Acute medicine & surgery
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Acute medicine & surgery · Jul 2019
The efficacy of a trauma call system: challenges in managing severe trauma at a rural emergency center without full-time emergency physicians.
There have been some reports about the efficacy of trauma team activation. In November 2015, we implemented a trauma call system, wherein a general surgeon, neurosurgeon, and orthopedic surgeon are called to the emergency department when severe trauma patients are transferred to our emergency department. In this study, we evaluated the efficacy of this trauma call system. ⋯ Our trauma call system did not significantly improve the mortality of trauma patients with an Injury Severity Score ≥16. However, it was effective for reducing the time from the arrival to the start of contrast-enhanced computed tomography or transcatheter arterial embolization.
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Acute medicine & surgery · Jul 2019
Case ReportsParaplesia after surfing in a young female novice surfer: a case report on surfer's myelopathy.
Surfer's myelopathy is a non-traumatic spinal cord injury that was first described in a publication in 2004. However, most emergency physicians are not familiar with this rare disease. ⋯ Emergency physicians must be better informed about surfer's myelopathy. Novice surfers and instructors should be educated on the early signs and symptoms of this condition.
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Acute medicine & surgery · Jul 2019
Case ReportsSuccessful support by veno-arterial extracorporeal membrane oxygenation for severe septic shock caused by Aeromonas hydrophila.
Septic shock is a subset of sepsis accompanied by profound circulatory and cellular metabolism abnormalities. Although veno-arterial extracorporeal membrane oxygenation (VA-ECMO) can provide temporary cardiac support to improve organ perfusion, hemodynamic support by VA-ECMO for adult patients with septic shock is still controversial. ⋯ Veno-arterial extracorporeal membrane oxygenation is a viable treatment option for adult patients with refractory septic shock accompanied by cardiac dysfunction. Further research is warranted to identify the candidates for support by VA-ECMO in a timely fashion.
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Acute medicine & surgery · Apr 2019
Physician-manned prehospital emergency care in tertiary emergency centers in Japan.
Use of a physician-manned prehospital emergency medical service (EMS) has recently become widespread in Japan. Understanding the epidemiology of critically ill patients is essential for planning national and regional physician-manned prehospital EMS systems. However, current knowledge on patients receiving physician-manned prehospital EMS is sparse. The present study aimed to determine the clinical features of critically ill patients with and without physician-manned prehospital EMS, using a national inpatient database in Japan. ⋯ Our study indicates that physician-manned EMS is dispatched to a relatively small proportion of critically ill patients in Japan.
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Acute medicine & surgery · Apr 2019
Case ReportsThe prognostic value of agonal respiration in refractory cardiac arrest: a case series of non-shockable cardiac arrest successfully resuscitated through extracorporeal cardiopulmonary resuscitation.
Agonal respiration following out-of-hospital cardiac arrest is associated with favorable neurological outcomes. Resuscitation using extracorporeal membrane oxygenation could contribute to achieving favorable neurological outcomes in patients with refractory cardiac arrest. ⋯ The presence of agonal respiration has the potential to confer a favorable neurological outcome in patients with refractory cardiac arrest if maintained, even when the initial cardiac rhythm is not shockable. In these cases, resuscitation should not be abandoned, and ECPR should be considered.