World journal of emergency medicine
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Mechanical ventilation is a double-edged sword to acute respiratory distress syndrome (ARDS) including lung injury, and systemic inflammatory response high tidal volumes are thought to increase mortality. The objective of this study is to evaluate the effects of dynamic ventilatory factors on ventilator induced lung injury in a dog model of ARDS induced by hydrochloric acid instillation under volume controlled ventilation and to investigate the relationship between the dynamic factors and ventilator-induced lung injuries (VILI) and to explore its potential mechanisms. ⋯ Mechanical ventilation with a large tidal volume, a high inspiratory flow and a high ventilation frequency can cause significant damage to lung tissue structure. It can significantly increase the expression of TNF-α and IL-8 as well as their mRNA expression. Furthermore, the results of our study showed that small tidal ventilation significantly reduces the release of pro-inflammatory media. This finding suggests that greater deterioration in lung injury during ARDS is associated with high inspiratory flow and high ventilation rate.
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Traumatic bilateral hip dislocation is a rare condition. Anterior shoulder dislocation combined with this condition is even a rare occurrence. A 57-year-old man had bilateral asymmetric hip dislocation with a posterior wall fracture of the left acetabulum associated with right shoulder anterior dislocation caused by falling down from a cherry tree. Traumatic hip dislocation and anterior shoulder dislocation represent a true orthopedic emergency. ⋯ Traumatic asymmetric hip dislocation and anterior shoulder dislocation are an orthopedic emergency and early diagnosis with immediate reduction of the dislocation is the key determinants of excellent result of treatment.
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In the recent past, propofol was temporarily removed from the emergency department (ED) for use in procedural sedation. We sought to determine which agents replaced it in clinical practice and the impact this change had on turnaround times (TAT) for sedated patients. ⋯ When propofol was unavailable, ketamine became a preferred ED sedation agent. Removal of propofol from the sedation armamentarium did not affect ED TAT.
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This study was undertaken to examine the current level of operations and management education within US-based Emergency Medicine Residency programs. ⋯ While most EM residency programs integrate basic operational education related to documentation and billing/coding, a smaller number provide focused education on the day-to-day management and operations of the ED. Residency leadership perceives graduating resident understanding of operational management tools to be limited. All respondents value further resident curriculum development of ED operations and management.
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Basic life support (BLS), a key component of the chain of survival decreases the arrest - cardiopulmonary resuscitation interval and increases the rate of hospital discharge. The study aimed to explore the knowledge of and attitude towards basic life support (BLS) among medical/paramedical professionals. ⋯ The average health personnel in our hospital lack adequate knowledge in CPR/BLS. Training and experience can enhance knowledge of CPR of these personnel. Thus standard of CPR/BLS training and assessment are recommended at our hospital.