MedWorm: Emergency Medicine

Cardiac tamponade: a case report

Internal and Emergency Medicine — Fri, 04 Jul 2008 06:02:25 +0100

Cardiac tamponade: a case report Content Type Journal ArticleCategory EM - Morbidity and Mortality ReportDOI 10.1007/s11739-008-0176-5Authors Anil Shukla, Beth Israel Deaconess Medical Center Department of Emergency Medicine 1 Deaconess Road Boston MA 02215 USADaniel McGillicuddy, Beth Israel Deaconess Medical Center Department of Emergency Medicine 1 Deaconess Road Boston MA 02215 USA Journal Internal and Emergency MedicineOnline ISSN 1970-9366Print ISSN 1828-0447 (Source: Internal and Emergency Medicine)

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Acute abdominal pain: value of non-contrast enhanced ultra-low-dose multi-detector row ct as a substitute for abdominal radiographs

Emergency Radiology — Thu, 03 Jul 2008 08:18:19 +0100

Abstract The aim of this study was to evaluate a non-enhanced ultra-low-dose (ULD) abdominal–pelvic multi-detector row computerized tomography (MDCT) to assess patients with acute abdominal pain who would otherwise undergo three-view abdominal X-ray series. Institutional review board approval was obtained with waiver of informed consent. This study was Health Insurance Portability and Accountability Act-compliant. One hundred and sixty-three patients (mean age, 51 years; range, 19–82 years, M/F = 110:53) who underwent ULD MDCT were included in the study. Two subspecialty radiologists independently reviewed the images for abnormal findings and image quality parameters. The effective radiation dose was calculated for each patient and compared to standard-dose computed tomography (CT) scans of 50 matched controls. Findings were confirmed by reviewing the patients’ medical records, and statistical analysis was performed. ULD MDCT showed a high sensitivity (100%), specificity (98.5%), and positive predictive value (91.7%) for detection of free air, stones, and intestinal obstruction. For other sources of abdominal pain, the overall sensitivity, specificity, and positive predictive value were 86%, 96%, and 95%, respectively. Mean effective radiation dose from this study was 2.10 mSv (range of 0.67 to 6.64 mSv) with a 78% mean dose reduction compared to standard-dose CT. There was good inter-observer agreement (=0.4 to 0.81). ULD abdominal–pelvic MDCT provides rapid and reasonably accurate diagnostic information in patients with acute abdominal pain at a very low radiation dose. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s10140-008-0743-0Authors Unni K. Udayasankar, Emory University School of Medicine Division of Abdominal Imaging, Department of Radiology 1364 Clifton Road NE Atlanta GA 30322 USAJianhai Li, Emory University School of Medicine Division of Abdominal Imaging, Department of Radiology 1364 Clifton Road NE Atlanta GA 30322 USADeborah A. Baumgarten, Emory University School of Medicine Division of Abdominal Imaging, Department of Radiology 1364 Clifton Road NE Atlanta GA 30322 USAWilliam C. Small, Emory University School of Medicine Division of Abdominal Imaging, Department of Radiology 1364 Clifton Road NE Atlanta GA 30322 USAMannudeep K. Kalra, Massachusetts General Hospital Department of Radiology 55 Fruit Street Boston MA 02114 USA Journal Emergency RadiologyOnline ISSN 1438-1435Print ISSN 1070-3004 (Source: Emergency Radiology)

Assessing emergency medical care in low income countries: a pilot study from pakistan

BMC Emergency Medicine — Thu, 03 Jul 2008 04:00:00 +0100

Background: Emergency Medical Care is an important component of health care system. Unfortunately it is however, ignored in many low income countries. We assessed the availability and quality of facility-based emergency medical care in the government health care system at district level in a low income country - Pakistan. Methods: We did a quantitative pilot study of a convenience sample of 22 rural and 20 urban health facilities in 2 districts - Faisalabad and Peshawar - in Pakistan. The study consisted of three separate cross-sectional assessments of selected community leaders, health care providers, and health care facilities. Three data collection instruments were created with input from existing models for facility assessment such as those used by the Joint Commission of Accreditation of Hospitals and the National Center for Health Statistics in USA and the Medical Research Council in Pakistan. Results: The majority of respondents 43/44(98%), in community survey were not satisfied with the emergency care provided. Most participants 36/44(82%) mentioned that they will not call an ambulance in health related emergency because it does not function properly in the government system. The expenses on emergency care for the last experience were reported to be less than 5,000 Pakistani Rupees (equivalent to US$ 83) for 19/29(66%) respondents. Most health care providers 43/44(98%) were of the opinion that their facilities were inadequately equipped to treat emergencies. The majority of facilities 31/42(74%) had no budget allocated for emergency care. A review of medications and equipment available showed that many critical supplies needed in an emergency were not found in these facilities. Conclusions: Assessment of emergency care should be part of health systems analysis in Pakistan. Multiple deficiencies in emergency care at the district level in Pakistan were noted in our study. Priority should be given to make emergency care responsive to needs in Pakistan. Specific efforts should be directed to equip emergency care at district facilities and to organize an ambulance network. (Source: BMC Emergency Medicine)

Skeletal trauma in children: what is different? (injury to wrist in a ten-year-old boy)

Emergency Radiology — Wed, 02 Jul 2008 15:22:36 +0100

Skeletal trauma in children: what is different? (Injury to wrist in a ten-year-old boy) Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s10140-008-0711-8Authors Leonard E. Swischuk, The University of Texas Medical Branch Department of Radiology Galveston TX USA Journal Emergency RadiologyOnline ISSN 1438-1435Print ISSN 1070-3004 (Source: Emergency Radiology)

Musculoskeletal: what is different in children? running; steps in hole; ankle sprain; my foot hurts

Emergency Radiology — Wed, 02 Jul 2008 15:22:35 +0100

Musculoskeletal: what is different in children? Running; steps in hole; ankle sprain; my foot hurts Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s10140-008-0741-2Authors Leonard E. Swischuk, UTMB Galveston TX USA Journal Emergency RadiologyOnline ISSN 1438-1435Print ISSN 1070-3004 (Source: Emergency Radiology)

Erratum.