European journal of emergency medicine : official journal of the European Society for Emergency Medicine
-
Increasing evidence supports a role for contrast-enhanced ultrasound in the assessment of blunt abdominal trauma. Accurate definition of organ injury can be demonstrated, as well as extension to solid organ capsule and even vascular injury. Low-dose contrast is needed for renal imaging, to avoid obscuration of deeper structures from intense cortical enhancement. ⋯ The spleen is best assessed in the delayed phase, thereby limiting misinterpretation of early heterogeneous contrast uptake. Typical sonographic features of traumatic injuries of the solid abdominal organs are described. Although contrast-enhanced computed tomography is the gold standard modality for imaging abdominal organ traumatic injury, contrast-enhanced ultrasound has developed a role in the emergency setting, particularly in low-energy injuries and in follow-up of traumatic injuries.
-
Our study attempted to describe the differences in circumstances, risk groups, and severity of road traffic injuries (RTIs) among injured children (1-15 years) and adults (≥16 years) coming to the tertiary-care hospital, Karachi, Pakistan. ⋯ The study may assist local authorities in Karachi to prioritize interventions to address common injuries among those who are at a high risk for RTIs. Further quantitative and qualitative studies are needed to assess the factors leading to RTIs among pedestrians in Karachi.
-
Multicenter Study Comparative Study
Multicentric investigation of survival after Spanish emergency department discharge for acute heart failure.
Ideally, discharges from the emergency department (ED) should be as safe as discharges after hospitalization. We have ascertained this hypothesis in patients with acute heart failure (AHF) directly discharged from EDs, analyzing their short-term outcome. ⋯ Direct ED discharge of patients with AHF after treatment and a short observation period is as safe as discharge after a longer time of inpatient hospitalization in general wards.
-
Randomized Controlled Trial Comparative Study
Use of the TrachView videoscope as an adjunct to direct laryngoscopy for teaching orotracheal intubation.
The main objectives of this study were to assess the ease of the use of the TrachView videoscope and to compare it with direct laryngoscopy (DL) for teaching orotracheal intubation to emergency medicine (EM) medical students. Thirty-seven EM students with no earlier intubation experience were asked to intubate a manikin's trachea using DL alone and DL in combination with the TrachView. This investigation involved a randomized, cross-over study design and each trainee received a 10-min demonstration with each technique before the beginning of the study. ⋯ However, the POGO score improved to 90% (range, 15-100%) with the addition of the TrachView device (P<0.001). The TrachView was considered easy to use by a majority of the EM students and improved visualization of the vocal cords compared with DL alone. The time to achieve successful intubation of the manikin's trachea was shorter when the TrachView was used as an adjunct to DL.
-
Review Case Reports
Carotid artery dissection: three cases and a review of the literature.
Carotid artery dissections are potentially disabling, probably underdiagnosed, and mainly affect young-aged and middle-aged people. We present three consecutive cases illustrating different clinical presentations and thereby emphasizing the diagnostic challenge of carotid artery dissections for the emergency physician. ⋯ Clinical vigilance is of utmost importance as early diagnosis and timely treatment favor long-term prognosis and even prevent ischemic complications. We review the literature and discuss the pathophysiology, etiology, clinical presentation, diagnosis, imaging techniques, treatment, and prognosis of carotid dissections.