The American journal of emergency medicine
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Case Reports
Non-diabetic ketoacidosis: A case of alcoholic ketoacidosis accompanied by hyperglycemia.
Alcoholic ketoacidosis (AKA) lacks specific clinical presentation. The results of blood testing commonly show hemoconcentration, elevated β-hydroxybutyrate levels, and acidosis in patients with AKA. Herein, we report a case of AKA accompanied by hyperglycemia and review the related literature. ⋯ Primary clinical presentations were severe nausea and vomiting. The patient initially diagnosed with DKA were eventually confirmed as AKA, who recovered after active therapy with rehydration and correction of hyperglycemia, electrolyte imbalance, and ketosis. This study provides a reference for clinicians to reduce missed diagnosis and the misdiagnosis rates of AKA.
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Observational Study
Impact of crowding in local ambulance demand on call-to-ambulance scene arrival in out-of-hospital cardiac arrest.
Rapid emergency medical service (EMS) response is an important prognostic factor in out-of-hospital cardiac arrest (OHCA). This study aims to evaluate the association between local hourly EMS demand and ambulance response in OHCA. ⋯ Crowding in local ambulance demand was associated with less ambulance dispatched within 1 km and delayed response to the scene in OHCA. Strategies to mitigate and adjust to ambulance demand crowding may be considered for better EMS response performance.
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This study aims to determine the secondary traumatic stress (STS), anxiety, and depression levels of the emergency healthcare workers (HCWs) and to identify the factors associated with the mental health of the emergency HCWs. ⋯ High levels of STS, anxiety, and depression were determined among emergency nurses and auxiliary staff during the pandemic. Poor job satisfaction and financial difficulties were associated with the mental health of emergency HCWs. The mental health of the emergency HCWs should be evaluated regularly. In addition to professional psychological support, social and financial support should be provided as well.
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Observational Study
Prospective real-time evaluation of the QTc interval variation after low-dose droperidol among emergency department patients.
To assess the QTc interval variation after low-dose droperidol in a population of undifferentiated, stable, and non-agitated patients receiving droperidol in the emergency department. ⋯ The QTc interval slightly increased after droperidol administration, but these prolongations were brief, mostly below 500 msec and did not lead to serious arrhythmias. The yield of continuous cardiac monitoring in patients receiving low doses of droperidol is likely low.
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Successful replantation relies on proper preservation of traumatically amputated parts. The established protocol for preservation, however, is inconsistently adhered to. The objective of this study is to examine the rate of proper preservation in multiple patient populations. ⋯ Level IV.