International journal of emergency medicine
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Injuries represent a significant and growing public health concern in the developing world, yet their impact on patients and the emergency health-care system in the countries of East Africa has received limited attention. This study evaluates the magnitude and scope of injury related disorders in the population presenting to a referral hospital emergency department in northern Tanzania. ⋯ These data give a detailed and more robust picture of the patient demographics, mechanisms of injury, types of injury and patient outcomes from similar resource-limited settings.
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Accidental hypothermia is defined as an unintentional decrease in body temperature to below 35°C, and cases in which temperatures drop below 28°C are considered severe and have a high mortality rate. This study presents the case of a 57-year-old man discovered drifting at sea who was admitted to our hospital suffering from cardiac arrest. Upon admittance, an electrocardiogram indicated asystole, and the patient's temperature was 22°C. ⋯ CPB was successful in gradually rewarming the patient and restoring spontaneous circulation. After approximately 1 month of rehabilitation, the patient was subsequently discharged, displaying no neurological deficits. The successful recovery in this case suggests that CPB can be considered a useful way to treat severe hypothermia, particularly in those suffering from cardiac arrest.
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⋯ A large number of EM training programs have global health experiences available, but these electives and the trainees may benefit from additional institutional support and formalized structure.
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Pituitary apoplexy is an uncommon but life-threatening condition that is often overlooked and underdiagnosed. We report a 45-year-old man who presented to our emergency department with a sudden onset headache, acute confusion, signs of meningeal irritation and ophthalmoplegia. An initial diagnosis of acute meningoencephalitis was made, which was amended to pituitary apoplexy following thorough investigation within the emergency department. ⋯ Formal visual field assessment demonstrated temporal visual field loss in the left eye. The patient was discharged to his usual residence a week later and follow-up was organised with both the endocrinologists and ophthalmologists. Follow-up MRI demonstrated that there was no significant change in either size or signal characteristics of the pituitary fossa mass (Figure 1B).
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Air ambulance service in Norway has been upgraded during the last years. European regulations concerning pilots' working time and new treatment guidelines/strategies have called for more resources. ⋯ The use of air ambulances and especially RW was significantly increased during the study period. The change in secondary FW operations reflected centralisation of medical care. When health care services are centralised, air ambulance services must be adjusted to the new settings.