Emergency Medicine Commons^™

Escape This Emergency Room: Simulation Education During A Pandemic, Michael C. Nguyen Md, Nicole Elliott Do, Julie A. Fritzges Do, Louis Morolla Do, Steven A Johnson Md

Department of Emergency Medicine

No abstract provided.

Interventions To Reduce Emergency Department Demand During A Pandemic, Cynthia Wang Bs, Bryan G. Kane Md, Jason L. Forgeon Md, Justin Giordano Do, Armando Orta Md, Richard S. Mackenzie Md

Department of Emergency Medicine

No abstract provided.

Cardiopulmonary Resuscitation (Cpr) Training Strategies In The Times Of Covid-19: A Systematic Literature Review Comparing Different Training Methodologies, Daniyal Mansoor Ali, Butool Hisam, Natasha Shaukat, Mirza Noor Ali Baig, Marcus Eng Hock Ong, Jonathan L. Epstein, Eric Goralnick, Paul D. Kivela, Bryan Mcnally, Junaid Razzak

Department of Emergency Medicine

Background: Traditional, instructor led, in-person training of CPR skills has become more challenging due to COVID-19 pandemic. We compared the learning outcomes of standard in-person CPR training (ST) with alternative methods of training such as hybrid or online-only training (AT) on CPR performance, quality, and knowledge among laypersons with no previous CPR training.
Methods: We searched PubMed and Google Scholar for relevant articles from January 1995 to May 2020. Covidence was used to review articles by two independent researchers. Effective Public Health Practice Project (EPHPP) Quality Assessment Tool was used to assess quality of the manuscripts.
Results: Of the 978 …

The Covid-19 Pandemic: An Opportunity To Strengthen Health Systems In Afghanistan, Umerdad Khudadad, Najibullah Safi, Wafa Aftab, Asrar Ali, Sameen Siddiqi

Department of Emergency Medicine

No abstract provided.

Assessment Of Knowledge, Attitude, And Practice Of Child Abuse Amongst Health Care Professionals Working In Tertiary Care Hospitals Of Karachi, Pakistan, Khuld Nihan, Aamir Makda, Huzaifah Salat, Munawar Khursheed, Jabeen Fayyaz, Uzma Rahim Khan

Department of Emergency Medicine

Introduction: UNICEF report (2004) states that a significant percentage of total child population under the age of 5 years suffered malnutrition. Child sexual abuse remains undiscussed across Pakistan. Health care professionals (HCPs) are usually the first notifiers of child abuse and are ethically obliged to manage and report it.
Objective: This study was conducted to assess HCPs' response in dealing with patients of child abuse. With a better understanding, we can have a better outcome for the victims.
Methods: A total of 101 participants filled out a structured questionnaire by HCPs working in three tertiary hospitals of Karachi i.e., Aga …

Global Trends In Adolescents' Road Traffic Injury Mortality, 1990-2019, Uzma Rahim Khan, Junaid A. Razzak, Martin Gerdin Wärnberg

Department of Emergency Medicine

Objective: The aim of this study was to determine the trends of road traffic injury (RTI) mortality among adolescents aged 10-14 years and 15-19 years across different country income levels with respect to the type of road users from 1990 to 2019.
Methods: We conducted an ecological study. Adolescents' mortality rates from RTIs at the level of high-income countries (HICs), upper-income to middle-income countries (UMICs), lower-income to middle-income countries and low-income countries were extracted from the Global Burden of Disease study. Time series were plotted to visualise the trends in mortality rates over the years. We also conducted Poisson regression …

Knowledge, Attitudes, Practices And Perceived Barriers Of Emergency Health Care Providers Regarding Sepsis And Septic Shock In A Tertiary Care Centre: A Cross-Sectional Study, Madiha Ismail, Umaira Aftab, Kiran Azizi, Badar Afzal Khan

Department of Emergency Medicine

This study aimed to assess knowledge, attitudes, practices, and perceived barriers of emergency healthcare providers regarding the management of sepsis and septic shock. This cross-sectional study was conducted in the Emergency Department of Aga Khan University Hospital, Karachi, Pakistan from August to October 2017. A total of 53 healthcare providers participated in the study. Overall, 42(79%) of the participants demonstrated correct knowledge of the sepsis bundle. The most common barrier reported in the compliance of the sepsis bundle was a shortage of staff (62%), followed by delayed presentation of patients (58%) and overcrowding (42%). Furthermore, better staffing was perceived by …

Spontaneous Tumor Lysis Syndrome In An Adenocarcinoma Of Unknown Origin., Joshua A. Kalter Ms3, Jamie Allen Do, Yuchen Yang Do, Tyler Willing Do, Elizabeth M. Evans Do

Department of Emergency Medicine

Spontaneous tumor lysis syndrome (STLS) is a rare oncologic emergency caused by massive cancer cell lysis or necrosis without a precipitating factor. Although tumor lysis syndrome (TLS) is most commonly associated with hematologic malignancies, a small number of cases in solid tumor malignancies have been reported. We present a case of spontaneous tumor lysis syndrome in a 77-year-old female with a widely metastatic, poorly differentiated adenocarcinoma of unknown origin. She presented in distributive shock, and laboratory testing at admission revealed acute renal failure, high anion gap metabolic acidosis, hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia. Rasburicase and continuous renal replacement therapy were …

Randomised Controlled Trial To Assess The Effectiveness Of Apnoeic Oxygenation In Adults Using Low-Flow Or High-Flow Nasal Cannula With Head Side Elevation Versus Usual Care To Prevent Desaturation During Endotracheal Intubation In The Emergency Department (Apoxed): Study Protocol, Shahan Waheed, Nazir Najeeb Kapadia, Muhammad Faisal Khan, Salima Mansoor Kerai, Ahmed Raheem, Rubaba Naeem

Department of Emergency Medicine

Introduction: Apnoeic oxygenation is a process of delivering continuous oxygen through nasal cannula during direct laryngoscopy. The oxygen that is delivered through these nasal cannulas is either low flow or high flow. Although the effectiveness of apnoeic oxygenation has been shown through systematic reviews and randomised controlled trials, a comparison of high-flow versus low-flow oxygen delivery has not been tested through a superiority study design. In this study we propose to assess the effectiveness of giving low-flow oxygen with head side elevation versus high-flow oxygen with head side elevation against the usual practice of care in which no oxygen is …

Breakout Of Vaping-Associated Lung Injuries (Vali) 2019: A Public Health Threat, Sadaf Sheikh, Muhammad Akbar Baig

Department of Emergency Medicine

No abstract provided.

Perception Of The Healthcare Professionals Towards The Current Trauma And Emergency Care System In Kabul, Afghanistan: A Mixed Method Study, Umerdad Khudadad, Wafa Aftab, Asrar Ali, Nadeem Ullah Khan, Junaid Razzak, Sameen Siddiqi

Department of Emergency Medicine

Background: Trauma and injury contribute to 11% of the all-cause mortality in Afghanistan. The study aimed to explore the perceptions of the healthcare providers (pre and in-hospital), hospital managers and policy makers of the public and private health sectors to identify the challenges in the provision of an effective trauma care in Kabul, Afghanistan.
Methods: A concurrent mixed method design was used, including key-informant interviews (healthcare providers, hospital managers and policy makers) of the trauma care system (N = 18) and simultaneous structured emergency care system assessment questionnaire (N = 35) from July 15 to September 25, 2019. Interviews were …

Fat Embolism Syndrome As The Presenting Syndrome Of Undiagnosed Sickle Cell Disease In A Middle-Aged Adult, Jamie Allen Do, Osman Z. Abbasi Do, Louis Morolla Do, Andres Zirlinger Md, Jeffrey M. Gesell Do, Benjamin Lin Ms

Department of Emergency Medicine

No abstract provided.

Concurrent Primary Cardiac Tumors In A High Risk Patient Presenting With Tamponade, Joseph B. Zackary Md, Lauren Crowley Ba, Shawn M. Quinn Do, Timothy S. Misselbeck

Department of Emergency Medicine

No abstract provided.

The Impact Of Appendectomy In Clostridium Difficile Infection And Length Of Hospital Stay., Rajesh Essrani Md, Dany Saturno, Shehriyar Mehershahi, Rajesh Kumar Essrani, Muhammad Rajib Hossain, Shri Jai Kirshan Ravi, Andrea Berger, Asif Mehmood

Department of Emergency Medicine

Introduction We aim to investigate Clostridium difficile infection (CDI) recurrence, severity, complications, and length of hospital stay in patients with and without prior history of appendectomy who were admitted to the hospital with CDI. Method We analyzed retrospective data for 862 patients, 18 years and older, with C. difficile inpatients diagnosed between January 1, 2017 and December 31, 2018 and sorted into two groups, with or without prior appendicectomy, to look for outcomes such as recurrence, hospital stay, complications, and related death in each group and use statistical analysis for comparison. Result There were 862 patients admitted with CDI, of …

Etiology Of Acute Undifferentiated Fever In Patients Presenting To The Emergency Department Of A Tertiary Care Center In Karachi, Pakistan, Noman Ali, Nadeem Ullah Khan, Shahid Shahid, Syed Mustahsan

Department of Emergency Medicine

Objective: Our study aimed at identifying the characteristics and etiology of various causes of acute undifferentiated fever in patients presenting to the emergency department of a tertiary care hospital.
Methods: This was a retrospective study conducted at the department of emergency medicine, Aga Khan University Hospital from January to June 2016. Adult patients presenting to Emergency department with acute undifferentiated fever were enrolled. Descriptive statistics were calculated in terms of mean±SD for continuous variables like age of the patients and duration of fever, whereas frequency and percentage were computed for categorical variables like gender and causes of fever.
Results: A …

Effectiveness Of High-Fidelity Simulation In Training Emergency Medicine Physicians In Point Of Care Ultrasonography In Pakistan: A Quasi-Experimental Study, Kiran Azizi, Madiha Ismail, Umaira Aftab, Badar Afzal Khan, Asad Mian

Department of Emergency Medicine

Background: Point-of-care ultrasound (PoCUS) is frequently utilized in emergency medicine (EM), with an extended-focused assessment with sonography in trauma (e-FAST) being the most widely used PoCUS modality. This modality is not only time- and cost-efficient, but it is highly accurate in the diagnosis and management of surgical patients in the emergency department, as well as being highly predictive of patient outcomes. Targeted training is essential to ensure a learner's confidence in image acquisition, interpretation, and translation of knowledge to making clinical decisions. High-fidelity simulation offers a uniquely safe and "mistake-forgiving" environment to teach and train medical professionals. The present study …

Silent Hypoxia In Covid-19: What Is Old Is New Again!, Sadaf Sheikh, Muhammad Akbar Baig

Department of Emergency Medicine

No abstract provided.

Emergency Preparedness And Response To The Covid-19 Pandemic: Our Experience From The Emergency Department Of A Tertiary Care Hospital In Pakistan, Badar Afzal Khan, Noman Ali, Asad Mian

Department of Emergency Medicine

No abstract provided.

Convalescent Plasma: Promise For Covid-19 Pandemic, Sadaf Sheikh, Muhammad Akbar Baig

Department of Emergency Medicine

No abstract provided.

Covid-19 Pandemic: Public Trust And Guiding Ethics Where Ventilators Equal Lives, Sadaf Sheikh, Muhammad Akbar Baig

Department of Emergency Medicine

No abstract provided.

Optimising Ventilator Use During The Covid-19 Pandemic, Sadaf Sheikh, Muhammad Akbar Baig

Department of Emergency Medicine

Hypoxemia is the most common cause for hospitalization in COVID-19 patients. Acute hypoxemic respiratory failure or acute respiratory distress syndrome (ARDS) is the most common complication in COVID-19 patients. Close monitoring of respiratory decompensation is essential. Supplemental oxygen, high flow nasal canula, non-invasive ventilation and endotracheal intubation are the most commonly suggested methods to improve oxygenation. Early intubation with pre-oxygenation, modified rapid sequence intubation and intubation using a video laryngoscope has been advised as a strategy including lung protective ventilation, prone position ventilation, adequate sedation and extracorporeal membrane oxygenation. Strict personal precautions and challenges related to airway management has been …

Physician Directed Smoking Cessation In The Ed: Do Patients Opt-Out?, Ali S. Aziz Bs, Natalie M. Greco Md, Timothy J. Batchelor Md, Andrew H F Miller Do, Theodore Doherty Do, Robert Kruklitis Md, Phd, Lauren Crowley Ba, Edward W. Casey Rph, Mba, Elizabeth A. Maclean Pharmd, Phd, Joann B. Trainer Pharmd, Marna R. Greenberg Do, Mph, Facep

Department of Emergency Medicine

No abstract provided.

The Covid-19 Intubation And Ventilation Pathway (Civp); A Commentary, Muhammad Akbar Baig

Department of Emergency Medicine

No abstract provided.

Second Degree Av Heart Block After Candlenut Ingestion, Andrew L. Koons Do, Lexis Laubach Bs, Alexandra Amaducci Do, Robert D. Cannon Do, Kenneth D. Katz Md, Ryan M. Surmaitis Do, Matthew D. Cook Do, Gillian A. Beauchamp Md

Department of Emergency Medicine

No abstract provided.

Self-Harm Poisonings Among Transgender Patients: Analysis Of Toxicology Investigator’S Consortium Registry, Marna R. Greenberg Do, Mph, Facep, Natalie E. Ebeling-Koning Do, Cody R. Mcwhirter Bs, Mikayla B. Hurwitz Bs, Lexis T. Laubach Bs, Gillian A. Beauchamp Md, Judith Sabino Mph, Cdp, Beth Careyva M.D., Andrew L. Koons, Matthew D. Cook Do, Kenneth D. Katz Md, Robert D. Cannon Do, Ryan M Surmaitis Do

Department of Emergency Medicine

No abstract provided.

Agents Of Exposure In Transgender Patient Cases Managed By A Toxicologist: An Analysis Of The Toxicology Investigator’S Consortium (Toxic) Registry, Phillip M. Grenz Do, Mikayla B. Hurwitz Bs, Cody R. Mcwhirter Bs, Lexis Laubach Bs, Gillian A. Beauchamp Md, Judith Sabino Mph, Cdp, Beth Careyva M.D., Matthew D. Cook Do, Marna R. Greenberg Do, Mph, Facep, Robert D. Cannon Do, Ryan M Surmaitis Do

Department of Emergency Medicine

No abstract provided.

Qualitative Analysis Of Emergency Medicine Resident Logged Patient Safety Observations, Bryan G. Kane Md, Jon D. Raso Bs, David M. Richardson Md, Kevin Weaver D.O.,Facoep, John W. Daubert Do, Rafay A. Khan Do, Claire L. Paulson Do, Dawn M. Yenser

Department of Emergency Medicine

No abstract provided.

Using The Qsat To Generate Multi-Source Feedback On An In-Situ Pediatric Simulation Case, Michael C. Nguyen Md, Nicole Elliott Do, Matthew D. Cook Do, Diane Begany Md, Zachary Matuzsan Do, Louis Morolla Do, Suzanne S. Partington Msn, Rn, Ccrn, Jennifer E. Macfarlan Mph, Michael Jong Md, Bryan G. Kane Md

Department of Emergency Medicine

No abstract provided.

Pediatric Congenital Heart Diseases: Patterns Of Presentation To The Emergency Department Of A Tertiary Care Hospital, Surraiya Bano, Saleem Akhtar, Uzma R. Khan

Department of Emergency Medicine

Objective: To observe presentation of Pediatric congenital cardiac defects to the Emergency Department (ED) of a tertiary care hospital in Pakistan.
Methods: This is a retrospective chart review of patients under the age of 16 years with congenital cardiac defects presenting to the Emergency Department of Aga Khan University Hospital over a period of eighteen months, from January 2012 to June 2013. Study population was divided into two groups; first group constituted children with undiagnosed congenital cardiac defects, whereas second group constituted children with diagnosed congenial cardiac defects presented to ED. In previously diagnose cases each visit was counted as …

Sex-Specific Outcomes In A Substance Use Intervention Program., Alexandra Amaducci, Marna R. Greenberg Do, Mph, Facep, Andrew W. Sheen Do, Hanna R. Warren Do, Pratik M. Parikh Do, Paige Roth Lsw, Kevin Weaver D.O.,Facoep, David M. Richardson Md, David B. Burmeister Do, Facep, Cpe, Jennifer Stephens Do, Robert D. Cannon Do

Department of Emergency Medicine

PURPOSE: We performed an emergency department (ED)-based substance use screening, motivational interview-based intervention, and treatment referral program with the goal of determining sex-specific outcomes. Specifically, in this quality improvement project, we aimed to determine whether there was a difference among sexes in the type of substances used; the frequency of positive screening results for substance use disorder; agreeing to an intervention; the type of follow-up evaluation, participation, and referral; and attempts to change substance use after intervention.

METHODS: We prospectively studied a convenience sample of patients at 3 hospitals in Northeastern Pennsylvania from May 2017 through February 2018. Inclusion criteria …