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The effectiveness of a short training course for emergency medicine residents to confirm tracheal tube placement by ultrasound

Authors: Mohammad Afzalimoghaddam, Kamal Basiri, Seyedhossein Seyedhosseini-Dvarani, Farideh Bagheri, Ehsan Karimialavijeh

Abstract Objective: The present study aimed to evaluate the performance of tracheal ultrasound by novice emergency medicine residents after participating in a short training course. Methods: This was an observational prospective study conducted between July 2016 and September 2017 at three university-affiliated emergency departments in Tehran, Iran. Adult patients (over 18 years of age) who […]

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Fatal neck necrotizing fasciitis caused by hypermucoviscous Klebsiella pneumoniae

Authors: U Wen Yeap

Abstract Klebsiella pneumoniae is a gram-negative rod enterobacteria that is notorious for its role as carrier of extended spectrum beta-lactamase (ESBL) and its carbapenem resistant Enterobacteriaceae (CRE) species. However, hypermucoviscous Klebsiella pneumoniae is distinctly different from ESBL and CRE. We report a case of neck necrotizing fasciitis caused by hypermucoviscous Klebsiella pneumoniae in a 56-year-old […]

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Delirium in critically ill patients: incidence, risk factors and outcomes

Authors: Lavitha Vyveganathan, Azarinah Izaham, Wan Rahiza Wan Mat, Shereen Tang Suet Peng, Raha Abdul Rahman, Norsidah Abdul Manap

Abstract Objective: To determine the incidence, and evaluate the risk factors and outcomes of delirium in general Intensive Care Unit (ICU). Design: Prospective cross-sectional observational study. Setting: Teaching hospital in Kuala Lumpur, Malaysia. Patients and participants: Patients ages of 18 and above admitted for more than 24 hours in general ICU were recruited into the […]

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Dispatcher-assisted cardiopulmonary resuscitation improves the neurological outcomes of out-of-hospital cardiac arrest victims: a retrospective analysis of prehospitalisation records in Kumamoto City

Authors: Tadashi Kaneko, Hiromichi Tanaka, Keiji Uezono, Ryuichi Karashima, Shinsuke Iwashita, Hiroki Irie, Kazuo Nishioka, Shunji Kasaoka

Abstract Background: Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) is an effective tool for improving the outcome of out-of-hospital cardiac arrest (OHCA) by providing dispatcher assistance (DA) to bystander cardiopulmonary resuscitation (BCPR) and public access defibrillators (PAD). However, it is unclear whether DA-CPR improves the neurological outcomes of OHCA. In this study, we assessed the effectiveness of DA-CPR […]

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The successful treatment of severe aspiration pneumonitis with the combination of hydrocortisone, ascorbic acid and thiamine

Authors: Margot M. Gurganus, Paul E. Marik, Joseph Varon

Abstract Aspiration pneumonitis is a neutrophil mediated inflammatory pneumonitis following the aspiration of regurgitated gastric contents. This syndrome occurs most commonly in patients with depressed levels of consciousness such as drug overdose, seizures, and during anesthesia. Aspiration pneumonitis is the most common cause of anesthesia-related deaths. Aspiration pneumonitis may be clinically silent or present as […]

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The accuracy of SIRS criteria, qSOFA and SOFA for mortality suspected sepsis patient admitted to the Intensive Care Unit Dr. Hasan Sadikin General Hospital Bandung, January-December 2017

Authors: Tinni T. Maskoen, LS Philip, Indriasari, I. Fuadi

Abstract Objective: The high mortality rate found on infectious patients in the intensive care unit (ICU) calls for sepsis identification tools. Sepsis consensus introduced Systemic Inflammatory Response Syndrome (SIRS) criteria, quick Sequential Organ Failure Assessment (qSOFA) score, and Sequential Organ Failure Assessment (SOFA) score. This study aimed at comparing the accuracy and quality to discriminate […]

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Prediction of optimal right internal jugular vein catheter depth: comparison between Peres’ formula and intracavitary ECG

Authors: Aida Rosita Tantri, Aldy Heriwardito, Hana Nur Ramila

Abstract Background: Incorrect central venous catheter (CVC) placement can lead to serious complications. In order to prevent complications, CVC insertion depth can be predicted using Peres’ formula or intracavitary electrocardiography (ECG). The accurate prediction of optimal CVC depth using Peres’ formula and intracavitary ECG on Malay race is unknown. Objective: To compare the accuracy of […]

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Secondary pyomyositis complicated by septic shock and sepsis-induced cardiomyopathy causing a massive erector spinae abscess in a patient after trigger point injection

Authors: Uwen Yeap, Yuto Makino, Kenji Sugimoto

Abstract Trigger point injection is a common pain control method widely practiced around the world. We report the case of a 53-year-old female who presented with lumbago and septic shock complicated with sepsis-induced cardiomyopathy three days after receiving a trigger point injection. She responded to sepsis treatment and empiric antibiotics but later required extensive drainage […]

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Post-surgical right coronary artery injury secondary to tricuspid valve repair

Authors: Andrés Parisi, Ying Tung Sia

Abstract Injury to the right coronary artery (RCA) is a rare complication of tricuspid annuloplasty. We report a 64-year-old woman with history of valvular heart disease that was admitted for decompensated right heart failure. The patient underwent aortic valve replacement and tricuspid annuloplasty. Shortly after tricuspid annuloplasty the patient developed right ventricular (RV) infarction with […]

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Intubation practices at Wellington Hospital Emergency Department: an eight month retrospective observational study

Authors: Kate Barnett, Ross Freebairn, Saptarshi Mukerji, Christopher Poynter, Louise Poynton, Christopher White

Abstract Objective: To determine the rate of intubations carried out in Wellington Hospital Emergency Department (tertiary hospital), New Zealand, to provide a description of intubating habits of clinicians including operator experience and methods, and to determine the rate of complications. Design: Eight month, retrospective, observational study. Setting: Wellington Hospital Emergency Department(WHED). Location: New Zealand. Patients […]

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Late pacemaker perforation of the right ventricle. A case report and review of diagnosis and management

Authors: Vivian Shokry, Ehab Gamil Daoud

Abstract Objectives: Pacemaker incidence and prevalence are on the rise over the last decade especially in the elderly population. Though complications are rare, most reported literature is about early pacemaker complication. Late complications are also reported, but mostly regarding malfunction or infections. Very few case reports and series report late cardiac perforations which could be […]

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Anticholinergic drug-induced benign unilateral anisocoria: common, but frequently overlooked side effect

Authors: Gaurav Gheewala, Salim Surani, Rizwan Ishtiaq, Sneha Reddy, Iqbal Ratnani

Abstract Sudden anisocoria have always been ominous signs among critically ill patients, which requires prompt attention. There are various causes of anisocoria, which call for comprehensive evaluation to rule out neurologic causes such as Adie’s pupil, uncal herniation, compression of third cranial nerve, meningeal irritation, and seizures as opposed to the pharmacological causes such as […]

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The optimal ICU organizational structure

Authors: Paul E. Marik, Joseph Varon

A variety of intensive care units (ICU) staffing models exist, which to a large extent are based on local practice and economic factors rather than cost-effectiveness and the quality of care delivered. The organizational structure of ICU in the United States are usually classified according to two types of models, namely a low- or high […]

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