ecj: A Pathfinder

This is a computer-generated pathfinder created against the Distant Reader study called ecj.

Each Distant Reader study carrel is composed of many individual items. Each item is bibliographically described with author, title, date, summary, and keyword values. Below is a list of the items' most signficant keywords as well as lists of the items themselves. Purpusing the content of this pathfinder provides the student, researcher, or scholar with one way to get their heads around the scope of the carrel. The keywords include:

Patients; Non; Care; Che; Una; Con; Dei; Della; Del; Patient; Case; Acute; Hospital; Pain; Department; Covid-19; Health; Trauma; Diagnosis; Risk; Med; Medicine; Treatment; Triage; Heart; Injury; Blood; Chest; Failure; Syndrome; Poisoning; Group; Lung; Cardiac; Ultrasound; Time; Resuscitation; Training; Troponin; Artery; Ecg; Levels; Pressure; Rupture; Bowel; Injuries; Infection; Right; Psychiatric; Gas; Decision; Acidosis; Skin; Niv; Embolism; Work; Air; Abdominal; Team; Allergy; Adult; Hepatitis; Dermatol; Paralysis; Sah; Optic; Infusion; Dirofilariasis; Hill; Cerulea; Appendiceal; Ascariasis; Fuji; Pneumoperitoneum

Depending on how this pathfinder was created, many of the bibliographic sections will include elaborations on the meaning(s) of the given keywords. These elaborations were generated by feeding the items' summaries to a large langauge model and asking the model to address the question, "What is X?", where "X" is the keyword. The result will be a few sentences of elaboration. Be forewarned. The elaborations are often plausible, but they should not be take as truth. Instead, they should be taken as points for consideration.

• Characteristics of psychiatric comorbidities in emergency medicine setting and impact on length of hospitalization: A retrospective study by Pini, Stefano; Benvenuti, Antonella; Pacciardi, Bruno; Massimetti, Gabriele; Abelli, Marianna; Sapia, Gabriele; Pardini, Francesco; Massa, Lucia; Miniati, Mario; Salarpi, Gianluca; Forfori, Francesco; Palagini, Laura (2022) - Recognition of medical patients with psychiatric comorbidity and early management could help to prevent negative prognostic events such as delirium, particularly in cognitively impaired patients who are known to be at greater risk, and ultimately take the medical community one step further in giving a relevant part of the population a better quality of care and outcome, while saving on National Health Service funds. We conducted Analyses Of Variance (ANOVA) confronting LoS between psychiatric diagnostic groups after a variance homo- geneity test; a Logistic Regression with Hosmer-Lemeshow Test (which assesses whether or not the observed event rates match expected event rates in subgroups of the model population) to retro-engineer a prediction model that would apply to our group distribution between PD and non-PD patients, which in turn is indicative of which variables characterised our sample and how by calculating the contribution of individual predictors. Keywords: agitation; care; comorbidity; delirium; emergency; group; impairment; non; patients; psychiatric; study; subjects
• Safety and differences between direct oral anticoagulants and vitamin K antagonists in the risk of post-traumatic intrathoracic bleeding after rib fractures in elderly patients by Turcato, Gianni; Zaboli, Arian; Tenci, Andrea; Ricci, Giorgio; Zannoni, Massimo; Scheurer, Christoph; Wieser, Anton; Maccagnani, Antonio; Bonora, Antonio; Pfeifer, Norbert (2021) - In addition, in cases of minor trauma (<3 rib fractures), no ITHs were observed in patients receiving DOACs.7 The elderly population is known to have a greater risk of trau- ma than younger individuals.1,3 Elderly patients’ falls frequently lead to visits to the ED and, though they generally have non-severe dynamics, they can lead to insidious traumatic conditions.1-3 In cases with the same severity and dynamics of the trauma, elderly patients have a risk of death twice as high as that of patients under 65 years of age.3 The risk of death over the age of 65 is esti- mated to increase by 6.8% each year due to the known fragility of the elderly, the high number of comorbidities and the chronic ther- apies commonly received by this population.2,3 Taking an OAT pre- trauma is a factor that promotes both immediate and delayed post- traumatic hemorrhage and can also cause serious hemorrhagic con- ditions even in non-severe trauma (minor head trauma, chest trau- ma, hip fracture).17,18 OAT can certainly cause problems in elderly and frail patients.19 Feeney et al. compared the risk of bleeding between patients taking VKAs and those taking DOACs in the case of severe closed trauma (ISS >15), excluding head trauma.22 In a cohort of 114 patients (78 VKAs vs 36 DOACs), patients receiving DOACs presented significantly lower mortality than those in the VKA group (DOACs group 8.3%, VKA group 29.5%, p=0.015), as well as a lower number of trans- fused units per patient (p=0.001).22 In contrast, as reported by Dennis et al., who focused on severe chest trauma with more than 3 rib fractures, the current study showed no difference between VKA and DOACs in this subgroup of more severe patients (14.3% vs 12.8%, p=807).7 Keywords: bleeding; chest; doacs; ith; patients; rib; risk; study; trauma; vkas
• Sigmoid volvulus: Treatment options and volvulus recurrence by Atamanalp, Sabri Selcuk; Peksoz, Rifat (2021) - In gangrenous patients, sigmoid resection with primary anastomosis or stoma is preferred.3 Our results related to the surgical treatment are compatible with the lit- erature findings. Results Non-operative decompression (barium enema in 13, rigid endoscopy in 351, flexible endoscopy in 397) was tried in 761 patients (73.2%) with 83.0% of success, 0.7% of mortality, 2.2% of morbidity, and 5.6% early recurrence rates. Keywords: decompression; patients; sigmoid; volvulus
• A case of meralgia paresthetica caused by prone positioning in a COVID-19 patient with acute respiratory distress syndrome by Karaaslan, Tahsin; Avarisli, Aysenur; Durdu, Bulent; Daskaya, Hayrettin (2022) - Clinical neu- rological manifestations of COVID-19 widely vary from mild anosmia to seizure, coma, and strokes.16 Over the last five decades, prone positioning has been used to treat hypoxemia and improve the gas exchange in severe ARDS patients,17 also in COVID-19 patients outside the ICUs.18 In a meta-analysis of 11 randomized-controlled studies involving 1,142 ARDS patients, Lee et al. examined the efficacy and safety of ven- tilation in prone position. [Meralgia pares- thetica after prolonged prone position at the intensive care unit among COVID-19 patients. Keywords: care; case; covid-19; meralgia; nerve; paresthetica; patients; position; positioning
• Facing the Emergency Department crisis in Italy by Coen, Daniele; Casagranda, Ivo; Cavazza, Mario; Cervellin, Gianfranco; Ghiadoni, Lorenzo; Lerza, Roberto (2021) - On the other hand, the failure of the chronic care model and its pro-activity, associated with some backwardness and ineffectiveness of general practice, and by and large of the whole of out of hospital medicine, has made it overly difficult for citizens to receive a quick and appropriate answer to their medical needs. “Community houses”, which are considered as the backbone of the future reform of out of hospital medicine, should not only offer a common roof to the various medical, nursing and social ser- vices, but should also become a reference point for training and professional education. Keywords: care; emergency; hospital; medicine; patients; physicians
• Non-operative management in blunt splenic trauma: A ten-years-experience at a Level 1 Trauma Center by Musetti, Serena; Coccolini, Federico; Tartaglia, Dario ; Cremonini, Camilla; Strambi, Silvia; Cicuttin, Enrico; Cobuccio, Luigi; Cengeli, Ismail; Zocco, Giuseppe; Chiarugi, Massimo (2022) - NOM of blunt splenic injuries includes Splenic Angio-Embolization (SAE). At the beginning of 20th century, the immunological function of the spleen was widely demonstrated.5-16 Actually NOM of blunt splenic injuries has been widely accepted and it was also facilitated by the implementation of inter- ventional radiology techniques.17-19 Splenic Angioembolization (SAE), was initially utilized to reduce spleen volume in hyper- splenism.20 In 1995, Sclafani et al.21 first introduced the concept of the splenic angioembolization as an effective tool in splenic trauma management. Keywords: failure; injuries; injury; management; nom; patients; splenic; surg; trauma
• COVID-19 and cutaneous manifestations: Two cases and a review of the literature by Bastoni, Davide; Borio, Giorgia; Rienzo, Paola; Magnacavallo, Andrea; Vercelli, Andrea; Poggiali, Erika (2022) - Non -co mmerc ial us e o nly patients with COVID-19 associated skin manifestations has been published in 2020 by Galvan Casas et al.12 The authors recognized five clinical patterns of presentation, as follows: i) acral areas of erythema with vesicles or pustules (pseudo-chilblains) (19%), ii) other vesicular eruptions (9%), iii) urticarial lesions (19%), iv) maculopapular eruptions (47%), and v) livedo or necrosis (6%). It is well-known that most viruses can cause skin manifestations acting as foreign particles in the skin1,2 through an inflammatory process,3 and COVID-19 associated skin rashes can be a manifestation of viremia,4 as firstly reported by Recalcati et al. in a case series of 18 COVID-19 patients.5 Since 2020 an increasing number of reports regarding COVID-19 associated cutaneous manifestations has been published,5-10 but the real incidence of the COVID-19 associ- ated cutaneous manifestations has yet to be estimated due to their heterogeneous spectrum of presentation. Keywords: acad; acral; case; covid-19; dermatol; et al; lesions; livedo; manifestations; patients; pattern; rash; skin
• A case of vocal cord dysfunction in the emergency department by Poggiali, Erika; Di Trapani, Giuseppe; Agosti, Antonio; Caiazza, Celestino; Manicardi, Alessandra; Zanzani, Chiara; Vollaro, Stefano; Vercelli, Andrea (2022) - E-mail: poggiali.erika@gmail.com Key words: Vocal cord dysfunction; upper airway obstruction; respira- tory distress; vocal cord; VCD. A case of vocal cord dysfunction in the emergency department Erika Poggiali,1 Giuseppe Di Trapani,2 Antonio Agosti,1 Celestino Caiazza,1 Alessandra Manicardi,3 Chiara Zanzani,3 Stefano Vollaro,4 Andrea Vercelli1 1Emergency Department, “Guglielmo da Saliceto” Hospital, Piacenza; 2Otorhinolaryngology Unit, “Guglielmo da Saliceto” Hospital, Piacenza; 3Intensive Care Unit, Emergency Department, “Guglielmo da Saliceto” Hospital, Piacenza; 4Neurology Unit, “Guglielmo da Saliceto” Hospital, Piacenza, Italy Non -co mmerc ial us e o nly Discussion VCD is a functional cause of respiratory distress. Keywords: care; case; cord; diagnosis; dysfunction; emergency; patients; vcd; vocal
• Management of acute behavioral disturbance in the Emergency Department: An Italian position paper from AcEMC, CNI-SPDC, SIP-Lo, SITOX by Paolillo, Ciro; Casagranda, Ivo; Perlini, Stefano; Bondi, Emi; Fraticelli, Carlo; Cerveri, Giancarlo; Pavone, Fabrizio; Lonati, Davide; Petrolini, Valeria Margherita; Locatelli, Carlo Alessandro; Lerza, Roberto (2022) - The main purpose is to draw up a docu- ment that presents a standardized method for the organization of the care of patients with acute behavioral disorders in EDs. A 2016 poll carried out by the Academy of Emergency Medicine and Care among doctors and nurses working in EDs highlighted a serious difficulty in knowing how to recognize a patient suffering from acute behavioral disorders and even more in knowing how to identify patients at risk of a dangerous agitation. Keywords: care; department; disorders; emergency; health; management; medical; patients
• Accuracy of nurses’ performance in triage using the emergency severity index and its relationship with clinical outcome measures by Shabrandi, Nazer; Bagheri-Saweh, Mohamad Iraj; Nouri, Bijan; Valiee, Sina (2022) - Limitations Considering the research method, inaccurate recording of information by triage nurses was considered as one of the limita- tions of the present study, which could not be handled by the researcher, and also considering the retrospective nature of the study, the information in the patient’s file was not fully recorded, so the researcher had to replace another patient’s file. The role descrip- tions of triage nurse in emergency department: a Delphi study. Keywords: care; department; emergency; esi; length; level; nurses; patients; performance; study; trauma; triage
• The state of the art of the management of anticoagulated patients with mild traumatic brain injury in the Emergency Department by Park, Naria; Turcato, Gianni; Zaboli, Arian; Santini, Massimo; Cipriano, Alessandro (2022) - The impact of direct oral anticoagulants in traumatic brain injury patients greater than 60-years-old. However, it is notable that, although prior studies and meta- analyses demonstrated an association between traumatic ICH and anticoagulation or antiplatelet agents in patients with head trau- ma,16-19 some recent studies did not demonstrate such an associa- tion.20-24 In a retrospective cohort analysis of 2567 patients, Lampart et al. did not find a significant relationship between traumatic ICH and any anticoagulant/antiplatelet agents, although combination therapy was associated with an increase in hospital mortality.25 Similarly, Uccella et al. found that patients taking OAT with GCS 15 after blunt head trauma did not have a higher risk for intracranial hemorrhage than the general population.26 These new observations could be due to the different cohorts of patients. Keywords: anticoagulants; brain; emerg; head; injury; intracranial; med; mtbi; patients; rcs; risk; scan; traumatic
• COVID-19 in sub-intensive care unit: An italian single-center experience along the three epidemic waves by Vallelonga, Fabrizio; Diella, Francesco Arcangelo; Converso, Marcella; De Filippi, Giovanna; Bosco, Francesca; Panero, Francesco; Aprà, Franco; Elia, Fabrizio (2022) - [years] 60 ± 11.7 65.7 ± 11.8 61.9 ± 11.8 0.01 Female [mmHg] 128 ± 19.7 130 ± 19.8 131 ± 20.9 0.72 Diastolic Blood Pressure Keywords: admission; age; analysis; care; covid-19; emergency; intubation; mortality; patients; rate
• Diagnostic significance of haematological testing in patients presenting at the Emergency Department by Lippi, Giuseppe; Targher, Giovanni; Neri, Giampaolo; Cattabiani, Clarissa; Pipitone, Silvia; Cervellin, Gianfranco (2012) - Results Values of haematological parameters among the different pathological conditions The main demographic and haematological characteristics of healthy controls and acutely admitted ED patients (consi- dered as either a whole sample or subdivided according to their acute pathologies) are summarized in Table 1. In agreement with previously published studies, we observed an increased RDW value in all groups of sdmitted ED patients, except in those with trauma, confirming that this parameter would mirror the presence of anisocytosis that might aspecifically occur throughout a variety of acute disorders. Keywords: acute; auc; cases; controls; count; groups; mpv; pancreatitis; patients
• CT imaging in idiopathic out-of-hospital cardiac arrest: An assessment of current practice and diagnostic utility by Harper, Isla; Easterford, Kate; Reed, Matthew (2022) - CT head or CT chest imaging is recommended for early iden- tification of neurological or respiratory causes, with whole body scanning reserved for OHCA with trauma or haemorrhage.5 Our study shows practice in the RIE ED conforms with this guidance.5 Our data support the use of head and chest CT imaging, with CT head and CTPA the only scan types to identify arrest causes. CT imaging was safe with no cases of contrast nephropathy, allergic reaction, or other complications. Keywords: arrest; care; cause; imaging; ohca; pathology; patients; resuscitation; scans; study
• Good clinical practice and scientific research in the EU - Rome, 2-4 November 2011 by Editors, The (2012) - Questo “matrimonio” tra l’aspetto clinico e la valenza epidemiologica del management della terapia antimicrobica è il principio su cui su basa la stewardship antimicrobica, che si propone come un insieme di interventi finalizzati a contenere Si tratta di una soluzione di microbolle capace di entrare in risonanza con il fascio di ultrasuoni, che consente di ottenere un imaging real time in scala di grigi con una efficace rappresentazione dell’architettura microva- scolare dei parenchimi. Keywords: care; che; clinica; con; copyright; della; dell’editore; distribuire; elettronicamente; l’autorizzazione; materiale; nel; nell’eu; non; patients; pct; protetto; ricerca; roma; scientifica; scritta; senza; terapia; una; w w
• Good clinical practice and scientific research in the EU - Rome, 2-4 November 2011 by Editors, The (2012) - Nei soggetti seguiti con il metodo tradizionale solo il 23,2% (10/43 soggetti riceveva analgesia e a solo il 9,3% (4/43) veniva somministrata una terapia con oppiacei. Patients and methods The data of 2003 were extracted from the ED manual report. Keywords: acute; buona; clinica e; con; copyright; da copyright; del; dell’editore; department; diagnosis; e ricerca; elettronicamente; emergency; iii; l’autorizzazione; materiale; medicina; nell’eu; nell’eu roma; non; novembre; o distribuire; pain; patients; pazienti; pratica; protetto; protetto da; results; roma; scientifica; scientifica nell’eu; scritta; senza; study; syncope; w .e; w w; years
• Intranasal Fentanyl for Analgesia in Adults with Acute Renal Colic by Etteri, Massimiliano; Bellone, Andrea (2012) - A randomised crossover trial of patient controlled intranasal fentanyl and oral morphine for procedural wound care in adult patients with burns. Abstract Objectives: The usual treatment of pain in acute renal colic is analgesic in intravenous (IV) route. Keywords: colic; fentanyl; group; ketorolac; minutes; morphine; non; pain; patients
• RDW and pro-BNP in predicting short-term mortality in geriatric patients presenting to the emergency department with acute decompensated heart failure by Özdemir, Serdar; Özkan, Abuzer (2022) - Comparison of prognostic value of red cell distribution width and NT-proBNP for short-term clin- ical outcomes in acute heart failure patients. Kataoka H. Arginine vasopressin as an important mediator of fluctuations in the serum creatinine concentration under decon- gestion treatment in heart failure patients. Keywords: blood; bnp; bun; failure; heart; mortality; patients; rdw; study; term
• Spontaneous subarachnoid hemorrhage in the emergency department by Garbossa, Diego; Fontanella, Marco; Ducati, Alessandro; Fronda, Chiara; Panciani, Pierpaolo; Fornaro, Riccardo; Tartara, Fulvio; Crobeddu, Emanuela; Marengo, Nicola (2012) - • Cerebral artery dissection (carotid or vertebral). • Pretruncal non aneurysmal SAH (14-22%). Keywords: aneurysms; angiography; blood; hemorrhage; non; patients; sah; subarachnoid
• Fluids and vasopressors in septic shock: basic knowledge for a first approach in the emergency department by Coen, Daniele (2023) - In this non-systematic review, the basic pathophysiological concepts and the most important mes- sages from clinical studies will be summarized, with the aim to identify the baseline skills and knowledge necessary for a first approach to septic shock patients in the emergency room. Unfortunately, however, in septic patients the ability to autoregulate vascular tone is often impaired.23 Thus, it is difficult to foresee the effects that the administration of adrenergic agents may have on regional flows. Keywords: administration; care; crit; crit care; et al; fluid; intensive; med; patients; sepsis; septic; shock; studies; treatment; vasopressors
• Challenges of the next generation hospitals: Rethinking the Emergency Department by Casagranda, Ivo; Gola, Marco; Bellone, Andrea; Coen, Daniele; Brambilla, Andrea; Guiddo, Grazia; Paolillo, Ciro; Lerza, Roberto; Capolongo, Stefano ; Boeri, Stefano (2022) - The presence of isolated ED areas and/or buffer spaces of varying sizes in case of an emergency can be use- ful;18 vi) immunocompromised patients: one or two positive-pres- sure rooms are required; vii) contaminated patients by chemical, biological and/or radiological agents: NBCR area with direct access from outside, showers, wastewater collection, audio video system for control and communication from outside are necessary; viii) patients in custody: dedicated room with security criteria doors, windows, and furniture, if necessary, should be guaranteed. Finally, since ventilation systems play a strategic role in the design of ED spaces, as several experiences have shown, it is sug- gested that as many rooms as possible should be created with an external view to ensure air exchange by opening windows.15 5. Keywords: areas; case; covid-19; design; emergency; healthcare; hospital; patients; spaces
• Diagnostic value of N-terminal ProB-Type Natriuretic Peptide in Emergency Department: Analysis by subgroups by Villa, P.; Dolci, A.; Dominici, R.; Panteghini, M.; Fundarò, C.; Guzzetti, S. (2012) - 36 Using the 450 ng/L cut-off, NT-proBNP sensitivity was 96.4 %, while specificity was 52.2 %. A Group B Group C Group Heart Failure NT-proBNP + 0 126 167 NT-proBNP - 0 9 2 No-Heart Fail- ure NT-proBNP + 12 72 4 NT-proBNP - 42 53 1 Figure 3. Keywords: diagnosis; dyspnea; failure; group; heart; patients; probnp
• Evaluation of severe trauma at the Emergency Department of the San Paolo Hospital of Savona: two years of experience by Frumento, F.; Corti, L.; Riccardi, A.; Guiddo, G.; Minuto, P.; Chiarbonello, B.; Castelli, M.; Lerza, R. (2012) - These observations underline the importance of periodically reviewing the protocols and make training on trauma also in hospitals that are not recognized as trauma center. Evaluation of severe trauma at the Emergency Department of the San Paolo Hospital of Savona: two years of experience F. Frumento, L. Corti, A. Riccardi, G. Guiddo, P. Minuto, B. Chiarbonello, M. Castelli, R. Lerza SC Pronto Soccorso, Osservazione Breve e Medicina d’Urgenza, Ospedale San Paolo, Savona Abstract The authors analyze the major trauma recorded in a couple of years in the Emergency Room of the San Paolo Hospital of Savona after the setting, in the same district, of the trauma center at the Santa Corona Hospital of Pietra Ligure. Keywords: center; hospital; injury; patients; trauma
• The dark side of the QT interval. The Short QT Syndrome: pathophysiology, clinical presentation and management by Comelli, I.; Lippi, G.; Mossini, G.; Gonzi, G.; Meschi, T.; Borghi, L.; Cervellin, G. (2012) - Keywords: short QT syndrome, channelopathies, sudden cardiac death. Shulze et al. have suggested that the clinical suspicion of SQTS should be substantially raised in the presence of short QT interval associated with arrhythmias (especially AF or VF), and familial history of SCD, SQTS or both (34). Keywords: heart; interval; msec; patients; scd; short; sqts; syndrome
• The impact of COVID-19 quarantine on mental health: an observational study from an outpatient service for non-psychotic patients in Russia (Moscow) by Zinchuk, Mickail; Beghi, Massimiliano; Castelpietra, Giulio; Ferrari, Silvia; Pashnin, Evgenii; Guekht, Alla (2023) - Pre/post comparison study of emergency mental health visits during the COVID-19 lockdown in Lombardy, Italy. In particular, there was a significant decrease in visits for organic psychiatric disorders (-43.5%). Keywords: covid-19; decrease; health; lockdown; number; pandemic; patients; period; quarantine; study; visits
• When emergency medicine embraces palliative care by Poggiali, Erika; Bertè, Raffaella; Orsi, Luciano (2022) - Hrev_master In Italy Emergency Medicine (EM) and Palliative Care (PC) are still considered two opposite disciplines with two opposite end- points: saving lives for EM clinicians, and taking care of end-stage patients for palliative care physicians. According to the WHO, PC is “an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychological and spiritual”.1 EM is defined as “a primary specialty established using the knowl- edge and skills required for the prevention, diagnosis and manage- ment of urgent and emergency aspects of illness and injury, affect- ing patients of all age groups with a full spectrum of undifferenti- ated physical and behavioural disorders”.2 Traditionally the domi- nant paradigm in EM has been therapies to maintain life at all costs, often without attention to a patients’ prognosis, treatment values, and preferences for care. Keywords: care; emergency; end; life; palliative; patients
• Biological prosthesis, platelet enriched plasma and bone marrow stem cells in complicated incisional hernia reconstruction in emergency surgery: a prospective case control study by Coccolini, Federico; Paratore, Filippo; Tartaglia, Dario; Cremonini, Camilla; Zocco, Giuseppe; Cobuccio, Luigi; Chiarugi, Massimo (2023) - However, abdominal wall and his function is generally considered to be less important than that of the nearby abdominal organs. Abdominal wall Thickness 7gg (cm) Mmean±SD / 2±0 2.4±0.5 2,8±0,4 <0.05 Median(range) / 2(1.91-2.29) 2(2.29-2.72) 3(2.41-2.76) Keywords: bone; group; hernia; mesh; patients; pep; reconstruction; repair; tissue; underwent; wall
• High flow nasal cannula combined with non-invasive ventilation versus high flow nasal cannula alone in patients with acute hypoxemic respiratory failure due to pneumonia: a randomized controlled trial by Ghezzi, Leonardo; Graziano, Francesca; Bottani, Giulia; Marullo, Giulia; Capsoni, Nicolò; Forni, Elisa; Vincenti, Fabrizio; Rebora, Paola; Bellone, Andrea (2023) - In a previous paper of Frat et al.,22 intubation rate was similar in the HFNC group compared with noninvasive ventilation group but there was a significant difference in favor of high-flow oxygen in 90-day mortality compared with noninvasive ventilation in acute hypoxemic respiratory failure patients. Introduction Patients with hypoxemic respiratory failure due to community acquired pneumonia are usually treated with different devices: nasal cannula, venturi or reservoir masks, Continuous Positive Airway Pressure (CPAP), High Flow Nasal Cannula (HFNC), Non-Invasive Ventilation (NIV) or mechanical ventilation.1-3 HFNC has been developed initially for critically ill neonate and infantes,4,5 however, in the last decade evidence suggested it is effective in diverse underlying conditions, such as hypoxemic res- piratory failure, pre and post intubation, exacerbation of Chronic Obstructive Pulmonary Disease (COPD), sleep apnea, acute heart failure, and conditions entailing do-not-intubate orders.6-8 HFNC could alleviate symptoms of acute respiratory failure with different mechanisms: deadspace CO2 washout, reduction of oxygen dilution (ensuring a more precise fraction of inspired oxy- gen, FiO2) and produce a moderate positive airway pressure effect when mouth is closed.9,10 Keywords: care; failure; fio2; flow; group; hfnc; nasal; niv; patients; pneumonia; po2
• Why do emergency department clinicians miss acute aortic syndrome? A case series and descriptive analysis by McLatchie, Rachel; Wilson, Sarah; Reed, Matthew; Ticehurst, Francoise; Easterford, Kathryn; Alawiye, Salma; Cowan, Alicia; Gupta, Aakash (2023) - Reasons for missed AAS diagnosis in the ED (more than one reason for some cases). Reason(s) determined for missed diagnosis Number of cases No evidence of consideration of AAS in differential diagnosis 31 Satisfied by alternative presumed diagnosis 19 Satisfied by exclusion of ACS 6 Diagnosis of AAS considered but not pursued as reassured by absence of radial-radial delay or BP differential 5 Diagnosis of AAS considered but not pursued as reassured by normal CXR 3 Diagnosis of AAS considered but not pursued due to atypical symptoms 1 Diagnosis of AAS considered but not pursued as reassured that pain had settled 1 Diagnosis of AAS suspected but CT misreported as being normal 1 Did not recognise widened mediastinum on CXR 1 Unknown (limited notes available) 2 [Emergency Care Journal 2023; 19:11153] In our review of missed AAS diagnosis in three UK EDs, we found that in approx- imately three quarters of cases, AAS did not seem to have been considered in the differential diagnosis. Keywords: aas; acute; aortic; cases; diagnosis; dissection; emergency; pain; patients; study
• Emergency department nurses’ perceptions of caring for patients with intentional self-poisoning: a qualitative study by Sharifi, Salar; Valiee, Sina (2023) - Therefore, the aim of this study was to explore emergency department nurses’ perceptions of caring for patients with intentional self-poisoning. (p. 9) Lack of desire to care Another sub-theme of being reluctant to care was nurses’ lack of desire to care for intentional self-poisoning patients so that emergency department nurses had a negative perception towards patients with intentional self-poisoning. Keywords: care; comprehensive; data; department; emergency; nurses; patients; poisoning; self; study; support
• Spinal Cord Injury without Radiographic Abnormality (SCIWORA): a case report and literature review by Morelli, Nicola; Poggiali, Erika; Ioannilli, Eva; De Mitri, Paola; Corvi, Andrea; Cervellin, Gianfranco; Vercelli, Andrea (2023) - Magnetic resonance imaging (MRI) plays a pivotal role in the diagnosis, management and prognosis of SCIWORA, being the golden standard technique to identify spinal cord injuries. 39.0523.303044. E-mail: poggiali.erika@gmail.com Key words: spinal cord injury; post-traumatic myelopathy; SCIWO- RA; cervical spine; magnetic resonance imaging; trauma. Keywords: abnormality; cervical; cord; cord injury; emergency; injury; mri; patients; sciwora; spinal; spinal cord; spine; trauma
• Hypocapnia as a predictor of the need for non-invasive mechanical ventilation in subjects with SARS-CoV-2 related pneumonia by De Vuono, Stefano; Berisha, Sokol; Settimi, Laura; Cianci, Pasquale; Lignani, Alessandra; Lanci, Gianmarco; Taliani, Maria Rita; Groff, Paolo (2023) - Comparison between patients treated with VMK versus HFNC VMK HFNC p Age, yrs 65 ± 12 62 ± 14 ns Days from symptoms onset 7.5 ± 3 7.2 ± 3 ns Days from positive swab 5.8 ± 3 6.3 ± 3 ns Number of comorbidities 1.2 ± 1.18 0.76 ± 0.7 ns SBP, mmHg 139 ± 22 140 ± 14 ns DBP, mmHg 80 ± 14 81 ± 10 ns Heart rate, bpm 93 ± 16 86 ± 19 ns Respiratory rate, breaths/min 25 ± 5 25 ± 4 ns Body temperature, °C 36.8 ± 0.7 36.9 ± 08 ns WBC, 103/mmc 7094 ± 2764 7829 ± 3512 ns HB, mg/dL 14.3 ± 1.4 13.4 ± 1.8 ns PTL, 103/mmc 193 ± 66 197 ± 59 ns Glycemia, mg/dL 161 ± 60 137 ± 33 ns Urea, mg/dL 42 ± 23 39 ± 12 ns Creatinin, mg/dL 0.87 ± 0.26 0.81 ± 0.19 ns GFR, mL/min/1,73 m2 87 ± 21 88 ± 16 ns D-dimer, µg/mL 710 ± 337 952 ± 1086 ns AST, IU/L 75 ± 60 86 ± 182 ns ALT, IU/L 67 ± 68 62 ± 99 ns Albumin, mg/dL 3.6 ± 0.3 3.6 ± 0.3 ns LDH, IU/L 412 ± 140 474 ± 260 ns CRP, mg/mL 7.6 ± 4.4 26.7 ± 69 ns pH 7.47 ± 0.04 7.47 ± 0.05 ns PaO2, mmHg 59 ± 6 57 ± 5 ns PaCO2, mmHg 31 ± 5 30 ± 4 ns HCO3-, mEq/L 23 ± 4 22 ± 3 ns P/F 281 ± 28 272 ± 21 ns Table 1. NO-NIMV NIMV p Age, yrs 62 ± 11 60 ± 12 ns Days from symptoms onset 7.2 ± 4 7.3 ± 2 ns Days from positive swab 6.7 ± 3 5.5 ± 3 ns Number of comorbidities 1 ± 0.9 1 ± 1 ns SBP, mmHg 140 ± 21 140 ± 18 ns DBP, mmHg 81 ± 13 80 ± 12 ns Heart rate, bpm 86 ± 17 92 ± 17 ns Respiratory rate, breaths/min 24 ± 3 25 ± 5 ns Body temperature, °C 36.8 ± 0.8 36.8 ± 0.8 ns WBC, 103/mmc 7475 ± 3571 7274 ± 2802 ns HB, mg/dl 13.8 ± 1.2 14.1 ± 1.8 ns PTL, 103/mmc 222 ± 75 184 ± 55 .045 Glycemia, mg/dl 135 ± 34 161 ± 57 .047 Urea, mg/dl 40 ± 12 42 ± 22 ns Creatinin, mg/dl 0.84 ± 0.19 0.85 ± 0.25 ns GFR, ml/min/1,73 m2 87 ± 18 88 ± 20 ns D-dimer, µg/ml 805 ± 413 806 ± 869 ns AST, IU/L 50 ± 21 95 ± 152 ns ALT, IU/L 52 ± 32 74 ± 98 ns Albumin, mg/dl 3.6 ± 0.2 3.6 ± 0.3 ns LDH, IU/L 369 ± 95 471 ± 232 ns CRP, mg/ml 7 ± 5 20 ± 55 ns pH 7.47 ± 0.04 7.47 ± 0.05 ns PaO2, mmHg 60 ± 7 58 ± 4 ns PaCO2, mmHg 32 ± 4 29 ± 5 .055 HCO3-, mEq/L 24 ± 4 22 ± 3 .017 P/F 284 ± 34 274 ± 20 ns Table 4. Keywords: analysis; cov-2; hypocapnia; need; nimv; patients; sars; study; subjects
• Evaluation of PaCO2 trend in COVID-19 patients undergoing helmet CPAP in the emergency department by Capsoni, Nicolo; Privitera, Daniele; Airoldi, Chiara; Gheda, Silvia; Mazzone, Annamaria; Terranova, Gianluca; Galbiati, Filippo; Bellone, Andrea (2023) - Introduction The use of continuous positive airway pressure (CPAP) in COVID-19 respiratory failure under a strict protocol has been described to be highly efficient. Lower PaCO2 values may represent a higher inspiratory effort and, there- fore, may help identify patients at greatest risk of CPAP failure. Keywords: care; covid-19; cpap; emergency; eti; failure; helmet; non; paco2; patients; trial
• A narrative review on palliative care in the emergency department: dealing with the uncertainty of death by Porta, Lorenzo; Mauri, Eugenia (2023) - The situation clearly demonstrated that, especially during times of crisis, emergency department proto- cols should incorporate palliative care and seek innovative tools which can allow for better management of palliative care patients and emotional/spiritual support of families.9,10 Thus, we aim in this narra- tive review to provide the reader with an introductory guide on the ethical and practical principles that should guide the emergency physician in a correct approach to these patients in the ED.11-15 Uncertainty and how to deal with it Doctors are historically taught to understand patients through scientific knowledge, basing their decisions on scientific evidence alone so that subjectivity does not bias their judgment. In the last decades emergency physicians have observed a steep increase in the emergency department (ED) admissions of palliative care patients who rely on the hospital for symptoms’ relief and management of acute exacerbations of their chronic dis- ease. Keywords: approach; care; death; department; disease; emergency; interventions; life; medicine; palliative; patients; physicians; sedation
• The predictive value of inflammatory biomarkers in the detection of multiple sclerosis attacks by Vural, Nafis; Duyan, Murat; Saridas, Ali; Ertas, Elif; Kalkan, Asım (2023) - Introduction Multiple sclerosis (MS) is the most prevalent immune-media- ted inflammatory demyelinating central nervous system disorder, with a diverse set of clinical signs and symptoms.1,2 MS exhibits significant heterogeneity in radiological and histopathological changes, clinical presentation, disease progression, and treatment response.3 Regarding its pathogenesis, it has been suggested that the innate and adaptive immune system causes inflammation of a dynamic interaction between glia and neurons, disorders of the blood-brain barrier, demyelination, and neuroaxonal injury to the brain and spinal cord.4,5 Since MS patients admitted to the emergency department (ED) have variable clinical symptoms, it is very important to distinguish between those in the attack (exacerbation, relapse, episode) period and those who do not. In the study of Hemond et al. in MS patients, high MLR was significantly associated with physi- cal disability status score (EDSS) and brain atrophy. Keywords: attack; lymphocyte; mean; mlr; nlr; patients; ratio; rlr; sclerosis; sii; study
• Accuracy of bedside sonographic measurement of optic nerve sheath diameter for intracranial hypertension diagnosis in the emergency department by Busti, Chiara; Marcosignori , Matteo; Marchetti , Francesco; Batori , Giuseppe; Giovenali , Laura; Corea , Francesco; Calabrò , Giuseppe; Monti, Manuel; Germini , Federico (2023) - Robba et al., in 2018,17 published a metanalysis including studies in which US ONSD measurement was com- pared with ICP by invasive devices and found a good diagnostic accuracy for US ONSD. For example, in a low-resources context and in low-risk patients (GCS 14-15, absence of hemorrhagic risk factors) affected by traumatic and non-traumatic brain injury, the timing for head CT execution could be based on US ONSD measurement: in case of ONSD ≤5.5 mm within 6-8 hours, in case of >5.5 mm within 1 hour. Keywords: care; eicp; emergency; injury; nerve; optic; patients; pressure; study; traumatic
• Selective serotonin reuptake inhibitors related bleeding risk: case report and review of literature by Boccatonda, Andrea; D'Ardes, Damiano; Guagnano, Maria Teresa; Cipollone, Francesco; Santilli, Francesca (2023) - Resting platelets incubated with esc- italopram became most spherical.11 Moreover, an in vitro study showed how medium or high amount of escitalopram can significantly inhibit platelet aggrega- tion induced by ADP and by collagen, together with a reduced expression of glycoprotein (GP)Ib, lysosome-associated membrane glycoprotein 3 (LAMP-3) and GP37 on platelet surface.12-15 Some SSRIs (e.g., fluoxetine, paroxetine or citalopram) may decrease the secondary phase of aggregation in response to ADP, and significantly lower adenosine triphosphate16 and serotonin release in normal platelet rich plasma.13,14 SSRIs can block sero- tonin release from dense granule during platelet aggregation.17 Tseng et al. demonstrated that SSRIs can decrease the amplifi- cation of platelet aggregation secondary to the activation of purinergic receptor P2Y12, thus reducing the activation of the downstream molecules of the ADP signaling pathways.13 Differences between citalopram and other SSRI Citalopram displays a greater effect to inhibit platelet adhesion to both collagen and fibrinogen surfaces than sertraline.6 Moreover, citalopram, but not paroxetine, may significantly decrease P-selectin expression on platelets after ADP activation, thrombin receptor-activating peptides (TRAP) and cross-linked collagen-related peptide (CRP-XL).18 Moreover, DOACs are known to increase the potential risk for upper GI tract bleeding.23 In the work of Wallerstedt et al, the addition of SSRI to war- farin-treated patients was correlated with an increased risk of clin- ically relevant bleeding.24 Keywords: bleeding; escitalopram; et al; heart; patients; platelet; reuptake; risk; serotonin; ssri; study; use
• Italian validation of the Manchester Triage System towards short-term mortality: a prospective observational study by Zaboli, Arian; Sibilio, Serena; Cipriano, Alessandro; Park, Naria; Bonora, Antonio; Pfeifer, Norbert; Giudiceandrea, Alberto; Brigo, Francesco; Turcato, Gianni (2023) - Non -co mmerc ial us e o nly are created by a panel of experts as study outcomes for validating triage systems, but at present, there are no data available regarding their actual effectiveness or usefulness.13,17 The choice to use out- comes such as mortality, in contrast to previous studies that select- ed objective and subjective outcomes simultaneously, is supported by the absence of gold standards for the evaluation of triage sys- tems.17,18 Thus, the study suggests that given the difficulty of unifying triage systems in Italy, the MTS could be implemented in all national EDs given its worldwide dis- Article Table 1. Keywords: code; death; emergency; mts; patients; priority; study; system; term; triage; years
• Precision medicine in hemostasis: a review of prothrombin complex concentrates and the role of viscoelastic tests in tailoring therapy by Cappellini, Iacopo; Lai, Franco; Magazzini, Simone; Consales, Guglielmo (2023) - In a study titled “Thromboelastometry-guided hemostatic resuscitation in severely injured patients: a propensity score- matched study”, the authors used ROTEM to guide the administra- tion of blood products and coagulation factors in severely injured patients. Coagulation factors: the initial phase of the TEG tracing, the R-time, reflects the time taken for initial fibrin formation. Keywords: bleeding; care; clot; coagulation; complex; factor; patients; pcc; prothrombin; rotem; teg; time; trauma; use
• Renal trauma during a rugby tackle by Pothiawala, Sohil; Schroll, Rebecca (2023) - The indications for radiologic evaluation of renal injury in blunt trauma include: i) clinical signs suggestive of renal trauma e.g., abdominal tenderness, distension, flank pain, ipsilateral lower rib fractures; ii) gross hematuria; iii) microscopic hematuria and one episode of hypotension (pre-hospital or initial ED systolic BP <90mm Hg); iv) presence of other major injuries Hemodynamically stable patients with microscopic hematuria, those with low-grade renal injuries (I-III), and even those with high-grade renal injuries (IV-V) can be managed conservatively. Angiography and selective embolization have shown a high success rate in the management of patients with high-grade (Grade IV and V) renal injuries with ongoing bleeding or vascular compli- cations.3,10 Patients with significant extravasation of urine on CT scan should be treated with retrograde ureteral stents to prevent development of a urinoma.2 Surgical intervention is required in less than 5% of patients, especially for hemodynamically unstable patients, or those with complete avulsion of the ureteropelvic junc- tion, or an expanding/pulsatile retroperitoneal hematoma sugges- tive of renal pedicle injury, to control hemorrhage and salvage the kidney.1 3-10% of patients with renal trauma develop complications like urinoma, delayed bleeding, hypertension, hydronephrosis, pyelonephritis, perinephric abscess, arteriovenous fistula, urinary fistula, and pseudoaneurysm.11 As the risk of complications is higher in patients with high-grade injuries, these patients should be discharged with appropriate follow-up with trauma/general surgery and/or urologist. Keywords: hematuria; injury; kidney; patients; renal; rugby; trauma
• Unraveling the intricacies of acute temporomandibular joint dislocation in emergency department: a multidimensional exploration of reduction techniques and success rate by emergency physicians by Vijay Kumar, S S; Shekhli, Shabbir; Jose, Anila (2023) - This study represents the first investigation in India to explore the success rate of TMJ dislocation reduction performed by EPs. Despite these limitations, our study provides valuable insights into the success rate of TMJ dislocation reduction by Emergency Physicians, which can pave the way for future research and improvements in patient care protocols. Keywords: cases; dislocation; emergency; eps; joint; patients; reduction; sedation; study; success; technique; tmj
• Estimated plasma volume status can help identify patients with sepsis at risk of death within 30 days in the emergency department by Turcato, Gianni; Zaboli, Arian; Sibilio, Serena; Mian, Michael; Brigo, Francesco (2023) - Overall, we established that ePVS, a rapid and easy test to administer at the time of ED admission, was independently associ- ated with mortality in sepsis patients and that it plays a role in iden- tifying mortality risk in patients with initially less severe sepsis. Although more studies are required to corroborate these clinical findings, ePVS may eventually be used as a clinical tool in the complex prognostic assessment of sepsis patients. Keywords: care; emergency; epvs; mean; mortality; patients; risk; sepsis; study; volume
• From syncope to ICD: clinical paths of the Brugada syndrome by Comelli, Ivan; Cervellin, Gianfranco; Meschi, Tiziana; Borghi, Loris (2010) - Antzelevitch C, Brugada P, Brugada J et al. L’incidenza e la prevalenza sono diffi- cili da stimare a causa della penetranza incompleta (portatori silenti), ma si pensa possa causare 4-10 morti improvvise per 10.000 abitanti all’anno, una cifra che rappresenta la causa più frequente di mor- te naturale nei maschi di età inferiore ai 50 anni nel Sudest asiatico16-20 dove questa sindrome è ben nota ed è denominata con diverse terminologie regionali: in Giappone è conosciuta come Pokku- ri (morte improvvisa e inaspettata durante la not- te), nelle Filippine come Banungut (urlo seguito da morte improvvisa durante il sonno), in Thailandia come Lai Tai (morte nel sonno)19-21. Keywords: aritmie; brugada; brugada syndrome; che; circulation; clinica; con; death; dei; del; della; ecg; heart; nei; nel; non; patients; pazienti; quadro; rischio; senza; soggetti; sono; syndrome; tipo; una; w w
• The role of bedside ultrasound in the diagnosis and outcome of patients with acute respiratory failure by Bellone, Andrea; Etteri, Massimiliano; Maino, Carlo; Bonetti, Chiara; Natalizi, Anna (2013) - The aim of our observational study was to compare the outcome of patients admitted to the hospital with acute respiratory failure according to a preliminary approach, the bedside ultrasound evaluation. This result needs further studies to confirm the impact of diagnostic approach and the outcome of patients with acute respiratory failure. Keywords: acute; care; diagnosis; failure; group; patients; respiratory; study; ultrasound
• Copeptin for risk stratification in acute illness: beyond cardiological problems by Cemin, Roberto; Lippi, Giuseppe; Donazzan, Luca; Manfrin, Massimiliano; Daves, Massimo (2013) - Since Cop analysis did not affect the clin- ical decision making and was performed on blood after all request testing had been per- formed, approval from ethical committee was deemed unnecessary. Patients, included those directly discharged from the ER, were further classified as having a severe health problem (Group 1) or not (Group 2), according to the type of diagnosis and treatment. Cop levels were significantly higher in patients who died at the hospital or shortly afterwards as compared with survivors (median 61 vs 40.6 pmol/L; P=0.014). Keywords: acute; cop; copeptin; death; emergency; hospital; patients; pmol
• Ischemic heart disease in the emergency room: state of the art, innovation and research by Lippi, Giuseppe; Cavazza, Mario; Peracino, Andrea; Tubaro, Marco; Nechita, Alexandru; Ballarino, Paola; Peacock, Frank W.; Di Somma, Salvatore (2013) - The peculiarity of this registry would also include the possibil- ity to present a picture of the true population referring to ED for chest pain patients in Italy and the different approach for rule-out and rule-in of the ED physicians. Parato VM, Mehta A, Delfino D, et al. Resting echocardiography for the early detection of acute coronary syndromes in chest pain unit patients. Keywords: acute; ami; chest; diagnosis; ecg; emergency; heart; lead; pain; patients; risk; troponin
• When the solution is not on the tip but under the tongue by Poggiali, Erika; Ghiadoni, Lorenzo; Serra, Sossio (2023) - Accordingly, we have a problem with effective pain management if only 3% of patients with pain, including 77% of those with severe pain, received the right treatment in the emergency setting. This law represents in a single phrase “the right of not suffering”, thus incorporating and formalizing the provisions of the Charter of Rights on unnecessary pain brought by the Tribunal for Patients’ Rights in 2005 and leading to a crucial “cultural transfor- mation” for pain management by fostering the dignity and autono- my of the patient in the process of care. Keywords: emergency; hospital; management; pain; patients
• Takotsubo cardiomyopathy: diagnosis in an emergency department by Mancini, Marina; Bartolini, Davide; Zanna, Mauro (2014) - Takotsubo syndrome should be considered as a possible diagnosis in patients admitted in an emergency department with a suspected diag- nosis of acute coronary syndrome. Sex hormones can influence sympathetic activity and coronary reactivity and have a role in the regulation of myocardial contraction.7 The most common presenting symptom of Takotsubo is acute chest pain, but patients may also present with dyspnea, pulmonary edema and more rarely cardiogenic shock.2,8 Clinical presentation of TC mimics acute myocardial infarction (AMI) and often people presented to the emergency department with a suspected acute coronary arterial syndrome. Keywords: acute; ballooning; cardiomyopathy; emergency; patients; syndrome; takotsubo
• Syncope and sudden death from the emergency physician’s perspective: is there room for new biomarkers? by Marino, Rossella; Floridi, Federico; Mann, Clifford; Semplicini, Andrea; Sighieri, Cinzia; Lupia, Enrico; Lentini, Pietro; Racani, Carlo; Di Somma, Salvatore (2013) - Cardiac syncope has higher risk for mortality especially for sud- den cardiac death, while non-cardiac one shows risk of repeated events of syncope with poor quality of life. It is very important to identify patients with cardiac syncope early because they could have a potentially more serious outcome than patients with non-car- diac syncope. Keywords: death; diagnosis; heart; patients; syncope
• Is it possible to safely increase the number of patients classified as non-urgent in triage? A prospective observational study by Zaboli, Arian; Sibilio, Serena; Mian, Michael; Brigo, Francesco; Turcato, Gianni (2024) - This study highlights the need to rethink strategies to declassify patients through MTS, especially given the continuous increase of non-urgent patients presenting in the ED. Despite this situation repeatedly reported by many authors, ED flow reports from several countries suggest that both the Emergency Severity Index (ESI) and Manchester Triage System (MTS), the two most commonly used triage systems, assign a non- urgent priority code to less than 5% of patients.5,6 Therefore, in the face of a significant increase in non-urgent patients, triage systems, which were created to distinguish urgency within acute conditions, appear to be unable to conceive of and thus address non-acute pathology or non-urgent presentations.5,6 The result is the inability to clearly categorize that range of patients who should not be eval- uated in the ED with a clear stratification as non-urgent.4-6 This may be particularly linked to the fact that triage systems are designed for classifying the severity of patients and not for deter- mining whether the ED is the appropriate setting for them.4,7 Moreover, triage systems like MTS include general indicators such as “recent mild problem” and “recent mild pain” that do not allow assigning a code 5 to patients who have an issue that occurred within 7 days of arriving in the ED.7 Triage systems were developed and introduced in the 1990s, a period when access to the ED by the population was more restrict- ed and known to be more appropriate.7 These systems were cali- brated to swiftly identify the most critical patients requiring imme- Emergency Care Journal 2024; volume 20:11904 [Emergency Care Journal 2024; 20:11904] Keywords: blue; code; emergency; mts; non; patients; study; triage
• Cardiopulmonary resuscitation in the elderly: analysis of the events in the emergency department by Tricerri, Augusto; Palleschi, Lorenzo; Zulli, Luigi (2013) - Bystander car- diopulmonary resuscitation (CPR) increases survival rates; however, the largest group of cardiac arrest patients are over 60 men being at home, whose most probable potential CPR provider is an old woman not likely to have received CPR training. Main diagnosis in cardiac arrest patients. Keywords: age; arrest; cardiopulmonary; hospital; outcome; patients; resuscitation
• Overcrowded ERs: analysis of the phenomenon and managing proposals by Rastelli, Gianni; Cavazza, Mario; Cervellin, Gianfranco (2010) - Ciascuno score di valutazione si basa su formule matematiche di complessità variabile, che comunque richiedono la disponibilità di rile- vazione informatica in real time di comuni para- metri operativi di PS, quali il calcolo del tempo di attesa tra la valutazione di triage e l’accesso all’am- bulatorio, la durata del periodo di permanenza in PS e il numero complessivo dei pazienti in carico32. Da questa premessa si intuisce il perchè di un manuale di Endocrinologia indiriz- zato ai “non specialisti”. Keywords: acad; alla; anche; ann; ann emerg; attesa; che; con; crowding; dal; degenza; degli; dei; del; delle; department; dipartimento; emerg; emerg med; emergency; emergency department; emergenza; fenomeno; hanno; incremento; letto; med; nel; nella; non; operatori; overcrowding; parte; patients; patologie; pazienti; più; posti; problema; risorse; sia; sono; sovraffollamento; una; w w
• Eating vegetables is not always a good advice. A case report and literature review of acquired methemoglobinemia by Vercelli, Andrea; Nasone, Irene; Pagani, Laura; Dacrema, Alessandro; Veneziani, Alberto; Agosti, Antonio; Poggiali, Erika (2024) - In cases of acquired MET, treatment with MB should occur when MetHb exceeds 20-30%, or at lower levels, if the patient is symptomatic. Further research is needed to fully under- stand the underlying mechanisms of acquired MET and to develop guidelines for safe nitrate-rich food consumption. Keywords: blood; blue; case; cyanosis; dose; emergency; med; methb; methemoglobinemia; oxygen; patients; treatment
• The use of a new automatic device for patients' assessment at Triage in Emergency Department by Gori, Chiara Serena; De Bernardinis, Benedetta; Salvatori, Daniele; De Nuzzo, Daniele; Tranne, Caterina; Ferri, Enrico; Di Somma, Salvatore (2010) - Our data demonstrated a statistical signifi- cance between the two groups with a total differ- ence of 475 minutes spent in one month in Triage procedures including vital signs measurements. Our results demonstrated the possibility to reduce time needed for vital signs measurement allowing nurses to assess more patients in the same Triage room in a single day with a favourable impact on waiting time especially for those with more se- vere diseases and patients’ satisfaction. Keywords: codes; min; patients; signs; time; triage
• How public ambulance arrivals impact on Emergency Department workload and resource use by Ferri, Enrico; Magrini, Laura; Alfano, Marco; Del Parco, Michele; Di Somma, Salvatore (2010) - Conclusion Our study confirms that ED ambulance referred patients are more likely triaged into a higher acuity category and are significantly more likely than oth- ers associated to older age, to hospital and inten- sive care unit or coronary care unit admission rate, but also to severity of injury, ED longer lenght of stay and greater use of radiology imaging tests and consultations. 2 Injury related visits and triage level difference between ambulance transported and walk in ED patients. Keywords: ambulance; arrivals; care; emergency; ems; hospital; level; patients; triage; use; w w; walk
• Beyond the Glasgow Coma Scale: an integrative review of new tools for neurological assessment in the intensive care unit for adult patients by Xhaferri, Alessia; Ramacciati, Nicola; Giusti, Gian Domenico (2024) - Dilation velocity is associa- ted with Glasgow Coma Scale scores in patients with brain injury. A Comparison Between the Effectiveness of Full Outline of Unresponsiveness and Glasgow Coma Score at Neurosurgical Intensive Care Unit Patients. Keywords: assessment; brain; care; coma; consciousness; gcs; glasgow; patients; pupillometry; review; scale; score; state; study
• Four good reasons to choose ketamine in the emergency department. A case series and literature review by Belviso, Fabiana; Poggiali, Erika; Ioannilli, Eva; Bastoni, Davide; Stamate, Monica; Vercelli, Andrea; Riccardi, Alessandro (2024) - As reported by Serra et al.,53 ketamine (IV: 0.1-0.3 mg/kg bolus; 0.1-0.3 mg/kg/h via con- tinuous infusion) may have a role in the management of pain unre- sponsive to opioids, in neuropathic pain, in opioid-induced hyper- algesia, and could also have a future role in palliative sedation in the EoL.54 Ketamine shows also potential as a bronchodilator for pediatric patients with acute asthma exacerbation and has emerged as a treatment option for pediatric patients with acute asthma exacerba- tion who do not respond to standard therapy as a temporizing measure to prevent mechanical ventilation.55,56 In the review by Garner et al.,57 the authors outline strategies for the assessment and management of patients with acute life-threatening asthma focus- ing on those requiring admission to the ICU and they suggest using ketamine or propofol as sedative agents for non-invasive mechan- ical ventilation because of their potential bronchodilation proper- ties. Ketamine Use allows Noninvasive Ventilation in Distressed Patients with Acute Decompensated Heart Failure. Keywords: acute; alcohol; care; case; dose; emergency; ketamine; management; med; pain; patients; review; use
• Outcomes of bailout use of continuous positive airway pressure in patients with severe COVID-19 respiratory failure by Giannone, Alberto; Piazza, Isabelle; Preti, Carlo; Pisano, Eleonora; Ghirardi, Arianna; Benetti, Alberto; Fagiuoli, Stefano; Lorini, Ferdinando L.; Rizzi, Marco; Di Marco, Fabiano; Cosentini, Roberto (2024) - The purpose of this study is to evaluate prognostic factors in COVID-19 severe respiratory failure patients treated with helmet CPAP. No beneficial effect was observed, compared with conventional oxygen therapy, with the use of HFNC.22 The same data about the inefficacy of HFNC in severe respiratory distress in COVID-19 patients was demonstrated by Grieco et al.14 In our population, due to the rapid saturation of ICU ventilated beds, H-CPAP was used extensively in very critical patients. Keywords: care; covid-19; cpap; failure; iqr; median; mortality; patients; respiratory; study
• Time performance of scoop stretcher versus vacuum mattress for prehospital spinal stabilization: open-label simulation-based randomized controlled trial by Stuby, Loric; Thurre, David (2024) - Standard operating procedure – scoop stretcher spinal stabilization (english translated version) Time performance of scoop stretcher versus vacuum mattress for prehospital spinal stabilization: open-label simulation-based randomized controlled trial Loric Stuby, David Thurre Genève TEAM Ambulances, Emergency Medical Services, Geneva, Switzerland Non -co mmerc ial us e o nly pression, respiratory discomfort, difficulties in airway manage- ment, increased intracranial pressure due to pain or compression of the jugular veins, worsening of injuries, patient agitation, and non- compliance.22-35 Furthermore, its effectiveness is questioned,36 as well as how it is fitted.37 Under certain circumstances, its use must be completely avoided, while in other cases it can be used intermit- tently (e.g., during mobilization). Keywords: care; emerg; immobilization; med; patients; prehospital; scoop; spinal; stabilization; stretcher; study; time; trauma; vacuum
• Prognostic value of lung ultrasound score performed in the Emergency Department in COVID-19 patients: a prospective multicenter study in central Italy by Barbieri, Greta; De Vuono, Stefano; Gargani, Luna; Berisha, Sokol; Spinelli, Stefano; Del Carlo, Chiara; Deri, Chiara; D'Angelo, Gennaro; Groff, Paolo; Ghiadoni, Lorenzo (2024) - [page 39] Prognostic value of lung ultrasound score performed in the Emergency Department in COVID-19 patients: a prospective multicenter study in central Italy Greta Barbieri,1,2 Stefano De Vuono,3 Luna Gargani,2 Using LUS score cut- off 1.3, the OR was 6.7 (CL2.7-1.6). Keywords: analysis; care; covid-19; emergency; lung; lus; med; patients; score; study; ultrasound
• Comparative efficacy analysis of mannitol and hypertonic saline in the management of traumatic brain injury: a scientific exploration of neuroprotective strategies by Nagaraju, Kishore; Lobo, Leema; Sharma, Manjari (2024) - Since the Correspondence: Nagaraju Kishore, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, PES University, 560050 Bangalore, India. E-mail: nkishore2468@gmail.com Key words: traumatic brain injury, mannitol, hypertonic saline, cere- bral edema, intracranial pressure, brain trauma, osmotherapy, fluid management. Mannitol’s present widespread use and the dearth of knowledge when compared with other medicines that lower intracranial pressure still require appro- priate investigation.18 Hypertonic saline To lower intracranial pressure after traumatic brain injury, hypertonic saline is utilized as a hyperosmolar treatment. Keywords: brain; brain injury; care; cerebral; edema; et al; hts; hypertension; hypertonic; icp; injury; intracranial; mannitol; patients; pressure; saline; tbi; treatment
• Procedural sedation and analgesia by Italian emergency physicians: a retrospective observational pilot study by Lorenzati, Bartolomeo; Abram, Sara; Giamello, Jacopo Davide; Bruno, Alice; Gambardella, Luigi; Lison, Davide; D'Agnano, Salvatore; Martini, Gianpiero; Sciolla, Andrea; Lauria, Giuseppe (2024) - Adverse event reporting tool to standardize the reporting and tracking of adverse events during procedural sedation: a consensus document from the World SIVA International Sedation Task Force. In addition, for the management of adverse events, antidotes such as flumazenil and naloxone were available. Keywords: asa; cases; drugs; emergency; events; fentanyl; midazolam; patients; procedures; propofol; psa; sedation; study; use
• AREA CRITICA | ROMA, Centro Congressi Fontana di Trevi 30 novembre - 1 dicembre 2023 by Editors, The (2024) - dei dati nei volontari sani ha mostrato che dato un valore di PS per ogni prova spirometrica il corrispondente PEF si trova in un intervallo di predizione che diventa sempre più ampio con l’aumentare dello sforzo espiratorio, con una correla- zione statisticamente significativa tra il PS e il PEF (r=0,52; p<0,05). È stato infatti costruito un questionario ad hoc, com- posto da 12 domande a risposta chiusa e una domanda a risposta aperta, distribuito per via telematica agli infermieri afferenti ai PS italiani coinvolti nell’attività di benchmarking, tra giugno e agosto 2018. Risultati. Keywords: alla; andrea; anni; ards; area; azienda; bologna; cantù; care; care journal; caso; che; come; con; con la; conclusioni; covid-19; crit; critica; dal; data; dati; degli; dei; del; della; department; device; di roma; di sepsi; di un; diagnosi; diagnosi di; dipartimento; doi; dopo; e il; e la; ecmo; emergency; emergency care; emergenza; gemelli; gestione; hfnc; hospital; icu; injury; intensiva; introduzione; irccs; italia; italy; journal; lung; maria; median; medicina; metodi; mmhg; mortalità; nei; nel; non; page; pao2; parametri; patients; pazienti; peep; picc; più; policlinico; polmonare; pressione; presso; pronto; rischio; risk; risultati; roma; score; sepsi; soccorso; sono; stato; strain; studio; study; system; terapia; test; tra; trattamento; trauma; una; universitaria; università; università di; uno; valori; vein; ventilazione; volume; è stato
• Ethics and emergency contraception by Mori, Maurizio (2007) - A fronte di tale quadro il medico di emergenza chie- deva l’intervento di un consulente cardiologo il quale, dopo nuova raccolta anamnestica ed esame clinico, refertava l’ECG con «alterazioni diffuse del- la ripolarizzazione» e consigliava di tenere in re- parto di Osservazione Breve Intensiva (OBI) la pa- ziente per la ripetizione degli enzimi di citonecrosi miocardica secondo Ciò implica infatti che l’infermiere possa prevedere il calibro e il tipo di catetere che andrà ad inserire (Tabella 1). Keywords: .e cj; accettazione; acute; alcune; alla; alle; alterazioni; altri; anche; anni; assenza; assistenza; base; bladder; br e; care; casi; caso; catetere; cerebrale; che; che il; cli; cli ni; clinica; clinica e; come; comportamento; con; con il; condizioni; contenuto; copyright; cui; cura; da copyright; dal; dea; degli; dei; del; del pronto; della; dell’editore; di un; diagnosi; dipartimento; distribuire elettronicamente; disturbi; dopo; d’urgenza; e della; e di; e il; e la; e terapia; elettronicamente; elettronicamente senza; emergency; emergenza; essere; formazione; ge nc; gestione; già; grado; gruppo; hanno; ice; iii; il paziente; infermieristica; inoltre; journal; laboratorio; lavoro; letteratura; livello; l’autorizzazione; l’autorizzazione scritta; materiale; medicina; medico; metaemoglobina; milano; modo; molto; nc y; nei; nel; nelle; non; o distribuire; ogni; organica; organizzazione; ospedale; ossigeno; parte; particolare; patients; patologia; paziente; paziente con; più; poco; possibile; possono; presenti; presenza; prima; problemi; processi; pronto; pronto soccorso; protetto; protetto da; psichiatra; psichiatrici; può; quali; quando; questo; quindi; r ice; ricerca; rischio; rispetto; risultati; scritta; scritta dell’editore; senza; senza l’autorizzazione; servizio; si è; sia; sindrome; sintomatologia; sintomi; soccorso; solo; sono; sostanze; spesso; stati; stroke; strutture; studio; study; sua; sulla; tale; terapia; torino; trattamento; tutti; una; unit; università; uno; urine; valutazione; vescicale; viene; w .e; w w; web; wellens; za zi
• Multimarkers approach in chest pain management in Emergency department: a focus on the prognostic role of sST2 and suPAR by Piccioni, Andrea; Baroni, Silvia; Scatà, Licia Antonella; Scaccia, Marta; Candela, Martina; Bronzino, Alessandra; Sarlo , Francesca; Savioli, Gabriele; Candelli, Marcello; Covino, Marcello; Gasbarrini, Antonio; Franceschi, Francesco (2024) - A prospective study by Rezar et al. also sug- gests measuring serum sST2 levels 24 h after admission for prog- nostication after cardiopulmonary resuscitation.33 Furthermore, in the STADE-HF study, an ancillary study of a randomized trial: NCT02963272, sST2 showed to be better associated with the risk of hospitalization when compared to suPAR, which, in contrast, resulted associated with long term mortality.34 Several studies have examined the connection between cardiovas- cular disease and suPAR levels in recent years, considering the protein’s function in endothelial damage and inflammatory response.50 In one of their meta-analyses, Pruc et al. underline how suPAR seems to be involved in the pathogenesis of ACS. Keywords: acs; acute; biomarkers; copeptin; disease; emergency; et al; failure; heart; levels; med; myocardial; patients; review; risk; sst2; studies; study; supar; troponin
• A young patient affected by hypertensive crises: when medical history lies by Aiosa, Giuseppe; Cecconi, Dalio; Giuffrè, Eliana; Ferrillo, Sara (2007) - A fronte di tale quadro il medico di emergenza chie- deva l’intervento di un consulente cardiologo il quale, dopo nuova raccolta anamnestica ed esame clinico, refertava l’ECG con «alterazioni diffuse del- la ripolarizzazione» e consigliava di tenere in re- parto di Osservazione Breve Intensiva (OBI) la pa- ziente per la ripetizione degli enzimi di citonecrosi miocardica secondo Ciò implica infatti che l’infermiere possa prevedere il calibro e il tipo di catetere che andrà ad inserire (Tabella 1). Keywords: .e cj; accettazione; acute; alcune; alla; alle; alterazioni; altri; anche; anni; assenza; assistenza; base; bladder; br e; care; casi; caso; catetere; cerebrale; che; che il; cli; cli ni; clinica; clinica e; come; comportamento; con; con il; condizioni; contenuto; copyright; cui; cura; da copyright; dal; dea; degli; dei; del; del pronto; della; dell’editore; di un; diagnosi; dipartimento; distribuire elettronicamente; disturbi; dopo; d’urgenza; e della; e di; e il; e la; e terapia; elettronicamente; elettronicamente senza; emergency; emergenza; essere; formazione; ge nc; gestione; già; grado; gruppo; hanno; ice; iii; il paziente; infermieristica; inoltre; journal; laboratorio; lavoro; letteratura; livello; l’autorizzazione; l’autorizzazione scritta; materiale; medicina; medico; metaemoglobina; milano; modo; molto; nc y; nei; nel; nelle; non; o distribuire; ogni; organica; organizzazione; ospedale; ossigeno; parte; particolare; patients; patologia; paziente; paziente con; più; poco; possibile; possono; presenti; presenza; prima; problemi; processi; pronto; pronto soccorso; protetto; protetto da; psichiatra; psichiatrici; può; quali; quando; questo; quindi; r ice; ricerca; rischio; rispetto; risultati; scritta; scritta dell’editore; senza; senza l’autorizzazione; servizio; si è; sia; sindrome; sintomatologia; sintomi; soccorso; solo; sono; sostanze; spesso; stati; stroke; strutture; studio; study; sua; sulla; tale; terapia; torino; trattamento; tutti; una; unit; università; uno; urine; valutazione; vescicale; viene; w .e; w w; web; wellens; za zi
• An uncommon urticaria by Bertolo, Olivo; Risucci, Piero; Pollet, Cristina; Sechi, Antonio (2007) - A fronte di tale quadro il medico di emergenza chie- deva l’intervento di un consulente cardiologo il quale, dopo nuova raccolta anamnestica ed esame clinico, refertava l’ECG con «alterazioni diffuse del- la ripolarizzazione» e consigliava di tenere in re- parto di Osservazione Breve Intensiva (OBI) la pa- ziente per la ripetizione degli enzimi di citonecrosi miocardica secondo Ciò implica infatti che l’infermiere possa prevedere il calibro e il tipo di catetere che andrà ad inserire (Tabella 1). Keywords: .e cj; accettazione; acute; alcune; alla; alle; alterazioni; altri; anche; anni; assenza; assistenza; base; bladder; br e; care; casi; caso; catetere; cerebrale; che; che il; cli; cli ni; clinica; clinica e; come; comportamento; con; con il; condizioni; contenuto; copyright; cui; cura; da copyright; dal; dea; degli; dei; del; del pronto; della; dell’editore; di un; diagnosi; dipartimento; distribuire elettronicamente; disturbi; dopo; d’urgenza; e della; e di; e il; e la; e terapia; elettronicamente; elettronicamente senza; emergency; emergenza; essere; formazione; ge nc; gestione; già; grado; gruppo; hanno; ice; iii; il paziente; infermieristica; inoltre; journal; laboratorio; lavoro; letteratura; livello; l’autorizzazione; l’autorizzazione scritta; materiale; medicina; medico; metaemoglobina; milano; modo; molto; nc y; nei; nel; nelle; non; o distribuire; ogni; organica; organizzazione; ospedale; ossigeno; parte; particolare; patients; patologia; paziente; paziente con; più; poco; possibile; possono; presenti; presenza; prima; problemi; processi; pronto; pronto soccorso; protetto; protetto da; psichiatra; psichiatrici; può; quali; quando; questo; quindi; r ice; ricerca; rischio; rispetto; risultati; scritta; scritta dell’editore; senza; senza l’autorizzazione; servizio; si è; sia; sindrome; sintomatologia; sintomi; soccorso; solo; sono; sostanze; spesso; stati; stroke; strutture; studio; study; sua; sulla; tale; terapia; torino; trattamento; tutti; una; unit; università; uno; urine; valutazione; vescicale; viene; w .e; w w; web; wellens; za zi
• Sepsis by Tombini, Valeria; Lamberti, Sonja; Bottiroli, Maurizio; Coen, Daniele (2006) - Le raccomandazioni concernono l’utilizzo degli ste- roidi, della proteina C-attivata (rhAPC), della ventila- zione, il controllo della glicemia e la terapia con bi- carbonati. La tachicardia e la tachipnea di questi pazienti sono sostenute dalle modificazioni emodinamiche e della microcircolazione già discusse. Keywords: acute; alla; anche; arteriosa; campaign; care; care med; centrale; che; clinica; con; con sepsi; crit; crit care; dal; degli; dei; della; della sepsi; dell’editore; di sepsi; distribuire; dovrebbe; elettronicamente; essere; et al; gli; hanno; ice; intensive; j med; l’autorizzazione; med; mortalità; nei; nel; non; ossigeno; patients; pazienti; più; pressione; può; scritta; senza; sepsi; sepsi severa; settico; severa; shock; sia; sono; studi; surviving; terapia; trattamento; una; valori; viene; w w
• Prognostic importance of the systemic inflammatory index and the systemic inflammatory response index in COVID-19 patients by Topal, Alikemal; Yarkaç, Akif; Bozkurt, Seyran; Buyurgan, Çağrı Safa; Köse, Ataman; Erdoğan, Semra (2024) - Neutrophil to lymphocyte ratio and C-reactive protein level as prognostic markers in mild versus severe COVID-19 patients. It was determined that the severity level increased in COVID-19 patients when the SII value was above 867.834 (p<0.0001, AUC=0.744), and the mortal- ity rate increased when it was above 1370.353 (p<0.0001, AUC=0.682). Keywords: covid-19; disease; index; mortality; patients; severity; sii; siri; study
• Investigating primary healthcare resource utilization, triage system awareness, and time expectations among patients presenting at emergency departments in Jordan: a cross-sectional study by Alnaeem, Mohammad M.; Suleiman, Khaled H.; Ababneh, Amal M.; Alrida, Nour (2024) - Dealing with non-urgent and urgent cases can lead to inefficiency and increased waiting times, causing stress and fatigue for healthcare providers.4-6 This can result in verbal and physical violence and lead to staff turnover, posing a threat to patient safety.7 The lack of patient awareness about the triage process can cause tension and unpredictability in patient care.8 Patients’ aware- ness about using primary healthcare resources is important to min- imize pressure on the ED and its staff.9 Understanding the patterns of patient engagement with primary healthcare facilities before resorting to ED visits is crucial for healthcare professionals and policymakers.10 Patients frequently start at primary care facilities before visiting the ED, and understanding this can help optimize the allocation of healthcare services.11 Despite primary healthcare facilities being widely available in Jordan, patients are still not properly aware of the triage system.12 High patient loads, crowding, and increased violence are sig- nificant challenges faced by EDs.13-15 Enhancing patient awareness can help allocate resources more efficiently and reduce wait times, resulting in better patient care and increased awareness of the Emergency Care Journal 2024; volume 20:12549 Characteristics and expec- tations among emergency department patients in India. Keywords: care; emergency; healthcare; participants; patients; primary; study; system; test; time; triage
• Examining the effectiveness of prognostic scoring systems and mortality predictors in aluminum phosphide poisoning: insights from emergency department settings by Vijay Kumar, S. S.; Shekhli, Shabbir; Jose, Anila (2024) - This study favors integrating these predictors into routine ED practices, particularly in Low- and Middle-Income Countries (LMICs), to prognosticate and enhance management outcomes in patients with AlP poisoning, offering essential guidance for emergency physicians. This study seeks to evaluate the predictive factors of mortality and outcomes in patients with AlP poisoning, with a special emphasis on evaluating the effectiveness of scoring sys- tems like MEWS, SI, MAP, GCS, and others in the ED setting. Keywords: alp; aluminum; care; emergency; gcs; india; levels; mortality; non; patients; phosphide; poisoning; study; survivors
• Cryptogenic stroke: atrial fibrillation under indictment by Jorfida, Marcella; Cerrato, Paolo (2009) - Inoltre, il rischio di stroke pare più alto nei primi mesi dopo la diagnosi di FA30. Wolf43 ha seguito 5070 persone per 34 anni: la car- diopatia ischemica raddoppia il rischio di stroke, l’ipertensione lo triplica, lo scompenso lo quadru- plica; la FA lo quintuplica. Keywords: asintomatica; atrial; che; con; degli; dei; del; della; durata; episodi; fattori; fdr; fibrillation; ictus; ischemico; non; ore; patients; pazienti; più; rischio; senza; sono; stroke; tra; tromboembolico; una; w w
• Persistent cool extremities as an independent predictor of adverse clinical outcomes among critically ill patients: a single-center retrospective observational study by Uchida, Masatoshi; Kikuchi, Migaku; Hoshiyama, Eisei; Wake, Koji (2024) - Conclusions Patients with subjective cool extremities had higher severity scores, required more invasive treatment, and had more frequent adverse clinical outcomes than those without cool extremities. Multivariable logistic regression analysis for the associations between cool extremities duration as a continuous variable and clin- ical outcomes. Keywords: admission; care; duration; extremities; hours; icu; icu admission; outcomes; patients
• From locked-in sensation to acute basilar artery occlusion: a rare case of posterior circulation stroke in a young patient by Poggiali, Erika; Morelli, Nicola; Terracciano, Chiara; Caborni, Claudia; Pergolotti, Benedetta; Gavioli, Pietro; Vercelli, Andrea (2024) - [page 65] From locked-in sensation to acute basilar artery occlusion: a rare case of posterior circulation stroke in a young patient Erika Poggiali,1,2 Kompanje EJ, Walgaard C, de Groot YJ, Stevens M. Historical sources of basilar artery occlusion. Keywords: acute; artery; artery occlusion; bao; basilar; case; emergency; occlusion; patients; stroke
• American emergency room wait times for psychiatric conditions from 2019 to 2021 by Monahan, Zach; Mack, Alyson; Place, Anna; Pierce, Aaron; Hartwell, Micah (2024) - Wait times of psychiatric visits by ICD10 F-sub- group The data on psychiatric wait time was also analyzed by ICD10 F-subgroup. E-mail: zach.monahan@okstate.edu Key words: wait times; emergency department; emergency psychia- try; mental health wait times; mental health access. Keywords: care; complaints; emergency; health; mental; non; patients; psychiatric; times; visits; wait; wait times
• The importance of psychological intervention in emergencies for patients with anorexia nervosa by Fiacco, Giacomo; Catone, Gennaro (2024) - The presence of an expert psychologist could optimize the assis- tance and treatment times for patients with AN in critical care. Approximately one-fifth to one-third of adolescent patients with Anorexia Nervosa (AN) require intensive care during the course of the illness. Keywords: care; emergency; patients
• Do not move! Spinal immobilization or spinal motor restriction: the long-lasting debate from the Napoleonic Wars to 2024 SIMEU policy statement by Serra, Sossio; Poggiali, Erika; Rugna, Mario; De Iaco, Fabio; Ghiadoni, Lorenzo (2024) - High-energy trauma is no longer a criterion for spinal immobiliza- tion in the adult population.18 The current evidence base for traditional techniques used during pre-hospital extrication of trauma patients is poor and more based on pragmatism than evidence-based research. The correct approach should balance the benefits and risks/burdens of SMR, and all the interventions should be goal-oriented (spinal cord/column protection in the context of overall patient and provi- der safety) rather than technique-oriented (immobilization).22 In light of the new evidence, the Italian Society of Emergency Medicine (SIMEU) produced a policy statement on extrication and spinal motion restriction in trauma patients (in press. Keywords: care; emergency; hospital; immobilization; patients; spinal; trauma
• Comparison of high flow and standard oxygen therapy in patients with acute hypoxemic respiratory failure in emergency department. A randomized controlled cross over superiority trial by Rahul Rohan, Mamidi; Sharma, Ashima; Nizami, Mohammed Ismail; Tarannum, Lubna (2024) - Two hours of HFNC therapy decreased the lactate lev- els below 2.0 mg/dL. Steady decrease in lactates were observed in HFNC group. This implies that there was a significant decrease in the intubation rate in HFNC group when treated with HFNC therapy for ≥24 h as compared with COT. Keywords: -co; -co mmerc; cot; group; hfnc; hours; ial; mmerc; mmerc ial; non; oxygen; patients; study; therapy
• Cardiospecific troponins in non-ischemic cardiological pathologies by Lippi, Giuseppe; Montagnana, Martina; Guidi, Gian Cesare (2006) - Clin Invest Med 2003; 26: 133-147. 2. Fahie-Wilson MN, Carmichael DJ, Delaney MP et al. Jaffe AS, Ravkilde J, Roberts R et al. Keywords: acute; anche; anticorpi; cardiac; cardiache; cardiol; cause; che; chem; clin; con; coronary; danno; dei; del; della; essere; et al; heart; incremento; livelli; nei; nel; non; patients; pazienti; presenza; può; rilascio; scompenso; sono; tni; tnt; troponin; una; valori; w w
• Emergency care of adult patients with congenital heart disease: are we prepared? Data from a tertiary center and long-term follow-up by Piazza, Isabelle; Memaj, Irdi; Della Bella, Lorenzo; Preti, Carlo; Bassareo, Pierpaolo; Cosentini, Roberto; Ferrero, Paolo (2024) - It has been hypothesized that, due to the marked improvement in acute and post-operative care, an increasing num- ber of CHD patients will reach adulthood and even later in life.1,2 Therefore, we can foresee that the Emergency Department (ED) will consistently face an increase in ACHD patients with a wide range of clinical needs.3-12 Moreover, the lack of standardized evi- dence-based diagnostic and therapeutic protocols might limit the effectiveness of acute treatment and eventually jeopardize the pro- gnosis of this subset of patients.13,14 Congenital heart defects in adult patients were classified by the ACHD Anatomic and Physiological (ACHD AP) system. Symptoms N (%) Dyspnea, N (%) 22 (29) Palpitations, N (%) 20 (27) Fever, N (%) 8 (11) Neurologic symptoms, N (%) 7 (9) Syncope, N (%) 6 (8) Chest pain, N (%) 5 (7) Bleeding, N (%) 3 (4) Keywords: adult; care; class; disease; emergency; heart; patients
• Non-urgent patients in the Emergency Departement by Rocco, Stefano; Fusello, Massimo (2008) - i MMG e i me- dici di Continuità Assistenziale, contattatati dal- l’AUSL, che si erano resi disponibili al progetto e che sono stati avviati a un breve percorso formativo sulla gestione clinica e l’utilizzo degli strumenti informatici dedicati. e al decentramento dei pa- zienti definiti CB in spazi separati dal PS, è stata la pro- posta di una loro gestione da parte Keywords: all’ambulatorio; che; con; curante; dei; del; della; department; emergency; gestione; medico; nel; non; patients; pazienti; percentuale; più; sono; una; w w
• Lactate clearance in cardiorespiratory emergency by Greco, Serena; Guiotto, Giovanna; Maffei, Antonino; Martino, Stefania; Romano, Giuseppe; Schiraldi, Fernando (2007) - Pertanto, la clearance del lattato a 2 ore risulta avere la stessa sensibilità ma maggiore specificità rispetto al valore assoluto di lattato a 2 ore (Tabella 3). Sebbene sia generalmente accettato che una ridotta clearance del lattato si asso- ci a una sopravvivenza più bassa26-28, rimangono an- cora dubbi circa l’ottimizzazione dei tempi di inter- vento terapeutico in rapporto alla clearance del latta- to29. Keywords: acuta; care; che; clearance; con; del; della; essere; lactate; lattato; med; negativo; non; ore; outcome; patients; pazienti; sono; stati; una
• Emergency department poisoning and toxicology patients admitted to the high dependency and intensive care units: an eight-year analysis by Kant, Abhay; Mong, Rupeng; Arciaga, Gabriel Joseph; Kuan, Kelvin Kaibin; Tan, Hock Heng (2024) - In our study the lactate levels were available for less than 30% while pH levels were available for about 33% of the total number of ICU patients. Age distribution of ICU, HD patients and overall numbers. Keywords: agents; anti; care; emergency; exposures; icu; medications; patients; poisoning; score; study
• The impact of COVID-19 pandemic on traumatic injuries in children: a longitudinal observational study by Zaboli, Arian; Molaro, Mara; Turcato, Gianni; Sibilio, Serena; Brigiari, Gloria; Weissmann, Gaia; Cogo, Paola; Schmidt, Olaf; Brigo, Francesco (2025) - Discussion Our study utilized ITSA over a prolonged period to assess the impact of the COVID-19 pandemic on pediatric ED attendances for trauma, revealing initial changes followed by a return to pre- pandemic levels. In the U.S., overall pediatric injuries decreased, but with rises in specific cases such as burns and penetrating injuries.6 The full extent of the pandemic’s impact on pediatric ED visits remains unclear, necessitating accu- rate analysis for timely diagnosis and treatment.1,6,8 Pandemic- related factors like lockdowns and reduced ED visits may have influenced trauma risk and attendance rates.9-11 This study aims to evaluate changes in ED attendances for pediatric trauma during pre- and post-pandemic periods to inform health policy and child safety strategies. Keywords: attendances; covid-19; data; emergency; pandemic; patients; study; trauma
• Triage nurse staffing: a study on the need for model improvements by Zaboli, Arian; Brigo, Francesco; Sibilio, Serena; Brigiari, Gloria; Massar, Magdalena; Magnarelli, Gabriele; Turcato, Gianni (2024) - This highlights that, over time, the critical role of triage nurses has not received ade- quate attention, with more reliance placed on expert opinions rather than robust, contest-based calculations.2 The calculation methods used in our study are based on formulas from other settings used to determine Full-Time Equivalent (FTE) staffing.11 However, these calculations proved inadequate in the triage context, raising concerns about their validity in other settings as well. Accurate prospective studies are needed to assess the sustainable workload for triage nurses. Keywords: acuity; code; number; nurse; patients; shift; staffing; study; triage
• The impact of pre-hospital emergency medical services on the outcomes of patients with burn: a systematic review and meta-analysis by Alanazy, Ahmed; Alruwaili, Abdullah (2025) - Level of training of EMS for managing patients with burn injuries Fein et al., (2014) reported inadequate training among EMS regarding caring for burn patients. Mortality risk Five articles included 3239 patients with burn injuries and assessed the mortality risk among burn patients Keywords: burn; care; emergency; ems; hospital; injuries; management; mean; n r; outcomes; patients; pre; providers; r nr; studies; study
• A modern management model for patients with acute and subacute psychiatric problems in the emergency department of Trento (Northern Italy) by Sano', Mjriam; Marchiori, Michela; Di Napoli, Wilma Angela Renata (2024) - E-mail: miriam.sano@apss.tn.it Key words: psychiatric emergencies; emergency department; mental health centre; emergency room; Broset Violence Checklist. This procedure makes it possible to promote specialised recep- tion in a dedicated environment, to facilitate continuity of care in services for the prevention, treatment and rehabilitation of mental disorders, to reduce the stigma associated with mental illness, to avoid overcrowding in emergency departments and to prevent inappropriate access to emergency services. Keywords: care; csm; department; emergency; health; management; patients; psychiatric; trento; violence
• Evaluation of the BronchiolitisMAD protocol in the out-of-hospital emergency services of the Community of Madrid by Jiménez-Sánchez Carpio, Beatriz; Sánchez-García, Laura; Marsinyach-Ros, Itziar; Rendo-Murillo, Joaquín Antonio; Quesada-Cubo, Víctor; Gómez-Morán Quintana, Marina; Lorente-Romero, Jorge; Sánchez-Sáenz, María Isabel; Cintora-Sanz, Ana María; Horrillo-García, Cristina (2025) - There is evidence regarding the usefulness and safety of using NIMV in pediatric patients with acute respiratory failure in trans- fers – with bronchiolitis being the most frequent, followed by asth- ma and pneumonia – when performed by specialized pediatric and neonatal transport teams.15 As a result, protocols for selecting appropriate patients and providing respiratory management train- ing are critical, especially when such transfers are performed by non-specialized personnel. Descriptive analysis of bronchiolitis patients in the pre- and post-protocol seasons. Keywords: bronchiolitis; care; community; emergency; hospital; madrid; ohes; patients; protocol; season; transport
• Brief Period Observation for patients with temperature or infections by Recupero, Roberto; Tartaglino, Bruno (2006) - In topi infettati e trattati con antibiotici la PCR ritor- na verso la norma in 24 ore. Nella scelta dell’an- tibiotico occorre tenere in giusta considerazione le ca- ratteristiche del paziente, la sua capacità di tollerare l’infezione, il rischio di essere colpito da batteri resi- stenti agli antibiotici comunemente impiegati come prima linea, eventuali allergie, indicazione alla tera- pia parenterale o a quella orale, costi. Keywords: anche; cap; causa; che; con; dei; della; dimissione; essere; fattori; febbre; hanno; infezioni; med; nel; non; ore; osservazione; patients; pazienti; pcr; più; pronto; ricovero; rischio; scritta; senza; soccorso; sono; stato; terapia; trattamento; una; w w
• An alternative perspective on triage systems: the Progressive Real-world Optimization of Triage System (PROGRESS) study by Zaboli, Arian; Brigo, Francesco; Sibilio, Serena; Brigiari, Gloria; Massar, Magdalena; Pfeifer, Norbert; Parodi, Marta; Rella, Eleonora; Turcato, Gianni (2025) - Integrating multiple tools into triage models can enhance their performance, improving patient prioritization accuracy. E-mail: zaboliarian@gmail.com Key words: triage; accuracy; patient prioritization; early warning score; emergency nurse; triage model; logistic models. Keywords: assessment; care; emergency; medical; model; mts; patients; study; systems; triage; urgent; validation
• Challenges in managing children with autism spectrum disorder in emergency and hospital settings: strategies for effective care by Al Sharif, Shafiqa M. (2025) - Dann et al. observed that the ED environment can be particularly overwhelming for ASD children, who may exhibit hypersensitivity to stimuli, resulting in challenging beha- viors and increased distress.14 Communication difficulties are a core aspect of ASD, posing barriers to effective healthcare delive- ry. Studies show mixed results regarding ER admissions in children under 6, with some indicating more visits, while others suggest that ASD children in this age group are less likely to visit the ER overall.21 Approximately 15% of adults with ASD have psychiatric ER visits compared to only 4% of adults without ASD, and psychiatric visits are more frequent than non-psychiatric visits among adults with ASD.22 This trend reflects the prevalence of challenging behaviors in this population, such as aggression, self-harm, and disruptive behaviors.22 While adults with ASD generally have lower rates of drug and alcohol use, those on the higher-functioning end of the spectrum may use alcohol to manage social challenges.23 Vohra et al. found that epilepsy, schizophrenia, and depression are the most common reasons for ER visits among adults with ASD.18 Injury- related visits are lower in adults with ASD compared to those without ASD, but a larger proportion of adults with ASD visit the ER for injury related to poisoning.18 Around 7% of patients with suicidal emergencies have ASD, and those with ASD exhibit higher rates of adjustment disorders and longer Intensive Care Unit (ICU) stays than their non-ASD counterparts.24 Additionally, older adults with ASD are more likely to have non-psychiatric comorbidities such as diabetes, cardiovascular disease, and high cholesterol.25 Challenges faced by autistic patients in ED Parent satisfaction with ED care for children with ASD is clo- sely linked to staff communication and interpersonal skills, parti- cularly regarding communication between staff members and the child with ASD. Keywords: asd; autism; care; children; communication; disorder; emergency; healthcare; patients; spectrum; visits
• Effectiveness and safety of an emergency department-based rapid response system by Delfanti, Fanny; Bertolini, Guido; Nattino, Giovanni; Acquistapace , Giulia; De Palma, Daniela; Ferrari, Piergiuseppe; Martinenghi, Sara; Maiandi, Stefano; Rossi, Marco; Ruocco, Anna Lilia; Spina, Maria Teresa; Chiodi, Benedetta; Paglia, Stefano (2025) - In particular, if MET interventions effec- tively reduced unplanned ICU transfers, we expected a steeper PRE-POST decrease of ICU transfers in MET wards compared to non-MET wards. PRE (2014-2016) POST (2017-2019) p2 Hospitalizations (N) MET wards 15,387 14,107 - Non-MET wards 16,029 14,897 - MET and non-MET wards 31,416 29,004 - Transfers to ICU1 – N (%) MET wards 242 (1.57%) 178 (1.26%) 0.028 Keywords: care; emergency; hospital; icu; met; mortality; patients; post; rrs; transfers; wards
• Arrival mode and triage evaluation in an emergency department cohort of patients with syncope: the ADDRESS study by Numeroso, Filippo; Casagranda, Ivo (2025) - The specific aims of the study are: i) to describe the arrival mode to the ED of patients with syncope and priority codes assigned upon triage evaluation; ii) to assess the efficacy of nurse triage in the case of patients with syncope by investigating the relationship between triage priority code and the following outcomes: cardiac syncope, syncope associated with Acute Principal Diseases (APDs); syncope requiring admission. To evaluate the accuracy of triage evaluation, we compared the presence of the outcome between patients with a low vs. a high triage priority code, using contingency tables and a chi-square test; in this regard, to assess the triage diagnostic yield for cardiac syncope and APDs, we compared patients with a low (white, green, and blue) vs. a high (orange and red) triage priority code in terms of clinical severity, while to assess the triage diagnostic yield for syncope requiring admission, we compared patients with a low (that is white and green) vs. a high (that is green, orange and red) care complexity triage priority code, according to regional guidelines.3 To explore how to improve the accuracy of the triage assessment, we compared patients with and without the outcomes considered, with regard to personal data, medical history (previous syncopal episodes and heart diseases), triage priority code, and clinical features of the syncopal episode (presence of witnesses, prodromal symptoms, injuries), using contingency tables and a chi- square test. Keywords: cardiac; care; code; emergency; patients; study; syncope; triage
• Prognosis of trauma patients with liver injury who underwent observation after emergency department evaluation: a single trauma center retrospective study by Nencioni, Andrea; Lumini, Enrico; Rossetto, Andrea; Tiritiello, Letizia; Di Stefano, Guido; Busa, Federico; Cittarella, Matteo; Cavigli, Edoardo; Bonizzoli, Manuela; Nazerian, Peiman (2025) - The prognosis of liver trauma patients not requiring immediate interventions remains unclear. This study aimed to evaluate the clinical outcomes of patients who suffered liver injuries and underwent a period of observation in the Emergency Department (ED). Keywords: aast; emergency; injuries; injury; liver; patients; study; surgery; trauma; wses
• Dynamics of geriatric emergency care: comprehensive assessment of emergency medical services utilization and its impact on healthcare resources in coastal India by S S, Vijay Kumar; Rao H T, Ananth Prasad; Shekhli, Shabbir; Jose, Anila (2025) - Similarly, the EDEN cohort (Emergency Department and Elder Needs) study conducted in Spain in 2022 reported that 6.9% of geriatric patients utilized EMS services, which aligns closely with our findings.13 This can be due to similar cultural factors, such as a strong emphasis on family care giving, thus contributing to lower EMS utilization rates among the older, alongside infrastructural limitations in rural areas affecting accessibility.14 In a study conducted in Tokyo in 2010, it was found that 64% of geriatric women were transported via ambulance to the ED, highlighting a significant gender difference in EMS usage.15 In contrast, our study observed only a slight male predominance among EMS patients. Additionally, EMS patients exhibited a greater incidence of adverse outcomes, including ED mortality, emphasizing the criti- cal importance of timely triage and effective resource allocation to enhance the care and outcomes of older patients in emergency set- tings.21 In comparison, a study conducted in Switzerland reported sim- ilar rates of hospitalization at 58%, with 32% of patients requiring ICU admission.22 Keywords: care; department; emergency; ems; icu; medical; outcomes; patients; services; study; walk
• Recommendations for the care of geriatric patients in the emergency department by Colantoni, Alessandra; Maioli, Fabiola; Romano, Alfonso; Bertini, Alessio (2025) - Arras J. Ethical issues in emergency care. In geriatric care, this principle often requires balancing aggressive treatment with symptom management and comfort care. Keywords: assessment; care; cga; department; emergency; emergency care; emergency department; frailty; geriatric; health; healthcare; medicine; outcomes; patients
• SEPSIS TRIESTE 2024 - 2nd Edition | Generali Convention Center Trieste, 20 e 21 settembre 2024 by Editors, The (2025) - A case series ..............................1 Predictors of mortality in septic patients .......................................................................................................3 Prognostic Role of the Arterial-Venous pCO2 Gap Calculated on Peripheral Venous Blood in Septic Patients in the Emergency Department .........................................................................................................6 A new device for the treatment of sepsis: the functionalized cartridge .....................................................7 Assessment of antibiotic concentrations in abdominal abscesses: protocol of a prospective study........8 A rare case of dizziness....................................................................................................................................9 CD169 and HLA-DR in blood cells and circulating extracellular vesicles in COVID-19 as markers infection and post-acute sequelae monitoring............................................................................................10 Septic shock and infective endocarditis from toxigenic Corynebacterium diphtheriae.........................12 Management of acute pyelonephritis in the EDOU and in the regular ward ..........................................15 Emergency Care Journal volume 21, supplementary 1, 2025 SEPSIS TRIESTE 2024 - 2nd Edition Generali Convention Center Trieste 20 e 21 settembre 2024 ABSTRACT BOOK SEPSIS TRIESTE 2024 - 2nd Edition - Trieste, 20 e 21 settembre 2024 Our study confirmed how MDW alone could not be used as a single predictor of mortality for septic patients Keywords: antibiotic; blood; care; care journal; cd169; department; doi; emergency; emergency care; fluid; hospital; icu; infection; italy; journal; mdw; medicine; mortality; patients; rome; samples; sepsis; study; therapy; trieste; university
• Training in the ABCDE approach by simulation for medical students by Pepe, Francesco; Trainito, Giuseppe; Mazzilli, Valerio; Lupo, Bruna; Pinelli, Maria Antonella; Vanni, Simone; Vignozzi, Linda; Innocenti, Francesca (2025) - Performance in AMPLE and ABCDE approach in the first and second scenario by G1 (3th year of the graduation program) and G2 students students (4th year of the graduation program). A brief activity in simulation enabled medical students to assess compre- hensively critical patients and to identify the “red flags” of each scenario. Keywords: abcde; approach; clinical; patients; simulation; students
• The initial management of mild and moderate burned patients in the emergency department: an expert consensus statement by Susi, Beniamino; Privitera, Daniele; Zanfardino, Giovanni; Di Lonardo, Antonio; Melandri, Davide; Fabbri, Andrea (2025) - While burns and fires cause over 300,000 deaths worldwide each year, most burn cases are not fatal.1,2 Burns are common traumatic injuries for which patients often present to the ED; mild to moderate burns represent the majority of burns that present to the ED and can be effectively managed there. Abstract Early diagnosis and treatment of burn patients are a key issue in the emergency setting. Keywords: burn; care; clinical; consensus; diagnosis; emergency; experts; hospital; management; pain; patients; phase; review; skin; treatment; use
• Diagnostic performance of YEARS criteria combined with point-of-care lung and venous ultrasound in suspected pulmonary embolism by Gigli, Chiara; Volpicelli, Giovanni; Annovi, Antonio; Sánchez Garrido-Lestache, Ángel; Vedovati, Maria Cristina; Becattini, Cecilia; Vanni, Simone; Nazerian, Peiman (2025) - All of these characteristics make this technique potentially suitable for widespread use as an adjunct to the physical examination in the acute care setting, as growing body of literature suggests.7,14,30 Two items of the YEARSc, the probability of PE and the clinical signs of DVT, are based on considerations that are strictly subjective and the risk of high variability when physicians with different experience and skills judge these two items is concrete.20-30 In the proposed US-YEARSc, the two surrogate items supported by an early lung and venous ultrasound study represent the objective translation of the probability of PE (direct visualization of pulmonary infarctions or signs of alternative diagnoses) and DVT (definitive confirmation of the diagnosis). Study patients were recruited from July 2014 to April 2015 in the Emergency Departments (EDs) of four Italian university hospitals (Careggi University Hospital, Firenze; San Luigi Gonzaga University Hospital, Torino; San Paolo University Hospital, Milano; University Hospital of Perugia). Keywords: care; diagnosis; dimer; embolism; lung; patients; study; ultrasound; yearsc
• Investigating the expected and perceived service quality of the elderly referring to the hospital emergency department: A multi-center cross-sectional study from northern Iran by Hasani-Kordcandi, Arezoo; Mohammadi, Sepideh; Pourhabib, Ali; Fotokian, Zahra (2025) - These findings suggest that gender did not significantly influence the elderly’s expectations and perceptions of emergency department service quality (Table 2). Perceived service quality. Keywords: care; data; department; elderly; emergency; mean; patients; quality; service; service quality; study
• A practice teaching from GIMSI (Italian Multidisciplinary Syncope Group) 2025: yoga as a treatment for recurrent vasovagal syncope by Poggiali, Erika; Solbiati, Monica; Casagranda, Ivo; Ghiadoni, Lorenzo (2025) - Second, patients with recurrent VVS syncope might benefit more from the very presence of someone who makes them feel cared for than from ‘traditional’ treatment. A randomized study of yoga therapy for the prevention of recurrent reflex vasovagal syncope. Keywords: heart; patients; syncope; vvs; yoga
• Socio-demographic and health perception factors influencing non-urgent emergency department visits in the Veneto region: a cross-sectional pilot study by Volpin, Roberta; Barina, Giulio; Borio, Giorgia; Liziero, Luciano; Simioni, Matteo; Piasentini, Silena; Bovo, Chiara (2025) - Patients seeking ED care vary widely in terms of demographic characteristics and health perceptions, often presenting with non- urgent issues. This study aims to assess personal and service-related factors influencing patients’ decisions to seek ED care, focusing on socio-demographic variables and health perceptions. Keywords: care; department; emergency; factors; health; healthcare; patients; primary; study; use; visits
• Evaluating the predictive accuracy of ChatGPT in risk stratification for chest pain in the emergency department by Malalan, Fabio; Zaboli, Arian; Fiore, Armando; Fanton, Nicola; Sponga, Laura; Zaia, Barbara; Mantelli, Giovanni; Barberi, Caterina; Pisani, Paola; Giorio, Laura; Turcato, Gianni (2025) - A prospective validation of the HEART score for chest pain patients at the emergency department. Clinical and anamnestic characteristics of study patients, divided between those with and without a MACE. Keywords: chatgpt; chest; chest pain; data; emergency; evaluation; mace; pain; patients; risk; study; troponin
• Sex disparities in older patients attending the european emergency departments: an EGERS sub-analysis by Fabbri, Andrea; Polyzogopoulou, Effie; Dündar, Defne Z.; Slagman, Anna; Ergin, Mehmet; Janssens, Kelly Ann Catherine; Bjornsen, Lars P.; Somodi, Sándor; Višnja, Nesek Adam; Demir, Hüseyin A.; Laribi, Said; Karamercan, Mehmet A.; study group, EGERS research network (2025) - ICD 10 Code groups N cases % (95% CI) N cases % (95% CI) P Diseases of the circulatory system (I00-I99) 398 14.7 (13.4-16.0) 447 15.4 (14.1-16.7) 0.371 Injury, poisoning and certain other consequences of external causes (S00-T88) 384 14.2 (12.9-15.5) 519 17.9 (16.5-19.3) Hospital admissions and mortality were higher in males, particularly in older age groups. Keywords: age; care; cases; data; emergency; females; males; medicine; patients; sex; study
• Reconsidering the role of lactate as a predictor of acute asthma severity in the emergency department by De Vuono, Stefano; Settimi, Laura; Bufi, Alessandro; Urbini, Chiara; Groff, Paolo (2025) - In order to assess if lactate levels at ED presentation can independently indi- cate the necessity for hospitalization, thereby acting as an objective measure of asthma attack severity we retrospectively collected data from 96 patients accessed to our ED in 2024, including patients’ medical history, vital signs and arterial blood gas analysis. In the univariate analysis, admission was significant- ly linked to lactate levels and P/F ratio. Keywords: asthma; emergency; lactate; levels; patients; severity
• Methanol poisoning during COVID-19 pandemic: a multicenter study of northern Iran by Divsalar , Jamileh; Ghasempouri, Seyed Khosro; Nekoukar, Zahra; Bordbari , Amir-Hassan; Zakariaei, Zakaria (2025) - This retrospective and descriptive cross-sectional study is a multicenter study in the western part of Mazandaran province over the initial 18 months of the pandemic to provide a more comprehensive view on MP patients. In light of the geographical location and increased travel to this northern province, coupled with the rising consumption of illicit and home- made alcoholic beverages and the associated incidence of methanol poisoning, we undertook an analysis of the demographic characteristics, diagnostic procedures, and treatment approaches among patients hospitalized in five designated hospitals within the region. Keywords: acidosis; alcohol; covid-19; iran; mazandaran; metabolic; methanol; pandemic; patients; poisoning; study
• L-lactate in acute mesenteric ischemia: a reliable biomarker for diagnosis and prognosis? by Deryol, Rıza; Şeker, Duray; Şeker, Gaye Ebru; Balas, Şener (2025) - Serum L-lactate, a marker of tissue hypoperfusion, has been investigated as a potential prognostic and diagnostic indicator in acute mesenteric ischemia. Preoperative serum L-lactate levels are significantly associated with mortality in patients with acute mesenteric ischemia and may serve as a prog- nostic biomarker. Keywords: acute; age; ischemia; lactate; length; levels; mortality; patients; preoperative; resection; serum; study
• How to manage a severe form of euglycemic diabetic ketoacidosis caused by SGLT2 inhibitors: a case report and literature review by Bologna, Carolina; Ferraro, Andrea; Augiero, Antonio; Nuzzo, Vincenzo; Guiotto, Giovanna (2025) - How to manage a severe form of euglycemic diabetic ketoacidosis caused by SGLT2 inhibitors: a case report and literature review Carolina Bologna,1 Andrea Ferraro,2 Antonio Augiero,2 Vincenzo Nuzzo,1 Giovanna Guiotto2 1Internal Medicine Unit, Ospedale del Mare, ASL Na1 Centro, Naples; 2Emergency Unit, Ospedale del Mare, ASL Na1 Centro, Naples, Italy Highlights - Sodium-Glucose Cotransporter-2 (SGLT2) inhibitors can cause a rare but fatal side effect known as Euglycemic Diabetic Ketoacidosis (EDKA); - EDKA is an endocrine emergency characterized by elevated ketone bodies and metabolic acidosis despite normal or near- normal blood glucose levels that typically manifests with nausea, vomiting, malaise, or fatigue; - Management is based on immediate discontinuation of the glifozine, hydration, insulin therapy and bicarbonates; - The therapy is often difficult due to the presence of hypokalemia and a vicious circle between glucagon and insulin; - Octreotide can be used to reduce insulin secretion and stabilize blood glucose levels without further insulin administration. The increase in glucagon is likely an indirect effect mediated by the reduction in insulin secre- tion, as there is no evidence to suggest a direct stimulation of the pancreatic alpha cells by SGLT2 inhibitors. Keywords: diabetes; diabetic; edka; euglycemic; glucose; inhibitors; insulin; ketoacidosis; levels; meq; patients; potassium; sglt2
• Prehospital spinal and cervical motor restriction in adult trauma patients: a narrative review by Gheri, Flavio; Toppi, Niccolò; Bortoli, Nicola; Forni, Marco; Celi, Simone; Romano, Roberto; Bocchi, Ilario; Coraci, Giuseppe; Petta, Domenica; Floccare, Douglas. J. (2025) - Furthermore, it is neces- sary to assess the economic, organizational, and psychological impacts associated with the widespread use of spinal immobiliza- tion devices.4,21,22 In light of these considerations, the present narrative review aims to critically analyze the available evidence on the clinical effectiveness of prehospital spinal immobilization, with specific attention to associated complications, device comparisons, the implementation of selective decision criteria, and the persistent gaps in the literature. The selection process was guided by the primary out- come, namely the identification of evidence concerning the most appropriate modality of cervical and spinal immobilization in adult trauma patients in prehospital settings, as described in the PCC Framework (Supplementary materials, Table 2).29 Narrative synthesis of results Clinical effectiveness of spinal immobilization Several studies have investigated the clinical effectiveness of prehospital spinal immobilization in terms of neurological and functional outcomes. Keywords: care; emergency; et al; immobilization; patients; prehospital; review; spinal; spine; studies; study; trauma
• Hepatic damage associated with dengue infection: insights from the emergency department of a tertiary care centre by Verma, Alka; Jafri, Asif Dabeer; Goel, Amit; Mishra, Ajay (2025) - The TLC value was significantly different between moderate to severe dengue patients. Syed AA, Aslam F, Hakeem H, et al. Frequency of worsening liver function in severe dengue hepatitis patients receiving paracetamol: A retrospective analysis of hospital data. Keywords: alt; ast; clinical; dengue; disease; fever; hepatic; hepatitis; infection; involvement; levels; liver; patients; severity
• Missed occlusions: diagnostic accuracy of ECG STEMI criteria for identifying occlusive myocardial infarction. A systematic review and meta-analysis by Costantini, Ilaria; Breglia, Andrea; Pilav, Merisa; Zanatta, Mirko; Ventura, Maria V.; Ricci, Giorgio (2025) - Missed occlusions: diagnostic accuracy of ECG STEMI criteria for identifying occlusive myocardial infarction. Five studies were prospective,11,16-19 while four were retrospective.9,20-22 Four studies used ECG STEMI criteria consistent with the Third or Fourth Universal Definition of Myocardial Infarction.9,11,21,22 Keywords: accuracy; acute; criteria; definition; diagnostic; ecg; elevation; infarction; omi; patients; review; sensitivity; specificity; stemi; studies; study
• Consensus paper on the use of BIVA (Bioeletrical Impendance Vector Analysis) in medicine for the management of body hydration by Di Somma, S.; Lukaski, H. C.; Codognotto, M.; Peacock, W. F.; Fiorini, F.; Aspromonte, N.; Ronco, C.; Santarelli, S.; Lalle, I.; Autunno, A.; Piccoli, A. (2011) - Moreover, the combined use of both BIVA and BNP improves the management of heart failure patients because it is useful to reach a faster and more accurate diagnosis, it is a valid support to distinguish cardiogenic dyspnea from noncardiogenic dy- spnea and supports decisions about diuretic therapy. In our ED, we evaluated hydration status at the admission, 24, 72 hours after admission and at the discharge time in acute heart failure patients using a multidi- mentional approach: together with BIVA, we evaluated BNP, ul- trasonographic measurement of the Caval Index and vascular pedicle width obtained through chest radiography. Keywords: acute; analysis; assessment; bioelectrical; biva; body; failure; fluid; heart; hydration; impedance; patients; status; therapy; vector; volume; water
• Clinics and Therapy by Editors, The (2011) - Sono importanti anche la presenza di bradicardia e ovviamen- te la genetica; in particolare è stato osservato che il rischio di eventi cardiaci letali è signifi cativamente maggiore nella LQT3 (20%) rispetto alla LQT1 (4%) o LQT2 (4%), men- tre il tasso di eventi cumulativo è più basso tra pazienti con LQT1 (30%) rispetto a quelli con LQT2 (46%) e con LQT3 (42%). che mostra un signifi cativo accorcia- mento dell'intervallo QTc e un miglioramento del rilassa- mento diastolico. Keywords: anni; che; clinica; con; copyright; dei; del; dell’editore; essere; età; eventi; farmaci; hematoma; long; lqt1; lqt3; lqts; moss; nei; nella; non; patients; pazienti; più; protetto; qt syndrome; qtc; rectus; rischio; scd; senza; sheath; sincope; soggetti; sono; syndrome; terapia; una; w w
• Proceedings of the Congress Antidotes in Depth 2011. Pavia, 28-30 Sept. 2011 by Editors, The (2011) - Nel caso in esame, data l’opposizione del paziente all’intervento chirurgico, il numero limitato di corpi estranei presenti a livello gastrico, l’assenza di segni e sintomi di intossicazione acuta e, soprattutto, la possibilità di uno stop a livello pilorico, abbiamo ritenuto di poter procedere al trattamento del paziente per via endoscopica. Sono state inoltre calcolate le percentuali di pazienti con alco- lemia > 300 mg/dl e di osmolarità > 295 mOsm/l. Le differenze percentuali nelle diverse classi AVPU erano significative per l’al- colemia (chi2 = 12,55; p < 0,002) e non per l’osmolarità calcolata. Keywords: abuse; acute; br e; calcium; cases; centre; che; clinica; con; control; copyright; d'urgenza; dei; della; dell’editore; department; digoxin; dose; drugs; effects; elettronicamente; fab; glucagon; high; italy; l’autorizzazione; materiale; national; non; o distribuire; patients; pavia; paziente; poisoning; protetto; scritta; senza; settembre; sono; substances; symptoms; system; tossicologia; toxicol; treatment; una; w .e; w w
• Proposal for the use in emergency departments of cardiac troponins measured with the latest generation methods in patients with suspected acute coronary syndrome without persistent ST-segment elevation by Casagranda, Ivo; Cavazza, Mario; Clerico, Aldo; Galvani, Marcello; Ottani, Filippo; Zaninotto, Martina; Biasucci, Luigi M.; Cervellin, Gianfranco; Lenzi, Tiziano; Lippi, Giuseppe; Plebani, Mario; Tubaro, Marco (2013) - According to these recommendations, the diagnosis of AMI is based on detecting the variation of cardiac troponin values with a typ- ical rise and falling pattern in patients with clinical suspicion of myocardial ischemia.2,3 This approach is also confirmed in the latest Universal Definition of Myocardial Infarction,2 which recommends, as a decision level for the diagnosis of AMI, that cTnI and cTnT eleva- tions are defined as concentrations greater than the 99th percentile of distribution values measured in a reference population consisting of apparently healthy individuals free from heart disease. Ottani F, Binetti N, Casagranda I, et al. Keywords: acute; cardiac; chest; clin; ctni; diagnosis; emergency; infarction; methods; myocardial; pain; patients; percentile; sensitivity; troponin; values
• Noninvasive ventilation in patients with acute cardiogenic pulmonary edema by Bellone, Andrea; Etteri, Massimiliano; Motta, Luca; Cappelletti, Anna; Morichetti, Chiara; Pina, Paolo; Pusinelli, Roberto; Guanziroli, Massimo (2013) - A meta-analysis of Weng et al. still supported the use of NIV for patients with ACPE and showed that continu- ous positive airway pressure reduces mortality more in patients with ACPE secondary to acute myocardial ischemia or infarction.31 Continuous positive airway pressure compared to bilevel positive airway pressure in patients with acute cardiogenic pulmonary edema: which is best? Nieminem MS, Bohm M, Cowie MR, et al. Keywords: acpe; acute; airway; care; edema; patients; pressure; ventilation
• Hyperlactatemia and hypotension: looking at septic shock from different perspectives by Coen, Daniele (2013) - Severe sepsis and septic shock: review of the literature and emergency depart- ment management guidelines. [Emergency Care Journal 2013; 9:e9] Hyperlactatemia and hypotension: looking at septic shock from different perspectives Daniele Coen Emergency Department, Niguarda Ca’ Granda Hospital, Milan, Italy Abstract The last decade has witnessed significant improvements in the treatment of patients with severe sepsis and septic shock, and a reduction in mortality from septic syndromes has been described by several epidemiological studies. Keywords: care; patients; sepsis; shock
• Acute gastrointestinal bleeding: safety and timing of endoscopy by Riccioni, Maria Elena; Bizzotto, Alessandra; Franceschi, Francesco; Zuccalà, Giuseppe; Casagranda, Ivo; Gasbarrini, Antonio; Costamagna, Guido (2013) - Ninety-one patients presented to the emergency department with upper GI bleeding. Gastroduodenal peptic ulcers accounted for 47% of upper GI bleeding cases. Keywords: acute; bleeding; endoscopy; gastrointestinal; mortality; patients
• Red blood cell distribution width and erythrocyte parameters in patients with brain injury after mild head trauma by Lippi, Giuseppe; Carbucicchio, Andrea; Avanzini, Paola; Dipalo, Mariella; Benatti, Mario; Cervellin, Gianfranco (2013) - Distribution of median and interquartile range values of red blood cell distribution width in patients with mild head injury. Distribution of median and interquartile range values of red blood cell count, hematocrit, hemoglobin, mean corpuscular volume and red blood cell distribution width in patients with mild head injury. Keywords: cell; distribution; head; injury; patients; rdw; trauma; width
• Counterpoint: highly-sensitive troponin immunoassays in the emergency department by Lippi, Giuseppe; Cervellin, Gianfranco (2013) - Although some unquestion- able advantages have emerged from the use of HS troponins, yet there are some drawbacks that are now putting to the test several emer- gency physicians, as well as some laboratory professionals. In an article published 4 years ago, Giannoni et al. already emphasized that the concentration of troponin(s) steadily increases across decades of ages, and is con- sistently higher in males than females, with values being nearly 15-fold higher in healthy men over 70 as compared with healthy women under 20.5 More recently, increased values of HS troponin in older men were also reported by Normann et al., as a result of a higher preva- lence of silent cardiovascular disease in this population, an aspect that might dramatically unbalance the diagnostic performance of these biomarkers, especially for identifying NSET- MI.6 Keywords: cardiac; emergency; immunoassays; lippi; patients; troponin
• The determinants for oxygen delivery: is increased fraction of inspired oxygen always crucial? by Nicosia, Francesco; Savelli, Francesco; Lari, Federico; Di Luzio, Raffaella; Giostra, Fabrizio; Di Battista, Nicola (2014) - However, its hemodynamic effects and the consequences on tissue oxygenation are still not entirely clear.4 Methods and Results In this paper we analized the data originally collected from Leach,6 and subsequently ana- lyzed by Huang,7 as a pretext to try to provide an explanation of the physiopathological effects of O2 administration on tissue oxygena- tion; and to frame in a pathophysiological con- text the revisions that are involving several guidelines on the administration of O2. In addition, O2 increases the production of tumor necrosis factor alpha (TNF�) and iso- prostane and the activation of caspase 3 and 9.31 There are clinical observations that show that serious hypoxemia is tolerated without evidence of inadequate tissue oxygenation.32,33 In a study of patients with exacerbation of COPD with severe hypoxemia (<40 mmHg) there was no evidence of dysoxia, even with levels of PaO2 equal to 22 mmHg.34 In patients at rest, even the most severe form of hypox- emia from lung failure in itself does not involve generalized tissue anaerobiosis.23 Directions and guidelines Therefore, O2 administration is used for many disorders causing hypoxia. Keywords: administration; do2; effects; oxygen; patients; pressure; tissue; vasoconstriction
• Minor head injury in anticoagulated patients: a 6-year retrospective analysis in an emergency department by Riccardi, Alessandro; Guiddo, Grazia; Chiarbonello, Bruno; Frumento, Flavio; Polletti, Piera; Castelli, Marina; Minuto, Pierangela; Lerza, Roberto (2014) - We defined minor head injury patients with GCS of 14-15, according to Italian Guidelines2 and according to the criteria adopted in our previous study.14 We analyzed the first CT scans of the head, and if executed, the second CT prior to dis- charging. Intracranial bleeding in head injured patients taking anticoagulants classified according to age. Keywords: bleeding; head; injury; patients; risk; scan; trauma
• Likelihood of being seen within emergency departments’ assigned urgency times for poisoned and injured individuals by Rosenthal, Rachel L. (2014) - As actual wait-time increased for patients, they were less likely to be seen within their assigned urgencies. The most powerful predictors of the study’s outcome were injury type and age, indi- cating that patients from special populations such as the elderly or those with injuries resulting from deliberate self-harm are less likely to be actually priority patients independ- ent of triage nurse assigned urgencies. Keywords: emergency; injury; level; patients; study; time; wait
• The number of emergency department visits for psychiatric emergencies is strongly associated with mean temperature and humidity variations. Results of a nine year survey by Cervellin, Gianfranco; Comelli, Ivan; Lippi, Giuseppe; Comelli, Denis; Rastelli, Gianni; Ossola, Paolo; Marchesi, Carlo (2014) - Correlation between emergency department visits for psychiatric emergencies and mean daily temperature. Correlation between emergency department visits for psychiatric emergencies and mean daily humidity. Keywords: department; disorders; emergencies; emergency; humidity; mean; number; patients; psychiatric; study; temperature; visits
• Ventimask in exacerbation of chronic obstructive pulmonary disease and mild acidosis before starting with bilevel positive airway pressure by Bellone, Andrea; Motta, Luca; Etteri, Massimiliano; Bianchi, Anna Maria; Cappelletti, Anna; Bossi, Ilaria; Guanziroli, Massimo; Pina, Paolo; Colombo, Livio (2014) - Oxygen therapy to correct the hypoxemia becomes necessary, but it may sometimes lead to a reduction in ventilation and may worsen the inequality of ventilation/perfusion ratio caused by release of hypoxic vasoconstriction.1 Various attempts to overcome this adverse effect, namely a danger- ous rise in the arterial carbon dioxide tension (PaCO2), include oxygen by nasal probes or catheter or simple disposable masks based on the Venturi principle which allow for fixed con- centrations of oxygen. The primary endpoint was to evaluate the efficacy of oxygen therapy with Ventimask compared with Venturi mask in terms of avoid- ing the need for non-invasive bilevel-PAP dur- ing the 1st h and reducing PaCO2 retention. Keywords: acute; copd; group; mmhg; oxygen; paco2; patients; therapy
• Emergency physicians’ and nurses’ perception of quality of elderly care in the Emergency Department. Results of a national survey by Cervellin, Gianfranco; Casagranda, Ivo; Piccioni, Pierdante; Ricci, Giorgio; Benatti, Mario; Pesenti Compagnoni, Massimo (2014) - The questions were the following: 1=In your ED the elderly care has the same quality of adult care; 2=Competence and communication attitudes of emergency health care profession- als are the same with elderly and adult patients; 3=Health and social recordings of elderly patients referred to the ED by their general practitioners are generally of good quality; 4=Health and social recordings of elderly patients referred to the ED by nursing homes are generally of good quality; 5=Medical causes for non specific, typically geriatric, presenta- tions (i.e., delirium, falls, hypokynesis) are sys- tematically investigated; 6=The willingness to admit elderly patients to medical wards is the same as for adult patients; 7=During ED process basic needs of elderly patients (i.e., meals, hygiene, micturition, evacuation) are always met; 8=In your ED objectives tools (i.e., scores) for functional, cognitive and social evaluation of elderly patients are generally used; 9=In your opinion in daily routine it would be possible to use objectives tools (i.e., scores) in functional, cognitive and social eval- uation of elderly patients; 10=It would be use- ful to use objectives tools (i.e., scores) for func- tional, cognitive and social evaluation of elder- ly patients in daily routine; 11=Before dis- charging an elderly patient, in your ED a quick functional, cognitive and social evaluation is generally performed; 12=The patient age influ- ences by itself the triage priority code, or some different priorities are given to the elderly if the triage code is the same; 13=In your Hospital elderly-specific diagnostic and therapeutic post- discharge pathways are generally provided; 14 This population is admitted to the ED more often than younger adults, and often presents higher level of acu- ity, more severe medical conditions, a large number of comorbidities, which require a large volume of testing since older patients are more prone to be admitted and are at higher risk of death.3,4 Since the number of elderly patients presenting to overcrowded EDs seems to be destined to further increase, the compre- hensive care of these patients is emerging as a crucial issue in the field of emergency medi- cine.3,4 Hence, some authors have recently hypothesized that the emergency care offered to elderly patients may be characterized by poorer quality compared to that administered to younger adults.5 Keywords: care; emergency; eps; hospital; patients; responders
• Fatal pulmonary embolism following ankle fracture in a 23-year-old man by Charitidou, Stella; Aslanidis, Theodoros; Papalexandris, Stellios (2014) - [Emergency Care Journal 2014; 10:4473] Fatal pulmonary embolism following ankle fracture in a 23-year-old man Stella Charitidou,1 Theodoros Aslanidis,2 Stellios Papalexandris3 1Emergency Department, General Hospital of Ptolemaida; 2Mobile Intensive Care Units, National Center of Emergency Care, Thessaloniki Department, Greece; 3Private Orthopedic Surgeon, Manchester, UK Abstract Patients with lower extremity injuries are at increased risk of venous thromboembolism. It has been suggested that this method of immobilization may increase the risk of deep-vein thrombosis (DVT) because of inactivation of the ankle pump.1 However, the real incidence of venous thorm- boembolism (VTE) and pulmonary embolism (PE) in patients with ankle fracture is still unknown, as the diagnosis includes various types of anatomic injuries, thus the literature reports a wide range of incidence for both VTE and PE. Keywords: ankle; fracture; incidence; patients
• A multicenter retrospective study on falls in elderly population. Epidemiology and impact on hospital workload in two Emergency Departments of Northern Italy by Cervellin, Gianfranco; Montali, Francesca; Campaniello, Giovanna; Benatti, Mario; Fiorini, Roberto; Rastelli, Gianni (2014) - Increased preva- lence of fall risk factors in older people fol- lowing hip fracture. A multicenter retrospective study on falls in elderly population. Keywords: age; falls; hospital; number; patients; risk; study; visits; years
• Complications in critically ill adult patients’ transportations reported in the recent literature by Bambi, Stefano; Lucchini, Alberto; Innocenti, Diego; Mattiussi, Elisa (2015) - Furthermore we cannot exclude a general underreporting of incidents and adverse events related to transports, with con- sequent publication biases.55 However, inter-hospital transports of ECMO patients seem to be substantially the safest, due to lack of major events and outcomes. Summary of studies on inter-hospital transport complications of extracorporeal membrane oxygenation/extracorporeal life support patients. Keywords: ambulance; care; complications; crit; ecmo; emergency; events; extracorporeal; hospital; ill; med; patients; problems; review; transfer; transport
• Ameliorating the emergency department workflow by involving the observation unit: effects on crowding by Iannone, Primiano (2015) - Since triage times and crowding in main ED area decreased, it was not a critical issue. In 2013 standardized hospital admissions from the observation unit increased (+231 patients) but fewer patients were admitted to acute beds directly from main ED area (-325 patients). Keywords: area; department; emergency; observation; patients; unit
• Point-of-care critical ultrasound in a rural emergency department by Zanatta, Mirko; Benato, Piero; De Battisti, Sigilfredo; Pirozzi, Concetta; Cianci, Vito (2015) - In traumatic patients emergency physicians suspected a complication of trauma in 32.4% of cases after PS. Sargsyan AE, Hamilton DR, Jones JA, et al. FAST at MACH 20: clinical ultrasound aboard the International Space Station. Keywords: care; ccus; diagnosis; emergency; pain; patients; point; trauma; ultrasound
• Nurses and advanced airway management: the experience of the Piacenza ambulance service by Mozzarelli, Fabio; Vigevani, Kezia; Nani, Stefano; Vercelli, Andrea; Rossi, Enrica (2015) - Lyon RM, Ferris JD, Young DM, et al. Field intubation of cardiac arrest patients: a dying art? The results show that the Piacenza ambulance service nursing staff has a good level of skills and competence in advanced airway management. Keywords: airway; arrest; care; emergency; intubation; management; patients; service
• Defining criteria to choose appropriate destination hospital for trauma patients: Piacenza Local Health Authority’s Piacenza trauma algorithm protocol by Mozzarelli, Fabio; Nani, Stefano; Rossi, Enrica; Pizzamiglio, Mario (2016) - In the Western world, trauma injury represents the first cause of death and invalid- ity in subjects up to 44 years of age and the third cause amongst the general population.1 Starting in the 1990s, a number of intra- and extra-hospital systems known as trauma sys- tems was introduced in the United States, Canada and various European countries to improve trauma patient care. [page 1] Defining criteria to choose appropriate destination hospital for trauma patients: Piacenza Local Health Authority’s Piacenza trauma algorithm protocol Fabio Mozzarelli,1 Stefano Nani,1 Enrica Rossi,1 Mario Pizzamiglio2 1Ambulance Emergency Service, Piacenza Local Health Authority, Piacenza; 2Emergency Department, Guglielmo Da Saliceto Hospital, Piacenza, Italy Abstract Ambulance crew’s choosing of appropriate destination hospital for trauma patients can affect survival and morbidity outcomes. Keywords: algorithm; care; center; data; destination; emergency; hospital; patients; piacenza; trauma
• Heart in acute pancreatitis: facts and fictions by Pezzilli, Raffaele; Barakat, Bahjat; Barassi, Alessandra (2015) - There are no studies on the ADM circulating concentration in acute pancreatitis patients and this topic should be explored in order to obtain more accurate information regarding cardiac involvement in acute pancreatitis. In addition, similar high levels of serum NT-proBNP are present in patients with mild acute pancreatitis as well as in those with severe disease.22 Thus, we should be aware that elevated values of NT-proBNP in patients with acute pancreatitis cannot be useful to detect hearth failure. Keywords: acute; cardiac; changes; pancreatitis; patients; pezzilli; serum
• Lactate levels as a marker of tissue hypoperfusion in acute heart failure patients seen in the emergency department: a pilot study by Sauser, Kori; Alkhawam, Lora; Pierchala, Linda; Pang, Peter S. (2016) - [Emergency Care Journal 2016; 12:5458] Lactate levels as a marker of tissue hypoperfusion in acute heart failure patients seen in the emergency department: a pilot study Kori Sauser,1 Lora Alkhawam,2 Linda Pierchala,3 Peter S. Pang4 1Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA; 2Department of Emergency Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL; 3Loyola University Medical Center, Chicago, IL; 4Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA Abstract Acute heart failure (AHF) may lead to sub- clinical tissue ischemia due to hypoperfusion from inadequate forward flow or congestion. A prospec- tive pilot study of ED AHF patients was con- ducted. Keywords: ahf; care; emergency; failure; heart; history; lactate; levels; patients; study
• The risks of defensive (emergency) medicine. The laboratory perspective by Montagnana, Martina; Lippi, Giuseppe (2016) - A crit- ical evaluation of laboratory tests in acute pancreatitis. Organizational solutions for stat testing in clinical laboratories. Keywords: emergency; laboratory; med; medicine; patients; testing; tests; urgent
• Physician’s changes in management of return visits to the Emergency Department by Long, Adrianna; Cambridge, Robert; Rosa, Melissa (2016) - If physicians treated URV patients the same as their initial visit rather than increas- ing the number of treatments or tests ordered on URVs, the cost of healthcare and patient’s waiting time could decrease significantly. Clinical policy: critical issues in the evaluation and management of Emergency Department patients with suspected appendicitis. Keywords: change; clinical; management; number; patients; physicians; repeat; tests; visit
• Defensive medicine in the emergency department. The clinicians’ perspective by Cervellin, Gianfranco; Cavazza, Mario (2016) - This kind of education- al policy should, of course, start from the University, since a large portion of medical students and residents frequently encounter defensive medicine practices and are often being taught to consider malpractice liability during clinical decision making.31 Along with revision of current legislation, getting back to basics may be the best way to fight against defensive medicine. [Emergency Care Journal 2016; 12:5615] Defensive medicine in the emergency department. Keywords: care; emergency; health; malpractice; medicine; patients; practice; tests
• Electrical cardioversion performed by emergency physicians in the emergency department by Bellone, Andrea; Etteri, Massimiliano; Sielert, Kirsten (2016) - Electrical cardioversion in patients with acute atrial fibrillation in Emergency Departments: a prospective randomized trial. [page 23] Electrical cardioversion performed by emergency physicians in the emergency department Andrea Bellone, Massimiliano Etteri, Kirsten Sielert Emergency Department, Sant’Anna Hospital, San Fermo della Battaglia, Italy Dear Editor, We would like to discuss about electrical car- dioversion in emergency department (ED) patients with acute atrial fibrillation (AF). Keywords: cardioversion; emergency; fibrillation; patients
• Traumatic events involving elderly patients treated with anticoagulants for atrial fibrillation: the downside of stroke prevention by Riccardi, Alessandro; Minuto, Pierangela; Ghinatti, Maria; Guiddo, Grazia; Calvia, Alessandro; Lerza, Roberto (2016) - Moreover, not only the risk of intracranial hemorrhage should be considered: fractures of hip, femur and pelvis, hemothorax and/or pneumothorax secondary to rib fractures could have more serious con- sequences in OAC patients, even death. In our follow- up that was extended only up to 30 days from the admission, we recorded three deaths, two in patients with intracranial hemorrhage, and one due to pulmonary embolism in hip frac- ture. Keywords: bleeding; emergency; fibrillation; patients; risk
• Common errors in the treatment of intra-abdominal infections: the irrational use of antimicrobial agents by De Simone, Belinda; Catena, Fausto; Sartelli, Massimo; Di Saverio, Salomone; Coccolini, Federico; Heyer, Arianna; Catena, Rodolfo; Ansaloni, Luca (2016) - Greater mortality rates were observed in the non-dees- calated group, probably because the greater severity of disease classification (APACHE II).16 It is essential that the dosing of antibiotics is adequately adjusted in order to achieve an effective drug level above the minimum inhibi- tion concentration but avoiding toxic side effects, above all in patients patients with acute kidney injury and continuous renal replacement therapy.17 Determination of serum levels should always be carried out, when this is possible. The use of antimicrobial agents – aimed to decrease morbidity and mortality rate relat- ed to intra-abdominal infections – is very high, often improper, in the Departments of General and Emergency Surgery and Intensive Cure Units. Keywords: antibiotic; control; esbl; iais; infections; patients; peritonitis; resistance; risk; sepsis; therapy; treatment
• Management of transient loss of consciousness of suspected syncopal cause, after the initial evaluation in the Emergency Department by Casagranda, Ivo; Brignole, Michele; Cencetti, Simone; Cervellin, Gianfranco; Costantino, Giorgio; Furlan, Raffaello; Mossini, Gianluigi; Numeroso, Filippo; Pesenti Campagnoni, Massimo; Pinna Parpaglia, Paolo; Rafanelli, Martina; Ungar, Andrea (2016) - Low risk patients can be discharged, while high risk ones should be monitored and treat- ed properly in case of worsening. Moderate risk patients should undergo clinical and instrumental mon- itoring in SOU, inside the ED. Keywords: department; emergency; management; patients; risk; syncope; unit
• Evidence for cost-effectiveness of ultrasound in evaluation of blunt trauma patients by Lane, Bennett H. (2016) - [page 63] Evidence for cost-effectiveness of ultrasound in evaluation of blunt trauma patients Bennett H. Lane Harvard Medical School, Boston, MA, USA Abstract The evaluation of the blunt trauma patient frequently includes the focused assessment with sonography for trauma (FAST) exam. The aim of this review is to evaluate the available evidence regarding whether ultrasound is cost-effective for evaluation of blunt trauma patients, and what factors may affect its cost-effectiveness. Keywords: cost; effectiveness; exam; fast; patients; study; trauma; ultrasound; use
• A retrospective analysis of the impact of toxicological diagnostics on clinical decision making in cases of acute drug poisoning by Liisanantti, Janne H.; Lehtiniemi, Suvi; Ala-Kokko, Tero I. (2017) - The 225 toxicologically screened (toxicological urine samples or paracetamol screening) drug poisoned patients divided into the two groups; need of specific therapies of extracorporeal treatment (N-acetyl cysteine or forced alkaline diuresis, acute hemodialysis, hemodiafiltration, or molecular adsorbent recirculating system) or symptomatic care. The rate of specific treatment was higher among screened patients compared with patients without screening (18.7 vs 1.1%, P<0.001). Keywords: acute; care; drug; hospital; patients; poisoning; screening; study; treatment
• Which clinical scoring system should we use for the evaluation of chest pain in the Emergency Department? A review by Parenti, Nicola; Agrusta, Federica; Luciani, Antonio (2016) - D’Ascenzo et al.,16 after a revision of seven derivation studies (25,525 patients) and fif- teen validation studies (257,654 patients), concluded that GRACE risk score performed better than the TIMI when predicting ACS. De Araujo Gonçalves P, Ferreira J, et al. TIMI, PURSUIT, and GRACE risk scores: sustained prognostic value and interaction with revascularization in NSTE-ACS. Keywords: chest; grace; heart; pain; patients; reliability; risk; score; timi
• The management of cellulitis and erysipelas at an academic emergency department: current practice versus the literature by Martin, Jeffrey W.; Wilson, Ruth; Chaplin, Tim (2017) - Peterson D, McLeod S, Woolfrey K, McRae A. Predictors of failure of empiric outpatient antibiotic therapy in emergency department patients with uncomplicated cellulitis. 106 patients received oral antibiotics only or were advised to continue existing courses of oral antibiotics (Table 1; Figure 1). Keywords: antibiotics; ceftriaxone; cellulitis; cephalexin; department; emergency; management; patients
• Unavoidable deaths in the Italian Emergency Departments. Results of a ten-year survey. A mirror of substantial social changes, or a warning for a hospital-system pathology? by Cervellin, Gianfranco; Casagranda, Ivo; Ricci, Giorgio; Mezzocolli, Ilenia; Paolillo, Ciro; Rossi, Rita; Bellone, Andrea; Guzzetti, Stefano; Giostra, Fabrizio; Rastelli, Gianni; Cavazza, Mario (2017) - Notably, among the elderly population, only 15% of all deaths are due to an acute disease or trauma, whereas 85% are related to chronic diseases.19 In Italy also there is a widespread per- ception of incresing rates of hospital deaths, in particular regarding deaths in the ED for chronic, end stage diseases (i.e., cancer, dementia, terminal illness), but defintive data on this subject are lacking. After this study, a large part of literature and research about the modern attitude to death seems to criticize the trend to increasing hospital deaths, since it resembles a threat to an idealized good death.29 Some Authors perceive that an increas- ing number of elderly patients is referred to the ED at the end of life, often from nursing homes and without any real medical per- spective. Keywords: average; care; deaths; department; eds; emergency; hospital; life; med; patients
• Percutaneous artery embolization of bleeding rectus sheath hematomas in hemodynamically unstable patients: Outcomes of 43 patients in a tertiary referral hospital by Cereda, Alberto; Aseni, Paolo; De Capitani, Lucio; Cereda, Marco; Vercelli, Ruggero; Giannattasio, Cristina; Rampoldi, Antonio Gaetano (2017) - 172.5±87.3 174±87 163±97 ns RDW (%) 16.7±3.4 16.1±2.8 20.5±4.1 0.011 Creatinine (mg/dL) 1.14±0.5 1,20±0.57 1.24±0.59 ns Azotemia (mg/dL) 58.73±42.8 58±44.5 63.6±33.3 ns PT (sec) 1.6±0.6 1.45±0.6 1.75±0.9 ns PTT (sec Percutaneous arterial embolization was fea- sible and successful in patients with a high burden of comorbidities and receiving anti- coagulation therapy. Keywords: bleeding; embolization; hematoma; mortality; patients; rectus; rsh; sheath; therapy
• Epiploic appendages' inflammation: appendagitis. Report of two cases and literature overview by Di Blasi, Aldo; Zulli, Luigi; Viscomi, Antonio; Tricerri, Augusto (2018) - Epiploic appendagitis (torsion) accounts for 1.3% of patients presenting with abdominal pain and constitutes 8.8 cases per million a year in the general pop- ulation.7 Golash et al.8 reported a series of 1,320 cases of acute abdominal pain among which only eight cases were due to acute epiploic appendagitis. First reported in 1959 by T Case,5 epi- ploic appendagitis remain an unusual find- ing often neglected in the differential diag- nosis of acute abdominal pain as reported in a study by van Breda Vriesman et al.,6 where such pathology was included in the clinical differential diagnosis in only two of 49 patients of acute abdomen. Keywords: acute; appendagitis; cases; colon; diagnosis; emergency; epiploic; pain; patients
• A case of esophageal perforation: Clinical and diagnostic management in emergency medicine by Di Serafino, Marco; Martorano, Maurizio; Delmonaco, Pamela; Gullotto, Chiara; Baglioni, Andrea; Martinelli, Leonardo; Savastano, Riccardo; Scarano, Enrico; Lisanti, Francesco (2018) - Esophageal perforation often exhibits large clinical variability in its pres- entation (chest/neck pain, dysphagia, hematemesis, pleural effusion, pneumome- diastinum, subcutaneous emphysema, empyema, peritonitis and sepsis can fre- quently be found), representing therefore a diagnostic and therapeutic challenge because of the rarity of the condition and its variability in the presentation. +39.0971613315 - Fax: +39.0971613315 E-mail: marcodiserafino@hotmail.it Key words: Esophageal perforation, pneumo- mediastinum, pneumothorax, subcutaneous emphysema. Keywords: body; case; chest; diagnosis; esophageal; esophagus; management; patients; perforation; surg; treatment
• A rare cause of acute abdominal pain by Bozzano, Viviana; Aseni, Paolo; Di Domenico, Sandro; Colombo, Riccardo; Corciulo, Mariella; Bellone, Andrea (2017) - Key words: acute abdominal pain; emergency department; renal artery thrombosis; liver transplantation. Renal artery thrombosis is a rare and misdiagnosed condition, but for its severity and its possible dramatic consequences, physician should consider it in the differen- tial diagnosis of acute abdominal pain. Keywords: acute; artery; emergency; pain; patients; thrombosis
• Current application of high flow oxygen nasal cannula in acute hypoxemic respiratory failure in the emergency department by Bottani, Giulia; Centurioni, Fabio; Veronese, Giacomo; Vincenti, Fabrizio; Forni, Elisa; Bellone, Andrea (2018) - E-mail: andrea.bellone@ospedaleniguarda.it Key words: hypoxemic respiratory failure; high flow oxygen nasal cannula; emergency medicine. High flow oxygen with nasal cannu- la vs conventional oxygen therapy Oxygenation and gas exchange Most studies investigating HFONC effect and comparison to other oxygenation techniques focus on PaO2 and its deriva- tives PaO2/FiO2 (P/F) and peripheral oxy- gen saturation (SpO2).15 The vast majority of the studies, mostly prospective and observational, showed a sharp statistically significant benefit of HFONC versus COT in PaO2 after treatment.15,16,20-23 Oddly, the better designed and with higher population- enrolled study (FLORALI study,24 multi- center randomized and controlled) is the only one showing a slight but significant superiority of COT after 6 hours on gas exchanges. Keywords: cannula; care; cot; failure; flow; hfonc; high; nasal; nimv; oxygen; patients
• Antidotes in Depth | Pavia, 2012-2017 by Buscaglia, Eleonora; Locatelli, Carlo (2017) - 3) e il timing di rimozione (tab. 4). La rimozione delle vittime dalla zona rossa deve essere immediata, la decontaminazione in caso di esposizione alla sola forma gassosa non è necessaria e il rischio di contaminazione secondaria assente (per la sola esposizione a gas). Keywords: abuse; accumulo di; acid; acidosis; activity; acuta da; acute; ad un; administration; admission; adr e; al di; alcuni; alla; alle; analysis; anche; anche di; anestesia e; anni di; anni la; antidotes; antiveleni di; antonio e; assenza di; assunzione di; atti; atti dei; attività di; author; azienda; base di; bibliografia; blood; blu di; brain; capacità di; care; careggi; case; case report; casi di; casi è; causa di; cav di; cell; center; centre; centro di; che; che di; che il; che la; che sono; che un; che è; chemical; children; clinica e; clinical; clinico di; cocaine; coma; come; comparsa di; con il; con la; con un; concentration; concentrazione di; conclusions; condizioni di; congressi di; consumo di; control; corresponding; corresponding author; corso di; cronica; cui; cui il; d384; da una; dal; data; dati di; days; deficit di; degli; dei; del; del farmaco; della paziente; della terapia; delle; department; depth; deve; di abuso; di accesso; di adr; di altri; di antidoti; di aritmie; di atropina; di benzodiazepine; di bergamo; di bi; di botulismo; di calcio; di cannabis; di carbonio; di caustici; di circa; di coma; di coscienza; di creatina; di dabigatran; di dio; di edema; di emergenza; di esposizione; di etanolo; di età; di eventi; di fab; di farmaci; di farmacovigilanza; di ferrara; di firenze; di foggia; di fronte; di funzionalità; di gravità; di informazione; di intossicazione; di istamina; di laboratorio; di lesioni; di liquidi; di litio; di medicina; di methb; di metilene; di milano; di olio; di origine; di osservazione; di ossigeno; di padova; di patologie; di pavia; di pediatria; di peso; di prima; di pronto; di questo; di riferimento; di roma; di routine; di salerno; di sanità; di sintomi; di sodio; di sostanze; di specializzazione; di supporto; di sviluppo; di tachicardia; di tale; di terapia; di tipo; di torino; di tossicità; di tossicologia; di tossina; di tre; di un; di uso; di verona; di violenza; di vipera; di vista; di vomito; di warfarin; diagnosi di; diagnosis; die; difficoltà di; discussione; disease; distanza di; donna di; dopo; dose di; doses; dosi; drug; durante la; d’urgenza e; e alla; e biagio; e centro; e con; e da; e degli; e della; e di; e gli; e il; e la; e le; e nel; e non; e più; e pronto; e renale; e rianimazione; e si; e sono; e un; ed è; effects; effetti; email; emergency; era di; erano; esami di; esophageal; essere; essere di; et al; evaluation; evidenza di; examination; experience; exposure; failure; farmacologia e; fascia di; fattori di; fine di; fino; follow; fondazione; foundation; fumo di; function; gastric; ghb; giorni di; giovanni di; grado di; grave; gruppo; hanno; health; history; hospital; hours; human; hypochlorite; il caso; il cav; il centro; il dosaggio; il farmaco; il pronto; il quadro; il ricovero; il trattamento; increase; indici di; infant; information; ingestione di; inoltre; intossicazioni; intoxication; introduzione; irccs; iron; italian; italy; italy corresponding; la diagnosi; la dose; la forma; la gravità; la più; la sintomatologia; la sua; laboratory; lavoro; lesions; levels; life; literature; lithium; livelli di; livello; liver; locatelli; l’insorgenza di; l’uso di; l’utilizzo di; management; mancanza di; manifestations; maugeri e; mcg; medica e; medical; medicine; medico; mese di; mesi; metabolic; metal; metformin; methods; mg di; mg e; mmhg; modalità di; monitoraggio; monossido di; months; morso di; national; nausea; nazionale di; necessità di; nei; nel; nella; new; non; non sono; non è; norma; obiettivo; objective; operativa di; oral; ospedale; ospedaliera; ospedaliera di; overdose; pain; parte di; particolare; patients; paziente di; paziente è; pazienti; pazienti con; percentuale di; perdita di; più; più di; poisoning; policlinico di; possibile; possibilità di; possono; presente; presenza di; presso il; presso la; prodotto; produzione di; progetto di; ps di; punto di; può; quadro di; quali; quantità di; quanto; quello di; questi; quindi; rabies; range; reaction; reazioni; references; renale; reparto di; report; respiratoria; results; ricerca di; rischio di; risk; risultati; role; scientifico di; scopo di; screening; segnalazioni di; segni di; segni e; seguito; sempre; series; serum; servizio di; severe; severity; si è; sia; signs; sindrome di; soccorso e; sod di; sodium; solo; somministrazione di; sono; sono di; sono il; sono la; sono stati; soprattutto; sospensione di; spesso; stata; stato di; studi di; study; substances; sulla; superiore di; symptoms; syndrome; system; tempo di; tentativo di; terapia con; termini di; test di; tests; therapy; time; tossicologia clinica; toxicity; toxicology; tra la; treatment; type e; un caso; una; unit; universitaria di; university; università di; uomo di; urine; use; valori di; valutazione; vengono; vi è; viene; violenza; water; weight; years; è da; è di; è il; è la; è stato; è un
• A call to improve delirium care: the Italian experience by Paolillo, Ciro; Ricevuti, Giovanni (2018) - A call to improve delirium care: The Italian experience Ciro Paolillo,1 Giovanni Ricevuti2 1Emergency Department, University Hospital of Udine; 2Geriatrics and Emergency Medicine, University of Pavia, Italy Thousands of tiny little creatures, some on horseback, waving arms, carrying weapons like some grand Renaissance bat- tle, were trying to turn people into zombies. Another reason is that excellence in delirium care is not gen- erally considered to be a core element of the skills of a physician. Keywords: care; delirium; diagnosis; hospital; patients; treatment
• Intranasal ketorolac and opioid in treatment of acute renal colic by Etteri, Massimiliano; Maj, Marta; Maino, Carlo; Valli, Riccardo (2018) - There is evidence in the literature that minimum clin- ically significant difference in pain scores on visual analogue scale is 1,3 cm.7,8 Secondary outcomes were the occurrence of adverse events and use of rescue therapy. Pain score after intravenous and intranasal treatment. Keywords: fentanyl; group; intranasal; ketorolac; pain; patients; renal
• Evaluation of the use of analgesics for blunt thoracic trauma in the accident and emergency department by Valli, Riccardo; Maino, Carlo; Etteri, Massimiliano; Maj, Marta (2018) - In consideration of the fact that inade- quate pain treatment may favor the insurgence of complications of blunt thoracic trauma, it is necessary to increase our efforts to improve the quality and timeliness of pain therapy in the ED. Pain relief therapies administered upon entrance in the ED and those prescribed to patients dis- charged within 24 hours of acceptance were analyzed. Keywords: emergency; pain; patients; study; therapy; thoracic; trauma
• A three-step approach to patients with suspected acute diverticulitis in the emergency department: An interdisciplinary algorithm proposal by Paolillo, Ciro; Sartelli, Massimo; Miele, Vittorio; Ansaloni, Luca; Valentino, Massimo; Merli, Cecilia; Coccolini, Federico; Toso, Francesco; Madia, Carmelo; Catena, Fausto (2018) - [Emergency Care Journal 2018; 14:7339] Emergency Care Journal 2018; volume 14:7339 Abstract Patients with acute abdominal pain due to acute colonic diver- ticulitis are a frequent cause of hospital admission. Aim of this review authored by a small group of emergency physicians, radiologists and surgeons with expertise in acute abdominal pain is focused on a multimodal and collaborative approach for treatment of patients suspected of AD. Keywords: acute; colon; colonic; diagnosis; disease; diverticulitis; emergency; pain; patients; treatment
• Characteristics of patients hospitalised in an emergency department observation unit in Japan by Mitsunaga, Toshiya; Ohtaki, Yuhei; Kiriyama, Nobuaki; Ohtani, Kei; Yajima, Wataru; Hibi, Takahiko; Takeda, Satoshi (2018) - If they cannot recruit a hospital in the region, then they contact an emergency medical coordinator at the Tokyo Fire Department, who will contact other regional emergency medical centres for a hospital that can accept the patient.9 In 2011, difficult cases of transport totalled 14,449, which was roughly a third of the total in 2008 (35,746).9 Although adherence to the Tokyo Rule affords some benefits, its overall effects have been limited.9 The keywords of difficult cases of transport have been not only orthopaedics, alcohol and mental illness but also elderly patient, which indicates that the problems of elderly patients in obtaining transport to emergency medical facilities in Japan persist.9 Emergency department observation unit In the United States and some other developed countries, where the massive number of patients who present at emergency departments has also become a serious problem,10,11 hospitals have introduced emergency department observation units (EDOU) in order to not only manage emergency departments safely and smoothly but also reduce the number of cases requiring hospitali- sation.12 Although many hospitals in Japan have introduced EDOUs as well, their usefulness in managing elderly patients remains unclear. Hrev_master Abstract In Japan, transporting elderly patients to emergency depart- ments has recently posed serious problems, including a longer average time from patients’ initial emergency calls to their arrival at hospitals. Keywords: department; edou; emergency; hospital; japan; patients; trauma; years
• Penetrating cardiac stab wounds: A case report with management algorithm and review of the literature by Grande, Antonino M.; Antonacci, Filippo; Aseni, Paolo (2018) - One hundred five penetrating cardiac injuries: a 2-year prospective evaluation. Degiannis E, Loogna P, Doll D. Penetrating cardiac injuries: recent experience in South Africa. Keywords: cardiac; chest; emergency; injuries; injury; patients; penetrating; trauma; wounds
• A case of lockjaw in the emergency department by Marullo, Giulia; Bottani, Giulia Maria; Guerrieri, Rossella; Basile, Adriano; Aseni, Paolo; Bellone, Andrea (2018) - Moreover, post surgical tetanus develops quickly, usually within 24 hours.3,6 Perfectly mimicking tetanus, strychnine poisoning could be another possible causative agent of muscle spasms and trismus in the absence of alteration of mental status but this condition is char- acterized by an acute onset, a generalized spread of the spasms and a rapid, often fatal course of the disease if not treated.1 Clinical course During some hours of observation in the Emergency Department the patient remained symptomatic for painful contrac- tions of facial muscles and strong lockjaw. A dose of 500 UI Human Tetanus Immunoglobulin (HTIG) was given intramuscularly along with a single dose of tetanus vaccine with tetanus toxoid. Keywords: care; case; department; disease; dose; emergency; patients; tetanus
• Management of syncope in the emergency department based on risk stratification by Reed, Matthew James (2018) - Syncope clinical man- agement in the emergency department: a consensus from the first international workshop on syncope risk stratification in the emergency department. Syncope Evaluation in the Emergency Department Study (SEEDS): a multidisci- plinary approach to syncope management. Keywords: department; emergency; heart; hospital; management; med; patients; risk; stratification; syncope
• Management of transient loss of consciousness in emergency department: what’s new from 2018 European Society of Cardiology guidelines? by Brignole, Michele (2018) - In practice, following Table 1, the majority of patients affected by unexplained syncope, who usually are admitted for diagnostic purposes, can safely be managed in ED syncope observation unit and in syncope out-patient unit instead of being hospitalized. The doc- ument gives strong focus to pathways and organizational issues In particular, the guidelines propose a care pathway for management of the patient with TLOC from their arrival in the ED, and give practical instructions on how to set up outpatient syncope clinics (syncope units) aimed at reducing hospitalization, under- and mis- diagnoses, and costs. Keywords: department; emergency; patients; risk; syncope; unit
• Prone positioning in severe acute hypoxemic respiratory failure in the emergency ward by Bellone, Andrea; Basile, Adriano (2018) - Prone position also improves resting lung volumes in dorso-caudal regions by reducing the superimposed pressures of both heart and abdominal organs.1-3 The final result of prone positioning in most subjects with acute hypoxemic respiratory failure due to severe pulmonary consolidation is to exhibit mild to dramatic improve- ments in oxygenation. This case highlights the usefulness of prone positioning as a complementary treatment of acute hypoxemic respiratory failure due to pneumonia in addition to HFNC and BiPAP in an Emergency Medicine Ward. Keywords: care; emergency; failure; patients
• Syncope in the older patient: initial evaluation and Emergency Department management according to 2018 European Society of Cardiology guidelines by Ungar, Andrea; Rafanelli, Martina (2018) - A history of heart disease is an independent predictor of cardiac syncope with a sensitivity of 95% and specificity of 45%.23 In particular, cardiac syncope should be suspected in patients with known or suspected left ventricular systolic dysfunction, valvular disease, left ventricular outflow tract obstruction, in those with an abnormal surface electrocardiogram (ECG) and where the clinical context and concomitant investigations suggest pulmonary embolism. Brady- and tachy-arrhythmias are the most common cardiac causes of cardiac syncope. Keywords: cardiac; diagnosis; et al; evaluation; falls; management; patients; risk; syncope
• Trauma-induced coagulopathy. A narrative review of goal-directed hemostatic resuscitation by Pigna, Federica; Lippi, Giuseppe; Saronni, Simone; Cervellin, Gianfranco (2018) - [page 99] Unlike the previous studies, Tapia et al. separated blunt from penetrating trauma patients, concluding that TEG-guided resusci- tation was similar to standardized massive transfusion protocols in blunt trauma patients receiving 6 units or more of red blood cells and in penetrating trauma patients receiving 10 units or more of red blood cells. Wang et al., Retrospective 80 TEG 32 15 9±10 2.9±4.8 5±6 13.6±14 8.8±10.6 201737 86 28 10 4±7 0.4±1.5 1±5 19±16 14±12 ISS, Injury Severity Score; RBC, red blood cells; PLT, platelets; FFP, fresh frozen plasma; ICU, intensive care unit; LOS, length of stay; pts, patients; TEG, thromboelastogram; ROTEM, thromboelastography. Keywords: blood; care; et al; group; mortality; patients; resuscitation; studies; teg; transfusion; trauma
• High-risk electrocardiogram patterns in patients with syncope managed in the emergency department by Tomaino, Marco; Unterhuber, Matthias; Del Rosso, Attilio (2018) - Risk of fatal arrhythmic events in long QT syndrome patients after syncope. In patients affected by syncope the evidence of BBB is highly suggestive for cardiac syncope. Keywords: block; clinical; ecg; figure; patients; risk; study; syncope; ventricular
• Brain natriuretic peptide and high-sensitivity Troponin at 3 hours post emergency department attendance with unexplained syncope predict 90 day outcome by Reed, Matthew James; Brutin, Hannah; Grubb, Neil R.; Lang, Christopher C.; Gray, Alasdair J.; Simpson, Kirsty; MacRaild, Allan; Weir, Christopher J. (2018) - Discussion This study has shown that BNP is associated with adverse out- come in ED syncope patients whose underlying cause is unknown after ED assessment. I predict signifi- cant arrhythmia, symptomatic significant arrhythmia and 90 day- outcome (death and/or MACE) in unexplained ED syncope patients. Keywords: admission; arrhythmia; bnp; cardiac; hours; outcome; patients; sensitivity; significant; study; syncope; troponin; value
• The Acute Abdomen Decision Making course for the initial management of non traumatic acute abdomen: A proposition of the World Society of Emergency Surgeons by De Simone, Belinda; Ansaloni, Luca; Sartelli, Massimo; Coccolini, Federico; Paolillo, Ciro; Valentino, Massimo; Ricci, Giorgio; Catena, Fausto (2019) - Abstract The Acute Abdomen Decision Making course® (AADM®) was developed by the World Society of Emergency Surgeons (WSES) members with the purpose to teach a systematic and con- cise method for approaching acute abdomen patient. Imaging patients with acute abdominal pain. Keywords: aap; abdomen; abdominal; acute; care; diagnosis; disease; emergency; examination; imaging; non; pain; patients; trauma
• Abbreviated National Early Warning Score predicts the need for hospital admission and in-hospital mortality in elderly patients by Mitsunaga, Toshiya; Hujita, Masahiko; Hasegawa, Izumu; Otani, Kei; Okuno, Kenji; Ohtaki, Yuhei; Seki, Yutaka; Mashiko, Kunihiro; Takeda, Satoshi (2018) - [Emergency Care Journal 2018; 14:7771] Emergency Care Journal 2018; volume 14:7771 Abstract The aim of this study was to evaluate the value of the Abbreviated National Early Warning Score (aNEWS) for predict- ing admissions and in-hospital mortality in elderly patients present to Emergency Department (ED). Our single-centred study has demon- strated the utility of the aNEWS as a predictor of patient admission and in-hospital mortality in elderly patients. Keywords: admission; anews; hospital; mortality; patients; score; study; warning
• Multicenter survey on emergency nurses’ perception of Numerical Rating Scale reliability at triage time in adult Emergency Department patients by Cervellin, Gianfranco; Comelli, Ivan; Bellone, Andrea; Giostra, Fabrizio; Acierno, Nicoletta; Mitaritonno, Michele; Paolillo, Ciro; Mastroianni, Fabrizio; Pistorello, Matteo; Rastelli, Gianni; Ricci, Giorgio; Tenci, Andrea; Caironi, Guido (2018) - The use of pain scales in assessing the efficacy of analgesics in post-operative dental pain. In general, triage nurses believe that NRS is only indicative and that their judgement matters (item 4, mode = 4, mean = 3.2). Keywords: department; emergency; item; mean; nrs; pain; patients; scale; triage
• Determinants of troponin T and I elevation in old patients without acute coronary syndrome by Di Micoli, Antonio; Scarciello, Chiara; De Notariis, Stefania; Cavazza, Mario; Muscari, Antonio (2019) - In both groups were examined the patients with normal troponins (cTnT<14 ng/L and cTnI<40 ng/L) and those with high troponins in absence of Acute Coronary Syndrome (cTnT>14 ng/L and cTnI> 40 ng/L). In fact, as the age increas- es, the percentage of patients with high troponin in the absence of ACS is increased. Keywords: age; cardiac; ctni; ctnt; elevation; patients; study; troponin
• A ripping bike race: spontaneous coronary dissection complicated by cardiac tamponade, unmasking vascular Ehlers-Danlos in a young man by Hendrickx, Inne; Scott, Benjamin (2019) - E-mail: Benjamin.scott@zna.be Key words: Spontaneous coronary artery dissection; Cardiac tampon- ade; Ehler-Danlos syndrome. Tweet M, Hayes S. Clinical features, management and progno- sis of spontaneous coronary artery dissection. Keywords: artery; danlos; dissection; patients; syndrome; vascular
• Critical issues of Emergency Medicine organization in Italy by Coen, Daniele; Casagranda, Ivo (2018) - In this context, emergency physicians have been asked to con- trol even more strictly the number of patients they admit, and to follow for a longer time acute patients waiting for an inpatient bed. In many hospitals this has brought about the development of intermediate care units, where emergency physicians take care of patients not so unstable to deserve an ICU bed, and yet sufficiently acute to require strict monitoring and aggressive treatment. Keywords: acute; care; emergency; hospital; medicine; patients
• An Italian pediatric case series of Maldive-imported dengue fever by Dondi, Arianna; Gottardi, Francesca; Fabi, Marianna; Attard, Luciano; Rossini, Giada; Re, Maria Carla; Lanari, Marcello (2019) - In Emilia Romagna (Northern Italy), an active regional sur- veillance program was established in 2007 to guarantee early diag- nosis of Dengue infections in individuals returning from high-risk areas.11 In 2010, the frequency of Dengue infection was estimated 20.5% in febrile patients returning to Emilia Romagna from endemic areas.11 Considering that A. albopictus density is high in most of the region in the summer and that local Dengue transmission has been reported in a French region with a compara- ble environment, prevention of local outbreaks was one of the rea- sons for hospital admission of patients during viremia. These features are typical of Dengue infection and in our cases were self-limited with similar timing of nadir (Figure 1). Keywords: case; children; day; dengue; fever; infection; italy; patients
• A health economic evaluation of using N-terminal pro brain natriuretic peptide for the management of acute heart failure: A pilot study in an Indonesian tertiary referral hospital by Almazini, Prima; Siswanto, Bambang Budi; Meyer, Markus; Nadjib, Mardiati; Firdaus, Isman; Fuady, Ahmad; Antonini, Paola; Di Somma, Salvatore (2019) - Introduction Worldwide prevalence of heart failure is continuously increasing due to the extension in life expectancy leading to an increase in patients morbidity and mortality.1,2 In the Asia Pacific region including Indonesia, hospitalized patients with acute heart failure (AHF) are of younger age and present more severe clinical condition when compared to United States (US).3 This suggests a morbidity gap between heart failure patients in Asia Pacific compared to other regions.3,4 In addition to the prevalence, various studies indicate a rise of health problems associated with high rates of rehospitalization and death in patients with heart failure.5 Data from the Acute Decompensated Heart Failure Registry (ADHERE)6 demonstrated that in Asia Pacific region rehospitalization rates of heart failure patients is 29%, with inhospital and 30 days mortality rates 12%6 and 17%,7 respectively. Therefore, a comprehensive efforts to improve management of heart failure patients also in Indonesia is urgently required. Keywords: cost; discharge; failure; group; heart; hospital; medical; n(%; patients; probnp; study
• Hospital admissions for alcohol-related problems in concomitance with weekends, New Year’s Eve and Christmas Eve: Myth or reality? by Lippi, Giuseppe; Ferrari, Anna; Bovo, Chiara; Cervellin, Gianfranco (2019) - Basically, our analysis was based on data retrieved from the local LIS, so that no information was available on drinking patters, reasons underneath alcohol requests and clini- cal picture. In multivariate analysis, younger age, female sex and alcohol testing during New Year’s Eve remained significant predictors of alcohol concentrations >0.1 g/L and >1.0 g/L. Keywords: alcohol; concentration; concomitance; eve; patients; year
• Critical issues and opportunities of emergency psychiatry in Italian emergency departments by Fraticelli, Carlo; Casolaro, Ilaria; Nigro, Massimiliano (2019) - We must change the widespread idea that most patients with urgent mental health presentations require hospitalisation, by implementing effective ways to deliver timely psychiatric care in the ED capable of reducing the prolonged stay of these patients in an unsuited environment (psychiatric boarding phenomenon), in the awareness that it is completely appropriate for emergency psychiatric patients to come to medical EDs because their emergencies must be cate- gorized as equivalent to acute medical or surgical conditions.14 Instead, there is the belief that most patients with potentially lethal psychiatric emergencies such as suicidal risk and psychosis always require hospitalization. In order to cope with the increase in psychiatric urgencies, some countries have organized psychiatric emergency services (e.g. the American Psychiatric Emergency Service) capable of han- dling urgencies that do not require hospitalization and also social problems, drug addiction and/or antisocial behaviour, through col- laboration with other professionals. Keywords: care; conditions; disorders; emergency; health; italy; mental; patients; psychiatry; services; treatment; violence
• Efficacy and tolerability of fixed association of oxycodone and naloxone in elderly patients with ribs fracture: An 18-month retrospective study by Riccardi, Alessandro; Spinola, Beatrice; Minuto, Pierangela; Licenziato, Marco; Ghiglione, Valeria; Lerza, Roberto (2019) - When physicians decided to administer NSAIDs or Acetaminophen, due to a lower NPS value reported by patients, we demonstrated a slight increase in NPS at 24 hours, after an initial reduction, and these data confirm that such analgesic could be inappropriate for treatment of a painful condition like rib fractures.2,3 The conse- quences of oligoanalgesia in the elderly are well-known and docu- mented,21,22 and opiophobia (especially in older patients) lead to over-prescription of NSAIDs,6 even when they are contraindicated or ineffective,3-5 with increased renal and gastrointestinal toxicity.27 Acetaminophen has been recommended by most societies and by the World Health Organization as the first-line agent in the treat- ment of mild-to-moderate pain, given its tolerability, nevertheless its poor analgesic efficacy in severe pain limits its utilization.28 The efficacy of oxycodone-naloxone are well documented, even in eld- erly people.23,24 Our study confirms also the good tolerability of the association of oxycodone-naloxone, as seen in literature:16,23,26 [page 79] Efficacy and tolerability of fixed association of oxycodone and naloxone in elderly patients with ribs fracture: An 18-month retrospective study Alessandro Riccardi, Beatrice Spinola, Pierangela Minuto, Marco Licenziato, Valeria Ghiglione, Roberto Lerza Emergency Department, San Paolo Hospital, Savona, Italy Non -co mmerc ial us e o nly [page 80] Keywords: constipation; fractures; naloxone; nps; oxycodone; pain; patients; rib
• Use of ultrasound for the assessment of dehydration in pediatric patients with mild to moderate dehydration by Ravanshad, Yalda; Azarfar, Anoush; Alamdaran, Seied Ali; Naseri, Mitra; Sarvari, Gholamreza; Bagheri, Sepideh; Vahabi Sani, Armin (2019) - Comparing the aorta diameter before and after fluid therapy in patients with mild dehydration, moderate dehydration and overall, using Wilcoxon paired t-test shows that aorta diameter is not sig- nificantly changed after fluid therapy (Table 1). Based on clinical scales, 69.44% percent of patients (25 patients) had mod- erate dehydration, and 30.56% (11 patients) had mild dehydration. Keywords: aorta; children; dehydration; diameter; fluid; ivc; patients; therapy
• Transient global amnesia: Isolated event or healthy predictor? Clinical experience of an Italian Emergency Department by Barbieri, Greta; Cipriano, Alessandro; Luly, Simona; Del Nista, Viola; Orsitto, Eugenio; Santini, Massimo (2019) - Patients were asked whether the TGA episode was the first, and, if it had not been, the number and the indicative date of the other previous episodes were asked, the presence of head trauma prior to TGA episode, current therapy, events precipitating the episode, presence of associated symptoms. Materials and Methods A cohort study was conducted at the ED of the University Hospital of Pisa on patients with TGA diagnosis (hospitalized, dis- charged or under observation patients) in the period from January 1, 2010 to December 31st, 2014, subjected to subsequent follow- up evaluation with a telephone interview. Keywords: age; amnesia; disease; emergency; episodes; factors; patients; study; tga; transient; years
• qSOFA score and LqSOFA score as predictors of outcome in an elderly population with chest infection treated in the Emergency Department. A case series by Velissaris, Dimitrios; Karamouzos, Vasileios; Pantzaris, Nikolaos Dimitrios; Kakoullis, Loukas; Pierrakos, Charalampos; Karanikolas, Menelaos; Gogos, Charalampos (2019) - Although the majority of publications show that qSOFA score has better accuracy than SIRS criteria for pre- dicting mortality in the non-intensive care unit (ICU) environment,9,10 there is ongoing debate regarding its usefulness because of poor sensitivity.11 Α meta-analysis published by Jiang et al. in 2018 attempted to compare the qSOFA score with the SIRS criteria and determine the accuracy of the qSOFA score in predict- ing mortality in ED patients with infections and showed that although qSOFA score ≥ 2 and SIRS score ≥ 2 were both strongly Article Figure 1. Discussion and Conclusions In this study, we assessed the predictive value of the qSOFA and the calculated LqSOFA score in a prospective case series of sepsis patients with chest infection. Keywords: analysis; emergency; lactate; mortality; patients; qsofa; score; sepsis; study
• Actions speak louder: Young female patients with acute ischemic stroke in the emergency department by Saban, Mor; Shachar, Tal; Patito, Heli; Zaretsky, Lev (2019) - Conclusions Young female AIS patients are associated with an atypical presentation that leads to delayed diagnosis and fatal outcomes in the ED. [page 87] Actions speak louder: Young female patients with acute ischemic stroke in the emergency department Mor Saban,1 Tal Shachar,2 Heli Patito,1 Lev Zaretsky1 1Department of Nursing, Faculty of Health and Welfare Sciences, University of Haifa, Haifa; 2Faculty of Medicine, Bar-Ilan University, Safed, Israel Non -co mmerc ial us e o nly Keywords: ais; care; cases; diagnosis; differences; emergency; females; patients; sex; stroke; treatment
• Time from triage to initial physician assessment: A 5-year retrospective analysis by Saban, Mor; Armoni, Nadav; Patito, Heli; Shachar, Tal; Darawsha, Aziz; Lipsky, Ari (2019) - The aim of the study is to examine whether ED physicians and consultants adhere to triage target times for initiating patient care, according to the level of urgency as defined in CTAS. Introduction Triage – initial assessment of patients who present to the Emergency Department (ED) – is aimed at diagnosing and priori- tizing as quickly and accurately as possible the current state of the patient and determining his/her trajectory of care.1-4 To this aim, the triage nurse uses a semi-structured scoring system that catego- rizes the level of clinical urgency of a presenting problem, based on inputs from several sources such as the patient’s subjective complaint, his or her medical background, and initial assessment.5,6 Research in ED triage has focused on the development of reli- able and valid triage scales and the examination of skills of regis- tered nurses in allocating acuity ratings.7-10 Several five-level triage scales for the ED have been developed in Anglophone countries; of these, the Canadian Triage and Acuity Scale (CTAS) is among the most commonly used.8 Keywords: care; department; emergency; evaluation; patients; physician; study; time; triage; urgent
• Is the nasal route a viable option for relieving acute pain in pediatric emergency medicine? A literature review by Aleysae, Nabil Abdulrahman (2019) - The minimum clinically significant differences (MCSD) in pain score, which selected by the authors and considered as the cutoff value for establishing the therapeutic importance of the results, were deemed to be significant when they had achieved. Reduction in pain score All included trials reported significant reductions in pain scores especially within the first 10 to 30 minutes post-interven- tion, however, pain reduction was maintained to 60 minutes in only one study for both intervention agents, IN fentanyl (INF) and IN ketamine (INK).38 Borland et al. Keywords: acute; administration; analgesia; children; emergency; intranasal; minutes; pain; patients; pediatric; review; studies; study; trials
• The role of transcranial Doppler ultrasonography in differential diagnosis of vertigo in the Emergency Department by Siniscalchi, Antonio; Malferrari, Giovanni (2019) - However, in vertigo patients, misdiagnosis can be also related to both inaccurate clinical evaluation,12 and a score of zero to the National Institute of Health Scale of stroke (NIHSS)13-15 as well as an excessive dependence of neuroradiological tests, such as com- puted tomography (CT).3 In a clinical study, a series of questions were asked to patients with vertigo to determine the reliability and consistency of eliminating the quality of symptoms and the timing and triggers of vertigo.16 When the main question was asked again 6 minutes later, half of the patients changed the type of primary vertigo,17 reducing the logic of a diagnostic process based on the type of vertigo.3 Patients with cardiovascular vertigo describe ver- tigo in almost 40% of cases. Patients with benign paroxysmal posi- tional vertigo, commonly elderly patients, often describe non-ver- tiginous vertigo.18,19 Despite these data, most physicians still use a quality symptom approach with vertigo patients regardless of tim- ing and triggers.3 A masked neurologist at the initial ED visit changed the diagnosis during the follow-up in 44% of patients. Keywords: artery; circulation; diagnosis; doppler; emergency; patients; stroke; tccd; transcranial; use; vertigo
• Evaluation of paraclinical methods in diagnosis of Foreign Body and its complications compared to operating room findings in patients with oral, pharyngeal and esophageal symptoms in Amir A’lam Hospital by Erfanian, Reza; Tajadini, Ardavan; Sohrabpour, Saeed; Aghazadeh, Keyvan; Mehdinezhad, Abdolhossein; Karimi, Ebrahim (2020) - This study aimed to evaluate the paraclinical methods in diagnosis of foreign body and its compli- cations compared to operating room findings in patients with oral, pharyngeal and esophageal symptoms. According to the results, foreign bodies diagnosed with lateral neck can be reliable to make a decision based on it in patients with foreign bodies. Keywords: bodies; body; cases; complications; operating; patients; room; study
• Evaluation of stroke related risk factors in wake up and non-wake up stroke patients by Sadeghi-Hokmabadi, Elyar; Shams Vahdati, Samad; Rikhtegar, Reza; Karzad, Nazila; Rezabakhsh, Aysa (2020) - Furthermore, we observed stroke patients with anticoagulant, antiplatelet or contraceptive drugs history but the significant differ- ences could not be detected between patients with WUS and non- WUS. Of 510 patients, 405 (79.4%) had non-WUS stroke (known-onset stroke) and 105 (20.6%) had WUS strokes (unknown-onset stroke). Keywords: factors; history; non; onset; patients; risk; stroke; study; table; wake; wus
• Anticoagulation therapy in older patients at risk for syncopal and not-syncopal fall and/or frailty. An AcEMC-GIMSI multidisciplinary consensus document by Casagranda, Ivo; Ungar, Andrea; Prevaldi, Carolina; Abete, Pasquale; Biagioni, Sergio; Del Rosso, Attilio; Diamanti, Michele; Fanciulli, Alessandra; Fumagalli, Stefano; Furlan, Raffaello; Lerza, Roberto; Locatelli, Carlo; Maggi, Roberto; Mussi, Chiara; Numeroso, Filippo; Rabajoli, Filippo; Testa, Sophie; Tomaino, Marco; Brignole, Michele (2020) - Despite being at an increased risk of thromboembolic events because of non-valvular AF, frail patients appear less likely to receive adequate OAT com- pared with non-frail patients.16-18 Frailty is associated with a higher cardio- and cerebrovascular risk,19 and net clinical benefit of OAT is higher in frail older patients than in non-frail elderly patients.20 For this reason, despite the common clinical practice, frail patients have a clear indication to OAT. Steffel J, Giugliano RP, Braunwald E, et al. Edoxaban versus warfarin in atrial fibrillation patients at risk of falling: ENGAGE AF-TIMI 48 Analysis. Keywords: agreement; anticoagulation; consensus; fibrillation; patients; risk; statement; votes
• STANDING update: A retrospective analysis in the Emergency Department one year after its validation by Ceccofiglio, Alice; Pecci, Rudi; Peruzzi, Giulia; Rivasi, Giulia; Rafanelli, Martina; Vanni, Simone; Ungar, Andrea (2020) - Similarly, another retrospective cohort study analysed data from 500 randomly selected ED patients receiving a diagnostic code related to peripheral vertigo, to assess the use of HINTS (Head Impulse, gaze-evoked Nystagmus, Test of Skew) algorithm and neuroimaging in the evaluation of vertiginous patients.19 Neuroimaging was performed in a significant proportion (36%) of patients, while the HINTS protocol was relatively under-utilized (7%); moreover, when the HINTS was used, it was often inappro- priately applied and ambiguously interpreted. Our study showed that the STANDING algorithm is under- used, being performed only in the 18% of patients. Keywords: department; dizziness; emergency; n,%; nystagmus; patients; standing; study; vertigo
• Oxygen therapy practices in the acutely ill medical patients: A social media-based nationwide study of clinicians’ preferences and summary of current recommendations by Karlis, George; Barouxis, Dimitrios; Georgiopoulos, Georgios; Mitropoulou, Panagiota; Mastora, Zafeiria; Xanthos, Theodoros (2020) - ©Copyright: the Author(s), 2020 Licensee PAGEPress, Italy Emergency Care Journal 2020; 16:8867 doi:10.4081/ecj.2020.8867 Oxygen therapy practices in the acutely ill medical patients: A social media-based nationwide study of clinicians’ preferences and summary of current recommendations George Karlis,1 Dimitrios Barouxis,2 Georgios Georgiopoulos,3 Panagiota Mitropoulou,4 Zafeiria Mastora,5 Theodoros Xanthos6 1Intensive Care Unit, General Hospital of Rhodes “Andreas Papandreou”; 2Cardiology Department, Laiko General Hospital, Athens; 3Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Greece; 4Queen Alexandra Hospital, Portsmouth, United Kingdom; 51st Department of Intensive Care Medicine, National and Kapodistrian University of Athens, Greece; 6European University Cyprus, School of Medicine, Nicosia, Cyprus Non -co mmerc ial us e o nly ifying opinions on PaO2 versus SaO2 as a preferred oxygenation parameter and preferences of oxygen therapy targets in specific acute clinical scenarios. The aim of this study was to identify healthcare profession- als’ preferences regarding oxygen therapy in common medical emergencies. Keywords: acute; care; doctors; emergency; nurses; oxygen; oxygenation; patients; respondents; sao2; survey; therapy
• Pain management in the emergency department: results from an observational longitudinal prospective study in a second-level urban hospital by Falchi, Anna Giulia; Spadoni, Anna; Blatti, Chiara; Manzoni, Federica; Perlini, Stefano (2020) - Additional data were collected from the medical records in terms of care area, priority code, pain intensity both in triage and during the visit, diagnosis of the type of pain (and in case of post traumat- ic pain all possible details about the trauma), administered therapy (drug, dose, administration and frequency route) and treatment indications, final discharge, follow-up, hospitalization. Pain intensity for the main causes of pain in ED at admission and after visit. Keywords: care; emergency; mean; nrs; pain; patients; study; therapy; times; treatment
• Changing Emergency Department and hospital organization in response to a changing epidemic by Coen, Daniele; Paolillo, Ciro; Cavazza, Mario; Cervellin, Gianfranco; Bellone, Andrea; Perlini, Stefano; Casagranda, Ivo (2020) - ED accesses and admission of COVID-19 patients from ED. The triage of COVID-19 suspected patients should aim to dis- tinguish them into some severity classes. Keywords: care; covid-19; emergency; epidemic; hospital; patients; spo2
• Family ENgagement in Intensive Care Environments (FENICE): A quasi-experimental study protocol by Danielis, Matteo; Palese, Alvisa; Terzoni, Stefano; Destrebecq, Anne (2020) - Secondly, the results of this study might have the potential to provide a better understanding of how families may modify patients’ outcomes and whether family members would benefit from an involvement program. Sampling and sample This study will involve two groups of family members of patients who will be admitted to two ICUs. Keywords: care; data; family; group; icu; intervention; involvement; members; patients; satisfaction; study; unit
• Role of lung ultrasound in identifying COVID-19 pneumonia in patients with negative swab during the outbreak by Aiosa, Giuseppe; Gianfreda, Romina; Pastorino, Marco; Davio, Piero (2020) - It assumes a great importance in order to select the right path to propose for the patient admitted to ED who, despite having neg- ative results for the nasopharyngeal swab, should instead be direct- ed to protected areas reserved for COVID-19 infected patients avoiding further spreading of the infection within the hospital wards and reducing exposure to the virus by healthcare profession- als. Figure 21C. On the left side, small subpleural nodules from which B lines are generated, thickened pleural line with a rough surface. Keywords: covid-19; figure; imaging; lung; patients; pneumonia; right; thickening
• COVID-19 outbreak and impact on mental health and psychiatric services by Fraticelli, Carlo; Alamia, Alberto; Guanella, Ester (2020) - Mental health in healthcare workers Healthcare workers taking care of the most severe cases in ICU and COVID units are continuously experiencing substantial psy- chological distress. The huge amount of work overload, isolation and fear for personal and relatives safety is exposing them to a high risk of mental health problems.6 Frequently reported symptoms among nurses and physicians are depression, anxiety, insomnia, and emotional distress. Keywords: care; covid-19; health; healthcare; patients; risk; workers
• Caustic ingestion in children: A 6-year retrospective study by Lovera, Cristina; Castagno, Emanuele; Bondone, Claudia; Ricceri, Fulvio; Urbino, Antonio F. (2020) - Endoscopic follow-up was correctly performed in all the patients with grade III lesions; it was performed also in 7/11 patients with grade II lesions (63.64%) and in 1/10 with grade I lesions (10%) even if not strictly indicated (p< 0.0001). Among the 9 children who underwent EGD with only 1 symptom, 7 (77.78%) had ingested alkaline agents; 4/9 (44.44%) showed grade I lesions (2 reported prolonged vomiting, 1 stom- achache and 1 oral lesions), 3/9 showed grade II lesions (1 with prolonged vomiting, 1 with hematemesis and 1 with dysphagia) and 2/9 children showed grade III lesions (both with prolonged vomiting). Keywords: accidental; cases; children; egd; grade; iii; ingestion; lesions; patients; study; symptoms
• Outcome at three months of COPD patients with acute hypercapnic respiratory failure treated with NPPV in an Acute Medicine Ward by Vincenti, Fabrizio; Basile, Adriano; Contro, Ernesto; Galbiati, Filippo; Oppizzi, Angela; Restelli, Elisabetta; Sommariva, Maurizio; Coen, Daniele (2011) - 5 emergency care journal Outcome at three months of COPD patients with acute hypercapnic respiratory failure treated with NPPV in an Acute Medicine Ward Fabrizio Vincenti*, Adriano Basile*, Ernesto Contro*, Filippo Galbiati*, Angela Oppizzi**, Elisabetta Restelli §, Maurizio Sommariva §, Daniele Coen*. Only 2 of the 15 patients who died underwent OT intubation Table 1 Baseline characteristics of the cohort of COPD patients admit- ted for AHRF Number of patients 57 Sex (M:F) 36:21 Age (mean) 73.7(+9 ) LTOT before index event 24 (42.1%) Keywords: ahrf; copd; failure; hospital; non; nppv; patients; treatment; ventilation
• Frequency of polypharmacy and drug interactions in inpatients in the emergency department, Southwest of Iran by Tahmasebivand, Mobina; Barzegari, Hassan; Izadpanah, Mandana (2021) - It also doubles the importance of predicting drug interactions and how to treat them.10 Many drug interactions are predictable, and many of them can be prevented. Abstract This study aimed to evaluate the polypharmacy extent and the frequency and severity of drug interactions by evaluating inpa- tients in the emergency department. Keywords: department; drug; drug interactions; emergency; interactions; number; patients; polypharmacy; study
• An acquired acute methemoglobinemia from dietary sources: Case reports and literature review by Mauro, Angela; Parente, Iolanda; Gagliardo, Thailjlia; Bonadies, Anna; Mancusi, Raffaele; Tipo, Vincenzo; Ponticiello, Eduardo (2021) - Acute diarrhea may also cause oxidation of hemoglobin to methemoglobin (Table 1).2 Although Acquired methemoglobinemia has been well described before, this represents a challenging condition for any clinicians. We present two cases of acquired methemoglobinemia related to nitrate ingestion from a vegetable source, in order to remind practitioners that the acute onset of cyanosis can depend on other factors than cardiovascular and/or respiratory disease. Keywords: blood; blue; case; child; cyanosis; emergency; levels; methemoglobinemia; patients
• Social distancing and dangers of access block to health care services during COVID-19 pandemic by Saban, Mor; Shachar, Tal (2020) - Illustration of COVID-19 effect on medical care access; A. Flow of routine medical care, B. Alterations in medical care during COVID-19 pandemic. Introduction The global pandemic of the coronavirus outbreak is putting unprecedented pressure on health care systems, with hospitals in the worst affected areas close to breaking point. Keywords: care; covid-19; emergency; health; patients; population; risk
• Antidotes in Depth 2010. Clinical Toxicology, Substances of Abuse and Chemical Emergencies by Editors, The (2011) - Infine, i destinatari delle comunicazioni di output possono essere selezionati sulla base della competenza e della responsabilità che essi hanno in tema di tutela e promozione della salute pubblica, nonché sulla base del carattere della comunicazione e della loro localizzazione geografica. Un ruolo importante per la raccolta delle informazioni è svolto anche dalle unità operative per il monitoraggio della stampa locale e nazionale e per il moni- toraggio della rete Internet, su cui circolano spesso informazioni relative al commercio in rete delle sostanze e alle nuove abitudini assuntive riportate dai consumatori stessi. Keywords: abuse; acidosis; acute; alla; alle; altri; anche; anni; antidotes; antidoti; azienda; base; care; case; casi; caso; centro; che; che il; chemical; circa; clinical; clinico; con; con un; control; copyright; cui; cyanide; da copyright; da sostanze; dal; data; dati; degli; dei; del; della; dell’editore; depth; di un; diagnosi; dipartimento; dopo; dose; drugs; d’abuso; d’urgenza; e della; e il; e la; effects; effetti; elettronicamente; emergencies; emergency; emergenza; essere; giorni; gli; hanno; il paziente; il sistema; information; intossicazioni; intoxication; irccs; levels; livello; l’autorizzazione; m ar; materiale; maugeri; medicina; metformin; nazionale; nei; nel; nelle; non; nostro; o distribuire; ospedale; ospedaliero; paroxetine; parte; patients; pavia; pazienti; più; poisoning; prima; pronto; protetto; protetto da; può; quali; questo; quindi; report; riferimento; rischio; scritta; senza; si è; sia; sistema; soccorso; solo; somministrazione; sono; sostanze; stato; stato di; strutture; studio; substances; syndrome; terapia; test; therapy; tipo; tossicologia; toxicity; toxicology; trattamento; treatment; tutti; una; unit; university; vengono; viene; w .e; w w; è stato
• Immunodepression COVID-19-related as a promoting factor for severe Pseudomonas sepsis in an infant with not respiratory symptoms by Zenzeri, Letizia; Giannattasio, Antonietta; Zito Marinosci, Geremia; Ponticiello, Eduardo; Iodice, Margherita Raffaella; Vitullo, Maria Erennia; Tipo, Vincenzo (2021) - According to World Health Organization (WHO) recommendations, during this pandemic our hospital ensures that Covid-19 patients can access life-saving treatment, without compromising public health objectives and safety of health worker.6 Care for all suspected and confirmed Covid-19 patients is provided in the designated treat- ment area, according to disease severity and acute care needs. Moreover, in Covid-19 patients, C-reactive protein and procalcitonin levels are often normal and a level of procalcitonin >0.5 ng/mL usually suggests a bacterial co-infection.11 In our case, clinical improvement with empiric antibiotic therapy and laborato- ry results at baseline strongly suggested a bacterial etiology, sub- sequently confirmed by blood culture. Keywords: case; children; clinical; coronavirus; covid-19; infection; patients; sepsis
• Acute Pancreatitis: Pathophysiology, Clinical Aspects, Diagnosis e Treatment by Pezzilli, Raffaele; Barakat, Bahjat; Fabbri, Dario; Imbrogno, Andrea; Cavazza, Mario (2011) - [12] suggest that a specialized center for the tre- atment of severe acute pancreatitis should have the following characteristics: The therapeutic approach to severe acute pancreatitis is reported in Figure 4. Keywords: acute; acute pancreatitis; complications; necrosis; pancreatic; pancreatitis; patients; severity; therapy; treatment
• Effectiveness and applicability of Non-Invasive Ventilation (NIV) in the Emergency Department in acute respiratory failure due to Sars-CoV-2 pneumonia by Lari, Federico; Giostra, Fabrizio; Guerrini, Stefania (2020) - This happens because phenotype L patients, by hyperventilating, are able to correct hypoxia thus shifting the hemoglobin dissociation curve to the left due to hypocapnia and respiratory alkalosis. Ventilate in NIV gently with low pressure (PEEP 8-10 cm H2O), even phenotype L patients. Keywords: ards; care; case; clinical; cov-2; lung; niv; non; patients; pneumonia; pressure; sars; ventilation
• COVID-19 pandemic management at the Emergency Department: the changing scenario at the University Hospital of Pisa by Barbieri, Greta; Spinelli, Stefano; Filippi, Matteo; Foltran, Francesca; Giraldi, Mauro; Martino, Maria Carola; Cipriano, Alessandro; Cinotti, Francesco; Santini, Massimo; Ghiadoni, Lorenzo (2020) - Indeed, these areas had to manage a very high number of COVID patients possibly caused by people originating from Lombardy movement to the coast in the 1st week- end of March.17 Alternately, the management of Northwest Tuscany area hospitals did not react promptly to the increase flow of COVID-19 patients to their EDs. Guidelines for management of COVID-19 patients in Tuscany by expert panel (including MS and LG) were released.11 On February 24th, Hospital Task Force for COVID-19 emer- gency management was activated at University Hospital of Pisa. Keywords: area; care; covid-19; emergency; hospital; hospitalization; italian; management; march; patients; pisa; university
• Intravenous access placement and fluid administration appropriateness in the emergency department by Salvetti, Massimo; Paini, Anna; Colonetti, Efrem; Mutti, Claudio; Bonetti, Silvia; Broggi, Alberto ; Bertacchini, Fabio; Muiesan, Maria Lorenza (2021) - In 99 % of patients PVCs were used at least once. Periard et al. have compared PVC and PICC in admitted patients, computing a total cost of 237 US$ for PVCs, and 690$ for PICCs; this difference was mainly due to PICC components being more expensive, and the need for angiography for placement.14 A study by Tandale et al. Keywords: administration; blood; emergency; fluid; patients; placement; pvc; pvcs; study
• First National Congress Great, Italy. Rome, 19-21 October 2010 by Editors, The (2011) - The aim of this study was to assess the prevalence of patients at risk of VTE in our Emergency Medicien Division, to determine the proportion of these hospital setting at risk patients who receveid prophylaxis as raccomended by the American College of Chest Physician (ACCP 2008) evidence based consensus guidelines, and to analyze the reason of an eventual prophylaxis underuse in these populations of patients. In recent years biomarkers have greatly improved the diagnosis and risk stratification of cardio- vascular diseases, but there are still unmet needs especially for a symptom-oriented early evaluation of emergency patients. Keywords: acute; admission; blood; cancer; chest; clinical; con; congresso; control; copyright; data; days; dei; del; della; dell’editore; department; di medicina; diagnosis; disease; dyspnea; elettronicamente; emergency; emergency department; evaluation; failure; gn o; group; guidelines; heart; hospital; italia; italy; lung; l’autorizzazione; management; materiale; medical; medicina; nazionale; non; o distribuire; ottobre; pain; patients; pazienti; pct; probnp; protetto; pulmonary; results; rischio; risk; roma; scritta; senza; sono; stati; study; symptoms; system; tra; treatment; una; university; w .e; w w; years
• The use of the biomarker “copeptin” for the diagnosis of acute chest pain in the Emergency Department by Conti, Elisa; Guidi, Marcello; Mario, Cavazza (2011) - In our study we included cases of chest pain less selected from the clinical point of view in order to test the usefulness of the marker in a larger variability of patients with this symptom, characteristic of the Italian Emergency Department. 9 The use of the biomarker “copeptin” for the diagnosis of acute chest pain in the Emergency DepartmentÊ Elisa Conti, Marcello Guidi, Mario Cavazza Emergency Department, University Hospital of Bologna - S. Orsola-Malpighi L’obiettivo dello studio è di verificare se la determinazione delle copeptina, in associazione alla negatività dei valori della tropo- nina, è in grado di accelerare la diagnosi di esclusione di infarto miocardico acuto (IMA) in pazienti con dolore toracico. Keywords: acute; chest; copeptin; diagnosis; group; nccp; nstemi; pain; patients; troponin
• RAPID score in Covid-19 patients: a clinical-radiological index for the safe discharge from the Emergency Department. A preliminary report by Vaccher, Filippo; Paolillo, Ciro; Di Meo, Nunzia; Ramanzin, Marco; Ravanelli, Marco; Maroldi, Roberto; Farina, Davide (2020) - Early identification of signs of severe illness, such as bilateral pneumonia, allows prompt initiation of optimized treat- ments.2,3 Currently, there are no guidelines supporting the decision between discharge and hospitalization in Covid-19 patients. The aim was to identify SD criterion in Covid-19 patients. Keywords: care; clinical; coronavirus; covid-19; cxr; disease; patients; score; symptoms
• Peripheral Iintravenous cannula usage in the Emergency Department by Stanley, Adam K.; Barnett-Vanes, Ashton; Reed, Matthew J. (2020) - The NHS spends an estimated £29m of its annual acute sector budget on PIVC procurement3 and around 70% of all hospi- talised patients require at least one PIVC during their stay.4 Despite their extensive and routine use, PIVC failure rates are reported as high as 50-69%.5-7 In addition, many PIVCs remain unused follow- ing insertion, particularly in the Emergency Department (ED).8,9 The risk factors for PIVC failure are not well understood and the literature has found extensive regional variation in practice when it comes to PIVC insertion and management.1,7,10 While various tech- nologies have been developed to address these issues, there remains a need for standardised, evidence-based guidelines. Overall, our findings highlight the prominence of PIVC failure and together with other published research can begin to inform the development of standardised guidelines, essential to control the extensive varia- tion in practice and high PIVC failure rates. Keywords: emergency; failure; insertion; patients; pivc
• Covid-pandemia: Learning from mistakes during the pandemic? by Bellone, Andrea (2020) - Those who acted early, differentiating routes within the Emergency Department (EDpt), creating different areas with vary- ing intensity of care; those who were quick in converting areas of mid-intensive care into Sub-Intensive Care Units (SICU) where to allocate only patients in need of non-invasive ventilation; those who quickly converted internal medicine areas into Covid-19 med- icine ones; those who converted SICU into Intensive Care Units (ICU); those who created new ICUs; ultimately, those who adapted hospitals to handle both the extraordinary pressure that hit Emergency Rooms (ERs) and many critical patients (yellow and red codes) still coming in, keeping ERs decongested and therefore able to work safely, guaranteed a fair treatment for all patients and probably improved the prognosis. A large proportion of patients concentrated in the ER, where they began to be oxy- genated and non-invasively ventilated. Keywords: care; emergency; health; hospital; patients
• A simple tool to help ruling-out Covid-19 in the emergency department: derivation and validation of the LDH-CRP-Lymphocyte (LCL) score by Giamello, Jacopo Davide; Paglietta, Giulia; Cavalot, Giulia; Allione, Attilio; Abram, Sara; Dutto, Luca; Bernardi, Sara; Bernardi, Emanuele; Tosello, Francesco; Lauria, Giuseppe (2020) - Alterations in the components of the LCL score are common to many serious presentations at the ED, but the presence of all the three items could characterize Covid-19 patients, and most of all their absence (i.e. LCL score = 0) could rule-out SARS-CoV-2 infection in the presence of a previous negative swab. Thus, a way to quickly discriminate ED patients with potential Covid-19 infection from non-Covid19 patients is needed in order to keep potentially contagious patients isolated while awaiting second-level testing. Keywords: covid-19; lcl; non; patients; score
• Rapid response air medical evacuation by civilian HEMS crew of critical patients during COVID-19 outbreak – First Fixed Points by Del Romano, Mauro; Ciapessoni, Lorenzo; Di Mola, Francesca ; Romanò, Gabriele; Gavezzotti, Massimo; Rigamonti, Marcello; Carnelli, Monica; Cappelletti, Roberto; Peup, Elena Sala; Orlandi, Edgardo; Villa, Guido Francesco; Manuel, Giordana; Ponzoni, Walter (2020) - In the absence of a relevant scientific literature on the aeromedical, non-military evacuation on rotary wing,3 and in the necessity to transfer Covid-19 patients from congested to less con- gested ICUs, we developed and applied specific procedures that take into consideration the pre-flight, in-flight and post-flight prob- lems of this type of transport. Abstract The Covid-19 emergency requires a shared plan for the long- range helicopter transfer of patients affected by the virus in order to reduce the overload of intensive care units. Keywords: care; covid-19; emergency; flight; helicopter; hems; medical; patients; transport
• Key words for 2020: Pandemic, emergency, anomie by Lorettu, Liliana (2021) - We also needed to weigh the principles of distributive justice and fair allocation of limited health resources. Emergency Care Journal 2021; volume 17:9436 Correspondence: Liliana Lorettu, Psychiatric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Villaggio S.Camillo SS 200 Sassari 07100, Italy. Keywords: care; emergency; pandemic; patients
• Clinical heterogeneity of a population of patients admitted to the Emergency Department with a diagnosis of COPD-exacerbation: Relevance of cardiovascular comorbidities by Groff, Paolo; Petrelli, Giuseppina; Giorgini, Paolo; Pilotti, Roberto; Parato, Vito Maurizio; Fabbri, Andrea (2021) - In the general population of COPD patients, the possibility of clustering some clinical features within homogeneous groups in terms of prognosis, therapeutic needs and evolution, has led to the Article Table 4. Aim of the study was to prospectively evaluate patients admitted to the ED for “exacerbated COPD” to describe their clinical heterogeneity and the influence that it may have on outcomes: death, length of hospitalization, exacerbation recurrence. Keywords: chronic; comorbidities; copd; data; diagnosis; disease; emergency; exacerbation; failure; heart; history; hospital; patients; presence; study
• The role of automated compression devices in out-of- and in- hospital cardiac arrest. Can we spare rescuers’ hands? by Latsios, George; Leopoulou, Marianna; Synetos, Andreas; Karanasos, Antonis; Melidi, Eleni; Toutouzas, Kostas; Tsioufis, Kostas (2021) - Safety of mechanical chest compression devices AutoPulse and LUCAS in cardiac arrest: A randomized clinical trial for non-inferiority. Furthermore, a study further supported the improved ROSC rate even in patients that were brought to the laboratory with ongoing ACCDs compressions.23 Mechanical compression devices can bridge patients in cardiac arrest to deployment of a fully percutaneous mechanical circulato- ry support in the cathlab. Keywords: arrest; cardiac; cardiopulmonary; chest; compressions; cpr; data; device; emergency; et al; hospital; manual; mechanical; patients; resuscitation; survival; use
• Factors associated with emergency department length of stay of internal medicine patients by Vonk, Sanne; Leermakers, Jaap; Logtenberg, Susan J.J.; Sankatsing, Sanjay U.C. (2021) - Figure 1 shows the number of ED visits per 25-minute-duration groups with the solid line representing the cumulative percentage of ED-LOS. Number of ED visits per and cumulative percentage of length of stay. Keywords: care; department; emergency; length; los; med; number; patients; stay; time
• Chronic carbon monoxide poisoning. A report of two cases by Riccardi, Alessandro; Bientinesi, Paolo; Monteverdi, Marta; Lerza, Roberto (2021) - The pathophysiology of carbon monoxide poisoning is com- plex and not completely known, in particular in chronic, occult Correspondence: Alessandro Riccardi, Emergency Room and Emergency Medicine, Ospedale San Paolo, Savona (SV), Italy. E-mail: dottriccardi@gmail.com Key words: Carbon monoxide poisoning; acute myocardial infarction; acute neurological syndromes. Keywords: carbon; case; chronic; monoxide; patients; poisoning
• Impact of COVID-19 pandemic and lockdown on emergency room access in Northern and Central Italy by Giostra, Fabrizio; Mirarchi, Maria Grazia; Farina, Gabriele; Paolillo, Ciro; Sepe, Catello; Benedusi, Francesca; Bellone, Andrea; Ghiadoni, Lorenzo; Barbieri, Greta; Santini, Massimo; Guiddo, Grazia; Riccardi, Alessandro; Lerza, Roberto; Coen, Daniele (2021) - [Emergency Care Journal 2021; 17:9705] Emergency Care Journal 2021; volume 17:9705 Abstract In Northern Italy the coronavirus infection has spread since February 2020: the increase in admissions of COVID-19 patients corresponded to a drastic decrease in admissions of regular patients to the Emergency Room (ER). The large increase in admissions of COVID-19 patients corresponded, at the same time, to a drastic decrease in admissions of regular patients to the emergency room.3-6 This was certainly the result of instruc- tions from health authorities not to approach the emergency room except for extreme necessities. Keywords: covid-19; emergency; lockdown; number; patients; reduction; room
• COVID-19 or not COVID-19, that is the question. The role of screening criteria and point-of-care lung ultrasound in the triage decision-making process in an Emergency Department during the phase 2 of the COVID-19 Italian epidemic by Poggiali, Erika; Bastoni, Davide; Ferrari, Mariachiara ; Moretto, Dario ; Buttafava, Federico; Mateo Ramos, Pau; Burzio, Valentina; Petri, Jolanda; Magnacavallo, Andrea; Vercelli, Andrea (2021) - Our study con- firms the pivotal role of the triage in the decision-making process and the management of the entire ED, and it demonstrates that fur- ther studies are necessary to validate the role of LUS as tool to promptly identify COVID-19 patients, if combined with a correct pre-triage interview. The aim of our study is to assess the sensitivity and specificity of our screening clinical and epidemiological criteria in detecting COVID-19 patients in the pre-triage area, and to investigate the role of LUS in the triage making-process during the “phase 2” of the COVID-19 Italian epidemic. Keywords: area; covid-19; criteria; emergency; interview; lung; lus; patients; study; triage
• Physiological deterioration in the Emergency Department: The SNAP40-ED study by Reed, Matthew J.; O'Brien, Rachel; Black, Polly L.; Lewis, Steff; Ensor, Hannah; Wilkes, Matt; McCann, Christopher; Whiting, Stewart (2021) - Deterioration in physiology was common in ED patients. It is also known that the ED, a complex and dynamic environment, holds potential risk to patients from large volumes of undifferentiated patients, overwhelming demand, patient flow or exit block and critical staffing issues.3,4 To date, evidence that continuous physiological monitoring improves outcome is limited.5,6 The SNAP40-ED study aimed to compare the ability of a pro- totype ambulatory monitoring device, formerly SNAP-40, now renamed Current Health (Current Health Ltd., Edinburgh, UK) to detect deteriorations in vital sign physiology of ED patients earlier than current standard monitoring and observation charting tech- niques. Keywords: care; deterioration; device; monitoring; novel; patients; sign; standard
• The role of emergency medicine residents during the global SARS-Cov-2 pandemic: The Pavia experience by Secco, Gianmarco; Cappa, Giovanni; Barcella, Bruno; Perlini, Stefano (2021) - As Emergency Medicine Residents, we had a major chance to reshape and improve our training experience, in our humanity as well as in our professional attitude. For many weeks thereafter tens of emergency COVID-19 patients were admitted every day through the ED requiring further adjust- ments in the organization of the Hospital, always in close cooper- ation with the out-of-hospital Emergency network.2 Among these, important and time-sensitive changes took place in the role of Residents in Emergency Medicine, as well as in other medical spe- cialties. Keywords: care; covid-19; emergency; hospital; patients; residents
• Potential benefits of anticoagulant doses of low molecular weight heparin in COVID-19: An observational retrospective study by Aschieri, Daniela; Stabile, Marco; Maestri, Cristina; Rosato, Luca; Coccia, Michela Giovanna; Novara, Paola; Lanati, Gianluca; Di Dio, Maria Teresa; Franco, Cosimo; Bisceglie, Giuseppina; Leddi, Giuseppe; Fabrizi, Enrico; Rucci, Paola; Taliani, Gloria (2021) - The first case in Italy was reported on February 21, 2020 and, a few days later, Castel San Giovanni Hospital was entirely dedicated to the treatment of COVID-19 patients. Giuseppina Bisceglie,6 Giuseppe Leddi,5 Enrico Fabrizi,7 Paola Rucci,8 Gloria Taliani9 1Cardiology Unit, Emergency Department, Castel San Giovanni Hospital, ASL of Piacenza, Castel San Giovanni; 2Plastic Surgery Unit, Surgery Department, Castel San Giovanni Hospital, ASL of Piacenza, Castel San Giovanni; 3Emergency Care Unit, Castel San Giovanni Hospital, ASL of Piacenza, Castel San Giovanni; 4Respiratory Intensive Care Unit, Castel San Giovanni Hospital, ASL of Piacenza, Castel San Giovanni; 5Orthopedic Unit, Castel San Giovanni Hospital, ASL of Piacenza, Castel San Giovanni; 6General Medicine Unit, Castel San Giovanni Hospital, ASL of Piacenza, Castel San Giovanni; 7DISES and DSS, Università Cattolica del S. Cuore, Piacenza; 8Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University, Bologna; 9Department of Translational and Precision Medicine, Sapienza University, Rome, Italy Non -co mmerc ial us e o nly systemic inflammation that induces diffuse endothelial injury and hypercoagulability state.2-5 The relationship between viral infec- tions and thrombosis is recognized, but it seems to be predominant in SARS-CoV2 infection, leading to life-threatening thrombotic complications such as venous and arterial thrombosis, pulmonary embolism and microvascular thrombi.6-8 Low Molecular Weight Heparin (LMWH) is recommended in COVID-19 patients by some expert consensus, but its efficacy and safety at therapeutic doses has not been described yet.9-11 We assumed that LMWH at therapeutic doses could exert a beneficial effect on the clinical course of COVID-19 thanks to its anticoagulant, anti-inflammatory and in vitro antiviral proper- ties.12-16 The aim of this observational study was to estimate the effect of anticoagulation on the in-hospital mortality of COVID-19. Keywords: castel; covid-19; disease; giovanni; heparin; hospital; lmwh; non; patients; san; study; vent; ventilation
• Use of CytoSorb in the emergency department-high dependency unit: A case report and a mini review by Biscardi, Emanuela; Carpinteri, Giuseppe; Castellino, Pietro; Malatino, Lorenzo (2021) - Brouwer WP, Duran S, Kuijper M, Ince C. Hemoadsorption with CytoSorb shows a decreased observed versus expected 28-day all-cause mortality in ICU patients with septic shock: a propensity-score-weighted retrospective study. Kogelmann K, Jarczak D, Scheller M, Drüner M. Hemoadsorption by CytoSorb in septic patients: a case series. Keywords: blood; care; cytosorb; emergency; icu; patients; sepsis; shock; therapy; use
• Allergic reactions due to concomitant administration of multiple drugs in intravenous fluid in emergency departments in Turkey by Çakmak, Mehmet Erdem; Kaya, Saltuk Buğra; Can Bostan, Özge; Damadoğlu, Ebru; Karakaya, Gül; Kalyoncu, Ali Fuat (2021) - +90.0505.4869750; Fax: +90.312.3100809 E-mail: mehmeterdemcakmak@gmail.com Key words: Drug allergy; drug hypersensitivity; emergency medicine; fluid therapy; intravenous infusion. Diagnosis of drug allergy The diagnosis of drug allergy was based on history, physical examination findings, SPT, IDT and DPT. Keywords: allergy; drug; emergency; fluid; patients; reactions; risk; study; tests
• SARS-CoV-2 management in Emergency Department: risk stratification and care setting identification proposal based on first pandemic wave in Pisa University Hospital by Barbieri, Greta; Cipriano, Alessandro; Carrara, Stella; Spinelli, Stefano; Cinotti, Francesco; Foltran, Francesca; Filippi, Matteo; Aquilini, Ferruccio; Tonerini, Michele; Santini, Massimo; Malacarne, Paolo; Ghiadoni, Lorenzo (2021) - Respiratory failure patients (left panel) and total of hospitalized (right panel), population divided according to mortality (dis- charged or death). Importance Considering these issues, ED management should provide prompt recognition of unstable or evolutive conditions, given pos- sibility of a rapid and unpredictable clinical deterioration, early identification of the most correct ventilation strategy and wise choice of the most appropriate care setting, balancing limited resources, and preventing ED over-crowding.5 From this point of view, the identification of anamnestic, clinical, or instrumental fea- tures predicting negative outcomes in COVID-19 patients could represent valuable tools for risk stratification.6-8 Despite prognosis of SARS-CoV-2 related disease are not yet completely understood and clinical presentation is variable ranging from asymptomatic carriers to lethal respiratory syndrome, many studies identified age, underlying comorbidities (i.e. chronic car- diovascular and respiratory diseases) as predictors of mortality.3,9 The development of respiratory failure is the most fearful com- plication.10 For this reasons, dyspnoea and respiratory parameters are fundamental to predict disease severity.11 Therefore, some clin- ical parameters could reveal respiratory deterioration, which requires ICU admission.6,7 Imaging can be helpful to stratify clini- cal impact of the respiratory syndrome. Keywords: care; covid-19; disease; indication; management; mortality; patients; respiratory; score; setting; years
• Steroids in severe COVID-19 patients: A retrospective analysis on the first pandemics in Lombardy by Vergnano, Beatrice; Calcinati, Serena; Signori, Davide; Benini, Annalisa; Pozzi, Maria Rosa; Verga, Luisa; Pizzagalli, Jonata; Bonfanti, Paolo; Bellani, Giacomo; Foti, Giuseppe (2021) - Since different severity of illness and different steroid dosage and timing of administration where reported,10-14 better profiling and targeting of COVID-19 patients is desired; thus, several RCTs are ongoing.15-17 During the first pandemic wave, in our third level hospital in Lombardy, on the basis of a multidisciplinary collaboration between intensivists, hematologists, rheumatologists and infectivologists we started to immunomodulate some patients with severe respiratory failure, still not requiring MV. Correspondence: Davide Signori, Department of Anesthesia and Intensive Care Medicine, San Gerardo Hospital, Via G. B. Pergolesi 33, 20900 Monza, Italy. Our results suggest a better profiling of COVID-19 patients for optimal rationales, timings, dosages of steroids since efficacy seems to differ broadly considering age, timing, disease severity and comorbidity. Keywords: admission; analysis; care; covid-19; cpap; crp; fio2; group; hospital; pao2; patients; steroid; therapy
• The pain in the Emergency Department: Choosing and treating wisely before and during the COVID-19 era by Poggiali, Erika; De Iaco, Fabio (2021) - [Emergency Care Journal 2021; 17:9903] Non commercial use only The chronic pain patients In this dramatic context, the care of chronic pain patients has been significantly impacted with the need to formulate new prac- tise recommendations to inform and help physicians, based on a biopsychosocial model of pain management.127,128 As reported in literature, chronic pain patients have higher prevalence of anxiety, depression, catastrophising and suicidal ideation,129-132 and are also at increased risk of COVID-19 due to multiple factors, including comorbidities, old age, and immune suppression.133,134 Based on this observation, telehealth and telemedicine with multidisci- plinary interactions have been recommended as a safe and effec- tive way to provide medical services and patient education during COVID-19 pandemic. Pain management is particularly complex in the elderly and emergency clinicians should always consider AGS Beers cri- teria® to avoid inappropriate medications, severe side-effects, and drug-drug interactions. Keywords: acute; care; clinicians; covid-19; covid-19 patients; delirium; department; drug; effects; emergency; emergency care; et al; italy; journal; management; med; medicine; non; pain; pain management; palliative; pandemic; patients; review; risk; treatment; use

• The Concordia case: thoughts about the incident by Catino, M. (2012) - Conclusione L’incidente della nave Costa Concordia mostra tutte le caratteristiche di un incidente organizzativo. Il comandante ha commesso un errore di tipo slip (scivolamento dell’attenzione), in particolare un mancato rilevamento di un oggetto – lo scoglio, un caso di “falso negativo”. Keywords: alla; anche; che; comandante; come; concordia; costa; dei; della; disastro; errori; gli; nave; nel; non; più; pratica; questo; sicurezza; sistema; sono; stato; una
• Decision making in emergency medicine: the need of combined efforts by Cavazza, Mario (2012) - Su questo aspetto è doveroso segnalare che, a moderare le nostre entusiastiche aspettative, intervengono le considerazioni fatte da alcuni autori (Gorini e Pravettoni, 2011) in merito ai rilevanti bias (“confirmation” e “anchoring”) che intervengono sistematicamente nel processo cognitivo di questo tipo e che possono portare a conclusioni troppo precoci o troppo “ristrette”. Di certo il sistema è compatibile con l’ambiente di PS, caratterizzato da tempi e capacità di acquisire informazioni ridotti, e con il sistema economico che sempre più, in epoca di “spending review”, impone riduzione dei costi, a volte ai limiti della tollerabilità etica. Keywords: che; con; del; nel; non; più; sempre
• A new training course for triage. The experience of Triage Education Group in Pinerolo by Civita, M.; Mana, E.; Sfasciamuro, C.; Odetto, C.; Laurita, E.; Cosola, A.; Esposito, P.; Voi, V.; Masoero, C.; Zanello, P.; Pivetta, E.; Cibinel, G.A. (2012) - Il decreto legge risulta molto dettagliato in termini di formazione con l’obiettivo di definire un linguaggio comune ed im- plementare criteri e metodologie idonei alla valutazione del paziente. Non -co mmerc ial us e o nly assistenza infermieristica • aspetti storici e teorici, il processo di triage nell’adulto e nel bambino (prima giornata); • Keywords: con; corso; del; formazione; gruppo; non; sono; triage
• Emergency Room of the Hospital associated with the University of Salerno: acute poisoning registered from April 2009 to September 2011 by Vitola, N. M.; De Roberto, M.; Caputo, D. (2012) - Le IA sono più frequenti nei maschi (59,9%) e nei soggetti di età 20-50 anni. Sia per le IA da alcol che da droghe, i dati sono riferiti alla sola popolazione adulta, non essendo state registrate tali intossicazioni in età pediatrica. Keywords: accessi; cav; che; con; dati; degli; dei; delle; farmaci; intossicazioni; non; pazienti; più; sono; totale; w w
• Biomarkers in emergency medicine: great opportunities or expensive puzzles? by Cavazza, Mario (2012) - Il rischio della “moda” passeggera può essere anche molto alto, ma non ritengo che sia più possibile permettersi un utilizzo non corretto e non pesantemente sostenuto da evidenze scientifiche incontrovertibili, di risorse costose e anche a volte non conclusive. In questo numero viene presentato il lavoro di Villa e coll. Keywords: che; con; heart; non; più
• Uneasy working and uncertainties facing: the power of intuition in emergency decision making. Neuro-psychobiological correlates by Colombo, R.A.; Fraticelli, C. (2012) - Al contrario, esperti – ossia coloro che sono maggiormente capaci di fare associazioni che stimolano accurati giudizi intuitivi e che posseggono complesse strut- ture cognitive riferite a un dominio rilevante di competenza (17) – seguono mappe mentali specifiche. La conoscenza che un esperto ha di un dominio di competenza si riflette negli schemi che egli è in grado di utilizzare in quel determinato ambito. Keywords: alla; che; cognitive; con; conoscenza; copyright; cosciente; dati; decisionale; dei; del; della; dell’editore; distribuire; elettronicamente; formazione; gli; gruppo; informazioni; intuition; intuitivo; l’autorizzazione; materiale; nel; non; più; possono; processo; protetto; può; schemi; scritta; senza; sia; sono; una
• Decision making in the emergency care unit: a study on meta-cognitive awareness by Donati, A.; Iannello, P.; Perucca, V.; Antonietti, A. (2012) - A tale fine è stato somministrato a un campione di medici di Pronto Soccorso, di chirurghi e di internisti il questionario Salomone, che consente di indagare il grado di consapevolezza e di conoscenza metacognitiva relativa ai processi mentali coinvolti nella presa di decisione. Uno studio sulla consapevolezza metacognitiva A. Donati, P. Iannello, V. Perucca, A. Antonietti Dipartimento di Psicologia, Università Cattolica del Sacro Cuore, Milano Sintesi Nel presente studio si rilevano il livello di consapevolezza e le credenze metacognitive che Keywords: alla; alle; buon; che; come; con; decisioni; decisore; dei; del; della; essere; formazione; livello; medici; nel; non; più; questionario; rimpianto; sono; una
• Emergency medicine between mind and body. Stress and managing strategies in professional groups at risk. Case study: air-traffic controllers by De Lucia, F. (2012) - In particolare i servizi del traffico aereo hanno lo scopo di: • prevenire le collisioni tra aeromobili; • prevenire le collisioni tra aeromobili sull’area di manovra degli aerodromi e gli ostacoli esistenti in detta area; • accelerare e mantenere ordinato il flusso del traffico aereo; • fornire informazioni utili per una sicura ed efficiente condotta del volo; • informare tempestivamente le appropriate organizzazioni circa aeromobili in difficoltà o che necessitano di assistenza e soccorso e collaborare con tali organizzazioni come da esse richiesto. Questo servizio, ormai in disuso, viene fornito solo in alcune porzioni di spazio aereo dove il traffico aereo è scarso: l’aumento costante della densità di traffico aereo ha fatto sì che esso sia ormai quasi del tutto sostituito dal servizio di controllo del traffico aereo che, ovviamente, fornisce un livello di sicurezza di gran lunga più elevato. Keywords: aereo; aeromobili; anche; che; cism; come; controllore; copyright; cui; degli; dei; del; delle; dell’editore; distribuire; elettronicamente; essere; gli; lavoro; livello; materiale; nel; non; più; possono; protetto; radar; reazioni; scritta; senza; sono; stress; tempo; traffico; traffico aereo; una; volo
• Evidence-based work up and management of non-specific neck pain in the emergency department by Siu, Victoria; Lin, Samuel; Sivakumar, Milan; Varkey, Thomas C. (2022) - Generic neck pain case presentation This particular hypothetical case presentation is based on a Emergency Care Journal 2022; volume 18:10929 Correspondence: Thomas C. Varkey, 3Department of Neurology, The University of Arizona College of Medicine, 302 W Medlock Dr. Apt #11, Phoenix, 85013 Arizona. E-mail: Tvarkey@utexas.edu Key words: Neck pain; management; evidence based imaging; thera- peutics; review article. This can be bolstered through the use of patient-centered documents such as educational pamphlets on the subject of neck pain which can also include acute worsening symptoms for which the patient will need to follow up for further care. Keywords: care; emergency; history; imaging; neck; neck pain; non; pain; patient; use
• When infection strikes the heart: identifying and treating non-rheumatic streptococcal myocarditis in a young man with chest pain and concurrent streptococcal pharyngitis by Mihevc, Matic (2023) - Non-rheumatic streptococcal myocarditis is a distinct form of myocarditis associated with streptococcal infec- tion and has clinical features resembling acute coronary syndrome. Conclusions Non-rheumatic streptococcal myocarditis is a serious compli- cation arising from streptococcal infection, displaying clinical and diagnostic features like acute coronary syndrome. Keywords: acute; case; chest; myocarditis; non; pain; patient
• AcEMC: an extremely successful year in the spirit of interdisciplinarity by Casagranda, Ivo (2010) - necessario dotare le organizzazioni sanitarie di strumenti di segnalazione e di gestione che permettano di correggere tempestivamente gli errori, e che siano in grado di costruire barriere difensive capaci di prevenirli. Vanno sottolineate anche la regia e la grande ospitalità offerta dal prof. Keywords: che; congresso; dei; del; della; d’urgenza; hanno; medici; medicina; non
• Pneumology and non-invasive ventilation by Editors, The (2010) - Tempo di valutazione e trattamento (tra l’accesso all’ambulatorio e emergency care journal PNEUMOLOGIA e NIV em er ge nc y ca re jo ur na l - o rg an iz za zi on e, c lin ic a, ric er ca • A nn o V I n um er o 4 • D ic em br e 20 10 • w w w .e Keywords: casi; che; con; cpap; dei; del; della; media; minuti; nel; non; pazienti; pronto; soccorso; trattamento; una; vni
• Diagnostics through images by Editors, The (2010) - , ma eclatante, di come l’integrazione con l’esplorazione ecografica con- senta di aumentare la sensibilità diagnostica strumen- tale a disposizione del clinico e del radiologo in caso di polmonite, in particolare quando la radiografia del torace non sia correttamente effettuabile in ortostasi e in due proiezioni. La successiva radiografia tora- cica, eseguita 11 giorni dopo la prima valutazione in Pronto Soccorso, con paziente apiretico e asintomatico, evidenzia un’area di addensamento parenchimale basa- le sinistro (Figura 2). Keywords: alla; caso; con; del; dopo; l’ecografia; non; paziente; radiografia; torace; una
• Neurology by Editors, The Editors (2010) - Al triage l’appropriatezza (Figura 2) è stata del 93,9%, con un 98,5% per i pazienti con dispatch e un 90,24% per quelli con accesso diretto. emergency care journal NEUROLOGIA em er ge nc y ca re jo ur na l - o rg an iz za zi on e, c lin ic a, ric er ca • A nn o V I n um er o 4 • D ic em br e 20 10 • w w w .e cj .it Keywords: alla; anche; basso; care; casi; che; clinica; con; copyright; dal; decidere; dei; del; della; dell’editore; department; distribuire; d’urgenza; elettronicamente; emergency; gli; headache; journal; l’autorizzazione; materiale; medicina; medico; nel; non; patient; pazienti; più; professione; pronto; research; ricerca; rischio; senza; sia; soccorso; sono; specificità; stati; stroke; tempo; triage; una; w w
• Toxicology by Editors, The (2010) - 30 Intossicazioni da metanolo in Sicilia: outbreak 2006-2008 C. Locatelli, S. Vecchio, S. Bigi, V. Petrolini, A. Giampreti, D. Lonati, P. Papa*, L. Rocchi*, L. Manzo Centro Antiveleni di Pavia e Centro Nazionale di Informazione Tossicologica, Servizio di Tossicologia, IRCCS Fondazione Salvatore Maugeri e Università degli Studi di Pavia *Laboratorio di Tossicologia Analitica Clinica, Servizio di Analisi Chimico Cliniche, Fondazione IRCCS Policlinico San Matteo, Pavia Intossicazioni collettive da metanolo possono verificar- si in zone dove il consumo di alcolici è elevato e in cui sono disponibili bevande alcoliche distillate illegalmen- te oppure in caso di adulterazione volontaria. Questo dato va sem- pre considerato in funzione del paziente (età, anamnesi remota, fattori di rischio) della sintomatologia presen- tata all’esordio e del presumibile tempo di esposizione. Keywords: alla; anche; anni; casi; cav; centro; che; clinica; come; con; dal; dati; degli; dei; del; della; essere; gli; gruppo; hanno; intossicazione; media; metanolo; metformina; morso; nei; nel; non; pavia; pazienti; più; prima; pronto; senza; soccorso; solo; sono; sostanze; stati; tossicologia; trattamento; tutti; una; w w
• Infectious diseases by Editors, The (2010) - della dia- tesi emorragica, l’eradicazione dell’inibitore del fattore VIII, la ricerca e il trattamento delle cause scatenanti e la 42 Emofilia acquisita in paziente HIV positivo: una singolare emergenza ematologica E. Migliore, E. Bernardi, A. Allione, L.A. Vettorazzi, B. Tartaglino SC Medicina d’Urgenza e DEA, AO S. Croce e Carle, Cuneo Uomo di 65 anni HIV positivo in triplice terapia antivi- rale con viremia indosabile e linfociti CD4+ nella nor- ma a recente controllo; viene ricoverato presso il nostro reparto per ematomi multipli con anemizzazione e al- lungamento dell’aPTT. Keywords: cerebrale; che; con; dei; del; della; fattore; malaria; nei; non; paziente; profilassi; pronto; soccorso; sono; stato; test; tetano; tqs; una; viene
• Clinics by Editors, The (2010) - Con tali premesse e con l’obiettivo di utiliz- zare la simulazione quale strumento di apprendimento pratico continuo, abbiamo formulato un programma di formazione per il DEA del nostro ospedale. A tre giorni dalla dimissione da struttura per riabili- tazione cardiologica, la paziente giungeva in DEA per dispnea ingravescente e ortopnea e veniva ricoverata in area semi-intensiva di Medicina d’Urgenza per quadro di shock cardiogeno trattato con beneficio con cPAP e inotropo. Keywords: alla; con; del; nella; non; paziente; pratiche
• Triage and operative models by Tosato, Franco (2010) - e che nell’ambito dei Codici Rossi ed, ancor di più, dei Codici Gialli sono raggruppate si- tuazioni sanitarie caratterizzate da livelli di rischio significativamente differenti. la gestione dei codici gialli prevede, dopo il triage d’acceso, l’avvio immediato alla gestione infermieristica post triage finalizzata ad un’ulteriore stratificazione del rischio sul quale viene modulata la risposta operativa, diversa per i Gialli ad alto rischio e Gialli a basso rischio, sotto- classificati come Giallo 1 e Giallo 2. Keywords: che; codice; colore; dei; del; della; non; pronto; questo; rischio; soccorso; triage; una
• Hypophosphatemia. From retrospective analysis to the analysis of the potential role of phosphatemia in panic disorders by Riccardi, Alessandro; Pastorino, Laura; Corti, Luca; Guiddo, Grazia; Robba, Fiorella; Minuto, Pierangela; Ghinatti, Maria; Chiarbonello, Bruno; Maritato, Francesco; Castelli, Marina; Lerza, Roberto (2010) - Sei pazienti (15%), con fosforemia media di 2,31 mg/dl (2,2- 2,4): il valore medio di HAS è risultato 22,33 (19- 26), corrispondente a lieve ansietà; la frequenza respiratoria acuta è risultata 24 (22-25), nessuno di questi pazienti ha presentato tetania, e abbiamo documentato parestesie simmetriche in 3 casi. Prima fase: studio retrospettivo Nella valutazione retrospettiva, abbiamo analizzato ogni caso di ipofosforemia (valore < 2,5 mg/dl) riscontrato in un anno di attività del nostro PS. Keywords: abbiamo; clinica; con; crisi; della; fosforemia; hypophosphatemia; ipofosforemia; manifestazioni; non; panico; pazienti; una
• Acute glyco-metabolic decompensation during septic shock by Cravino, Maria Marta; Urso, Felice; Arzilli, Giuliana; Sechi, Antonio (2010) - emergency care journal casi clinici em er ge nc y ca re jo ur na l - o rg an iz za zi on e, c lin ic a, ric er ca • A nn o V I n um er o 3 • Se tt em br e 20 10 • w w w .e cj .it maltophilia e Candida glabrata per cui è stato necessario sostituire il fluco- nazolo con il caspofungin. Keywords: che; con; del; non; nostro; pazienti; stato; una
• Case report: emergency treatment of near-fatal acute asthma by Lo Cigno, Dario; Federico, Vischia; Sechi, Antonio (2010) - Non-invasive ventilation is a respiratory support meth- od that in COPD has been used succesfully in the last 20 years; there is an increasingly interest about using non-invasive ventilation also in asthmatic patients. However, while in COPD the efficacy of non-invasive ventilation is indisputable, there is not yet an agreement on using non-invasive ventilation in asthma. Keywords: acute; airway; asthma; copd; mmhg; niv; non; patient; pressure; ventilation
• The exclusion of acute venous thrombosis in ER: experience in Udine by Mariotti, Barbara; Barboni, Enrico; Lizzio, Sebastiano; Paolillo, Ciro; Mazzoran, Lucia; Sbrojavacca, Rodolfo (2010) - Abbiamo analizzato i pazienti consecutivi con sospetta TVP, affe- riti al PS di Udine nell’arco di un anno di attività, valu- tati con l’ausilio di criteri clinici – probabilità pre-test (PPT) di trombosi – e CUS, escludendo il dosaggio del dimero-D. Dei 549 pazienti non esclusi abbiamo diagno- sticato una TVP in 48 casi, di cui in 3 era associata a embolia polmonare (EP). è stato valutato e validato in nume- rosi studi clinici e si è dimostrato accurato nel categorizzare i pazienti con sospetta TVP in PS in quanto meno del 5% dei soggetti classificati come “bassa PPT” presenta la malattia7. Keywords: con; cus; del; della; dimero; era; esclusa; non; pazienti; ppt; sono; stata; thrombosis; tvp; una
• Medical students' penal responsibilities by Albini, Elena (2010) - 45 • preso atto che l’ipotensione materna è una del- le complicanze codificate dell’anestesia epidurale, che l’ipotensione deve risolversi al più presto, an- che per evitare danni cerebrali al nascituro e che la procedura prevista per l’anestesia epidurale non è stata seguita, nel caso di specie, nel rispetto delle leges artis; • accertato che il calo della pressione si è verifica- to subito dopo l’inizio della procedura anestesio- logica, la conclusione che il calo della pressione e, quindi, il danno neurologico del bambino sono stati conseguenza dell’anestesia epidurale non cor- rettamente eseguita è conclusione che si impone sul piano scientifico e Il giudice di primo grado ha, dunque, ritenuto es- sere dato scientifico condiviso, legge scientifica condivisa, che il calo della pressione arteriosa dalla madre, se prolungato e rilevante, provoca danni al feto e ha, appunto, affermato – dopo aver fotocopia- to, nella stessa pagina, la parte della cartella clinica in cui era stata descritta la procedura dell’anestesia epidurale con l’indicazione, tra l’altro, dell’ora in cui era stata eseguita, dell’ora in cui la pressione aveva incominciato a scendere, dai livelli cui era scesa con il trascorrere dei minuti, circa trenta, Keywords: alla; anche; calo; che; con; corte; dal; dei; del; della; epidurale; era; giudice; grado; hanno; medico; nel; non; parte; quale; responsabilità; secondo; sentenza; specializzando; stata; una
• A research agenda for Italian emergency medicine by Iannone, Primiano (2010) - In quel caso, l’effetto dell’accademia, della esistenza della specialità e il contatto e Che cominciano con la scelta di research questions talo- ra mal poste, nella più totale ignoranza delle espe- rienze già compiute e attingibili dalla letteratura, oltre che scarsamente rilevanti per i clinici e per i pazienti. Keywords: alla; che; con; della; d’urgenza; medicina; non; più; research; ricerca; una
• Efficacy of a sedo-analgesia protocol in pre-hospital trauma treatment by Soffritti, Mattia; Ricciardelli, Adelina; Ragazzi, Riccardo; Manca, Francesco; Occhionorelli, Savino (2010) - mostrato un ottimo controllo del dolore e dello stato di agita- zione nella stragrande maggioranza dei traumatiz- zati, con percentuali nettamente superiori a quelle attestate dalla letteratura nella maggior parte dei DEA, e il fentanyl è risultato essere un farmaco ef- ficace e sicuro nel trattamento extraospedaliero del trauma. Tutto questi fattori hanno fatto sì che molti autori ritenessero il fentanyl il farmaco di prima scelta per il trattamento analgesico nel Keywords: analgesia; che; dei; del; dolore; emerg; fentanyl; maas; non; nrs; pazienti; trauma
• From literature and web by Melchio, Remo (2010) - la cui contem- poranea presenza in pazienti clinicamente valutati già a basso rischio di embolia polmonare (< 15%) consentiva di interrompere il processo diagnostico: in questi pazienti cioè non era indicato effettuare nemmeno il test del D-dimero, in quanto il rischio di danno derivato dalla diagnosi o dalla terapia nei falsi positivi eccedeva il rischio di “mancare la dia- gnosi” di embolia polmonare che era dell'1,8%. e il segno dell’appiattimento Keywords: che; con; dei; del; non; pazienti; polmonare; rischio
• Pulmonary embolism: the role of emergency scan and intervening radiology in medium-high-risk patients with pulmonary embolism by Arboscello, Eleonora; Ponassi, Irene; Lomeo, Agnese; Parodi, Maria Nives; Barbera, Paolo; Morfino, Michela; Pollicardo, Nicoletta; Delfino, Roberto; Mhamed, Dahane; Tallone, Roberto (2010) - L’an- gio-TC eseguita immediatamente dopo conferma- va un quadro di embolia polmonare submassiva coinvolgente le arterie polmonari segmentarie e subsegmentarie bilateralmente per cui la paziente, alle ore 11,46, veniva ricoverata in UTIC della Car- diologia ospedaliera dove iniziava il trattamento trombolitico. La clinica e la valutazione dello score di Wells con un punteggio di 4, di probabilità intermedia, orien- Keywords: alla; anche; casi; caso; che; con; dal; del; della; destra; embolia; emergency; mmu; non; paziente; più; polmonare; senza; terapia; una; valutazione; veniva; ventricolo; w w
• Green beans are the ones to blame by Zambruni, Andrea; Rizzoli, Domenico; Cavazza, Mario (2010) - Il sensorio resta integro, e la funzione intellettiva è preservata lungo tutto clinica e terapia em er ge nc y ca re jo ur na l - o rg an iz za zi on e, c lin ic a, ric er ca • A nn o V I n um er o I • M ar zo 2 01 0 • w w w .e Accertamenti specifici e trattamento Prima di iniziare il trattamento specifico sono sta- ti prelevati campioni di feci e sangue e conservati a 4 °C (dopo sieraggio del campione ematico) per il dosaggio della tossina botulinica. Keywords: alla; botulism; casi; che; con; dei; del; della; essere; non; paralisi; più; può; siero; sono; terapia; tossina; una
• Traumatic injuries in ER: managing based on the evaluation of the clinical risk by Prevaldi, Carolina (2010) - In- fatti un’ottimale preparazione consente di eviden- ziare il tessuto devitalizzato, le eventuali lesioni di strutture profonde e la presenza di corpi estranei. Se consideriamo che il 5,4% degli accessi in Pronto Soccorso è dovuto a ferite traumatiche, che nel 10,3% di tutti i pazienti visitati vengono effettuate procedure che riguardano la cura delle ferite e aggiungia- mo il fatto che l’11% del contenzioso medico-legale per il medico d’urgenza è dovuto a ferite con lesione tendi- nee, nervose o legamentose, o a problemi legati alla infe- zione e/o alla presenza di corpi estranei nelle ferite, si evince la rilevanza di questa patologia per il medico d’urgenza. Keywords: alla; anche; casi; caso; che; chiusura; clinici; con; copyright; corpi; dei; del; della; dopo; essere; estranei; ferita; infezione; materiale; med; nel; non; paziente; più; poiché; possono; può; rischio; senza; sia; soluzione; sono; tetano; tutti; una; w w
• Realization and implementation of a digital nursing protocol in ER by Fuggetta, Leonardo; Sechi, Antonio; Serafini, Paola (2010) - Linee guida per la pro- gettazione e la stesura della cartella infermieristica. Risultati Nel software elaborato, la documentazione dell’as- sistenza infermieristica è stata integrata con quella medica e con quella del Triage già informatizzate (quella medica non prevedeva la prescrizione della terapia che è introdotta con il presente progetto), a completamento dell’informatizzazione del proces- so clinico-assistenziale della p.a. Keywords: alla; alle; assistenza; assistenziale; campi; cartella; che; con; consuntivazione; dati; degli; dei; della; documentazione; fase; figura; gestione; gli; infermieristica; informazioni; maschera; modello; nel; non; p.a; percorso; prescrizione; prestazioni; processo; progetto; registrazione; senza; software; sono; terapia; una; w w
• From literature and web by Migliore, Elena; Melchio, Remo (2010) - Dopo il trattamento endoscopico e con inibitore di pompa (IPP) ev ad alte dosi, un gruppo di pazienti riceveva ASA 80 mg/die, mentre ai pa- zienti dell’altro braccio veniva somministrato pla- cebo; entrambi assumevano IPP per os. Tuttavia, i pazienti in cui non veniva sospesa l’ASA risultavano avere un tasso di mortalità a 30 giorni sia per qualsiasi causa sia per causa cardiovascolare, cerebrovasco- lare e per complicanze gastroenteriche significati- vamente minori rispetto al gruppo placebo (1,3% versus 12,9% per qualsiasi causa e 1,3% versus 10,3% per le tre cause succitate). Keywords: che; con; della; non; pazienti
• Planning the beautiful exit or building the environmental well being? by Balocco, Eusebio; Pesenti Campagnoni, Massimo (2009) - In altre parole, nel momento in cui cresce l’iden- tità e l’attrezzatura professionale del Medico di PS e lotta per essere “riconosciuto” come porta- tore di una sua legittima autonomia professio- nale, altre identità professionali lottano spesso, in modo altrettanto tenace, per difendere spazi che tendono a soprapposti e quindi richiedono di essere negoziati. Vediamo che in quel decen- nio sono state poste le basi culturali ed organiz- zative della Medicina d’Urgenza: risalgono a tale periodo l’introduzione del triage in PS, anche co- me tentativo di gestire gli accessi e di razionaliz- zare le richieste emergenti, la definizione delle abilità necessarie per la professione del medico d’urgenza e l’introduzione di standard formativi, il superamento della “diatriba” medico di pron- to soccorso- medico d’urgenza e la conseguente creazione di un unico organismo di rappresen- tanza, la SIMEU. Keywords: anche; che; con; dei; del; della; essere; medicina; medico; non; più; pronto; soccorso; sono; una
• Non-invasive mechanic ventilation in treating acute respiratory failure by Lari, Federico; Scandellari, Novella; De Maria, Ferdinando; Zecchi, Virna; Bragagni, Gianpaolo; Giostra, Fabrizio; DiBattista, Nicola (2009) - Le forme di IRA correlate ad ALI/ARDS presentano scarsa risposta al trattamento con NIMV e per que- sto EPAc e riacu- tizzazione di BPCO risultano le patologie con il miglior outcome, ALI/ARDS e polmonite severa quelle con più elevato rischio di fallimento per cui non è consigliabile una loro gestione routinaria con NIMV al di fuori di un ambiente intensivistico. Keywords: acute; alla; anche; ards; base; bpco; che; con; dei; del; della; epac; failure; invasiva; iot; ira; letteratura; medico; nimv; non; noninvasive; ore; pazienti; peep; pressione; pressure; rct; respiratoria; senza; sono; studi; terapia; trattamento; una; uti; ventilation; w w
• ER new members: an educational path by Refatti, Franca; Allegretti, Maria Grazia; Marzano, Amelia; Ramponi, Claudio; Baldantoni, Enrico (2009) - inaspettato.13 Un medico con lunga esperienza lavorativa e for- mato all’attività di tutoring e alla gestione dei brie- fing e debriefing, coordina il percorso e fa da ponte fra il professionista e l’organizzazione; sono indi- viduati inoltre, per ogni inserimento, altri due me- dici “esperti” di riferimento. i professionisti e gli ope- Keywords: alla; apprendimento; attività; che; competenze; con; debriefing; dei; del; delle; essere; formazione; gli; inserimento; medico; minuti; nel; non; osservazione; pazienti; percorso; pronto; soccorso; sono; una; w w
• Acute scrotal pain: an approach to the diagnosis with the help of scan by Valentino, Massimo; Bertolotto, Michele; De Luca, Carlo; Ciccarese, Eduardo; Pavlica, Pietro; Barozzi, Libero (2009) - Nei linfomi e nelle leucemie l’interessamento te- sticolare si manifesta con un aumento di volume considerevole e con una ipervascolarizzazione si- mile a quella che si osserva nell’orchite acuta. Gli autori illustrano la tecnica e l’anatomia dello studio del testicolo con US e gli aspetti delle principali patologie che possono presentarsi in urgenza con dolore scrotale acuto. Keywords: acuto; alla; casi; che; color; con; dei; del; della; diagnosi; dolore; doppler; essere; flusso; nei; nel; non; più; presenta; può; scrotale; senza; testicolare; testicolo; torsione; tra; una; vascolarizzazione; w w
• Reviews from literature and web by Dutto, Luca; Melchio, Remo (2009) - TC del cranio, delle consulenze neurologiche, il numero di ricoveri ed il tempo di permanenza in Pronto Soccorso. L’applicazione di tale protocollo riduce inol- tre significativamente il numero di ricoveri (9,0% vs 14,7%; p < 0,05). Keywords: che; del; della; intensità; non; pazienti; trattamento; una
• Is it worthwhile? by Coen, Daniele (2009) - Alla continua tentazione della medicina difen- siva, con il rischio di fare troppo e male per una paura sempre meno infondata di essere chiamato a rispondere in tribunale per aver omesso prestazio- ni o esami, anche se privi di una chiara giustifica- zione clinica. 4 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca , r ice rc a • A nn o V n um er o V • O tt ob re 2 00 9 • w w w .e cj .it editoriale emergency care journal La Scuola di Specializzazione è oramai cosa fatta. Keywords: che; con; dei; della; d’urgenza; non; pazienti; pronto; soccorso; una
• EFAST: The evolution of FAST in politrauma by Testa, Americo; Soldati, Gino; Portale, Grazia; Pignataro, Giulia; Giannuzzi, Rosangela; Gentiloni Silveri, Nicolò (2009) - In sintesi, il potenziamento dell’organizzazione sanitaria con- siste nel miglioramento della gestione delle vie ae- ree, del riconoscimento e trattamento delle lesioni toraciche e del controllo del circolo (shock emorra- gico), ovvero della gestione dell’ABC6,11. L’esame ecografico mirato nel trauma o “focused goal- directed”, noto con l’acronimo FAST (v. oltre), ese- guito dal medico d’urgenza a completamento della sua valutazione clinica, rappresenta una rivoluzio- ne nella gestione del trauma e del paziente critico in generale. Keywords: addominale; alla; care; che; clinica; con; dal; dei; del; della; ecografico; emergency; emoperitoneo; essere; fast; gestione; j trauma; lesioni; linee; l’esame; med; nei; nel; non; o v; parte; paziente; più; pnx; presenza; può; senza; sign; sonography; studio; terapia; toraco; trauma; ultrasound; una; valutazione; versamento; w w
• A retrospecitve analysis of undertriage cases in ER patients with STEMI by Dellafiore, Silvia; Gadda, Giorgio; Borgonovo, Chiara; Rubanu, Sebastiana; Doneda, Renzo; Ghinaglia, Monica; Ramuscello, Susanna; Paglia, Stefano; Coen, Daniele (2009) - Conclusioni Come conclusione di questo studio retrospettivo ci sembra di poter ribadire le seguenti osservazio- ni: • se correttamente applicato, un triage codificato è in grado di inviare tempestivamente alla visita medica virtualmente il 100% dei pazienti che si presentano al PS per un dolore toracico dovuto a STEMI in atto, consentendo allo stesso tempo di selezionare con elevata specificità una popo- lazione di circa il 35% che ha un bassissimo ri- schio per STEMI e che può attendere la visita per un tempo più lungo; • un corretto approccio di triage ai pazienti con dolore toracico è però insufficiente nel ricono- scere precocemente tutti gli STEMI in quanto una piccola, ma non insignificante percentuale di casi (specie tra gli anziani e le donne) si pre- senta con sintomatologia aspecifica in assenza di dolore toracico; • laddove gli aspetti organizzativi lo consentano, un ulteriore miglioramento nella precoce identi- ficazione dei casi di STEMI si potrebbe ottenere solo praticando un ECG a tutti i pazienti > 40 anni con dolore toracico non traumatico in ac- cesso al PS e a tutti i pazienti con dispnea, car- diopalmo, sincope, astenia, vomito da cause non precisabili, specie se anziani o con anamnesi po- sitiva per precedenti eventi o fattori di rischio cardiovascolare. In questo studio abbiamo dunque verificato nella realtà e su di un campione particolarmente nume- roso di casi quanto spesso e in che modo si verifi- ca un errore di undertriage nei pazienti che al ter- mine della valutazione in PS ricevono una diagno- si di STEMI. Keywords: casi; che; codice; come; con; dei; del; dolore; non; pazienti; più; ritardo; soccorso; sono; stemi; toracico; tra; triage; tutti; una; verde
• Imaging of psot-surgical complications in urinary pathologies by Bertini, Luca; Campagnano, Sarah; De Cicco, Maria Luisa; Valentini, Cristina; Casciani, Emanuele; Masselli, Gabriele; Polettini, Elisabetta; Gualdi, Gian Franco (2009) - La deiscenza dell’anastomosi ureterale dopo creazio- ne di una tasca ileo-cecale (MAINZ-pouch I) può es- sere rilevata all’esame di urografia-TC con la vi- sualizzazione di un urinoma intraperitoneale. La prostatectomia radicale consiste nella sezione del collo vescicale con asportazione della prostata, del tessuto adiposo periprostatico, delle vescicole se- minali, delle ampolle deferenziali e nella sezione dei dotti deferenti. Keywords: alla; che; complicanze; con; consiste; degli; della; dopo; essere; intervento; nel; non; paziente; più; possono; post; può; radicale; renale; resezione; sono; una; ureterale; uretero; vescica; vescicale; w w
• Thoughts on aggressive acting out matrices in ER and potential prevention acts by Nardi, Laura; Recupero, Roberto (2009) - e raccolte e recepite dall’altro e E l’assenza di una chiara decodifica del bisogno sotteso al tornare e tornare in Pronto Soccorso, la mancanza di coordinamento con servizi territo- riali del settore sanitario e sociale che a questi bi- sogni affettivi, emotivi e sociali possono tentare una risposta, la disarticolazione degli interventi da punti rete di organizzazioni di volontariato (centri di incontro, centri di accoglienza a bassa soglia, idonei luoghi di ascolto), che determina il cronicizzarsi della presentazione di un Keywords: acting; aggressivo; alla; anche; aspetti; capacità; che; come; con; cui; degli; dei; del; della; dell’editore; deve; dolore; ecc; essere; gli; ice; importante; loro; materiale; modo; nel; non; operatori; paziente; persona; personale; più; possono; pronto; può; quando; questo; rabbia; relazione; riconoscimento; scritta; soccorso; sociale; sono; spesso; teorie; tra; una; w w
• US proposals: not always to share but sometimes to follow! by Morabito, Gemma C. (2009) - Esistono persone che non possono permettersi un medico di famiglia e che non si rivolgono a una struttu- ra sanitaria fino a che una complicanza non li conduce in un Dipartimento d’Emergenza, altre che ricevono dia- gnosi di patologie severe ma non vengono assistite ne- gli ospedali perché senza assicurazione o perché quella che hanno non “copre” quello specifico problema o te- rapia. In un Paese come il nostro, l’Italia, in cui molto è lasciato all’iniziativa in- dividuale, è mia opinione personale che qualcosa di più si debba fare per aumentare la valutazione di quello che le strutture e gli operatori sanitari fanno. Keywords: che; con; dei; delle; d’emergenza; medicina; negli; non; più; questo; una
• PEEP in non invasive ventilatory treatment of worsened BPCO by Lari, Federico; di Battista, Nicola (2009) - clinica e terapia 9 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca , r ice rc a • A nn o V n um er o IV • A go st o 20 09 • w w w .e cj .it migliora, una rapida ricerca telefonica rivela l’assen- za di posti letto nelle terapie intensive e semi inten- sive (anche respiratorie) degli ospedali vicini. Introduzione Nel trattamento della riacutizzazione di BPCO con acidosi respiratoria, in aggiunta alla terapia medi- ca, è indicato il trattamento con ventilazione mec- canica non invasiva con metodiche a doppio livel- lo di pressione: inspiratoria più elevata (pressione di supporto, PSV) associata a pressione espiratoria inferiore (PEEP), in respiro spontaneo. Keywords: aeree; bpco; che; con; cpap; del; delle; non; paziente; peep; pressione; trattamento; una; ventilazione; vie
• ER role in identifying first-episode psychosis by Ebbli, Daniele; Ciancaglini, Panfilo (2007) - Si è anche evidenziato che nell’anno precedente alla comparsa della patologia conclamata sono già presen- ti alcuni dei sintomi patognomici della patologia e che nei 3-5 anni precedenti sono presenti sintomi aspeci- fici, che configurano un malessere, non ancora inqua- drabile in una patologia definita, quanto invece defi- nibile come stato mentale a rischio (Figura 1)4. editoriale 6 emergency care journal em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o III n um er o V I • D ic em br e 20 07 • w w w .e cj .it Keywords: alla; anni; che; con; degli; dei; del; delle; non; più; una
• Focused clinical evaluation of patients with behavioral disorders in ER by Coen, Daniele (2007) - Nel caso di molti piccoli e medi ospedali per esem- pio, l’assenza di un reparto di psichiatria o anche solo l’ assenza di uno psichiatra di guardia durante la notte, fanno sì che il medico di Pronto Soccorso deb- ba occuparsi, almeno in un primo momento, tanto dei TAB. 1 Condizioni a rischio per una causa organica della sin- tomatologia comportamentale • Insorgenza tardiva (oltre i 40 anni) • Assenza di una storia psichiatrica • Insorgenza improvvisa dei sintomi • Presenza di malattie sistemiche note • Recenti modificazioni della terapia • Rapporto temporale con un quadro di convulsioni • Keywords: che; comportamento; con; dei; del; della; disturbi; emergency; essere; medico; non; organica; pazienti; pronto; psichiatra; psichiatrici; sintomatologia; sintomi; soccorso; una
• Wellens' syndrome by Lai, Franco; Baldini, Alessio; Trombaccia, Gloria; Becheri, Marco (2007) - clinica e terapia 15 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o III n um er o V I • D ic em br e 20 07 • w w w .e cj .it A fronte di tale quadro il medico di emergenza chie- deva l’intervento di un consulente cardiologo il quale, dopo nuova raccolta anamnestica ed esame clinico, refertava l’ECG con «alterazioni diffuse del- la ripolarizzazione» e consigliava di tenere in re- parto di Osservazione Breve Intensiva (OBI) la pa- ziente per la ripetizione degli enzimi di citonecrosi miocardica secondo Keywords: che; con; dea; della; ecg; era; non; paziente; sindrome; tale; una; w w; wellens
• Thrombolysis in acute ischemic stroke: where and when? by Micieli, Giuseppe; Marcheselli, Simona; Ottolini, Stefano; Badalamenti, Salvatore (2007) - Soprattut- to realistico è che un’adeguata équipe dedicata alla diagnosi e al trattamento in fase acuta possa inter- venire nell’area dell’urgenza (e quindi in Pronto Soc- corso), qui espletando tutte le procedure diagnosti- che (non invasive) che permettono, al di là della TC ce- rebrale per la diagnosi differenziale ischemia/emorra- gia, di definire il sottotipo eziopatogenetico di ictus e quindi di programmare adeguatamente e tempesti- vamente le ulteriori indagini e un trattamento di pre- venzione secondaria precoce. clinica e terapia 19 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o III n um er o V I • D ic em br e 20 07 • w w w .e cj .it le in tutti i centri, ma nei centri meno “esperti” vi è un incremento della mortalità (13,3% CI: 11,6%-15,1%) rispetto ai centri con maggiore esperienza nell’utiliz- zo del trombolitico (10,6% CI: 9,8%-11,6%). Keywords: acute; alla; anche; che; clinica; con; dei; del; della; nel; non; pazienti; più; sono; stroke; strutture; studio; study; terapia; thrombolysis; trattamento; trombolisi; una; unit; w w
• Adults ingesting a foreign body: how to manage it in ER by Cuneo, Sonia; Canepa, Valentina; Vignolo, Stefania; Laforge, Susy; Saggese, Maria Paola (2009) - Il trattamento endoscopico è differibile non oltre comunque le 24 ore quando il CE non è a rischio e dall’indagine anamnestica si evince che il CE per- mane in esofago da tempo. L’esame endo- scopico dimostrava la presenza del CE in ipofarin- ge, che veniva prontamente rimosso e il paziente ri- tornava in osservazione nella OBI del PS di invio. Keywords: alla; bolo; casi; caso; che; con; dei; del; della; dopo; d’urgenza; essere; nel; non; oggetti; paziente; perforazione; più; presenza; può; rischio; sono; trattamento; una; veniva; w w
• Protestant ethics in ER nurses and doctors' training. Some acquisitions and considerations before and after a training course by Pesenti Campagnoni, Massimo; Balocco, Eusebio (2007) - organizzazione e formazione 24 emergency care journal em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o III n um er o V I • D ic em br e 20 07 • w w w .e cj .it organizzazione e formazione 25 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o III n um er o V I • D ic em br e 20 07 • w w w .e cj .it questo disinteresse saranno esplorate più avanti a proposito dell’assenza di un linguaggio organizzati- Keywords: alcune; che; come; con; dea; dei; del; della; essere; formazione; gruppo; milano; nel; non; organizzativa; organizzazione; partecipanti; più; processi; professionale; pronto; servizio; soccorso; sono; una
• Tracheal rupture post-emergency intubation by Billè, Andrea; Errico, Luca; Ardissone, Francesco; Cardinale, Luciano (2009) - La rottura della trachea è una lesione potenzial- mente letale che richiede un sollecito e adeguato trattamento, in quanto espone il paziente al rischio dell’insufficienza respiratoria incontrollabile e, più raramente, della mediastinite e della sepsi. A fronte dell’elevato nu- Fig. 1 - Radiografia del torace in proiezione A-P in decubito supino, che dimostra la presenza di enfisema sottocutaneo e cervico-mediasti- nico a. Da rilevare anche la sovradistensione e apparente erniazione della cuffia del tubo al di fuori del lume tracheale (frecce bianche nel particolare b). Keywords: aeree; casi; con; cuffia; della; intubazione; nel; non; paziente; post; presenza; respiratoria; rottura; rupture; surg; thorac; tracheale; tubo; una; ventilazione
• A case of mesenteric panniculitis by Volpicelli, Giovanni; Saracco, Walter (2009) - Al momento dell’accesso presso il no- stro DEA, il paziente accusava dolore acuto a cari- co del fianco e della fossa iliaca a sinistra, con una temperatura corporea di 38°C. ecj 4 2009:ecj 4 2009.qxd Un caso di pannicolite mesenterica Molteplici passaggi in DEA prima di una diagnosi definitiva ed un trattamento appropriato Giovanni Volpicelli, Walter Saracco* Medicina d’Urgenza, Ospedale S. Luigi Gonzaga, Orbassano (TO) *Medicina d’Urgenza, Ospedale Generale di Asti SINTESI La pannicolite mesenterica è una rara malattia carat- terizzata da episodi ricorrenti di dolore addominale acuto, il cui riconoscimento in DEA è importante per evitare un trattamento aggressivo chirurgico non ne- cessario. Keywords: addominale; con; del; della; gli; malattia; mesenteric; nel; non; panniculitis; paziente; sono; una
• Nursing ultrasound examination in catheterization by Romei, Luca; Sabatini, Antonietta; Biagioni, Catia (2007) - Ciò implica infatti che l’infermiere possa prevedere il calibro e il tipo di catetere che andrà ad inserire (Tabella 1). orien- tate sulla vescica, permette all’operatore opportuna- mente formato di ottenere informazioni utili per l’uso e la gestione del catetere vescicale4. Keywords: alla; bladder; catetere; che; con; contenuto; della; infermieristica; nel; non; nurs; sono; una; vescica; vescicale; w w
• Hypercalcemia as a rate complication sarcoidosis by Volpicelli, Giovanni; Mussa, Alessandro (2009) - è una no- ta complicanza di questa malattia1, ma il verificarsi di una condizione di ipercalcemia grave è un even- to piuttosto raro2, così come è estremamente rara una conseguente grave insufficienza renale clinica- mente acuta3. La presentazione in DEA con sintomi del tutto aspecifici, e indubbiamente inu- suali per una recidiva di sarcoidosi, ha rappresen- tato una sfida per il medico d’urgenza. Keywords: calcio; con; dei; del; della; era; ipercalcemia; non; paziente; renale; sarcoidosi; stata; una; veniva
• Emergenct triage methodology due to carbon monoxide poisoning by Gambarana, Ilaria; Fagiani, Anna; Petrolini, Valeria (2009) - A differenza del PS pedia- trico, il triage è stato effettuato in base ai sintomi presenti e riferiti al momento dell’eposizione al CO e non in base a quanto previsto dal protocollo di triage per l’intossicazione di una singola persona: a 28 pazienti è stato assegnato il codice verde e a 5 il codice giallo. Ciò è dovuto al fatto che il valore di COHb dipende dal tempo intercorso dal termine dell’e- sposizione e la determinazione del dosaggio. Keywords: che; codice; cohb; con; del; non; pazienti; protocollo; sono; triage
• A new discipline: Confined Areas Medicine by Agostinis, Stefano; Morra, Antonio; Bozzetto, Pierangelo (2009) - Le condizioni ambientali oggettive che de- finiscono il microclima di un ambiente confinato, e che devono essere valutate in quanto in grado di influire sul benessere termico dell’individuo presente, sono temperatura e umidità dell’aria, il- luminazione, irraggiamento da superfici calde e ventilazione (fonte: Badii 2005, glossario del Ministero dell’Interno). ecj 4 2009:ecj 4 2009.qxd 39 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca , r ice rc a • A nn o V n um er o IV • A go st o 20 09 • w w w .e cj .it emergenza territoriale emergency care journal Definizione dello spazio confinato e rischi connessi Si definisce “ambiente confinato” uno spazio carat- terizzato da aperture limitate per entrate e uscite e una ventilazione naturale sfavorevole. Keywords: alla; aree; che; con; confinato; degli; dei; del; delle; emergenza; esistono; essere; non; più; protetto; può; questo; sanitario; senza; sono; sopravvivenza; spazio; strutture; territoriale; una; vittime; w w
• From literature and web by Ricca, Marco; Melchio, Remo (2009) - Dal funnel plot è emersa una asimmetria dei risultati, a favore dei gruppi in trat- tamento mediante infusione a bolo, che può avere principalmente due spiegazioni: il fatto che nella quasi totalità degli studi il gruppo in trattamento con infusione a bolo riceveva una dose di antibioti- co maggiore rispetto al controllo, oppure il piccolo numero di studi incorporato nella meta-analisi. tra studi clinici controllati e osservazio- nali: eterogeneità dei pazienti arruolati (grande in- tervallo di confidenza della meta-analisi); utilizzo nella quasi totalità degli studi randomizzati di dosi di antibiotico superiori nel gruppo “a bolo”; ade- guata analisi farmaco-cinetica e dinamica effettua- ta solamente in pochi studi; prevalenza negli studi osservazionali di pazienti con infezioni da gram ne- gativi (più sensibili per somministrazioni prolun- gate/continue data l’assenza dell’effetto post-anti- biotico da parte dei beta-lattamici nel confronto di tali microorganismi). Keywords: che; non; pazienti; pci; somministrazione; studi; trombolisi; una
• Ethics and sanitary organization by Casagranda, Ivo; Mori, Maurizio (2009) - Su questo fatto assai strano e forse il meno notato dai tecnici stessi, e cioè che la tecnica ci è piomba- ta addosso come l’irruzione di qualcosa di estraneo, hanno rivolto invece 5 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca , r ice rc a • A nn o V n um er o III • G iu gn o 20 09 • w w w .e cj .it editoriale La tecnica diventa l’irruzione di un elemento estra- neo nella nostra vita, davanti al quale noi restiamo ammaliati e che, come apparizione di una nuova onnipotenza, può assumere per noi qualcosa di si- mile a un valore religioso. Keywords: che; come; con; della; non; questo; tecnica; una
• Chronic pancreatitis: a changing etiology or a gap in technological medicine by Pezzilli, Raffaele; Bellacosa, Lara; Barakat, Bahajat (2009) - Che sia una malattia rara deve essere ri- visto in quanto nel 1998, Lankisch e Banks hanno riportato che la prevalenza della pancreatite Non vi è alcun dubbio che, nei paesi occidentali, l’alcol sia il più frequente fattore associato alla pan- creatite cronica, che la pancreatite cronica alcolica clinicamente sia presente in giovani adulti di 30-40 anni di età, con una maggiore prevalenza del sesso maschile, che istologicamente vi siano lesioni cro- niche “ab initio” e che, da un punto di vista clinico, Keywords: che; chronic; cronica; dei; della; fattore; frequenza; gastroenterol; l’alcol; malattia; nel; non; pancreatite; pancreatite cronica; una
• Unilateral re-expansion pulmonary oedema treated with C-PAP by Volpicelli, Giovanni; Fogliati, Claudio (2009) - Da questo momento in poi il quadro clinico mi- gliora progressivamente, con una SpO2 che rag- giunge e si mantiene stabilmente oltre il 95% e una normalizzazione di PA (sempre oltre 110/70), FC e Fig. La nuova radiografia ri- vela la riespansione quasi completa del polmone sinistro (con l’eccezione di una sottile falda di pneumotorace, peraltro già presente in precedenti radiografie), con la presenza di evidenti segni di flo- rido edema alveolo-interstiziale monolaterale sini- stro (Figura 2). Keywords: che; con; del; della; dopo; edema; non; pap; polmonare; pulmonary; riespansione; trattamento; una
• Can a course modify the quality of triage in ER? by Parenti, Nicola; Zardi, Andrea; Manfredi, Roberta; Sangiorgi, Diego; Lenzi, Tiziano (2009) - Un gruppo di tre esperti (due infermieri e un medico) in triage e nelle LGTI, “blinded” sugli scopi dello stu- dio e sulle valutazioni degli altri membri del panel, esaminò, usando le LGTI, i 360 scenari di triage ela- borati dai 10 infermieri prima e dopo il corso. Raccolta dati Abbiamo raccolto gli scenari di triage con Keywords: che; corso; dei; del; dopo; guida; lgti; linee; non; pazienti; prima; priorità; sono; triage
• Payments for ER services: ethical and economical questions by Sturlese, Ugo (2006) - Gli assistiti non esenti, la cui condizione è stata codifica- ta come codice verde, ad eccezione di quelli afferen- ti al pronto soccorso a seguito di traumi ed avvele- namenti acuti, sono tenuti al pagamento di una quo- ta di 41,00 euro. L’esperienza ci insegna che occorre defini- re regole “oggettive”, che non lascino spazio alla sog- gettività decisionale degli operatori e che consenta- no di essere applicate a una popolazione numerica- mente consistente. Keywords: alla; base; che; con; degli; dei; del; della; essere; non; più; prestazioni; pronto; soccorso; una
• Metformin poisoning: which therapy? by Casagranda, Ivo; Garrè, Simona; Uberti, Rossana; Marenco, Mauro (2006) - Questa tecnica non solo corregge l’aci- dosi, ma rimuove dal plasma il lattato e la metformina in quanto sostanza dializzabile2,11. Gli esami ematochimici all’ingresso evidenziano: gli- cemia 14 mg/dl, creatinina 7,70 mg/dl, azotemia 242 mg/dl, cloro 87 mEq/l, sodio 140 mEq/l e potassio 5,2 mEq/l. L’emogasanalisi (EGA) presenta i seguenti valori: pH 6,92, PaO2 90,6 mmHg, PaCO2 27,6 mmHg, HCO3 5,5 mmol/l, acido lattico 18 mmol/l. La paziente viene trattata con 2 fiale di glucosata al 33% in bolo e con sodio bicarbonato 200 mEq ev. Keywords: acidosi; bicarbonato; con; della; meq; metformina; mmhg; non; paziente
• HELLP syndrome. Case description and literature review by Villa, Antonio; Milani, Olivia; Fabris, Elisabetta; Perego, Francesca; Fabbri, Carola; Rodegher, Donatella (2007) - La paziente è stata trattata con trasfusioni di piastri- ne e plasma, alfa-metil-dopa e corticosteroide; rag- 1188 HELLP syndrome.. Descrizione di un caso e revisione della letteratura SINTESI La HELLP syndrome (Haemolysis, Elevated Liver enzymes, Low Platelets) è una complicanza di un quadro di preeclampsia- eclampsia, descritta e inquadrata nosologicamente solo negli ul- timi anni. Agli esami ematochimici di laboratorio eseguiti all’in- gresso (Tabella 1) si riscontravano un movimento dell’LDH (ancora compatibile con lo stato di gravi- danza), un lieve movimento delle transaminasi oltre il limite superiore di normalità e piastrinopenia. Keywords: anche; che; con; dei; della; enzymes; gynecol; hellp; hellp syndrome; hemolysis; j obstet; laboratorio; liver; liver enzymes; nel; non; obstet; obstet gynecol; pazienti; più; platelets; preeclampsia; sono; stata; syndrome; terapia; una
• Correlations between socio-anagraphic characteristics and color codes of admissions to ER in Valle d'Aosta by Marrone, Gaetano; Panzarasa, Pietro; Pesenti Campagnoni, Massimo; Comelli, Mario (2009) - La variabile che sembra influenzare maggiormen- te la possibilità che il codice sia bianco rispetto ad altri colori è la “modalità di invio”: essendo, in- fatti, la stima dell’odds ratio ad essa relativo pari all’incirca a 4,05, il rapporto tra la probabilità che il codice risulti bianco quando la persona arriva in pronto soccorso con auto presentazione è 4,05 volte la probabilità che il codice risulti bianco quando la persona arriva in Pronto Soccorso in emergenza. I nostri dati evidenziano che la modalità di invio ( au- topresentazione vs inviati dal MMG), la non residenza in Regione, Keywords: 100,0; bianco; che; codice; colore; con; dei; del; della; d’aosta; emergency; nel; non; pazienti; più; popolazione; pronto; soccorso; sono; totale; tra; valle; w w
• Alcool as the main responsible for recurrent road accidents by Fabbri, Andrea; Vandelli, Alberto (2006) - In uno stu- dio di sopravvivenza la giovane età sarebbe il principa- le fattore associato al fenomeno recidive di incidente L’alcol è il principale responsabile delle recidive nei traumi da incidente stradale Andrea Fabbri, Alberto Vandelli Dipartimento dell’Emergenza, Presidio Ospedaliero “Morgagni-Pierantoni”, Azienda Unità Sanitaria Locale di Forlì SINTESI L’identificazione dei predittori del fenomeno recidive di incidente stradale rappresenta un elemento fondamentale per le strategie di prevenzione, ma pochi sono i dati disponibili in letteratura. l’alcolemia misurata è ri- sultata al di sotto del cut off considerato (10-50 mg/dl) in ben 178/425 casi, il 41,9% del totale 2,3. Keywords: alcohol; alcol; caratteristiche; casi; con; dea; dei; del; delle; eventi; fenomeno; follow; incidente; nel; non; positiva; recidive; rischio; soggetti; sono; stradale; studio; una; variabili; w w
• Scan role in diagnosing acute appendicitis by Summa, Massimo; Perrone, Fabrizio; Priora, Fabio; Giaminardi, Eliana; Longhin, Roberta; Spinoglio, Giuseppe (2006) - Gli esami di laboratorio non permettono di discrimi- nare i pazienti con appendicite acuta (valore predit- tivo positivo basso per la conta leucocitaria e per la PCR) anche se conservano una certa validità nel- Ciò ha portato tradizionalmente il chirurgo a interve- nire quando la diagnosi è probabile nel timore che un atteggiamento attendista incrementi il rischio perito- nitico, accettando il rischio di una quota elevata (cir- ca il 15-30%) di appendicectomie di appendici nor- mali1. Keywords: acuta; appendicite; che; clinico; con; del; della; diagnosi; non; pazienti; sono; una
• Acute pyelonephritis in ER by Volpicelli, Giovanni; Cravino, Marta M.; De Leo, Anna M.; Frascisco, Mauro F. (2007) - In questi, comunque pochi, dati pre- liminari analizzati, la CEUS ha dimostrato una sensi- bilità del 80% e una specificità del 100%, con una ac- curatezza diagnostica del 88% (Tabella 6). Nel complesso la sensibilità del test è risultata del 19%, con una specificità del 71% e una accuratezza del 35% (Tabella 5). medicina di laboratorio e trasfusionale TAB. Keywords: acuta; casi; che; con; dea; dei; del; della; diagnosi; gruppo; iavu; nel; non; pazienti; pielonefrite; renale; rmn; senza; sintomi; sono; una
• From literature and web by Melchio, Remo; Migliore, Elena; Pomero, Fulvio (2009) - va la necessità di un trial con almeno 1000 pazien- ti per poter dimostrare la presenza o meno di un beneficio in termini di mortalità. Per quanto riguarda la scelta del trombolitico (strep- tokinasi, urokinasi e rt-PA; approvati dall’FDA), non vi sono studi che abbiano dimostrato la superiorità dell’uno rispetto all’altro e la metanalisi del 2005 non ha evidenziato differenze significative; tuttavia, le linee guida ACCP consigliano l’utilizzo di rt-PA poiché ha il minor tempo di infusione (10 mg a bo- lo seguiti da 90 mg in 2 ore) ed è considerato fibri- no-specifico, attivando preferenzialmente il plasmi- nogeno sulla superficie del trombo. Keywords: cardiaco; che; con; del; nel; non; pazienti; una
• ER: between sel-organizational and workplace learning processes by Balocco, Eusebio (2006) - Il riferimento è a quella razio- nalità filosofica, scientifica e tecnica che si è affermata con l’Illuminismo, il positivismo e lo scientismo do- minante, che hanno prodotto, spesso in modo non consapevole, una progressiva emarginazione di pa- radigmi alternativi o diversi e delle radici non sempre razionali delle scienze. Nega il fatto che le strutture che noi vediamo oggi siano un’ottimizzazione delle strutture funziona- li. Keywords: alla; auto; caos; che; complessità; con; dei; della; kaufman; modo; non; organizzazione; più; questo; qui; sempre; senza; sistemi; solo; sono; una; vita
• The Acid-Base balance history (Part II) by Tarantino, Mario (2007) - Riferisce che il sangue assorbe molti più volumi di CO2 che di ossigeno, e trascu- rabili quantità di azoto. e T. Mann (1908- 1993), che scopriro- no pure che esso contiene zinco, un atomo per mo- lecola, essenziale per l’attività catalitica, e che la sul- fanilamide ne Keywords: acido; alla; anche; anni; aveva; base; bicarbonato; che; chimica; co2; come; con; così; cui; dal; degli; dei; della; della co2; disordini; era; erano; fisiologia; gas; gli; laboratorio; medicina; metodi; nei; nel; nel sangue; non; parte; pco2; più; prima; questa; risultati; sangue; secolo; senza; sia; studi; sua; sul; tipo; tra; una; w w
• ER doctor and patient's Stockholm syndrome by Presenti Campagnoni, Massimo (2009) - Un signore di cinquantasei anni ha inalato sette giorni prima vapori di ammoniaca e da allora è af- fetto da tosse, nonostante le cure del Medico di Medicina Generale (MMG): il MMG richiede la vi- sita “urgente” dello Pneumologo, che non visita ma lo manda in PS. Poco dopo, un secondo cardiologo visita un altro paziente per dolore toracico protratto insorto due giorni prima, e lo invia in PS per eseguire dosaggio della troponina: nella sua area ambulatoriale sono presenti due infermieri professionali ma “non pos- sono” eseguire il prelievo del sangue perché gli esa- mi “urgenti” si fanno in PS e perchè altrimenti il si- gnore dovrebbe pagare il ticket. Keywords: che; con; dal; del; della; malato; medico; non; una
• From literature and web by Melchio, Remo; Dutto, Luca; Bracco, Christian (2006) - Si tratta di uno studio dal disegno estre- mamente lineare, che ripropone la metodica ecogra- fica quale sempre più importante strumento a dispo- sizione del medico d’urgenza nella gestione del pa- ziente critico; in effetti, esso consente al letto del ma- lato l’identificazione di anomalie meno facilmente obiettivabili con il semplice esame clinico (ad esem- pio, protocollo FAST per la ricerca di lesioni emorra- giche nel paziente traumatizzato) e nel contempo sup- porta efficacemente il medico nell’effettuazione di pro- cedure operative di primaria importanza per il pazien- te critico quale l’inserzione di linee venose centrali. Gli Autori hanno analizzato la possibilità di ottimizzare la percen- tuale di successo nell’esecuzione della metodica e di contenere la quota di complicanze ricorrendo al posi- zionamento di una via venosa giugulare sotto guida ecografica. Keywords: che; con; dei; del; nel; non; pazienti; una
• Emergency contraception: different bioethical perspectives by Bo, Marco (2007) - Proprio in considerazione dell’influenza che il fe- nomeno dell’obiezione di coscienza esercita sulla ef- fettiva possibilità di ottenere in tempo la dispensa- zione di questi farmaci e del fatto che il DEA è luo- go dove la loro richiesta è frequente, può essere uti- le cercare di analizzare i presupposti etici generali che sono alla base dei diversi comportamenti pre- scrittivi, sulla base di quanto emerge dalla lettera- tura ad oggi disponibile. Una argomentazione differente è, invece, quella di coloro che ritengono che, pur restando l’utilizzo del- la contraccezione d’emergenza un fatto da evitare, la sua prescrizione possa essere considerata accettabile, se può concretamente evitare il ricorso all’aborto. Keywords: alla; anche; che; come; contraccettivi; contraccezione; cui; dei; del; della; d’emergenza; emergency; essere; farmaci; gravidanza; non; più; prescrizione; questi; una; w w
• Education and organizational (in)coherence by Tosato, Franco (2006) - editoriale 11 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o II nu m er o V • O tt ob re 2 00 6 • w w w .e cj .it diografista o ecografista, un ruolo tra l’altro spesso non accettato dal team leader (il gestore delle vie ae- ree), che pretende per questi ambiti di competenza la consulenza specialistica istituzionale del cardiolo- go e del radiologo. editoriale 9 emergency care journal em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o II nu m er o V • O tt ob re 2 00 6 • w w w .e cj .it Keywords: abilità; che; corsi; dei; del; delle; gestione; infatti; nella; non; parte; pronto; questo; soccorso; una
• Rupture of gastroesophageal varices DEA managing by Miglio, Federico; Mulè, Paolo (2009) - Premessa fondamentale perché questo compito possa essere svolto nella maniera più effi- cace possibile è che il medico di urgenza sia suffi- cientemente a conoscenza della fisiopatologia dell’i- pertensione portale e della terapia farmacologica e interventistica da effettuare in emergenza. Se, da una parte, il riscontro diagnostico di una emorragia digestiva del tratto gastroenterico supe- riore, indipendentemente dalla causa, è caratteriz- zato dal riscontro di ematemesi, vomito caffeano, rettorragia o melena, è però altrettanto vero che la grande maggioranza dei pazienti con emorragia da varici è affetta da una malattia cronica di fegato e, pertanto, è possibile che si presenti con ittero, asci- te, encefalopatia e severa anemia. Keywords: alla; anche; anni; beta; bloccanti; che; child; cirrosi; con; dei; della; emorragia; endoscopica; epatica; esofagee; essere; farmaci; medico; nei; nel; non; ogni; pazienti; più; portale; presenza; pressione; questo; rischio; sanguinamento; segni; sia; sono; terapia; una; variceal; varici; viene; w w
• Customer satisfaction in the observation unit of the Emergency Room by Cirone, Monica; Robba, Fiorella; Lagorio, Guglielmo; Guiddo, Grazia; Lerza, Roberto (2009) - Non esistono ,infatti ,opi- nioni univoche sulle modalità e sulla tempistica di una valutazione che sia il più possibile obiettiva e rispondente al vero2. Per tali motivi, non è pensabile che questo tipo di pazienti abbia voglia e tempo di riflettere su molte domande oppure su domande particolarmente dettagliate, magari dovendo anche stilare una specie di graduatoria di punteggio che vada da un giudizio pessimo all’eccellenza. Keywords: alla; anche; che; con; degenza; dei; del; della; hanno; loro; non; pazienti; più; pronto; può; questo; scheda; servizio; sia; soccorso; sono; una
• From literature and web by Leccardi, Stefano; Bracco, Christian; Dutto, Luca; Melchio, Remo (2007) - Dal momento che vi è consenso generale sulla mag- giore appropriatezza di un follow up compreso fra 6 e 24 mesi negli studi di mortalità in pazienti con trau- ma cranico, gli stessi Autori hanno pertanto intra- preso un post-hoc follow up di 24 mesi in questo sot- togruppo. L’analisi complessiva su oltre 770 soggetti ha posto in evidenza come non sussista un beneficio significativo nell’utilizzo di una profilassi antibiotica post-ripara- tiva: il rischio relativo di infezione successiva alla ri- parazione della ferita Keywords: che; con; dei; della; nei; nel; non; pazienti; terapia; una
• Retrospective-observational study on syncope by Poggi, Alessia; Bracco, Christian; Bruno, Emanuela; Leccardi, Stefano; Melchio, Remo; Sturlese, Ugo (2006) - In 23 soggetti si è rilevata un’anamnesi positiva per diabete mellito (7,82% del totale). Una diagnosi di sincope vasovagale è stata effettuata in 115 pazienti (39,11% del totale); in 19 soggetti è stata posta diagnosi di sincope situazionale (6,46%); in un soggetto è stata posta diagnosi di sincope del seno caro- tideo (0,34%); il totale delle sincopi a genesi neurome- diata è risultata così essere di 135 (45,92% del totale). Keywords: casi; che; con; dea; dei; del; delle; diagnosi; indeterminata; nel; non; pazienti; presenza; sincope; soggetti; sono; stata; totale; una
• Injuries caused by arthropods: diagnostic and therapeutic approach in ER by Moreno, Dutto; Lauria, Giuseppe (2009) - Il veleno, come quello delle ve- spe, è particolarmente ricco di allergeni e, in parti- colare tra questi l’antigene 5 sembra essere, coin- volto nelle principali manifestazioni allergiche di soggetti predisposti2. i peli e Keywords: alla; anche; base; casi; che; con; cui; degli; dei; del; delle; dolore; essere; gli; insetti; lesioni; locale; medico; molto; necessario; nei; nel; nella; non; ore; particolare; particolarmente; più; possono; può; reazioni; senza; sia; soggetto; sono; sostanze; specie; trattamento; una; w w; zecche
• Hypokalemic paralysis and acid-base balance by Casagranda, Ivo; Boverio, Riccardo; Defrancisci, Andrea; Ferrillo, Sara; Gargiulo, Francesca (2006) - un prolungamento dell’intervallo PR e un allargamento del complesso QRS. Caso clinico n. 2 Il signor C.D., di 80 anni, viene trasportato presso il nostro Pronto Soccorso per la comparsa di importante astenia, insorta il giorno prima e con andamento ingra- vescente, inizialmente localizzata agli arti superiori e successivamente coinvolgente anche gli arti inferiori. Keywords: acido; alla; anche; arti; base; casi; caso; cause; che; clinica; cloruro; con; concentrazione; cui; del; della; dopo; essere; gli; ipokaliemica; med; meq; metabolica; nei; nel; non; normale; paralisi; paziente; potassiemia; potassio; quadro; questo; senza; sono; stato; terapia; una; veniva; w w
• Imaging of community-acquired pneumonias by Valentini, Cristina; Bertini, Luca; Scala, Annarita; Trenta, Federica; Martines, Valentina; Casciani, Emanuele; Polettini, Elisabetta; Gualdi, Gian Franco (2009) - Di recente scoperta è la SARS, polmonite infettiva febbrile causata da un Coronavirus, che si manife- sta, nella maggior parte dei casi, con un’area di consolidamento a margini ben definiti, più rara- mente con opacità multifocali o diffuse; tuttavia, la radiografia del torace può apparire normale in fase precoce. ecj 2 2009 IInnttrroodduuzziioonnee Le polmoniti acquisite in comunità (PAC) sono, se- condo la definizione dell’IDSA, infezioni acute del parenchima polmonare che si associano a sintomi di infezione acuta e alla presenza, alla radiografia del torace, di un infiltrato acuto polmonare (oppu- re a caratteristiche auscultatorie tipiche della pol- monite) e che si verificano in persone che non so- no ospedalizzate. Keywords: addensamento; alla; aree; aspetto; casi; che; come; con; dei; del; della; forma; lobo; nel; nelle; non; polmonare; polmoniti; presenza; può; radiografia; sono; torace; una; w w
• From literature and web by Migliore, Elena; Ricca, Marco; Melchio, Remo (2009) - MMooddiiffiiccaazziioonnee ddeellllaa tteerraappiiaa aannttiibbiioottiiccaa ssuullllaa ssccoorrtt aa ddeellll ’’aannttiibbiiooggrraammmmaa ee mmoorrttaall ii ttàà iinnttrraaoossppeeddaalliieerraa iinn ppaazziieennttii ccoonn HHCCAAPP:: ll ’’ iimmppoorrttaannzzaa ddii iinniizziiaarree bbeennee La Health-Care-Associated Pneumonia (HCAP) è una polmonite che insorge in pazienti con storia di recente ricovero ospedaliero (almeno 2 giorni nei 90 giorni precedenti) o degenti presso case di cura e strutture di lungodegenza o che hanno da poco terminato un trattamento antibiotico o emodializ- zati e immunodepressi. La sepsi è una condizione clinica che, data la sua elevata incidenza e mortalità, rende conto di un nu- mero di decessi tutt’altro che trascurabile (circa 215.000/anno negli Stati Uniti). Keywords: alla; che; con; dei; del; della; mortalità; non; pazienti; più; sepsi; studio; una
• Hemogasanalysis: an ever changing fascinating investigation by Tarantino, Mario (2007) - editoriale 6 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o III n um er o IV • A go st o 20 07 • w w w .e cj .it lico, la modificazione del bicarbonato plasmatico è la risultante della sua attività come tampone e del compenso respiratorio; in un disordine di tipo respi- ratorio, la modificazione del bicarbonato plasmatico è la risultante dell’alterazione primaria della pCO2 e dell’intervento dei tamponi non bicarbonato e del compenso renale a difesa del pH del sangue: la cor- rezione alla pCO2 di 40 mmHg consente di esclude- re la componente respiratoria e di valutare più accu- ratamente se la componente metabolica sia dovuta solo ai fattori di compenso o se vi possa contribuire l’associazione di un disordine di tipo metabolico. Pertanto, sosteneva Siggaard-Andersen, il BE è un indice che permette di distinguere tra la com- ponente metabolica e la componente respiratoria e può essere utilmente impiegato nella diagnosi diffe- renziale dei disordini misti: quando per esempio in un disordine di tipo respiratorio il BE è diverso da 0, vi è l’indicazione dell’associazione di una componen- te metabolica in forma di disordine misto. Keywords: acido; base; bicarbonato; che; componente; dei; del; della; disordini; metabolica; nei; non; più; profilo; tampone; tra; una
• From awareness to mindfulness by Balocco, Eusebio (2009) - «Se vogliamo essere felici, dobbiamo innaffiare il seme della consapevolezza che è in noi. 4 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca , r ice rc a • A nn o V n um er o I • F eb br ai o 20 09 • w w w .e Keywords: che; come; consapevolezza; della; essere; milano; mindfulness; modo; non; più; processi; pronto; può; soccorso; sono; una
• Headache in ER by Cortelli, Pietro; Aguggia, Marco (2007) - Nonostante i neurolettici siano frequentemente usati in PS, è tuttavia preferibile limitare il loro utilizzo so- lamente in pochi pazienti, dal momento che sono far- maci difficili da dosare e con una modesta efficacia. Riconoscere i pazienti con cefalea primaria implica la possibilità di dimetterli dal PS affidandoli a una ge- stione ambulatoriale specialistica che riduca i futuri accessi in PS e Keywords: alla; anni; caso; cefalea; cerebrale; che; clinica; come; con; dal; dei; del; della; dopo; essere; gli; headache; nel; neurologica; non; obiettivo; pazienti; secondaria; segni; senza; sono; terapia; trattamento; una; viene; w w
• Managing patients affected by syncope in ER: differential diagnosis and risk stratification by Vitale, Elena; Maggi, Roberto; Demarchi, Giuseppe; Casagranda, Ivo; Brignole, Michele (2009) - Il medico d’urgenza dovrebbe dunque individuare, in prima istanza, il rischio che il paziente ha breve termine (inteso entro 10 giorni) di incorrere in even- ti minacciosi per la vita. Si tratta di sincope o di condizione che assomi- glia alla sincope? Keywords: alla; cardiaca; cardiopatia; che; con; coscienza; della; diagnosi; ecg; essere; eventi; fattori; guida; linee; malattia; non; pazienti; perdita; rischio; risk; score; senza; sincope; sono; studio; termine; una; valutazione; w w
• Neuropathic pain by Re, Giuseppe; Ricci, Virgilio; Rasi, Fabrizio (2009) - Così pure la flessione laterale del col- lo genera dolore verso il lato di sofferenza radicola- re e la compressione del capo, o manovra di Spur- ling, riducendo gli spazi La duloxetina e la venlafaxina, agenti di seconda linea in quanto meno efficaci ma più sicuri, possono essere presi in considerazione in presenza di fattori di rischio cardiovascolare. Keywords: alla; allodinia; anche; antidepressivi; casi; caso; centrale; che; clinica; con; copyright; crps; degli; dei; del; del dolore; della; dell’editore; di un; diabetica; die; distribuire; dolore; dolore neuropatico; dosaggio; e terapia; effetti; efficacia; elettronicamente; essere; farmaci; gabapentin; gli; herpetica; ice; il dolore; linea; livello; l’autorizzazione; meccanismi; nei; nel; nervo; nervoso; neuropatico; nevralgia; non; o v; oppioidi; pain; parte; pazienti; periferico; più; possono; post; protetto; può; questi; scritta; senza; sintomi; sono; spesso; studi; sulla; terapia; tipo; trattamento; triciclici; una; w w
• Cognitive strategies: a method to reduce diagnostic errors in ER by Prevaldi, Carolina (2009) - Poiché patologie potenzialmente pericolose possono presentarsi in modo vago, il medico di Pronto Soccorso deve essere cosciente del fatto che giudizi troppo prematuri, con la conseguente chiusura precoce del caso o precoce ca- tegorizzazione, possono condurre a diagnosi errate, soprattutto quando le diagnosi sono effettuate anche sotto la spinta emotiva. Que- sta affermazione non si riferisce alla qualità delle decisioni effettuate nell’ambiente caratteristico del Pronto Soccorso, ma piuttosto al fatto che il medi- co d’urgenza, non seguendo il paziente nel tempo, Keywords: anche; che; cognitivi; come; con; dei; del; della; diagnosi; errori; essere; gli; medico; metodo; modo; non; paziente; processo; pronto; può; quali; quando; questo; senza; soccorso; sono; una; w w
• Syncope in old people. The importance of multiparametric monitor in OBI evaluation by Riccardi, Alessandro; Pastorino, Laura; Chiarbonello, Bruno; Beatini, Luca; Corti, Luca; Castelli, Marina; Lerza, Roberto (2006) - organizzazione e formazione 30 emergency care journal em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o II nu m er o V • O tt ob re 2 00 6 • w w w .e cj .it organizzazione e formazione 31 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o II nu m er o V • O tt ob re 2 00 6 • w w w .e cj .it rametrico. Keywords: che; con; dei; del; non; pazienti; più; pronto; sincope; soccorso; sono; una
• Mesenteric venous thrombosis: multidisciplinary therapeutic approach by Pieri, Stefano; Agresti, Paolo; Monaco, Gianluca; Conversano, Laura; Oliviero, Emanuela; Liotta, Gianluca; Colombo, Giovanni Maria (2007) - clinica e terapia 17 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o III n um er o IV • A go st o 20 07 • w w w .e cj .it Fig. 2 - Arteriografia: l’iniezione di mezzo di contrasto dall’aorta eviden- zia una povertà di irrorazione del circolo mesenterico superiore. clinica e terapia 18 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o III n um er o IV • A go st o 20 07 • w w w .e cj .it casi. Keywords: che; clinica; con; dei; del; della; essere; intestinale; mesenterica; nel; non; paziente; quadro; sono; superiore; terapia; trattamento; trombosi; una; vena; w w
• Emergency clinical path of ST Elevation Acute Myocardial Infarction by Lenzi, Tiziano; Parenti, Nicola; Antenucci, Cesare; Metalli, Mauro (2007) - Esistono quindi due possibilità nell’algoritmo: • dolore toracico con infarto miocardico acuto a ECG tipo STEMI ad alto rischio di complicanze, e/o lisi controindicata con criteri alla PTCA: si pre- dispone accesso diretto a emodinamica di centro accreditato hub; • dolore toracico con infarto miocardico acuto a ECG tipo STEMI a basso rischio: si predispone accesso diretto a UTIC del centro spoke con possibilità di fi- brinolisi pre-ospedaliera se indicata e secondo la check list in Figura 1. la valutazione in sala di emer- genza dei pazienti con IMA e ST elevato. Keywords: caso; centro; con; dei; del; della; dell’ima; ecg; fibrinolisi; medico; non; ore; pazienti; ptca; rischio; sono; stemi; tempo; terapia; tipo
• Informed consent, living will, and bio-medical revolution by Mori, Maurizio (2008) - E il criterio ri- cercato rimanda alla qualità della vita e non può es- sere “oggettivo” (nel senso di dipendere dai “binari della vita”). È sufficiente che il pa- ziente vada dal medico perché questo atto sia im- mediatamente indice della sua (del paziente) vo- lontà di affidarsi a lui: questo atto costituisce di per sé un consenso (implicito se si vuole) a tutto ciò che il medico decide di fare per lui e per il bene del- la vita. Keywords: anche; bene; binari; che; come; consenso; cui; dei; della; essere; gli; informato; medico; nel; non; perché; più; può; questo; sempre; senza; sono; una; vita
• From literature and web by Melchio, Remo; Bracco, Christian; Martini, Giampiero (2006) - Appare quin- di chiaro che la differenza di costo tra Gli Autori di questo studio hanno vo- luto rispondere a questa domanda disegnando uno studio prospettico osservazionale con un follow up a 30 giorni su una popolazione non selezionata di pa- zienti adulti con dolore toracico non traumatico in PS. Keywords: che; con; dei; del; dolore; nel; non; pazienti; rischio; sono; studio; toracico; una
• Local emergency and medicine of disasters by Morra, Antonio (2006) - Mi riferisco a nomine a sfondo “politico” che nulla hanno da spartire con chi si è costruito un’esperienza ope- rativa o culturale, maturata negli anni, condivisa con colleghi stranieri e convalidata da confronti in campo manageriale e organizzativo, che raramen- te è possibile ottenere in Italia. editoriale 4 emergency care journal em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o II nu m er o IV • A go st o 20 06 • w w w .e cj .it Keywords: che; non; sistemi; una
• Metabolic alkalosis: pathogenesis and physiopathology by Tarantino, Mario; Vitale, Elena; Casagranda, Ivo (2008) - Tra i più importanti è lo stato del volume extracel- lulare, e in particolare del volume circolante effet- tivo (VCE): una contrazione del VCE aumenta il ri- assorbimento del bicarbonato e, viceversa, un’e- spansione del VCE aumenta l’escrezione del bicar- bonato. Se a un soggetto in con- dizioni normali vengono somministrati 1000 mEq di bicarbonato al giorno per due settimane, non si riesce a produrre un’alcalosi: la concentrazione del bicarbonato plasmatico e il pH del sangue arrivano a sfiorare Keywords: acido; alcalosi; alkalosis; anche; aumento; base; bicarbonato; che; clinica; cloro; come; con; deficit; del; della; dell’alcalosi; diminuzione; disordine; fattori; hco3; metabolica; nel; non; potassio; può; riassorbimento; sangue; sia; sono; una; volume; w w
• Acute mountain sickness by Tassan Din, Chiara; Pesenti Campagnoni, Massimo (2006) - Verrà inoltre presentato il caso di un uomo di 56 anni, affetto da edema polmonare acuto d’alta quota e mal di monta- gna acuto. I chemocettori ca- rotidei rilevano la diminuzione della pressione par- ziale dell’ossigeno e, mediando la cosiddetta risposta ventilatoria ipossica, rendono possibile l’incremento della PaO2 e la riduzione della PaCO2. Keywords: acute; alla; alle; altitude; ams; anche; che; clinica; con; dei; della; dell’ams; edema; essere; male; med; montagna; mountain; non; ogni; ore; paziente; più; polmonare; possono; quali; quota; senza; sickness; sintomi; soggetti; sono; terapia; una; veniva; w w
• The Acid-Base balance history (Part I) by Tarantino, Mario (2007) - e F.G. Hopkins (1861-1947) dimostrarono che l’acido lattico si forma durante la contrazione musco- lare in condizioni anaerobie e che questo acido è pre- sumibilmente il principale prodotto del metabolismo dei carboidrati in anaerobiosi. Essi trovarono che un carico acido è tollerato sorprendentemente bene dall’animale specialmente se carnivoro, e attribuiro- no questa tolleranza alla neutralizzazione dell’acido nell’organismo mediante “consumo” dell’“alcali” del sangue, come era dimostrato dalla diminuzione dell’“alcalinità” del sangue e dal simultaneo aumento dell’eliminazione urinaria di “alcali”, da loro identifi- cato nel sodio. Keywords: acido; acidosi; alcali; alla; anche; anni; aumento; aveva; base; basi; bicarbonato; che; co2; con; dal; dei; del; della; dell’acido; dopo; era; erano; gli; lattico; nei; nel; nell’urina; non; pazienti; perché; più; primi; questo; sangue; secolo; sodio; studi; suo; termine; tra; trattamento; una; urinaria; van; w w
• Myocardic extended ischemia after scombroid syndrome by Bassoni, Maria Serena; Biancardi, Marco; Magnani, Viviana; Alini, Donato; Martinotti, Renato Guido (2006) - la quantità di istamina riscontra- ta nei campioni di pesce analizzati, anche perché la concentrazione dell’istamina può variare in parti di- verse dello stesso pesce. Essa è stata definita anche “intossicazio- ne da istamina”, in quanto quest’ultima è la princi- pale tossina coinvolta, ma la patogenesi della malat- tia non è ancora stata completamente chiarita. Keywords: anche; caso; che; clinica; con; dei; del; della; diagnosi; histamine; ischemia; istamina; malattia; nel; non; paziente; pesce; più; sgombroide; sindrome; sintomi; sono; terapia; una; viene; w w
• Infant Botulism: a network to improve the diagnosis and treatment of a rare and under-diagnosed disease by Lonati, Davide; Locatelli, Carlo; Bigi, Stefania; Vecchio, Sarah; Petrolini, Valeria; Giampreti, Andrea; Fenicia, Lucia; De Medici, Dario; Manzo, Luigi (2008) - i veicoli finora individuati tramite indagini epidemiologiche e di laboratorio sono il miele e, in rarissimi casi, la pol- vere di casa. emergency 6 2008 cop tossicologia NBCR emergency care journal 35 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o IV n um er o V I • D ic em br e 20 08 • w w w .e cj .it Keywords: anche; botulinum; botulismo; campioni; casi; caso; causa; centro; che; clostridium; con; dal; dei; della; diagnosi; essere; feci; infantile; intestinale; laboratorio; malattia; miele; nei; nel; non; parte; pazienti; più; può; sia; sono; spore; stato; tipo; tossicologia; tossina; una; viene; w w
• From literature and web by Migliore, Elena; Rinaudo, Enrica; Melchio, Remo (2008) - Per contro, più ecla- tante, è il rischio di ipoglicemia che risulta signifi- cativamente incrementato di circa 5 volte nei pa- zienti critici di tutti i tipi sottoposti a stretta terapia insulinica rispetto all’approccio tradizionale (13,7% vs 2,5%; RR 5,13, IC 95% 4,09-6,43). Se un limite del lavoro è per noi l’alta prevalenza di studi di provenienza nordamericana, dove il si- stema sanitario risponde a regole diverse, tuttavia la revisione risulta di sicuro interesse, in quanto evi- denziando ciò che si conosce e ciò che è dibattuto sull’argomento, si pone come un punto di partenza per ulteriori approfondimenti, ricerche e applica- zioni anche nel nostro Paese. Keywords: che; come; con; della; dimero; hanno; nel; non; normale; pazienti; probabilità; sia; una; valore
• From literature and web by Melchio, Remo; Bracco, Christian (2007) - revisioni dalla letteratura e dal web 45 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o III n um er o IV • A go st o 20 07 • w w w .e cj .it si reiterava il modulo per un massimo di 15 minuti. Gli Autori della revisione prendono in esame fattori anamnestici, obiettivi e clinici dagli studi della letteratura e ne forniscono la sensibilità diagnostica: tuttavia, non essendovi criteri standard (anche di tipo laboratoristico) con cui confrontare la valutazione clinica, risulta difficile interpretare i risul- tati. Keywords: alla; cardiaco; che; compressioni; con; dal; dei; del; della; gli; nel; non; una
• Loeb’s formula: a rich though waisted heritage by Sgambato, Francesco; Sgambato, Ester; Fucci, Armando (2006) - Infatti, analizzando più attentamente il caso cli- nico capitato alla nostra osservazione, scoprivamo quasi sempre che, nelle forme clinicamente silenti, l’iperpotassiemia si associava a un’acidosi metaboli- ca con un aumento, quindi, della concentrazione idrogenionica, che nella formula di Loeb è posizio- nata al denominatore: La formula di Loeb: una ricca eredità dissipata Francesco Sgambato, Ester Sgambato, Armando Fucci Dipartimento di Medicina, UO Complessa di Medicina Interna, Ospedale “Sacro cuore di Gesù” – Fatebenefratelli, Benevento SINTESI La formula di Loeb è una delle pietre miliari nella dimostrazio- ne Keywords: alla; altri; anche; animali; che; clinica; come; con; cui; degli; dei; della; di loeb; era; esempio; essere; formula; grande; henderson; loeb; loeb j.; nel; nelle; non; più; potassio; può; questo; sali; sempre; senza; sia; solo; soluzioni; sono; sua; una; vita; w w
• Mistakes in medicine and the culture of fault by Catino, Maurizio (2008) - E il criterio ri- cercato rimanda alla qualità della vita e non può es- sere “oggettivo” (nel senso di dipendere dai “binari della vita”). È sufficiente che il pa- ziente vada dal medico perché questo atto sia im- mediatamente indice della sua (del paziente) vo- lontà di affidarsi a lui: questo atto costituisce di per sé un consenso (implicito se si vuole) a tutto ciò che il medico decide di fare per lui e per il bene del- la vita. Keywords: anche; bene; binari; che; come; consenso; cui; dei; della; essere; gli; informato; medico; nel; non; perché; più; può; questo; sempre; senza; sono; una; vita
• Pulmonary scan by Copetti, Roberto; Soldati, Gino (2006) - diagnostica per immagini, radiologia interventistica e medicina nucleare 36 emergency care journal em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o II nu m er o IV • A go st o 20 06 • w w w .e cj .it diagnostica per immagini, radiologia interventistica e medicina nucleare 37 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o II nu m er o IV • A go st o 20 06 • w w w .e cj .it Keywords: alla; care; che; chest; come; con; del; della; diagnostica; figura; immagini; lichtenstein; linee; lung; medicina; nel; non; pleurico; polmonare; polmone; presenza; pulmonary; sign; sono; ultrasound; una; w w
• From literature and web by Melchio, Remo; Martini, Giampiero; Dutto, Luca (2006) - Sulla base di questi dati si potrebbe ipotiz- zare un non perfetto utilizzo di LDB-CPR nello studio di Hallstrom o, in alternativa, una CPR manuale di qualità più scarsa nello studio di Ong. La sindrome nota come Acute Lung Injury (ALI, dan- no polmonare acuto, edema polmonare non cardioge- no) è caratterizzata dall’incremento della permeabili- tà della membrana alveolo-capillare con la comparsa di infiltrati bilaterali alla radiografia del torace ed è de- finita da un rapporto PaO2/FiO2 < 300, in assenza di segni clinici o strumentali (ad esempio pressione di incuneamento in arteria polmonare < 18 mmHg) di scompenso cardiaco. Keywords: che; con; cpr; dei; del; della; manuale; nei; nel; non; pazienti; risultati; studio; una
• Talking about “appropriateness” by Iannone, Primiano; Lenzi, Tiziano (2007) - In che veste e in che misura i pa- zienti, i loro diritti, le loro preferenze entrano nel giu- dizio di appropriatezza? editoriale 10 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o III n um er o III • G iu gn o 20 07 • w w w .e cj .it chizzazione delle evidenze scientifiche; la de-valo- rizzazione dei metodi basati sul consenso fra esperti, confinati alle sole aree “grigie” della letteratura; l’ana- lisi dei numerosi bias possibili che intervengono nel giudizio di efficacia degli interventi sanitari – uno per tutti, il publication bias che sovrastima l’efficacia dei nuovi trattamenti (farmacologici e non) – perché è più facile pubblicare studi con risultati positivi; la presa di coscienza delle enormi pressioni dell’indu- stria farmaceutica, che prima “crea” le malattie, poi le pubblicizza con grande profusione di mezzi, e poi, ovviamente, offre il rimedio a caro prezzo (esempi il- lustri: la calvizie, la disfunzione erettile, il disordine di iperattività-attenzione, l’osteoporosi, ma potrem- mo continuare a lungo nell’elenco delle cosiddette non-diseases); la sacrosanta valorizzazione dei biso- gni e delle preferenze del paziente individuale, pri- ma ingiustamente tenuti fuori dai giudizi di appro- priatezza; l’introduzione del concetto di effectiveness (efficacia reale) e di cost-effectiveness contrapposti a quello di efficacy (efficacia teorica). Keywords: alla; anche; appropriatezza; che; con; degli; dei; del; delle; iii; nel; non; più; ricoveri; sono; tutti; una
• Humanitarian crises and assistance by Salinari, Raffaele K. (2006) - dei diritti umani e che, da questo punto di vista, tenuto conto dell’evoluzione del quadro geo- politico internazionale, le Ong umanitarie devono ri- pensare modalità, definizioni e mezzi per agire ripri- stinando non solo il ruolo dell’aiuto umanitario, co- me previsto nell’originale definizione delle Conven- zioni di Ginevra, ma anche estendendo il concetto di aiuto umanitario a quello di prevenzione dei disastri e Per quanto riguarda il metodo con il quale gli aiuti vengono portati, invece, fatto salvo il dibattito ineren- te la definizione, è necessario affrontare un’altra di- Crisi umanitarie e aiuto umanitario Raffaele K. Salinari Presidente Terre des Hommes International Materiale protetto da copyright. Keywords: anche; che; crisi; definizione; dei; della; non; più; sono; umanitario; una
• Dehydration in adults and old people by Casagranda, Ivo; Vitale, Elena; Giuffré, Eliana; Cecconi, Dalio (2007) - La disidratazione nell’adulto e nell’anziano Ivo Casagranda, Elena Vitale, Eliana Giuffré, Dalio Cecconi Dipartimento di Emergenza e Accettazione, ASO Santi Antonio e Biagio e Cesare Arrigo, Alessandria SINTESI La disidratazione è dovuta a una riduzione dell’acqua totale corporea ed è caratterizzata da un’alterazione della concen- trazione del sodio plasmatico, dell’osmolalità e da un aumen- to dei valori dell’urea plasmatica. Cerebral salt wastig Nei pazienti con lesioni cerebrali di tipo traumatico e non, si può evidenziare una disidratazione con ri- duzione del VEC, caratterizzata da perdita urinaria di sodio e acqua17. Keywords: acqua; caso; che; come; con; concentrazione; del; della; diarrea; disidratazione; essere; iii; lec; liquidi; mmol; na+; nel; non; perdita; più; plasmatica; può; questo; riduzione; sodio; soluzione; sono; terapia; una
• Anaphylaxis management in ER by Borrelli, Paolo; Pesenti Campagnoni, Massimo (2006) - clinica e terapia 10 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o II nu m er o III • G iu gn o 20 06 • w w w .e cj .it da alcune settimane soffre di prurito e bruciore agli occhi se svolge le pulizie di casa e che in occasione di una festa ha manifestato edema delle labbra dopo aver gonfiato dei palloncini per addobbare la casa. clinica e terapia 14 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o II nu m er o III • G iu gn o 20 06 • w w w .e cj .it Keywords: adrenalina; alla; allergica; allergy; anafilassi; anaphylaxis; anche; caso; che; clinica; con; dei; delle; dell’anafilassi; dopo; esser; gli; gravità; iii; immunol; ipotensione; nei; nel; non; ore; paziente; più; può; reazioni; senza; soluzione; sono; terapia; una; w w
• Decision Making by Baldi, Pier Luigi (2006) - L’approccio appena descritto presenterebbe alcuni punti deboli, fra cui il carico eccessivo per la memo- ria di lavoro, soprattutto se il numero degli attributi è molto elevato, il fatto che non sempre il decisore è consapevole di quali siano gli attributi rilevanti, la possibilità che la valutazione degli attributi si modi- fichi nel tempo (ad esempio, la posizione dell’appar- tamento può subire una drastica diminuzione del punteggio di desiderabilità, perché nei paraggi viene costruita una centrale a carbone). I risultati misero in luce che la scelta della terapia ra- diante passava dal 18%, quando le alternative erano presentate in termini di sopravvivenza, al 44%, quan- do erano presentate in termini di morte. Keywords: alternative; che; cui; decisione; dei; della; esempio; gli; gruppo; non; persone; più; problemi; sono; strategie; una
• Cephalea, Horner's syndrome and cerebral ischemia: pathognomonic triad by Pomero, Fulvio; Dutto, Luca; Bracco, Christian; Cena, Paola; Melchio, Remo; Fenoglio, Luigi M. (2007) - Tale sintomatologia era iniziata 3 giorni prima del ricove- ro e il paziente era stato trattato con farmaci antin- fiammatori non steroidei senza particolare beneficio. Il coinvolgimen- to dei nervi cranici avviene nel 12% dei pazienti e in particolare vengono interessati l’ipoglosso, l’oculo- motore, il trigemino e il facciale18. Keywords: artery; carotid; che; circa; con; dei; del; della; dissecazione; dissection; non; pazienti; stroke; terapia; una; vasi
• A common case of haematemesis in ER rarely caused by gastroenteric bleeding: Dieulafoy’s lesion by Mosconi, Emilio (2007) - L’evoluzione dell’endoscopia e lo sviluppo di tecniche terapeutiche endoscopiche hanno notevolmente ridotto la mortalità e, attualmen- te, ci si aspetta che essa sia ridotta al minimo, soprat- tutto se la causa dell’emorragia gastroenterica è diagno- sticata e trattata rapidamente12,19,20. La prognosi è migliorata con lo sviluppo della gastroscopia e delle tecniche terapeutiche endoscopiche soprattutto se la causa del- l’emorragia è diagnosticata e trattata rapidamente (periodo libe- ro da malattia = 28-36 mesi). Keywords: bleeding; casi; cause; che; con; corso; dei; della; dieulafoy; disease; essere; gastroenterology; gastroscopia; haemorrhage; iii; lesione; nel; non; oppure; paziente; può; stomach; terapia
• Patients suffering benign chronic pain becoming acute: ER approach by Nervetti, Giovanni; Milanesi, Anna; Motta, Massimo; Mellado, Carmen; Lovo, Francesca (2006) - Più della metà dei pazienti non ha seguito un iter dia- gnostico specifico prima dell’accesso al nostro PS e, pertanto, non conosce la causa del dolore e non è se- guito da strutture di riferimento. Ne deriva che il dolore è una percezione come la vista e l’udito e, quindi, il risultato della trasmissione di informazioni attraverso un circuito neuronale dalla periferia alle vie spino-talamiche e, da qui, alla corteccia cerebrale2. Keywords: casi; che; con; cronico; dei; del; della; dolore; malati; nel; non; pain; pazienti; soccorso; sono; stati; test
• ER triage in patients showing acute hypersensitivity reactions: one year's experience by Porro, Fernando; Bergonti, Carlo; Serafini, Silvia; Ghilardi, Gianluca (2006) - Il nostro scopo era verificare l’appropriatezza della gestione di questi pazienti al triage e nella fase a esso successiva (“post-triage”). i tempi medi di attesa per la visita e i tempi di per- manenza in PS dopo la visita. Keywords: allergy; anaphylaxis; che; clin; codice; con; dei; del; ipersensibilità; manifestazioni; nella; non; pazienti; sono; triage; visita
• Social service at DEA: experience in Mauriziano Hospital, Turin by Pons, Daniela; Vigna, Iolanda; Veronese, Nadia; Carillo, Pier Carla; Malvasio, Paola; Pala, Liliana; Soragna, Aldo (2007) - In coerenza con quanto statisticamente noto, anche il nostro campione rende evidente che il 67% delle per- sone ultra 65enni è di sesso femminile (Figura 3). Il Servizio Sociale collabora ancora con gli operatori del progetto ADPO-Assistenza Domiciliare Post Ospedaliera(nota1) segnalando i casi già selezionati per il tipo di intervento e collaborando contestualmente con gli altri Servizi coinvolti. Keywords: che; con; dea; dei; del; delle; gli; iii; nel; non; persone; più; senza; servizio; sociale; socio; sono; ultra; una; w w
• Foreign patients in ER: receiving, understanding, treating by Dal Molin, Alberto; Grosso, Michela; Petterino, Antonella (2006) - Da un’ana- lisi poco attenta si può concludere che il fenomeno è scarsamente presente, ma se si osserva il dato grezzo (2372) Infatti non bisogna dimenticare che il Pronto Soccor- Keywords: anni; biella; che; codici; come; con; degli; dei; del; non; pronto; soccorso; sono; stranieri; una
• Bleeding of the upper gastroenteric segment of non-varicose origins: DEA managing by Longanesi, Annamaria; Mulè, Paolo; Miglio, Federico (2008) - Non lesioni quadri esofago-gastro- Non stigmate duodenali 5 Stigmate maggiori Nessuna o Sangue nel viscere, di risanguinamento segni “neri” coagulo adeso, vaso visibile o sanguinante cordanza con i dati originariamente riportati ma ha sottolineato come lo score sia più valido nello stra- tificare il rischio di morte del paziente, piuttosto che nel predire l’eventualità di un risanguinamen- to della lesione riscontrata. L’EGDS in urgenza e il ricovero in area critica van- Keywords: anche; base; basso; bleeding; che; clinica; con; critica; dei; del; delle; endoscopica; essere; nel; nella; non; pazienti; più; presenza; ricovero; risanguinamento; rischio; sangue; score; sng; sono; superiore; terapia; una; viene; w w
• Diagnostics through images in ER. From guidelines to clinical practice by Cibinel, Gian A.; Barozzi, Libero (2006) - diagnostica per immagini, radiologia interventistica e medicina nuclea- 42 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o II nu m er o III • G iu gn o 20 06 • w w w .e cj .it TAB. 3 Indicazioni per l’impiego dell’ecografia e della TC in emergenza e urgenza; grado di appropriatezza secondo le linee guida ASSR e ACR (disponibile su www.ecj.it). diagnostica per immagini, radiologia interventistica e medicina nuclea- 40 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o II nu m er o III • G iu gn o 20 06 • w w w .e Keywords: acr; alla; con; dei; della; diagnostica; emergenza; guida; immagini; linee; non; radiology; sono; sospetta; urgenza; w w
• Motorcycle accidents in forensic pathology. Human factors, and injury and crash tipologies by Lanino, Annalisa; Verri, Anna; Morandi, Anna; Marinoni, Alessandra (2008) - medicina legale 28 Le lesioni fratture-emorragie comportano un ri- schio molto elevato di gravità delle conseguenze (p < 0,001), l’assenza dell’abbigliamento protettivo un rischio maggiore del 53% di avere ferite gravi (anche se non significativo) e l’assenza del casco del 6% (non significativo). Al fine di valutare il ruolo dell’abbigliamento pro- tettivo e del casco, abbiamo ritenuto utile disaggre- gare l’analisi in base alla localizzazione delle ferite al corpo o al capo rispettivamente. Keywords: abbigliamento; alla; anni; casco; che; conducente; del; delle; ferite; gravità; guida; lesioni; non; più; protettivo; relazione; senza; sono; statisticamente; tipologia; totale; tra; una; urto; w w
• From literature by Melchio, Remo; Dutto, Luca (2006) - resa diagnostica del percorso con una bassa ospedalizzazione e un con- Il 25% dei pazienti è stato ospe- dalizzato per la sincope e un ulteriore 13% per le com- plicanze (trauma) o la comorbidità. Keywords: anche; autori; che; con; dei; del; gli; nel; non; pazienti; sono
• Divinum opus est sedare dolorem by Casagranda, Ivo (2006) - la civiltà occidentale e la cultu- ra del nostro tempo ci suggeriscono e per certi versi ci im- pongono, credo vada fatto ogni sforzo di tipo formativo, organizzativo e normativo (ad esempio rendendo più au- tonomi gli infermieri nell’utilizzo dei farmaci secondo protocolli concordati e validati) per gestire con più effica- cia questo problema. La Joint Commission on Accreditation of Healthcare Organisations (JCAHO) richiede, nei suoi standard di qualità, che tutti i pazienti vengano valuta- ti per il dolore e che di conseguenza ne abbiano una trattamento adeguato. Keywords: anche; che; come; dei; del; della; dolore; infermieri; nel; non; questo; una
• Work shifts in Emergency Medicine by Recupero, Roberto; Nardi, Laura (2007) - dei turni di lavoro notturno in PS. Nella seconda fase (stagnazione) l’operatore continua a lavorare ma si accorge che il lavoro non soddisfa del tutto i suoi bisogni. Keywords: anche; che; chi; con; dei; del; della; durante; essere; fase; iii; lavoro; medicina; non; notte; notturno; ogni; ore; più; può; sonno; turni; una
• Syncope in Prinzmetal’s variant angina by Parenti, Nicola; Mucci, Fabrizio; Lenzi, Tiziano (2006) - Fondamentale è la diagnosi differenziale tra le cause comuni di sincope e quelle gravi e pericolose. Classificazioni e terminologia Utile e chiara è le recente classificazione e terminologia proposta dall’European Society of Cardiology (ESC)6: • pre-sincope: termine usato per descrivere tutte le sen- sazioni che precedono una sincope, che possono o non possono esser seguite da perdita di coscienza; • sincope neuro-mediata, riflessa e neurogenica sono si- nonimi e descrivono una sincope dovuta a un’anor- male risposta riflessa del sistema nervoso autonomo; • sincope vaso-vagale “classica”: è un tipo di sinco- pe neuro-mediata evocata da emozioni intense; • sincope situazionale: è un tipo di sincope neuro- mediata che avviene durante o dopo minzione, de- fecazione, tosse o deglutizione; • sincope ortostatica: è diagnosticata in presenza di documentata ipotensione ortostatica; • sincope cardiogena: in caso di ischemia cardiaca o aritmia documentata; • sincope cerebrovascolare; • episodi non propriamente sincopali, ma con per- dita di coscienza non dovuta a ipoperfusione ce- rebrale: ischemia cerebrale (TIA, ictus), cause me- taboliche (ipoglicemia, ipossia, iperventilazione), epilessia, emorragia subaracnoidea, intossicazioni, pseudo-sincope psicogena. Keywords: alla; angina; caso; cause; che; con; del; della; diagnosi; ecg; episodi; esser; gli; monitoraggio; non; paziente; prinzmetal; può; sempre; sincopali; sincope; sono; terapia; una
• From literature and web by Melchio, Remo; Bracco, Christian (2007) - (da 15:2 a 30:2) e con l’in- dicazione a effettuare anche soltanto le compressioni toraciche per i soccorritori “laici” che non se la sen- tono di ventilare bocca a bocca i pazienti in arresto cardiaco extraospedaliero. I pazienti non rianimati dai soccorritori laici e che hanno dovuto at- tendere l’arrivo del soccorso avanzato avevano una sopravvivenza del 2,2%. Keywords: alla; che; compressioni; con; del; della; hanno; nel; non; pazienti; rischio; sono; una
• Use of psychopharmacological drugs in ER by Villari, Vincenzo (2008) - Per tale motivo è molto importante che lo psichiatra sia ben integrato nel Dipartimento di Emergenza e Accettazione (DEA) e che vi siano protocolli concordati e condivisi a livello del sin- golo ospedale per la formalizzazione di procedure operative che garantiscano la valutazione congiun- ta internistica e psichiatrica Per tale motivo appare importante raccomandare che lo psi- chiatra sia ben integrato nel PS e nel Dipartimento di Emergenza e Accettazione (DEA) e che vi siano protocolli concordati Keywords: anche; bdz; che; ciò; con; cui; dei; del; della; disturbi; effetti; essere; farmaci; gli; lorazepam; nel; non; pazienti; più; prima; può; sia; sono; spesso; terapia; una; w w
• RITG (Registro Italiano dei Traumi Gravi): multiregional Italian Register of Acute Traumas by Giugni, Simone; Gordini, Giovanni; Cancellieri, Francesco; Ciminello, Michela; Fratarelli, Eufreasia; Sangiovanni, Milena; Dibartolomeo, Stefano; Sanson, Gianfranco; Michelutto, Vanni (2006) - i quali il più determinante è il tasso di compilazione superiore al 70% per un sottogruppo di “dati sentinella”. All’infortunistica stra- dale vanno aggiunti gli incidenti domestici, quelli sul lavoro, quelli conseguenti ad attività sportive e del tempo libero e a violenza (in totale più di 4.500.000 eventi all’anno, con un tasso di mortalità ISTAT per incidenti non stradali pari a 22,8 uomini e 24,8 don- ne per 100.000 abitanti). Keywords: che; come; con; dati; degli; dei; del; della; injury; nel; non; ospedali; pazienti; più; progetto; qualità; questo; registro; sistema; sono; stati; system; trauma; una
• Clinical audit in practice by Perraro, Franco (2008) - Si tratta, in ogni caso, di progetti ed esperienze importanti e utili che vengono defi- Audit clinico nella pratica Franco Perraro Presidente onorario di SIQuAS/VRQ e di SIMEU Materiale protetto da copyright. Evidentemente c’è ignoranza sui temi della qualità e non è Keywords: alla; attività; audit; che; clinical; clinico; come; con; criteri; dati; degli; dei; della; dell’audit; devono; essere; gli; l’audit; miglioramento; nel; non; più; pratica; può; qualità; sono; standard; una
• Systemic inflammatory response syndrome: a case of septic shock by Gentiloni Silveri, Nicolò; Carbone, Luigi (2008) - clinica e terapia 15 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o IV n um er o IV • A go st o 20 08 • w w w .e cj .it clinica e terapia 18 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o IV n um er o IV • A go st o 20 08 • w w w .e cj .it Keywords: alla; che; con; dal; della; dopo; nel; non; o iv; ore; paziente; risposta; senza; sepsi; settico; shock; sirs; terapia; una; w w
• Pain management in ER by Burattin, Anna; Tonni, Maurizio; Poli, Mariapaola (2006) - In tale ambito è sta- to redatto e adottato un Manuale applicativo per la rea- lizzazione dell’ospedale senza dolore in seno al Progetto del Piano Socio Sanitario Regionale 2002-2004, in applicazione del paragrafo relativo alle cure palliati- ve, la terapia del dolore e gli interventi assistenziali nella fase finale della vita; in esso si individua tra gli obiettivi prioritari la predisposizione di efficaci ed ef- ficienti interventi per il controllo del dolore, che rap- presenta uno dei sintomi principali e più disturbanti per la qualità di vita del malato e che in molte situa- zioni assume le caratteristiche di vera e propria ma- lattia. La sede del dolore è multipla nell’11,4% dei pa- zienti; interessa in 35 pazienti il capo, in 22 il tora- ce, in 13 l’addome, in 82 gli arti e in 24 pazienti la colonna (Figura 1). Keywords: casi; che; dei; del; della; dolore; emergency; nel; non; pain; pazienti; pronto; sintomo; soccorso; sono; trattamento; una
• Acute abdominal pain: emergency diagnosis and treatment (Part II) by Cristoni, Lorenzo; Palmonari, Valeria; Iannone, Primiano; Lenzi, Tiziano (2008) - clinica e terapia 26 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o IV n um er o IV • A go st o 20 08 • w w w .e cj .it clinica e terapia 28 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o IV n um er o IV • A go st o 20 08 • w w w .e cj .it Fig. Keywords: acute; addominale; che; clinica; complicanze; con; dei; del; diagnosi; dolore; dopo; nel; non; pain; paziente; più; senza; sintomi; terapia; una; w w
• Bioethics and pain: which is Medicine's role in comforting? by Mori, Maurizio (2006) - In passato il valore di una persona si misurava nella capacità di af- frontare il dolore e la morte, mentre oggi la sopporta- zione delle sofferenze e l’accettazione della morte sem- bra non contino più. A prima vista si direbbe che il compito specifico e precipuo della medicina è quello di lenire il dolore fisico patologico. Keywords: alla; anche; che; con; cui; c’è; dal; dei; della; dolore; esempio; essere; fisico; infatti; istituzioni; medicina; nel; non; nuove; ossia; più; problema; può; quello; questo; sembra; senso; senza; sia; sono; una; vita
• From literature by Melchio, Remo; Dutto, Luca; Martini, Gianpiero (2006) - Gli Autori concludono che la terapia intensiva con in- sulina è in grado di ridurre significativamente la mor- bilità ma Lo studio evidenzia che il clopidogrel riduce significativamente il rischio di morte, reinfarto e stroke nei pazienti con infarto miocardico senza aumentare si- gnificativamente il rischio di emorragia maggiore. Keywords: autori; che; con; dei; del; gli; hanno; icu; mortalità; nei; nel; non; pazienti; studio; terapia; una
• How a hospital must face a massive emergency: the case of Martini Hospital, Turin by Morra, Antonio; Odetto, Lorenzo; Bozzetto, Pierangelo (2008) - emergency 4 2008 cop em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o IV n um er o IV • A go st o 20 08 • w w w .e cj .it 40 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o IV n um er o IV • A go st o 20 08 • w w w .e cj .it emergenza territoriale e medicina delle grandi emergenze creano molti problemi sotto il profilo clinico e or- ganizzativo. Keywords: caso; che; con; dei; della; disaster; emergency; emergenza; gestione; gli; hospital; martini; maxiemergenza; non; ospedale; piano; sono; torino; una
• When the system runs the risk of exploding or imploding by Casagranda, Ivo (2006) - In quest’ottica il medico di famiglia presente conti- nuamente per 12 ore al giorno potrebbe, a seconda delle necessità, usufruire per i propri pazienti di per- corsi snelli, messi a disposizione dall’ospedale di rife- rimento o da apposite strutture di tipo poliambulato- riale gestite dall’ASL, sul modello della walk-in clinic statunitense. Little, T.R. Pellegrino Il delicato equilibrio fra il banalizzare il sintomo di un paziente e l’essere partecipi di accertamenti diagnostici esagerati è ancora Keywords: che; dei; del; hanno; letto; medico; non; persone; pronto; questo; sistema; soccorso; una
• From literature and web by Allione, Attilio; Bernardi, Emanuele; Ricca, Marco; Melchio, Remo (2008) - 44 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o IV n um er o IV • A go st o 20 08 • w w w .e cj .it 44 revisioni dalla letteratura e dal web Dalla letteratura e dal web Attilio Allione, Emanuele Bernardi, Marco Ricca, Remo Melchio Dipartimento di Emergenza, AO Santa Croce e Carle, Cuneo Materiale protetto da copyright. Il trattamento con cortico- steroidi della CIRCI è stato maggiormante studiato nell’ambito della sepsi e dell’ARDS, mentre servono altri studi per definire il trattamento ottimale nel paziente critico con CAP, pancreatite acuta e insuf- ficienza epatica. Keywords: che; con; dei; della; nel; non; pazienti; settico; shock; soggetti; terapia; una
• Bad healthcare system, doctors' mistakes, and mass media by Perraro, Franco (2008) - Si tratta, in ogni caso, di progetti ed esperienze importanti e utili che vengono defi- Audit clinico nella pratica Franco Perraro Presidente onorario di SIQuAS/VRQ e di SIMEU Materiale protetto da copyright. Evidentemente c’è ignoranza sui temi della qualità e non è Keywords: alla; attività; audit; che; clinical; clinico; come; con; criteri; dati; degli; dei; della; dell’audit; devono; essere; gli; l’audit; miglioramento; nel; non; più; pratica; può; qualità; sono; standard; una
• Accidental hypothermia by Casagranda, Ivo; Lombardi, Giovanni; Cecconi, Dalio; Turchetti, Stefano; Scoti, Peppino; Cavozza, Corrado; Medici, Dante (2006) - è avvenuta in decima giorna- ta e il paziente è stato trasferito in venticinquesima giornata in un centro di riabilitazione con una lieve alterazione della coordinazione dei movimenti fini a sx. Per quel che riguarda le alterazioni elettrolitiche pla- smatiche, sono meno frequenti quelle che riguarda- no il sodio, il calcio e il magnesio, almeno fino a 25 °C. Keywords: alla; alterazioni; anche; arresto; cardiaco; care; caso; causa; centrale; che; clinica; con; dei; della; durante; essere; esterno; fino; hypothermia; ipotermia; liquidi; med; meq; nel; non; paziente; più; possono; può; questo; riduzione; riscaldamento; sistema; sono; sul; temperatura; terapia; una; viene; w w; ° c
• Acute abdominal pain: emergency diagnosis and managing (Part I) by Cristoni, Lorenzo; Palmonari, Valeria; Iannone, Primiano; Lenzi, Tiziano (2008) - clinica e terapia 26 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o IV n um er o IV • A go st o 20 08 • w w w .e cj .it clinica e terapia 28 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o IV n um er o IV • A go st o 20 08 • w w w .e cj .it Fig. Keywords: acute; addominale; che; clinica; complicanze; con; dei; del; diagnosi; dolore; dopo; nel; non; pain; paziente; più; senza; sintomi; terapia; una; w w
• Education, organization and sense-making: some intervening hypoteses by Balocco, Eusebio (2006) - organizzazione e formazione 23 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o II nu m er o 1 • Fe bb ra io 2 00 6 • w w w .e cj .it organizzazione e formazione 24 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o II nu m er o 1 • Fe bb ra io 2 00 6 • w w w .e cj .it • Keywords: alla; anche; che; come; con; dei; del; della; formazione; milano; non; organizzazione; più; pronto; sensemaking; soccorso; sono; una
• The search for a myocardial ischemia marker. The case of albumin modified by ischemia by Bagnati, Marco; Basile, Matteo; Toto, Barbara; Bellomo, Giorgio (2006) - Il siero è stato preincubato per 30 minuti con le concentrazioni indicate di rame e, in seguito, la capacità legante cobalto del siero stesso è stata misu- rata utilizzando lo stesso test impiegato per la valutazione di IMA nel siero di pazienti. È stata valutata, in questo studio, la capacità di IMA di predire la comparsa di valori elevati di troponina I e, quindi, di necrosi 6-24 ore dopo l’insorgenza della sinto- matologia. Keywords: albumin; capacità; cobalto; con; dei; del; della; hanno; ischemia; nel; non; pazienti; studi; test; una
• Pain management in Emergency departments. Evaluating the efficacy of an improving method by Gavetti, Dario; Frigerio, Simona; Di Giulio, Paola; Dimonte, Valerio (2008) - Obiettivo dello studio L’obiettivo è valutare l’efficacia dell’introduzione di una scala di autovalutazione del dolore nel ridurre l’intensità del dolore nei pazienti in dimissione dal PS, rispetto all’ingresso. Nel nostro Paese, i dati su modalità e strumenti uti- lizzati per la gestione del dolore in PS sono carenti. Keywords: che; con; dei; del; dimissione; dolore; emergency; fase; grave; intensità; nel; nella; non; pain; pazienti; post; pre; sono; tra; triage; una
• Indications and limits of traditional radiology in acute abdomen by Valentino, Massimo; Monteduro, Francesco; Pavlica, Pietro; Barozzi, Libero (2008) - Nuovo atlante del colon e del tenue. In caso di pneumoperitoneo mas- sivo l’aria distende l’addome ricordando il pallone del football americano (segno del pallone da foot- ball) delineando il legamento falciforme e, talvol- ta, l’uraco7. Keywords: anse; che; con; del; delle; dell’addome; diagnostica; diretto; essere; ileo; intestinale; laterale; non; paziente; proiezione; radiogramma; radiologia; una; w w
• Use of CPAP in ED: a comparison between two different systems by Groff, Paolo; Giostra, Fabrizio; Di Battista, Nicola; Miglio, Federico; Cavazza, Mario (2006) - la prima ora di trattamento e dura- ta del trattamento mediante CPAP (p < 0,002); inoltre, ha evidenziato una correlazione diretta tra il valore del- la frequenza respiratoria a un’ora di trattamento e dura- ta della permanenza in Area Critica (p < 0,01). I livelli di CPAP-PEEP sono regolati dal flus- so di ossigeno che alimenta i canalicoli: per esempio, un flusso di O2 di 20 l/min realizza una CPAP-PEEP di 5 cm H2O, un flusso di O2 di 30 l/min realizza una CPAP-PEEP di 10 cm H2O. Il sistema così costituito presenta alcuni vantaggi teori- ci. Keywords: boussignac; che; con; cpap; dati; dei; del; della; durata; edema; fio2; flusso; frequenza; gruppo; nel; non; pao2; parametri; pazienti; più; pressure; respiratoria; sistema; sono; stati; trattamento; una; w w
• From literature and web by Bracco, Christian; Rinaudo, Enrica; Bernardi, Emanuele; Melchio, Remo (2008) - 44 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o IV n um er o III • G iu gn o 20 08 • w w w .e cj .it 44 revisioni dalla letteratura e dal web Materiale protetto da copyright. Per valutare l’efficacia di tale protocollo operativo, è stata condotta una analisi su oltre 800 soggetti an- dati incontro a una condizione di arresto in sede extraospedaliera; sono state considerate le percen- tuali di sopravvivenza e il grado di disabilità neu- rologica rispettivamente nei soggetti gestiti secon- do le modalità convenzionali e nei soggetti riani- mati secondo lo schema MICR, in un periodo com- preso tra gennaio 2005 e novembre 2007. Keywords: che; con; del; della; nei; non; pazienti; una
• Cardiopulmonary Resuscitation and real life by Prevaldi, Carolina; Ragusa, Giuseppe; D’Este, Fabio (2006) - Dopo ogni compressione occorre lasciare riespande- re il torace prima di comprimere ancora per consen- tire il ripristino del flusso polmonare e il riempimen- to diastolico del cuore. Da un lato, se il panel che pianifica la revisione della li- nea guida non sollevava un quesito specifico, non c’era alcuna possibilità che la linea guida venisse modificata in funzione di nuovi risultati presenti in letteratura. Keywords: che; compressioni; con; controllo; cpr; dei; della; dopo; guida; hanno; linea; non; prima; resuscitation; ritmo; senza; soccorritori; sono; studi; sul; una
• Errors and difficulties in ER: how to manage the clinical risk by Bianchin, Claudio; Prevaldi, Carolina (2008) - 6 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o IV n um er o II • A pr ile 2 00 8 • w w w .e cj .it editoriale emergency care journal Difficile dire quanti, e quali, errori si verificano nel- le nostre unità operative di Pronto Soccorso. 7 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o IV n um er o 1I • A pr ile 2 00 8 • w w w .e cj .it editoriale differenziali determinando un elevato grado di in- certezza diagnostica. Keywords: che; degli; dei; del; della; errori; eventi; gli; non; sistema; una
• From literature and web by Melchio, Remo; Dutto, Luca; Martini, Gianpiero (2006) - La somministrazione di un inibitore dei fattori Va e VIIIa, la proteina C attivata (Drotrecogin alfa), si è di- mostrata in grado di ridurre del 6,1% il rischio relati- vo di morte in pazienti settici, a dispetto di un lieve in- cremento di emorragie maggiori. Si tratta della revisione sistematica forse più completa tra quelle attualmente disponibili sul- l’argomento, che conferma sostanzialmente i dati precedenti su mortalità e assenza di protezione rena- le. L’incremento della diuresi nel primo giorno di trattamento in assenza di grossi effetti collaterali po- trebbe spiegare la popolarità di cui gode ancora at- tualmente questo trattamento nelle terapie intensive (al limite della superstizione, secondo alcuni com- mentatori, chance per l’insufficienza cardiaca grave che necessita di sbloccare la diuresi secondo altri). Keywords: che; con; dei; del; della; dispnea; mortalità; morte; nei; nel; non; pazienti; rischio; studio; una
• Palpitations by Iannone, Primiano; Lenzi, Tiziano (2008) - La ma- novra di Valsalva anticipa il click e prolunga l’even- tuale soffio. La finestra di registrazione (24-48 ore), inoltre, è piuttosto limi- tata e non consente di indagare efficacemente il car- diopalmo a insorgenza sporadica. Keywords: anche; aritmie; atriale; battiti; cardiopalmo; cardiopatia; cause; che; clinica; come; con; dei; del; della; fibrillazione; non; onde; pazienti; più; possono; prematuri; senza; sincope; sindrome; sintomo; sono; tachicardia; una; ventricolare; w w
• Carbon monoxide: silent killer and expert imitator (Part II) by Petrolini, Valeria; Bigi, Stefania; Vecchio, Sarah; Lonati, Davide; Giampreti, Andrea; Locatelli, Carlo; Butera, Raffaella; Manzo, Luigi (2008) - Le linee guida SIMSI, SIAARTI, ANCIP utilizzano i seguenti criteri di inclusione per l’OTI nell’intossi- cazione da CO42: • pazienti in coma; • pazienti con momentanea perdita di coscienza; • pazienti con sintomi neuropsichiatrici (cefalea, nausea, vomito, vertigini, modificazioni caratte- riali ecc.); • pazienti con acidosi metabolica scompensata; • pazienti con dolore toracico e segni ECG di ischemica miocardica; • aritmie; • pazienti in gravidanza; • bambini in età inferiore ai 6 mesi per la presenza di HbF. Fermo restando, inoltre, che il valore di COHb è in- dicativo solo per la diagnosi di intossicazione da monossido di carbonio e non è di per sé indice del- la gravità dell’intossicazione, si consiglia, in attesa di ulteriori approfondimenti scientifici e in via tran- sitoria, anche il trattamento di: • pazienti asintomatici con COHb superiore a 25%; • bambini asintomatici con età inferiore a 12 anni con COHb superiore a 10%; • pazienti asintomatici con pregressa ischemia mio- cardica e con COHb superiore a 15%. Le alterazioni della ripolarizzazione visibili all’elettro- cardiogramma e le asinergie parietali possono essere presenti in fase acuta e scomparire con il tempo o insorgere a distanza di giorni dall’intossicazione19. Keywords: acute; anche; carbon; carbon monoxide; che; clinica; cohb; con; dei; del; della; diagnosi; essere; intossicazione; med; monoxide; monoxide poisoning; nei; non; pazienti; più; poisoning; può; sintomi; sono; test; toxicol; una; w w
• Communication in the Observation Units by Nardi, Laura; Recupero, Roberto (2008) - Accorgimenti relazionali: una parte integrante della cura Abbiamo, dunque, cercato di tratteggiare le caratte- ristiche del contesto emotivo e relazionale in cui av- viene l’incontro tra il paziente e il medico. e piangevo e più loro non capi- vano e discutevano di quale farmaco utilizzare per calmarmi». Keywords: alla; anche; avere; bisogno; che; come; comunicazione; con; condizione; cui; dal; del; della; essere; fondamentale; gli; il medico; il paziente; medico; mente; modo; momento; necessità; nel; non; obi; patologia; paziente; persona; più; prima; pronto; può; quando; questo; relazione; scritta; sempre; senza; sia; situazione; soccorso; solo; sono; sua; suo; tempo; torino; tra; una; w w
• New instruments to diagnose acute dyspnoea of cardiogenic origin by Elia, Fabrizio; Aprà, Franco; Olliveri, Federico (2008) - Con valori al di sotto di 100 per il BNP e 300 per il NTproBNP lo scompenso cardiaco può essere considerato im- probabile. In rapporto alla valutazione clinica com- plessiva l’ecografia aveva una sensibilità dell’85,3% e una specificità del 96,8%. Keywords: acute; alla; anche; bnp; cardiaco; cardiogeno; care; che; chest; con; dei; del; della; diagnosi; diagnostica; dispnea; edema; emergency; failure; heart; interstiziale; lung; med; nel; non; pazienti; peptide; più; polmonare; presenza; pronto; rispetto; scompenso; sensibilità; soccorso; sono; sovraccarico; toracica; tra; ultrasound; una; valori; w w
• Introducing the Journal by Casagranda, Ivo Casagranda (2005) - La volontà era quella di offrire un prodotto con dei contenuti fruibili, utili, interessanti e con una ricadu- ta pratica. Etica e Bioetica: molte sono ormai le discipline inte- ressate ai e dai problemi di tipo etico e bioetico. Keywords: anche; che; come; con; dei; della; d’urgenza; medicina; medico; nel; non; più; questa; rivista; sia; una
• Thinking of… Thinking over by Casagranda, Ivo (2008) - Mi scrive Massimo Pesenti Campagnoni, dire t t o re del DEA di Aosta, dopo aver letto l’articolo sopra citato: «Sono orgoglioso di far parte di un sistema che nello spirito e richiamando i principi fondatori del Siste- ma Sanitario Nazionale, tratta tutti coloro che arriva- no in Pronto Soccorso alla stessa maniera, classifican- doli per codice colore in funzione dei bisogni, secon- do algoritmi espliciti e non secondo censo, fornendo subito, anche se nel “casino”, non una pre s t a z Lì c’è spesso da aspettare parecchio tempo, in un ambiente trascu- rato e poco confortevole, però non ti viene chiesto che il nome e l’indirizzo e non ti viene richiesto il pa- gamento della prestazione che quando arriva è rapi- da, senza fronzoli e fatta con molta competenza. Keywords: che; con; del; non; pronto; sistema; soccorso; una
• Role and identity of ER doctors by Mengozzi, Ubaldo; Casagranda, Ivo (2005) - Il Medico d’Urgenza: ruolo e identità Il ruolo: come “parte affidata” Stando a quanto scritto sopra, il ruolo del Medico d’Urgenza coincide con quello della disciplina di rife- rimento, della quale traduce necessariamente da un punto di vista operativo i contenuti che la caratteriz- zano e che per molti aspetti ne disegnano anche l’identità. editoriale 8 In questi anni la necessità di acquisire tali compe- tenze ha indotto la FIMUPS prima e la SIMEU dopo a predisporre momenti formativi che potessero offrire ai medici uno standard professionale di base. Keywords: che; con; della; d’urgenza; gli; medicina; nel; non; pronto; questo; ruolo; soccorso; specializzazione; una
• Carbon monoxide: silent killer and expert imitator (Part I) by Petrolini, Valeria; Bigi, Stefania; Vecchio, Sarah; Lonati, Davide; Giampreti, Andrea; Locatelli, Carlo; Butera, Raffaella; Manzo, Luigi (2008) - A distanza di 4-40 giorni dall’evento acuto possono manifestarsi deficit neurologici che in alcuni casi per- mangono in modo definitivo: la frequenza di questa “ s i n d rome neurologica ritardata” o “sindrome post- i n t e rv a l l a re” viene variamente valutata fra il 5 e il 76% a seconda dei metodi di indagine e della durata del follow-up15,16. I dati disponibili in Italia, anche se non molto recenti, stimano che l’intossicazione da CO causi ogni anno circa 6000 ricoveri e più di 350 de- c e s s i4. Keywords: acuta; alla; anche; carbon; carbonio; che; circa; clinica; cohb; con; dei; del; della; dopo; età; intossicazione; monossido; monoxide; nei; nel; non; ossigeno; paziente; più; poisoning; può; risulta; senza; sintomi; sono; terapia; una; viene
• Portal vein thrombosis by Santamaria, Gian Mario; Morelli, Stefania; Trucco, Paola; Davio, Piero; Casagranda, Ivo (2005) - La differenziazione della trombosi in acuta e cronica è importante per la terapia e per la pro- gnosi. clinica e terapia 15 medico o chirurgico sull’evoluzione della Keywords: acuta; alla; anche; anticoagulante; casi; caso; che; clinica; collaterali; con; cronica; cui; dei; della; dell’addome; diagnosi; dopo; essere; fattori; flusso; gli; mentre; nei; nel; non; pazienti; più; portale; presenza; può; pvt; risulta; sia; sono; stato; studio; terapia; trombosi; una; vein; vena; venosa; viene
• Necrotizing fasciitis: clinical approach and diagnosis in DEA by Venturi, Alessandro; Rizzoli, Domenico; Cavazza, Mario (2008) - n i n a (PCT) per valori della prima compresi fra 50 e 150; una PCR > 150 mg/l o una PCT > 2 mg/ml ne documente- rebbe la probabile origine batterica1 1; • verifica in questi casi di presenza di SIRS che do- c u m e n t e rebbe un coinvolgimento funzionale ge- neralizzato dell’organismo; *SIRS: presenza di almeno 2 delle seguenti alte- razioni: - frequenza cardiaca stabilmente > 90 - f requenza respiratoria stabilmente > 20 o pCO2 < 35 - temperatura corporea < 36 °C o > 38 °C - globuli bianchi < 4000 o > 12.000 • esecuzione rapida in tali situazioni di emocultura e terapia antibiotica. e assegna un punteggio da 0 a 2 alle loro va- riazioni rispetto alla norma. Keywords: alla; anche; antibiotica; casi; caso; che; clinica; con; dal; dei; della; diagnosi; essere; fasciitis; fascite; livello; necrotizing; necrotizzante; non; patologia; paziente; precoce; pronto; può; quadro; senza; shock; soccorso; sono; surg; tale; terapia; tessuti; una
• Antibiotics usefulness and choice in BPCO acute exacerbation by Tartaglino, Bruno (2005) - In altro studio2, condotto su 112 pazienti con EA-BPCO, vi era una correlazione tra l’isolamento all’esame colturale dello sputo di Ente- robatteriacee e Pseudomonas spp e un FEV1 < 35%. clinica e terapia 20 Colonizzazione o infezione Numerosi studi hanno indagato il ruolo Keywords: atb; bpco; che; con; copd; del; delle; non; patogeni; pazienti; più; sono
• Difficulties reporting system in intensive care by Bianchin, Claudio; Bernardi, Lorenzo; Mazzon, Davide; Di Silvio, Lucio (2008) - Il Reparto è dotato di 11 posti letto con un tasso di sa- turazione medio del 60% e con una degenza media di 4-5 giorni. Le problematiche re- lative alla comunicazione e al rispetto di protocolli e p ro c e d u re confermano quanto già evidenziato in pre- cedenti studi9. Keywords: alla; avversi; care; che; con; dati; degli; dei; del; della; eventi; gravità; incident; nel; non; scheda; segnalazioni; sono; stati; tra; una
• Naloxone: intravenously, intramuscular, inhalatory and intranasal use in emergency cases by Locatelli, Carlo; Lonati, Davide; Petrolini, Valeria; Butera, Raffaella; Georgatos, Joannhe; Arrigoni, Simona Arrigoni; Giampreti, Andrea; Manzo, Luigi (2005) - Nelle overdose da clonidina, invece, la somministrazione di naloxone può provo- care un aumento della pressione arteriosa147,148. del naloxone in Medicina d’Urgenza avviene prevalen- temente per il trattamento della sindrome nota come overdose derivante dall’uso voluttuario di eroina e di alcuni agonisti oppioidi. Keywords: administration; agonisti; alla; anche; ann; che; con; copyright; da oppioidi; dei; della; dell’editore; depressione; di naloxone; distribuire; dopo; dosi; effetti; efficace; elettronicamente; emerg; endovenosa; essere; farmaci; fino; gli; l’autorizzazione; med; minuti; naloxone; nbcr; nei; nelle; non; opioid; oppioidi; overdose; pazienti; pharmacol; più; protetto; può; recettori; respiratoria; scritta; senza; sia; somministrazione; sono; tossicologia; una
• Organizational network in trauma management in Italy by Chiara, Osvaldo; Cimbanassi, Stefania; Fava, Alba; Vesconi, Sergio (2005) - Anche il fenomeno degli incidenti domestici e del tempo libe- ro mostra un impatto consistente sullo stato di salute della popolazione, con un numero di accessi in Pronto Soccorso di circa 4 milioni all’anno. In considerazione dei dati epidemiologici italiani, che indicano circa 450 traumi maggiori per anno per milione di abitanti, si considerano necessari in un SIAT di 2 milioni di abitanti un CTS con tutte le specialità e alme- no due CTZ, dotati solo di alcune specialità, tenendo anche conto delle caratteristiche del territorio e delle problematiche stagionali. Keywords: care; che; chirurgia; con; copyright; dal; decessi; dei; del; della; dell’editore; distribuire; elettronicamente; lesioni; l’autorizzazione; nel; non; pazienti; protetto; scritta; senza; sono; system; team; trauma; una
• Cardiovascular natriuretic peptides in emergency by Zaninotto, Martina; Mion, Monica; Rocco, Stefano; Plebani, Mario (2005) - In tale senso essi vanno utilizzati e richiesti e, data la complessità dei meccanismi che intervengono nel loro rilascio, la variazione delle concentrazioni circolanti va interpretata alla luce della storia clinica e di valutazio- ni cardiologiche e strumentali, ma in ogni caso sta a indicare una patologia che causa uno stress cardiaco: medicina di laboratorio e trasfusionale 43 emergency care journal Martina Zaninotto, Monica Mion, Stefano Rocco*, Mario Plebani Servizio Medicina di Laboratorio, Azienda Ospedaliera, Università degli Studi, Padova *Dipartimento di Emergenza, Azienda Ospedaliera, Università degli Studi, Padova Peptidi natriuretici cardiaci nell’emergenza Un’esperienza nella diagnosi differenziale di dispnea Keywords: 0,05; cardiaca; che; con; dei; del; diagnosi; dispnea; natriuretici; nel; nella; non; patologia; pazienti; peptidi; probnp; pronto; soccorso; una
• Emergency management of the individuals potentially contaminated by radioactive material and management of the hospitalization path by Muni, Alfredo; Becciolini, Aldo; Santoro, Antonio; Di Giorgio, Angelo; Testori, Ornella; Rouhanifar, Hamed; Zoccola, Roberto; Valentini, Daria; Bianchi, Donatella; Lombardi, Giovanni; Cecconi, Dalio; Casagranda, Ivo (2008) - i n a m e t ro superficiale Berthold LB 123: La revisione dei piani (coperti in parte da segreto mi- litare, e in gran parte con contenuto riservato) ha ri- guardato: • l’individuazione degli obiettivi sensibili e la loro protezione; • il coordinamento delle sale operative di emergen- za per l’individuazione degli indicatori di sospet- to attentato; • il coordinamento operativo sul campo tra le fun- zioni di pubblica sicurezza (varie forze di polizia), di soccorso tecnico (Vigili del Fuoco) e soccorso sanitario (118); • le dotazioni straordinarie per la gestione degli eventi NBCR e l’addestramento al loro utilizzo; • l ’ e ffettuazione di esercitazioni teoriche e pratiche congiunte tra le organizzazioni di soccorso e il lo- ro coordinamento da parte della sala operativa p rovinciale della Prefettura, responsabile unico dell’attivazione del Piano. Keywords: alessandria; alla; che; con; contaminato; contaminazione; dal; dea; degli; dei; del; della; emergenza; essere; materiale; medicina; medico; nazionale; nbcr; non; nucleare; parte; paziente; personale; piano; protetto; protezione; radioattività; sanitaria; senza; sono; sul; una
• the importance of research for nursing professions in Emergency Medicine (as well) by Di Giulio, Paola (2005) - Vengono riportati, e brevemente commentati, alcuni esempi di ri- cerche potenzialmente rilevanti per la professione infermieristica e viene sottolineata l’importanza della stretta relazione che deve esi- stere tra ricerca, formazione e pratica e della rilevanza dei quesiti di ricerca per l’assistenza e il miglioramento della pratica. Le procedure diagnosti- che e terapeutiche e le attività infermieristiche erano responsabili del 55,2% degli eventi. Keywords: alla; che; come; con; dei; della; dolore; d’emergenza; eventi; gli; infermieri; non; pazienti; più; ricerca; sono; stato; una
• Motorcycle accident in a forensic-pathological perspective by Lanino, Annalisa; Verri, Anna; Morandi, Anna; Marinoni, Alessandra (2008) - la tipologia lesiva si evince che il cranio e gli arti inferiori risulta- no maggiormente interessati da un quadro lesivo di tipo fratturativo-emorragico, mentre il tronco e gli ar- ti superiori da complessi lesivi di tipo contusivo- escoriativo. La pro g ressiva modificazione di tali quadri lesivi è p revalentemente attribuibile all’evoluzione delle s t ru t t u re dei veicoli (a quattro e a due ruote) e della viabilità, verificatasi innanzitutto attraverso l’adozio- ne di dispositivi e/o meccanismi di sicurezza e di mezzi di protezione, sia attivi sia passivi, i quali rap- p resentano del resto essi stessi una non trascurabile fonte di lesioni (v. lesioni al collo e al torace da cin- tura di sicurezza e/o da manubrio o volante, lesioni al volto da airbag, lesioni al piede da pedaliera, ecc.). Keywords: alla; arti; che; delle; gli; inferiori; legale; lesioni; non; più; sono; superiori; tipologia; tra; urti; urto; velocità
• Bioethics and Emergency Medicine: problems and perspectives by Mori, Maurizio (2005) - i problemi specifici che si pongono nella Medi- cina d’Urgenza vengono individuati i punti cardinali per l’orien- tamento in bioetica, nella convinzione che la conoscenza delle principali posizioni in questo ambito consente al lettore una scel- ta più consapevole e oculata. Recentemente, papa Benedet- to XVI ha precisato che il relativismo è la prospettiva «che, non riconoscendo nulla come definitivo, lascia come ultima misura solo il proprio io con le sue voglie, e sotto l’apparenza della libertà diventa per ciascuno una prigione, perché separa l’uno dall’altro, riducendo Materiale protetto da copyright. Keywords: altri; anche; bioetica; che; compito; con; così; cui; dei; della; essere; gli; medicina; nel; non; perché; più; posizione; questo; relativismo; sia; sono; una; vita
• From literature by Melchio, Remo; Dutto, Luca; Rinaudo, Enrica (2005) - Si tratta del primo studio randomizzato su questo aspetto: tuttavia presenta il limite di una scarsa numerosità del campione per cui gli eventi verificatisi sono scarsi (e l’end point combinato molto “ampio”). Il lavoro riveste un particolare interesse nel definire il ruolo del BNP in urgenza. Keywords: autori; che; con; controllo; del; della; gli; nei; non; pazienti; rischio; ritmo; scompenso; studio; una
• Revolving doors. When ER is most people's main healthcare reference point by Casagranda, Ivo (2007) - i sistemi e che, proprio per questa sua collocazione, è un senso- re molto attento in grado di percepire i mutamenti di ca- rattere sociale accanto a quelli di tipo sanitario. compartecipazione in alcuni casi del singolo cittadino (il cosiddetto ticket) e che, pertan- to, egli Keywords: anche; che; con; dei; frequent; gruppo; non; più; pronto; soccorso; una; users
• Hippocrates, the τεχνη, the individuals and the institutions by Pesenti Campagnoni, Massimo (2007) - In que- sto senso, si deve chiarire che il compito del medico non è difendere la “vita” tout court, ma la “vita buo- na”, e che l’assistenza sanitaria non può limitarsi alla mera parte organica. Si deve riconoscere che situazioni nuove richiedono ri- sposte nuove, e che è sbagliato e anche dannoso continuare a ragionare in base a schemi passati. Keywords: anche; che; come; con; così; del; della; malato; medico; nel; non; perché; più; può; una; vita
• Acute bronchial asthma by Ramuscello, Susanna; Tombini, Valeria; Perucchini, Emanuela; Coen, Daniele (2007) - la limitazione del flusso nelle vie ae- ree, ma due hanno guadagnato un’ampia credibilità quando utilizzati nei pazienti di età superiore ai 5 an- ni: la spirometria (in particolare FEV1) e la misurazio- ne del picco di flusso espiratorio (PEF). Viene richiesta una radio- grafia del torace, che evidenzia una stria disventilati- va alla base destra e un lieve rinforzo del disegno pol- monare ilo-perilare e bibasilare. Keywords: aeree; agonisti; alla; anche; asma; asthma; bambini; che; chest; clinica; cochrane; con; crisi; dei; del; della; dell’asma; dell’editore; distribuire; dopo; d’asma; elettronicamente; emergency; essere; fev1; ice; iii; l’autorizzazione; med; meno; nei; nel; non; ogni; ore; paziente; pef; più; possono; pronto; può; respiratoria; scritta; senza; sintomi; soccorso; somministrazione; sono; terapia; trattamento; treatment; una; vie; w w
• Infective endocarditis: diagnostic and therapeutic approach in emergency medicine by Previati, Rita (2007) - Il trattamento di scelta è con una penicillina penicillinasi-resistente, come l’oxa- cillina (sostituibile con vancomicina in caso di allergia alla oxacillina) associata alla gentamicina. • sede anatomica cardiaca coinvolta: endocardite del cuore destro o sinistro; • tipo di microrganismo responsabile: l’identificazio- ne del microrganismo responsabile fornisce infor- mazioni importanti per l’andamento clinico, la prognosi e la terapia. Keywords: alla; anche; aortica; batterica; cardiaco; che; con; criteri; dei; del; delle; diagnosi; d’urgenza; endocardite; essere; febbre; infective; nel; non; paziente; più; può; rischio; scompenso; sono; terapia; una; valvolare; viene; w w
• Clinic scan in ER: forensic-pathological implications and report criteria by Testa, Americo; Cittadini, Francesca; Ursella, Stefano; d’Aloja, Ernesto; Gentiloni Silveri, Nicolò (2007) - La società scientifica internazionale riconosce un in- discusso ruolo chiave della metodica diagnostica eco- grafica a letto del paziente critico, utilizzabile subito in maniera affidabile e innocua, al fine di chiarire un iter diagnostico ed eventualmente interventistico al- trimenti difficile e indaginoso, e ne prevede e auspi- ca una diffusione capillare nei Dipartimenti di Emer- genza1,7,12. 12, 16 e 18 di detto Codice sottolinea- no, infatti, che tutti «i trattamenti medici siano ispi- rati ad aggiornare e sperimentare acquisizioni scienti- fiche anche al fine dell’uso appropriato delle risorse, sempre perseguendo il beneficio del paziente» e che «il medico è tenuto a una adeguata conoscenza Keywords: alla; alle; anche; che; codice; colpa; come; con; cui; dal; dei; del; della; dell’esame; deve; d’urgenza; ecografica; emergency; emergenza; eseguita; essere; gli; legale; livello; medicina; medico; metodica; nei; nel; non; paziente; più; professionale; pronto; può; responsabilità; scritta; senza; sia; soccorso; tale; tra; ultrasound; una; urgenza; valutazione; w w
• Quickly and well… A survey on customer satisfaction of low injury severity scores in ER by Baldantoni, Enrico; Chiusole, Daniela; Fauri, Ivo; Refatti, Franca; Scillieri, Marco; Torboli, Pierluigi (2007) - dei problemi sani- tari che hanno indotto i pazienti a rivolgersi al PS che, sotto que- sto profilo, svolge un’azione vicariante nei confronti di altri li- velli assistenziali. In tale ambulatorio i pazienti sono visitati da un medico del PS che può trattare direttamente i pazien- ti, ovvero prescrivere gli accertamenti specialistici ri- tenuti necessari. Keywords: alla; anni; bianchi; che; codici; con; degli; dei; del; della; distribuzione; emergency; medico; molto; nel; non; pazienti; sono; tab; totale; una; visita; w w
• Forensic microbiology and bioterrorism risk (Part II) by Nasso, Maria; Romolo, Francesco Saverio (2007) - Quando si cominciò, poi, a percepire il rischio di un potenziale utilizzo di agenti biologici per un attacco terroristico, i CDCs entrarono a far parte del Laboratory Response Network, una rete organizzata per realizzare una più rapida identifica- zione degli agenti utilizzati e, quindi, potenziare la ri- sposta a un possibile attacco con queste armi13,14. L’emergenza bioterrorismo, però, non ha contraddistin- to solo gli Stati Uniti, ma in tutti i Paesi occidentali, com- presa l’Italia, il rischio di episodi di terrorismo con armi non convenzionali è divenuto più plausibile. Keywords: alla; alle; analysis; anthracis; anthrax; bacillus; bioterrorism; camr; che; con; crimine; cui; dei; del; della; di un; distribuire; dna; elettronicamente; era; essere; forense; forensics; gli; ice; isolati; loci; materiale; microbial; mlva; molto; nel; non; number; più; polimorfismi; possibile; questo; repeat; salute; sono; stato; tandem; una; un’indagine; usamriid; variable; vntr; w w
• Forensic microbiology and the bioterrorism risk (Part I) by Nasso, Maria; Romolo, Francesco Saverio (2007) - Bi- sogna attendere il 1963 per un primo tentativo di de- finizione di criminalistica da parte di Kirk, che la qualifica come “scienza dell’individuazione”5. Stime prudenti affermano che la sola Europa perse, durante la pandemia, circa trenta milioni di abitan- ti16,17. Keywords: agenti; alla; anni; anthracis; anthrax; armi; biological; bioterrorism; che; chemical; come; con; dei; della; durante; emerg; era; forensi; gli; guerra; hanno; health; med; nel; new; non; più; sarin; scienze; senza; stati; una; w w; warfare; weapons
• From literature and web by Melchio, Remo; Ferrillo, Sara; Bracco, Christian (2007) - Inoltre per rendere più ve- loce l’iter del paziente in Pronto Soccorso sono stati previsti in alcuni casi percorsi diagnostici preferen- ziali per le patologie più rappresentate e in alcune realtà, come il San Antonio Public Hospital, sono sta- te istituite strutture revisioni dalla letteratura e dal web 45 emergency care journal em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o III n um er o II • A pr ile 2 00 7 • w w w .e cj .it Keywords: che; con; del; non; pazienti; più; una
• Nurse's role in evaluating early treatment of acute pain during triage in ER by Palermo, Patrizia; Fagiani, Anna; Bottino, Giorgio; Crocco, Linda; Luparia, Angela (2007) - è che il trattamento del dolore acuto in Pronto Soccorso da parte dell’infermiere di triage, in alcuni casi ben selezionati, migliori la qualità dell’assistenza of- ferta. Procedure È stato stilato un protocollo da parte del Direttore medico di Dipartimento che esplicitava le condizio- ni da trattare e il tipo di farmaco da utilizzare dopo aver interpellato il medico d’urgenza in quel momen- to in servizio. Keywords: casi; che; con; dei; del; dolore; emerg; medico; nel; nella; non; pain; pazienti; pronto; questo; soccorso; trattamento; triage; una; vas
• From literature and web by Melchio, Remo; Martini, Gianpiero (2007) - In considerazione del fatto che il volume di attività dell’ospedale non presenta una relazione linea- re con l’esperienza del singolo medico è ragionevole pensare che la disponibilità immediata di consulenti, di medici d’urgenza più addestrati e il numero annuo di diagnosi di IMA per ED sia in grado di condizionare da solo il rischio di IMA non ri- conosciuto. Keywords: antibiotici; che; del; diagnosi; non; pazienti; rischio; una; volume
• The real context in emergency medicine by Cavazza, Mario (2011) - È certo che è richiesta sempre lucidità e determinazione nell’ imboccare un percorso diagnostico piuttosto che una decisione terapeutica, laddove si deve continuamente mediare tra rapidità decisionale (grande al- leata del medico di urgenza) e la fretta (subdola nemica e insi- diosa trappola sempre innescata), o tra le più moderne opportu- nità diagnostico - terapeutiche (spesso costose e non a vasta fruibilità) e le risorse attuali del pubblico sistema della salute (in continua e rigorosa razionalizzazione). S pe di zi on e in A .P. D .L . Keywords: anche; che; con; contesto; dei; del; della; emergenza; lavoro; nel; non; più; questo; ricerca; sempre; una
• Biomarker validation in the emergency department. General criteria and clinical implications by Lippi, Giuseppe; Mattiuzzi, Camilla; Cervellin, Gianfranco (2014) - Non -co mmerc ial establishing reference ranges,8 Non -co mmerc ial 8 and also places Non -co mmerc ial and also places a substantial economical burden on ED and Non -co mmerc ial a substantial economical burden on ED and laboratory, especially when the use of laborato- Non -co mmerc ial laboratory, especially when the use of laborato- ry resources is poorly discretionary, or even Non -co mmerc ial ry resources is poorly discretionary, or even inappropriate. Receiver operating characteristicNon -co mmerc ial Receiver operating characteristicNon -co mmerc ial us e o nly Keywords: -co; accutni; emergency; ial; immunoassay; lippi; mmerc; non; sensitivity; troponin
• Management of the patient with sepsis in emergency department: a new alternative protocol by Monti, Manuel; Stefanecchia, Lucia; Fusco Moffa, Igino; Fioriti, Luciano; Filippucci, Manolo; Vincentelli, Giovanni Maria; Borgognoni, Francesco (2014) - Point: should lactate clearance be substituted for central venous oxygen saturation as goals of early severe sepsis and septic shock therapy? Introduction The progression of sepsis towards an unfa- vorable outcome depends mainly on delayed diagnosis and treatment, on the virulence of the pathogen and on the immune status of the patient.1 Jones has recently defined sepsis as a complex puzzle, where the host response to the infection is characterized by different reac- tions such as inflammation, endothelial dys- function, alterations to the coagulation-fibri- nolysis system and others.2 The course of the disease can lead to severe sepsis, multiple organs failure, hypotension, and septic shock.3 The hospitalization rate of people with a principal diagnosis of septicemia or sepsis more than doubled from 2000 through 2008, increasing from 11.6 to 24.0 per 10,000 people with a prevalence of gram-negative infections.4 Patterns of infecting organisms were similar to those in previous studies, with predominant organisms being Staphylococcus aureus (20.5%), Pseudomonas species (19.9%), Enterobacteriacae (mainly E. coli, 16.0%), and fungi (19%).5 The early goal-directed therapy (EGDT) is often underused partly due to the difficulty in invasive procedures. Keywords: care; emergency; lactate; med; non; sepsis; septic; treatment
• Late postpartum preeclampsia induced acute pulmonary edema, a rare presentation of a common disease: A case report by Rua, João; Costa, Joana; Leite, José; Marques, Ricardo; Queiró, Joana; Fortuna, Jorge; Rodrigues, Adriano (2018) - ©Copyright J. Rua, 2018 Licensee PAGEPress, Italy Emergency Care Journal 2018; 14:7240 doi:10.4081/ecj.2018.7240 Late postpartum preeclampsia induced acute pulmonary edema, a rare presentation of a common disease: A case report João Rua,1 Joana Costa,1 José Leite,1 Ricardo Marques,1 Joana Queiró,2 When severe, marked hypertension and end-organ damage become evident with pulmonary edema, oliguria, renal failure, impaired hepatic function or thrombocytopenia.4 Organ infarction or hemorrhage, congestive heart failure or pulmonary edema, renal failure and HELLP syndrome are potentially life threatening.7 Preeclampsia also leads to a reduction in plasma oncotic pressure, altered endothelial permeability and decrease in colloid osmotic pressure to left ventricular end-diastolic pressure gradient. Keywords: acute; edema; emergency; hypertension; non; postpartum; preeclampsia; severe
• Encountering and counselling patients and family members in out-of-hospital emergency care in non-conveyance situations: Follow-up study in Finland by Paavilainen, Eija; Mikkola, Riitta; Salminen-Tuomaala, Mari; Leikkola, Päivi (2018) - [Emergency Care Journal 2018; 14:7468] Emergency Care Journal 2018; volume 14:7468 Abstract Rather little is known about emergency care in out-of-hospital settings, for example in patients’ homes, where acute situations often emerge and require rapid action from those present. Introduction Emergency care, as a life-saving health care service, has been studied quite extensively worldwide over the past years.1-3 However, little is still known about emergency care that takes place in out-of-hospital settings, for example in patients’ homes. Keywords: care; conveyance; counselling; data; emergency; family; hospital; members; non; patient; respondents; situations
• Customer satisfaction: what can we save? by Lerza, Roberta (2011) - Le principali obiezioni degli operatori della sanità si potrebbero sem- plicemente riassumere con il fatto che se un cittadino/utente può certamente esprimere un giudizio su di un prodotto che cerca, ac- quista o utilizza, ad esempio un paio di scarpe, quando lo stesso cittadino si trova ad utilizzare un servizio sanitario, il suo giudizio è influenzato da talmente tante variabili, che la sua valenza può es- sere molto relativa. Più difficile è il giudizio e la percezione su alcune innovazioni cliniche che hanno radicalmente cambiato il nostro lavoro e che costituiscono come minimo un for- Keywords: che; chi; con; del; della; giudizio; non; paziente; più; può; servizio; sono; tra; una
• Non-invasive intensive care in the emergency care unit by Di Battista, Nicola (2011) - Una comune e condivisa cultura intensi- vistica costituisce l’unica strada possibile per il conseguimento: 1. di un elevato filtro in ingresso verso le terapie intensive, e quindi di una maggiore appropriatezza del loro impiego, 2. di un precoce inquadramento emodinamico, e quindi di una maggiore efficacia dell’intervento terapeutico 3. di una migliore compren- sione fisiopatologica del timing in cui l’intervento terapeutico si inserisce, e quindi di un suo più efficiente monitoraggio, 4. di una più efficace continuità assistenziale del paziente critico, e quindi di un suo outcome più favorevole, 5. di una riduzione dei costi assistenziali globali, e quindi di una possibile sosteni- bilità economica. La Medicina d’Urgenza occupa una sorta di pole position nel- editoriale Materiale protetto da copyright. Keywords: che; dei; del; essere; non; paziente; più; una
• Onset of angioedema following a viper bite: different options for diagnostic procedure in an emergency department by Riccardi, Alessandro; Minuto, Pierangela; Da Col, Anna; Panunzio, Viviana; Lerza, Roberto (2011) - Five different types of non-allergic angioedema are defined in literature (1). In fact, the old term “angioneurotic oedema” derived from the opinion that in non-allergic angioedema precipitating factors included minor trauma, estrogen, infection and emotional stress (7,8). Keywords: allergic; angioedema; emergency; non; patient
• Evaluation of the context: from Saint Vincent's thoughts to real world applications by Casagranda, Ivo (2011) - i casi nei quali vi è una particolare difficoltà nella diagnosi, sovente accresciuta dall’urgenza; e di distinguere tale situazione da quel- le in cui il medico è malaccorto, non si adopera a fronteggiare adeguatamente l’urgenza o tiene comportamenti semplicemente omissivi, tanto più quanto la sua specializzazione gli impone di agire tempestivamente proprio in urgenza”. Blaiotta, emerge il concetto di contesto che dovrebbe essere tenuto in conto nell’esprimere il giudizio. Keywords: che; cui; della; medico; non; responsabilità; una
• Centralization of politrauma. Study of Ferrara’s reality and simulation of an agreed-upon protocol by Melcarne, Luigi; Ricciardelli, Adelina; Melandri, Roberto; Farinatti, Marco; Gatti, Alessandro; Occhionorelli, Savino (2011) - In-hospital - Capacità del protocollo di identifi- care i pazienti politraumatizzati necessitanti di primario accesso al centro hub. La procedura, oltre a favorire una riduzione della mortalità e morbilità del paziente politraumatizzato, offre al sistema l’op- portunità di garantire una migliore riqualificazione professio- nale degli operatori del soccorso e una razionalizzazione delle risorse per l’azienda sanitaria. Keywords: centralizzazione; che; come; con; dati; dei; del; delle; ferrara; hospital; hub; nel; non; pazienti; più; politrauma; protocollo; quindi; sono; trauma; una
• Interactive managing of critical events: hypothesis for a new educational technique by Orsini, Cinzia; Cricca, Elisabetta; Galavotti, Sandro; Mazzotti, Marina; Parma, Brunella; Corsi, Amedeo (2011) - SINTESI Introduzione è noto che la professionalità di un qualsiasi operatore sanitario è determinata da tre elementi distintivi fondamentali: il possesso di conoscenze tecniche aggiornate, di abilità manuali e di ca- pacità comunicative e relazionali. L'obiettivo del corso è indurre un contraddittorio, tra le varie professionalità in campo, su alcune problematiche di ordine organizzativo/scientifico, con lo scopo di uniformare le modalità d'intervento, fermo restando la professionalità di ognuno, l'unicità dei vari scenari e la validi- tà del concetto di agire per principi e non sempre e comunque per protocolli. Keywords: alla; che; con; corso; dei; del; della; figura; formazione; item; nel; non; una; w w
• Triage Emergency Method Version 2 (TEM v2). A new triage within hospital method by Parenti, Nicola; Serventi, Vito; Miglio, Rossella; Masi, Stefano; Sarli, Leopoldo (2011) - Infatti, prima di iniziare lo studio, abbiamo inviato con mail, il TEM v1 e una breve guida a tutti i parteci- panti. A quanto ci risulta, questo è il primo studio italiano che usa una tecnica Delphi per raggiungere consenso su un metodo di triage e per migliorarlo. Keywords: abbiamo; atto; che; cheê; con; consenso; conê; daê; dei; del; delphi; di triage; diê; dolore; esperti; gruppo; guida; inê; metodo; non; nonê; nrs; orê; partecipanti; primo; round; senzaê; studio; tabella; tem; triage; una
• Suicide and attempted suicide: a challenge in emergency-urgency. Critical review and experience in the emergency departments of Parma’s province. by Rastelli, Gianni; Trevia, Marco; Lippi, Giuseppe; Cervellin, Gianfranco (2011) - è utile, spes- so indispensabile, somministrare già in PS una benzodiazepina (diazepam o lorazepam) e un farmaco antipsicotico (aloperidolo, clotiapina o clorpromazina) per ridurre l’agitazione e il pericolo potenziale per il paziente e per il personale13. Dal momento che il rischio di ripetere il gesto è molto più elevato nelle settimane successive al tentativo precedente, è opportuna una rapida e solida presa in carico che parta proprio dal contatto con il PS o con il MMG. Keywords: alla; anche; casi; che; comportamenti; con; dal; dei; del; della; depressione; disturbi; essere; gli; il suicidio; medico; morte; nei; nel; non; paziente; personalità; persone; più; pronto; rischio; soccorso; sono; suicide; suicidio; tentato; tra; una; valutazione

• Acute intoxication following massive bupropion sniffing: A case report by Sartori, Simone; Brilli, Valentina; Lanzi, Cecilia; Pratticò, Luca; Sarcoli, Elisabetta; Di Milia, Maria Grazia; Gambassi, Francesco; Mannaioni, Guido (2021) - Discussion This case of intranasal bupropion misuse shared only some of the most common clinical features of a classical bupropion inges- tion overdose (considering comparable amounts of medication).14 Therapeutic daily doses for bupropion are usually up to 300 mg/day15 reaching peak concentration after 1.5 hours and 3-5 hours for immediate or modified-release formulations, respectively.16 Half-life is about 21 hours in chronic users and it can be even longer for the presence of active metabolites.14 Therapeutic win- dow is considered between 5 to 100 ng/mL.17 Bupropion misuse might rapidly become a concerning issue and monitoring by healthcare professionals is needed. Keywords: bupropion; care; case; day; hours; intoxication; intranasal; misuse; urine
• Gino Strada (1948-2021) by Monti, Giorgio (2021) - It will remain operate there for 7 years, while other hospitals in Kabul and Laskargah were opened. Paediatric hospitals were then opened in Iraq, in Kurdistan, and in the Central African Republic. Keywords: care; emergency; hospital; war
• Communicating science in the time of Coronavirus: What we have learned by Barbieri, Greta; Poggiali, Erika; Salvatore, Veronica; Salinaro, Francesco (2021) - The other original paper that adds knowledge to scientific community regarding COVID-19 therapy is the one by Vergnano et al., who argue that corticosteroids in selected COVID-19 patients may have a relevant impact on out- come.5 As we know, COVID-19 affected not only the body but also the mind. Beghi et al. demonstrated an increase in number of admissions for psychiatric evaluations after the lockdown, com- pared to those of the previous year, underlining the negative psy- chological effects of quarantine and the need of specific support.6 COVID-19 pandemic also notably increased the use of High- Flow Nasal Cannula (HFNC) for respiratory support, in alternative to traditional low-flow nasal cannulas or to prevent continuous positive airways pressure and mechanical ventilation. Keywords: care; emerg; emergency
• Pre-hospital emergency care system: Utilization of ambulance services in Nairobi county by Musyoka, Felistus Ndanu; Kioko, Abdushakur Ndolo (2021) - This implies that, over this period (almost 2 decades), there has not been a significant improvement in the utilization of pre-hospital emergency care ambulances in Nairobi. There was low public aware- ness on available pre-hospital emergency care services and toll- free lines for emergency services. Keywords: ambulance; care; emergency; health; hospital; kenya; medical; pre; services; study
• Developing a conceptual model for studying various points of delays and underlying factors in the emergency healthcare system by Muraleedharan, Manesh; Chandak, Alaka Omprakash (2022) - An analysis of cross-sectional survey characteristics data and spatial modeling19 Maternal death and delays in accessing emergency obstetric Pre-hospital delay Disease-related characteristics, Health system care in Mozambique18 characteristics The effect of emergency department delays on 30-day In-hospital delay Disease-related characteristics, Organizational level factors mortality in Central Norway21 Factors associated with emergency medical service delays Pre-hospital delay Socioeconomic characteristics, Health system in suspected ST-elevation myocardial infarction in Victoria, characteristics, Disease-related characteristics Australia: A retrospective study20 Independent patient factors Factors influencing time-dependent quality indicators for patients Pre-hospital delay Socioeconomic characteristics, Health system with the suspected acute coronary syndrome3 In-hospital delay characteristics, Disease-related characteristics Factors influencing pre-hospital delay in patients presenting Pre-hospital delay Socioeconomic characteristics, Health system characteristics with ST-elevation myocardial infarction and the impact of pre-hospital electrocardiogram22 Factors influencing patient delay before primary percutaneous Pre-hospital delay Socioeconomic characteristics, Health system coronary intervention in ST-segment elevation myocardial infarction: characteristics, Disease-related characteristics The Stent for life initiative in Portugal26 Independent patient factors The influence of emergency department crowding on the efficiency In-hospital delay Organizational level factors of care for acute stroke patients16 Pre-hospital delay and its associated factors in first-ever stroke Pre-hospital delay Socioeconomic characteristics, Health system registered in communities from three cities in China27 characteristics, Disease-related characteristics Independent patient factors Factors Associated With Delays in Seeking Medical Attention Pre-hospital delay Socioeconomic characteristics, Disease-related in Patients With ST-segment Elevation Acute Coronary Syndrome10 characteristics Independent patient factors First Aid Practices and Health-Seeking Behaviors of Caregivers Pre-hospital delay Socioeconomic characteristics, Health system for Unintentional Childhood Injuries in Ujjain, India: characteristics, Disease-related characteristics A Community-Based Cross-Sectional Study6 Healthcare-seeking behavior for infectious diseases in a Pre-hospital delay Health system characteristics, Disease-related community in Bangladesh15 characteristics A population-based study on healthcare-seeking behavior Pre-hospital delay Health system characteristics, Disease-related of persons with symptoms of respiratory and gastrointestinal-related characteristics Independent patient factors infections in Hong Kong5 Delays from first medical contact to antibiotic administration The study aims to review various literature related to emergency healthcare delays and develop a conceptual framework for future research. Keywords: care; characteristics; delay; emergency; factors; health; healthcare; hospital; model; patient; pre; review; seeking; system
• A sabbath in the emergency room or a case of anticholinergic toxicity? by Agosti, Antonio; Bricchi, Silvia; Rovati, Francesca ; Vancea Opris, Mara; Ponzi, Davide Giulio; Mariani, Francesco; Morelli, Nicola ; Magnacavallo, Andrea; Vercelli, Andrea; Poggiali, Erika (2022) - E-mail: poggiali.erika@gmail.com Key words: Anticholinergic toxicity; anticholinergic syndrome; Datura stramonium; toxic plants. Antonio Agosti,1 Silvia Bricchi,1 Francesca Rovati,1 Mara Vancea Opris,1 Davide Giulio Ponzi,1 Francesco Mariani,1 Nicola Morelli,2 Andrea Magnacavallo,1 Andrea Vercelli,1 Erika Poggiali1 1Emergency Department, Guglielmo da Saliceto Hospital, Piacenza; 2Neurology Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy Highlights - Anticholinergic syndrome is a real medical emergency. - Anticholinergic syndrome should always be considered in the differential diagnosis of a sudden onset of altered mental status. - Medications, psychoactive drugs, homeopathic solutions, and toxins can cause anticholinergic syndrome with fatal outcome. - Plant-induced anticholinergic syndrome should be always considered and investigated. - Datura stramonium and Atropa belladonna are the most common cause of anticholinergic toxicity. Keywords: anticholinergic; care; case; datura; diagnosis; emergency; med; patient; physostigmine; stramonium; syndrome; toxicity; toxicol
• The crisis of the Italian emergency medicine and specialty: The point of view of COSMEU by Borio, Giorgia (2022) - E-mail: borio.giorgia@hsr.it Key words: Emergency medicine; emergency specialty; health crisis; national health system; Italy. In this contest the role of emergency medicine residents has been crucial as reported by Secco et al.3 Immediately we have been enrolled in the frontline with the unavoidable consequence of a break in our resi- dency program. Keywords: care; covid-19; emergency; medicine; specialty
• Evidence-based imaging for the management of lower back pain in the emergency department: A narrative review by Akkihal, Kartik; Adams, Edy C.; Khan, Soman; Jafri, Faraz; Taboada, Jorge; Varkey, Thomas (2022) - This narra- tive review will present a hypothetical typical standardized case of a patient presenting with lower back pain, examine the current evi- dence and recommendations from the major ruling bodies in inter- nal medicine, neurology, neurosurgery, and radiology, evaluate the major statements released by the Choosing Wisely campaign, and finally, present a new diagnostic decision tree for the management of lumbar back pain. Evidence-based imaging for the management of lower back pain in the emergency department: Keywords: care; department; emergency; imaging; low; lumbar; pain; patient; studies
• Out of hospital cardiac arrest during COVID-19 pandemic: A retrospective study from north east of Italy by Breglia, Andrea; Ruggeri, Marco Stefano; Pettenella, Pietro; Ippolito, Renato; Fossa, Claudio; Zanatta, Mirko (2022) - [Emergency Care Journal 2022; 18:10436] [page 5] Out of hospital cardiac arrest during COVID-19 pandemic: A retrospective study from north east of Italy Andrea Breglia,1 Marco Stefano Ruggeri,1 Pietro Pettenella,1 Renato Ippolito,2 Claudio Fossa,1 Mirko Zanatta3 1Emergency Department, Cazzavillan Hospital, Arzignano; 2Emergency Department, Padua University Hospital, Padua; 3Emergency Department, San Lorenzo Hospital, Valdagno, Italy Non -co mmerc ial us e o nly Materials and Methods We performed a retrospective observational study in the rural western district of Vicenza (Veneto, Italy), which counts nearly 120.000 inhabitants, to evaluate patients affected by non-traumatic OHCA and we analyzed epidemiological and clinical characteristics associated with sustained Return Of Spontaneous Circulation (ROSC). Moreover, in the PP we observed an increase of cardiac causes of cardiac arrest and a reduction of unknown cause of OHCA (40% vs 8% and 50% vs 81% respectively; p=0.001). Keywords: arrest; cardiac; care; cpr; hospital; ohca; pandemic; rosc
• Emergency medicine residents in Italy: Data from a national survey by Piazza, Isabelle; Barcella, Bruno; D'Ercole, Adriana; Zaccaria, Gianpiero; CoSMEU group (2022) - It exists only since 2009, and CoSMEU (Coordinamento Specializzandi Medicina d’Emergenza-Urgenza) is the national association of EM residents. Communication and leadership skills are demanding, but pivotal to work efficiently and to deal with patient distress and family expectations in very difficult situations.3 CoSMEU (Coordinamento Specializzandi Medicina d’Emergenza-Urgenza) is the national association of EM residents in Italy, that was born in 2017 with the aim to enhance a standardized training, to safeguard the interests of EM doctors in training, to develop opportunities and to formalize specific academic paths.4 We conducted a survey on the academic year 2019-2020 to assess the Italian EM residents’ awareness about their level of education, skills achievement and future perspectives. Keywords: care; emergency; medicine; months; program; residents; training
• Community Emergency Medicine: the right care, at the right time, in the right place by Sorlini, Cristina (2022) - Community Emergency Medicine: The right care, at the right time, in the right place Cristina Sorlini Senior Clinical Fellow in Emergency Medicine, Royal London Hospital, Barts Health NHS Trust, London; Member of the Italian Resuscitation Council Executive Board Non -co mmerc ial us e o nly Some colleagues may consider this shift from dealing with the hyper-acute, life-threatening conditions toward this more compre- hensive approach to the “generally-unwell” patient as a betrayal of the true mission of EM physicians. [Emergency Care Journal 2022; 18:10595] Emergency Care Journal 2022; volume 18:10595 Dear Editors, The deep, ongoing crisis of Emergency Medicine (EM) is, sadly, a well-recognised problem of the Italian National Health Care System. Keywords: care; community; emergency; medicine
• Happy birthday to the Italian Territorial Emergency Service (118): Thirty years of your valuable service by Poggiali, Erika; Barbieri, Greta (2022) - +39.0523.303044 E-mail: poggiali.erika@gmail.com Key words: 118; territorial emergency service; Italy; anniversary. The Roman parade kicked off the celebrations, which were held in all Italian regions, in a pro- gramme of events promoted by the scientific societies SIEMS (the Italian Society of Emergency Medical Services) and SIIET (the Italian Society of Territorial Emergency Nurses), by voluntary organisations and by technical and professional rescue associations (Figure 2). Keywords: care; emergency; march; service; system
• The role of pre-hospital ambulance care in the management of road traffic injuries in Addis Ababa (Ethiopia) by Ragasa, Mulugeta Bonsa; Legesse, Tesfaye Girma; Wudineh, Birhanu Asrat ; Abayneh, Helina (2022) - Socio-demographic characteristics of road traffic injury victims transported by ambulance from the scene to emergency depart- ment of selected public hospitals, Addis Ababa, Ethiopia, 2022 (n=262). Characteristics of road traffic injury victims transported by ambulance from scene to emergency department of selected public hospitals, Addis Ababa, Ethiopia, 2022 (n=262). Keywords: ababa; addis; ambulance; care; emergency; ethiopia; hospital; injury; pre; road; study; traffic; victims
• Delayed splenic rupture after a minor blunt trauma: A case report and literature review by Borio, Giorgia; Semeraro, Gianluca; Manzo, Emanuela; Maffi, Paola Angela Maria ; Etteri, Massimiliano (2022) - E-mail: borio.giorgia@hsr.it Key words: Delayed splenic rupture; spleen; splenic injury; blunt splenic trauma. As reported in our clinical case, category II was referred to as “delayed presentation of splenic injury” and was connected to a history of blunt abdom- inal trauma, the lack of clinical evidence of intra-abdominal injury, and the absence of CT imaging at initial evaluation. Keywords: blood; blunt; care; dsr; emergency; injury; management; patient; rupture; spleen; splenic; trauma
• Italian Emergency Medicine residents’ perspectives by Cascio, Michela; Barcella, Bruno; Zaccaria, Gianpiero; Piazza, Isabelle; CoSMEU group (2022) - Another main issue is the shortage of EM physicians in our health system. In this regard, we believe in the impor- tance of being able to be trained directly by EM specialists, now that their number is increasing. Keywords: care; emergency; italian; italy; medicine; work
• Emergency medicine residents: Don’t give up! by Ghiadoni, Lorenzo (2022) - In this issue of Emergency Care Journal we publish a letter from some young colleagues from CoSMEU (the Italian associa- tion of Emergency Medicine, EM).1 They express great concern on the several aspects the EM situation in Italy.2 The first issue is the collapse of the Emergency Departments (ED)2,3 caused by crowding/boarding combined with low available resources, particularly regarding EM physicians. The change from Admission and Emergency Medicine and Surgery (MeCAU) to Emergency and Urgency Medicine in the hospitals could be a sign as stated by COSMEU, along with the possible equivalence reco- gnized by the Italian Ministry of Health with cardiology, gastroen- terology, pneumology, internal medicine and geriatrics.6 Keywords: care; emergency; italy; medicine
• Psychiatric ward admissions during the COVID-19 pandemic in Canton of Ticino (Swiss Confederation) and the province of Como (Italy): a comparison between two different systems of care and outbreak response strategies by Beghi, Massimiliano; Alamia, Alberto; Alippi, Maddalena; Colombo, Raffaella Ada; Fraticelli, Carlo (2023) - According to the selected model for the overall psychiatric admissions in Mendrisio Hospital, the increase of 1 point in the Stringency Index is associated with an increase in the number of psychiatric admissions of 0.02% (rate ratio: 1.0002 CI: 1.00008 – 1.00037, p<0.00019). Non -co mmerc ial us e o nly According to the model selected for compulsory psychiatric admissions in Mendrisio Hospital the increase of 1 point in the Stringency Index is associated with an increase of the number of psychiatric admissions of 0.06% (rate ratio: 1.0006, CI: 0.00026 – 0.00093, p=0.00023). Keywords: admissions; care; compulsory; covid-19; emergency; hospital; italy; model; pandemic; psychiatric; study
• A rapidly progressive painful skin lesion by Poggiali, Erika; Santilli, Giovanni; Vercelli, Andrea (2023) - +39.0523.303044 E-mail: E.Poggiali@ausl.pc.it Key words: Streptococcus pyogenes; necrotizing fasciitis; skin necrosis; soft tissue infection; necrotizing cellulites; streptococcal gangrene. NF is a rare life-threatening bacterial soft tissue infection that rapidly spreads along soft tissue planes, causing progressive destruction of the muscle fascia and subcutaneous fat.1 Prompt diagnosis and timely treatment are crucial to avoid devastating consequences, including limb loss, organ damage and death. Keywords: care; emergency; fasciitis; necrotizing; tissue
• Emergency care accessibility for road accidents victims: a review by Rahvy, Aisyah Putri; Gani, Ascobat (2023) - Emergency and trauma care Emergency care systems for universal health cov- erage: ensuring timely care for the acutely ill and injured. This study aims to review emergency care accessibility from approach- ability, acceptability, availability, affordability, and appropriate- ness dimensions for crash victims. Keywords: accessibility; accidents; care; crash; emergency; emergency care; health; review; road; study; traffic; trauma; victims
• From unknown poisoning to carbamazepine poisoning by Simonovska, Natasa; Chibishev, Andon; Bekarovski, Niko; Babulovska, Aleksandra; Ivanova, Biljana; Naumovski, Kiril; Kostadinovski, Kristin (2023) - Patients with an underlying seizure disorder are more susceptible to seizures. They reported the results of patients with altered mental status in whom the cause could not be determined via blood and imaging tests, and the altered mental sta- tus in 31.5% of these patients was found to be caused by poisoning. Keywords: admission; carbamazepine; care; clin; emergency; hours; patient; poisoning; seizures
• Sun, alcohol, and skin lesions by Poggiali, Erika; Vercelli, Andrea (2023) - +39.0523.303044. E-mail: E.Poggiali@ausl.pc.it Key words: skin lesions, porphyria cutanea tarda, hyperferritinemia. Screening for hereditary haemochromatosis and HCC using ultrasound examination are always recommended in PCT patients, especially with cirrhosis and advanced fibrosis.5 Phlebotomy is the first line treatment to be continued until ferritin concentration is less than 20 to 25 ng/mL. When phlebotomy is contraindicated, 100 mg hydroxychloroquine orally twice a week can be prescribed.2 Broad-spectrum sun protection, alcohol cessation, and hepatitis C treatment must be always recommended to prevent dis- ease progression and relapses. Keywords: care; emergency; porphyria; skin; tarda
• The importance of concord between nations for scientific progress in cardiopulmonary resuscitation. A literature review by Rostami Zolghadri, Prashin; García Cañete, Joaquín; Pfang, Bernadette Genevieve; Hernández Clemente, Juan Carlos (2023) - Non -co mmerc ial us e o nly ings of Galen had been upheld as the standard of medical science for 15 centuries, while Avicenna’s Cannon of Medicine had become a reference for European medicine five centuries ago.3,4 However, Paracelsus condemned all teaching not based on experi- mentation. Gurvich deserves to take his rightful place in medical history for the discovery, development, and clinical implementation of the biphasic transthoracic defibrillator, as well as for his contributions to the theory of fibrillation and cardiovascular physiology.18,19 Gurvich first reported using the rounded biphasic waveform for defibrillation as early on as 1939. Keywords: care; cpr; death; emergency; gurvich; history; medical; medicine; negovsky; research; resuscitation; safar; science; university
• Cardiopulmonary resuscitation by law enforcement agents in Spain: lessons from a mixed methods case study by Pérez-Regueiro, Irene; Carcedo-Argüelles, Lucía; Fernández Fernández, Elena; García Fernández, José Antonio; Lana, Alberto (2023) - The association of fire or police first responder initiated interventions with out of hospital cardiac arrest survival. In traffic school, 24 years ago, I received basic training, later I did two other CPR courses on my own, but there is no formal or continuous training (...) Keywords: arrest; care; case; cpr; emergency; hospital; officer; resuscitation; study; training
• CEU 2023 Florence: an appointment with the future of the emergency system by Ghiadoni, Lorenzo (2023) - E-mail: lorenzo.ghiadoni@unipi.it Key words: emergency medicine; CEU2023; Italian emergency medi- cine system. Härtel C, Prosen G, Brown R, Dryver E. European core cur- riculum or emergency medicine, Version 2.0. Keywords: care; emergency; italy; medicine; system
• Comments on “Why do emergency department clinicians miss acute aortic syndrome? A case series and descriptive analysis” by Vercelli, Andrea; Berardi, Eleonora; Poggiali, Erika (2023) - We agree with all these statements, but we believe that point- of-care ultrasound (POCUS) can play a primary role in the early identification of these patients, particularly for the promptly diag- nosis of acute aortic dissection. Bernett J, Strony R. Diagnosing acute aortic dissection with aneurysmal degeneration with point of care ultrasound. Keywords: care; diagnosis; dissection; emergency; ultrasound
• Learning to communicate. The experience of an Italian emergency department by Vignola, Valentina; Cassinelli, Davide; Berté, Raffaella (2023) - Specific education in this field is usually undergone only by the few who gain awareness — often after experiencing recurrent emotional burnouts — that effective communication is one of their major professional responsibilities. Since I do not teach you effective communication and positive relationships, you should not consider these among the essential tools you need to have in your toolbox”. Keywords: care; communication; course; emergency
• Authors’ response to Comments on “Why do emergency department clinicians miss acute aortic syndrome? A case series and descriptive analysis” by Reed, Matthew J.; McLatchie, Rachel; Wilson, Sarah; Ticehurst, Francoise; Easterford, Kathryn; Alawiye, Salma; Cowan, Alicia; Gupta, Aakash (2023) - Alicia Cowan,1 Aakash Gupta1 1Emergency Medicine Research Group Edinburgh (EMERGE), Department of Emergency Medicine, Royal Infirmary of Edinburgh, Edinburgh; 2Acute Care Group, Usher Institute of Population Health Sciences and Informatics, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh; 3Emergency Department, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK Correspondence: Matthew J. Reed, Emergency Medicine Research Group Edinburgh (EMERGE), Department of Emergency Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK. Tel.: Dear Editor, We thank Vercelli et al.1 for their comments on our paper: Why do emergency department clinicians miss acute aortic syndrome? A case series and descriptive analysis. Keywords: care; edinburgh; emergency
• What lies beneath a maggot infestation of an ulcerated foot wound? by Triggia, Irene; Poggiali, Erika (2023) - +39.0523.303044. E-mail: poggiali.erika@gmail.com Key words: skin lesions, neoplastic ulcer, squamous cell carcinoma, foot lesions, myiasis. We present here the case of a 55-year-old male patient with a past medical history of HIV infection on appropriate antiretroviral therapy (Bictegravir/Emtricitabine/Tenofovir Alafenamide), pre- viously treated for hepatitis C with sustained viral response, who was diagnosed with squamous cell cancer of his right hand 2 years before, and treated with carboplatin and taxol, and surgery (partial amputation) for cancer progression and recurrent infec- tions. Keywords: care; cell; emergency; myiasis; wound
• The murder of a psychiatrist in Italy raises problems for all of us by Fraticelli, Carlo (2023) - E-mail: carlofratic@gmail.com Key words: Italian mental health system, Law 180, mental health providers, workplace violence, forensic psychiatric treatment, REMS, judicial psychiatric hospitals, OPGs Conflict of interest: the author declares no conflict of interest, the author declares accuracy. Healthcare workers in mental health and emergency rooms are par- ticularly vulnerable to workplace violence, while this problem is affecting all healthcare settings. Keywords: care; emergency; health; mental; psychiatric; rems; treatment
• Concomitant high-risk pulmonary embolism and subdural hematoma: endo-vascular system thrombolysis as a possible solution to a difficult challenge by Alvich, Vincenza Clelia; Valentini, Marco; Monti, Debora; Perlini, Stefano; Salinaro, Francesco (2023) - Patients with high-risk PE and a subset of patients with intermediate–high-risk PE should be considered for advanced reperfusion therapies due to higher mortality with anti- coagulation alone.4 Advanced therapies for acute PE include systemic fibrinolysis, catheter-based intervention, surgical pulmonary embolectomy, and mechanical circulatory support. Although in recent years, the scientific literature has been con- solidating the role of endovascular systems in the treatment of high-risk PE patients with major bleeding risk,7,8 poor data are available to evaluate the prognosis of patients with actual bleeding who concurrently require early pulmonary thrombus dissolution. Keywords: care; emergency; left; mmhg; patient; pulmonary; risk
• Influence of bystander activation on pre-hospital emergency care response time: systematic review by Musyoka, Felistus Ndanu; Tenambergen, Wanja; Mapesa, Job; Ndolo, Abdushakur; Agot, George; China, Joy; Koyio, Lucina; Ngunu, Carol; Mulonzi, Martin; Njeri, Veronica (2023) - al. reported an inverse association between ambulance response time interval and survival following all bystander-witnessed cardiac arrests.53 Discussion This systematic review analyzes the influence of bystanders on PEC response time. Interest in emergency response time has heightened over time. Keywords: activation; arrest; bystander; cardiac; care; emergency; hospital; interval; pec; response; response time; resuscitation; studies; study; survival; time
• Bowel sounds in the chest of a 7-day-old baby: what’s going on? by Di Nora, Alessandra; Pizzo, Francesco; Pavone, Piero (2023) - Al-Jazaeri A. Simplified technique for minimally invasive repair of congenital diaphragmatic hernia using hollow-needle snare and transthoracic traction stitches. E-mail: alessandradinora@gmail.com Key words: diaphragmatic hernia; Bochdaleck hernia; respiratory dis- tress; neonatology. Keywords: care; case; chest; hernia
• Navigating the contradiction: balancing patient care and caregiver protection. From heroes to victims by Antonini, Tiziana; Capellini, Paola; Scaratti, Giuseppe (2023) - Now, patients demand greater control over their therapies, blurring the line between doc- tor and patient. At risk is the possibility to cope with increasing situations of social conflicts and events such as those related to the aggressiveness of patients, the verbal and often physical aggression against the health profession- als, exposure to the temptation to abandon work and devote oneself to something else. Keywords: aggression; care; covid; emergency; health; patient; service; team; violence
• The organization of ambulance decontamination during the COVID-19 pandemic: a process analysis based on the Lean Thinking philosophy by Imbriaco, Guglielmo; Flauto, Alfonso (2023) - [page 109] The organization of ambulance decontamination during the COVID-19 pandemic: a process analysis based on the Lean Thinking philosophy Guglielmo Imbriaco,1,2,3 Alfonso Flauto1,2 1Prehospital Emergency Medical Dispatch Centre Emilia Est; 2Helicopter Emergency Medical Service, Maggiore Hospital Carlo Alberto Pizzardi, Azienda USL di Bologna, Bologna; 3Critical Care Nursing Master Course, University of Bologna, Bologna, Italy Correspondence: Guglielmo Imbrìaco, Prehospital Emergency Medical Dispatch Centre Emilia Est, Helicopter Emergency Medical Service, Maggiore Hospital, Largo Bartolo Nigrisoli 2, 40133, Bologna, Italy Tel.: Ambulance decontamination during the Triage phase, when EMS teams unload patients and report handovers to ED nurses, seems the most effective strategy. Keywords: ambulance; care; decontamination; emergency; ems; health; hospital; lean; patient; process; thinking; time
• Lung ultrasound: a valid help in the differential diagnosis between pneumothorax and pulmonary blebs by Sandionigi, Francesca; Cortellaro, Francesca; Forni, Elisa; Coen, Daniele (2013) - E-mail: daniele.coen@ospedaleniguarda.it Key words: lung ultrasound, pneumothorax, pul- monary bleb. Supine anteroposterior (AP) chest radiography has been reported to have very poor sensitivity in the detection of pneumothorax (36-75%), while the sensitivity of lung ultrasound is higher (92-98%) with similar specificity (both of 99-100%); the accu- racy of chest radiography and ultrasound is respectively 74 and 96%.2,3,6,7,11,12 Keywords: care; chest; diagnosis; lung; pneumothorax; sliding; ultrasound
• Painful burning lesions on the chest wall of a patient with advanced breast cancer by Poggiali, Erika; Braho, Etilda; Bertè, Raffaella (2023) - E-mail: poggiali.erika@gmail.com Key words: skin lesions; electrochemotherapy; palliative care; pain management; breast cancer. Ten years earlier, she had undergone a bilateral radical mastectomy and radio-chemotherapy for breast cancer. Keywords: care; ect; emergency; patient
• Advanced Cardiac Life Support (ACLS) knowledge, practice, and associated factors among general practitioners and nurses at Primary Hospitals in Ethiopia by Senbeta, Tirunesh Geremew; Seid, Seada Jemal; Wudineh, Birhanu Asrat; Abayneh, Helina Bogale (2023) - The fourth part comprised 12 questions related to associated factors of ACLS knowledge and practice. Work experience showed an inverse association with participants’ ACLS knowledge [COR=0.71, 95% CI: 0.60-0.85], suggesting that knowledge levels tended to decline with increasing work experience. Keywords: acls; advanced; arrest; cardiac; care; emergency; ethiopia; good; knowledge; life; nurses; participants; practice; study; support; training
• A report from Lybia of a young Italian emergency physician. What I learned and what I was forgetting by Montemerani, Sara (2024) - E-mail: sara.montemerani@uslsudest.toscana.it Key words: disaster medicine, emergency medicine, emergency res- ident, Lybia. I realized what I was missing because I was overwhelmed by my routine work: humanity and communication, the two basics of emergency medicine. Keywords: bodies; care; emergency; journal; medicine; work
• AcEMC has been founded: the Academy of Emergency Medicine and Care by Editors, The (2010) - In questo contesto sono inoltre fon- damentali sia l’utilizzo estensivo della simulazione come metodologia didattica per migliorare le com- petenze tecniche e quindi le performances, sia l’ap- prendimento delle non technical skills, vale a dire di quelle abilità cognitive personali e sociali che ne sono l’aspetto complementare e che contribuiscono alla realizzazione di performances sicure, efficienti e affidabili. I soci fondatori: Nicola Di Battista, Ivo Casagranda, Mario Cavazza, Daniele Coen, Tiziano Lenzi, Carlo Locatelli, Federico Miglio, Massimo Pesenti Campagnoni, Carolina Prevaldi, Bruno Tartaglino emergency care journal editoriale em er ge nc y ca re jo ur na l - o rg an iz za zi on e, c lin ic a, ric er ca • A nn o V I n um er o I • M ar zo 2 01 0 • w w w .e Keywords: care; che; della; dell’emergenza; nel; urgenza
• Respiratory alkalosis in the acute hypoxemic patient during non-invasive mechanical ventilation: troubleshooting and prognostic relevance by De Leo, Giancarlo; Pinto, Luigi; Maiellari, Michele; Tedeschi, Ersilia; Bitetto, Michele (2024) - Arterial blood gas (ABG) result demonstrated acute respiratory alkalosis and mild hypoxemia: pH 7,59, pCO2 26 mmHg, pO2 70 mmHg, HCO3-24.2 mmol/L, pO2/FiO2 ratio 333, Base Excess +3.2 mmol/L, Lactate 1.1 mmol/L. A standard Chest X-ray showed only mild bilateral opacities. Patient affected by chronic interstitial lung diseases (ILD), such as Non Specific Interstitial Pneumonia (NSIP), experience a progres- sive worsening of gas exchange the leads to hypoxemia and in some occasion to chronic respiratory failure. Keywords: acute; alkalosis; care; case; failure; niv; patient; ventilation
• Possible care protocols for patients undergoing road transfer on a biocontainment stretcher model N 36 (36 m3 air ˃60 ACH) by D'Urso, Federico; Meroni, Luca; Rech, Roberto; Musumeci, Angelo; Bonini, Anna; Piotti, Cristina; Ciriaci, Ascanio; Menghini, Sabrina (2024) - Rapid Response air medical evacuation by civilian HEMS crew of critical patients during COVID-19 outbreak – First Fixed Points. The need to transport patients affected by a Highly Transmissible Disease (HTD), who pose a serious threat to those who stood in their immediate surroundings and who also needed intensive measures to be kept alive, grudg- ingly found the extensive daily application of devices that, before 2019, served a very restricted population of people. Keywords: biocontainment; care; case; complexity; high; isolator; need; patient; range; transfer; transport
• Emergency medicine residents in the war zone: organizing humanitarian expeditions to train healthcare personnel during the conflict in Ukraine by Cappa, Giovanni; Mauri, Valeria; Negrello, Erika; Barcella, Bruno; Resta, Flavia; Angeli, Valentina; Marconi, Stefania; Tiraboschi, Lorenzo; Minzioni, Paolo; Pietrabissa, Andrea; Auricchio, Ferdinando; Perlini, Stefano (2024) - For this humanitarian project, our university (University of Pavia, Italy) provided us with specifically designed material and other simulation devices. For instance, we were asked to organize first aid courses right next to the front lines, but we believed that the risks would be too high in these circumstances. Keywords: care; courses; emergency; figure; medicine; pavia; university
• The importance of discrete event simulation as a methodology for performance evaluation in the emergency department by Angler, Yannik; Lossin, Astrid; Goetz, Olav (2024) - Based on process observations, interviews and time studies, a process model was developed in a general hospital ED to realistically simulate workflows. Time comparison between time study and basic model by total mean value in minutes. Keywords: care; emergency; model; patient; performance; simulation; staff; study; time; utilization; waiting
• A national survey of Italian emergency medicine residents: it's time to stay and play by Piazza, Isabelle; Barcella, Bruno; Cascio, Michela; group, CoSMEU (2024) - While one-third of EM residents have accepted a job contract, nearly all of them are against contracts with Calabria Decree from the 2nd year of residency. CoSMEU (Italian Society of Emergency Medicine Residents) is the national association of Italian EM resi- dents, that was founded in 2017 to promote standardized training, protect the interests of EM physicians in training, develop oppor- tunities, and formalize specific academic pathways.1 In our last survey, published in 2022, EM residents complained about a lack of training and possibilities for practical application to finish their training as scheduled. Keywords: care; emergency; medicine; residency; residents; training; year
• Uses of simulation during COVID-19 pandemic: a scoping review by Mormando, Giulia; Costantini, Ilaria; Paganini, Matteo; Vittadello, Anna; Pinello, Cristian; Tiozzo, Giulia; Giglia, Marco; Frigo, Martina; Pons, Sofia; Savino, Sandro; Navalesi, Paolo; Ingrassia, Pier Luigi (2024) - Types of participants: studies describing the use of simulation to train healthcare professionals, personnel involved in simulation training, and healthcare students; ii) Concept: to obtain and describe a perspective on the use of simu- lation in training healthcare professionals/students/sim trainers during the COVID-19 pandemic; iii) Context: papers detailing the use of simulation during the COVID-19 pandemic in all settings and locations, starting from January 2020 to June 2021; iv) Types of evidence sources: all types of studies reporting data (research studies/original studies) or extensively describing the experience of sim centers. Figure 2 shows the distribution of simulation zones between COVID- related and during COVID studies. Keywords: care; covid; covid-19; data; pandemic; patient; review; simulation; studies; study; training
• Promoting leadership and communication skills in emergency medicine residents: the role of High-Fidelity Simulation by Maiorano, Lorenzo; Capretti, Elisa; De Paris, Anna; Prota, Alessio; Paolucci, Elisa; Marchetti, Rudy; Coppa, Alessandro; Savinelli, Caterina; Pini, Riccardo; Innocenti, Francesca (2024) - The aim of this study was to evaluate the effectiveness of a training program based on HFS in improving leadership skills as well as the TS of residents in Emergency Medicine. The novelty of this experience was that a brief course of sessions, which included different clinical scenarios of critically ill patients, allowed Emergency Medicine residents to train and improve their leadership skills specifically. Keywords: care; clinical; emergency; leader; leadership; medicine; residents; session; simulation; skills; team; training
• Management of fever and associated symptoms in children and adults: an Italian national survey by Chiaretti, Antonio; Grattagliano, Ignazio; Carlomagno, Francesco; Magi, Massimo; Carbone, Luigi; Zecca, Silvia; Bondone, Claudia; Gatto, Antonio; Di Sarno, Lorenzo; Franceschi, Francesco (2024) - This survey provides a current state of fever management among physicians in different settings throughout Italy. Yet, this study is one of the few surveys that investigated fever management in hospitals and in outpatient clinics. Keywords: care; children; drug; emergency; fever; ibuprofen; management; paracetamol; participants; survey; symptoms
• No evidence of "weekend effect" for complications of medical and surgical care by Mattiuzzi, Camilla; Lippi, Giuseppe (2024) - Mortality risks associated with emergency admissions during weekends and public holi- days: an analysis of electronic health records. (CDC) WONDER online database (years 2018-2022),3 which provides mortality data for US citizens across locations and over time. Keywords: care; complications; deaths; mortality; weekend
• Optimizing ambulance nurse performance in southern Tuscany: insights from a Delphi study by Ramacciani Isemann, Christian; Radi, Francesco; Romei, Elena Sofia; Righi, Lorenzo (2024) - Furthermore, fostering feedback mechanisms within emergency ambulance services, as highlighted by Wilson, promotes reflection and learning, which are critical for continuous improvement in emergency care. Simulation training for emergency nurses: Enhancing skills and perfor- mance. Keywords: care; data; emergency; ems; intervention; nurses; performance; proposals; round; study; training
• An unusual case of acute respiratory distress syndrome in a young man by Cianci, Antonella; Spampinato, Michele Domenico; Perna, Benedetta; Maroncelli, Giacomo; Pesci, Chiara; De Giorgio, Roberto; Guarino, Matteo (2024) - Case Report A 32-year-old man presented to the Emergency Department (ED) with acute respiratory distress, complaining of chest pain that had worsened in a few hours. Acute respiratory failure from abused substances. Keywords: acute; ards; care; case; cocaine; distress; lung; patient; pulmonary
• Perception of undergraduate emergency medical services students about mental health by Alruwaili, Abdullah; Alanazy, Ahmed; Alyousif , Fatimah; Alnajjad , Kawthar; Alali , Asrar (2025) - This signifies a substantial increase in the impact of mental disorders on global health over the recent period.5 The prevalence of mental health disorders increased by 25% glob- ally during the first year of the COVID-19 pandemic.6 According to the World Mental Health Report that was made in 2022, almost one billion of the world population from various nations suffer from different types of mental disorders.7 In Saudi Arabia, the prevalence of mental health disorders remains high and continues to rise.8 Despite that, over the last three decades, Saudi Arabia has undergone significant transformations in its mental health care sys- tem, and mental disorders are still increasing.9,10 The establishment of Primary Health Care (PHC) centers across the nation aimed to enhance the identification and management of medical issues with- in the community. Keywords: block; care; disorders; emergency; health; illness; mental; students; study; unsure
• Efficacy of intranasal naloxone compared to other administration routes in prehospital opioid overdose management and beyond: a narrative review by Venuso, Luigi; Ricciardi, Francesco; Del Prete, Antonio; Virgolesi, Michele; Pucciarelli, Gianluca; Langella, Luigi; Rea, Teresa (2025) - In the study by McDonald et al.,17 three main objectives were pursued: i) to describe the pharmacokinetic profile of intranasal naloxone; ii) to compare early systemic exposure between intranasal and intramuscular naloxone; and iii) to estimate the bioavailability of intranasal naloxone. Intranasal naloxone at 1 mg, 2 mg, and 4 mg achieved peak plasma concentrations of approximately 0.95 ng/mL, 1.72 ng/mL, and 3.5 ng/mL, respectively, within 15-30 minutes, consistently surpassing those achieved with intramuscular naloxone in terms of total exposure. Keywords: administration; care; emergency; intranasal; minutes; naloxone; opioid; overdose; prehospital; review; studies
• A red and warm abdomen. What’s the matter? by Poggiali, Erika; Giosia, Valeria; Coen, Daniele (2024) - E-mail: poggiali.erika@gmail.com Key words: skin, cellulitis, skin infection, Streptococcus pyogens, Staphilococcus aureus. Risk factors for acute cellulitis of the lower limb: a prospective case-control study. Keywords: care; cellulitis; emergency; journal; skin
• Extreme nutritional neglect leading to cardiac arrest in a child: a rare presentation of severe acute malnutrition in England by Reed, Ashley; Bar, Mohamed (2024) - Such a presentation portrayed the deleterious consequences of severe malnutrition. Moreover, tissue damage in severe malnutrition contributes to increased serum LDH levels, liver cell damage, acute kidney injury, Disseminated Intravascular Coagulation (DIC), possible haemolysis, and rhabdomyolysis. Keywords: acute; arrest; blood; care; case; children; health; malnutrition; mmol; neglect; patient; years
• Virtual reality in pediatric emergency department and burn unit: a scoping review of current applications by Cammisa, Ignazio; Eftimiadi, Gemma; Korn, David; Ferretti, Serena; Capossela, Lavinia; Gatto, Antonio; Chiaretti, Antonio (2025) - While Yıldırım et al. found no significant difference in pre- procedural emotional appearance scores or procedure-related pain and anxiety scores, VR had a more pronounced positive effect on anxiety in studies by Wong et al. and Chan et al.19,29,32 Chen et al. documented, in children with a mean age of 9.13 years, a shorter time required for intra- venous injections in case of VR application (53.5±19.0 seconds vs. 61.3±25.8 seconds, p=0.046) according to Wong et al. who also showed a shorter length of venipuncture procedure in the VR group (4.43 minutes vs. 6.56 minutes) in children with a mean age of 7.21 years.29 On the other hand, Schlechter et al. found similar first-attempt IV success rates between the groups and a similar number of IV attempts. Keywords: anxiety; burn; care; children; distraction; emergency; et al; group; pain; procedures; reality; review; studies; trial; use
• Hikikomori, a risk factor for life-threatening malnutrition: a case report of an emergency within the vulnerability by Artusi, Nicola; Russo, Emanuele; Valeri, Gianmaria; Tecchiolli, Marzia; Cominotto, Franco (2025) - Maximizing the effect and influence of social emergency medicine. The patient should meet the following criteria: i) marked social isolation in one’s home; ii) duration of continuous social iso- lation of at least 6 months; iii) significant functional impairment or distress associated with the social isolation.14 In general, hikikomori is considered a non-psychotic phe- nomenon, distinguishable from the state of self-enclosure based on positive or negative symptoms of schizophrenia. Keywords: care; case; covid-19; department; emergency; health; hikikomori; patient
• Emergence of Mpox and new epidemics: psychological and social impact of stigma in communication and prevention by Fiacco, Giacomo; Grandinetti, Antonietta (2025) - People with Mpox face stigma related to the fear of infection and the unknowns surrounding the virus.3 The stigma faced by AIDS patients had a strong association with the mode of transmission of the virus, with the moral and physical qualities of HIV-positive individuals, and with the harsh moral judgment imposed by the media and public opinion.4 Unfortunately, it is not uncommon for social stigma to be linked to health status. Chinese newspapers' coverage of HIV transmission over a decade (2000–2010): Where HIV stigma arises. Keywords: care; communication; health; mpox; stigma; virus
• If you hear a new worrisome heart murmur… by Poggiali, Erika; Sacco, Francesco Maria; Ragonesi, Giudy (2025) - Trends in presenting characteristics and hospital mortality among patients with ST elevation and non-ST elevation myocardial infarction in the National Registry of Myocardial Infarction from 1990 to 2006. Post-myocardial infarction ventricular septal defect 4. Keywords: care; emergency; fatebenefratelli; heart; infarction
• Personality, cognitive, and emotional factors in the emergency department: complementary physicians’ profiles by Riva, Silvia; Antonietti, Alessandro; Iannello, Paola (2025) - Through a nuanced understanding of these factors, healthcare systems can better equip emergency physicians to manage the intricate, unpre- dictable nature of emergency care, thereby fostering improvements in in both overall patient care and professional satisfaction overall patient care and professional satisfaction. This study focuses on the role of personality traits, cognitive abilities, and emotional resilience in shaping the decision-making processes of emergency physicians operating under uncertainty. Keywords: ambiguity; care; cluster; cognitive; decision; emergency; making; mean; personality; physicians; risk; scale
• Feedback devices may not improve chest compression depth during simulated out-of-hospital cardiac arrest: a multicenter randomized controlled trial by Stuby, Loric; Simonet, Sylvain; Bourgeois, Laurent; Thurre, David; Suppan, Laurent (2025) - Feedback devices may not improve chest compression depth during simulated out-of-hospital cardiac arrest: a multicenter randomized controlled trial Loric Stuby,1 Sylvain Simonet,2 Laurent Bourgeois,2 David Thurre,3 Laurent Suppan4,5 1Genève TEAM Ambulances, Emergency Medical Services, Geneva; 2École Supérieure de Soins Ambulanciers, College of Higher Education in Ambulance Care, Geneva; 3Fire Rescue Centre, Martigny; 4Division of Emergency Medicine , Department of Acute Care Medicine, Geneva University Hospitals; 5Department of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine, Faculty of Medicine, University of GenevaSwitzerland way management likely leads to increased rates of Return Of Spontaneous Circulation (ROSC) and faster time to airway place- ment, while its effect on longer-term survival outcomes or aspira- tion events may be limited.10 One of our previous studies suggests that early i-gel® use significantly improves CCF and ventilatory parameters but may reduce compression depth,11 an important determinant of survival and functional outcome.12 Additionally, research highlights a discrepancy between perceived and actual CPR performance, underscoring the value of real-time feedback to bridge this gap.13,14 By guiding providers in maintaining compres- sions within optimal depth and rate ranges, feedback devices could enhance CPR quality. Studies indicate contradictory impacts of CPR feedback devices. Keywords: arrest; care; chest; compression; cpr; depth; device; emergency; feedback; hospital; quality; resuscitation; study; ventilation
• Emergency department visits in Italy: 2017-2023 trends, decline and recovery by Mattiuzzi, Camilla; Lippi, Giuseppe; Paolillo, Ciro (2025) - We found a fluctuating trend, with ED visits peaking in 2019, followed by a sharp decline in 2020 and 2021, and partial recovery in 2022 and 2023. The cumulative burden of ED visits in Italy exhib- ited a fluctuating trend, with a steady increase from 2017 to 2018, peaking in 2019, followed by a sharp decline in 2020, reaching its lowest point in 2021, before rising again in the subsequent two years, culminating in 58.5 ED visits Í1,000 population in 2023 (Figure 1). Keywords: care; covid-19; emergency; pandemic; visits; years
• Why it is important to recognize delirium in our emergency department by Paolillo, Ciro; Casagranda, Ivo (2025) - Hrev_master Dear Editor, We feel it is appropriate to highlight the need for accurate diag- nosis and sustained monitoring of delirium in the Emergency Department (ED) context. Despite the high-risk setting, there is a notable lack of research quantifying the incidence of delirium specifically within the ED, which remains a significant gap in the current literature. Keywords: care; delirium; emergency
• Severe scombroid poisoning complicated by distributive shock, acute respiratory distress syndrome and Kounis syndrome: a case report by Pelagatti, Lorenzo; Gambassi, Francesco; Ieri, Alessandra; Bardacci, Yari; Vanni, Simone (2025) - Although typically self-limiting, scombroid syndrome can, in rare cases, lead to severe complications. The uniqueness of this clinical case lies in the unusually severe presentation of scombroid syndrome, which typically follows a benign course. Keywords: care; case; emergency; fish; histamine; kounis; patient; poisoning; report; scombroid; shock; symptoms; syndrome
• Healthcare professional support: diabetic ketoacidosis avoidance and care by James, Steven; Watts, Stacey; Hatt, April; Frakking, Thuy; Broadbent, Marc; Furlong, Karen; Perry, Lin; Lowe, Julia; Clark, Sean (2025) - Healthcare professional requirements for the care of adult diabetes patients managed with insulin pumps in Australia. Reduced diabetes knowledge in consumers can increase the risk for acute diabetes complications such as DKA, and chronic micro- and macro-vascular disease through sub- optimal management; multiple behaviours within three self-mana- gement cycles have been reported to be involved in sustained T1D self-management.12 Diabetes education, like medical education, should be viewed as a life-long need rather than a discrete event. Keywords: australia; care; data; diabetes; dka; emergency; health; healthcare; knowledge; people; support; t1d
• When arrhythmia hides a tumor: a case of atrial fibrillation unmasking superior vena cava syndrome by Iommi-Diez, Sara; Campos Bas, Jorge; Almanzo, Santiago (2025) - [page 39] When arrhythmia hides a tumor: a case of atrial fibrillation unmasking superior vena cava syndrome Sara Iommi-Diez,1 Jorge Campos Bas,1 Santiago Almanzo2 1Department of Family and Community Medicine, Hospital Universitari i Politècnic La Fe, Valencia; 2Department of Surgery, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain Correspondence: Santiago Almanzo, Department of Surgery, Faculty of Medicine and Dentistry, University of Valencia, Avinguda Blasco Ibáñez 13, 46010, Valencia, Spain. +34.652.598 008 E-mail: almanzo@alumni.uv.es Key words: superior vena cava syndrome, atrial fibrillation, venous congestion signs, small-cell lung carcinoma. Keywords: care; case; cava; fibrillation; patient; svcs; vena
• Emerging management strategies for aluminum phosphide poisoning by Jafri, Asif Dabeer; Satale, Aniket; Sagar, Aarti; Sanjeev, Om Prakash; Singh, Ratender Kumar; Rizvi, Kayenaat (2025) - With no specific antidote available, AlP poisoning carries a high mortality rate, necessitating prompt life-supportive care. Early gastric decontamination with coconut oil and SBC, supplemented by antioxidant therapy, shows promise in reducing mortality in AlP poisoning. Keywords: alp; alp poisoning; aluminum; care; case; coconut; hours; oil; patient; phosphide; poisoning; sbc; toxicol; treatment
• Persistent hypoxia in a pediatric patient following a house fire by Howard, Lauren E.; Hobart-Porter, Nicholas (2025) - The risk of progression to secondary infection, acute respiratory distress, pulmonary dysfunction, and chronic changes to airway structure associated with inhalational injury make early intervention and supportive management of the utmost importance.5 However, it is important to keep in mind that pediatric patients may have other etiologies for hypoxia, even when being evaluated for inhalational injury following burns. Care of pediatric patients in the Emergency Department is certainly complicated. Keywords: anchoring; bias; care; case; department; diagnosis; emergency; heart; hypoxia; injury; patient
• Structured simulation-based education in emergency medicine residency programs: Pavia’s proposal for competence development and crisis management (Italy) by Barcella, Bruno; Bonzano, Marco; Perlini, Stefano; Salinaro, Francesco; Simulation Group, Emergency Medicine (2025) - Clinical rotations, EM training program at University of Pavia. Simulation-based education fills critical gaps in EM training, espe- cially in non-technical skills, procedural readiness, and crisis deci- sion-making. Keywords: care; curriculum; emergency; emergency medicine; italian; management; medicine; national; pavia; programs; residency; residents; simulation; skills; standards; training; year
• National report on emergency department applications in Türkiye via the Ministry of Health Communication Center by Çamcı, Melih; Gökhan, Şervan (2025) - Accurate resolution, thorough analysis, and effective management of patient complaints are essential for ensur- ing satisfaction, maintaining quality, and sustaining competitive- ness.22 Limitations This study, while comprehensive, is subject to several limita- tions. Yalçınkaya D, Güçlü A. Evaluation of patient complaints in hospitals: a foundation university hospital example. Keywords: applications; care; clinical; communication; complaints; eds; emergency; health; healthcare; hospital; issues; management; mohcc; patient; services; study
• Not only a day. Emergency Medicine Day is every day, at all times by Poggiali, Erika; Innocenti, Francesca; Ghiadoni, Lorenzo (2025) - Emergency Medicine Day is every day, at all times Erika Poggiali,1 Francesca Innocenti,2 Lorenzo Ghiadoni3 1Emergency Department, Guglielmo da Saliceto Hospital, Piacenza; 2High-Dependency Unit, Emergency Department, Careggi University Hospital, Florence; 3Academy of Emergency Medicine and Care, Pavia, Italy human rights at all times and in every place. Recognizing the value of this profession and promoting a sustainable work envi- ronment is a task that involves local hospital administration and national politics, adequately supported and addressed by national and supranational societies.2,3 The 27th of May 2025 has recently come and gone, and with this new issue of Emergency Care Journal we would like to express our gratitude to all the emergency medical staff around the world who are working tireless and compassionately to care for all patients, regardless of their origin, faith, gender, or social condi- tion. Keywords: care; emergency; eusem; journal; medicine
• The need of a health technology assessment perspective in emergency medicine by Iannone, Primiano (2013) - So, the health tech- nology assessment (HTA), defined as the multi-disciplinary field of policy analysis that examines the medical, economic, social and ethical implications of the incremental value, diffusion and use of a medical technology in health care, is intended to provide a bridge between the world of the biomedical research and that of the decision-making. In any case, HTA can offer a substantial contribute to decide the wise allo- cation of the limited resources devoted to health care, and to stop the relentless rise of health care wastes (such as over treatment, failure of care co-ordination and processes, pricing failures, over diagnosis and defensive medicine), seriously threatening the sustain- ability of publicly based health care systems, and respecting the law of diminishing returns, according to Donabedian’s definition:2 The balancing of improvements in health against the cost of such improvements. Keywords: care; emergency; health; medicine; technology
• ECJ: a new journal for new challenges in emergency medicine by Cavazza, Mario (2013) - +39.051.636.2111 - Fax: +39.051.636.1202 E-mail: mario.cavazza@aosp.bo.it Key words: emergency medicine, AcEMC, Emergency Care Journal, multidisciplinarity. Hrev_master [Emergency Care Journal 2013; 9:e1] Keywords: care; emergency
• Emergency department utilization rates and modalities among immigrant population. A 5-year survey in a large Italian urban emergency department by Zinelli, Marcello; Musetti, Valentina; Comelli, Ivan; Lippi, Giuseppe; Cervellin, Gianfranco (2014) - [page 23] lization and hospitalization by immigrants was found, even after 10 years from migration.13 In Norway, work immigrants from Germany and Poland had a considerably lower use of the ED, while asylum seekers from Somalia and Iraq use these services more than Norwegians.14 Although high rates of ED use among migrants have been related to inadequate access to other services, a German study failed to find that migrant status was a predictor of inappro- priate utilization.15 Not surprisingly, the rela- tionships between migrants and health have been considered a cultural dilemma.16 In Italy, a retrospective survey based on 2005 Italian Health Conditions Survey, carried out by the Italian National Statistical Office (Istituto Nazionale di Statistica; ISTAT), showed a higher ED utilization rate by immi- grants, most notably from those born in Morocco, other African countries and Albania.17 The aim of the present study was to compare utilization rates and modalities of presenta- tion to the large urban ED of the University Hospital of Parma, Italy, by the Italian-native and foreign-born populations. A significant difference between utilization rates by Italian-born and foreign-born was observed for all the triage- codes considered, with higher rate by foreign- born low-acuity codes (green plus white codes: 87.5 vs 73.9%, P<0.0001) and lower for high- acuity codes (yellow plus red codes: 12.5 vs 26.1%, P<0.0001). Keywords: care; codes; emergency; foreign; health; immigrants; italy; population; utilization
• Error risk in the decision making process by Baldi, Pier Luigi (2014) - Conclusions The highest number of correct answers by the subgroup working under conditions of stress and distraction compared to those of the group working under stress conditions prompt- ed a reconsideration of the procedure used to disrupt the attention functions of the partici- pants. Results and Discussion The correlation coefficient between response times and number of correct answers is highly significant (r=0.62, P<0.01), which proves that being allowed to work under nei- ther stress nor distractions promotes perform- ance quality. Keywords: answers; care; conditions; decision; group; making; number; response; stress
• Metacognitive competence as a goal for medical training by Antonietti, Alessandro; Andolfi, Valentina Rita; Colombo, Barbara (2014) - A dual vision of thinking processes is now widely accepted.8 Impressions are not misleading This vision, which leads to attribute to System 1 the responsibility for the malfunction of thinking processes and to System 2 (when it is correctly activated) the merit for its success, raises some concerns. Keywords: care; cases; cognitive; decision; emergency; heuristics; information; processes; situation; system; thinking; time
• Reliability analysis of GEM® Premier™ technology: a multicenter study by Faggiano, Francesco; Franchin, Tiziana; Ritrovato, Matteo; Derrico, Pietro (2015) - The intelligent Quality Management (iQM), is an innovative system for quality control of blood gas analyzers and was cleared by Food and Drug Administration (FDA) in October 2002.2 The iQM system is conceptually consistent with EP23-A, Laboratory Quality Control E-mail: matteo.ritrovato@opbg.net Key words: Reliability; Point-of-care testing; Blood gas analyzer. Keywords: blood; care; gas; gem; premier; time
• Hospital-based emergency care in the Russian Federation: a historical analysis of statutory regulations by Bagnenko, Sergei; Miroshnichenko, Aleksandr; Alimov, Ruslan; Minnullin, Ildar; Rodigin, Anthony (2015) - The bed reserve at des- ignated EC hospitals in Russian Federation (RF) is expected to continue to decrease in the face of an increasing number of annual hospi- talizations. Results and Discussion Historical overview Until recently, legal regulation of an admis- sion ward’s (AW) function within designated hospitals of emergency medical care (HEMC) occurred via a fairly limited number of regula- tions. Keywords: care; emergency; healthcare; hospital; journal; medical; ministry; regulation; russian
• A forgotten life-threatening medical emergency: myxedema coma by Pizzolato, Elisa; Peano, Alberto; Barutta, Letizia; Bernardi, Emanuele; Maggio, Elena; Lorenzati, Bartolomeo; Migliore, Elena; Allione, Attilio; Tartaglino, Bruno Maria (2016) - Italy Abstract Nowadays myxedema coma is a rare medical emergency but, sometimes, it still remains a fatal condition even if appropriate therapy is soon administered. A diagnosis of myxedema coma was formulated. Keywords: care; case; coma; disease; emergency; hypothyroidism; myxedema; patient; therapy
• Management of traumatic wounds in the Emergency Department: a secondary publication by Prevaldi, Carolina; Paolillo, Ciro; Locatelli, Carlo; Ricci, Giorgio; Catena, Fausto; Ansaloni, Luca; Cervellin, Gianfranco (2016) - Sub-statements of Statement 2 are: avoid antibiotic administration in low risk wounds (for all three variables considered) (2A); con- sider antibiotic administration when one or two high risk variables are present (2B); if the decision to avoid antibiotic administration in high risk wounds is made the reason must always be clearly stated (2C); in every wound consider the risk of tetanus according to the patient’s immunization status (2D). Moreover, trau- matic wounds have been historically a major source of litigation against EPs, accounting for up to 24% of all the medical lawsuits, mainly due to missed identification and treatment of tendon or nerve injuries, or to infection and/or presence of foreign bodies.2 Hence, although most wounds will heal without any treatment, a prompt and careful repair of these injuries reduces infection and scarring, thus improving the patient’s satisfaction and avoiding signifi- cant additional costs.1 However, in current clinical practice several different approaches to traumatic wounds are still practiced, due to cultural gaps, myths and local traditions. Keywords: care; department; emergency; infection; management; med; risk; statement; tetanus; traumatic; wounds
• Laboratory testing in the emergency department: an Italian Society of Clinical Biochemistry and Clinical Molecular Biology (SIBioC) and Academy of Emergency Medicine and Care (AcEMC) consensus report by Lippi, Giuseppe; Panteghini, Mauro; Bernardini, Sergio; Bonfanti, Laura; Carraro, Paolo; Casagranda, Ivo; Cavazza, Mario; Ceriotti, Ferruccio; Ciaccio, Marcello; Coen, Daniele; Giavarina, Davide; Giostra, Fabrizio; Paolillo, Ciro; Plebani, Mario; Ricci, Giorgio; Cervellin, Gianfranco (2017) - Carraro P. Recommendations for appro- priate laboratory tests in emergency department typical conditions. The main drivers for prescribing urgent laboratory tests in emer- gency settings entails obtaining data that may actually imply a substantial change in the diagnostic reasoning and/or managed care, combined with a low turnaround time (TAT), so that a timely intervention can be effectively established.9 Rather understand- ably, inappropriateness of test ordering may have a dramatic impact on both laboratory organization and patients care. Keywords: acemc; care; emergency; laboratory; mean; medicine; sibioc; testing; tests
• Academy of Emergency Medicine and Care-Society of Clinical Biochemistry and Clinical Molecular Biology consensus recommendations for clinical use of sepsis biomarkers in the emergency department by Lippi, Giuseppe; Montagnana, Martina; Balboni, Fiamma; Bellone, Andrea; Casagranda, Ivo; Cavazza, Mario; Da Rin, Giorgio; Coen, Daniele; Giavarina, Davide; Giostra, Fabrizio; Guzzetti, Stefano; Pauri, Paola; Sbrojavacca, Rodolfo; Trenti, Tommaso; Ciaccio, Marcello; Cervellin, Gianfranco (2017) - PCT and CRP were the two biomarkers that received the largest consensus as sepsis biomarkers (grade B recommendation), and a grade B recommendation was also reached for rou- tine assessment of blood lactate. Accuracy of plasma sTREM-1 for sepsis diagnosis in systemic inflammatory patients: a systematic review and meta-analysis. Keywords: care; ie s; ifi; meta; sepsis
• Choosing wisely in emergency medicine by Coen, Daniele (2018) - As to the field of Emergency Medicine, 10 inappropriate prac- tices have been identified in the US by the American College of Emergency Physicians, 10 more in Canada, 5 in the UK and 6 in Australia. Emergency Care Journal 2018; volume 14:7619 Correspondence: Daniele Coen, Department of Emergency Medicine, Niguarda Cà Granda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy. Keywords: care; emergency
• An explorative study of antecedents of organizational mindfulness in emergency room by Presutti, Michele; Paolillo, Rocco; Casagranda, Ivo (2018) - The block where Safety Culture precedes explains up to 70% of variance of Organizational Mindfulness, 68% of which is comprised by Safety Culture, and 2% by Work Engagement. Results show how the communal sphere of Safety Culture seems a better predic- tor of Organizational Mindfulness than the individual sphere of Work Engagement. Keywords: care; culture; dimensions; emergency; engagement; mindfulness; reliability; research; safety; work; work engagement
• A case of embolic stroke from atrial myxoma by Varutti, Rosanna; Trillò, Giulio; Piazza, Rita; Bassi, Flavio (2018) - E-mail: rosanna.varutti@gmail.com Key words: Embolic stroke; Atrial myxoma; Cardiac bypass. Neurological manifestations of atrial myxoma: a retrospective analysis. Keywords: care; emergency; figure
• The point-of-care testing in the emergency department by Carraro, Paolo (2019) - Introduction Quick availability of laboratory tests is a critical issue for the Emergency Department (ED). Cardiac troponin assays: guide to understanding analytical characteristics and their impact on clinical care. Keywords: blood; care; emergency; laboratory; poct; point; quality; testing; tests; use
• Attitudes and beliefs of emergency physicians on lab tests utilization in clinical practice. A multicenter survey by Saccenti, Carlotta; Lunian, Marco; Montagnana, Martina; Balloni, Andrea; Azin, Giulia Maria; Lerza, Roberto; Mitaritonno, Michele; Pistorello, Matteo; Santoro, Michele; Fiorini, Roberto; Bonfanti, Laura (2019) - E-mail: labonfanti@ao.pr.it Key words: Emergency medicine; Laboratory tests; Clinical biochem- istry; Diagnostic process; Diagnostic strategies; Emergency Department. Although both volume and quality of laboratory tests have enormously increased during the past decade,23-25 no single test is capable to accurately define a healthy status, so that diagnostic testing only prescribed to satisfy patient’s wishes should be eluded. Keywords: care; department; emergency; eps; laboratory; lippi; medicine; responders; tests
• Cyanide intoxication by apricot kernels: A case report and literature review by Ekinci, Faruk; Yildizdas, Dincer; Ates, Alper; Gökay, Naime (2019) - Our report concludes with previous cases of cyanide poisoning after ingestion of apricot kernels and a quick look at sources, man- ifestations and treatment of acute cyanide poisoning. Our report concludes with a literature review of cyanide poisoning and previous cases with this significant and potentially fatal poisoning after ingestion of apricot kernels. Keywords: acute; apricot; blood; care; cyanide; foods; ingestion; kernels; med; poisoning; report
• La liaison fructueuse: Laboratory and emergency medicine by Lippi, Giuseppe; Cervellin, Gianfranco (2019) - E-mail: giuseppe.lippi@univr.it Key words: Laboratory medicine; Emergency medicine; Diagnosis; Testing. This would actually require a substantial adaptation of subsidiary diagnostic sciences, such as laboratory medicine, which shall mod- ify their organization to provide rapid tests, characterized by high diagnostic accuracy, for enabling emergency physicians to make early rule out or diagnoses.6 Fulfilling these essential requirements can only be accomplished through a strict partnership between lab- oratory professionals and emergency physicians, who should actively cooperate and collaborate to design the urgent test menus according to their characteristic nature. Keywords: care; emergency; laboratory; lippi; medicine; physicians
• Evaluation and diagnosis of gallstone ileus using point of care ultrasound in the Emergency Department by Van Rees, Steven; Price, Kristen; Betcher, Joseph (2020) - We would propose using point-of-care ultrasonography with abdominal plain films as an adjunct for expedius bedside evaluation and diagnosis of gallstone ileus in elderly patients. Point-of-care ultrasound and abdominal plain films were used to identify and diagnose bowel obstruction due to a cholecysto- enteric fistula, also referred to as gallstone ileus. Keywords: bowel; care; diagnosis; gallstone; ileus
• Mind in emergency: Needs, criteria, priorities and methods by Sbattella, Fabio (2019) - To function well in the face of a critical environmental change, to manage and exit the state of emergency, the mind needs instead to actively interact in order to: clarify the nature, gravity and prox- imity of the imminent threats; fielding decision-making processes functional to the chaotic context (as happens for example with heuristic decision strategies); gain time (for example to breathe and oxygenate the hardware that risks overheating); have addition- al resources (information, connections to other minds, solutions); to maintain empowerment (the feeling of being able to do some- thing good while being powerless); dispose of actions or instru- ments of emotional regulation; reconnect with known people, per- sonal objects (for example the smartphone), known places. First of all: what do we mean by mind? Keywords: care; emergency; mind; needs
• Can Left ventricular outflow tract aortic velocity time integral guide fluid resuscitation in septic patients? - A case report by Colombo, Livio; Panizzardi, Francesco; Rusconi, Irene; Roncoroni, Anna; Bergamaschi, Marta; Macheda, Alfredo (2020) - If we had based our hemodynamic evaluation only on clinical exam and clinical parameters, we could have taken a different way to treat this patient, probably using more fluids and therefore worsening the condition of heart failure: this is a critical issue especially in septic patients, considering that up to 60% of them suffer from myocardial depression9 although its clinical meaning is still subject of debating.10 Conclusions In selected cases in ED, in which there could be different caus- es of instability induced by a modification of two or more between vascular tone, cardiac function and volemia, we think that the use of LVOT-VTI as we showed in this case report, could be an useful tool for ED physician, partly thanks to its reproducibility and sim- ple use, but mostly because it could guide the clinician to better understand the pathophysiology behind the single case and moni- tor adequately patients’ response to therapy. How to calculate cardiac output using aortic VTI. Keywords: care; case; lvot; patient; pressure; vti
• Emergency Key Performance Indicators in the Italian region Friuli Venezia Giulia by Valent, Francesca; Di Chiara, Antonio; Di Bartolomeo, Stefano (2020) - The level of evi- dence for emergency department performance indicators: sys- tematic review. Five indicators were summary descriptive measures, 10 were outcome measures, the others were process indicators; 20 were specific on acute myocardial infarction, 12 on trauma, 4 on stroke. Keywords: care; data; emergency; ems; health; hospital; indicators; information; kpi; performance; process; region; trauma
• Severe lactic acidosis from acute cyanide poisoning after intentional amygdalin ingestion in a teenager by Green, Jack (2020) - Our patient met other lab criteria that continued to support the diagnosis of cyanide poisoning. Cyanide poisoning after bitter almond ingestion. Keywords: acidosis; care; cyanide; diagnosis; history; ingestion; mmol; patient; poisoning
• Lung ultrasound in COVID-19: a useful diagnostic tool by Secco, Gianmarco; Delorenzo, Marzia; Zattera, Caterina; Giacomuzzi Moore, Bianca; Demitry, Lorenzo; Vezzoni, Giulia; Resta, Flavia; Barcella, Bruno; Cappa, Giovanni; Perrone, Tiziano; Salinaro, Francesco; Perlini, Stefano (2020) - Evolution of lung artefacts in relation to the reduction of lung aeration. Recent observations sug- gest that the description of the artefacts in term of variability and internal structure could have an important role in the characteriza- tion of the lung surface, directing the diagnosis, and identifying different groups of lung diseases. Keywords: care; covid-19; doi; emergency; lung; lus; ultrasound
• Audit and Feedback in emergency: a systematic review and an Italian project to investigate and improve quality of care by Licata, Sabrina; Tullio, Annarita; Valent, Francesca (2020) - Starting with the results obtained by Rogers et al.,4 Oostema JA, Chassee T, Baer W, et al. Keywords: a&f; approach; audit; care; department; emergency; feedback; health; improvement; project; quality; results; review; studies; time
• A case of hematuria and vomiting in the emergency room: Never forget the emphysematous pyelonephritis by Poggiali, Erika; Tansini, Fabio ; Christodoulakis, Konstantinos; Giovini, Manuela; Magnacavallo, Andrea; Vercelli, Andrea (2021) - +39.0523.303044 E-mail: poggiali.erika@gmail.com Key words: Emphysematous pyelonephritis; hematuria; acute renal fail- ure; urosepsis; hydroureteronephrosis. Clinical characteristics of emphysematous pyelonephritis. Keywords: bilateral; care; case; emergency; emphysematous; epn; gas; pyelonephritis; right
• “If you want to change the world, pick up your pen and write” by Ghiadoni, Lorenzo (2021) - Emerg Care J 2021;17:9708 5. Dear researchers, if you want to spread your results in the research community, open your pc, follow our suggestions and submit your manuscript to Emergency Care Journal! Keywords: care; emergency; journal

• Lumbo-sacral radiculopathies due to discal hernias: when they become an urgency by Staffa, Guido; Sacco, Carlo; Serchi, Elena; Re, Giuseppe (2010) - clinica e terapia em er ge nc y ca re jo ur na l - o rg an iz za zi on e, c lin ic a, ric er ca • A nn o V I n um er o 2 • G iu gn o 20 10 • w w w .e cj .it Degenerazione discale Riassorbimento del disco Distruzione interna del disco Erniazione clinica e terapia em er ge nc y ca re jo ur na l - o rg an iz za zi on e, c lin ic a, ric er ca • A nn o V I n um er o 2 • G iu gn o 20 10 • w w w .e cj .it Keywords: che; con; del; della; disco; una
• The cognitive error in decision making by Baldi, Pier Luigi (2010) - ABSTRACT emergency care journal organizzazione e formazione em er ge nc y ca re jo ur na l - o rg an iz za zi on e, c lin ic a, ric er ca • A nn o V I n um er o 2 • G iu gn o 20 10 • w w w .e cj .it organizzazione e formazione em er ge nc y ca re jo ur na l - o rg an iz za zi on e, c lin ic a, ric er ca • A nn o V I n um er o 2 • G iu gn o 20 10 • w w w .e cj .it Keywords: alimenti; che; data; decision; focalization; making; networks; pseudodiagnosticity; question; unit
• From literature and web by Bracco, Christian; Melchio, Remo (2007) - i soggetti che sviluppavano una TRALI risultavano più frequentemente affetti da sepsi e più frequente- mente presentavano in anamnesi una storia di alcoli- smo. revisioni dalla letteratura e dal web 43 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o III n um er o V I • D ic em br e 20 07 • w w w .e cj .it 43 le” del PS è estremamente interessante e senz’altro non può che innescare un processo di miglioramento del- la qualità del servizio erogato basata sulla conoscenza approfondita dell’effettivo lavoro svolto. Keywords: che; con; dei; del; lavoro; nei; pazienti; una
• Pulmonary scan in evaluating alveolar-interstitial syndrome in ER by Volpicelli, Giovanni; Mussa, Alessandro; Casoli, Giovanna; Garofalo, Giorgio; Cardinale, Luciano; Perotto, Fabio; Frascisco, Mauro (2006) - Il risultato dell’ecogra- fia polmonare è stato confrontato con la diagnosi ra- diografica e con la diagnosi clinica di dimissione. La radiografia è stata poi interpretata da un radiologo che non era a conoscenza dell’esito dell’eco- grafia e del quadro clinico del paziente. Keywords: alla; alveolo; artefatti; che; clinica; con; del; della; diagnosi; interstiziale; lung; pazienti; polmonare; radiografia; sono; ultrasound; una
• Integration of nursing staff into Medical Emergency Service 118 by Mazzolini, Emilio; Garrino, Lorenza; Calabrò, Paolo (2006) - dal lavoro di tesi del Master di primo livello Organizzazione e Coordinamento dell’Assi- stenza di Torino, anno accademico 2004-2005. L’inizio è previsto con la visita guidata, della durata di un’intera giornata, durante la quale si realizza un incontro tra il neoas- sunto, il Coordinatore e gli Infermieri guida (titolare e riserva), utile alla conoscenza reciproca e alla rileva- zione delle Keywords: affiancamento; alla; attività; centrale; che; con; coordinatore; dei; del; della; gestione; gli; guida; infermiere; infermieristico; inserimento; mezzi; neoassunto; operativa; postazione; valutazione
• Voluminous post-traumatic mediastinal haematoma: late presentation in DEA by Cardinale, Luciano; Priola, Sandro Massimo; Prato, Antonio; Volpicelli, Giovanni; Fava, Cesare (2008) - In questo ar- ticolo viene presentato il caso di un uomo di 42 an- ni che, in seguito a un politrauma, sviluppa tardi- vamente un voluminoso ematoma mediastinico a sua volta responsabile di tamponamento cardiaco. Il caso che viene qui presentato Luciano Cardinale, Sandro Massimo Priola, Antonio Prato, Giovanni Volpicelli*, Cesare Fava SCDU Radiologia e *Medicina d’Urgenza, Ospedale San Luigi Gonzaga, Orbassano (TO) riferisce di un paziente che, inizialmente stabile e con in- dagini radiologiche di routine negative, sviluppa tardiva- mente un voluminoso ematoma mediastinico, a sua volta responsabile di tamponamento cardiaco, svelati grazie al- l’impiego della Tomografia Computerizzata Multidetet- tore (TCMD) e meritevoli di trattamento chirurgico d’ur- genza. Keywords: caso; che; con; dei; del; della; livello; mediastinico; paziente; trauma; una; viene
• From literature and web by Migliore, Elena; Rinaudo, Enrica; Melchio, Remo (2008) - L’outcome pri- mario era la mortalità cardiovascolare durante un follow up medio di 37 mesi; gli outcomes secondari erano la mortalità per altre cause e il peggioramen- to dello scompenso cardiaco. 45 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o IV n um er o V • O tt ob re 2 00 8 • w w w .e cj .it 45 Rhythm control versus rate control per la fibrillazione atriale nello scompenso cardiaco: risultati del AF-CHF trial, un ennesimo scacco La fibrillazione atriale (FA) è la più frequente arit- mia riscontrata nei pazienti ospedalizzati ed è as- sociata in questi soggetti a un raddoppio della mortalità globale. Keywords: cardiaco; che; control; del; pazienti; una
• Clinical governance of acute atrial fibrillation: application of a specific diagnostic/therapeutical protocol by Cervellin, Gianfranco; Bonfanti, Laura; Scioscioli, Francesco (2006) - ricerca 29 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o II nu m er o II • A pr ile 2 00 6 • w w w .e cj .it L’importanza della FA non si esaurisce nella sola di- mensione epidemiologica, ma è strettamente correla- ta ai rischi di mortalità e morbilità: la mortalità in pre- senza di FA è globalmente raddoppiata rispetto ai con- trolli in ritmo sinusale, mentre nei soggetti con scom- penso cardiaco aumenta fino a 8 volte; il rischio di stroke in presenza di FA cresce rapidamente, dal 2% per la fascia di età compresa tra Separatamente per anno considerato e, successiva- mente, per fascia di età, è stato analizzato il numero di ricoveri versus dimissioni, rapportandolo anche al trattamento utilizzato e al ritmo presente al momento della dimissione o del ricovero. Keywords: 2001; che; dei; del; della; gestione; nel; obi; pazienti; ricoverati; una
• Where to find the antidote? by Locatelli, Carlo; Petrolini, Valeria; Lonati, Davide; Giampreti, Andrea; Vecchio, Sarah; Bigi, Stefania; Manzo, Luigi (2008) - Banca Dati Nazionale Antidoti Tel segreteria 0382 26261 Centro Antiveleni di Pavia Tel urgenze 0382 24444 Via Maugeri 10 Fax 0382 24605 27100 Pavia www.cavpavia.it e•mail antidoti@cavpavia.it Autorizzazione all’inserimento dei dati nella “Banca Dati Nazionale Antidoti” presente nel sito www.cavpavia.it Il sottoscritto (cognome)…………………………………………….. (nome) ……………………………………. data ………………………....……………………..Firma …………………………………………………………………… Il sottoscritto esprime il proprio consenso al trattamento dei dati personali per le attività connesse alla banca dati nazio- nale degli antidoti in ottemperanza al DLgs 196/2003 “Codice in materia di protezione Keywords: antidotes; antidoti; banca; che; dati; degli; della; disponibilità; nazionale; più; quantità; strutture; territorio; toxicol
• From literature and web by Melchio, Remo (2008) - Il razionale di tale indicazione è rap- presentato da evidenze sull’uomo e sull’animale che hanno riportato un peggioramento dell’agitazione psicomotoria, dell’ipertermia e del vasospasmo co- ronarico in pazienti con intossicazione da cocaina trattati con β-bloccanti. Gli Autori conclu- dono che la somministrazione del β-bloccante è as- sociata a un minore rischio di infarto miocardico nei pazienti che usano cocaina, e che il beneficio supera il rischio di vasospasmo coronarico; sugge- riscono, quindi, la necessità di uno studio prospet- tico randomizzato per verificare quest’ipotesi in modo più definitivo. Keywords: che; cocaina; pazienti

• New acquisitions in treating infection due to necrotic pancreatitis: prevention or cure? by Pezzilli, Raffaele; Barakat, Bahjat (2008) - In questo articolo prenderemo in considerazione gli ultimi studi pubblicati sul- la profilassi e terapia della necrosi pancreatica infetta e li va- luteremo criticamente. Tuttavia alcuni quesiti sono in attesa di una risposta: • quali sono le dosi ottimali di meropenem da uti- lizzare in pazienti con pancreatite acuta? Keywords: acute; con; del; della; gruppo; necrosi; nel; pancreatica; pancreatitis; pazienti; sono; studio; una
• Bleed caused by varicose veins rupture in a rare site in portal hypertension. Differential diagnosis with causes of acute hypovolemic shock in emergency. by Procopio, Rosarino; Scaramuzzino, Elio (2011) - nostro DEA in stato di shock e con un violento dolore in regione dorso-lom- bare sinistra insorto improvvisamente al proprio domicilio. Viene presentato, di seguito, il caso di una donna con cirrosi epatica scompensata, voluminosa ascite e sanguinamento da rottura di varici a livello dell’asse splenico che ha posto, sin dall’inizio, per come si è presentato, il problema di diagnosi differenziale con altre cause di shock ipovolemico. Keywords: con; della; portale; una; vena

• Aspiration of blood clot during PTCA in patients affected by myocardial infarction by Melchio, Remo (2008) - Tutti han- no inoltre ricevuto clopidogrel e oltre il 90% anche abciximab. Remo Melchio Dipartimento di Emergenza, AO Santa Croce e Carle, Cuneo Ecg-febbraio08.qxp 9/9/08 4:35 PM Pagina 45 Keywords: con; del

• Admission to the emergency care unit after faintness: patients' characteristics and paths by Pecorelli, G.; Strocchi, E.; Casacanditella, G.; Borghi, C.; Cavazza, M. (2012) - è piuttosto bassa e la causa della sincope è spesso ipotizzata solo sulla base del quadro clinico. e solo 6 venivano inviati in DH o DS. Keywords: dei; pazienti; sincope
• Reliability and effectiveness of a 4-level emergency triage by Parenti, Nicola; Bacchi Reggiani, Maria Letizia; Sangiorgi, Diego; Lenzi, Tiziano (2008) - In conclusione, a quanto ci risulta, questo è il pri- mo studio che misura l’affidabilità e la validità nel predire il ricovero di un metodo di triage usato in un PS italiano ed è il primo studio che valuta l’affi- dabilità intra-operatore di un sistema di triage a 4 livelli. I più co- muni sistemi di triage sono il traffic director, lo spot- check e il triage globale1. Keywords: codici; dei; del; emerg; guida; infermieri; nel; priorità; sono; studio; triage; validità

• Cardiology by Editors, The (2010) - Conclusioni Il processo decisionale in Pronto Soccorso dovrebbe essere guidato da specifiche indicazioni derivanti dalla valu- tazione clinica, supportata dalle linee guida, in funzione della qualità diagnostica e prognostica. emergency care journal CARDIOLOGIA em er ge nc y ca re jo ur na l - o rg an iz za zi on e, c lin ic a, ric er ca • A nn o V I n um er o 4 • D ic em br e 20 10 • w w w .e cj .it Keywords: cardiogena; cohort; dcc; della; diagnosi; diagnostica; dispnea

• Sim baby: expensive play station or training to error culture in pediatric emergency? by Pederzini, Fabio; Conrad, Gerson; Comploi, Marco; Rammlmaier, Georg; Pettenazzo, Andrea; Bruno, Cesare (2007) - L’alternanza tra teoria del CRM e pratica è stata con- dotta attraverso la simulazione in contesti mobili (dentro l’ambulanza, l’elicottero, la ricostruzione di un domicilio), così da garantire ai partecipanti più competenze sulla base dell’apprendimento passo per passo in un contesto di training realistico e dinami- co, in team multidisciplinare videoregistrato; l’abilità dei tutors nell’analisi dello scenario non ha abusato del videobriefing e ha creato le condizioni per un’at- mosfera amichevole e aperta alla riflessione sulla co- municazione in team e sullo sviluppo di una cultura dell’errore in situazione critica di emergenza pediatri- ca. 38 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o III n um er o III • G iu gn o 20 07 • w w w .e cj .it Keywords: del; emergenza

• A case of Vaccine-Induced Thrombotic Thrombocytopenia (VITT) with thrombosis of the superior mesenteric artery after ChAdOx1 nCov-19 COVID-19 Vaccine by Pini, Laura; Malerba, Paolo; Giordani, Jordan; Stassaldi, Deborah; Aggiusti, Carlo; Martini, Giuliana; Arenare, Giulia; Premoli, Chantale; Bosio, Giulia; Lancelotti, Marco; Bosisio, Francesca; Muzi, Giorgia; Muiesan, Maria Lorenza (2021) - Abstract We describe the case of a 64 years-old woman admitted to the Emergency Department of the ASST-Spedali Civili of Brescia with fever and gastrointestinal symptoms 10 days after the first dose of ChAdOx1 nCov-19 vaccine. Ad26.COV.2 vaccines.8,9 This paper reports a clinical case of a Vaccine-Induced Thrombocytopenic Thrombosis (VITT) involving the superior mesenteric artery in a 64-year-old woman who received the first dose of ChAdOx1 nCov-19 vaccine 10 days before admission. Keywords: brescia; case; chadox1; ncov-19; patient; thrombocytopenia; thrombosis; vaccination; vaccine; vitt
• Thyroid storm without precipitating factors in a previous healthy child: A case report by Mori, Takaaki; Mitani-Konno, Marie; Hagiwara, Yusuke; Hasegawa, Yukihiro (2022) - None None None GI, gastrointestinal symptoms such as nausea, vomiting, diarrhea, and increased total bilirubin level over 3.0 0mg/dL; CNS, central nervous system dysfunction including decreased consciousness, seizure, somnolence/lethargy, restlessness, delirium, mental abrasion/psychosis; CHF; congestive heart failure including pulmonary edema, moist rale in more than half of the lung field, Class by the New York Heart Association, or Class in Killip classification, or cardiogenic shock; TS, thyroid storm; TD, thyroid disease; PE, physical examination +81.43.300.5111; Fax: +81.43.312.8130. E-mail: takaakimori001019@gmail.com Key words: Thyroid storm; healthy child; precipitating factors. Keywords: case; fever; history; patient; pediatric; storm; symptoms; tachycardia; thyroid
• Magic truffle intoxication: A case report by Le Daré, Brendan; Pelletier, Romain; Couette, Aurélien; Morel, Isabelle; Gicquel, Thomas (2022) - [Emergency Care Journal 2022; 18:10347] Emergency Care Journal 2022; volume 18:10347 Abstract Unusual forms of hallucinogenic mushrooms are emerging, which may delay diagnosis and compromise optimal management. We believe that recognition of this unusual form of hallucinogenic mushroom by emergency physicians might con- tribute to better diagnosis and subsequent optimal management, especially since hallucinogenic substances are not routinely tested in toxicological analyses. Keywords: case; emergency; mushroom; patient; psilocybin; report
• An unexpected turn of events: A rare case of Acquired Haemophilia A after a violin spider bite by Zattera, Caterina; Luly, Simona; Cipriano, Alessandro; Rizzelli, Grazia Maria Luisa; Cecconi, Nadia; Santini, Massimo (2022) - Abstract We report an interesting clinical case of Acquired Haemophilia A (AHA) after a probable Loxosceles rufescens spider bite in a 73- year-old woman, admitted to an Emergency Department (ED) of Central Italy during April 2019. 0382.5011 - Fax: 0382.503139 E-mail: caterina.zattera01@universitadipavia.it Key words: Acquired haemophilia A; spider bite; violin spider. Keywords: aptt; bite; blood; case; day; emergency; fviii; patient; spider
• Anaemia, thrombocytopenia and skin lesions by Poggiali, Erika; Orofino, Giorgio; Peccatori, Jacopo (2022) - EP is member of the editorial board of Emergency Care Journal. [Emergency Care Journal 2022; 18:10498] [page 1] Anaemia, thrombocytopenia and skin lesions Erika Poggiali,1 Giorgio Orofino,2 Keywords: emergency; patient; pemphigus; pnp
• A case of unstable bradycardia requiring comprehensive management in the emergency department: BRASH syndrome by Genc, Sinan; Erdurmus, Omer Yusuf; Erhan, Abdullah; Oguz, Ahmet Burak; Koca, Ayca; Eneyli, Muge Gunalp; Polat, Onur (2022) - It is predicted that BRASH syndrome cases will be seen more frequent- ly due to both the increasing use of drugs that are blamed in the eti- ology and the increasing elderly population. This syndrome can lead to bradycardia and various Ecg findings regardless of the degree of hyperkalemia.4 Patients in BRASH syndrome case reports generally presented at the emergency department with complaints of shortness of breath, discomfort, dizziness, syncope, fatigue, and weakness, and these symptoms are strongly thought to be caused by hypotension, shock, and bradycardia due to the mechanism of the syndrome.3 Decompensated heart failure findings, such as pretibial edema, jugular venous blood flow, exertional dyspnea, orthopnea, cyanotic appearance, hypoxia, and a prolonged capillary refill time, are often seen upon physical examination.9 Early diagnosis and initiation of correct treatment by emer- gency physicians are crucial in BRASH syndrome.10 It is important to determine this clinical situation, since atropine and pacemaker applications, included in the standard bradycardia algorithms, may not be effective in the treatment of patients with BRASH syn- drome.11 In the treatment steps, the AV nodal blocker drug should be stopped first.1 In patients with high levels of hyperkalemia, IV calcium, which provides cardiac stabilization, should be initiated together with treatments that lower potassium levels (e.g., albuterol and Keywords: bradycardia; brash; case; failure; hyperkalemia; nodal; patient; syndrome
• A rare cause of Emergency Department visit for melena: Gastric Mucormycoma mimicking Adenocarcinoma by Comelli, Ivan; Bosi, Simone; Caruana, Pietro; Lippi, Giuseppe; Cervellin, Gianfranco (2012) - Hematemesis and melena are the most common presentations of acute UGIB, and patients may present with both symptoms. Hematemesis is the presentation symptom in 40-55% of patients, including patients with coffee-ground emesis. Keywords: bleeding; gastrointestinal; melena; mucormycosis; patient; ugib
• An ischemic stroke effectively treated with systemic thrombolytic therapy in an underage patient: clinic and ethics by Stella, Federica; Pistollato, Erica; della Rocca, Foscarina; Vettore, Gianna; Tosato, Franco (2012) - The estimated annual stroke incidence rate for children in the main literature reviews is 2.1-2.7 per 100 000 per year for strokes, even if the frequency of ischemic stroke appears to be greater than previously suggested (3). Abstract We describe the clinical case of a 15-year-old boy presenting with acute onset of left hemiplegia due to ischemic stroke, suc- cessfully treated with systemic thrombolysis with t-PA. Keywords: administration; children; patient; right; stroke; therapy; tpa
• An acute and severe immunodeficiency syndrome due to a pancreatic ACTH-producing tumor by Cevenini, Monica; Guidetti, Elena; Cacciari, Giulia; Ruggeri, Eugenio; Campana, Davide; Tomassetti, Paola; Corinaldesi, Roberto (2012) - A peculiar feature of ectopic ACTH secreting tumors, in par- ticular those with features of a pancreatic mass, is the phe- notypic behavior characterized by tumor cells changing from a non-secreting to an ACTH secreting functional profile. Pancreatic neuroendocrine tumors (PNETs): incidence, prognosis and recent trend toward improved survival. Keywords: acth; cushing; ectopic; liver; pancreatic; patient; syndrome; tumor
• A case of massive pulmonary embolism causing cardiac arrest managed with successful systemic thrombolytic in the emergency department by Yılmaz, Fevzi; Tekin, Yaşar; Toprak, Nazmi; Eyı̇nç, Mehmet Berk; Arslan, Engin Deniz (2022) - Although thrombolytic administration is regarded as the treatment of choice for high-risk PE, CPR constitutes a relative contraindication for thrombolytic therapy, due largely to the concern of potential bleed- ing after traumatic chest compressions. E-mail: fevzi_yilmaz2002@yahoo.com Key words: Pulmonary embolism; cardiac arrest; thrombolytic therapy; life saving therapy. Keywords: arrest; diagnosis; embolism; emergency; patient; therapy; thrombolytic
• Atypical presentation of acute idiopathic megacolon in a 14-year-old patient by Barakat, B.; Agosti, R.; Ruggeri, E.; Tonini, V.; Cervellera, M.; Guidetti, E.; Cevenini, M.; Imbrogno, A.; Fabbri, D.; Pareo, I.; Fucili, A.; Corinaldesi, R.; Stanghellini, V.; Pezzilli, R.; De Giorgio, R. (2012) - The case herein reported represents an unusual form of acute idiopathic megacolon characterized by massive descending and sigmoid colon distension complicated with a volvulus in a 14-year-old boy with no Hirschsprung’s disease. Nonetheless, the favourable response to anti-cholinesterase drugs (e.g. intravenous neostigmine) used in patients with acute colonic pseudo-obstruction supports a possible decrease of parasympathetic activity (4). Keywords: acute; colon; colonic; megacolon; obstruction; patient; sigmoid
• A case of retinal detachment resulting from air bag deployment by Yılmaz, Fevzi; Baltacıoğlu, Bora; Akça, Erdi; Yavuz, Yavuz Fatih (2023) - +905055907307; Fax: +902422494400 E-mail: fevzi_yilmaz2002@yahoo.com Key words: motor vehicle accident; airbag-mediated injury; eye injury; head injury; retinal detachment. lacerations.21 Based on the findings of some authors, seat belts are the best way to reduce the risk of eye injuries associated with motor vehicle accidents.22 Numerous U.S. studies failed to differentiate the data regarding seat belt use. Keywords: air; case; detachment; emergency; eye; injuries; injury; patient; retinal
• Ultrasound assessment of diaphragmatic dysfunction and its improvement with levosimendan in patients with chronic obstructive pulmonary disease by De Rosa, Clarissa Anna; Cristiano, Giovanna; Guarino, Mario (2023) - Time 1 (one hour after the start of continuous-24 hours i.v. levosimendan infusion). Time 3 (three hours after the start of continuous-24 hours i.v. levosimendan infusion). Keywords: diaphragm; diaphragmatic; excursion; hours; infusion; levosimendan; patient; right; start; time
• A case of cardiotoxicity following intramuscular injection of tropicamide and phenylephrine ophthalmic solution in a drug-addicted young woman by Agosti, Antonio; Vercelli, Andrea; Demichele, Elena; Mariani, Francesco; Biagi, Andrea; Ferraro, Stefano; Cervellin, Gianfranco; Poggiali, Erika (2023) - She used to inject tropicamide ophthalmic solution (Visumidriatic®) intramuscularly to achieve loss of contact with reality and altered thinking, as known side effects due to the mus- carinic blocking activity of tropicamide.12 She had never used the combined solution of tropicamide and phenylephrine before. Over the past 10 years, several cases of tropicamide abuse via intravenous injection have been reported in several countries, including Turkey, Italy, France, Tajikistan, and Kazakhstan, but also Italy.14 When taken in large doses, tropicamide can produce stimulant, euphoric, and hallucinogenic effects,15 with a mechanism not com- pletely understood but probably due to the block of the muscarinic receptor M4.1,16 that causes a central anticholinergic syndrome with the occurrence of agitation, often with pressured speech, delirium, and visual and/or auditory hallucinations. Keywords: case; effects; emergency; eye; patient; phenylephrine; tropicamide
• A case of hemorrhagic shock due to massive upper gastrointestinal bleeding: from the differential diagnosis to the correct management by Marziani, Beatrice; Spampinato, Michele Domenico; Caputo, Fabio; Guarino, Matteo; Luppi, Francesco; Perna, Benedetta; Passaro, Angelina; Cariani, Daniele; Merighi, Alberto; Arena, Rosario; De Giorgio, Roberto (2023) - A detailed discussion about the disease, prog- nosis, patient’s perception, knowledge, and treatment preference is fundamental to developing the correct diagnostic and therapeutic strategy in accordance with the patient’s wishes, especially in crit- ical conditions.20 Conclusions In summary, despite the unfavorable outcome, three important caveats should be considered: i) the patient’s clinical history and physical examination are crucial for the diagnosis and manage- ment of patients with UGIB; ii) hemodynamic status, instead of hemoglobin levels, should determine the severity of bleeding and guide the appropriate diagnostic and therapeutic work-up, includ- ing airway protection, breathing, and circulatory support, eventu- ally with an appropriate massive resuscitation strategy; iii) although not the gold standard, CECT can be a useful tool in patients with massive UGIB to establish a differential diagnosis in combination with OGD (Figure 1). Based on this case, we reviewed the diagnostic and therapeutic approaches for patients with massive UGIB and pro- vided a practical approach to this life-threatening emergency. Keywords: bleeding; blood; emergency; endoscopy; gastrointestinal; management; patient; pressure; ugib
• Right-sided spontaneous, massive hemothorax in a 27-week pregnant lady: a case report by Pradhan, Pratisha; Kumar, Alok; Hada Batajoo, Kabita; Shrestha, Trishna; Pradhananga, Sneha (2023) - Chest X-ray and therapeutic thoracocen- tesis revealed massive right-sided hemothorax and computed tomography suggested pulmonary varix as the cause which was managed with emergency chest tube drainage. [Emergency Care Journal 2023; 19:11595] Emergency Care Journal 2023; volume 19:11595 Abstract Spontaneous, massive hemothorax due to pulmonary varix is an uncommon, yet catastrophic cause of respiratory distress during pregnancy and postpartum. Keywords: case; chest; emergency; hemothorax; patient; pregnancy; pulmonary; spontaneous; tube; varix
• What does a floating mass in a young patient's heart do? by Sonnessa, Tommaso; Vaira, Daniela (2023) - Eleven years’ experience with Korean cardiac myxoma patients: focus on embolic complica- tions. E-mail: Sonnessa.Tommaso@hsr.it Key words: atrial myxoma; cardiac myxoma; cardiac tumor; echocar- diography; chest pain. Keywords: atrial; cardiac; emergency; myxoma; patient
• Tongue abscess: a rare occurrence possibly mimicking angioedema by Riccardi, Alessandro; Dignetti, Paola; Tasso, Franco; Caiti, Matteo; Lerza, Roberto (2013) - [Emergency Care Journal 2013; 9:e23] Tongue abscess: a rare occurrence possibly mimicking angioedema Alessandro Riccardi, Paola Dignetti, Franco Tasso, Matteo Caiti, Roberto Lerza Emergency Department, San Paolo Hospital, Savona, Italy Abstract Despite the popularity of tongue piercing in recent years, the finding of a tongue abscess is considered extremely rare by international lit- erature. +39.019.8404963 - Fax: +39.019.8404529. E-mail: a.riccardi@asl2.liguria.it Key words: tongue, abscess, angioedema. Keywords: abscess; angioedema; emergency; patient; tongue
• Acute limb ischemia due to left brachial artery occlusion in a 40-year-old female patient: a case report by AlMadhwahi, Nabil; Al-Hanash, Sallam; Barat, Ali; Alshujaa, Mohammed; Najran, Mohammed; Fadhel, Ali; Al-Jammal, Eman; Ahmed, Faisal; Altam, Abdulfattah; Badheeb, Mohammed (2024) - The Rutherford classification has been extensively uti- lized in assessing the risk for ALI, categorizing it as viable (class I), threatened (class II), marginally threatened (IIa), immediately threatened (IIb), and irreversible (class III) based on vascular exam, Doppler US findings, and sensorimotor deficits.7 Overall, ALI represents a consequence of an underlying etiol- ogy, typically a cardio-embolic phenomenon, which is reported in up to 60% of patients.2 This manifestation is particularly prevalent among elderly individuals suffering from atrial fibrillation, which constitutes approximately 80% of cardioembolic etiologies, in conjunction with valvular heart disease or prior ischemic heart dis- ease that leads to cardiac wall motion abnormalities.5 Additionally, atherosclerotic disease, aneurysmal formations, traumatic injuries, and previous vascular interventions are known contributing factors for ALI in the upper limbs.5 Previous reports have shown inconsistencies in the most com- monly involved artery in upper limb ALI, with some reports observing a higher incidence of brachial artery occlusion.3 Nevertheless, most of these cases were reported in patients with existing cardiac arrhythmias, atherosclerotic disease, prior trauma, or coronary or vascular interventions.1,8 This method has been extensively employed as a primary treatment for upper limb ALI and was performed on our patient, who was categorized as immediately threatened (IIb), necessitat- ing urgent surgical intervention.4 Alternative approaches include catheter-directed thrombolysis. Keywords: acute; ali; artery; brachial; case; limb; occlusion; patient; report; upper
• Hydronephrosis and pelvic rupture due to calculus with completely normal laboratory results by Demirci, Burak; Akın, Burak; Gündoğan, Selman; Özbilir, Göker İhsan; Alkan, Mehmet Oktay; Coşkun, Abuzer (2024) - Discussion The occurrence of spontaneous renal pelvic rupture, initially documented by Wunderlich in 1856, is an infrequent complication associated with obstructive ureteral stones.7 In contrast to cases of renal parenchymal rupture that necessitate immediate care, the clinical progression of this condition is typically characterized by a mild severity.1-6 The primary aim of this research endeavor is to conduct an exhaustive examination of the pathological indications of hydronephrosis and pelvic rupture in an individual who presents with a normal laboratory evaluation. Keywords: case; emergency; pain; patient; pelvic; renal; rupture
• A rare symptom of foodborne botulism: dysgeusia. Case report and clinical review by Esposito, Simone; Coletta, Francesco; Di Maiolo, Giovanna; Lo Chiatto, Filomena; Rinaldi, Pasquale; Lanza, Anna; Panico, Getano; Sala, Crescenzo; Tomasello, Antonio; Villani, Romolo (2024) - Botulism treatment consists of symp- tom control, mechanical respiratory support, and Botulinum Antitoxin (BAT) administered intravenously. Foodborne botulism is a severe neuro-paralytic syndrome caused by the ingestion of preformed botulinum toxins in contami- nated foods. Keywords: antitoxin; botulinum; botulism; cases; clin; clostridium; dis; foodborne; infect; patient; symptoms; treatment
• Spontaneous rupture of a splenic artery pseudo-aneurysm post sleeve gastrectomy: case report by Taddei, Filippo; Furlan, Anna; Azzolini, Valentina; Pitoni, Federica; Paolillo, Ciro (2024) - Pseudo-aneurysm of the splenic artery occurs more frequently in the female sex, particularly during pregnancy and puerperium due to several co-factors. Cost-effective- ness of endovascular repair, open repair, and conservative management of splenic artery aneurysms. Keywords: aneurysm; artery; case; patient; pseudo; rupture; splenic
• Euglycemic diabetic ketoacidosis due to small bowel perforation: a case report by Fornaciari, Lorenzo; Bondavalli, Lisa; Mulas, Cesare Salvatore (2024) - Usually, metabolic acidosis and ketosis are not the primary goals of care for DKA patients. Effect of canagliflozin on blood pressure and adverse events related to osmotic diuresis and reduced intravascular volume in patients with type 2 diabetes mellitus. Keywords: day; dka; emergency; icu; mmol; patient; potassium
• A left humerus fracture-induced Takotsubo syndrome by Rapino, Alessandro; Ceccuzzi, Giovanna; Perna, Benedetta; Maroncelli, Giacomo; Spampinato, Michele Domenico; Farina, Gabriele; De Giorgio, Roberto; Guarino, Matteo (2024) - The highest mortality was registered in TS patients secondary to neurological issues.3,4,16 In the literature, TS related to traumatic events is mostly linked to traumas (road accidents and falls) involving the head, chest, and lower limbs.4,16 There is no clear linear correlation between the type or severity of trauma and TS. In most cases, TS occurs in female and post-menopausal patients due to emotional stressful triggers,6,11 while it is rarely observed in male patients and is generally induced by physical stress (i.e., activity/trauma, infections, hypoxia, neuro- logical disorders, surgery, pain).12 Keywords: case; ecg; emergency; patient; takotsubo; trauma
• Efficacy of EFAST-PS in pelvic trauma for the assessment of the pubic symphysis in emergency settings: a mini review by Piazzai, Federica; Morelli, Gilda; Barone, Lorenzo; Carli, Manuel; Borchi, Chiara; Rosati, Moris; Righi, Lorenzo; Montemerani, Sara (2024) - Efficacy of EFAST-PS in pelvic trauma for the assessment of the pubic symphysis in emergency settings: a mini review Federica Piazzai,1 Gilda Morelli,2 Lorenzo Barone,3 Manuel Carli,4 Chiara Borchi,5 Moris Rosati,6 Lorenzo Righi,1 Sara Montemerani7 1Emergency Department, Azienda USL Toscana Sud Est; 2Rehabilitation Facility, Istituto Anna Torrigiani; 3Intensive Care Unit, Azienda USL Toscana Centro, Ospedale Santa Maria Annunziata; 4Emergency Department, IRCCS Ospedale Sacro Cuore Don Calabria Negrar di Valpolicella; 5IRCCS Don Carlo Gnocchi, Firenze; 6Cardiology and Cardiac Intensive Care Unit, Azienda Ospedaliero Universitaria Senese, Siena; 7Acceptance and Emergency Medicine and Surgery Unit, San Donato Hospital in Arezzo - Pegaso 2 Helicopter Service, Emergency Department, Azienda USL Toscana Sud Est, Italy Highlights - The most widely used classification for pelvic fractures is the Young-Burgess classification, which categorizes pelvic injury based on the direction of impact in anteroposterior compression (APC), lateral compression (LC), vertical shear (VS), and combined mechanisms. - Pelvic fractures are frequently associated with high-energy traumatic mechanisms. Keywords: efast; emergency; fractures; patient; symphysis; trauma; ultrasound
• An unusual malposition of the nasogastric tube in the pleural space: a case report by Eminente, Dino; Zotti, Sonia; Gilardi, Emanuele; Grandi, Tommaso; Navarin, Silvia; Sambuco, Federica; Travaglino, Francesco (2024) - NGT placement can be normally done bedside, although in patients with an abnor- mal anatomy, e.g. pharyngeal pouch, this may be done under X-ray guidance or in endoscopy.2 If the patient shows signs of respiratory distress-like cough, gasping, or cyanosis, the tube may be entered into the trachea. If NGT insertion has failed after three attempts or if the tube has been pulled out by the patient on three occasions, it is recommended to contact an expert team as soon as possible.3 Even tough pH impedance measurement is the gold standard to confirm the correct placement of NGT,4 in clinical practice this is commonly confirmed via the whoosh test (auscultation i.e. introduction of air via the NGT whilst listening with a stethoscope), or by visual inspection of fluid from the tube, and observation of water bubbles.5 Keywords: emergency; ngt; patient; placement; pneumothorax; tube
• A myocardial infarction detected in an unusual way by Barakat, Massimo; Bertagnin, Enrico; Mulazzani, Lorenzo; Galuppi, Francesco; Nizzardo, Sanda Giovanna (2025) - His medical history included cholecystectomy for lithiasis, radical prostatectomy for prostate cancer, dual-cham- ber pacemaker implantation for second-degree atrioventricular block, drug-eluting stent implantation in the left anterior descend- ing artery for acute myocardial infarction, chronic ischemic heart disease, hypertension, and type 2 diabetes mellitus. Gosalia A, Haramati LB, Sheth MP, Spindola-Franco H. CT detection of acute myocardial infarction. Keywords: contrast; emergency; infarction; patient; scan; ventricle
• SOS: a silent threat. A case report on paracetamol overdose by Nagraj, Shreya; Kumar N S, Akshay; Sharma, Manjari; Kumar, Praveen (2025) - Discussion Easy accessibility to OTC medications like paracetamol can lead to unintentional overuse.2 Paracetamol poisoning is the most frequent reason for liver transplantation in the United States, and the second most prevalent cause worldwide is acetaminophen poi- soning. If patients come across the acronym SOS on a prescription, it means that they should take the drug as needed rather than on a set schedule. Keywords: case; medication; otc; paracetamol; patient
• A series of clinical cases highlighting cardiotoxicity induced by polymyxin B by Patel, Rachna B.; Patel, Bhavin B.; Hajariwala, Nisarg R.; Maheshwari, Pankaj; Chauhan, Virendra C.; Kaneria, Killol; Ganju, Anil; Kadam, Abhishek; Harshe, Pradnya; Sapre, Chinmaye; Parikh, Kamlesh (2025) - Over time, the patient stabilized for few days with Meropenem injections and Teicoplanin injections, latter on patient again started having fever, hypotension and elevated infection markers; so after sending cul- tures, polymyxin B injection was started with a loading dose of 1,500,000 units followed by 750,000 units every 12 hours, he developed breathlessness and arrhythmias, specifically ventricular tachycardia. E-mail: nisarghajariwala@gmail.com Key words: polymyxin B, ventricular tachycardia, chronic kidney disease, ischemic heart disease, diabetes mellitus, hypertension. Keywords: cardio; case; patient; polymyxin; tachycardia; toxicity; units
• The key role of ECG in diagnosing secondary hypothermia in a patient with shock: a case report by Borja Cano, Maria; Turbau Valls, Miquel; Agra Montava, Ivan; Gomez Robles, Joaquin Jose; Fernandez Gonzalez, Diego; Lazzari, Roberto (2025) - Osborn’s J wave evolution in severe hypothermia. [page 45] The key role of ECG in diagnosing secondary hypothermia in a patient with shock: a case report Maria Borja Cano,1 Keywords: case; ecg; hypothermia; patient; sepsis; shock; temperature
• Non-operative treatment for bowel obstruction in a 37-year-old woman with common mesentery: a case report by Mastronardi, Manuela; Casagranda, Biagio; de Manzini, Nicolò; Palmisano, Silvia (2025) - We present a case of a patient with common mesentery who was admitted for bowel obstruction and successfully managed with non-operative treatment. E-mail: manuela.mastronardi@gmail.com Key words: bowel obstruction, common mesentery, non-operative management. Keywords: bowel; case; mesentery; obstruction; patient; report; surg
• Palpitations in a Fontan patient: what now? by Sepe, Catello; Perani, Cristiano (2025) - Fontan heart. Arrhythmias in congenital heart disease: a position paper of the European Heart Rhythm Association (EHRA), Association for European Paediatric and Congenital Cardiology (AEPC), and the European Society of Cardiology (ESC) Working Group on Grown-up Congenital heart disease, endorsed by HRS, PACES, APHRS, and SOLAECE. Keywords: emergency; fontan; heart; patient
• From bacterial pyelonephritis to meningitis: a case report and literature review by Jafri, Asif Dabeer; Sanjeev, Om Prakash; Sundar, Shyam; Rizvi, Kayenaat (2025) - Spontaneous gram-negative bacillary meningitis in adult patients: character- istics and outcome. This case underscores the rare but life-threatening progression of pyelonephritis to meningitis in diabetic patients. Keywords: case; coli; infection; meningitis; patient; pyelonephritis; tract
• Telmisartan-induced type 4 renal tubular acidosis: a case report by Nguyen Ngoc, Thang; Nong Thao, Vy; Nguyen Ba, Son; Nguyen Minh, Nghia (2025) - Conflict of interest: the authors have no conflicts of interest to declare Contributions: TNN, study concept, design, collection and assembly of data, manuscript original drafting; VNT, administrative support, provision of patients, contribution to manuscript writing and editing; SNB, contribution to manuscript writing and editing; MNN, contri- bution to manuscript writing and editing. Patients with diabetes mellitus are particularly vulnerable to type 4 RTA due to dysregulation of the RAAS, increasing their risk of hyperkalemia.6 The introduction of RAAS inhibitors, such as ARBs, can further aggravate this imbalance, potentially triggering type 4 RTA, as observed in this case. Keywords: case; day; hyperkalemia; patient; rta; type
• From a sore throat to Lemierre syndrome. A case report and literature review by Drei, Andrea; Rava, Gianluigi; Predieri, Silvia; Mari, Lucio; Farina, Gabriele (2025) - [page 49] From a sore throat to Lemierre syndrome. Key words: Lemierre syndrome; sepsis; Fusobacterium necropho- rum; pharyngitis; jugular vein thrombosis. Keywords: case; day; emergency; fusobacterium; jugular; lemierre; patient; review; syndrome; therapy; vein
• A silent case of aortic dissection: a case report by Passaretti, Marco; Maino, Carlo (2025) - Insights from the international registry of acute aortic dissection: a 20-year experience of collaborative clinical research. In the suspected life-threatening cardio-thoracic-vascular aeti- ology (ACS vs. PTE vs. acute aortic syndrome), the main diagnos- tic scores/pathways were calculated: i) HEART Pathway5: 3 points (low risk of 6 weeks MACE, 0.9-1.7% ), negative troponine at one and three hours (rule-out for SCA); ii) Keywords: acute; case; dimer; dissection; emergency; pain; patient
• Shiitake mushroom bezoar: a rare cause of small bowel obstruction in Vietnam and lessons in diagnosis and management by Pham, Tri-Nhan; Tran, Minh-Quang; Pham, Phu-Cuong; Trinh, My-Tran; Ngo, Quang-Duy; Le, Kim-Long (2025) - E-mail: longlk@pnt.edu.vn Key words: shiitake mushroom bezoar; small bowel obstruction; emergency surgery; case report. Shiitake mushroom bezoar: a rare cause of small bowel obstruction in Vietnam and lessons in diagnosis and management Tri-Nhan Pham,1,2 Minh-Quang Tran,2,3 Phu-Cuong Pham,1,2 My-Tran Tran,2,3 Quang-Duy Ngo,1 Kim-Long Le2,3 1Department of Gastroenterology Surgery, Nhan Dan Gia Dinh Hospital, Ho Chi Minh City; 2Department of Surgery, Pham Ngoc Thach University of Medicine, Ho Chi Minh City; 3Department of Hepato-Pancreato-Biliary, Nhan Dan Gia Dinh Hospital, Ho Chi Minh City, Viet Nam sea, vomiting, fever, or changes in bowel habits, having passed normal yellow stools earlier that day. Keywords: bezoar; bowel; case; imaging; management; mushroom; obstruction; patient; sbo; shiitake
• Severe acute dystonia induced by ondansetron in a paediatric patient: a case report by Nagaraju, Kishore; Balachandran, Roshni; Bhat, Srilakshmi Ravindra; Karkada Srinivas, Venkatesh; Ranganathan, Srinivasan (2025) - However, caution remains necessary, par- ticularly for patients with pre-existing neurological conditions.3,4 Recent research has focused on dystonic reactions associated with ondansetron use, especially as it remains the first-line antiemetic for acute gastroenteritis in paediatric patients. Although it is well-tolerated, recent reports have raised concerns regarding dystonic reactions associated with its use, particularly in children. Keywords: acute; dystonic; gastroenteritis; ondansetron; patient; reaction
• Clostridium difficile infection presenting as a leukemoid reaction: a case report and mini-review of the literature by Jafri, Asif Dabeer; Singh, Muktesh; Ansari, Rehana; Singh, Ratender Kumar (2025) - Extracolonic man- ifestations of Clostridium difficile infections: presentation of 2 cases and review of the literature. Surgical drainage of the abscess was perfor- med, and microbiological analysis identified Clostridium difficile. Keywords: abscess; case; cdi; clostridium; difficile; dis; extraintestinal; infection; leukemoid; patient
• Comments on From a sore throat to Lemierre syndrome. A case report and literature review by Poggiali, Erika; Gallo, Davide; Dacrema, Alessandro; Botti, Camilla; Rossi, Beatrice; Caborni, Claudia; Vercelli, Andrea (2025) - E-mail: E.Poggiali@ausl.pc.it Keywords: Lemierre syndrome, Fusobacterium necrophorum, pharyngotonsillitis, jugular vein thrombosis. Finally, as emergency doctors, we recommend using bedside US to investigate possible jugular vein thrombosis in all young patients presenting with pharyngotonsillitis. Keywords: emergency; jugular; patient; thrombosis; vein
• Accidental ingestion of dishwasher detergent by an elderly patient: a case of successful conservative management by Floresta, Maria; Venturi, Annamaria; Tubertini, Eleonora; Mele, Loredana; Fantini, Jacopo; Giostra, Fabrizio (2025) - Additionally, the inability to clearly communicate symptoms and provide relevant information, such as the timing of substance intake, the onset of symptoms, and the amount and type of toxicants ingested, is a fur- ther problem in both categories of patients. According to the guidelines of the American Society of Gastrointestinal Endoscopy11 and the recommendations from the World Society of Emergency Surgery,12 the management and treat- ment of patients who have experienced caustic intoxication should include an endoscopy performed within 12 to 24 hours after inges- tion. Keywords: damage; day; detergents; emergency; ingestion; management; patient
• Spontaneous rupture of a normal spleen: a case report and literature review by Poggiali, Erika; Botti, Camilla; Turchio, Piergiorgio; Giannone, Giancarlo; Filosa, Mauro; Moschini, Elisa; Vercelli, Andrea; Nazerian, Peiman (2025) - Spontaneous splenic rupture after the start of lung cancer chemotherapy. Pathologic diagnosis of spontaneous splenic rupture in systemic lupus erythematosus. Keywords: atraumatic; case; diagnosis; emergency; med; pain; patient; report; review; rupture; spleen; splenic
• Transient global amnesia: an atypical presentation of acute aortic dissection by Masoero, Monica; Leotta, Giannina; Vischia, Federico; Sechi, Antonio (2013) - Especially in pain-free dissections (occurring in 5-15% cases) with predominant neurological symptoms, diagnosis of AD can be difficult and delayed.2,3 Despite major advances in diagnostic imag- ing and progress in therapy, the diagnosis of aortic dissection still remains unsuspected in a high number of patients (up to 28%), and mortality rate is still high.2,4 In literature, only few cases of transient global amnesia (TGA) have been reported in association with acute aortic dissection (AAD).5-16 Hence, with the case reported below, we want to emphasize AD as a rare cause of pure TGA. In AD patients, the propagation of the dissection and false lumen to the cere- bral arteries could transiently reduce cerebral blood flow and entail an ischemic stroke with focal signs or a hypoxic encephalopathy with syncope, seizure, or global amnesia. Keywords: amnesia; case; dissection; emergency; patient; tga; transient
• Treatment with lipid therapy to resuscitate a patient suffering from toxicity due to local anesthetics by Monti, Manuel; Monti, Alessio; Borgognoni, Francesco; Vincentelli, Giovanni Maria; Paoletti, Federico (2014) - [page 41] Treatment with lipid therapy to resuscitate a patient suffering from toxicity due to local anesthetics Manuel Monti,1 Alessio Monti,2 Francesco Borgognoni,1 Giovanni Maria Vincentelli,3 Federico Paoletti1 1Emergency Department, Local Health Unit UMBRIA1, Assisi; 2Department of Engineering, Roma Tre University, Rome; 3Emergency Department, Fatebenefratelli Hospital, Rome, Italy Abstract Recently, although without a universal recognition, the use of lipid emulsions as a rescue therapy for the bupivacaine cardiac tox- icity has been proposed. The first studies about the systemic toxi- city of local anesthetics were done by Murloy.3 More recently, Lee,6 performing a study named Closed Claims Database for the American Society of Anaesthesiology and using data from 1980 to 2000, pointed out that the toxici- ty of LA is the main cause of brain damage or death. Keywords: anesth; anesthetics; bupivacaine; emergency; emulsion; lipid; pain; patient; region; resuscitation; toxicity
• Fatal myocardial damage due to zinc phosphide intentional ingestion by Marino, Francesco; Salvetti, Massimo; Bazza, Abramo; Rossi, Mara; Muiesan, Maria Lorenza (2014) - The main target organs of phosphine toxici- ty are lungs, cardiovascular, gastro-intestinal and endocrine-methabolic systems, with a wide range of effects.3-11 We describe a case of zinc phosphide poisoning admitted to our emergency medicine unit (EMU). We present a case of fatal myocardial dam- age caused by zinc phosphide ingestion. Keywords: acute; emergency; ingestion; patient; phosphide; poisoning; zinc
• Multiple abdominal abscesses complicated by severe sepsis as a result of occult Crohn’s disease by Vannini, Antonio; Croci, Luca; Guidetti, Elena; Tovoli, Francesco; Cassani, Fabio; Bolondi, Luigi (2014) - E-mail: francesco.tovoli2@.unibo.it Key words: intra-abdominal infections, sepsis, Crohn disease, liver abscess, psoas abscess. The role of beta-lac- tam antimicrobials as single agents in treatment of intra-abdominal infection. Surg Infect (Larchmt) 2000;1:57-63. 10. Keywords: abscesses; disease; las; liver; patient
• Reliability and factor structure of brief emergency department patient satisfaction scale by Atari, Maryam; Akbari-Zardkhaneh, Saeed; Atari, Mohammad (2015) - Therefore, ED patient satisfaction con- sists of five domains as measured by BEPSS. Since the psychometrically cor- rect assessment of satisfaction is imperative for quality improvement purposes, BEPSS may be nationally utilized in order for assessment of ED patient satisfaction. Keywords: bepss; department; emergency; factor; patient; satisfaction; scale
• Severe acute lactic acidosis and hypoglycemia due to isolate tramadol poisoning by Granauro, Patricia; Di Comite, Vincenzo; Lippi, Giuseppe; Marzi, Umberto; Cervellin, Gianfranco (2016) - [page 41] Discussion Hypoglycemia has been extensively described as a possible, albeit rare, adverse effect of tramadol, even at therapeutic dosages, surprisingly especially in patients without a history of diabetes mellitus, and not taking anti-diabetic drugs.20 Our case is, how- ever, the very first case report of severe acute lactic acidosis triggered by tramadol, although in presence of concomitant transient and promptly corrected hypoglycemia. [Emergency Care Journal 2016; 12:5659] Severe acute lactic acidosis and hypoglycemia due to isolate tramadol poisoning Patricia Granauro,1 Vincenzo Di Comite,2 Giuseppe Lippi,3 Umberto Marzi,4 Gianfranco Cervellin1 1Emergency Department, University Hospital of Parma, Parma; 2Internal Medicine Unit, University Hospital of Parma, Parma; 3Section of Clinical Chemistry, University of Verona, Verona; 4Intensive Care Unit, University Hospital of Parma, Parma, Italy Abstract The article describes a case of severe acute lactic acidosis and hypoglycemia after inten- tional ingestion of tramadol overdose. Keywords: acidosis; case; parma; patient; tramadol
• Never underestimate renal colic: a case of pelvic rupture by Battista, Tiziana; Cantiello, Domenico; Salzillo, Marta; Pezzulo, Ermenegildo; Paternosto, Diego (2016) - [Emergency Care Journal 2016; 12:5854] Never underestimate renal colic: a case of pelvic rupture Tiziana Battista,1 Domenico Cantiello,2 Marta Salzillo,2 Ermenegildo Pezzulo,2 Diego Paternosto2 1School of Emergency and Urgency Medicine, Second University of Naples, Naples; 2Emergency Department, S. Anna and S. Sebastiano Hospital, Caserta, Italy Abstract Authors describe a case of pelvic rupture as a consequence of renal colic. Pelvic rupture is an unusual condition that often is not consid- ered in patients suffering renal colic. Keywords: case; colic; patient; pelvis; renal; rupture
• Epinephrine auto-injection radically increases risk for clostridial infection and necrotizing fasciitis by Larson, Kenneth; Grone, Gary; Austin, Cindy L.; Thompson, Simon J. (2017) - In this review of the published litera- ture, we found three pediatric patients (≤18 years old) with C. perfringens infections secondary to epinephrine injections, with only one patient surviving (Table 2). [Emergency Care Journal 2017; 13:6256] Epinephrine auto-injection radically increases risk for clostridial infection and necrotizing fasciitis Kenneth Larson,1 Gary Grone,2 Cindy L. Austin,3 Simon J. Thompson3 1Trauma & Burn Surgery Center; 2Department of Trauma Services; 3Trauma & Burn Research, Mercy Hospital, Springfield, MO, USA Abstract Clostridial perfringens is a bacteria commonly found on skin flora. Keywords: clostridial; day; epinephrine; gangrene; gas; injection; necrotizing; patient; perfringens
• Medical malpractice claim risk in emergency departments by Bianchin, Claudio; Prevaldi, Carolina; Corradin, Matteo; Saia, Mario (2018) - Abdominal pain In the category of abdominal pain, the missed/delayed diagno- sis of appendicitis is the main cause of malpractice claims against ED doctors. The analysis of large datasets of cases of acute appendicitis leading to malpractice claims shows an association with certain characteris- tics of the clinical from which recommendations for ED doctors can be derived. Keywords: cases; claims; diagnosis; emergency; errors; malpractice; patient; risk
• The cause of fever and pulmonary infiltrate: a difficult etiological diagnosis by Barakat, Bahjat; Pezzilli, Raffaele (2017) - Gopalarathinam R, Orlowsky E, Kesavalu R, Yelaminchili S. Adult onset still's disease: a review on diagnostic workup and treatment options. Still’s disease was suspected, antibiotics were interrupted and a serum ferritin assay was carried out which was very high (3219 ng/mL; reference values 11-306 ng/mL). Keywords: adult; criteria; diagnosis; disease; onset; patient
• Traumatic gastric rupture following blunt abdominal trauma: a case report about an atypical modality of presentation by Giambelluca, Dario; Picone, Dario; Pennisi, Natalino Carmelo; Luciani, Bruno; Lo Re, Giuseppe; Romeo, Placido (2017) - Traumatic gastrointestinal lesions can be caused by three different injury mechanisms: i) crush injury, which occurs when an organ is compressed violently against the spine by directly applied pres- sure; ii) burst injury, which occurs when a sudden, violent compression of the abdom- inal wall is applied to a filled and extended hollow viscous, without any direct mechan- ical compression, resulting in an increase of intraluminal pressure; history of a recent meal has been often observed; iii) shear injury, caused by sudden deceleration of an organ at one point of fixation or its vascular pedicles.3 Gastric rupture following Heimlich maneuver, bag and mask ventilation and cardiopulmonary resuscitation has also been reported in literature.4 Actually, the most commonly used injury scoring grades for traumatic injuries of stomach is The American Association for the Surgery of Trauma injury scoring scale: according to this score, increasing morbidi- ty and mortality correlates with increasing severity of injury, which is assessed on the basis of depth of parenchymal damage and involvement of vessels.5 Partial rupture of the stomach wall may lead to full thickness rupture at a later stage. Traumatic gastric rupture is usu- ally associated with other visceral injuries, such as splenic lesions and fractures. Keywords: abdomen; air; injuries; injury; patient; rupture; trauma
• Respiratory distress due to platypnea-orthodeoxia syndrome: A diagnostic challenge in emergency setting by Di Domenico, Sandro; Aseni, Paolo; Bonacchini, Luca; Bottiroli, Maurizio; Guerrieri, Rossella; Basile, Adriano; Bellone, Andrea (2018) - The early presence of microbubbles in the left atrium is suggestive for intra-cardiac shunt, while a delayed appearance of the contrast is consistent with extra-cardiac shunt that in most of the cases is intrapulmonary.10 Some cases of aneurysm of the ascending aorta associated with right to left shunting across a PFO have been reported during last years.11-14 In a series of 18 patients with POS and PFO,15 4 patients had an associated aortic root aneurysm, and 12 patients presented an enlarged aortic root. The etiology of POS can be divided into four major groups: intra-car- diac shunt, pulmonary shunt, ventilation-perfusion mismatch or a combination of these as shown in Table 1. Keywords: oxygen; patient; pfo; pos; position; pressure; pulmonary; right; shunt
• A case of successful organ donation after extremely prolonged manual cardiopulmonary resuscitation in a buried hypothermia victim of avalanche by Varutti, Rosanna; Trillò, Giulio; Di Silvestre, Adriana; Peressutti, Roberto; Bassi, Flavio; Latronico, Nicola (2019) - ©Copyright: the Author(s), 2019 Licensee PAGEPress, Italy Emergency Care Journal 2019; 15:8338 doi:10.4081/ecj.2019.8338 A case of successful organ donation after extremely prolonged manual cardiopulmonary resuscitation in an avalanche victim Rosanna Varutti,1,2 Giulio Trillò,2 Adriana Di Silvestre,3 Roberto Peressutti,3 Flavio Bassi,4 Nicola Latronico1 1Department of Anesthesia and Critical Care Medicine 2, University Hospital, Brescia; 2Helicopter Emergency Medical Service, University Hospital, Udine; 3Regional Transplant Center, University Hospital, Udine; 4Department of Intensive Care 2, University Hospital, Udine, Italy Non -co mmerc ial us e o nly [Emergency Care Journal 2019; 15:8338] HEMS, helicopter emergency medical service; AED, accident Emergency Department; ECLS, extracorpo- real life support; ROSC, return of spontaneous circulation; CPR, cardiopulmonary resuscitation; EpT, epitympanic temperature; EvT, endovascular temperature; EtCO2, end tidal CO2; CCA, cardio-circulatory arrest; BLS/ACLS, basic life support/advanced cardiopul- monary life support; NTP, no touch period. Keywords: case; emergency; hospital; italy; patient
• Automated mechanical chest compression as a bridge to primary percutaneous coronary intervention: Case report by Faria, Bebiana; Fernandes, Marina; Ribeiro, Silvia; Lourenço, António (2020) - [page 99] Automated mechanical chest compression as a bridge to primary percutaneous coronary intervention: Case report Bebiana Faria, Marina Fernandes, Sílvia Ribeiro, António Lourenço Hospital Senhora da Oliveira, Guimarães, Portugal Non -co mmerc ial us e o nly Discussion In STEMI patients presenting with CS in which PCI is estimat- ed to occur 120 min after diagnosis, immediate fibrinolysis and transfer to a PCI center should be considered. This case underlines the difficulty in man- aging these critically ill patients in peripheral hospitals without advanced resources and discusses some therapeutic options, high- lighting automated mechanical chest compression as a bridge to a percutaneous revascularization procedure. Keywords: case; cpr; hospital; patient; resuscitation
• A serious fit of cough: A 66-year-old patient with myasthenia gravis presenting with spontaneous intercostal lung herniation after coughing. Case report and pathophysiological discussion by Gerloni, Riccardo; Artusi, Nicola; Sisto, Ugo Giulio; Tollot, Saverio; Copetti, Roberto (2020) - ©Copyright: the Author(s), 2020 Licensee PAGEPress, Italy Emergency Care Journal 2020; 16:8911 doi:10.4081/ecj.2020.8911 A serious fit of cough: A 66-year-old patient with myasthenia gravis presenting with spontaneous intercostal lung herniation after coughing. Few cases of spontaneous lung herniation are reported in literature, most of them associated with rib fractures and persistent coughing, mechanical ventilation with positive pressure, emphyse- ma and COPD. Keywords: case; emergency; fractures; herniation; lung; panel; patient; spontaneous
• Endoscopic removal of slow release oxycodone tablets in a case of voluntary acute poisoning by Serra, Sossio; Geniere Nigra, Stefano (2021) - ©Copyright: the Author(s), 2021 Licensee PAGEPress, Italy Emergency Care Journal 2021; 17:9226 doi:10.4081/ecj.2021.9226 Endoscopic removal of slow release oxycodone tablets in a case of voluntary acute poisoning Sossio Serra, Stefano Geniere Nigra Emergency Department, Maurizio Bufalini Hospital, Cesena (FC), Italy Non -co mmerc ial us e o nly As recently reported by Hoegberg et al., when some components are present in slow release formulation drugs (eg. hypromellose or alginate or acrylate), clinicians should be alert for risk of pharmacobezoar formation. Keywords: case; egds; emergency; ingestion; patient; tablets
• Lung ultrasound monitoring of CPAP effectiveness on SARS-CoV-2 pneumonia: A case report by Montanari, Marco; De Ciantis, Pierpaolo; Boccatonda, Andrea; Venturi, Marta; d'Antuono, Giuseppe; Gangitano, Gianfilippo; Cocco, Giulio; D'Ardes, Damiano; Schiavone, Cosima; Giostra, Fabrizio; Perin, Tiziana (2020) - Lung ultrasound can guide pulmonary recruitment and pronation maneuvers in patients undergoing non-invasive ventilation. Lung ultrasound is a bed-side, simple, low cost and repeatable method.1,2 Some reports in literature reported that awake early proning in the emer- gency department induces improved oxygen saturation in Covid- 19 patients.7,8 We report the case of a 55-year-old male patient hos- pitalized in a critical setting and subjected to Continuous Positive Airway Pressure (CPAP) and prone position, in which the use of ultrasound monitoring allowed to verify the effectiveness of the pressure support used in recruiting previously atelectasis lung areas. Keywords: areas; cpap; lines; lung; patient; ultrasound; ventilation
• Simultaneous arterial and venous thromboembolic events associated with COVID-19. A case report by Reed, Ashley; Howard, Caroline; Barakat, Mohamed ; Navi, Ali (2021) - Acute pul- monary embolism in COVID-19 patients on CT angiography and relationship to D-dimer levels. Managing patients with multiple pathologies occurring concurrent- ly requires effective inter-speciality working in order to take a holistic approach to managing the patient opposed to managing the conditions in isolation. Keywords: case; covid-19; embolism; patient; pulmonary; risk
• Jehovah’s Witness survives severe favism complications: Advance provisions of treatment and new challenges for the physicians by Salvetti, Massimo; Capellini, Sara; Delbon, Paola ; Maghin, Francesca; Muiesan, Maria Lorenza; Conti, Adelaide (2021) - For patients “critically ill” (with increase in lactate and base deficit, hemody- namic instability, hypoperfusion or shock) experimental hemoglobin-based oxygen carrier (HBOC) therapy and subsequent monitoring for adverse effects can also be considered.5 Finally, attempts must be made to reduce the risk of iatrogenic anemia, lim- iting laboratory testing as much as possible.6 In case of emergency the initiation of life-saving blood trans- fusion to JW patient who cannot express his or her wishes (e.g., unconscious, dementia or ongoing psychiatric condition) depends on an advance directive. From a medical point of view, the treatment of a patient without blood transfusion has always been an ethical prob- lem that afflicts the physician, who may feel that complying with the patient’s wishes will force them to provide suboptimal care.9,10 On the other hand, clinicians can create opportunities to provide quality care for all patients, if they accept the challenges of learn- ing how to treat patients safely and successfully without the tradi- tional treatment of blood transfusion.11-12 From a legal point of view, the value given to anticipated medical provisions in many Countries represents a fundamental milestone and a defense for healthcare providers who, by complying with the patients’ wishes, are no longer liable for failure to render assistance. Keywords: anemia; blood; case; jehovah; patient; transfusion; treatment
• Subclinical pericarditis long after SARS-CoV-2 infection: a case report by Falchi, Anna Giulia; Leonardi, Sergio; Cappa, Giovanni; Perlini, Stefano (2021) - Although pericardial involvement after COVID-19 infection has been already described, the incidence of subclinical pericarditis has not and may have implications for the monitoring of patients with uncomplicat- ed COVID-19 infection managed as outpatients. Introduction Cardiac complications of COVID-19 infection are emerging in the current pandemic, although few descriptions are available in those who are managed as outpatients.1 Notably, SARS-CoV2 can cause long-lasting illness, and the term long COVID describes the disease in people who continue reporting symptoms several weeks after the infection. Keywords: covid-19; ecg; infection; patient; pericarditis
• Kounis syndrome after almonds ingestion: From the diagnostic approach to new therapeutic options by Fiore, Giorgio; Gaspardone, Carlo; Di Maio, Silvana; Oppizzi, Michele; Margonato, Alberto (2021) - The complex diagnostic workup led to the diagnosis of vasospastic Kounis syndrome, an infrequent type of acute coronary syndrome, mostly overlooked, with challenging diagnostic and therapeutic features. +393391449399 E-mail: gio.fio@hotmail.it Key words: Kounis syndrome; allergic angina; vasospastic angina; acute chest pain; acute coronary syndrome. Keywords: acs; acute; case; emergency; kounis; management; patient; syndrome
• Acute accidental inhalation of Chlorine gas: A mini review by Lai, Franco; Baldini, Alessio; Becheroni, Luca; Cappellini, Iacopo; Balzarini, Barbara; De Antoniis, Francesco ; Ieri, Alessandra; Gambassi, Francesco; Pagnini, Chiara; Pelagatti, Lorenzo; Rugna, Mario; Magazzini, Simone (2021) - Distribution of calls for chlorine gas exposures by year, proveniences and circumstances arrived to Toxicology Unit & Poison Control Centre, Azienda Ospedaliero Universitaria Careggi, Florence, Italy. Kim J-A, Yoon S-Y, Cho S-Y, et al. Acute health effects of accidental chlorine gas exposure. Keywords: acute; azienda; chlorine; control; emergency; exposure; florence; gas; hypochlorite; patient; poison; symptoms

• Severe hyponatremia due to water intoxication in a child with sickle cell disease: A case report by Rossi, Roberta; Castagno, Emanuele; Matarazzo, Patrizia; Tuli, Gerdi; Saracco, Paola; Urbino, Antonio F.; Bondone, Claudia (2022) - Copeptin levels in water and sodium imbalance disorders associated to hyponatremia, such as Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) and cerebral/renal salt wasting, result higher than normal and urine osmolality is consequently also high.10-12 In our case, the time between water intake and seizures onset was approximately 12-24 hours, as already reported: the time sufficient to precipitate hyponatremic seizures after excessive water intake ranges from 90 minutes to 48 hours.1,4 Our patient also presented rhabdomyolysis, which is a known, but rare complication of hyponatremia, and whose underlying mechanism is still unclear. We report a case of acute hyponatremia due to water intoxication without Antidiuretic Hormone (ADH) excess in a child with sickle cell disease. Keywords: case; emergency; hyponatremia; intake; intoxication; rhabdomyolysis; seizures; water
• A direct comparison between five lung-US and chest-CT-scans in a patient infected by SARS-CoV-2 by Poli, Valentina; Spinelli, Stefano; Toscano, Manuela; Vitale, Francesca; Ranalli, Alessandro; Tonerini, Michele; Romei, Chiara; De Liperi, Annalisa; Barbieri, Greta (2022) - Two instrumental examinations were performed at the same time at the ED: lung ultrasound and chest CT scan. Considering the respiratory conditions, high flow nasal cannulas (FiO2 60%) were applied in dedicated negative pressure rooms of the infectious disease ward, in line with the indications regarding the ventilatory support of COVID-19 patients.12,13 Videoclip n. 2 shows lung ultrasound and chest CT performed on the fourth day of hospitalization, corresponding to the twelfth day from the onset of symptoms (Videoclip n.2: Second CT and Lung US (03/21/20) LUS score 36/45). Keywords: case; chest; lung; lus; scan; score; ultrasound
• Normal lipase acute pancreatitis: A case report and brief review of literature by Sanjeev, Om P.; Singh, Ratender Kumar; Ghatak, Tanmoy (2022) - On review of pub- lished literature on acute pancreatitis with normal lipase levels, 23 such case reports were retrieved. Nevertheless, a few cases of AP with normal lipase levels have also been report- ed.4-13 We report a similar case of AP, where serum lipase levels surprisingly remained normal throughout the course of the disease. Keywords: acute; amylase; case; emergency; journal; lipase; pancreatitis; serum
• A rare and unusual cause of acute abdominal pain: A case of spontaneous isolated dissection of the celiac trunk by Poggiali, Erika; Negri, Chiara; Mosso, Federico; Petrini, Marcello; Michieletti, Emanuele; Vercelli, Andrea (2022) - Neychev V, Krol E, Dietzek A. Unusual presentation and treat- ment of spontaneous celiac artery dissection. Aneurysmal celiac trunk dissection caused by median arcuate ligament syndrome successfully treated by endovascular technique: a case report. Keywords: artery; case; celiac; dissection; pain; trunk
• Acute testicular pain: right spermatic vein thrombosis. A case report by Morkuzu, Suat; Kas, Hidir; Oz, Emrah; Yazar, Cihan (2023) - Due to the uncommon existence of spermatic vein thrombosis, the emergency department should be aware of misdiagnosis and the right therapy modalities. In addition to varicocele and hypercoagulability, structural defects, physical activity, and trauma can also cause spermatic vein thrombosis. Keywords: case; emergency; pain; testicular; thrombosis; vein
• The esophageal rapunzel syndrome: a case of a trichobezoar in the esophagus by Ağar, Mehmet; Çelik, Muhammet Reha; Ulutaş, Hakkı; Gülçek, İlham; Kalkan, Muhammed (2023) - Rapunzel syndrome was first described by Vaughn in 1968,2 and is defined as the extension of the trichobezoar from the pylorus into the duodenum, jejunum and even the colon, even if the most common site in the stomach.3 Based on the current literature, trichobezoars in the esophagus are very rare, and isolated esophageal trichobezoars are uncommon, generally related to tube feeding or esophageal disorder (achalasia, epifrenic diverticulum). Gastric trichobezoars — sonographic and computed tomographic appearance. Keywords: case; esophageal; esophagus; rapunzel; report; syndrome; trichobezoar
• Shared psychotic disorder: a case report in Switzerland by Mastromo, Daniele; De Pietra, Aldo (2023) - Subject A, 21 years old, is the son of subject B, who is a 41-year- old woman and subject A’s mother. Subject A (the son) was dominant and the one who had initiated the delusions he had gradually imposed on subject B, who was passive and dependent by nature. Keywords: case; deux; disorder; folie; psychiatric; psychosis; subject
• Mild to moderate bleeding: diagnostic and therapeutic paths by Cenci, Caterina; Silvestri, Elena; Marchi, Alberto; Emmi, Giacomo; Prisco, Domenico (2013) - First level tests (Table 3)6 include blood count with platelet count, bleeding time and/or the more recent platelet function analyzer (PFA)-100, which explore primary haemosta- sis, prothrombin time (PT), activated partial thromboplastin time (aPTT) and the dosage of fibrinogen, which explore the coagulation cas- cade. Diagnosis and manage- ment of mild bleeding disorders. Keywords: bleeding; blood; case; coagulation; factor; platelet; tests; time
• An unusual case of chest pain: ultrasonographic diagnosis of Mondor’s disease by Barakat, Bahjat; Pezzilli, Raffaele (2013) - Boehlen F, Bader M, Moerloose P. Superficial thrombophlebitis of the chest wall associated with anticardiolipin anti- bodies: antiphospholipid syndrome or Mondor’s disease? [page 11] An unusual case of chest pain: ultrasonographic diagnosis of Mondor’s disease Bahjat Barakat,1 Raffaele Pezzilli2 1Department of Emergency Medicine, S. Orsola-Malpighi Hospital; 2Department of Digestive Diseases and Internal Medicine, S. Orsola-Malpighi Hospital, Bologna, Italy Abstract Mondor’s disease is characterized by super- ficial thrombophlebitis affecting the subcuta- neous veins, especially those of the anterolat- eral thoracoabdominal wall. Keywords: case; chest; disease; mondor; superficial; thrombophlebitis
• An unusual initial presentation of colorectal cancer: abdominal wall and scrotal abscess associated with right ventricular metastasis by Barakat, Massimo (2024) - Non -co mmerc ial us e o nly Discussion Colorectal cancer is the third most common malignancy and the second most common deadly cancer worldwide as of 2020.1 There are only a few case reports of abdominal wall involvement by colorectal cancer as the initial presentation.2-6 White et al.8 reviewed 16000 colon cancer patients at Massachusetts General Hospital between 1938 and 1970, out of which only 9 had a pre- senting complaint of abdominal wall abscess. E-mail: massimo.barakat@gmail.com Key words: colorectal cancer, abdominal wall abscess, scrotal abscess, cardiac metastasis, computed tomography. Keywords: abdominal; abscess; cancer; case; colon; wall
• Neurotoxicity and PRES after severe citalopram intoxication in a 12-months-old baby by Minghetti, Sara; Lazzerotti, Alessandra; Sala, Debora; Vimercati , Chiara; Giudici, Sofia; Florio, Santa; Formica, Francesca; Zambrano, Stefania; Agarwal, Nivedita; Peruzzi, Cinzia (2024) - Among SSRIs, citalopram has a high rate of seizures in over- dose and cardiac toxicity, most of all in doses higher than 400mg/day.4,5 Posterior Reversible Encephalopathy Syndrome (PRES) is described in adult patients with SSRI accidental inges- tions.6-9 When SS occurs in adults, cyproheptadine is used as an antidote (12-32 mg/day).10 Within this context, we review the liter- ature on pediatric citalopram intoxication and we describe the first case of pediatric SS with PRES after accidental ingestion of an unspecified dose of this drug treated with cyproheptadine. Antiseizures drugs such as valproic acid, lamotrigine, gabapentin, pregabalin, topiramate and carba- mazepine, phenytoin and oxcarbazepine could have serotoninergic properties and should be avoided in case of SS.18 In conclusion, pediatric citalopram intoxication could represent a severe neurological pediatric emergency with PRES features. Keywords: case; citalopram; cyproheptadine; day; figure; hospitalization; intoxication; occipital; seizures; syndrome
• Aortic dissection presenting with respiratory failure: case report and literature by Gherardi, Simone; Ippolito, Renato; Pasqualin, Stefano; Cianci, Vito; Paganini, Matteo (2024) - The fol- lowing keywords were searched in titles and abstracts: aortic dis- section; acute aortic dissection; aortic syndrome; hypoxia; dysp- nea; intramural hematoma; and pulmonary artery. Insights from the international registry of acute aortic dissection: a 20-year experience of collaborative clinical research. Keywords: aad; acute; aorta; aortic; artery; case; diagnosis; dissection; emergency; hematoma; pulmonary; right; type
• Refractory ventricular tachycardia: a challenge in an emergency setting. A case report by Desai, Tanvi; Swaika, Sarbari; Srivastava, Aviral (2025) - During his ED stay, he experienced refractory VT, which was managed through anti-arrhythmic medications and mul- Common symptoms include palpitations, dizziness, lightheadedness, exercise intolerance, syncope, or sudden cardiac arrest.3 Working on a sympathetic drive, refractory VT may be trig- gered by ischemic heart disease, electrolyte imbalances, medica- tion misuse, drug toxicity, non-adherence to therapy, substance abuse, thyrotoxicosis, sepsis, myocarditis, and infiltrative car- diomyopathies like cardiac sarcoidosis or amyloidosis.4 We report a case involving a middle-aged male with a prior idiopathic VT diagnosis who presented with refractory VT and was later diagnosed with cardiac sarcoidosis. Keywords: arrhythmias; cardiac; case; emergency; figure; tachycardia
• A legendary chest X-ray by Nicoletti, Gea; Tizzani , Davide; Molino , Paola (2025) - Sakamoto K, Ando K, Noma D. Spontaneous bilateral pneu- mothorax resulting from iatrogenic buffalo chest after the Nuss procedure. Tieze syndrome 4 Buffalo chest syndrome Answer The correct answer is buffalo chest syndrome. Keywords: buffalo; case; chest; emergency; syndrome
• Acute onset of bilateral mydriasis, headache, and vomiting: a challenging diagnosis by Cianci, Antonella; Marziani, Beatrice; Bachechi, Tommaso; Bandini, Camilla; Cuoghi, Francesca; Spampinato, Michele Domenico; Pesci, Chiara; De Giorgio, Roberto; Guarino, Matteo (2025) - We report a 65-year-old woman presenting to the emer- gency department with bilateral mydriasis and complaining of acute severe headache associated with blurry vision, photophobia, vomiting, and a recent history of fever with respiratory symptoms. The main causes of bilateral mydriasis are summarized in Table 1.1-18 Several uncommon aetiologies of bilateral mydriasis have also been reported as isolated clinical findings: Keywords: acute; angle; bilateral; case; closure; diagnosis; emergency; glaucoma; mydriasis; syndrome
• A rare trouble in the small bowel by Barakat, Massimo; Capone, Mario; Lotrecchiano, Ludovica (2025) - Case report on a rare cause of small bowel perforation perforated ileal diverticulum. Tel.: +390512144327 E-mail: massimo.barakat@gmail.com Key words: jejunal diverticulitis, diverticula, small bowel, abdominal pain, computed tomography, abdominal surgery Contributions: MB conceptualized and wrote the manuscript. Keywords: bowel; case; diverticulitis; emergency; jejunal
• Spontaneous bladder rupture in acute alcohol intoxication by Barakat, Bahjat; Pezzilli, Raffaele; Casadei, Riccardo (2014) - Introduction It has been reported that spontaneous blad- der rupture is a rare condition associated with significant morbidity and mortality1 and occurs in a high proportion of cases in alcoholics.2 We report a case of spontaneous bladder rupture in a 45 year-old man that was admitted to our emergency room because of a persistent epi- gastric pain. Subsequently, a total of 25 cases of spontaneous bladder rupture have been identified and these cases were associat- ed with alcohol2,5,6 or drug abuse.7 Keywords: alcohol; bladder; case; emergency; rupture
• The cause of intestinal bleeding cannot be missed: the case of primary aortoenteric fistula by Barakat, Bahjat; Calculli, Lucia; Pezzilli, Raffaele (2016) - Typical ultrasonographic appearance of abdominal aortic aneurysm: A) longi- tudinal scan; B) axial scan with clear evidence of the parietal thrombosis delimiting the true lumen; C) and D) echo-color-Doppler confirming the aneurysm with thrombosis. [Emergency Care Journal 2016; 12:5845] The cause of intestinal bleeding cannot be missed: the case of primary aortoenteric fistula Bahjat Barakat,1 Lucia Calculli,2 Raffaele Pezzilli3 1Department of Emergency; 2Department of Diagnostic Medicine and Prevention; 3Department of Digestive System, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy Abstract Primary aortoenteric fistula (PAEF) is a rare condition of intestinal hemorrhage. Keywords: aneurysm; bleeding; case; fistula; gastrointestinal; paef
• Investigating a rare cause of intestinal occlusion by Barakat, Bahjat; Pezzilli, Raffaele (2017) - Discussion Intestinal occlusion due to migration of large gallstones is a rare event affecting mainly older females (female-male ratio of 4.5:1) who usually suffer from other comor- bidities.1,3 It has also been reported that the incidence of gallstone ileus is 0.095% which is a lower percentage than that reported in the past.1 Clinical diagnosis is sometimes difficult as in our present case. Halabi WJ, Kang CY, Ketana N, et al. Surgery for gallstone ileus: a nation- wide comparison of trends and out- comes. Keywords: bowel; case; gallstone; obstruction; presence
• Global T waves inversion and QT prolongation. An uncommon presentation of acute pulmonary embolism by Savastano, Simone; Querio, Martina; Anesi, Ernesto; Camporotondo, Rita (2018) - In APE T waves usually remain positive in I, aVL (as in our case) and only in few cases T waves may be negative in V5, V6 and II. In the same paper the maximal T wav nega- tivity was also compared and it was shown that in APE T waves were less negative than in the other two conditions with a maximal negativity of 3.4 mm. Keywords: ape; case; emergency; waves
• Case of a floating right atrial thrombus successfully treated with fibrinolysis by Bernard, Chloé; Bouchot, Olivier; Georges, Marjolaine; Morgant, Marie Catherine (2019) - Introduction Deep vein thrombosis and pulmonary embolism (PE) are com- mon, but right heart thrombus (RHT) is detected in less than 5% of cases of thromboembolic disease.1-2 PE with RHT is associated with poor outcomes, especially in the absence of immediate treat- ment.1-4 Indeed, the majority of deaths occur in the first 24 hours (62%). Control transthoracic echocardiography at 12 hours: complete right atrium thrombus dissolution. Keywords: case; fibrinolysis; right; thrombus; treatment
• Volvulus of ileum: A rare case of small bowel obstruction and the effectiveness of abdominal ultrasound imaging for the diagnosis by Barakat, Bajhat; Pezzilli, Raffaele (2019) - The US showed the twisting of small bowel around its mesentery (Figure 3). Abdominal ultrasonography: shows the twisting of small bowel around its mesentery. Keywords: bowel; case; diagnosis; obstruction; type; volvulus
• A rare cause of inguinal region swelling and pain in women: Hydrocele of the canal of Nuck by Barakat, Bahjat; Barakat, Massimo; Vasuri, Francesco; Pezzilli, Raffaele (2019) - The canal of Nuck typically closes in infancy, however, in some women, the canal of Nuck remains patent, allowing for the development of canal of Nuck cysts or indirect inguinal hernias. The canal of Nuck typically closes in infancy, however, in some women, the canal of Nuck remains patent, allowing for the devel- opment of canal of Nuck cysts or indirect inguinal hernias. Keywords: canal; case; cyst; hydrocele; nuck
• Pulmonary hypertension: when the acute event leads to diagnosis. Case report in a patient with Ehlers-Danlos syndrome. by Secco, Gianmarco; Falchi, Anna Giulia; Salinaro, Francesco; Blatti, Chiara; Giacomuzzi Moore, Bianca; Perlini, Stefano (2020) - When acute pulmonary thromboembolism is accompanied by chronic pulmonary embolism (acute on chronic thromboembolism), pulmonary endarterectomy should be consid- ered in addition to pulmonary embolectomy. The wide margin of error is probably explained by the dif- ficulty to distinguish the analogous symptoms and first instrumen- tal data of acute pulmonary embolism from clinical features of a pre-existent CTEPH. Keywords: acute; case; chronic; cteph; embolism; heart; hypertension; pulmonary; right
• A rare case of acute alcohol intoxication mimicking an electrocardiographic pattern for acute coronary syndrome with ST-segment elevation by Lai, Franco; Pelagatti, Lorenzo; Pagnini, Chiara; Baldini, Alessio; Versari, Daniele; Magazzini, Simone (2020) - Consistently with litera- ture, we speculated that alcohol levels might be correlated to myocardial ischemia since ECG pattern normalization only occurred with alcohol level normalization. The authors have supposed that increased urinary Mg excretion induced by alcohol assumption may be the cause of acute alcohol induced angina. Keywords: acute; alcohol; case; elevation; ethanol; segment
• An unusual case of neck hematoma and hypercalcemia by Porta, Lorenzo; Ghezzi, Roberto; Cadonici , Anna Chiara; Dalino Ciaramella , Paolo; Martes, Chiara; Basile, Adriano; Bellone, Andrea (2021) - Neck emer- gency due to parathyroid adenoma bleeding: a case report. Rehman HU, Markovski M, Khalifa A. Spontaneous cervical hematoma associated with parathyroid adenoma. Keywords: adenoma; bleeding; case; emergency; hematoma; hyperparathyroidism; neck; parathyroid

• A sinister needle in an enormous haystack: A clinician survey regarding Acute Aortic Syndrome diagnostic practice in United Kingdom Emergency Departments by McLatchie, Rachel; Gupta, Aakash; Wilson, Sarah; Reed, Matthew J.; Research Group, Aortic Dissection Diagnosis in ED (2022) - Masoero M, Leotta G, Vischia F, Sechi A. Transient global amnesia: an atypical presentation of acute aortic dissection. The diagnostic value of D-dimer in acute aortic dissection: a meta-analysis. Keywords: aas; acute; eds; emergency; survey
• A dark and black esophagus by Scarilli, Flavio; Tizzani, Davide (2024) - E-mail: flavio19sx@gmail.com Key words: black esophagus, Gurvits, ketoacidosis, diabetes, AEN. Black esophagus: acute esophageal necrosis syn- drome. Keywords: acute; aen; emergency; esophagus; necrosis
• Is there still a role for abdominal plain X-ray in acute abdomen? by Paolillo, Ciro; Spallino, Ilenia; Cervellin, Gianfranco; Catena, Fausto (2015) - [Emergency Care Journal 2015; 11:5528] Is there still a role for abdominal plain X-ray in acute abdomen? So, is there still a role for abdominal plain X-ray in acute abdomen? Keywords: acute; bowel; obstruction; pain; radiography
• Acute pancreatitis associated with massive paraesophageal hernia involving the presence of the pancreatic body and tail by Barakat, Bahjat; Calculli, Lucia; Pezzilli, Raffaele (2018) - Even if in Italy gallstones especially are the predominant etiological factor, there are also less frequent causes associated with acute pancreati- tis and we believe that the case of acute pancreatitis associated with massive incarcerated paraesophageal hernia involving the presence of the body and tail of the pancreas in the thorax is worth reporting. The primary objectives in the treatment of acute pancreatitis are essentially: pain control, electrolyte and fluids support, energy intake, and removal of the causal agent, attenuation of inflammation, and prevention and eventual treatment of local and systemic complications in necrotiz- ing forms.2 Gallstones are the predominant etiological factor espe- cially in Italy followed by alcohol abuse.3 Keywords: acute; hernia; hiatal; liv; pancreas; pancreatitis; paraesophageal
• Role of bedside-focused ultrasonographic evaluation in the critical patient: a case report by Bruzzone, Andrea; Ponassi, Irene; Passalia, Caterina; Arboscello, Eleonora; Ghio, Riccardo (2011) - Condition Test Rapid Available Hypovolemic • Gastrointestinal bleeding Upper: NGT Lower:Ê DRE +++ +++ Endoscopic + + • Peritoneal bleeding/ AAA Focused-US +++ +/++ CE-CT +/++ ++ • CVP low Focused-US +++ +/++ Cardiogenic • ACS ECG +++ +++ I-troponin + +++ Copeptin* +++ ? • Structural hearth disease Focused-US +++ +/++ • Rhythm disturbance ECG +++ +++ • Aortic dissection/ rupture CE-CT +/++ ++ Extra-cardiacÊ obstructive • Pneumothorax RX ++ +++ Focused-US +++ +/++ • Pleural effusion RX ++ +++ Focused-US +++ +/++ • Cardiac tamponade Focused-US +++ +/++ • Pulmonary embolism CE-CT +/++ ++ Focused-US** +++ +/++ *NotÊ validatedÊ yet. Tc is the gold standard for lung contusion diagnosis, it is expensive and subjects the patient to the risks of transport, con- trast agent side effects and radiation and is therefore non-viable for the seriate monitoring of the patient. Keywords: + +; acute; chest; diagnosis; lung; pleural; pulmonary; ultrasonography

• Childhood poisoning: a 10-year experience in a tertiary hospital in Enugu State, Nigeria by Iheji, Chukwunonso Chigozie; Onu, Ngozi Nancy; Nduagubam, Obinna Chukwuebuka; Usuah, Joshua Alexander; Iheji, Grace Ugochi; Ndu, Ikenna Kingsley (2024) - This study retrospectively assessed the sociodemographic profiles, poisoning agents, clinical features and management of cases of childhood poisoning admitted at Enugu State University Teaching Hospital, Enugu. It was a 10-year retro- spective study of all the cases of childhood poisoning admitted within the period of study at the Children’s Emergency Room of Enugu State University Teaching Hospital (ESUTH), Enugu. Keywords: cases; childhood; children; duration; emergency; enugu; hospital; kerosene; nigeria; poisoning; spo2; study
• Association between “D-dimeritis” in the emergency department and COVID-19 hospital burden by Lippi, Giuseppe; Ferrari, Anna; Maccagnani, Antonio; Paolillo, Ciro (2025) - Now that the clinical pressure of COVID-19 on healthcare sys- tems has eased considerably due to herd immunity (triggered by natural infection, vaccination, or both), better healthcare prepared- ness for pandemic emergencies and improved therapeutic manage- ment,8 it is predictable that the number of test requests for D-dimer from Emergency Departments (EDs) (i.e., the healthcare site where the vast majority of patients with more aggressive forms of SARS-CoV-2 infection are initially admitted) may have experi- enced a reasonable decrease. This peak of test requests was then followed by a gradual decline, with the number of aggregate D-dimer test requests in 2024 being almost three times lower than in the last year before the pandemic (i.e., 2019). Keywords: covid-19; dimer; hospital; requests; test
• Risky behaviors and injury severity score of the injured motorcyclist by Yousefzade-Chabok, Shahrokh; Hosseinnia, Marjan; Sheikhi, Mohammad; Homaie Rad, Enayatollah; Kouchakinejad-Eramsadati, Leila; Khodadadi-Hassankiadeh, Naema (2025) - In addition, there was a statistically significant relationship between having a vehicle license and overall motorcycle behavior of p ≤ 0.001 and all three subscales of Unfit erroneous riding, intrusive and exhibitive behaviors = p = 0.007, opportunistic monetary and temporal behavior of p ≤ 0.001 and helmet use behaviors p = 0.009 (Table 3). Uttra S, Laddawan N, Ratanavaraha V, Jomnonkwao S. Explaining sex differences in motorcyclist riding behavior: an application of multi-group structural equation modeling. Keywords: accidents; behavior; driving; helmet; hospital; injuries; iran; license; motorcycle; motorcyclists; relationship; riding; study; traffic
• The importance of lay descriptors of respiratory symptoms: a retrospective analysis of under-triaged emergency calls by Imbriaco, Guglielmo; Masina, Juliette; Ghedini, Giorgia; Federiconi, Gianluca; Kayal, Jihan Samira; Demaria, Diana; Giamello, Jacopo Davide (2025) - ‘Tell me exactly what’s happened’: When linguistic choices affect the efficiency of emergency calls for cardiac arrest. What linguistic factors determine call-taker recognition of ago- nal breathing in emergency calls for cardiac arrest? Keywords: arrest; breathing; calls; dispatchers; emergency; hospital; lay; resuscitation
• Seasonal variation in the frequency of myocardial infarction diagnosed in a large emergency department of a European country with a temperate climate by Lippi, Giuseppe; Mattiuzzi, Camilla; Cervellin, Gianfranco (2015) - First, the different distribution of AMI frequency at our latitude may be used as a reasonable basis to establish more stringent preventive meas- ures during the darker months of the year.8 Although vitamin D measurements were unavailable in our AMI patients, a relative defi- ciency of this important hormone has been extensively reported in autumn and winter, and this evidence may at least partially con- tribute to explain the enhanced burden of ischemic heart disease due to the stringent relationship existing between vitamin D defi- ciency and AMI.9 We conducted a retrospective analysis to verify whether the frequency of AMI cases diagnosed in the emer- gency department (ED) may follow a seasonal pattern in a European country with a temper- ate climate. Keywords: ami; frequency; hospital; infarction; myocardial; winter
• Out-of-hospital cardiac arrest survival in Athens: Data from a Greek public hospital by Solomos, Zisimangelos S.; Tatsi, Maria S.; Psomiadou, Victoria E.; Tsifi, Angeliki D.; Theodoridis, Dimitrios S.; Petropoulou, Aikaterini P.; Miltiadou, Konstantinos G. (2019) - E-mail: zisimosmed@gmail.com Key words: Out-of-hospital cardiac arrest; Cardiopulmonary resuscita- tion; Mortality; Greek hospital. The conduction of simi- lar efforts by other medical institutions as well as multicenter stud- ies cannot be overemphasized in order to acquire a clearer picture regarding cardiac arrest outcomes in Greece. Keywords: arrest; athens; cpr; greece; hospital; ohca; resuscitation; study; survival
• Trends in obstetric emergency department attendance the first months of the coronavirus pandemic by Yambasu, Sahr; Gaughan, Eve (2021) - This information was compared to the monthly numbers of coronavirus cases as recorded by the Irish govern- ment in official daily briefings.6,7 Variables and data sources Anonymised administrative data on obstetric ED attendance in January to July 2019 and January to July 2020 was obtained. These steps may have played a role in ensuring that obstetric ED attendances did not decrease significantly. Keywords: attendance; data; emergency; hospital; pandemic

• Sublingual Sufentanil: an option for pre-hospital pain management in trauma patients by Pucciarelli, Gianluca; Lucenti, Enrico; Andreucci, Andrea; De Iaco, Fabio; Torrano, Vito; Marinangeli, Franco; Sbrana , Giovanni (2023) - Although several authors 8-11 focused their research on studying the effect of Sufentanil on pain management, especially in major surgery, such as orthopedics, abdominal, plastic, or pulmonary surgeries, howev- er, the optimal dose of Sufentanil in the adult population with acute pain remains unclear, especially, using the sublingual route. E-mail: gianluca.pucciarelli@uniroma2.it Key words: sublingual Sufentanil; pain management; pre-hospital; Emergency Medical Services. Keywords: emergency; management; pain; sublingual; sufentanil
• An unusual abdominal pain in the emergency department: a delayed presentation of diaphragmatic injury by Paolillo, Ciro; Siragusa, Valentina (2016) - Tel: +39.0432.552360. E-mail: ciropaolillo@gmail.com Key words: Abdominal pain; Thoracic trauma; Diaphragmatic injury. Received for publication: 20 March 2016. Murray in 19985 reported that 62% of the patients with acute diaphragmatic injuries had a normal chest radiograph at the time of injury. Keywords: diaphragm; injury; pain; rupture; trauma
• Acute abdominal pain in emergency room: Is it always a simple diagnosis? by Barakat, Bahjat; Bacci, Francesco; Pezzilli, Raffaele (2018) - Hematologic disorders represent the 0.3% of all admissions for acute abdominal pain. Guideline for the diagnostic pathway in patients with acute abdominal pain. Keywords: department; emergency; figure; lymphoma; mass; pain
• Levobupivacaine combined with dexamethasone for serratus plane block can provide long-lasting analgesia in multiple rib fractures by Di Pietro, Santi; Mascia, Benedetta; Perlini, Stefano; Iotti, Giorgio Antonio (2019) - In principle, SPB can be repeated several times in case of pain recurrence, although in our experience this is usually unnecessary: in fact, rib fracture pain typically reaches its apex in the very first days following the trauma, after which it can usually be treated with NSAIDs and paracetamol. In this context, SPB is currently performed using a variety of local anesthetics at different concentrations and dilutions, reporting a duration of pain control up to 12 hours following the procedure. Keywords: block; fractures; pain; rib; serratus; spb

• Procedural sedation in a tertiary referral trauma centre: A retrospective audit by Falconer, James; Richardson, Drew (2019) - Taylor1 noted in his study that both morphine and midazolam were associated with sedation related complications, therefore the dif- ference in sedation medications likely partially explains the differ- ence in sedation complications between the two studies. This study was undertaken to compare procedural sedation complications between the study institution and available litera- ture; but also to determine if sedation complications were amenable to simple intervention. Keywords: complications; department; emergency; procedural; sedation; study; years
• The importance of staff's attitudes in the care of individuals with mental health problems in the emergency department by Piccinelli, Marco (2019) - Numbers are expected to rise over time, straining the emergency care system in many countries.1-3 The specific needs of individuals with mental health problems are often challenging for the emergency department. Indeed, low confidence levels are often reported by the emergency department staff in the assessment of individuals with mental health problems at triage, a significant proportion of these individuals are seen in a timeframe which is rated as unsuitable for their condition and the lack of a quiet non-stimulating environment, together with frustra- tion over long waiting time, might be demanding for them and pro- duce emotional distress and behavioural discontrol. Keywords: department; emergency; health; mental; problems
• Emergency Contraception: a survey of Hospital Emergency Departments Staffs by Bo, Marco; Casagranda, Ivo; Galzerano, Mario; Charrier, Lorena; Gianino, Maria Michela (2011) - Also intriguing was the widely held notion that EC pills have a complex mechanism of action rather than acting through simple inhibition of ovulation. The survey also revealed gaps in physician knowledge about the pharmacokinetic and pharmaco- dynamic properties of emergency contraception pills. Keywords: contraception; department; emergency; hours; intercourse; knowledge; physicians; pill; prescription; requests; women
• Emergency Contraception: a survey of Hospital Emergency Departments Staffs by Bo, Marco; Casagranda, Ivo; Galzerano, Mario; Charrier, Lorena; Gianino, Maria Michela (2011) - Also intriguing was the widely held notion that EC pills have a complex mechanism of action rather than acting through simple inhibition of ovulation. The survey also revealed gaps in physician knowledge about the pharmacokinetic and pharmaco- dynamic properties of emergency contraception pills. Keywords: contraception; department; emergency; intercourse; knowledge; physicians; pill; prescription; requests; women
• Evaluation of satisfaction levels of expatriate patients presenting to emergency department by Ersoy, Suleyman; Konar, Naime Meriç ; Çalışkan, Hacı Mehmet ; Sönmez, Bedriye Müge ; Çelik, Burak (2021) - We found a statistically significant difference when we evaluated expatriate patients’ monthly average number of emergency department applies and their views on prior- ity to apply to emergency departments for health problems, the cleanliness of emergency departments, attitude of doctors, security and receptionist/nursing staff towards patients in Turkey and in their country of residence. Participants’ view about emergency departments Liking the cleanliness of emergency department in the country of residence? Keywords: country; department; emergency; good; participants; residence; satisfaction; turkey

• Fever and acute urticaria in a young male patient by Borio, Giorgia; Farolfi, Federica (2022) - A diagnosis of COVID-19 related urticarial rash was done. E-mail: giorgia.borio1991@gmail.com Key words: Urticarial rash; COVID-19; skin; SARS-CoV-2. Keywords: covid-19; emergency; journal; rash
• A systematic review of the factors influencing retention or turnover intention among emergency personnel in epidemics by Rahimi, Mohammad Kazem; Heidari, Edris; Montazeralfaraj, Razieh; Farajkhoda, Tahmineh (2023) - The checklist has 20 questions for scoring the research design, sample, measurement, and statisti- cal analysis and can be used in health studies for systematic review.18 The total score was 20 and studies with a score of 14-20, 8-14, and less than 8 were classified as good, moderate, and low in terms of quality, respectively (Figure 1 of the Supplementary Materials). Considering the role of frontline health- care workers in responding to and hindering epidemics, studies on maintaining these workers should be prioritized.14 Keywords: covid-19; emergency; factors; health; healthcare; intention; job; nurses; pandemic; quality; retention; review; studies; study; support; turnover; turnover intention; workers
• Effects after the lockdown on emergency room admissions for psychiatric evaluation: An observational study from the province of Forlì-Cesena, Italy by Beghi, Massimiliano; Brandolini, Riccardo; Biondi, Laura; Corsini, Claudia; Fraticelli, Carlo; Sant'Angelo, Rosa; De Paoli, Giovanni (2021) - The medium-term impact of COVID-19 lockdown on referrals to secondary care mental health services: A controlled interrupted time series study. The sample was divided into two groups: variables related to post lockdown period (May 4th, 2020-August 31th, 2020) and vari- ables related to the control period (May 4th, 2020-August 31th, 2019). Keywords: covid-19; data; emergency; health; lockdown; pandemic; people; study

• The Emergency Rooms and Emergency Medicine should not be the answer to the weakness of the Italian National Health System by Poggiali, Erika; Barbieri, Greta; Salvatore, Veronica; Salinaro, Francesco (2021) - We want to remember that emergency medicine is the medical specialty concerned with the care of illnesses or injuries requiring immediate medical attention. E-mail: poggiali.erika@gmail.com Key words: Emergency room; emergency medicine; national health sys- tem; health crisis; COVID-19. Keywords: emergency; health; medicine; system
• A call to action against gender-based violence and discrimination from the Emergency Departments by Poggiali, Erika; Bastoni, Davide; Fraticelli, Carlo; Beghi, Massimiliano; Coen, Daniele; Ghiadoni, Lorenzo (2023) - +39.0523.303044. E-mail: E.Poggiali@ausl.pc.it Key words: gender based violence; domestic violence; discrimina- tion; anti-discrimination admission pathway. Analysing the data from the first nine months of 2023 of calls to the national “Anti-violence and anti-stalking” helpline (1522), approximately half of the victims (47.6%) were victims of physical violence. Keywords: discrimination; emergency; gender; health; violence; women
• We can and must do something by Bellone, Andrea (2024) - [Emergency Care Journal 2024; 20:12290] [page 45] We can and must do something Andrea Bellone Academy of Emergency Medicine and Care, Pavia, Italy Correspondence: Andrea Bellone, Academy of Emergency Medicine and Care, Pavia, Italy. E-mail: andreabellone@libero.it Key words: climate change, health, mortality. Hrev_master The environmental consequences of climate change are well known. Keywords: change; climate; health
• Two silent epidemics: air pollution and climate change. “Slow and sustainable medicine” as part of the solution by Poggiali, Erika; Ghiadoni, Lorenzo; Coen, Daniele (2024) - Air pollution in the Po Valley The Po Valley has been identified by the European Environment Agency (EEA) as the most polluted region in Western Europe, facing the persistent environmental challenge of air pollution. [Emergency Care Journal 2024; 20:12488] Emergency Care Journal 2024 volume 20:12488 Human health is one of the earliest biosensors of climate change, which increases the frequency and severity of many dis- eases, as reported by Bellone.1 In Europe, air pollution is becoming a severe health problem that needs to be addressed by physicians of all specialties as well as governments and the general public. Keywords: air; change; children; climate; emergency; health; italy; pollution; valley
• EMDR intervention after a disaster: The Morandi Bridge collapse by Fernandez, Isabel; Callerame, Chiara (2019) - Following its inclusion within the recommendation of the WHO guidelines and ISTSS guidelines and given the great body of EMDR early interventions implemented worldwide in the past two decades, it is evident that EMDR interventions should become part of both contingency and emergency plans for aftermath recovery in all its phases following a disaster. Furthermore, EMDR interventions can be very helpful in reducing secondary traumatic stress and emo- tional responses in institutional representatives and emergency workers, to safeguard their wellbeing and enhance their capacity to deliver help in the post-disaster intervention to their community. Keywords: disaster; disorder; emdr; emergency; event; health; intervention; ptsd; stress; study; survivors; trauma; treatment
• Victims of Violence in Accident & Emergency: Reporting Survey of Eleven Emergency Structures Out of Eighteen by Ruggieri, Maria Pia; Guzzo, Anna Santa; Magnanti, Massimo; Cerqua, Giannantonio (2011) - Keywords: sexual violence, victims of violence, critical areas, emer- gency department ABSTRACT Introduction Sexual violence is a widespread and common phenomenon in our society, which unfortunately often goes unreported or undetected: a hidden “iceberg” of great dimension. The 2006 ISTAT Survey, commissioned by the Ministry of Equal Rights and Opportunities (4, 5), has thrown light on some disturbing numerical data: from a sample of 25,000 women ranging in age from 16-70 years, 6,743,000 were victims of physical or sexual violence (31.9%); 5 million were victims of sexual violence (23.7%); 3.961.000 were victims of physical violence (18.8%); 6.092.000 were victims of psychological violence from their current partner (36.9%); 1.100.000 were victims of ‘stalking’, that is they had been constantly followed or harassed. Keywords: code; health; training; triage; victims; violence; workers

• Non-operative management of simultaneous hepatic and renal grade V injuries after blunt trauma by DeMuro, Jonas P. (2014) - Multiple simultaneous injuries can be attempted to be managed nonoperatively, but in a recent large series of NOM of solid organ injuries, the fail- ure rate for multiple solid organ injuries man- aged with NOM was reported to be high at 85%.9 Malhotra, et al, also found that when managing simultaneous injuries to the liver and spleen, compared to a single organ injury, they had a higher mortality, longer lengths of stay, and increased transfusion requirements.3 However, Emergency Care Journal 2014; As experience has accumulated with nonoperative management of solid organ injuries, patients that do not fit into these ideal categories have also been successfully managed. Keywords: grade; injuries; injury; organ; trauma

• A rhythmic chest pain by Cristoni, Lorenzo; Tampieri, Andrea; Lenzi, Tiziano (2013) - Electrocardiogram showing wide QRS complex tachycardia. For practical convenience, we preferred this to adenosine administration, as indicated by ACLS guide- lines to help in the differential diagnosis of wide complex stable tachycardia. Keywords: complex; diagnosis; qrs; sinus; tachycardia; treatment

• Emergency service health care workers’ opinions and experiences on the practice of family-witnessed resuscitation: a cross-sectional study during the COVID-19 pandemic in Türkiye by Güney, Tuğba; Dinç, Leyla (2024) - Emergency service health care workers’ opinions and experiences on the practice of family-witnessed resuscitation: a cross-sectional study during the COVID-19 pandemic in Türkiye Tuğba Güney,1 Leyla Dinç2 1Ministry of Health Ankara Provincial Health Directorate, Ankara Training and Research Hospital, Ankara; 2Hacettepe University Faculty of Nursing, Ankara, Türkiye Non -co mmerc ial us e o nly (ENA),6 the American Heart Association (AHA),7 and the European Resuscitation Council,8 and countless evidence regard- ing the benefits of family presence during CPR,4,9-15 it is still a con- troversial issue due to the continuing concerns of health care pro- fessionals and a lack of institutional protocols.16 Waldemar et al.17 conducted a retrospective observational cohort study using data from the Swedish Registry of Cardiopulmonary Resuscitation, which included 3257 cardiac arrest patients. High scores on the Family Presence Risk-Benefit Scale indi- cate that emergency healthcare professionals perceive family pres- ence as more helpful during CPR, while low scores are interpreted as negative perceptions of family presence. Keywords: cpr; emergency; family; fwr; healthcare; participants; presence; professionals; resuscitation; risk; scale; study
• The illusion of certainty by Iaboli, Luca; Caselli, Luana (2017) - This requires the readers to understand a wealth of basic statistical concepts, such as relative risk, absolute risk, number needed to treat, num- ber needed to harm and odds ratio that enable to critically evaluate the design, the implementation and the analysis of each study and subsequently to interpret the results correctly. But in high-income countries the prevalence of the disease is much lower and the problem about HIV self-testing is that also people at low risk of infection might think to do the test. Keywords: doctors; hiv; risk; test

• Two cases of paradoxical hypothermia in a Sahara desert multi-stage ultramarathon by Kaufman, Elizabeth A.; Lipman, Grant S.; Sharp, Louis J.; Krabak, Brian J. (2014) - Heat-related illnesses are a concern for any medical provider of ultramarathon runners with presentations that range from mild, usu- ally self-limited heat exhaustion to potentially fatal heat stroke.7 Heat-related illness can present similarly to EAH8 or altitude illness,9 but a concomitant concern for, or presentation of hypothermia has not been discussed in recent practice guidelines.10 Exertional hypothermia was first documented in the tem- perate 1901 Boston Marathon in one runner who had consumed large amounts of alcohol, and in another who was exhausted more than the average.11 However, as there are no report- ed cases of exertional hypothermia in hot con- ditions, a seemingly contradictory state, we introduce and define the term, paradoxical hypothermia. [Emergency Care Journal 2014; 10:4279] Discussion There are little data that examine the inci- dence of hypothermia in geographical regions with a warm climate.12 Hypothermia is the con- dition when the body’s temperature falls to 35°C (95°F) or below,13 that can present as a primary environmental disease or a complicat- ing secondary state to a medical or traumatic condition. Keywords: hypoglycemia; hypothermia; med; stage; ultramarathon
• Cutis marmorata as a manifestation of decompression illness by Villa, Antonio; Fiocchi, Mara (2020) - E-mail: antonio_villa@fastwebnet.it Key words: Cutis marmorata; decompression illness; scuba diving. ©Copyright: the Author(s), 2020 Licensee PAGEPress, Italy Emergency Care Journal 2020; 16:8950 doi:10.4081/ecj.2020.8950 Cutis marmorata as a manifestation of decompression illness Antonio Villa, Mara Fiocchi Medical Examiner Divers (MED), Milan, Italy Keywords: cutis; dci; decompression; marmorata; med

• A comment on Critical issues of Emergency Medicine organization in Italy by Demicheli, Vittorio (2018) - [Emergency Care Journal 2018; 14:7913] Emergency Care Journal 2018; volume 14:7913 Dear Editor, I read the interesting editorial entitled Critical issues of Emergency Medicine organization in Italy1 by Coen and Casagranda. Even if this process if far from being completed (as the edito- rial carefully illustrates), having emergency medicine centred its medical knowledge around the patient it seems to me that the next logical step is to revisit professional roles, rules and responsibili- ties accordingly. Keywords: emergency; medicine
• Deep learning in Emergency Medicine: Recent contributions and methodological challenges by Faita, Francesco (2020) - Abstracts of all articles have been analyzed to appropriately select only papers that report technical description and validation of deep learning systems concerning emergency medicine. Dermatologist-level clas- sification of skin cancer with deep neural networks. Keywords: analysis; data; deep; emergency; learning; lee; medicine; network; prediction; study; system; triage

• Severe symptomatic bradycardia after a dinner of spicy oleander soup by Tampieri, Andrea; Mucci, Fabrizio; Palmonari, Valeria; Giovannini, Eugenio; Lenzi, Tiziano; Cenni, Patrizia (2016) - Cardiac glycosides also have vagotonic effects that can result in bradycardia and heart block. Life threatening human toxicity may occur after ingestion of leaves, flowers, or seeds from plants containing cardiac glycosides. Keywords: block; digoxin; emergency; fab; glycosides; oleander; poisoning; treatment
• A successful hybrid operation for life-threatening hemorrhagic shock secondary to an iatrogenic ruptured pseudoaneurysm of the external iliac artery following percutaneous arterial access by Shoji, Takahiro; Harada, Hirohisa; Yamazoe, Shinji; Yamaguchi, Yoshihiro (2018) - References 1. Tsetis D, Perdikakis E, Kehagias E. Percutaneous treatment if iatrogenic femoral artery access complications. Treatment of iatrogenic femoral arterial pseudoaneurysms: comparison of US-guided thrombin injection with compression repair. Keywords: access; arterial; artery; complications; eia; puncture; treatment

• Bridging language barriers by implementing a translated-based triage scale manual into the mother tongue language: a tool for strengthening emergency care by Zagalioti, Sofia-Chrysovalantou; Exadaktylos, Aristomenis; Fortounis, Konstantinos; Gkarmiri, Sofia; Apostolopoulou, Aikaterini; Fyntanidou, Barbara (2024) - In a recent study, we aimed to evaluate the effect of triage training of Emergency Nurses (ENs) in the use of the Swiss Triage System (STS) manual translated into Greek, after an intervention of one week. The effect of triage training was studied experimentally by comparing performance before and one week after training. Keywords: emergency; training; triage
• A multicenter study on reliability and validity of a new triage system: the Triage Emergency Method version 2 by Parenti, Nicola; Sangiorgi, Diego; Cervellin, Gianfranco; Petrino, Roberta; Rastelli, Gianni; Ghetti, Gianni; Cavazza, Mario (2013) - To prevent communication between participants, the stu- dents assigned triage codes in different rooms and in the presence of two investigators. Effect of a triage course on quali- ty of rating triage codes in a group of uni- versity nursing students: a before-after observational study. Keywords: emergency; group; nurses; reference; reliability; standard; study; tem; triage

• A simple pleural effusion or not? by Teoh, Victoria Wen Yeng; Deraman, Mohd Adli; Loch, Alexander (2023) - Giant left atrium in a patient with prosthetic mitral valve. Yuksel UC, Kursaklioglu H, Celik T. Apical hypertrophic car- diomyopathy with giant left atrium. Keywords: atrium; effusion; figure; giant; heart
• A common complaint does not always mean a common diagnosis by Cavaleri, Francesco; Porta, Lorenzo; Poggiali, Erika (2024) - E-mail: poggiali.erika@gmail.com Key words: pericardial effusion, dyspnoea, coronary artery fistula, point-of-care ultrasound. 7. Blaivas M. Incidence of pericardial effusion in patients pre- senting to the emergency department with unexplained dysp- nea. Keywords: effusion; emergency; fistula; heart; pericardial
• Is there a place for heart-type fatty acid binding protein in the era of high-sensitive cardiac troponin T for the diagnosis of acute myocardial infarction? A systematic review by Claassens, Daniel M.F.; Coers, Djura O.; Bergmeijer, Thomas O.; Chan Pin Yin, Dean R.P.P.; Ten Berg, Jurriën M. (2019) - However, since high sensitive troponin (hs TnT) assays are available, it is questionable whether hFABP still has value as a diagnostic tool for MI. Both hs TnT and high sensitive troponin I assays are available. Keywords: acid; fatty; heart; hfabp; protein; tnt

• Correlation of UCH-L1 and GFAP in predicting severity of traumatic brain injury in an Asian population by Poh, Khadijah; Poh Yuen Ying, Rozaida; Mohd Noor, Suzita; Bustam, Aida; Norazit, Anwar; Zambri, Aliyah; Noor Azhar, Muhaimin (2024) - Conclusions This study adds to existing literature for potential associations between GFAP and UCH-L1, with TBI severity. Comparison of indices of traumatic brain injury severity: Glasgow Coma Scale, length of coma and post-traumatic amnesia. Keywords: biomarkers; brain; correlation; gfap; injury; outcome; scale; severity; study; tbi; uch; uchl1
• The relationship between the injury severity based on injury severity score and child seating position in the vehicle by Kouchakinejad-Eramsadati , Leila; Zohrevandi , Behzad; Bashi Shahabi, Faranak; Homaie Rad, Enayatollah; Hosseinpour, Marieh; Khodadadi-Hassankiadeh, Naema (2025) - Out of 257 child occupants under 6 years, only 4.1% of the children used child seats and 7.7% used seat belts. Thus, the governments should explore new strategies to increase the use of child seats by parents. Keywords: car; children; injury; iss; los; middle; position; rear; safety; seat; seating; severity; study
• Acute longitudinal ligament rupture following acute spinal trauma by Hansom, Donald; Mathieson, Calan; Purcell, Margaret; MacDonald, Duncan (2014) - Stress, strain or rupture of soft tissue structures such as the ALL may be caused by relatively mild acceleration forces.3 Injury to the ALL usually occurs as a result of hyperex- tension, with the primary perpetrator being whiplash injuries. The anterior part of the disc space opens up and sometimes a fracture of the back of the vertebral body and/or damage to the interverte- bral disc is noted.3 Whilst whiplash injuries are common, and in some centres are present in up to 57% of all emergency accident cases,7 the incidence of associated ALL rupture is poorly documented. Keywords: anterior; fracture; injuries; injury; rupture; spinal; spine
• Cerebral sinus venous thrombosis in traumatic brain injury by Mueller-Hoecker, Christina; Pietsch, Urs (2016) - Glassner S, Srivastava K, Cofnas P, et al. Prevention of venous thrombotic events in brain injury: review of current practices. The spectrum can range from venous congestion detectable or not on neuroimaging, to the parenchymal cor- tical or subcortical ischemic injury. Keywords: emergency; injury; sinus; thrombosis

• Takuo Aoyagi, inventor of pulse oximetry: the great scientist passed away three years ago, in the middle of the first wave of COVID-19 pandemic by Cervellin, Gianfranco (2023) - Takuo Aoyagi: discovery of pulse oximetry. Miyasaka K, Shelley K, Takahashi S, et al. Tribute to Dr. Takuo Aoyagi, inventor of pulse oximetry. Keywords: aoyagi; blood; oximeter; oximetry; pulse
• The importance of hematocrit for oxygen delivery and hemodynamics by Nicosia, Francesco; Savelli, Francesco; Di Luzio, Raffaella; Lari, Federico; Giostra, Fabrizio; Di Battista, Nicola (2013) - Further reductions of hematocrit decrease the DO2 because they reduce Hb, and a further increase in blood flow is unable to compensate this reduction. In more advanced stages, the inade- quate supply of O2 to the heart limits the increase in blood flow. Keywords: anemia; blood; flow; hematocrit; oxygen; resistance
• Cerebral hyperperfusion syndrome after carotid endarterectomy: case report by Fine, David; Teijido, John; Benson, Laurie; Treat, Matthew (2025) - CT perfusion may see increased cerebral blood flow, increased cerebral blood volume, shortened mean transit time, and shortened time to peak. Cerebral hyperperfusion syndrome is a rare complication of these procedures, and this case report illus- trates a patient with this condition after carotid endarterectomy. Keywords: blood; carotid; cerebral; endarterectomy; hyperperfusion; syndrome
• Reduction of burden of hemolyzed specimens in a large urban emergency department: A real-world, five years’ experience by Cervellin, Gianfranco; Aloe, Rosalia; Bonfanti, Laura; Bonelli, Patrizia; Lippi, Giuseppe (2017) - The prevalence of hemolyzed specimens has been found espe- cially high in healthcare settings entailing blood collection from intravenous lines.2 These conventionally include the emergency department (ED), intensive care unit (ICU), as well as neonatal and pediatric wards. Crit Rev Clin Lab Sci 2011;48:143-53. 2. Lippi G, Cervellin G, Mattiuzzi C. Critical review and meta-analysis of spu- rious hemolysis in blood samples col- lected from intravenous catheters. Keywords: blood; emergency; hemolysis; specimens
• Diagnosing myocardial injury in the high-sensitivity troponin era by Lippi, Giuseppe; Cervellin, Gianfranco (2018) - This important evidence has led some authors to postulate that cardiac troponins may be used as the cholesterol of the third millennium, despite the fact that management of patients with measurable (but non-diagnostic) values of cardiac troponins remains undefined, especially in the short-term period (i.e., within 1-year).16,17 The last and perhaps more debated issue concerns the approach used for estimating the variation of cardiac troponin between two consecutive blood samplings. Throughout such a relatively short history (i.e., the first Universal Definition was only published in 2000),5 the major breakthroughs have concerned the identifica- tion of cardiac troponins (either I or T) as the reference (and virtu- ally only) biomarkers of myocardial injury, and the subsequent development of the so-called high-sensitivity cardiac troponin immunoassays, which have enabled to increase analytical sensitiv- ity, precision and reproducibility of these measurements far beyond the limits of the former techniques. Keywords: blood; emergency; infarction; sensitivity; troponin

• Pneumomediastinum as a manifestation of a bronchial carcinoid tumour: a very rare association of two uncommon diseases by Barakat, Massimo; De Santis, Costanza; Zafarana, Gabriella; Lotrecchiano, Ludovica; Galasso, Thomas; Candoli, Piero; Solli, Piergiorgio; Daddi, Niccolò (2024) - Introduction Pneumomediastinum is defined as the presence of air in the mediastinum;1 it is a rare entity, diagnosed in 1/44500 of emergen- cy attendances.1 Bronchopulmonary carcinoids represent a spec- trum of tumours arising from neuroendocrine cells of the bron- chopulmonary epitelium;2 they are a rare entity, accounting for approximately 1.2% of primary lung malignancies.2 To the best of our knowledge, there are only four reports of bronchial carcinoid tumour presenting with pneumomediastinum3- 6 and this is the first case managed with a sleeve resection of an extremely short section of a main bronchus. secretion.2 Plain X-rays are nonspecific, although these tumours often appear as an isolated, well-defined hilar or perihilar mass.2 CT scan is able to determine the location, extent, and characteristics of the primary tumour (well-defined, spherical or ovoid masses that narrow, deform, and/or obstruct airways; calcifications are evident in up to 30% of cases) as well as the involvement of mediastinal lymph nodes and presence of distant metastases.2 18F-FDG and 68Ga- DOTANOC PET have high accuracy in identifying primitive tumours and their metastases.2 Bronchoscopy is useful to detect these tumours and, most of all, to allow histological examination.2 Surgical resection is the only curative treatment.2 Bronchoscopic resection should be considered only in patients with comorbidities which contraindicate surgery.2 Chemotherapy is indicated in patients with diffuse metastatic disease.14 Conclusions To the best of our knowledge, there are only four reports of bronchial carcinoid tumour presenting with pneumomediastinum.3- 6 Keywords: bronchus; carcinoid; chest; emergency; left; pneumomediastinum; tomography; tumour

• The McKittrick-Wheelock syndrome: A rare case with a complex acid-base disorder by Formagnana, Pietro; Piombo, Marianna; Caccia Dominioni, Costanza; Gori, Giulia; Santoro, Michele; Casagranda, Ivo (2018) - The final diag- nosis was hypovolemia, acute renal failure, electrolyte and acid- base imbalance in patient with mucous diarrhea and tubulovillous adenoma. Discussion MWS is classically characterized by a triad: i) chronic secreto- ry diarrhea due to a colorectal tumor; ii) severe dehydration with acute renal failure; iii) electrolyte abnormalities and acid-base imbalance.6,7 According to literature most of reported cases are due to vil- lous adenoma, with some cases secondary to adenocarcinoma or neuroendocrine tumor.8 Only a little percentage (0.76-2.4%) of vil- lous adenomas become secretory4 and the etiopathogenesis of this process is not completely clear. Keywords: acid; base; diarrhea; electrolyte; failure; mckittrick; syndrome; wheelock

• What is happening in that urinary catheter bag? by Antoci, Valentina; Ferrari, Valentina; Dacrema, Alessandro (2022) - Purple urine bag syndrome 4. +39.0523.303044 E-mail: alessandro.dacrema01@gmail.com Key words: purple urine bag syndrome; urinary catheterization; urinary tract infection; purple urine; Escherichia coli; Klebsiella pneumoniae. Keywords: bag; pubs; purple; syndrome; urine
• An unrecognized disease in routine clinical practice: the Heyde’s syndrome by Casadei, Beatrice; Grasso, Valentina; Cariani, Giulio; Barakat, Bahjat; Pezzilli, Raffaele (2014) - Sucker C. The Heyde syndrome: proposal for unifying concept explaining the associ- ation of aortic valve stenosis, gastroin- testinal angiodysplasia and bleeding. Knobloch W, Hauser E, Niehues R, et al. Calcifying aortic valve stenosis and occult gastrointestinal hemorrhage (Heyde syn- drome): description of 2 cases. Keywords: angiodysplasia; aortic; bleeding; colon; heyde; replacement; stenosis; syndrome; valve; von; willebrand

• Bad news about an old poison. A case of nicotine poisoning due to both ingestion and injection of the content of an electronic cigarette refill by Cervellin, Gianfranco; Luci, Michele; Bellini, Carlotta; Lippi, Giuseppe (2013) - Hagiya et al. have recently described the case of nicotine poisoning due to intravenous injec- tion of cigarette soakage in a nurse who soaked 20 cigarettes in 100 mL of tap water for 1 h, and intravenously injected 5 mL of ciga- rette soakage solution, containing approxi- mately 5.7 mg nicotine, in a suicidal attempt. Nicotine poisoning after ingestion of contaminated ground beef. Keywords: cigarettes; drug; ingestion; methadone; nicotine; poisoning
• Delayed neuropsychiatric syndrome after carbon monoxide poisoning: inclusion of hyperbaric oxygen therapy in the recovery protocol by Lo Pardo, Dante; Amedola, Davide; Senatore, Giuliana; Damiano, Alberto; Pezzuti, Gabriela; Pugliese, Nicola; Locatelli, Gianpiero; Siani, Alfredo; Vitola, Nicola Maria (2016) - Tel: +39.089.672142. E-mail: nicola.vitola@gmail.com Key words: Carbon monoxide poisoning; Hyperbaric oxygen therapy; Delayed neuropsychi- atric sequelae; Suicide attempt. Pepe G, Castelli M, Nazerian P, et al. Delayed neuropsychological sequelae after carbon monoxide poisoning: predictive risk factors in the Emergency Department. Keywords: carbon; dns; hbot; monoxide; oxygen; poisoning; sessions; therapy
• A perfect refractory electrical storm by acute toxicity of accidental aconitine intake by Menichetti, Francesca; Bartolucci, Paola; Matteucci, Maria Luisa; Gori, Luigi; Ieri, Alessandra; Gambassi, Francesco; Baronti, Roberto; Vanni, Simone; Mannaioni, Guido; Del Rosso, Attilio (2021) - In 65 case reports of probable aconite poisoning that resulted in ventricular dysrhythmias 54 developed ventricular tachycardia, six developed torsades de pointes, 15 patients developed ventricu- lar fibrillation, 10 developed ventricular ectopies and one devel- oped a broad complex tachycardia not otherwise specified. Most fatal cases have been determined by ventricular tachycardia or respiratory paralysis. Keywords: aconite; aconitine; aconitum; current; emergency; poisoning; rhythm

• Teaching suturing skill to emergency physicians: the experience of a hands-on practical training in a laboratory simulation-based setting by Manno, Alberto; Pascale, Marco Maria; Santoro, Michele Cosimo; Saviano, Angela; Benicchi, Andrea; Gabrielli, Maurizio; Covino, Marcello; Franceschi, Francesco (2023) - Attending suturing skill courses could be very useful for both trainees and specialists in emergency medicine. Introduction Traumatic wounds are one of the most common pathologies presenting to the emergency department (ED), thus, achieving expertise in suturing techniques is to be considered a priority for the emergency physician.1 Nevertheless, basic surgical skills learn- ing opportunities are often insufficient in medical student’s educa- tion programs.2-5 Keywords: course; emergency; group; medical; skill; students; suturing; teaching; time; training
• Experimental data on authority of source bias in decision making by Baldi, Pier Luigi (2013) - [Emergency Care Journal 2013; 9:e24] Experimental data on authority of source bias in decision making Pier Luigi Baldi Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy Dear Editor, The psychological approach to reasoning and decision making has shown i) the restrict- ed cognitive resources available to people (see for example, the notion of bounded rationality by Simon1); ii) the inferential errors attributa- ble, at least partly, to limited working memory capacity2; iii) the use of heuristics, i.e. strate- gies which allow saving cognitive resources by simplifying elaboration yet at the risk of bias- es, etc. These errors, or distortions, do not appear to be negligible but rather important and recurring behavioral anomalies.3,4 Moreover, since 1950s several psychological studies have highlighted the role of emotions in decision making, a role that has been evi- denced also by the neurosciences.5 The three experimental studies presented here were aimed to evaluate the influence of authority of source on decision making, each one examining the following fields: logic, grammar, and figurative art. Keywords: group; making

• Ultrasound diagnosis of lung herniation: The push-out sign by Iaboli, Luca; Baldini, Luca; Galassini, Roberto; Copetti, Roberto (2018) - E-mail: liaboli@hotmail.com Key words: Lung ultrasound; Lung herniation; Push-out sign. ©Copyright L. Iaboli et al., 2018 Licensee PAGEPress, Italy Emergency Care Journal 2018; 14:7808 doi:10.4081/ecj.2018.7808 Ultrasound diagnosis of lung herniation: Keywords: herniation; lung; sign; ultrasound
• Simultaneous bilateral spontaneous pneumomediastinum and pneumothorax in a cannabis user by Vural, Sevilay; Zeytin, Ahmet Tuğrul; Kaya, Şeyhmus; Öztürk, Barış (2019) - It is well established and doc- umented that tobacco use is a risk factor for spontaneous pneu- mothorax.2 Some studies suggest that cannabis (also known as marijuana) is also a risk factor for spontaneous pneumothorax, but this link is not as obvious as that with tobacco.3,4 A full drug history should be obtained from patients diagnosed as spontaneous pneumothorax or pneumomedi- astinum, especially in young population. Keywords: cannabis; emergency; lung; pneumomediastinum; pneumothorax; smoking

• The story of Christian Eriksen. To close the loop by Giusti, Gian Domenico; Ramacciati, Nicola (2024) - Christian Eriksen’s inspiring journey from cardiac arrest to scoring a goal serves as a powerful testament to the life-saving potential of CPR training and the public’s proactive approach to learning these essential skills. To close the loop Gian Domenico Giusti,1,2 Nicola Ramacciati3 1Perugia Hospital, Perugia; 2Department of Medicine and Surgery, Perugia University, Perugia; 3Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende (CS), Italy Non -co mmerc ial us e o nly diopulmonary resuscitation and cardiac arrest in association with Christian Eriksen. Keywords: arrest; cardiac; eriksen; public
• Point: high-sensitive troponin assays – a valuable tool for astute physicians by Plebani, Mario; Zaninotto, Martina (2013) - In fact, using sensitive assays, troponin con- centrations change very rapidly within shorter time intervals, thus allowing a more reliable rule-in process, and a reliable and more effi- cient rule-out strategy, which is even more important in emergency settings.14 Fourth, in real life high-sensitive troponins improve the diagnostic accuracy without sig- nificantly increasing the admission rates, as recently documented by Mion et al.15 Fifth, high-sensitive assays improve the risk stratification even in patients with normal concentrations of cardiac troponins measured with conventional assays.16 Sixth, high-sensitive assays improve the detection of minor myocardial damage in sev- eral clinical conditions, particularly in chemotherapy monitoring as well as in the administration of other drugs with side effects, thus allowing an early identification of myocardial damage.17 It has been demonstrat- ed that the early identification of myocardial damage using cardiac troponin assays may result in improved outcomes and reduction of the incidence of heart failure.18,19 In summary, a robust evidence has been col- lected to demonstrate the clinical effectiveness of high-sensitive assays for cardiac troponin. [Emergency Care Journal 2013; 9:e15] Point: high-sensitive troponin assays – a valuable tool for astute physicians Mario Plebani, Martina Zaninotto Department of Laboratory Medicine, University of Padua, Italy Dear Editor, A large body of evidence has been collected in the last decade to demonstrate the clinical value of cardiac troponins, both cardiac tro- ponin I (cTnI) and T (cTnI), as reference bio- chemical markers of myocardial injury.1,2 Keywords: assays; cardiac; infarction; troponin
• Elevated serum high-sensitive cardiac troponin T in adolescent runner: exercise or something else? by Barakat, Bahjat; Pezzilli, Raffaele; Prestinenza, Paola (2014) - Measurement of a plasma stroke bio- marker panel and cardiac troponin T in marathon runners before and after the 2005 Boston marathon. Changes in serum cardiac troponins following a 21-km run in junior male runners. Keywords: cardiac; serum; troponin

• Usefulness of dynamic compression bedside ultrasonography in the diagnosis of abdominal wall abscess by Barakat, Bahjat; Pezzilli, Raffaele (2015) - Bedside dynamic compression ultrasound showing a hypo-anechogenic area with fluctuating internal echoes, irregu- lar margins of the left rectus abdominis muscle. Dynamic compression ultrasound is usually the technique to easily detect the pyomyosi- tis,3-6 while CT scan generally does not add any further useful information. Keywords: abscess; emergency; ultrasound

• What we have learned from the Rigopiano tragedy by Pescini, Antonella; D’alfonso, Paola (2019) - As a consequence of the Rigopiano tragedy, in the year 2018 the Abruzzo region wrote a new plan for maxi health emergencies, recognizing psychological suffering among the needs to be met in case of disaster. A staff of psychologists trained in emergency psychology was involved to assist the fami- lies of the missing persons without ever abandoning them for eight consecutive days. Keywords: emergency; family; information; missing; people; psychological; psychologists; relatives; support; time; victims

• The efficacy of education in emergency-urgency: a review by Cunsolo, Cristina; Garrino, Lorenza (2008) - organizzazione e formazione 29 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o IV n um er o V I • D ic em br e 20 08 • w w w .e cj .it lavorativo (area critica verso area non critica), il nu- mero di interventi di rianimazione cardiopolmona- re che vengono effettuati, l’attitudine personale5. organizzazione e formazione 31 em er ge nc y ca re jo ur na l - o rg an iz za zi on e, cli ni ca ,r ice rc a • A nn o IV n um er o V I • D ic em br e 20 08 • w w w .e cj .it Keywords: resuscitation

• Addressing a community need: assessing the confidence and attitude of senior medical students in responding to in-flight emergencies by Almutairi, Yazeed; AlQahtani, Maha; Binghaith, Abdullah; Alsayed, Saud; Sharaf, Abdulelah; AbuDujain, Nasser M.; Aljarallah, Saleh (2024) - The knowledge, confidence and attitudes of medical students in managing in- flight medical emergencies. Subsequently, longitudinal studies are needed to extract more data on the knowledge and confidence of medical students toward IMEs. Keywords: emergencies; emergency; flight; imes; life; students; support; training; year
• Investigation of emergency medicine residents’ skills in using external pacemakers by Kocal, Samiye; Yılmaz, Fevzi; Eyinç, Mehmet Berk; Öztoprak, Hüseyin; Şirin, İlker (2025) - A pre-test was administered to the physicians who agreed to participate in a study on external pacemaker applications. All of the physicians involved in the study were subsequently given theoretical and prac- tical training on external pacemaker applications, followed by a post-test. Keywords: application; emergency; pacemaker; physicians; study; test; training
• Standard vs. mass training in basic life support and defibrillation: a prospective analysis among Italian high school students within a municipal project by Dal Corso, Luca; Aldegheri, Massimiliano; Anselmi, Elena; Burro, Alberto; Moretti, Francesca; Rossi, Fabio; Sebastiani, Simone; Silvagni, Davide; Zandonà, Michele; Cerruto, Maria Angela (2025) - ME students showed superior skill in environmental safety and compression frequency, while SE students excelled in hand placement. Regarding chest compression frequency, ME students consistently maintained correct compression rates at 97.9%, compared to 87.4% of SE students (p=0.001). Keywords: blsd; method; school; students; teaching; training

• Trends of popularity of cardiac biomarkers: Insights from Google Trends by Lippi, Giuseppe; Mattiuzzi, Camilla; Cervellin, Gianfranco (2018) - The cumulative number of Google searches is then dis- played along an arbitrary scale, ranging between 0 and 100. A value of 100 (i.e., the peak) reflects the highest number of Google searches for the term, a value of 50 reflects 50% the number of Google searches compared to the peak, whilst a value <1 mirrors a number of Google searches <1% than the peak. Keywords: google; myoglobin; searches; trends; troponin

• Imaging sketch of bedside ultrasonography to improve the diagnosis of rupture of splenic artery aneurysm by Barakat, Bahjat; Pezzilli, Raffaele (2015) - Splenic artery aneurysm is a rare and poten- tially life-treating disease7 and its diagnosis should be kept in mind in all those patients having a sudden onset pain in the upper abdomen with of without arterial hypotension. A rare clinic presentation of abdominal pain: rup- ture of splenic artery aneurysm: a case report. Keywords: aneurysm; artery; emergency; figure; splenic
• Pseudoaneurysm of the splenic artery mimicking a solid lesion by Pezzilli, Raffaele; Cevenini, Monica; Mosconi, Cristina; Pagano, Nico; Renzulli, Matteo; Golfieri, Rita (2016) - Once several other disorders as evident bleeding, severe hemolyt- ic anemia, compensatory volume fluid shifts, sepsis, and large hematomas are excluded, large hematocrit declines that cannot be read- ily explained or unable to be visualized with standard endoscopic procedures must prompt the physician to the diagnostic approach of splenic artery pseudoaneurysm and its hemo- dynamic stabilization. ©Copyright R. Pezzilli et al., 2016 Licensee PAGEPress, Italy Emergency Care Journal 2016; 12:5880 doi:10.4081/ecj.2016.5880 Non co mmerc ial us e o nly for splenic artery pseudoaneurysm is angio- graphic-directed embolization, with either coils, or, less frequently, stent.4-6 Conclusions The treatment of choice of splenic artery pseudoaneurysm is operator-dependent based on the tortuosity of the target vessel, the loca- tion, morphology and size of the lesion. Keywords: artery; mass; presence; pseudoaneurysm; splenic
• Thrombosis of the innominate artery during prolonged cardiac support by right transaxillary Impella 5.0 device by Cannata, Aldo; Carrozzini, Massimiliano; Tata, Giuseppe; Russo, Claudio Francesco (2021) - However, it was complicated by a sudden refractory cardiac arrest, treated by means of reverting to Impella full support and an emergent institution of a femoral-femoral veno-arterial Extracorporeal Membrane Oxygenation (ECMO). To the best of our knowledge, this is the first report of a thrombosis of the innominate artery occurred during support with transaxillary Impella 5.0. Keywords: artery; device; impella; support; transaxillary

• Classical warm up phenomenon of atrial tachycardia by Ali, Amjad; Manjunath, Cholenahally N. (2015) - E-mail: drmz2007@gmail.com Key words: Warm up; Atrial tachycardia; ECG. Received for publication: 11 March 2015. Electrocardiogram suggesting paroxysmal irregular narrow complex tachycardia. Keywords: ecg; tachycardia
• Young male with chest pain and abnormal T-waves by Thazhathidathil, Amrithanand Velluridathil; Agrawal, Naman; Mathew, Roshan (2020) - Recognizing such ECG pattern is clinically impor- tant since it presents without obvious ST segment elevation and may lead to under treatment. De Winters ECG is a kind of atypical pattern character- ized by ST depressions and peaked T Keywords: ecg; emergency

• Plasmapheresis in hypertriglyceridemia-related pancreatitis: a case report by Tampieri, Andrea; Cenni, Patrizia; Morselli, Claudia; Lenzi, Tiziano (2012) - At the follow-up visit the patients was asymptomatic, and serum TG level, total cholesterol, LDL and HDL were normal. Discussion This case emphasizes the role of serum amylasemia as a pitfall in the diagnosis of AP; the relevance of HTG as an effectively treatable, metabolic cause of AP; the efficiency of apheresis in lowering serum TG levels and its possible usefulness in the management of HTGP. Keywords: htgp; levels; pancreatitis; serum
• Stress and coping strategies in the emergency room by Iannello, Paola; Balzarotti, Stefania (2014) - The influence of coping styles on levels of perceived stress A linear regression analysis was performed to examine whether coping styles are signifi- cant predictors of perceived stress after con- trolling for physicians’ age and gender. Second, to examine the association between perceived stress and physicians’ coping styles, testing whether the type of coping style influ- ences their perception of work related stress. Keywords: avoidance; coping; emergency; emotion; levels; physicians; strategies; stress; study; styles; work

• Survivor from asphyxiation due to helium inhalation by Etteri, Massimiliano; Bellone, Andrea; Vella, Morena; Capiaghi, Eleonora; Motta, Luca; Malfasi, Ilaria (2016) - Imaging studies showed pulmonary edema and the patient was treated with non-invasive ven- tilation in Intensive Care Unit. Moreover it was performed a thoracic CT scan which confirmed the diagnosis of bilateral pulmonary edema that was bilateral, symmetric, ground-glass like, and not involv- ing the anterior areas of the chest. Keywords: bag; edema; emergency; helium; pressure

• Splenic abscess leading to spontaneous splenic rupture by Bhullar, Annum A.; Canders, Caleb P.; Rouhani, Amir; Lai, Steven (2021) - volume 17:9204 Correspondence: Caleb P. Canders, MD, Department of Emergency Medicine, Santa Clara Valley Medical Center, 751 S Bascom Ave, 95128 San Jose, CA, USA. Tel.: 310.7940785 - Fax: 310.7940599. E-mail: ccanders@mednet.ucla.edu Key words: Splenic abscess; splenic rupture; splenic hemorrhage; splenectomy. Emergent exploratory laparotomy confirmed splenic rupture and the patient subsequently underwent open splenectomy, during which he was found to have a splenic abscess with peritonitis. Keywords: abscess; abscesses; rupture; splenic

• Choledocholithiasis during staged surgical management of gallstone ileus: case report by Teijido, John; Fine, David; Konicek, Andrew (2024) - Beltran MA, Csendes A. Mirizzi syndrome and gallstone ileus: an unusual presentation of gallstone disease. Management of gallstone ileus is challenging given the frequent frailty and numerous comorbidities in such patients. Keywords: bowel; fistula; gallstone; ileus; obstruction
• Clinical-radiological and intraoperative discrepancy in massive pneumatosis intestinalis and portomesenteric venous gas in a patient with septic shock by Pezzullo, Filomena; Comune, Rosita; Scaglione, Mariano; Lassandro, Giulia; Catalano, Marco; D'Avino, Raffaele; Cioffi, Luigi; Carbone, Roberto; Pezzullo, Angela; Tamburrini, Stefania (2025) - Careful correlation of radiological, laboratory, and clinical findings is essential, and surgical exploration remains mandatory in unstable patients to prevent catastrophic outcomes. Clinical decision-making for discordant PI findings involves a careful balance between avoiding unnecessary surgery and preventing a catastrophic outcome from missed ischemia and should prioritize patient stability, using a multi-factorial approach that includes clinical symptoms, lab results, and CT findings, rather than relying solely on imaging. Keywords: bowel; findings; gas; intestinalis; ischemia; necrosis; pmvg; pneumatosis
• Pylephlebitis secondary to strangulated umbilical hernia with small bowel ischemia by Bruschi, Ennio; Graziani, Giovanna; Vergendo, Maurizio; Conte, Antonello; Valentino, Massimo (2013) - Diagnosis of small bowel ischemia secondary to strangulated hernia with pylephlebitis was made on the basis of CT findings. Symptoms and diagnostic imaging findings of small bowel ischemia have been described. Keywords: bowel; findings; gas; ischemia; portal; vein
• Imaging of a rare case of Bochdalek hernia in an adult female by Barakat, Bahjat; Bruno, Antonio; Calculli, Lucia; Pezzilli, Raffaele (2016) - In advanced stage, small bowel obstruction leads to bowel dilation and retention of fluid within the lumen proximal to the obstruction. If bowel dilation is excessive, or strangulation occurs, perfusion to the intestine can be compromised leading to necrosis or perforation, complica- tions, which increase the mortality, associated with small bowel obstruction. Keywords: bowel; figure; hernia; obstruction

• Epidemiology of cycling road injuries-related deaths by Mattiuzzi, Camilla; Lippi, Giuseppe (2024) - A recent systematic review of road cycling injuries and illnesses found that the most common injuries were abrasions, lacerations, and hematomas (40- 60% of the total), followed by fractures (6-15%) and head injuries and concussions (5-15%).1 However, to our knowledge, there is no recent data on the mortality of cyclists in traffic accidents, we planned an analysis to specifically fill this gap. We conducted a digital search of the ultimate version of the Global Burden of Disease Collaborative Network,2 to retrieve data on cyclist road injuries over the past three decades (i.e., over the searchable years 1991 to 2019). Keywords: age; injuries; road; ×100,000

• Endovascular aortic graft infection resulting in retroperitoneal abscess: report of a case by Ferri, Enrico; Magrini, Laura; Alfano, Marco; Del Parco, Michela; Gori, Chiara Serena; Di Somma, Salvatore (2010) - Endovascular graft infection begins with aspecific clinical manifestations, including fever, weak- ness, malaise, weight loss, abdominal, back, and leg pain, claudication, anemia, intestinal bleeding and elevated biochemical and inflammatory mark- ers1-3,6. Endovascular graft infection begins with unspecific clini- cal manifestations. Keywords: endovascular; graft; infection; stent
• Macroscopic hematuria: A rare etiology in western countries by Barakat, Bahjat; Fabbrizio, Benedetta; Pezzilli, Raffaele (2018) - Almost all the infections were acquired in Africa and Schistosoma mansoni was identified in 39% of the cases, whereas Schistosoma haematobium was found in 22% and about 60% of the patients present- ed symptoms. There are three important species which affect man: Schistosoma mansoni causes intestinal schistosomiasis and occurs in Africa, Brazil, Venezuela, Madagascar, the Arabian peninsula, the West Indies and Surinam; Schistosoma haematobium causes urinary schistosomiasis and occurs in Africa and the Middle East; Schistosoma japonicum caus- es intestinal schistosomiasis and occurs in China, Indonesia and the Philippines. Keywords: bladder; haematobium; infection; schistosoma; schistosomiasis

• An early diagnosis of Mondini-like dysplasia in the Emergency Department at the first episode of bacterial meningitis by Kang, Jeong Ho; Song, Sung Wook; Lee, Sung Kgun; Ko, Seo Young; Bu, Ji Hwan (2019) - E-mail: sungwook78@gmail.com Key words: Mondini dysplasia; Inner ear malformation; Meningitis; Incomplete partition. Nowadays, various malformations involving the inner ear have been reported and the original Mondini dysplasia was regarded one of several variants of IEMs. Keywords: csf; dysplasia; ear; emergency; hearing; meningitis; mondini; recurrent; right

• Hikikomori: a world within a room by Dodi, Icilio; Pappalardo, Marco; Veronese, Piero (2025) - [Emergency Care Journal 2025; 21:13637] Emergency Care Journal 2025 volume 21:13637 Dear Editor, Hikikomori is a condition characterized by prolonged and extreme social withdrawal lasting at least six months, resulting in substantial functional impairment or distress associated with this isolation.1 While the cultural roots of social withdrawal can be observed in Japanese mythology (e.g., the sun goddess Amaterasu, a paramount deity in Shinto, exemplifies voluntary seclusion), the contemporary phenomenon of hikikomori emerged from what was often termed “truancy” or “school refusal” (futoko) during the 1970s and 1980s. This condition is demon- strating a global spread, with Japan reporting millions of cases, establishing hikikomori as a well-recognized pathological condi- tion within the scientific community and a subject of significant global concern; in Italy, there are estimated between 100,000 and 120,000 individuals affected.4 This condition predominantly impacts males (male-to-female ratio approximately 3:1), with the average duration of social withdrawal typically ranging from one to four years. Keywords: condition; emergency; hikikomori; individuals; psychiatric; withdrawal

• Gastrointestinal stromal tumor of the small bowel mimicking a gas-fluid collection by Savastano, Sergio; Boi, Luca; d'Amore, Emanuele S.G. (2018) - ©Copyright S. Savastano et al., 2018 Licensee PAGEPress, Italy Emergency Care Journal 2018; 14:7448 doi:10.4081/ecj.2018.7448 Gastrointestinal stromal tumor of the small bowel mimicking a gas-fluid collection Sergio Savastano,1 Luca Boi,1 Emanuele S.G. d’Amore2 1Department of Radiology; 2Department of Pathology, San Bortolo Hospital, Vicenza, Italy Figure 1. AJR Am J Roentgenol 2005;184:803-11. 3. Kumar A, Jakhmola CK, Chauhan SS, et al. Atypical presenta- tion of gastrointestinal stromal tumor masquerading as a large duodenal cyst: A case report. Keywords: emergency; fluid; gas

• Metacognitive awareness in coping with mental health challenges and decision-making among emergency physicians by Joseph, Albin; Jose, Tony P. (2025) - E-mail: tony.jose@vit.ac.in Key words: mental health; emergency care; emergency physicians; metacognition; decision-making. Metacognitive awareness in coping with mental health challenges and decision-making among emergency physicians Albin Joseph, Tony P. Jose Department of Social Sciences, School of Social Sciences and Languages, Vellore Institute of Technology, Tamil Nadu, India Keywords: decision; emergency; making
• Complex decision-making: initial results of an empirical study by Baldi, Pier Luigi (2011) - Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê m Stressful conditions Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê s 7,3 2,49 t = -4,73*** Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê m Stress-free conditions Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê s 11,05 2,5 t-test on independent samples (n = 40). Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê m ThreeÊ choices Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê s 10,45 2,87 t = 2,8** Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê m FourÊ choices Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê Ê s Ê 7,9 2,88 t-test on independent samples (n = 40). Keywords: choices; conditions ê; decision; making; threeê ê; ê m; ê ê

• Cause of respiratory paralysis: kidney, not the lung by Tomar, Laxmikant Ramkumarsingh; Agarwal, Mukul P.; Rajpal, Surender; Aggarwal, Amitesh (2015) - [Emergency Care Journal 2015; 11:4837] Inhibition/dysfunction of certain ion exchangers and certain antibodies in distal renal tubular cells causes less H+ secretion in distal renal tubular cells and leads to metabolic acidosis:6-8 absence or nonfunctioning H+- ATPase in the apical part of renal tubule caus- es decrease of H+ excreation from intercalated cells; deficiency or malfunctioning of cytoplas- mic anion-exchanger 1 (HCO3/Cl-ATPase) in the basal membrane prevents HCO3 resorption and less H+ formation and excretion; higher antibody titres against carbon anhydrase II diminishing H production for secretion. Secretory- defect distal renal tubular acidosis is asso- ciated with transporter defect in H(+)- ATPase and anion exchanger-1. Keywords: acidosis; distal; hypokalemia; paralysis; potassium; rta; weakness

• Be afraid of a long-standing skin lesion by Bosisio, Marco Alessandro; Sepe, Catello (2025) - E-mail: catello.sepe@asst-spedalicivili.it Key words: cutaneous squamous cell carcinoma; skin cancer; imag- ing; management; skin lesion. Cutaneous squamous cell carcinoma Answer The correct answer is cutaneous squamous cell carcinoma (cSCC). Keywords: carcinoma; cell; emergency; skin

• Noninvasive ventilation for acute exacerbations of chronic obstructive pulmonary disease in the emergency department: early predictors of in-hospital outcome by Ferrari, R.; Giostra, F.; Agostinelli, D.; Monti, G.; Pomata, D. P.; Cavazza, M. (2012) - Università degli Studi di Bolo- gna, Alma Mater Studiorum Introduction The applications of early non-invasive ventilation (NIV) are nowadays expanding in the Emergency Department (ED) for the treatment of different types and etiologies of acute respiratory failure (ARF) Emergency physicians (EP) often face the challenge of predicting short-term outcomes for patients with ARF in the ED Aim To critically analyze and describe the impact of NIV and the peculiar characteristics connected to its use in the ED, with specific attention to ARF presentation due to acute exacerbation of chronic obstructive pulmonary disease (AECOPD) In our ED the global safety and efficacy of NIV in avoiding TI and improving the outcome of carefully selected and controlled patients admitted for ARF is confirmed and is similar to what has been documented in previous RCTs We showed the possibility to identify in the ED early predictors of outcome: some clinical parameters, biomarkers and arterial blood gas analysis data to recognize severe conditions and the response to treatment An appropriate patient selection and a properly timed intervention are required for the optimal administration of safe and effective early NIV in haemodynamically stable patients, not yet meeting criteria for IMV, who can be closely monitored in an environment where TI is promptly available, with a medical and nursing motivated team with an extensive training and experience in NIV Unnecessary delaying TI remains the major hazard of NIV in ARF. Keywords: arf; niv

• Thorned heart. Description of a near-fatal cardiac embolism after percutaneous vertebroplasty by Pigna, Federica; Calamai, Simone; Scioscioli, Francesco; Buttarelli, Lorenzo; Nicolini, Francesco; Cervellin, Gianfranco (2020) - Intra-cardiac cement embolism is considerably less frequent, but is a potentially fatal complica- tion, mostly managed with cardiac surgery. Pulmonary embolism may eventually develop once the cement migrates within the pulmonary artery, and can hence be considered the most frequent complication of cement extravasation (involving ~4.6% of patients), often being asymptomatic (due to the small size of the emboli), but occasionally hemodynamically compro- mising.12,13 Intra-cardiac cement embolism is considerably less fre- quent, but is a potentially fatal complication, mostly managed with cardiac surgery.14 Only rarely cardiac embolism has been success- fully managed with endovascular procedure.19 Surprisingly, late clinical manifestations of cardiac injury due to cement embolism have even been described.20 Keywords: cement; compression; doi; embolism; vertebroplasty

• Marie Curie, an extraordinary scientist and human being who still inspires us by Poggiali, Erika; Cervellin, Gianfranco (2025) - Marie Curie installed X-ray equipment and provided guidance to medical staff. Ultimately, a total of 150 women received X-ray training from Marie and Irène Curie.4 A photograph from 1914 shows Marie Curie driving a Renault automobile that had been converted into a mobile radiological unit (Figure 2). Keywords: curie; marie; nobel; ray; women; work

• Things are not always what they seem by Barakat, Massimo; Sartoni Galloni, Stefania; Di Paolo, Nilde (2025) - Pneumatosis cystoides intestinalis presenting as pneumoperitoneum in a patient with chronic obstructive pulmonary disease: a case report. Pneumatosis cystoides intestinalis is characterized by the presence of multiple gas-filled cysts within the submucosa or sub- serosa of the gastrointestinal tract.1,2 Keywords: air; cystoides; figure; intestinalis; pneumatosis
• Subcutaneous emphysema of the neck as a complication of high flow nasal cannula therapy in children: a case report by Pierantoni, Luca; Dondi, Arianna; Biagi, Carlotta; Scozzarella, Andrea; Camela, Federica; Lanari, MArcello (2021) - Though the pressure generated by HFNC in the distal airway is difficult to measure, it appears to be dependent on the size of the patient, the diameter of the nasal can- nula compared to the nares and the flow rate.10 We suggest that other factors can be involved in overinflation, such as disease severity which can lead to increasing alveolar air trapping and a certain degree of bronchopulmonary dysplasia, related to the child’s prematurity, even if it does not prevent the use of HFNC in this clinical setting.11 Considering the increasing evidence of effi- cacy and use of HFNC,12,13 the clinical staff should strictly monitor the response to HFNC therapy especially for patients with severe bronchiolitis or with other risk factors. To date, only few cases of air leak syndrome as a com- plication of HFNC have been reported in children.6 Case Report A 3-month-old infant came to our hospital for acute bronchi- olitis. Keywords: air; bronchiolitis; cannula; flow; hfnc; high; nasal

• A small lump in the abdomen by Barakat, Massimo (2023) - Abdominal hernias: Radiological features. In these cases, abdominal imaging may be the first clue to correct diagnosis.2,3 Abdominal US and CT scan can define hernial content, distinguish it from other abdominal wall masses (such as hematomas, abscesses, sebaceous cysts, haeman- giomas, arteriovenous malformations, and other soft tissue tumours), and detect signs of complications within the hernia sac, i.e., incarceration and strangulation, which require an urgent surgi- cal evaluation.2,4 Epigastric hernias occur on the linea alba between the xiphoid process and umbilicus.2 These hernias contain the fal- ciform ligament in only 2.4% of cases.5 Considering that abdomi- nal wall hernias represent the second most common indication for surgery after acute appendicitis in Western countries,6 a prompt imaging recognition of this rare epigastric hernia may allow a con- servative management. Keywords: abdominal; emergency; ligament; wall
• A 15-year-old girl with cramping movements by Spadafora, Amanda; Andrade, Andrea; Lim, Rodrick (2017) - E-mail: Rod.Lim@lhsc.on.ca Key words: Cramping movements; Abdominal wall tic; Tic disorders; Children; Adolescents. Received for publication: 26 July 2017. Tics are unique from other movement disorders in that the patient is able to suppress the movements, however often only for a limit- ed period of time, and are common (5% of children). Keywords: abdominal; movements; tic
• Suspicion for malpositioned ventriculoperitoneal shunt diagnosed with bedside ultrasound by Biessel, Jay; Keesling, Ross; Betcher, Joe (2018) - [page 79] Diagnosis This patient was diagnosed with a malpositioned VP shunt with abdominal wall fluid collection utilizing bedside ultrasound. Interestingly enough, she had a VP shunt replaced several months later due to worsening headaches, only to have the same repeat complication of abdominal wall perforation. Keywords: abdominal; emergency; shunt

• Italian train derailment and the civil protection emergency psychologist intervention: A case report by Biella, Riccardo; Artale, Liliana (2020) - We become referent about communications from rescue operators and we mediate or explain/reinterpret every difficult communication that’s needed to be given directly from them. We also limit or block every intrusive or disturbing contact from other people (ex. crowd, media). Keywords: emergency; intervention; operators; people; rescue; team; way

• A slow and dangerous swelling of the tongue and the face by Poggiali, Erika; Pagani, Laura; Pergolotti, Benedetta; Vercelli, Andrea (2024) - Urticaria is suggestive of histaminergic AE, whereas itching may not be present. Swelling can occur within minutes in the case of histaminergic AE and usually subsides within 24-48 hours, but relapses are common and unpredictable, in contrast with a typically slower and more progressive onset in bradykinin-medi- ated AE,5 which usually reverts within 48-72 hours, although it can persist for up to five days.6 Both the two forms can lead to an imminent upper airway obstruction and a life-threatening emer- gency. Keywords: acei; allergy; angioedema; emergency; inhibitor

• A rare case of intussusception diagnosed by ultrasonography: lipoma of the colon by Barakat, Bahjat; Pezzilli, Raffaele (2015) - Intussusception, as a cause of intestinal obstruction in adult, is rare entity and it requires early diagnosis and surgical intervention.1-3 Contrary to the management of intussusception in children –about 80% of whom is treated effectively by pneumatic or hydrostatic reduction, in adults treatment is mainly surgical.4,5 It should be underlined that the treatment of adult intussusception is not universally agreed upon and all authors sug- gest that laparotomy is mandatory in order to identify the pathological lesion causing it.3-5 In our case a lipoma was found on the pathologi- cal specimen. Keywords: adult; figure; intussusception

• Necrotic lesions of the hands by Bastoni, Davide; Poggiali, Erika (2022) - Prognostic factors in patients with hepatitis C virus infection and systemic vasculi- tis. Antiviral therapy is indicated in patients with chronic C hepatitis, while immunosuppressive or immunomodulatory therapy, including steroids, plasmapheresis, and cytotoxic agents, is reserved for organ-threatening manifesta- tions.3 The prognosis is poor, particularly in elderly patients.4 The main causes of death are renal failure and widespread vasculitis with the involvement of the gastrointestinal system.5,6 Liver fibro- sis at the time of diagnosis is the poorest prognostic factor in patients with C hepatitis.7 References 1. Keywords: emergency; hepatitis; vasculitis

• That purplish huge hole on the chest wall by Rienzo, Paola; Poggiali, Erika (2024) - E-mail: poggiali.erika@gmail.com Key words: Pyoderma Gangrenosum, skin diseases, ulcer, skin lesions, thoracic surgery, VATS. Pathophysiology of pyoderma gangrenosum (pg): an updated review. Keywords: dermatol; emergency; gangrenosum; pyoderma

• Thyrotoxic Hypokalemic Periodic Paralysis (THPP): a challenge for the Emergency Medicine physician in Western countries. A case report by Stella, F.; Gottardo, L.; Busetto, M.T.; Pianetti, S.; Semplicini, A. (2012) - Furthermore, polymorphism of the CACNA1S gene (coding for a calcium channel) has been demonstrated in Asiatic THPP patients. The relevant characteristics of the onset of THPP are (Lin, 2005): presentation in an adult male with no family history of periodic paralysis; presence of systolic hypertension; tachycardia; high QRS voltage; first-degree atrioventricular block on ECG; normal blood acid-base state; hypokalemia; hypophosphatemia and hypercalciuria. Keywords: countries; paralysis; thpp

• Subarachnoid haemorrhage? Think again by Liu, Cjien-Ting; Hsu, Chien-Chin; Chen, Kuo-Tai (2018) - Marked cerebral oedema may develop in patients with hypoxic encephalopathy, severe head trauma, meningitis, postradia- tion therapy, and hypervolemia.1,2 Several studies have reported that cranial CT of such patients sometimes reveals increased attenuation along the basal cisterna or corti- cal sulci, which mimics SAH.1-3 The key to differentiating true and pseu- do-SAH is identifying the presence of severe cerebral oedema in the absence of a large amount of subarachnoid blood or a substantial parenchymal haematoma on a cranial CT scan. Cranial CT of pseudo-SAH will show the marked effacement of sulci and basal cisterns, slit-like ventricles, and poor grey-white matter differentiation.1,2 Furthermore, the distribution of blood along the fissure and sulci exhibits irregular hyperdensity in true SAH, whereas it dis- plays a smoother line in pseudo-SAH. Keywords: haemorrhage; sah

• Eye and headache: Not always an inseparable association by Poggiali, Erika; Morini, Chiara; Murelli, Vincenzo (2022) - Chiara Morini,2 Vincenzo Murelli3 1Emergency Department, Guglielmo da Saliceto Hospital, Piacenza; 2Ophthalmology Unit, Guglielmo da Saliceto Hospital, Piacenza; 3Radiology Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy Question Given the patient’s history and CT imaging, what is the most likely diagnosis? 1) Calcification of the globe 2) Foreign body 3) The calcified plaques are variable in size, can be single or multiple, involve one or both eyes, and are very common in elderly patients.4 Corneal and conjunctival calcification is the main extravascular site for calcification among patients with end-stage renal disease on maintenance haemodialysis.5 Calcifications of the trochlea are common findings on CT scan of the orbit6 and should be consid- ered in the differential diagnosis of hyperintense densities in the superomedial orbit, especially in cases of trauma where it can be confused with a foreign body. Keywords: calcification; emergency; optic

• Esmolol for the treatment of recurrent ventricular tachycardia by Savastano, Simone; Greco, Alessandra; Matrone, Benedetta (2016) - We report two cases of recurrent ven- tricular tachycardia, which were unresponsive to the standard pharmacological treatment but successfully responsive to esmolol infusion. Introduction The protective role against ventricular arrhythmias of oral administration of beta blockers in patients with catecholaminergic polymorphic ventricular tachycardia1 or with ST-segment elevation myocardial infarction (STEMI)2 has been shown, however there is very little evidence about the use of intra- venous beta blockers for the treatment of recurrent ventricular tachycardias. Keywords: esmolol; infusion; ventricular

• Doctor, something is stuck in my eye! by Poggiali, Erika; Dacrema, Alessandro; Vercelli, Andrea (2025) - In the last years, there has been an increase in cases of human diro- filariasis caused by D. repens in central and northern Europe.5-7 These trends may be attributed to several factors, including global climate change as well as the international movement of people, travel, and trade. Dirofilariasis due to Dirofilaria repens in Italy, an emergent zoonosis: report of 60 new cases. Keywords: dirofilariasis; emergency; repens
• A worrying dance in the subcutaneous adipose tissue by Barakat, Massimo; Marcucci, Matteo (2025) - Dirofilariasis is a vector-borne parasitic disease caused by filarioid nematodes of the genus Dirofilaria, transmitted by various mosquito species of the family Culicidae (Aedes, Anopheles, Culex, Ochlerotatus, Coquillettidia or Mansonia).1 These nema- todes naturally infect dogs, cats and/or some wild carnivores, and humans have long been considered accidental “dead-end” hosts, because these parasites do not usually reach sexual maturity in human tissues.1 Based on its location, human dirofilariasis is clas- sified into three forms: ocular,2 subcutaneous and pulmonary.3 Subcutaneous dirofilariasis 3. Keywords: dirofilariasis; emergency; human; ultrasonography

• What lies behind the pain after shoulder dislocation? by Poggiali, Erika; Biancalana, Elisa (2022) - +39 0523 303044 E-mail: poggiali.erika@gmail.com Key words: Hill-Sachs fracture; bone loss; humeral lesion; anterior shoulder instability. Clinical presentation includes shoulder pain, weakness, and limited range of motion; a potential long-term complication is shoulder instability.5 Hill-Sachs fractures are common in the clini- cal practise, but often not recognized on post-reduction radio- graphs. Keywords: emergency; hill; sachs; shoulder

• A painful massive cyanotic edema of the left leg by Marchetti, Alessandra; Guarona, Guglielmo; Elia, Fabrizio (2024) - Early thrombus removal strategies for acute deep venous thrombosis: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. The iliofemoral segment is almost always involved and occluded in the lower extremities due to the anatom- A 70-year-old woman presented to our Emergency Department because of acute pain and swelling in her left lower limb. Keywords: cerulea; dolens; emergency; phlegmasia

• Mucocele of the appendix: a simple ultrasonographic diagnosis for a rare disease by Pezzilli, Raffaele; Barakat, Bahjat (2014) - Ultrasonographic appearance of unilocular, ovoid, anechoic, numerous fine echo spots capsulated cystic mass with the onion skin sign in the appendiceal area. Contrast-enhanced computed tomography scan shows tubular dilatation of cystic mass of the appendix containing fluid. Keywords: appendiceal; figure; mucocele

• An alien in the gallbladder. A rare case of biliary ascariasis in an Italian emergency department by Ferri, Enrico; Ianni, Angelo; Magrini, Laura; Di Somma, Salvatore (2016) - Albendazole and mebenda- zole are first-line agents for the treatment of ascariasis.20 Conclusions Although gallbladder ascariasis is more commonly detected in developing tropical and subtropical countries, clinicians need to be aware about this disease because of its possi- ble spreading due to world travel, population migration and climate changing. Ultrasono - graphy is an important, simple, cheap, safe and reliable and non-invasive diagnostic pro- cedure in the evaluation of the patient with gallbladder ascariasis who usually arrives to ED with a clinical picture suggestive of gall- stone disease. Keywords: ascariasis; ascaris; biliary; emergency; gallbladder; lumbricoides

• Using Mount Fuji for diagnosis of tension pneumocephalus by Ak, Rohat; Doğanay, Fatih; Ecmel Onur, Özge (2016) - An axial non-con- trast head computed tomography (CT) demon- strated a massive accumulation of air that was compressing the frontal lobes which was called Mount Fuji sign (Figure 1). Mount Fuji sign refers to the presence of air between the tips of frontal lobes giving the appearance of Mount Fuji and this sign is indicative of a tension pneumocephalus. Keywords: fuji; tension

• A rare cause of pneumoperitoneum by Poor, Daniel; Ramirez, Mayra; McGovern, Terrance; Shroff, Ninad (2017) - volume 13:6606 Correspondence: Terrance McGovern, Department of Emergency Medicine, 703 Main Street, Paterson, NJ 07503, USA. Emergency Care Journal 2017; Keywords: emergency; pneumoperitoneum

Epilogue

For more detail, about this study carrel, see the computed home page. For more detail about study carrels in general, see the read me file.

Created: 2025-12-25