International Journal of Critical Care and Emergency Medicine is an open access, peer reviewed journal publishing articles on emergency medicine and the intensive care. The Journal provides a platform for authors to contribute their findings and help raise awareness among readers in various aspects of emergency medicine. The journal aims to publish highest quality clinical content via open access platform providing the readers free, immediate and unlimited access.

International Journal of Critical Care and Emergency Medicine is an open journal which accelerates research updates in various aspects such as Acute Injury, Basic Investigations, Cardiology, Cardiopulmonary Resuscitation, Chest Pain Emergency, Clinical Controversies, Critical Care, Disaster Management, Emergency, Emergency Diagnostic and Therapeutic Techniques, Emergency Medicine, First Aid, Healthy Policy and Ethics, Immediate Response to Trauma, Injury and Disease Prevention, Intensive Care, Observational Cohort Studies, Out-of-Hospital Emergency Medical Service, Pharmacology, Pre-Hospital Care, Radiology, Rescue Squad, Sports Medicine, Sudden Illness, Toxicology, Traumatology, Visual Diagnosis in Emergency Medicine, Wound Care Techniques, etc. Original Article, Reviews, Mini Reviews, Short Communications, Case Reports, Clinical Image, Perspectives/Opinions, Letters, Short Note and Commentaries are accepted for publication. All articles published in the journal are subject to a rigorous peer review process. It encourages authors to publish their work in detail.

 
Journal Information

Title: International Journal of Critical Care and Emergency Medicine

ISSN: 2474-3674

Editor-in-chief: Yasushi Shibata

NLM title abbreviation: Int J Crit Care Emerg Med

ISO abbreviation: Int J Crit Care Emerg Med

Other titles: IJCCEM

Category: General Medicine

DOI: 10.23937/2474-3674

Peer review: Double blind

Review speed: 3 weeks

Fast-track review: 10 days

Publication format (s): Electronic and print

Publication policy: Open Access; COPE guide

Publication type(s): Periodicals

Publisher: ClinMed International Library

Country of publication: USA

Language: English

Contact email: contact@clinmedjournals.org

 
Articles Search by   Keyword   |   Journal title   |   Author name   |   DOI

 

 Open Access DOI:10.23937/2474-3674/1510085

Hyponatremia in Children with Systemic Inflammatory Response Syndrome Presenting to the Emergency Department

Osama El-Assal, MD, PhD, Sarah A Marzec, MD, Michael L Forbes, MD, Michael Bigham, MD, Ryan Reichert, MD, Jeffrey D Solomon, MD and Miraides F Brown, MS

Article Type: Retrospective Study | First Published: July 25, 2019

Hyponatremia is observed in children with meningitis, encephalitis, pneumonia, urinary tract infections, and Kawasaki disease. The presence of hyponatremia is associated with increased morbidity and mortality in adults. The clinical significance of hyponatremia in febrile pediatric patients is unknown. The objective of this study was to evaluate the prevalence and prognostic value of hyponatremia in children presenting to the emergency department (ED) with systemic inflammatory response syndrome...
 

 Open Access DOI:10.23937/2474-3674/1510084

Comparison of the Sequential Organ Failure Assessment (SOFA) and Quick SOFA Scores in Predicting in-Hospital Mortality among Adult Critical Care Patients with Suspected Infection

Mohammed A Said, MBChB, MPH, Wangari-Waweru Siika, MBChB, Vitalis Mung'ayi, MBChB and Reena Shah, MBChB, MRCP, MSc

Article Type: Original Article | First Published: July 13, 2019

Sepsis is global health priority and the leading cause of death in critical care. The SEPSIS 3 criteria introduced in 2016 is the latest tool in diagnosing sepsis. It uses SOFA and qSOFA scores in place of the SIRS criteria for better ability to predict mortality in patients with suspected infections. The performance of these scores in critical care units outside high-income countries remains largely unknown....
 

 Open Access DOI:10.23937/2474-3674/1510083

Characterization of Pediatric Procedural Competency in Emergency Physicians

Daniel Slubowski, MD , Brian Wagers, MD and Jessica Kanis, MD

Article Type: Research Article | First Published: July 11, 2019

Medical and traumatic resuscitation are among the core competencies of emergency medicine. When compared to adult patients, the frequency of high acuity pediatric patients requiring procedures is low. Currently in emergency medicine practice, especially in academic settings, maintaining proficiency in high acuity and low frequency pediatric procedures may be a problem for physicians after completing training....
 

 Open Access DOI:10.23937/2474-3674/1510082

The 'SAFE PT' Handover: A Qualitative Study for Developing an Improvised Tool Facilitating Safe Patient Handover

Ahmed Mikky, MD, Mohamed Al Busafi, MD and Issa Al Salmi, MD, PHD

Article Type: Qualitative Study | First Published: July 03, 2019

The aim of this study is to identify and establish an effective and a standardized tool that is easily reproducible for the safe handover of patients at end of shift at the emergency department (ED) for continuity of care, smooth transition and minimising errors. This tool is designed to assist emergency physician and nurses in building a safe patient culture one that is reliable and upholds the standards of quality and improvement guided by international goals....
 

 Open Access DOI:10.23937/2474-3674/1510081

Iatrogenic Related to the Knowledge Deficit of Patient Safety in the Care: A Descriptive Analysis

Eliza Miranda Ramos, Matheus Dullius Lima, Valter Aragao do nascimento, Ph.D and Elaine Cristina Fernandes Baez Sarti

Article Type: Research Article | First Published: June 22, 2019

Iatrogenic conditions are those that result from the intervention of the multidisciplinary health team, whether correct or incorrect, justified or not, but which result in detrimental consequences for the patient's health. Few studies have focused on assessing the risks to patients, especially those hospitalized in emergency and intensive care services, and only in the last decades attention has been drawn to the importance of these problems...
 

 Open Access DOI:10.23937/2474-3674/1510080

The Outcome of Undisplaced Femoral Neck Fracture in Elderly

Adnan A Faraj, FRCS, Parvez Hussain, MRCS and Karthika Velusamy, MBBS

Article Type: Review Article | First Published: June 06, 2019

The management of Garden type 1 and 2 undisplaced proximal femoral intracapsular fracture in elderly patients is controversial. Many options including arthroplasty and fixation have been suggested based on patient's age and cognitive function. We have retrospectively reviewed 85 elderly patients with undisplaced femoral neck fracture. The mean age of the cohort was 81 years. 52 patients were treated with cemented hemi-arthroplasty, 19 with dynamic hip screw fixation, 10 had cannulated screw fixa...
 

 Open Access DOI:10.23937/2474-3674/1510079

Pneumococcal Sepsis as a Cause of Massive Splenic Infarction in Patient with Unknown Celiac Disease

Alessandro Graziani, Federica Mirici Cappa, Erica Fiorini, Pierpaolo Casalini and Francesco Albertini

Article Type: Case Report | First Published: June 06, 2019

Splenic Infarction (SI) is a rare event that occurs when the Splenic Artery (SA) or its branches become occluded by embolus or by in situ thrombosis. Most SI events are a result of embolic sources either cardiac or aortic. However malignant hematological disorders and autoimmune diseases are the predominant causes of splenic thrombosis. Massive Splenic Infarction (MSI) results from compromised blood flow to more than half of the spleen. In this paper we describe a case of a previously healthy pa...
 

 Open Access DOI:10.23937/2474-3674/1510078

A Prospective Study on Severe Hypotension in Critically Ill Patients Sedated with Propofol

Sherif Abdelmonem, Tamer Helmy, Iman El Sayed and Salma Ghazal

Article Type: Original Research | First Published: June 06, 2019

We aimed to verify if mean arterial pressure (MAP) at initiation of Propofol infusion and the APACHE score can predict the risk of severe hypotension. A prospective study on 100 patients treated with Propofol during their stay at the Main University Hospital between 2017 and 2018. We estimated relative risks (RRs) of severe hypotension according to MAP and APACHE score categories using a modified Poisson model for binary outcome....
 

 Open Access DOI:10.23937/2474-3674/1510077

A Case Control Study of Risk Factors for Depression in Intensive Care Unit Patients

Sherif Abdelmonem, PhD, Ghada Abdel Hadi, PhD, Akram Fayed, PhD, Iman El Sayed, PhD and Khaled Mogazy, MD

Article Type: Observational Study | First Published: May 04, 2019

A case-control study was conducted on 159 adult patients admitted to the ICU of a governmental hospital, Alexandria, Egypt. We classified the patients using the Arabic version of Hamilton scale as either depressed or not. Bivariate and multivariate analyses were done to detect the relation between depression and different predictors after controlling the confounding effect of all other factors. The prevalence of depression in the ICU patients was 46.5%. The strongest risk factor for depression w...
 

 Open Access DOI:10.23937/2474-3674/1510076

Postoperative Delirium in a Patient Following Laparoscopic Cholecystectomy and Spinal Anesthesia

Arash Peivandi Yazdi, Leila Mashhadi and Mehryar Taghavi Gilani

Article Type: Case Report | First Published: April 15, 2019

Delirium is one of the postsurgical complications in the geriatric population. Its incidence was reported up to 65% following major operations, and it is accompanied with high cost, morbidity and mortality. A 65-year-old man candidate for laparoscopic cholecystectomy under spinal anesthesia. His hypertension was under control with captopril 50 mg daily. In the middle of the surgery, he had cardiac arrest and cardiopulmonary resuscitation was performed. Vital signs improved within 6 minutes, but ...
 

 Open Access DOI:10.23937/2474-3674/1510075

Glaucopsia in Emergency Department

Sinan Cem Uzunget, MD, Zamir Kemal Erturk, MD, Vahide Bilir Ozban, MD and Osman Hakan Guclu, MD

Article Type: Case Report | First Published: April 15, 2019

Glaucopsia is a rare disease that ensue with blue/gray vision or blurring of vision as a result of amine exhalation effect. It is known that the amine vapor forms caused epithelial edema and microcysts formation under the epithelium of the corneal surface. This mechanism is reason of ocular effects. The symptoms of amine effect start 30-90 minutes after exposure and within 4-6 hours and it recovers without any treatment. Amine vapor does not asso...
 

 Open Access DOI:10.23937/2474-3674/1510074

Enhancement of NK Cell Cytotoxicity against MDA-MB-231 Cell by Presence of OK432

Sellamuthu Subbanna Gounder, Rafeezul bin Mohamed and Baskar Subramani

Article Type: Original Article | First Published: April 12, 2019

Several advancements are made in the field of immunotherapy for enabling an effective cure for cancer. Treatments are being approached with multipronged approach with combination therapies as well as by gene therapy. Cancer incidence however progressing further mainly due to the changes in lifestyle. Epidemiological surveys indicate that cancer incidence is being more predominant in females; in particularly breast cancer is the most common diseas...
 

 Open Access DOI:10.23937/2474-3674/1510073

The Importance of Detecting Regulatory T Cells in Neonatal Sepsis

Yao Yu, Yingzuo Shi and Yisen Zhang, MD

Article Type: Short Review | First Published: April 11, 2019

Sepsis is a deadly complication of pediatric infection. Tregs are a typical subset of lymphocytes showing immune suppressive function. Tregs show grateful influence to immune system in neonatal sepsis. The proportion of Tregs relate with inflammatory response, Oxidative stress sepsis and this would be a new curing targeting to immunotherapy. In this short review, we analysis the research findings of Tregs in neonatal sepsis and emphasize the sign...
 

 Open Access DOI:10.23937/2474-3674/1510072

Assessment of the Degree of Stress during Pediatric Ground Transport

Carme Alejandre, MD, David Vila, PhD, Ana Olego, M Jose Tovar, Angels Llorens, Marta Hernandez, M Paz Larrosa and Elisabeth Esteban, PhD

Article Type: Original Research Article | First Published: April 11, 2019

A total of 220 patients were included, of whom 135 were male (61.4%) with a median age of 2.5 months (IQR 3 days-21 months). Median transfer time was 29 minutes (IQR 13-52 minutes). Sixty-three patients needed non-invasive ventilation (28.6%). The median score before the transfer was 16 (IQR 15-19) and after it 16 (IQR 14-18). In 23 cases (10.5%) patients were accompanied by their parents in the ambulance; no statistically significant differences were observed in the value of the score (p 0.959)...
 

 Open Access DOI:10.23937/2474-3674/1510071

The Quantum Entanglement Dynamics Induced by Non-Linear Interaction between a Moving Nano Molecule and a Two-Mode Field with Two-Photon Transitions Using Reduced Von Neumann Entropy and Jaynes-Cummings Model for Human Cancer Cells, Tissues and Tumors Diagnosis

Alireza Heidari, Jennifer Esposito and Angela Caissutti

Article Type: Research Article | First Published: March 30, 2019

In the current study, an analytical model is presented to analyze interaction between a moving 6-Methoxy-8-[[6-Methoxy-8-[[6-Methoxy-2-Methyl-1-(2-Methylpropyl)-3,4-Dihydro-1H-Isoquinolin-7-yl]Oxy]-2-Methyl-1-(2-Methylpropyl)-3,4-Dihydro-1H-Isoquinolin-7-yl]Oxy]-2-Methyl-1-(2-Methylpropyl)-3,4-Dihydro-1H Isoquinolin-7-ol and a two-mode field in the presence of two-photon transitions and in the coupling regime dependent on intensity for human canc...
 

 Open Access DOI:10.23937/2474-3674/1510070

Femoral Fractures in Children Treated in a Regional Trauma Center in Nigeria

SE Ibeanusi and J Chioma

Article Type: Research Article | First Published: March 14, 2019

Fractures of the femur in children are not as common as those of adults but presents significant morbidity when they do occur. Such fractures present in diverse pattern in terms of age, causes, season, treatment and outcome. Presentation and treatment is influenced by age of the patients, locality of practice, available resources and experience of treating surgeons. To evaluate the pattern of presentation, treatment and outcome of fractures of th...
 

 Open Access DOI:10.23937/2474-3674/1510069

Preparing Residents for Emergent Vascular Access: The Comparative Effectiveness of Central Venous and Intraosseous Catheter Simulation-Based Training

Kristin Schwab, MD, Jodi Friedman, MD, Michael E Lazarus, MD and Jason P Williams, MD

Article Type: Brief Report | First Published: February 16, 2019

Resident physicians are often required to perform central venous catheter (CVC) or intraosseous catheter (IO) placement when supervision is not readily available. We assessed whether brief CVC and IO simulation-based training increases resident knowledge and comfort performing these procedures unsupervised. Residents were assigned to either a 60-minute CVC training or a control group that received no training; they were also assigned to either a 30-minute IO training or a control group. Both tra...
 

 Open Access DOI:10.23937/2474-3674/1510068

What Statistics do Emergency Physicians Need to Know

Edward A Ramoska, MD, MPH*, Virat Patel, MD, Alin Gragossian, DO and Romy Nocera, PhD

Article Type: Original Article | First Published: February 14, 2019

We evaluated 545 articles. Almost 60% of them were cohort studies; 17% were randomized controlled trials, 15% were cross-sectional studies and 4% were meta-analyses. The mean number of statistical tests per article was 4.16 (SD = 1.98), with a median of 4 (IQR = 2). The top ten statistical techniques applied (descriptive statistics, confidence intervals, contingency tables, t-tests, epidemiologic statistics, non-parametric tests, regression analysis, power analysis, multiway tables, and non-para...
 

 Open Access DOI:10.23937/2474-3674/1510067

Use of Programmed Multilevel Ventilation as a Superior Method for Lung Recruitment in Heart Surgery

Peter Candik, Adrian Kolesar, Martin Nosal, Matus Pauliny, Frantisek Sabol, Viera Donicova, Viliam Donic and Pavol Torok

Article Type: Original Article | First Published: January 26, 2019

During cardiac surgery, extracorporeal circulation (ECC) causes lung injury. In these inhomogenously affected lungs, the pressure control ventilation (PCV) cannot adequately ventilate differently damaged lung compartments. We invented and used original multilevel lung ventilation method named 3-LV based on alternating 3 or more pressure levels, ventilation frequencies and delivered tidal volumes. The goal of this article is to compare lung mechanics in cardiac surgery patient after ECC using sta...
 

 Open Access DOI:10.23937/2474-3674/1510066

Altruism: Brief Review of Current Opinions and Implications on Community Emergency Medicine

Oshionwu EJ and Nwose EU

Article Type: Commentary | First Published: January 25, 2019

There are several theories on altruism including the concept of pseudo-altruism. The latter constitute divergent opinion around egoism and socioeconomic status (SES). Review has identified that the conflict between altruistic and pseudo-altruistic theoretical approaches can be resolved by combining elements from both concepts. The objective of this commentary is to advance (1) That there is 'benefit to the helping altruistic individual in all altruism theories; and (2) A unifying viewpoint in te...
 

 Open Access DOI:10.23937/2474-3674/1510065

Predictors of Adverse Outcome Early After ICU Discharge

Katsiari M, Ntorlis K, Mathas C and Nikolaou C

Article Type: Original Article | First Published: January 07, 2018

Clinicians are often confronted with the timely discharge decision, in order to avoid readmission and escalation of costs. Aim of the present study was to determine potential risk factors for ICU readmission or death early after ICU discharge. The Intensive Care Unit (ICU) is the designated department in the hospital for the care of the most unstable and sickest patients. Depending on ICU availability, it is possible these intubated and critically ill patients are being hospitalized in other are...
 

 Open Access DOI:10.23937/2474-3674/1510064

Extreme Hypernatraemia and Sepsis in a Patient with Huntington's Dementia: A Conundrum in Fluid Management

Harish Venkatesh, Sanjeev Ramachandran, Atanu Basu and Hari Nair

Article Type: Case Report | First Published: January 05, 2019

We report a unique case of extreme hypernatraemia of 196 mmol/L and severe sepsis in a young 39-year-old adult with Huntington's dementia, which presented a challenge in fluid management. The hypernatraemia was thought to be caused by chronic severe dehydration from poor intake and the sepsis was thought to have started as an inadequately treated urinary tract infection. The patient was initially treated aggressively with hypotonic saline and intravenous antibiotics but was subsequently managed ...
 

 Open Access DOI:10.23937/2474-3674/1510063

An Exploratory Study of Overnight Education in the Medical Intensive Care Unit

Camille R Petri, Brittany L Ranchoff, Amy P Cohen, Amy M Sullivan, Richard M Schwartzstein and Margaret M Hayes

Article Type: Brief Report | First Published: January 04, 2019

Many hospitals in the United States employ overnight intensivist coverage for their medical intensive care units, but little is known about the effect of this staffing model on trainee education, and the learning that occurs overnight. This study examined the educational interactions occurring between residents and overnight intensivists in the context of the overnight multidisciplinary learning environment....
 

 Open Access DOI:10.23937/2474-3674/1510062

Is it Always Necessary to Take Blood Cultures before Starting Antibiotics in the Emergency Department? A Review of Usefulness of Blood Cultures in Community-Acquired Pneumonia, Cellulitis, Urinary Tract Infection and Pyelonephritis

Koh Nan Jun, Quek Hui Yu and Lateef F

Article Type: Review Article | First Published: January 03, 2019

Routine blood cultures are commonly taken in patients who present to the Emergency Department (ED) with suspicion of infection. This is also in conjunction with treatment guidelines for severe community-acquired pneumonia, acute meningitis and bacteraemia, etc. The above practice has become a major area of resource utilisation, despite many studies showing poor yield of these cultures. The poor yield of blood cultures is financially costly for patients, and even more so for hospitals. Hidden cos...
 

 Open Access DOI:10.23937/2474-3674/1510061

Efficacy of Cervical Immobilization in Multiple Trauma Patients

S Cacho Garcia, D Pena Otero and M Eguillor Mutiloa

Article Type: Review Article | First Published: January 03, 2019

Immobilization is one of the most used procedures to prevent spinal cord injury in multiple trauma patients in prehospital setting. However, its protocolary use has historical principles rather than a scientific origin. Although this technique restricts the movement of the injured spine, there is no evidence supporting its use in all patients suffering from trauma. The concept of multiple trauma includes all those patients who have traumatic injuries that affect at least two or more organs (or m...
 

 Open Access DOI:10.23937/2474-3674/1510060

Non-Small Cell Lung Cancer Presenting as a Facial Soft Tissue Metastasis in a Non-Smoker

Berman Zoe, Pearl Joshua and Wiesel Ory

Article Type: Case Report | First Published: December 12, 2018

Lung cancer is an aggressive disease with projections estimating that more than 150,000 Americans will die in 2018 from lung cancer. Mortality is associated with advanced stage of disease and metastatic disease. While the major sites of metastases are the solid organs, the rate of soft tissue metastases has been reported as 0.75-9%. In an asymptomatic patient who is a nonsmoker, there is low likelihood to diagnose early lung cancer unless found i...
 

 Open Access DOI:10.23937/2474-3674/1510059

Widened Mediastinum on Chest X-Ray as an Indicator of Mediastinal Injuries: A Relic of the Past?

Sunder Balasubramaniam, Rachel Yanlin Chen, Deng Tianshu and Teo Li Tserng

Article Type: Retrospective Study | First Published: December 12, 2018

The humble chest X ray (CXR) is an important factor in the assessment of the patient with traumatic injury. The Advanced Trauma Life Support (ATLS) programme recommends performing a CXR as part of the secondary survey, and this is widely used in Singapore. All general hospitals that receive trauma patients in Singapore have resuscitation bays capable of rapidly obtaining a CXR film using either a fixed radiology machine or a portable machine kept...
 

 Open Access DOI:10.23937/2474-3674/1510058

Stem Cell Therapy for Ischemic Stroke: From Bench to Bedside

Jolien De Meyer, Jolien De Pryck and Said Hachimi-Idrissi

Article Type: Original Article | First Published: December 01, 2018

Every year ischemic stroke takes many lives and leaves millions of people with neurological deficits. Currently the only approved therapy is recombinant tissue plasminogen activator, which should be administered within a narrow time window of 4.5 hours. Stem cell therapy was first initiated in several preclinical studies with promising results and lately in some clinical trials. Our research consists of 2 systematic reviews where preclinical and clinical studies were pooled. We provide a systemi...
 

 Open Access DOI:10.23937/2474-3674/1510057

Incidence of Venous Thromboembolism in Asian Trauma Patients - An Asian Trauma Centre Review

Wee Ming Tay, TS Go and LT Teo

Article Type: Research Article | First Published: November 24, 2018

To evaluate the incidence of venous thromboembolism (VTE) in Asian trauma patients and the relation to use of chemoprophylaxis with low molecular weight heparin (LMWH). The Tan Tock Seng trauma database between December 2011 and December 2012 was reviewed. All trauma patients with an injury severity score of 9 or more were included. All medical records were screened for Duplex ultrasound (US) of lower limbs, any computed tomography pulmonary angiogram (CTPA) performed and whether there was use o...
 

 Open Access DOI:10.23937/2474-3674/1510056

A Young Woman with Dyspnea Following Delivery- Cardiomyopathy, Pulmonary Embolism or Both?

Yonatan Gershinsky, David Leibowitz and Shaden Salameh

Article Type: Case Report | First Published: November 21, 2018

Postpartum cardiomyopathy is an important cause of heart failure in young women with an increasing rate in recent years. It may occur from the last month of pregnancy and up to five months after delivery. The etiology remains unclear and the disease has a high level of morbidity and mortality. Complications include CHF, arrhythmias, cardiogenic shock and thromboembolism. Treatment is similar to the treatment for CHF. Bromocriptine has shown encouraging preliminary results but is not standard the...
 

 Open Access DOI:10.23937/2474-3674/1510055

Role of Obstetric High Dependency and Intensive Care Unit in Improving Pregnancy Outcome and Reducing Maternal Mortality-A Study in Rural Central India

Surekha Tayade, Neha Gangane, Poonam Shivkumar, Dinesh Baswal, Apurva Ratnu, Himanshu Bhushan and Jaya Kore

Article Type: Research Article | First Published: November 19, 2018

To analyze the requirement of High Dependency Unit (HDU) and Intensive care Unit (ICU) in an obstetric population in terms of utilization rate, indications for admission, interventions required and gestational outcome. Retrospective observational study was carried out from October 2016 to September 2017 in Kasturba Hospital, Mother and Child Health Wing, Mahatma Gandhi Institute of Medical Sciences Sewagram placed in rural central India. Data rel...
 

 Open Access DOI:10.23937/2474-3674/1510054

Regional Citrate Anticoagulation in Continuous Renal Replacement Therapies

Domingo Daga-Ruiz, Jonathan PĂ©rez-Vacas, Fernando Segura-Gonzalez, Gonzalo Moratalla-Cecilia, Araceli Puerto-Morlan, Pilar Nuevo-Ortega and Alba Fernandez-Porcel

Article Type: Original Article | First Published: November 16, 2018

We designed this Observational prospective cohort study to assess the safety, effectiveness and efficiency of the introduction of Regional Citrate Anticoagulation (RCA) as election strategy for Continuous Renal Replacement Therapies (CRRT). All patients in need of CRRT without contraindications to the use of RCA were included. It was necessary to adapt and implement the original RCA protocol, for the first time in a Spanish ICU. A total of 90 patients between October 2016 and October 2017 were i...
 

 Open Access DOI:10.23937/2474-3674/1510053

Intravenous Subdissociative-Dose Ketamine versus Morphine for Acute Traumatic Pain in Geriatric Patients in the Emergency Department: A Case Series

Sergey Motov, Jefferson Drapkin, Antonios Likourezos, Peter Flom, Catsim Fassassi, John Marshall and Ronald Simon

Article Type: Case series | First Published: November 12, 2018

We compare analgesic efficacy and safety of sub-dissociative dose ketamine (SDK) to morphine for managing acute traumatic pain in geriatric emergency department (ED) patients. A subset of geriatric patients from a randomized double-blind trail experiencing moderate to severe acute traumatic pain who received SDK at 0.3 mg/kg or morphine at 0.1 mg/kg by short intravenous infusion over 15 minutes was analyzed at 15, 30, 60, 90, and 120 minutes post-medication administration. Primary outcome was re...
 

 Open Access DOI:10.23937/2474-3674/1510052

Thinking Outside the

Catsim Fassassi and Ronald Simon

Article Type: Case report | First Published: November 02, 2018

35-year-old woman with a past psychiatric history and alcohol abuse was found unresponsive on the bathroom floor by her boyfriend. EMS was called, and chest compressions were commenced by the boyfriend while awaiting EMS arrival. EMS found the patient to be in PEA and continued CPR on scene and during transport. ROSC was achieved while en route to the hospital. On arrival to the ED she was initially normotensive but quickly decompensated requirin...
 

 Open Access DOI:10.23937/2474-3674/1510051

Utility of an Emergency Department Chest Pain Protocol in Ruling Out Acute Coronary Syndrome

Shieh Mei Lai, Poongkulali Anaikatti, Pravin Thiruchelvam, Siang Chew Chai, Thon Hon Yong, Yew Seong Goh, Sheldon Lee, Rahul Goswami, Charlene Jin Yee Liew and Pak Liang Goh

Article Type: Original Article | First Published: October 12, 2018

To assess the safety and efficacy of an Emergency Department Chest Pain Protocol in ruling out Acute Coronary Syndrome in a regional hospital in Singapore. An audit was carried out of the cases admitted to our Short Stay Unit (SSU) under the Chest Pain Protocol from June to November 2014. Patients presenting with chest pain and possible acute coronary syndrome, but with normal initial electrocardiogram (ECG) and troponin level, could undergo this rule-out protocol, which comprised serial ECGs an...
 

 Open Access DOI:10.23937/2474-3674/1510050

Acidosis and ketonuria in an 8-Year-Old Male

Caitlin Gilman and Tanya Chadha

Article Type: Case Report | First Published: October 12, 2018

The patient is an 8-year-old Caucasian male with no significant past medical history referred to the emergency department by his pediatrician for possible appendicitis. The day prior to presentation, his mother noted decreased energy and appetite. He went to sleep soon after arriving home from school and woke up twice overnight with non-bloody, non-bilious emesis. He began complaining of right-sided back and abdominal pain in the morning and was brought to his pediatrician, where he was immediat...
 

 Open Access DOI:10.23937/2474-3674/1510049

The Role of Probiotics in Critically Ill Adult Patients with Pneumonia

Julie Kalabalik and Ayse Elif Ozdener

Article Type: Review Article | First Published: October 12, 2018

There is increased interest in the role of the gastrointestinal (GI) or gut microbiome and its role in prevention and treatment of disease. The gut microbiome alone consists of approximately 400 strains of bacteria, fungi, and parasites. Anaerobes are the predominant type of microorganism in the GI tract with Firmicutes and Bacteroidetes being the dominant phyla. The gut microbiome is involved in metabolism, host protection, and immune function. It plays an important role in metabolism of nondig...
 

 Open Access DOI:10.23937/2474-3674/1510048

Things to Keep in Mind in High Flow Therapy: As Usual the Devil is in the Detail

Salvador Diaz-Lobato, Jose Manuel Carratala Perales, Jose miguel Alonso Inigo, Sagrario Mayoralas Alises, Barbara Segovia, Noelia Escalier, Maria Ines Mattioli, Ana Jaureguizar and Diurbis Velasco

Article Type: Original Article | First Published: October 12, 2018

High-flow nasal cannula oxygen therapy (HFNC) has revolutionized the treatment of patients with respiratory failure in different settings. Several mechanisms of action explain us why HFNC has become a first line therapy for these patients. Some authors have referred to the adverse effects that can occur when we use HFNC and its limitations. However, there are numerous aspects that we should consider when prescribing this treatment and that are no...
 

 Open Access DOI:10.23937/2474-3674/1510047

Caring Critically Ill Patients in the General Wards in Tanzania: Experience of Nurses and Physicians

Lilian T Mselle and Halima Msengi

Article Type: Research Article | First Published: October 12, 2018

Studies in Tanzania have reported that many hospitals in the country have no intensive care unit (ICU) where critically ill patients could be managed thus critically ill patients are cared for with other non-critical patients. The aim of this study is to describe nurses and physicians' experience of caring critically ill patients in the general wards at the Regional hospital. A descriptive qualitative design was used. Purposeful sampling method was used to enroll 10 nurses and 5 physicians worki...
 

 Open Access DOI:10.23937/2474-3674/1510046

Early Protocolized Bedside Ultrasound in Shock: Renal Function Improvements and Other Lessons Learned

Talayeh Rezayat, Igor Barjaktarevic, Ian Mecham, Lisa Yee, Ramy Salah, Lisa Zhu, Kereat Grewal, Jody Anderson, Nicholas J Jackson, David Elashoff and Elizabeth Turner

Article Type: Research Article | First Published: October 06, 2018

Rapid assessment and treatment of the critically ill in shock is crucial to survival. The RUSH (Rapid Ultrasound in Shock and Hypotension) exam uses Ultrasound (US) to determine the etiology of undifferentiated shock, but data to demonstrate impact of focused US on clinical outcomes is sparse. This study aimed to assess the clinical impact of early incorporation of the RUSH US exam in the care of patients with new onset shock on a population leve...
 

 Open Access DOI:10.23937/2474-3674/1510045

To Determine Blood Lactate Levels in Patients with Sepsis Admitted to a Respiratory Intensive Care Unit and to Correlate with their Hospital Outcomes

Amit K Asati, Rajnish Gupta and D Behera

Article Type: Original Article | First Published: September 28, 2018

Sepsis is one of major causes of mortality in non-cardiac ICU patients. The screening of the patients for sepsis needs a careful evaluation of criteria and confirmation of infection. SIRS criteria for identification of patients with sepsis is not alone sufficient. Lactate has been shown to be a very important severity marker in sepsis cases and has been found to be more useful for predicting the outcome of sepsis than common severity scores such ...
 

 Open Access DOI:10.23937/2474-3674/1510044

Severe Venlafaxine Intoxication with Refractory Pulseless Electrical Activity Cardiac Arrest Successfully Treated with Intravenous Lipid Emulsion

John Blixt, Shazia Raheem and Stephen Bujarski

Article Type: Case Report | First Published: September 22, 2018

Venlafaxine, a serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressant, has been associated with severe cardiotoxicity in massive overdoses. Treatment is usually supportive. Over the past decade, intravenous lipid emulsion has been gaining interest in the treatment of intoxications with lipophilic substances. We report a case of refractory pulseless electrical activity cardiac arrest following a massive overdose of venlafaxine successfully treated with intravenous lipid emulsion infusi...
 

 Open Access DOI:10.23937/2474-3674/1510043

Penile Fracture: Report of Eight Cases and Review of Literatures Reported in China

Xuelu Zhou and Shangjun Zhou

Article Type: Research Article | First Published: August 29, 2018

In 113 publications 984 cases (including our eight cases) were retrieved. An annual incidence in China has been estimated between 0.002/million and 0.2/million male populations. The commonest causes were coitus and masturbation. Clinical features were the classical triad of "cracking" sound, immediate detumescence and pain. Swelling, ecchymosis and deformity were present in the majority of patients. Diagnosis was made mainly on clinical grounds; ...
 

 Open Access DOI:10.23937/2474-3674/1510042

Modeling Quality Improvement Strategies to Reduce Treatment Delays for Severe Sepsis at a Tertiary Care Hospital in India

Srihari Cattamanchi, Lucas C Carlson, Felicity Gonzalez and Anbrasi Edward

Article Type: Original Article | First Published: August 16, 2018

Extensive evidence from high-income countries has demonstrated the value of quality improvement (QI) methods yet reports of their use in LMICs are markedly limited. We aim to explore how QI can be implemented in the setting of an LMIC to remove barriers to timely antibiotic therapy for severe sepsis....
 

 Open Access DOI:10.23937/2474-3674/1510041

Sphingomonas Paucimobilis Bacteremia in a Hemodialysis Patient and Literature Review

Sevtap Gursoy, Kadriye Kart Yasar, N Didem Sari, Nuray Kuvat and Savas Ozturk

Article Type: Case Report | First Published: August 11, 2018

Sphingomonas paucimobilis is an aerobic, non-fermentative gram-negative motile bacterium that may be an unusual infectious agent for immunocompromised host. Intravascular instrumentations are commonly applied in the hemodialysis patients. These procedures have an increased risk for infection with unusual, rare and opportunistic pathogens....
 

 Open Access DOI:10.23937/2474-3674/1510040

Effects of the Miyakejima Volcano Eruption on Public Health

Mikio Shiozawa, Alan Kawarai Lefor, Naohiro Sata, Yoshikazu Yasuda and Hideo Nagai

Article Type: Original Research Article | First Published: August 06, 2018

In June 2000, the Miyakejima volcano suddenly erupted, forcing evacuation of all inhabitants. We undertook this study to evaluate the effects on the health of inhabitants after their returning to the island 4 years after the eruption. We examined 269 inhabitants, who visited the Miyakejima Central Clinic, and specifically discussed symptoms related to exposure and anxiety related to the disaster....
 

 Open Access DOI:10.23937/2474-3674/1510039

Clinical Characteristics and Predictors of Recurrence and Surgical Management of Pneumothorax

Chihiro Nakano, Toru Yamagishi, Norio Kodaka, Kayo Watanabe, Kumiko Kishimoto, Takeshi Oshio, Kumiko Niitsuma, Nagashige Shimada and Hiroto Matsuse

Article Type: Original Article | First Published: July 30, 2018

Most cases of pneumothorax comprise primary spontaneous pneumothorax (PSP), which usually occurs in young, tall men and results from rupture of subpleural blebs or bullae. Secondary spontaneous pneumothorax (SSP), on the other hand, is associated with an underlying lung disease, such as emphysema or asthma; acute or chronic infections; lung cancer; and congenital disease, including cystic fibrosis, catamenial pneumothorax, and lymphangioleiomyoma...
 

 Open Access DOI:10.23937/2474-3674/1510038

Found the Needle in the Haystack! The Case of a Fishbone Causing Vasovagal Syncopes and Abdominal Pain: A Case Report

Daniel Sermoneta, Francesco Favi, Carlo Salvadori, Marco Coniglio and Francesco Saverio Mari

Article Type: Original Article | First Published: July 30, 2018

Foreign body ingestion is a very common reason for access to the Emergency Department and in most cases, it doesn't cause symptoms; in case of fishbones, intestinal perforation is rare but possible. In this report, besides the typical picture of bowel perforation, we found atypical symptoms due to the specific location. ...
 

 Open Access DOI:10.23937/2474-3674/1510037

Clinical Profile and Outcomes of Elderly Patients in an Asian Intensive Care Unit: A Retrospective Observational Study

Shahla Siddiqui and Robin Choo

Article Type: Original Article | First Published: July 14, 2018

Over the last decade an increasing number of elderly patients are being admitted to the Intensive care units across the World. With a rapidly ageing population Asian countries face a tremendous burden of care for these patients. Family expectations have also increased with more demanding aggressive life support even in the older patients. Patients are generally getting less frail as they age and with the improvement in technology and advancements in medical science the outcomes of these patients...
 

 Open Access DOI:10.23937/2474-3674/1510036

Ventricular Tachycardias in Structurally Normal Hearts - A Case Report and Review of the Literature

Juergen Schiefermueller

Article Type: Case Report | First Published: June 21, 2018

The acute management of broad complex tachycardias in the Emergency Department (ED) can often pose a significant challenge, not just for the more inexperienced of doctors. This is often due to the potentially lethal nature of this arrhythmia, the perceived complexity of ECG interpretation or handling of antiarrhythmic drugs. Whilst most doctors are aware that broad complex tachycardias are in the vast majority of cases related to structural abnor...
 

 Open Access DOI:10.23937/2474-3674/1510035

Acute Inferior Wall ST Segment Elevation Myocardial Infarction diagnosed During Bi-Ventricular Pacing

Jaspreet Singh, Shankar K Thampi, Amit Alam, Rajiv Jauhar, Apoor Patel, and Avneet Singh

Article Type: Case Report | First Published: June 15, 2018

Specific criteria have been developed for the diagnosis of acute myocardial infarction in patients with right ventricular pacing, but not for patients with bi-ventricular pacing. We present a case of a patient with a biventricular implantable cardioverter defibrillator (BiVICD), who presented with symptoms consistent with acute coronary syndrome (ACS), new ST elevations of the inferior leads, and was found to have acute occlusion of right coronar...
 

 Open Access DOI:10.23937/2474-3674/1510034

Noise Pollution in the Pediatric Intensive Care Unit and its Effect on Sedation

Bree Kramer and Christopher Heard

Article Type: Research Article | First Published: June 14, 2018

Noise exposure is an important factor in the management of intensive care patients. There are many different causes of noise in the ICU such as equipment, monitors, staff, family plus other additional sources. Patients in the ICU are exposed to these noise sources for 24 hours a day with no respite. The noise levels can vary significantly during the day as well as significantly between patient bed-spaces. There are detrimental effects from excess...
 

 Open Access DOI:10.23937/2474-3674/1510033

Acute Dyspnoea with Co-Incidental Finding of Carbon Monoxide Poisoning - A Case Report with Review of Current Literature

Teresa A Hand and Debkumar Chowdhury

Article Type: Case Report | First Published: June 06, 2018

Carbon monoxide poisoning can present in subtle ways with a variable range of symptoms from mild headaches to profound neurological impairment. The primary aim of this article is to highlight the importance of early detection of carbon monoxide poisoning through meticulous clinical assessment. The secondary aim of this article is to review the current treatment strategies. ...
 

 Open Access DOI:10.23937/2474-3674/1510032

Effective Neurally Adjusted Ventilatory Assist (NAVA) Ventilation in a Child with a Large Bronchopleural Fistula

Jean-Michel Liet, Alexis Chenouard, Sebastien Faraj, Armelle Garenne and Pierre Bourgoin

Article Type: Case Report | First Published: June 06, 2018

Managing mechanical ventilation in patients with bronchopleural fistula (BPF) can be hazardous, especially in case of large air leaks and underlying parenchymal lung disease. The fistulous tract offers low airflow resistance, and air escapes through the BPF to the detriment of the tidal volume, jeopardizing the minute ventilation and oxygenation. ...
 

 Open Access DOI:10.23937/2474-3674/1510031

Bilateral Diaphragmatic Paresis after Cardiac Surgery: The Key is the Clinical Point-of-Care Ultrasound

Jose Luis Vazquez Martinez, Aida Lopez de Pedro, Ana Coca Perez, Raul Montero Yeboles and Cesar Perez-Caballero Macarron

Article Type: Case Report | First Published: January 31, 2018

Bilateral diaphragmatic paresis following cardiac surgery is rare. We present a case in which several extubation attempts failed in an infant after cardiac surgery. Point-of-care ultrasonography (POCUS) showed a slight but symmetric decrease of diaphragmatic motion, confirmed by fluoroscopy. Phrenic electromyography (EMG) was informed inconsistently as normal. After eight weeks of non-invasive ventilation the patient was weaned to room air, revea...
 

 Open Access DOI:10.23937/2474-3674/1510030

Rapidly Progressive Fatal Gas Gangrene due to Clostridium Septicum in a Patient with Colon Cancer Revealed by Autopsy

Haruka Kuno, Harumi Gomi, Kazutaka Fukushima, Yukiko Kodama, Taijiro Shirokawa, Kousei Miura, Shijima Taguchi, Norio Takayashiki and Takao Kanai

Article Type: Case Report | First Published: November 24, 2017

Gas gangrene is a rare, life-threatening deep skin infection typically related to contaminated wounds, although it may occur without injury. Non-traumatic gas gangrene due to Clostridium spp. is most commonly caused by Clostridium septicum....
 

 Open Access DOI:10.23937/2474-3674/1510029

Successful Treatment of Cerebral Sinus Thrombosis with Edoxaban Alone

Yasushi Shibata

Article Type: Case Report | First Published: November 22, 2017

As initial therapy for cerebral sinus thrombosis, heparin injection and subsequent oral anticoagulant, namely warfarin, has been recommended. We treated a patient with cerebral sinus thrombosis with edoxaban alone as an outpatient. This is the first report of cerebral sinus thrombosis being treated with edoxaban alone....
 

 Open Access DOI:10.23937/2474-3674/1510028

Agenesis of the Bilateral Internal Carotid Arteriesled to the Development of Vertigo

Yasushi Shibata

Article Type: Case Report | First Published: October 26, 2017

Agenesis of the bilateral internal carotid arteries is a rare disease. There have been few case reports of subjects who developed cerebral infarction, intracranial hemorrhage or subarachnoid hemorrhage. We experienced a rare case of agenesis of the bilateral internal carotid arteries in which the patient developed vertigo....
 

 Open Access DOI:10.23937/2474-3674/1510027

Environmental Factors Urging the Development of Atopic Diseases in 75 Children

Arnaldo Cantani

Article Type: Review Article | First Published: May 17, 2017

Allergic asthma and rhinitis, Atopic Dermatitis (AD), urticaria and gastrointestinal allergy, are common diseases of infants and children. It was recently estimated that 14% of children suffer from AD, 8% from food allergy, and 12% from asthma. The cumulated incidence of these diseases in adolescents has been estimated between 25-35%, while the prevalence is about 20%....
 

 Open Access DOI:10.23937/2474-3674/1510026

Targeted Temperature Management Following Cardiac Arrest: In-Hospital Trends in Utilization

Saiprasad Narsingam, Benjamin S Abella, Anne V Grossestreuer and Paul S Chan

Article Type: Original Research | First Published: May 15, 2017

Targeted temperature management (TTM) improves outcomes in patients with Out-of-Hospital cardiac arrest (OHCA) due to Shockable rhythms. The frequency with which TTM is used for Non-Shockable cardiac arrest rhythms and for In-Hospital cardiac arrest (IHCA) is unknown....
 

 Open Access DOI:10.23937/2474-3674/1510025

A Rare Case of Boerhaave Syndrome Presenting with Right Tension Pneumothorax and Review of the Literature

Jennifer Li, Simon Turner, Gordon Finlayson, Basil Nasir, John Yee and Anna McGuire

Article Type: Case Report | First Published: May 12, 2017

Although rare, spontaneous esophageal perforation or "Boerhaave syndrome", carries a high case fatality rate. The 'classic' presentation of chest pain, vomiting and subcutaneous emphysema is actually uncommon clinically, with the literature reporting variable initial presentations....
 

 Open Access DOI:10.23937/2474-3674/1510024

Mid-Regional Proadrenomedullin as a Prognosis Biomarker of Mortality in Patients Treated with Non-Invasive Ventilation in the Emergency Room

Manuel Pinero Zapata, Miriam Martinez Villanueva, Francisco V Aviles Plaza, Cesar Cinesi Gomez, Aurelio Luna Maldonado and Maria E Legaz Moreno

Article Type: Research Article | First Published: May 11, 2017

The mid-regional fragment of the peptide complex Pro-adrenomedullin (MR-proADM) is a ubiquitous biomarker tissue distribution in the human body with increased levels in the course of certain diseases of great importance for vital engagement and whose clinical course is often associated with dyspnoea....
 

 Open Access DOI:10.23937/2474-3674/1510023

Emerging Concepts in Acute Heart Failure: From the Pathophysiology to the Clinical Case Based Approach

Antonio Giovanni Solimando, Antonella Argentiero, Anna Ruckdeschel, MaxBittrich, Andreas Schneider, Rodolfo Sbrojavacca, Angelo Vacca, Georg Fritz and Hermann Einsele

Article Type: Case Report | First Published: February 25, 2017

Acute heart failure (AHF) represents a heterogeneous clinical syndrome, comprising new or worsening signs and symptoms on a background of stable chronic heart failure (HF), as well as new-onset HF. In either clinical picture, urgent care is crucial. Given the variety of clinical scenario, stratifying patient subgroups on a pathophysiologic base can help direct appropriate therapy. ...
 

 Open Access DOI:10.23937/2474-3674/1510022

Cerebral Air Embolism in Commercial Flights: A Potentially Fatal Complication of Intrathoracic Lesions

Beatriz Oyanguren, Araceli Alonso-Canovas, Alicia de Felipe and Jaime Masjuan

Article Type: Case Report | First Published: February 18, 2017

Five patients with CAE were admitted to our Emergency Department (A-E). All experienced loss of consciousness (LOC). Chest radiograph showed thoracic bullae. Brain computed tomography (CT) showed subarachnoid bubbles (A), intraparenchymal bubbles (B), global hypoperfusion (C), or no abnormalities (D, E). With supportive treatment, four survived, while B died. Including ours, 18 cases of CAE during commercial flights have been reported. LOC and dy...
 

 Open Access DOI:10.23937/2474-3674/1510021

An Unstable Coronary Situation: A Case of Two Aborted Myocardial Infarctions in Three Days

Ephraim B Winzer and Axel Linke

Article Type: Case Report | First Published: January 25, 2017

In patients with stable coronary artery disease percutaneous coronary intervention (PCI) effectively improves symptoms in the absence of any effect on prognosis. In contrast, in patients with acute coronary syndrome (ACS) PCI significantly reduces the risk of acute myocardial infarction and death as compared to conservative, noninvasive strategy....
 

 Open Access DOI:10.23937/2474-3674/1510020

Efficacy of Early Laparoscopic Surgery in Acute Abdomen Secondary to Perforated Jejunal Diverticulitis

Ramiro Galvez-Valdovinos, Ernesto Marin Y Santillan and Gustavo Lopez-Ambriz

Article Type: Case Report | First Published: September 12, 2016

A 39-year-old man with abdominal pain, fever and general poor state. Physical examination showed fever, Tachycardia, Left basal hypoventilation and acute surgical abdomen. A Abdominal X-Ray showed accumulation of calcifications in mesogastric. The laboratory test showed leukocytosis and the abdominal CT-Scan showed the cause of the acute surgical abdomen. The laparoscopic surgery was recommended and performed....
 

 Open Access DOI:10.23937/2474-3674/1510019

Pre-Hospital Ultrasound: Current Indications and Future Perspectives

Mirko Zanatta, Piero Benato and Vito Cianci

Article Type: Review Article | First Published: July 20, 2016

The mission of pre-hospital medical service is to provide rapid and high quality life support. The development of specific protocols, the availability of new diagnostic tools have determined a significant improvement of pre-hospital care. The use of ultrasound in the pre-hospital medical service is a new and reliable diagnostic device....
 

 Open Access DOI:10.23937/2474-3674/1510018

Aetiology and Presentation of Intestinal Obstruction among Patients Presenting to a Tertiary Hospital in Uganda

Arlene Muzira Nakanwagi, Stephen C Kijjambu, Peter Ongom and Tonny Stone Luggya

Article Type: Research Article | First Published: July 04, 2016

Intestinal Obstruction is the impairment of normal flow of intestinal contents from mouth to anal canal with aetiology that varies depending on various factors. Understanding aetiology of a country's surgical services has proven to aid better planning for its emergency surgical conditions. Mulago, which is Uganda's National Referral Hospital, is resource constrained with a surgical burden of 33% due to acute abdomen with Intestinal Obstruction. T...
 

 Open Access DOI:10.23937/2474-3674/1510017

Arginine in the Critically Ill: Can we Finally Push Past the Controversy?

Martin D Rosenthal, Cameron Rosenthal, Jayshil Patel, Janeen Jordan, Kristina Go and Frederick A Moore

Article Type: Review Article | First Published: July 04, 2016

Arginine is a conditional amino acid that has a wide breadth of metabolic activity and applications when supplemented. During critical illness, high stressed states, and increased metabolic demand arginine becomes an essential amino acid. It is during this time that supplementation benefits the host. Arginine supplementation during sepsis, however, has remained controversial as there is theoretical harm stemming from arginine serving as a substra...
 

 Open Access DOI:10.23937/2474-3674/1510016

How to Deal With Febrile Neutropenia in Chemotherapy - Treated Cancer Patients? A Comprehensive Approach to Prevention and Therapy

Jean A Klastersky

Article Type: Commentary | First Published: July 03, 2016

Chemotherapy-induced neutropenia in patients with cancer were comprehensively discussed recently by Bennett et al. While similar appraisals are available in the literature, evaluation of the problem on a national basis is useful for practicing physicians as it take into consideration local aspects relating to microbiological epidemiology and general medical practice that can modulate international guidelines....
 

 Open Access DOI:10.23937/2474-3674/1510015

Addressing Moral Distress in Critical Care Nurses: A Pilot Study

Rose Allen and Eve Butler

Article Type: Research Article | First Published: May 03, 2016

Background: Moral distress can affect critical care nurses caring for complex patients. It can result in job dissatisfaction, loss of capacity for caring, and nurse turnover, resulting in a negative impact on quality care. Aim: This study purpose was to determine how moral distress impacts critical care nurses (adult and pediatric) and to implement improvement strategies to reduce moral distress, improve job satisfaction, and retention. Theoretic...
 

 Open Access DOI:10.23937/2474-3674/1510014

Use of Transthoracic Impedance Data to Evaluate Intra-arrest Chest Compression Quality

Jonathan W Kamrud, Lori L Boland, Carol L Frazee, Tyler G Kinzy, Paul A Satterlee and Charles J Lick

Article Type: Research Article | First Published: May 02, 2016

Mechanical compression devices purportedly improve the quality of chest compressions by minimizing interruptions and maintaining optimal rate and depth, but this claim has not been objectively substantiated using transthoracic impedance (TTI) recordings from applied setting cardiac arrests. In this study, we use TTI data to compare chest compression quality metrics from the manual versus mechanical compression phases of out-of-hospital cardiac ar...
 

 Open Access DOI:10.23937/2474-3674/1510013

Use of Steroid for Extubation Failure due to Stridor in Surgical Intensive Care Patients

Nissar Shaikh, Tasneem Mehesry, Gulzar Hussain, Arshad Chanda, Ali Belkhair, Syed Sheikh, Faisal Malmstrom and Marcus AE

Article Type: Research Article | First Published: April 08, 2016

Extubation failure increases morbidity and mortality in intensive care. Laryngeal edema which developed post extubation is one of the major risk factor for extubation failure. Post extubation laryngeal edema occurs in up to 37% of the extubations. Steroids are commonly used pre extubation to prevent development of laryngeal edema. Aim of this study was to find whether steroids can prevent post extubation laryngeal edema and types of patients who ...
 

 Open Access DOI:10.23937/2474-3674/1510012

Almost Total Airway Obstruction Due to Unidentified Massive Hemoptysis under Extracorporeal Membrane Oxygenation

Satoshi Kazuma, Yoshiki Masuda, Hiroomi Tatsumi, Kanako Takahashi, Shinichiro Yoshida, Maiko Honma, Hitoshi Imaizumi and Michiaki Yamakage

Article Type: Case Report | First Published: February 26, 2016

A 54-year-old female weighing 62 kg had hemoptysis with an unidentified focus 4 months before and had been followed in the Department of Respiratory Medicine. Angiographic embolization was performed for a right bronchial artery ramification suspected of being the bleeding focus by bronchofiberscopy, but there were few effects. Right middle lobectomy was performed to control the persistent hemoptysis, and tracheal extubation was performed on the s...
 

 Open Access DOI:10.23937/2474-3674/1510011

Inter-hospital Critical Care Transport: Implementation of a Novel Policy and Review of the Literature

Andrea M Pakula, Jannet Gannon, Lisa Mundy, Kathleen Berns, Anita Stoltenberg and Beth A Ballinger

Article Type: Literature Review | First Published: January 30, 2016

The decision to transport a critically ill patient is based on the need for diagnostic or therapeutic procedures that are not available within the intensive care unit. Most commonly this type of transport is within the home facility and is for procedures such as imaging or for operative intervention. Theoretically, intra-hospital transfers are safer than the transfers to another institution, as transfers outside of the home facility tend to requi...
 

 Open Access DOI:10.23937/2474-3674/1510010

Inadvertent Late Migration of Jugular Catheter and Bilateral Pleural Effusion and Pneumomediastinum

Yiheng Wang, Lixian He, Xiaoling Hu, Zhigang Zhou, Hong Zhou

Article Type: Case Report | First Published: January 30, 2016

The authors report an inadvertent late migration of right jugular catheter and the unexpected complications. Postoperative computed tomography reveals bilateral pleural effusion and pneumomediastinum. We speculate that the migration during the maintenance or multiple attempts of placing a guidewire damaged the wall of right brachiocephalic vein or superior vena cava, and punctured through right pleura and anterior mediastinal leading into the com...
 

 Open Access DOI:10.23937/2474-3674/1510009

High Flow Conditioned Oxygen Therapy for Prevention of Reintubation in Critically Ill Patients: A Preliminary Cohort Study

Gonzalo Hernandez, Concepcion Vaquero Collado, Susana Garcia Plaza, Ana Villasclaras Pacheco, Candido Pardo Rey, Eugenia de la Fuente O'Connor, Rafael Cuena, Paloma Gonzalez Arenas, Rafael Fernandez

Article Type: Original Research Article | First Published: December 31, 2015

Oxygen delivery after extubation is the cornerstone treatment to maintain adequate oxygenation and avoid reintubation. Oxygen is usually delivered through low-flow nasal prongs; when necessary, flow is increased or patients are switched to a high-flow face mask. Some other interventions after extubation focus on specific causes of reintubation; for example, high risk patients are administered prophylactic corticosteroids before planned extubation...
 

 Open Access DOI:10.23937/2474-3674/1510008

Relationship Between Isolating Multi-Drug Resistant A. Baumannii and K. Pneumoniae in Bronchial Aspirate and Subsequently in Blood Cultures: Evaluation of Colistin Aerosol Therapy in Intensive Care Patients

Distasi Maria Antonietta, Del Gaudio Tito, Malcangi Annarita and Pirronti Angela

Article Type: Research Article | First Published: December 30, 2015

Klebsiella pneumoniae (K. pneumoniae) and Acinetobacter baumannii (A. baumannii) are multiresistant pathogens most frequently found in patients hospitalized in the Intensive Care of our hospital. We found the highest rate of positivity in the bronchial aspirates, often followed by a similar observation in blood culture. We carried out a study to evaluate the reduction of sepsis that developed after the detection of these microorganisms in bronchi...
 

 Open Access DOI:10.23937/2474-3674/1510007

Glycemic Disturbances on Admission as a Predictor of Inpatient Mortality

Daniel Saenz-Abad, Jose Antonio Gimeno-Orna, Maria del Carmen Lahoza-Perez, Elena Rivero-Sanz, Marta Jordan-Domingo, Artur Juan-Arribas, Maria del Mar Becerra-Mayor and Cristina Baquer-Sahun

Article Type: Original Research | First Published: October 30, 2015

This is a case-control retrospective analytical study. The cases were patients deceased during hospitalization and controls where those discharged in the same time period. Patients were age-matched and the final outcome of the study was hospital mortality. Rapid Emergency Medicine Score (REMS) and Charlson comorbidity index as well as blood analysis (full blood count, glucose, renal function, ions) were determined. Abnormal glucose levels (dysgly...
 

 Open Access DOI:10.23937/2474-3674/1510006

Ventricular Arrhythmias in Acute Coronary Syndrome Patients: Therapy of Electrical Storm

Tobias Willich and Andreas Goette

Article Type: Review Article | First Published: October 01, 2015

This review provides an overview of the available therapeutic options for acute care and management of malignant ventricular arrhythmias (VA) such as ventricular tachycardia (VT), ventricular fibrillation (VF) and electrical storm (ES). As therapeutic options antiarrhythmic drug (AAD) therapy, implantable cardioverter defibrillator therapy (ICD), radiofrequency catheter ablation (RFA) and neuroaxial modulation like stellate ganglion blockade or r...
 

 Open Access DOI:10.23937/2474-3674/1510005

To Give or Not To Give - Is that the Question?: The Changing Face of Emergency Oxygen Therapy

Carol Ann Kelly and Dave Lynes

Article Type: Non-systematic Review | First Published: September 14, 2015

Oxygen's image, together with its reputation, is changing. No longer is it regarded as a benign panacea for all clinical presentations; indeed it is now increasingly evident that oxygen has the potential to contribute to clinical deterioration and mortality. There is an emerging recognition that oxygen is a drug when administered as a therapeutic intervention and should be used with caution. Contemporary guidelines offer criteria and directives f...
 

 Open Access DOI:10.23937/2474-3674/1510004

Cerebral Fat Embolism Syndrome: Diagnostic State of the Art: with and without Intra-medullary Fixation, with and without Long Bone Fractures

Bethany Radin DO, H Neal Reynolds, Uttam K Bodanapally and David Dreizin

Article Type: Research Article | First Published: August 31, 2015

Objective: To review the spectrum of scenarios in which cerebral fat embolism syndrome (CFES) may present, the clinical presentation, traditional diagnostic criteria, and current diagnostic technologies. Methods: Three cases are presented representing Classical presentation (CFES presenting after Intramedullary rods for long bone fractures), Atypical presentation (CFES presenting after long bone fractures without intramedullary rods), and Unexpec...
 

 Open Access DOI:10.23937/2474-3674/1510003

Albuminuria in Critically lll Patients: A Prospective Cohort Study

oortje Godijn, Simone M Smits and Peter HJ van der Voort

Article Type: Original Article | First Published: August 14, 2015

In the intensive care unit (ICU) physicians are challenged to predict patient outcome when patients are admitted. Over the years, several tools have been developed for this purpose. Examples are the Acute Physiology and Chronic Health Evaluation (APACHE) and Sepsis Related Organ Failure Assessment (SOFA) scoring systems....
 

 Open Access DOI:10.23937/2474-3674/1510002

Use of Dexmedetomidine in the Management of Alcohol Withdrawal Syndrome in Critically Ill Patients

Julie Kalabalik and Jesse B. Sullivan

Article Type: Review Article | First Published: July 30, 2015

Alcohol consumption plays a role in the development of over 200 diseases and conditions in individuals worldwide, including liver cirrhosis, cancers, traumatic injury, and alcohol dependence. In hospitalized patients with alcohol use disorders (AUD), up to 25% will develop acute alcohol withdrawal syndrome (AWS). In critically ill patients, presence of AWS is associated with increased duration of mechanical ventilation, prolonged intensive care u...
 

 Open Access DOI:10.23937/2474-3674/1510001

Protocols for Uncontrolled Donation after Circulatory Death: International & Comprehensive Analysis

Ivan Ortega Deballon

Article Type: Editorial | First Published: July 18, 2015

Determination of death, the exact moment that a person's death occurs, has been a constant challenge throughout human being history. What we already know is that death usually does not occur abruptly, at a specific time and for all parts of the body simultaneously. Human resistance to degradation by lack of oxygen varies depending on the type of cell and organ. It is possible, for example, for successful cornea transplants from deceased individua...

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Aspirin-Triggered Resolvin D1 Versus Dexamethasone in the Treatment of..
Pubmed ID:27110599 | PMC ID:PMC4841619
Elder Mistreatment and its Subtypes across Different Sociodemographic and..
Pubmed ID:26973979 | PMC ID:PMC4786076
Balance and its Clinical Assessment in Older Adults - A Review..
Pubmed ID:26942231 | PMC ID:PMC4773046
Caregiver Abuse of Chicago Chinese Older Adults in a Community..
Pubmed ID:27606358 | PMC ID:PMC5008847
The Relationship of Older Adults' Physical Pain to Depression and..
Pubmed ID:27642644 | PMC ID:PMC5023019
Sphingosine 1-Phosphate Receptor 2 Regulates the Migration,..
Pubmed ID:27275017 | PMC ID:PMC4888913
Mammary Epithelial Cell Lineage Analysis via the Lyon's Hypothesis..
Pubmed ID:27453956 | PMC ID:PMC4957014
Epigenetic Loss of MLH1 Expression in Normal Human Hematopoietic Stem Cell..
Pubmed ID:27570841 | PMC ID:PMC4996274
Long-Term Function, Pain and Medication Use Outcomes of Radiofrequency..
Pubmed ID:26005713 | PMC ID:PMC4440581
Caspase Cleaved Tau in Alzheimer's Disease: A Therapeutic Target..
Pubmed ID:25639474 | PMC ID:PMC4308811
Corpora Amylacea in Neurodegenerative Diseases: Cause or Effect?..
Pubmed ID:26550607 | PMC ID:PMC4634668
Differences in ME and CFS Symptomology in Patients with Normal and..
Pubmed ID:28713856 | PMC ID:PMC5510614
Gene-Specific Promoter Methylation Status in Hormone-Receptor-Positive..
Pubmed ID:26005715 | PMC ID:PMC4440485
A Derivative of Differentiation-Inducing Factor-3 Inhibits PAK1..
Pubmed ID:26688830 | PMC ID:PMC4682050
Overcoming Endocrine Resistance in Hormone-Receptor Positive Advanced..
Pubmed ID:26726315 | PMC ID:PMC4697745
Zinc Ionophore (Clioquinol) Inhibition of Human ZIP1-Deficient Prostate..
Pubmed ID:26878064 | PMC ID:PMC4751054
Electron Microscopic Analysis of Silicate and Calcium Particles..
Pubmed ID:27158665 | PMC ID:PMC4858188
Effects of chest physical therapy in patients with non-tuberculous mycobacteria
Pubmed ID:28804763 | PMC ID:PMC5552049
A Community-Based Exercise and Support Group Program Improves Quality..
Pubmed ID:26640827 | PMC ID:PMC4667740
Four Weeks of Balance Training Does Not Affect Ankle Joint Stiffness in Subjects..
Pubmed ID:27642647 | PMC ID:PMC5025258
Social Ecology and Diabetes Self-Management among Pacific Islanders..
Pubmed ID:28736764 | PMC ID:PMC4516390
Examining Characteristics of Hospitalizations in Heart Failure Patients: Results..
Pubmed ID:28736765 | PMC ID:PMC5517048