Hegelundcooley3687
"Body packers" are persons who voluntarily or through coercion, swallow or insert drug-filled packets into body cavity, generally in an attempt to smuggle them across secure borders. The drugs most often involved in body packing are heroin and cocaine. Body packers can present in the emergency department as a result of ruptured drug packets, bowel obstruction, or for medicolegal purposes. Suspected cases are diagnosed with X-ray and computed tomography scan of the abdomen. Symptomatic patients require urgent removal of packets. We present a case of foreign national male in whom a drug packet got ruptured and 49 other packets were retrieved with help of laxatives and manual evacuation.Hemosuccus pancreaticus (HP), a term used for upper gastrointestinal bleeding (UGIB) from the ampulla of Vater through the pancreatic duct, is most commonly caused by the rupture of aneurysm of the splenic artery associated with acute or chronic pancreatitis. It is a rare cause of UGIB, and estimates of its rate (1/1500) are based on small case series. Because of its rarity, the diagnosis is easily overlooked. Here, we have described a case of alcohol-induced acute pancreatitis that developed hemorrhagic shock due to HP.
Patients with an alcohol use disorder (AUD) have an increased risk of developing complications during their hospital stays; however, how AUD impacts the length of stay (LOS) and the utilization of hospital resources remains inconclusive.
This study aimed to identify the associations between AUD, defined by self-reported alcohol consumption, blood alcohol content (BAC), and hospital LOS (HLOS) including intensive care unit (ICU) LOS in the trauma patient population.
We conducted a retrospective study analyzing data obtained from 2010 to 2018 at a university-based, level-one trauma emergency department. We identified 1689 adult trauma patients who completed the AUDs identification test (AUDIT) and were admitted to the hospital. We retrieved BAC, age, gender, LOS, and injury severity score (ISS) from the patient charts. The independent samples' median test was used to assess the association of HLOS and ICULOS with ISS, BAC levels, or AUDIT scores.
ISS was directly associated with higher HLOS (
< 0.001) and ICULOS (
< 0.001); however there was no statistically significant association between AUDIT scores and ICULOS (
= 0.21) or HLOS (
= 0.86). There was also no statistically significant association between BAC and HLOS (
= 0.09) or ICULOS (
= 0.07).
Our study found no associations between AUDIT, BAC, and both hospital and ICU LOS in trauma patients even though the literature supported an increased risk of medical complications in the AUD patients.
Our study found no associations between AUDIT, BAC, and both hospital and ICU LOS in trauma patients even though the literature supported an increased risk of medical complications in the AUD patients.
The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score helps to diagnose necrotizing soft-tissue infection (NSTI). The LRINEC score has been reported to be associated with poor prognosis, although few studies have evaluated this association.
We aimed to describe the characteristics of NSTI and assess whether the LRINEC score was associated with mortality and amputation.
We conducted a retrospective observational study from January 2007 to May 2018, in a Japanese tertiary care hospital.
Patients with NSTI were identified through our hospital database using the discharge diagnosis. We extracted data on patient characteristics, laboratory examinations, microbiological information, treatment, and in-hospital mortality.
We estimated the odds ratios (ORs) and associated 95% confidence intervals (CIs) for in-hospital mortality using logistic regression models.
We identified 58 patients. The median LRINEC score was 8 (interquartile range [IQR] 6-9). Forty-four patients (75.9%) scored 6 or more. The eight patients with amputations had a median score of 6 (IQR 4.5-7.5) versus 8 (IQR 7-9) for patients who underwent debridement (
= 0.091). Survivors and nonsurvivors had median scores of 8 (IQR 6-9) and 6 (IQR 5-8), respectively (
= 0.148). The OR for mortality in patients with liver cirrhosis was 10.5 (95% CI 1.00-110.36;
= 0.050).
There was no association between the LRINEC score and patients' outcomes mortality and amputation. Further studies are warranted to evaluate the utility of the LRINEC score and factors associated with poor prognosis in patients with NSTI.
There was no association between the LRINEC score and patients' outcomes mortality and amputation. Further studies are warranted to evaluate the utility of the LRINEC score and factors associated with poor prognosis in patients with NSTI.
Airway management in the emergency department is challenging because conventional screening tools cannot be applied. Therefore, a rapid noninvasive means of identifying a difficult airway will be advantageous for emergency physicians.
The aim of this study is to examine the association between ultrasound measurements of anterior neck soft tissue and difficult airway as judged by the Cormack Lehane grading.
A prospective study was done for 18 months on patients requiring intubation presenting to the emergency medicine department.
Ultrasound measurements of anterior neck soft tissue were obtained in 60 cases at the levels of thyrohyoid membrane, hyoid bone, and vocal cords. Another examiner who was blinded to the ultrasound measurements performed endotracheal intubation and noted Cormack-Lehane grading.
Descriptive statistics such as mean, standard deviation, frequency, and percentage were used. Inferential statistics such as Student's
-test and receiver operating characteristic (ROC) curve analysis were done using the SPSS software version 22.
The thickness of anterior neck soft tissues at the level of hyoid bone in difficult patients was 0.73 cm (95% confidence interval = 0.65-0.80) compared to easy patients 0.47 cm (95% confidence interval = 0.44-0.51) with a
= 0.001 and at the level of thyrohyoid membrane in difficult patients it was 1.83 cm (95% confidence interval = 1.7-1.89) compared to easy patients 1.46 cm (95% confidence interval = 1.41-1.51) with a
= 0.001. Area under the ROC curve was significant at all the three levels with the highest at the level of thyrohyoid membrane 0.99 and least at the level of vocal cords 0.79, the area under the curve was 0.92 at the level of hyoid bone.
Sonographic measurements of the anterior neck soft tissue can be used as a screening tool by an emergency physician to detect difficult intubation.
Sonographic measurements of the anterior neck soft tissue can be used as a screening tool by an emergency physician to detect difficult intubation.
Patients come to the emergency department (ED) for the evaluation of foreign-body sensation in the neck. Given the dearth of clinical studies for this complaint, these patients are treated subjectively by different providers. We aim to propose a treatment approach that results in the timely diagnosis and removal of foreign bodies by comparing the common radiologic studies used in the ED for this complaint, determining the utility of consults, and providing an approach that minimizes length of stay.
We conducted a retrospective cohort study of adults between January 2014 and December 2015 presenting to LIJ and NSUH EDs with a chief complaint of foreign-body sensation in the pharynx, larynx, or esophagus. Fifty unique cases were studied. Consultations with ear, nose, and throat (ENT) and/or gastrointestinal, any imaging studies used, and time until discharge from the hospital were the primary exposures studied. The time for each diagnostic path for successful removal of a foreign body was compared for each aging be considered.
Based on our data, we recommend that an attempt to localize the foreign body be completed by the emergency physician. If an initial attempt does not resolve the sensation, an ENT consult to remove the possible object should be initiated. Only after failure by ENT should radiological imaging be considered.
The incidence of road traffic accidents (RTA) is increasing every day, especially in developing nations. Amongst various attributable factors, the menace of the stray animals remains one of the most underrecognized factors leading to animal-vehicle collision (AVC). selleck kinase inhibitor Objectives Our prospective cross-sectional study aims to survey the incidence of RTA attributable to stray animals and record the pattern of injuries along with other epidemiological parameters.
The present study was conducted at a tertiary care trauma centre located in a major city of eastern India, between June 2019 and March 2020. Variables like demographic details, type of vehicle and injury with severity score, use of safety gear including types of stray animals were collected and analysed.
A total of 185 patients had suffered RTA due to AVC during the study period. The median age of occurrence was 29.0 years. The evening was the most frequent time of accidents (4 PM to 8 PM) with two-wheelers affected in 92% of cases. Stray dogs accountvent animal homelessness and wander freely on streets and major roads.
Distance and other factors may play a significant role in both the implementation of care and the number of secondary health outcomes. The distance from an injury site can play a substantial impact on the mortality of different injuries and access to health-related services. Within this study, we sought to understand the effect of the site to treating center distance and access to relevant health-care services on effect and secondary injuries of coal mining-related injuries.
We evaluated patient demographics, coal mining locations, and patient outcomes. This study is a retrospective review of patients with coal mining hand injuries included in our Level 1 trauma database as well as the amount of health-related resources defined by WV GIS Health Care (Hospitals). The sample consists of coal mine workers. All patients had to meet the study criteria and were admitted during the study period of January 1, 2005, through March 31, 2015. We then were able to locate the coal mines where these coal miners were inj the challenge of injuries occurring at extended distances and requires that treatment becomes as efficient as possible to maximize the chances of a full recovery.
The objective of this study is to understand if the distance between the location of injury and trauma center plays a role in the outcome of coal mines related to hand injuries treated at Charleston Area Medical Center.
The objective of this study is to understand if the distance between the location of injury and trauma center plays a role in the outcome of coal mines related to hand injuries treated at Charleston Area Medical Center.
The role of resuscitative thoracotomy in the emergency department (ED) for patients that have suffered severe thoracoabdominal trauma has been the subject of much debate. Most studies that characterize emergency thoracotomy are from urban, academic, and trauma centers. We sought to describe patient and hospital characteristics of a nationally representative sample of ED thoracotomy (EDT).
The health-care cost and utilization project 2013 National ED Sample (NEDS) and the 2013 National Inpatient Sample (NIS) maintained by the agency for health-care research and quality were used to generate a nationally representative estimate of resuscitative thoracotomies performed in the ED. We obtained patient demographics and clinical characteristics and compared the descriptive statistics of the two datasets.
The NEDS dataset identified 124 unsuccessful EDTs, whereas the NIS dataset identified 77 admissions for thoracotomy. When weighted to create a national estimate, these represent 952 emergency thoracotomies performed in the US in 2013.
