Acute medicine & surgery
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Acute medicine & surgery · Jan 2020
ReviewBasic point-of-care ultrasound framework based on the airway, breathing, and circulation approach for the initial management of shock and dyspnea.
Ultrasound (US) carried out and interpreted by clinicians at the bedside is now called point-of-care US (POCUS). Clinical studies on POCUS have been carried out based on the ideas of "creation", "extraction", and "combination". "Creation" refers to findings for the upper airway and lung being obtained at the bedside. "Extraction" refers to findings suitable for POCUS being extracted from comprehensive US, including echocardiography, abdominal US, and whole-leg US. "Combination" refers to these POCUS applications being combined for the comprehensive assessment of patients with trauma, shock, or dyspnea. Emergency and critical care physicians have many opportunities to encounter trauma or non-trauma patients with shock, dyspnea, or both. ⋯ Therefore, we propose a basic POCUS framework based on the systematic airway, breathing, and circulation approach for the initial management of shock and dyspnea in adult patients. In this article, we update and review each application of POCUS and their combination in this framework. Furthermore, we propose the practical usage of the framework based on clinical presentations to improve the management of shock and dyspnea.
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Acute medicine & surgery · Jan 2020
Case ReportsVeno-venous extracorporeal membrane oxygenation and prone ventilation for therapeutic management of COVID-19.
The efficacy and safety of the combined use of veno-venous extracorporeal membrane oxygenation (ECMO) and prone ventilation are currently not known for coronavirus disease 2019 (COVID-19). ⋯ Oxygenation and lung compliance gradually improved during prone ventilation, and both patients were successfully extubated. For patients with severe SARS-CoV-2 pneumonia who require veno-venous ECMO, the use of prone ventilation could be beneficial, and should be considered.
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Acute medicine & surgery · Jan 2020
Validation of chief complaints, medical history, medications, and physician diagnoses structured with an integrated emergency department information system in Japan: the Next Stage ER system.
Emergency department information systems (EDIS) facilitate free-text data use for clinical research; however, no study has validated whether the Next Stage ER system (NSER), an EDIS used in Japan, accurately translates electronic medical records (EMRs) into structured data. ⋯ Chief complaints, medical history, medications, and physician's ED diagnoses in EMRs were well-translated into existing categories or coding by the NSER system.
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Acute medicine & surgery · Jan 2020
A text mining analysis of perceptions of the COVID-19 pandemic among final-year medical students.
The coronavirus disease 2019 (COVID-19) pandemic has presented various challenges to medical schools. We performed a text mining analysis via essay task to clarify perceptions among final-year medical students toward the COVID-19 pandemic. ⋯ Our analysis of perceptions among final-year medical students toward the COVID-19 pandemic revealed that most medical students are strongly affected by the COVID-19 pandemic and are motivated to work as physicians among health care professionals.
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Acute medicine & surgery · Jan 2020
Impact of non-pharmaceutical interventions for the COVID-19 pandemic on emergency department patient trends in Japan: a retrospective analysis.
The coronavirus disease (COVID-19) pandemic massively impacted emergency department (ED) visits. The unavailability of specific therapies or vaccines has made non-pharmaceutical interventions (NPIs) an alternative strategy for COVID-19. We assessed the impact of NPIs (nationwide school closures and state of emergency) on ED visits during the COVID-19 pandemic in Japan. ⋯ The application of an NPI during the COVID-19 pandemic could have significantly reduced patient attendance in the ED.