and analyzed, it is equally crucial to acknowledge and celebrate the moments of impeccable execution, where

Resuscitation 95

Resuscitation Ultrasounds Critical Access Documentation/Coding 95

Emergency Live

JUNE 22, 2023

Paranoid Personality Disorder is characterised by a persistent and unwarranted tendency to interpret the intentions and actions of others as evil (paranoia) The post Paranoid personality disorder: what it is and how to deal with it appeared first on Emergency Live.

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93

Emergency Medicine Journal

JUNE 22, 2023

Clinical introduction A 67-year-old woman presented to the ED with a 1-week history of dyspnoea on exertion. She did not report fever or cough. Her medical history only included hyperlipidaemia. She was a never-smoker. Physical examination revealed the following findings: BP, 148/98 mm Hg; HR, 112/min; body temperature, 35.8℃; RR, 20/min; and oxygen saturation, 94% on ambient air.

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76

Emergency Medicine Journal

JUNE 22, 2023

While emergency departments are open to anyone without appointment, the need for prioritisation results in periods of waiting that are both wasteful and frustrating. However, value can be added to patient care by (1) engaging the waiting patient, (2) empowering the waiting patient and (3) educating the waiting patient. If these principles are implemented, they will benefit both the patient and the healthcare system.

Emergency Department 74

Emergency Department 74

Emergency Live

JUNE 22, 2023

Also called aortic valvular stenosis, aortic stenosis occurs when the aortic valve (one of the four heart valves) becomes obstructed or narrowed The post Aortic stenosis, what is it and what are the consequences? appeared first on Emergency Live.

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Emergency Medicine Journal

JUNE 22, 2023

Background The COVID-19 pandemic has been linked to a sharp drop in ED attendance, but the exact reasons for this are unclear. The aim of this study was to investigate differences between individuals attending the ED before and during the pandemic and the reasons for their choices. Methods Two population-based online surveys were conducted before (2019) and during (2020) the pandemic.

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52

Emergency Live

JUNE 22, 2023

Cardiovascular risk factors are generally related to cardiovascular diseases. These factors are divided into modifiable and non-modifiable risk factors The post Heart health: what are the cardiovascular risk factors? appeared first on Emergency Live.

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Emergency Medicine Journal

JUNE 22, 2023

Much needed attention is being focused on disparities in healthcare delivery and health status, issues that were highlighted and exacerbated by the Covid pandemic. Emergency medicine has historically acknowledged its disparities in treatment for pain related to age and race but less on the effects of language and culture. This month’s Reader’s Choice and Global abstract is from Australia, where Chen et al compared the management of non-serious back pain given to culturally and lingui

Documentation/Coding 52

Documentation/Coding 52

Emergency Live

JUNE 22, 2023

Significant collaboration between ADAC Luftrettung and Volocopter for the development of electric vertical take-off and landing aircraft (eVTOL) for rescue services A step forward in air rescue and emergency medicine The collaboration is the result of a partnership that began in 2018, when ADAC Luftrettung, a German air rescue organisation, and Volocopter, a pioneer in […] The post Germany, from 2024 electric vertical take-off aircraft (eVTOL) to improve emergency medical assistance appear

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NRC Health

JUNE 22, 2023

Cincinnati Children’s has tried many methods to better understand and improve the patient experience. “When you provide a defining moment, you see it in the face of a child.” The post Leveraging patient feedback and high-reliability interventions for inpatient communication appeared first on NRC Health.

Pediatrics 52

Pediatrics 52

Emergency Live

JUNE 22, 2023

Significant collaboration between ADAC Luftrettung and Volocopter for the development of electric vertical take-off and landing aircraft (eVTOL) for rescue services A step forward in air rescue and emergency medicine The collaboration is the result of a partnership that began in 2018, when ADAC Luftrettung, a German air rescue organisation, and Volocopter, a pioneer in […] The post Germany, from 2024 electric vertical take-off aircraft (eVTOL) to improve emergency medical assistance appear

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Emergency Medicine Journal

JUNE 22, 2023

We thank Shi and Mao for their interest 1 in our recently published article on The age-adjusted Reverse Shock Index multiplied by the Glasgow Coma Scale (rSIG/A) in prehospital assessment of trauma patients and their allocation to trauma centres or trauma team activation. 2 The authors point out some shortcomings in our manuscript. We would like to take the opportunity to address them.

Shock 40

Shock Wellness 40

Emergency Medicine Journal

JUNE 22, 2023

We read with great interest the article by Frieler et al. 1 The authors validated the accuracy of the rSIG (SBP/HR x GCS) in predicting the risk of mortality in trauma patients. The results of this study are positive. However, we have some concerns before rSIG is commonly used in the prehospital setting. First, the site of the trauma is a significant contributor to the large degree of heterogeneity in trauma; hence, anatomical variables should be considered in clinical prediction models. 2 For e

Head Injuries 40

Head Injuries 40

Emergency Medicine Journal

JUNE 22, 2023

We thank Mark Hodkinson 1 for his encouraging comments regarding our recently published modified Delphi study and we agree that the output will help to expand the evidence base underlying prehospital critical care delivery. 2 We would like to respond to the points raised within the letter. The author rightly notes that a considerably lower proportion of paramedics participated than doctors.

Research 40

Research Operations Hospitals 40

Emergency Medicine Journal

JUNE 22, 2023

It is pleasing to see that the long-awaited update to the top research priorities for prehospital critical care has been published, 1 and the authors should be commended on their study and its valuable contribution to the literature and developing prehospital critical care. The Delphi process, 1 as described by the authors, was not without its limitations.

Research 40

Research Wellness 40

Emergency Medicine Journal

JUNE 22, 2023

Editor’s note: EMJ has partnered with the journals of multiple international emergency medicine societies to share from each a highlighted research study, as selected by their editors. This edition will feature an abstract from each publication.

Research 40

Research 40

Emergency Medicine Journal

JUNE 22, 2023

Introduction This month’s update is from the emergency department and critical care unit at Salford Care Organisation, within the Northern Care Alliance NHS Foundation Trust. We used a multimodal search strategy, drawing on free open-access medical education resources and focused literature searches. We identified the five most interesting and relevant papers (decided by consensus, with editorial oversight) and highlight the main findings, key limitations and clinical bottom line for each

Airway Management 40

Airway Management Emergency Department Outcomes 40

Emergency Medicine Journal

JUNE 22, 2023

Case presentation A 15-year-old boy presents to the ED with 1 day of periumbilical non-radiating abdominal pain. The pain, described as a stinging sensation, started gradually 1 day prior to presentation after eating lunch and increased to an intensity of 8 out of 10 at its worst over the day. The patient reports that the pain has since improved to 4 out of 10.

Ultrasounds 40

Ultrasounds Wellness 40

Emergency Medicine Journal

JUNE 22, 2023

Objective Paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs) and opiates/opioids, administered parenterally via intravenous or intramuscular route, are widely used to provide analgesia for patients with moderate to severe pain. This systematic review and meta-analysis evaluated the level of analgesia provided by intravenous paracetamol (IVP) alone compared with NSAIDs (intravenous or intramuscular), or opioids (intravenous) alone in adults attending the ED with acute pain.

Administration 40

Administration Outcomes 40

Emergency Medicine Journal

JUNE 22, 2023

Clinical introduction A healthy, obese 38-year-old man had acute flank pain for 2 days. He also complained of a fever for 1 day. He denied haematuria, nausea, vomiting or constipation. A point-of-care abdominal ultrasound was obtained ( figure 1 ). Question What is the diagnosis? Diverticulitis Appendicitis Epiploic appendagitis Urolithiasis Answer: C Epiploic appendagitis (EA) is an inflammation in the epiploic appendages, which is caused by spontaneous torsion or thrombosis of the central drai

Ultrasounds 40

Ultrasounds 40

Emergency Medicine Journal

JUNE 22, 2023

Background Acute low back pain (LBP) is a common complaint in the emergency department and achieving effective analgesia can be challenging. Methods In this multicentre randomised double-blind clinical trial conducted at three EDs in Iran from August to November 2020, we assessed the efficacy and adverse effects of two muscle relaxants in patients aged 18 years or older who suffered LBP in the last 6 weeks.

Emergency Department 40

Emergency Department Research 40

Emergency Medicine Journal

JUNE 22, 2023

Background Disparate care in the ED for minority populations with low back pain is a long-standing issue reported in the USA. Our objective was to compare care delivery for low back pain in Australian EDs between culturally and linguistically diverse (CALD) and non-CALD patients. Methods This is a retrospective review of medical records of the ED of three public hospitals in Sydney, New South Wales, Australia from January 2016 to October 2021.

Emergency Department 40

Emergency Department Administration Hospitals Outcomes 40

Emergency Medicine Journal

JUNE 22, 2023

Patients living with frailty are at risk of worse outcomes. 1 The Clinical Frailty Scale (CFS) is a tool that has been developed to assess a patient’s level of frailty. 2 It is determined by a patient’s baseline health (status two weeks prior to hospital admission), with a score of 1 being very fit and 9 being terminally ill. 2 Prior to the COVID-19 pandemic, frailty screening was part of the National Health Service England commissioning tariff, although there is no current agreement

Outcomes 40

Outcomes Hospitals 40

Emergency Medicine Journal

JUNE 22, 2023

Self-harm is one of the most common reasons for people to present to EDs. 1 Ambulance clinicians are often the first professionals involved in their care. This encounter affects immediate actions and long-term outcomes by influencing future help-seeking behaviour. 2 Little is known about prehospital care for people who self-harm, 3 although assessing and managing this group represents a unique challenge for ambulance clinicians. 4 This study aims to explore the views and experiences of Yorkshire

Ambulance Services 40

Ambulance Services Academics Research Outcomes 40

Emergency Medicine Journal

JUNE 22, 2023

Introduction The History, Electrocardiogram (ECG), Age, Risk Factors and Troponin (HEART) score is commonly used to risk stratify patients with possible myocardial infarction as low risk or high risk in the Emergency Department (ED). Whether the HEART score can be used by paramedics to guide care were high-sensitivity cardiac troponin testing available in a prehospital setting is uncertain.

EKG/ECG 40

EKG/ECG Emergency Department Outcomes 40

Emergency Medicine Journal

JUNE 22, 2023

Self-harm refers to any act of self-poisoning or self-injury carried out by a person, irrespective of motivation. 1 Paramedics are often the first health professionals in contact with those who self-harm, but their contribution to care of these patients is under-researched. Romeu et al have conducted a cross-sectional questionnaire exploring the experiences of paramedics of caring for people who self- harm. 2 Understanding the views of paramedics to caring for patients who self-harm is important

Poisoning 40

Poisoning Research 40