Singap Med J
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Early cardiopulmonary resuscitation (CPR) and defibrillation prior to the arrival of emergency medical services can improve survival from out-of-hospital cardiac arrest (OHCA) with good neurological outcome. However, the rate of local bystander CPR is only 24.3% and bystander defibrillation 2.1%. In 2015, the R-AEDI (Registry for AED Integration) initiative was started to improve OHCA survival rates. ⋯ The AED heat map allows us to identify areas that are lacking in or require improved public access AED coverage. The online AED registry found in the myResponder app is useful to locate AEDs rapidly during OHCAs. More community education would improve the rate of bystander defibrillation.
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Inappropriate attendances (IAs) at emergency departments (ED) are contributed by patients with mild or moderate medical conditions that can be effectively managed by primary care physicians. IAs strain limited ED resources and have an adverse impact on efficiency. This study aimed to identify factors associated with IA at the ED of a tertiary hospital in Singapore. ⋯ This study identified subgroups in the population who were more likely to contribute to IAs at the ED. These findings offer relevant insights into future research directions and strategies that might potentially reduce avoidable IAs.
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The electric scooter has been gaining popularity locally as a commute mode. We aimed to understand the current landscape of electric scooter-related injuries in Singapore. ⋯ The incidence of electric scooter-related injuries appears to be on the rise and may potentially incur significant morbidity and healthcare costs. Further efforts at safety education and enforcement should be made to prevent accidents and minimise the impact of these injuries.
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Medical emergencies occur at a rate of one in 604‒753 flights. Doctors travelling on commercial flights may encounter an in-flight medical emergency requiring their assistance. There is a paucity of studies on how confident primary care doctors are in managing in-flight medical emergencies. This study aimed to determine the knowledge, confidence and attitude of primary care doctors in managing in-flight medical emergencies. ⋯ Only one in ten primary care doctors in this study felt confident managing in-flight medical emergencies. A higher total knowledge score of in-flight medical emergencies was positively associated with greater confidence in managing them. Educational programmes to address this gap in knowledge may be useful to improve doctors' confidence in managing in-flight medical emergencies.
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Constipation is common in infants and children. Helping parents understand the vicious cycle of childhood chronic constipation is the key to successful management. Weaning, toilet training, transitions to kindergarten/school, a bout of febrile illness and overseas holidays are common life milestones that may be associated with an increased risk of constipation. ⋯ The Bristol stool chart is a free, useful tool for parents or caregivers to report and monitor the child's stools. Red flags in constipation include delayed passage of meconium beyond 48 hours of life, associated intestinal obstruction symptoms, developmental delays, behavioural problems and frequent soiling of underwear. Behavioural modifications should be considered in primary care, together with pharmacotherapy such as laxatives.