Articles: emergency-services.
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Multicenter Study
The effects of the 2022 computed tomography IV contrast shortage on the emergency department diagnosis of abdominal pathology.
A COVID-19 lockdown in China resulted in a global disruption in IV contrast media production, which resulted in a hospital system advisory limiting contrast studies. The purpose of this study was to describe the effects of the IV contrast shortage on the ED diagnosis of emergent abdominopelvic pathology. ⋯ We did not identify differences in diagnoses during the contrast shortage period compared to the control period, and did not identify any missed important diagnoses as a consequence of the IV contrast shortage.
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Multicenter Study
Emergency centre thoracotomy for penetrating trauma: Insights from 2 South African district-level emergency centres.
Trauma is a major contributor to global disease burden, disproportionally affecting low- and middle-income countries, especially in the African Region. Emergency centre thoracotomy (ECT) is a potentially life-saving procedure for a sub-group of trauma patients in extremis. Most literature regarding ECT originated in high-income countries. This study aimed to describe patient, procedure and outcome characteristics of ECTs performed at two facilities in a resource-limited setting in South Africa. ⋯ The performance of ECT in this resource-limited district-level setting, followed by stabilisation and transfer of patients to tertiary hospitals seems to result in comparable or better survival rates than reported in international literature. Further research is needed to better describe the performance and outcomes of EC thoracotomies in a resource-limited setting. This study setting, with high incidence of trauma and ECT performed, provides an excellent opportunity for further research. Prospective studies may demonstrate correlations between specific patient and procedural characteristics and outcomes and may guide the development of local guidelines.
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Point-of-care ultrasound (PoCUS) can be used as a non-invasive and radiation free adjunct in the triage of patients with clavicle injuries. However, the diagnostic accuracy of PoCUS performed by non-radiologists for this purpose is not yet sufficiently established. ⋯ PoCUS of the clavicle is a useful adjunct in the triage of patients with clavicle injuries and can help to distinguish which patients need further diagnostic workup.
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Multicenter Study
Assessment of Prognostic Scores for Emergency Department Patients With Upper Gastrointestinal Bleeding.
Early prognostic stratification could optimize the management of patients with upper gastrointestinal bleeding and reduce unnecessary hospitalizations. The aim of this study was to assess and compare the performance of existing prognostic scores in predicting therapeutic intervention and death. ⋯ The GBS and the modified GBS are the 2 best performing scores because they achieve both key objectives: stratifying patients based on their risk of therapeutic intervention and/or death and identifying low-risk patients who may qualify for outpatient management.
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Singapore medical journal · Jan 2025
Multicenter StudyGastrointestinal transit time of radiopaque ingested foreign bodies in children: experience of two paediatric tertiary centres.
Foreign body (FB) ingestion is a common paediatric emergency. While guidelines exist for urgent intervention, less is known of the natural progress of FBs passing through the gastrointestinal tract (GIT). We reviewed these FB transit times in an outpatient cohort. ⋯ This study provides insight into the transit times of FB ingested by children, which helps medical professionals to decide on the optimal time for follow-up visits and provide appropriate counsel to caregivers.