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Chest pain is a common presentation to the emergency department (ED) that can be caused by a multitude of etiologies. It can be challenging to differentiate life-threatening conditions from more benign causes. A 54-year-old woman presented to the ED complaining of chest pain with dyspnea in the setting of recent blunt trauma. This case offers a thorough yet practical approach to the diagnostic workup of chest pain with dyspnea in the ED setting. The surprising final diagnosis and case outcome are then revealed. [ABSTRACT FROM AUTHOR]

Introduction: Rectus abdominis muscle strains are common and can be debilitating in both professional and amateur athletes who engage in strenuous activity. Case Report: We report a rare case of rectus abdominis muscle tear in an amateur bodybuilder diagnosed by point-of-care ultrasound (POCUS) in the emergency department (ED). The patient had presented to the ED three separate times after strenuous exercise, received costly diagnostic workups, and ultimately was diagnosed on the third visit with grade 2 bilateral rectus abdominis tear. The patient was given appropriate education and sports medicine follow-up. He underwent rehabilitation focused on trunk and core stability. At eight-week follow-up, the patient had made a full recovery. Conclusion: To our knowledge, a case of bilateral rectus abdominis tear diagnosed by ultrasound in the emergency setting has not been previously published. Our case report highlights the utility of POCUS in diagnosing musculoskeletal pathology and preventing costly bounce-back visits. [ABSTRACT FROM AUTHOR]

Introduction: Visceral arterial aneurysms and pseudoaneurysms are rare but dangerous pathologies, with reported incidence of 0.01–0.2% of the worldwide population, as found on autopsy. Pancreaticoduodenal artery pathology accounts for approximately 2% of all visceral aneurysms; it is commonly caused by chronic inflammatory processes, such as pancreatitis or adjacent pseudocysts. Morbidity and mortality commonly result from rupture of the aneurysm itself, leading to life-threatening hemorrhage into the peritoneum or gastrointestinal tract. Case Report: Here we present the case of a 64-year-old male patient with previous history of alcohol use disorder leading to chronic pancreatitis and prior embolization of an inferior pancreaticoduodenal pseudoaneurysm, who presented to the emergency department (ED) with abdominal pain, nausea, and vomiting, and was found to have a large recurrent inferior pancreaticoduodenal pseudoaneurysm with associated obstructive cholangitis and pancreatitis via contrast-enhanced computed tomography (CT) of the abdomen and pelvis. The patient was managed emergently by interventional radiology angiography with embolic coiling and percutaneous biliary catheter placement, and he subsequently underwent biliary duct stenting with gastroenterology. The patient was successfully discharged after a brief hospitalization after resolution of his pancreatitis and associated hyperbilirubinemia. Conclusion: Pancreaticoduodenal artery aneurysms and pseudoaneurysms are rare and dangerous visceral pathologies. Patients can be diagnosed rapidly in the ED with CT imaging and need urgent endovascular management to prevent morbidity and mortality. [ABSTRACT FROM AUTHOR]

Introduction: Peritonsillar abscesses form between the tonsillar capsule, the superior constrictor, and palatopharyngeus muscles. Physicians traditionally make this diagnosis clinically; however, ultrasound allows clinicians to further identify and differentiate between peritonsillitis, peritonsillar abscess, and phlegmon formation. By increasing both the sensitivity and specificity, ultrasound improves the diagnostic accuracy for patients with peritonsillar abscesses. This case demonstrates the utilization of ultrasound in peritonsillar abscesses and the application of point-of-care ultrasound (POCUS) in identifying complications of procedures used for treatment in the emergency department (ED). Case Report: A 19-year-old male presented to the ED with complaints of severe sore throat and fever for the prior five days. A POCUS using an endocavitary probe with sterile cover demonstrated hypoechoic debris with a “swirl sign.” Ultrasound was used to successfully guide needle aspiration by using in-plane needle guidance. The patient had significant bleeding after needle aspiration, and repeat POCUS clearly identified a new pocket of blood that had formed and was contained in the soft tissue. We monitored the size of the hematoma in real time with ultrasound to ensure the hematoma had no rapid expansion and was stable. Conclusion: Among the differential diagnoses for sore throat, the diagnosis of peritonsillar abscess is particularly concerning as it is both common and generally requires swift intervention. Presentations can range from a mild infection to a life-threatening emergency with potential airway compromise. The two primary avenues for treatment include either needle aspiration or incision and drainage. Ultrasound can successfully identify the abscess and other landmarks for safe and successful drainage, as well as early identification of complications. [ABSTRACT FROM AUTHOR]

Introduction: Cerebrovascular accidents rarely occur in children; the incidence of ischemic stroke in patients <16 years of age is between 0.6–7.9/100,000. However, they are the fourth most common cause of acute neurological deficits in the pediatric population, and possible cases should be evaluated with a high index of suspicion to ensure timely intervention. Case Report: We describe a previously healthy 17-year-old male who presented to the pediatric emergency department with a left facial droop and hemiparesis consistent with a stroke. The patient’s age and lack of comorbidities made this an extremely uncommon presentation. Our patient’s neurologic symptoms were believed to have been caused by a recent traumatic clavicular injury sustained two weeks prior, which subsequently led to vascular insult. Conclusion: Cerebrovascular accidents are an important cause of morbidity and mortality in pediatric patients. Cerebrovascular accidents in children are most often secondary to congenital causes; however, care should be taken to assess for acquired causes, such as trauma to major blood vessels. While rarely implicated in traumatic injuries, arterial structures posterior to the medial clavicle can result in severe complications. [ABSTRACT FROM AUTHOR]

Introduction: Ferric derisomaltose is the newest available parenteral iron formulation. Studies have demonstrated a good safety profile with improved tolerability compared to alternative parenteral iron formulations. To date there have been no reported acute, life-threatening cardiac events associated with ferric derisomaltose. Case Report: An 86-year-old male who had previously tolerated routine iron infusions received a first dose of ferric derisomaltose at an outpatient infusion clinic. Six minutes into the infusion the patient became unresponsive with no palpable pulse. Return of spontaneous circulation was achieved after two minutes of chest compressions. Electrocardiogram showed complete heart block requiring transcutaneous pacing and vasopressor administration. The patient was transferred to the emergency department for stabilization and then admitted to the cardiac intensive care unit. During admission, the patient received a dual-chamber, permanent pacemaker without complication and was ultimately discharged. Conclusion: It may be reasonable to consider parenteral iron as a toxicological etiology for patients presenting with complete heart block temporally associated with parenteral iron administration, particularly in patients with underlying conduction abnormalities. [ABSTRACT FROM AUTHOR]

Introduction: Phlegmasia cerulea dolens (PCD) is an uncommon, potentially life-threatening complication of acute deep venous thromboses that requires a timely diagnosis. The name of the condition, the visual diagnostic criteria, and the preponderance of cases in the literature referencing findings exclusively in patients with lighter skin complexions means that PCD may not be on the differential diagnosis for the patient with more melanated skin who is experiencing this time-sensitive vascular emergency. Case Report: We describe one case of PCD in a patient with darker skin complexion and the importance of identifying clinical findings, regardless of skin color, given the paucity of reference images for PCD in darker complected patients. Our literature review yielded 60 case reports for PCD. Only two papers included images referencing patients of color. Conclusion: Accurate diagnosis requires recognition of diagnostic findings, which may vary significantly between phenotypically distinct populations. Many pathognomonic physical exam findings rely on descriptors based on presentation in phenotypically white patients. [ABSTRACT FROM AUTHOR]

Introduction: Severe hypernatremia is a critical situation, and when coupled with intravascular depletion and hypotension can create a treatment dilemma. Case Report: We present the case of a medically complex patient who had gradually worsening alteration of mental status and mean arterial pressures in the 50s on presentation to the emergency department. Conclusion: Final diagnoses included severe hypernatremia and hypovolemic shock secondary to poor oral intake. We used judicious fluid repletion with gradual improvement in sodium levels and permissive hypotension to avoid rapid osmotic shifts. Balancing reperfusion and the risk for osmotic effects of aggressive fluid resuscitation can be a challenging situation for the multidisciplinary team. [ABSTRACT FROM AUTHOR]

Introduction: Accurate diagnosis of traumatic arthrotomy of the knee (TAK) is critical for patients presenting to the emergency department (ED) to ensure timely treatment. Current diagnostic modalities including plain radiography, computed tomography (CT), and the saline load test (SLT) have advantages and disadvantages. Point-of-care-ultrasonography (POCUS) offers a possible timely, low-cost, and efficient alternative method of diagnosing TAK. In this case series we present three cases where POCUS was used to diagnose TAK in the ED. Case Series: Three patients in their early 20s presented to the ED complaining of knee trauma with wounds in proximity to the joint. Mechanisms of injury included a gunshot wound in one case and blunt trauma (motor vehicle collision and bicycle crash) in two cases. In all three cases TAK was suggested on POCUS examinations by the presence of intra-articular hyperechoic foci consistent with air artifact. All three cases had TAK confirmed by orthopedic evaluation. Discussion: Ultrasound may have utility in the evaluation of patients presenting with knee trauma where TAK is a concern. The SLT is generally considered the gold standard test for diagnosis of TAK, but it is invasive and has a wide range of diagnostic accuracy. Intra-articular air has been found to be a sensitive marker for TAK in CT studies. Thus, additional investigations into the diagnostic accuracy of POCUS for this finding should be undertaken. [ABSTRACT FROM AUTHOR]

Background: Healthcare medical dispatch systems play a fundamental role in the daily operations of prehospital services. This study aims to describe the curriculum development of the Emergency Medical Dispatch (EMD) Program to improve the training of dispatchers and to share the experience in the interest of better prehospital dispatch systems. Methods: A selected group of education experts and academics in emergency medical services dispatch were assigned to develop an EMD curriculum over 6 months. The data of this study was collected by reviewing approved documents of the EMD Program including program curriculum, syllabus, logbook, and exam blueprint after approval letters were received from the Health Academy, Saudi Commission for Health Specialties. Results: The development of the EMD program utilized a consecutive mixed approach starting with a competency-based with backward design method to ensure the achievement of targeted outcomes followed by the Kern Six-step curriculum development model, namely: (1) problem identification and general need assessment; (2) targeted need assessment; (3) goals and objectives; (4) educational strategies; (5) implementation; and (6) evaluation and feedback. This resulted in four comprehensive modules with a 14-week EMD Program. Conclusion: EMD services play a fundamental role in the daily operations of prehospital healthcare services. Developing an EMD Program with a consecutive mixed approach might improve the current operations of EMD services. [ABSTRACT FROM AUTHOR]

Copyright of Izmir Katip Celebi University Faculty of Health Sciences Journal / İzmir Katip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi is the property of Izmir Katip Celebi University, Faculty of Health Sciene Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

(1) Background: First aid administered during road accidents can save millions of lives. However, the knowledge and attitudes of the Jordanian population towards first aid are lacking. This study aimed to examine the knowledge, attitudes, and barriers to performing first aid among the Jordanian population during road accidents. (2) Methods: An online questionnaire was developed and distributed using various Jordanian social media platforms. The questionnaire collected the participants' sociodemographic details and assessed their first aid knowledge, attitudes toward first aid, and barriers preventing the participants from performing first aid in emergencies. (3) Results: 732 participants participated in this study. The median knowledge score regarding first aid items was 9 (7–10) out of the maximum possible score of 15. The median first aid attitude score was 24 (22–27) out of a maximum possible score of 30. The most commonly reported barrier to performing first aid among the participants was "lack of first aid training" (76.78%), followed by "lack of knowledge about first aid" (75.81%) and "fear of performing first aid" (57.51%). The participants with lower income levels exhibited more negative attitudes towards first aid (4). Conclusions: This study underscores the urgent need for enhanced first aid training and awareness in Jordan. The participants' first-aid knowledge overall was limited, although positive attitudes toward first-aid delivery were observed. The findings emphasize the need for regular and structured first-aid training courses, addressing barriers such as fear and misinformation and ensuring accessibility across all socioeconomic levels to improve preparedness for road traffic accidents and other emergencies. This comprehensive approach can better equip the Jordanian population to effectively manage emergencies and improve public health outcomes. [ABSTRACT FROM AUTHOR]

In-flight medical incidents are becoming increasingly critical as passengers with diverse health profiles increase in the skies. In this paper, we reviewed how airlines, aviation authorities, and healthcare professionals respond to such emergencies. The analysis was focused on the strategies developed by the top ten airlines in the world by examining training in basic first aid, collaboration with ground-based medical support, and use of onboard medical equipment. Appropriate training of crew members, availability of adequate medical resources on board airplanes, and improved capabilities of dialogue between a flying plane and medical doctors on the ground will contribute to a positive outcome of the majority of medical issues on board airlines. In this respect, the adoption of advanced telemedicine solutions and the improvement of real-time teleconsultations between aircraft and ground-based professionals can represent the future of aviation medicine, offering more safety and peace of mind to passengers in case of medical problems during a flight. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the knowledge levels of parents in the Albaha region regarding pediatric eye emergencies, explore demographic influences, and propose tailored interventions to enhance awareness. Methods: The study was conducted in the Albaha region of Saudi Arabia, employing a quantitative design with an online questionnaire. Results: The study was conducted among 402 participants, with an even gender distribution of (n = 201, 50%) males and (n = 201, 50%) females. There was a significant representation in the 41-50 years age range (n = 125, 31.1%), with a majority holding a diploma or university degree (n = 264, 65.7%). The experiences of participants with pediatric ocular emergencies showed that 153 individuals (38.1%) had come across such circumstances. As a whole, 171 (42.5%) were judged inadequate, and 231 (57.5%) showed adequate knowledge. Significant associations were observed between knowledge levels and gender in favor of females (p -value = 0.003) and having experienced an eye emergency in children (p -value = 0.021), with no significant difference considering age, educational level, or residency. Conclusion: This study revealed that participants exhibited a moderate level of knowledge, while the study underscores the need for targeted educational interventions addressing gender-specific disparities and leveraging personal experiences. Tailored programs can enhance awareness and improve outcomes in pediatric eye emergencies. This research lays the groundwork for future initiatives aimed at fostering a well-informed community in the Albaha region. [ABSTRACT FROM AUTHOR]

Copyright of Revista Científica de Enfermería (2071-5080) is the property of Colegio de Enfermeros del Peru and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Reconstructive Urology is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Reconstructive Urology is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Reconstructive Urology is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Reconstructive Urology is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Although game-based applications have been used in disaster medicine education, no serious computer games have been designed specifically for training these nurses in an IEMT setting. To address this need, we developed a serious computer game called the IEMTtraining game. In this game, players assume the roles of IEMT nurses, assess patient injuries in a virtual environment, and provide suitable treatment options. Methods: The design of this study is a retrospective comparative analysis. The research was conducted with 209 nurses in a hospital. The data collection process of this study was conducted at the 2019-2020 academic year. A retrospective comparative analysis was conducted on the pre-, post-, and final test scores of nurses in the IEMT. Additionally, a survey questionnaire was distributed to trainees to gather insights into teaching methods that were subsequently analyzed. Results: There was a significant difference in the overall test scores between the two groups, with the game group demonstrating superior performance compared to the control group (odds ratio = 1.363, p value = 0.010). The survey results indicated that the game group exhibited higher learning motivation scores and lower cognitive load compared with the lecture group. Conclusions: The IEMT training game developed by the instructor team is a promising and effective method for training nurses in disaster rescue within IEMTs. The game equips the trainees with the necessary skills and knowledge to respond effectively to emergencies. It is easily comprehended, enhances knowledge retention and motivation to learn, and reduces cognitive load. [ABSTRACT FROM AUTHOR]

Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100 years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception. [ABSTRACT FROM AUTHOR]

Background: Bites caused by European vipers are rare medical emergencies but can occasionally cause life-threatening complications. Viper venom causes local symptoms, which can be accompanied by systemic manifestations in severe cases. The local effects of snakebites include edema and, more rarely, necrosis and compartment syndrome. The consequences of envenomation are often more pronounced in children due to their smaller body size. Case presentation: We present the case of a 6-year-old girl who experienced multiple viper bites in the lower limb in northwest Italy. The girl received supportive care but progressed to develop compartment syndrome that required emergency fasciotomy. The patient's condition improved promptly after surgical decompression and administration of antivenom, but full recovery required prolonged hospitalization and rehabilitation. Conclusions: This case highlights the importance of obtaining a timely assessment of the severity of viper envenomation without delaying the administration of antivenom in most serious cases. The presence of multiple bite marks on the patient is one factor that may help to predict the clinical severity of snakebites and anticipate symptom progression. [ABSTRACT FROM AUTHOR]

The SmartEUS project aims to design, develop, and test a highly innovative model for the provision of Emergency Urgency Services (EUS) based on the concept of clinical pathway (i.e., the entire emergency care chain). The project is innovative both from an organizational and technological point of view. It is based on an e-Health approach, capable of exploiting new digital technologies in a coordinated way to support the evolution of emergency health systems towards dynamic and safer processes. The paper presents the SmartEUS platform which can integrate the information from all the key players in medical emergency response (emergency operation center, emergency medical service, hospital emergency department) improving their coordination. The most relevant innovations of the proposed solution are data integration and interoperability, advanced communication and collaboration, knowledge-based resource allocation, telemedicine integration to support decision making in dispatching and resource assignment. In fact, a Decision Support System is integrated into SmartEUS cloud platform to suggest to the emergency operation center which emergency medical service and hospital emergency department. In fact, information on the patient status can include results from ambulance's on board telediagnosis equipment, alerting the hospital emergency department even before the arrive of the patient, thus guaranteeing the appropriateness of care according to patient needs (e.g., patient pre-triage index, potential pre-hospital diagnosis) and reducing emergency department overcrowding and resources saturation. [ABSTRACT FROM AUTHOR]

Background: Recent research has indicated that sex is an important determinant of emergency medical response in patients with possible serious injuries. Men were found to receive more advanced prehospital treatment and more helicopter transportation and trauma centre destinations and were more often received by an activated trauma team, even when adjusted for injury mechanism. Emergency medical dispatchers choose initial resources when serious injury is suspected after a call to the emergency medical communication centre. This study aimed to assess how dispatchers evaluate primary responses in trauma victims, with a special focus on the sex of the victim. Methods: Emergency medical dispatchers were interviewed using focus groups and a semistructured interview guide developed specifically for this study. Two vignettes describing typical and realistic injury scenarios were discussed. Verbatim transcripts of the conversations were analysed via systematic text condensation. The findings were reported in accordance with the Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist. Results: The analysis resulted in the main category "Tailoring the right response to the patient", supported by three categories "Get an overview of location and scene safety", "Patient condition" and "Injury mechanism and special concerns". The informants consistently maintained that sex was not a relevant variable when deciding emergency medical response during dispatch and claimed that they rarely knew the sex of the patient before a response was implemented. Some of the participants also raised the question of whether the Norwegian trauma criteria reliably detect serious injury in women. Conclusions: The results indicate that the emergency medical response is largely based on the national trauma criteria and that sex is of little or no importance during dispatch. The observed sex differences in the emergency medical response seems to be caused by other factors during the emergency medical response phase. [ABSTRACT FROM AUTHOR]

Background: Snakebites are a dangerous and significant medical emergency that occurs worldwide. The World Health Organization has recommended that teaching and training in the prevention and management of snakebites be included in the curriculum of nursing schools and other educational activities. Identification of venomous snakes and first aid would be more critical in the prevention of occupational danger worldwide. This study aims to assess the knowledge in identifying venomous snakes, snakebites, and first aid methods of snakebites among nursing students in the Southern Province of Sri Lanka. Methods: A descriptive, cross-sectional study was performed among 425 nursing students who were studying in different educational settings: undergraduates at the University of Ruhuna, and nursing students in the three schools of nursing in Galle, Matara, and Hambantota. Data were gathered by incorporating a pre-tested self-administered questionnaire after obtaining institutional permission. The total score of whole knowledge ranged from 0 to 34 for the identification of venomous snakes. Data collection was performed after obtaining ethical clearance from the Ethics Review Committee, Faculty of Allied Health Sciences, University of Ruhuna, Sri Lanka. Results: Most of the students (82.6%) were in the 24–26 age category and the majority were females. Most of the sample (64.7%) had low knowledge of identifying venomous snakes. A higher percentage of students (57.4%) had a sufficient level of knowledge about first aid methods associated with snakebites and 169 participants (39.8%) had a high level of knowledge regarding first aid methods. Further, a significant impact on students' knowledge and knowledge of first aid methods was reported. Conclusion and recommendation: The overall knowledge of identifying venomous snakes among the nursing students was inadequate. However, the knowledge about the first aid methods was at a moderate level. Strategies are needed to improve knowledge in identifying venomous snakes and first aid methods of snakebites amongst nursing students in both educational settings. [ABSTRACT FROM AUTHOR]

Objective: This study investigated changes in mental health in Hong Kong over two years and examined the role of resilience and age in mitigating the negative effects of public health emergencies, particularly the COVID‐19 pandemic. Methods: Complete data of interest from two telephone surveys conducted in 2020 (n = 1182) and 2021 (n = 1108) were analysed. Participants self‐reported depressive and anxiety symptoms using the Patient Health Questionnaire 4‐item version (PHQ), psychotic‐like experiences (PLEs) using three items from the Prodromal Questionnaire Brief (PQB), and resilience using the Connor‐Davidson Resilience Scale 2‐item version (CD‐RISC‐2). Results: We observed an increase in the percentage of participants with high depressive and anxiety symptoms and PLEs from 1.6% to 6.5% between 2020 and 2021. The likelihood of having high depressive and anxiety symptoms or PLEs depended on resilience and age, with no significant between‐year differences. Resilience and age interaction effects were significant when comparing the high PHQ‐high PQB group to the low PHQ‐low PQB group only in 2021 but not in 2020. Conclusions: This study provides valuable insights into the impact of the COVID‐19 pandemic on mental health in Hong Kong, emphasising the age‐dependent nature of resilience in mitigating negative effects. Future research should explore the mechanisms by which resilience promotes mental health and well‐being and identify ways to enhance resilience among older individuals during public health crises. Key points: COVID‐19 had a significant impact on mental health with depressive and anxiety symptoms and psychotic‐like experiences being a concern.Resilience is a protective factor, weaker in older participants, against depressive and anxiety symptoms and psychotic‐like experiences.Targeted support strategies should consider age‐related differences in resilience to promote mental well‐being during public health crises. [ABSTRACT FROM AUTHOR]

Person reference is pervasive in talk. Conversation analytic work has identified preferences in person reference relating to recognitional reference. However, the principles shaping nonrecognitional reference are less well understood. We propose a preference for association in an institutional setting in which recognition is not relevant. Our data are calls to the New Zealand police emergency line that were institutionally classified as family harm. Using a collection methodology, we found that nonrecognitional person reference typically takes the form my x which directly associates speaker and referent, for example, "my partner," "my ex-partner," "my dad." Initial references that suggest no association (e.g. "someone" or "an abusive guy") were subsequently revised by callers using self-repair or targeted by call takers through questions that seek clarification about association. The shifts from nonassociative to associative references demonstrate participants' orientations to the relevance of association and are evidence of a preference for association in the setting under examination. Data are in English. [ABSTRACT FROM AUTHOR]

We examine occasions when callers phone emergency services yet preface their reason for calling as "not an emergency." Data are phone calls to U.S. (911) and U.K. (999) emergency lines and U.K. (101) nonemergency police lines. Data were transcribed using Jefferson conventions and analyzed using conversation analysis. The "not an emergency" formulation is recurrently used to mark a shaky or borderline fit between the caller's situation and the emergency category presumed by the dedicated phoneline. Typically, "not an emergency" formulations prefaced descriptions of a possible emergency in which the caller balances the justification for the call on the boundary of what counts as an emergency. Recurrent concerns for callers using "not an emergency" are to manage preemptive calls about impending potential emergency, and to disclaim responsibility for the decision to call an emergency service. Call takers offer callers latitude to present a complicated description of their circumstances instead of swiftly sanctioning them for an inappropriate call. Our article contributes to work on how the boundaries between categories are constructed and negotiated in interaction. Data are in British and American English. [ABSTRACT FROM AUTHOR]

Introduction: Pursuant to the COVID-19 pandemic, an executive order issued by the New York State (NYS) governor allowed pharmacists to act as laboratory directors for a limited-service laboratory (LSL) to order and perform Food and Drug Administration (FDA) and Emergency Use Authorization (EUA) Clinical Laboratory Improvement Amendment (CLIA)-waived COVID-19 point-of-care testing (POCT). Objectives: To (i) assess the status of NYS community pharmacists with POCT in the early stages of the COVID-19 pandemic, (ii) assess the readiness and willingness of community pharmacists to incorporate COVID-19 POCT into their workflow during a pandemic, and (iii) assess community pharmacists' perception of the barrier to initiating COVID-19 POCT. Methods: This is a prospective cross-sectional study conducted from February 4 to February 21, 2021. An electronic survey consisting of 66 Likert-type questions, select all that apply, and fill-in-style questions were emailed to 250 Community Pharmacy Enhanced Service Network (CPESN) NY pharmacies, with a follow-up email sent halfway into the data collection period. The data were analyzed using descriptive statistics. Results: The result indicated that most participants (median = 5) demonstrated readiness and willingness to offer COVID-19 testing. Barriers to COVID-19 POCT were identified: impact on pharmacy workflow (59%), lack of payment mechanism (55%) and lack of sufficient training (21%). Most participants expressed interest in continuing POCT beyond the pandemic (86.1%). Conclusion: Community pharmacists in NYS reported willingness to initiate COVID-19 POCT. Addressing the identified barriers, such as workflow disruption and reimbursement challenges, will enable pharmacies to be better prepared to provide patient care, including POCT. [ABSTRACT FROM AUTHOR]

Background: Before the arrival of patients at medical facilities, emergency medical teams often encounter numerous challenges in dealing with mass casualties resulting from road traffic accidents. This study examines the challenges that pre-hospital emergency medical services face during mass casualty incidents caused by road traffic accidents. Materials and Methods: This... [ABSTRACT FROM AUTHOR]

Background: Pre-hospital care is crucial in supervising and handling urgent patients and medical crises. Emergency medical centers' swifter response and heightened precision lead to time efficiency and alleviate the burden on hospital capacities. This research pinpoints the influential factors contributing to the enhancement of pre-hospital emergency time indicators at Qazvin... [ABSTRACT FROM AUTHOR]

This compilation covers emergency medical management lessons from the February 6th Kahramanmaraş earthquakes. The objective is to review relevant literature on emergency services patient management, focusing on Koenig's 1996 Simple Triage and Rapid Treatment (START) and Secondary Assessment of Victim Endpoint (SAVE) frameworks. Establishing a comprehensive seismic and mass casualty incident (MCI) protocol chain is the goal. The prehospital phase of seismic MCIs treats hypovolemia and gets patients to the nearest hospital. START-A plans to expedite emergency patient triage and pain management. The SAVE algorithm is crucial for the emergency patient secondary assessment. It advises using Glasgow Coma Scale, Mangled Extremity Severity Score, Burn Triage Score, and Safe Quake Score for admission, surgery, transfer, discharge, and outcomes. This compilation emphasizes the importance of using diagnostic tools like bedside blood gas analyzers and ultrasound devices during the assessment process, drawing from 6 February earthquake research. The findings create a solid framework for improving emergency medical response strategies, making them applicable in similar situations. [ABSTRACT FROM AUTHOR]

* Context.--Two major categories of laboratories performing nonwaived testing under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) are the Certificate of Accreditation (CoA) and Certificate of Compliance (CoC) laboratories. Accreditation organizations collect more detailed laboratory personnel information than the Centers for Medicare & Medicaid Services (CMS) Quality Improvement and Evaluation System (QIES). Objective.--To estimate total numbers of testing personnel and testing volumes in CoA and CoC laboratories, by laboratory type and state. Design.--We developed a statistical inference method by using the respective correlations between testing personnel counts and test volume by laboratory type. Results.--QIES reported 33 033 active CoA and CoC laboratories in July 2021. We estimated testing personnel to be 328 000 (95% CI, 309 000-348 000), which is supported by the count of 318 780 reported by the US Bureau of Labor Statistics. There were twice as many testing personnel in hospital laboratories as in independent laboratories (158 778 versus 74 904, P < .001). Independent laboratories had the highest test volume per person, which was twice as high as physician office laboratories (62 228 versus 30 102, P < .001). Hospital and independent laboratories comprised 34% of all CoA and CoC laboratories but performed the largest portion of testing (81%). Physician office laboratories, accounting for 44% of all CoA and CoC laboratories, performed a comparatively low proportion of total tests (9%). Conclusions.--Numbers of testing personnel vary considerably by laboratory type and across states. These data can provide valuable insight when assessing laboratory workforce training needs and planning for public health emergencies. [ABSTRACT FROM AUTHOR]

People with disabilities, especially children and youth, are often not considered in emergency and disaster preparedness planning, which leaves them vulnerable and at a higher risk of the negative effects of natural and human caused disasters. The purpose of this study was to understand the extent of emergency and disaster preparedness and factors influencing preparedness among children and youth with disabilities and chronic conditions, their caregivers and service providers. Our scoping review involved searching six international databases that identified 1146 studies of which 27 met our inclusion criteria. The studies in this review involved 2613 participants (i.e., children, parents, educators and clinicians) across nine countries over a 20-year period. Our results highlighted the following trends: (1) the extent of emergency preparedness; (2) factors affecting emergency preparedness; and (3) interventions to enhance preparedness. Our findings underscore the critical need for more attention to emergency preparedness for children and youth with disabilities, their families and service providers and their inclusion in planning. Support is needed for emergency preparedness for children with disabilities at an individual, family and community level. Clinicians should assist children with disabilities and their families to develop a disaster and emergency preparedness plan that includes their medical needs, basic supplies and connections to relevant resources and supports. Clinicians and educators should advocate for the inclusion of children and youth with disabilities in emergency and disaster preparedness. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to assess the level of mental workload of Chinese nurses through a latent profile analysis and to explore its relationship with public health emergency response capacity. Design: A cross-sectional design with a convenience sample. Methods: A convenience sample of nurses from five tertiary hospitals in Chengdu between May and December 2022. Demographic, work-related information, Nurse's version of NASA's Task Load Index Scale and Nurse's Public Health Emergency Response Capacity Scale were used in this study. Results: The mean scores for mental workload and emergency response capacity for nurses were (57.19 ± 15.67) and (3.58 ± 0.77) respectively. We found that the mental workload of nurses fell into three potential categories. In addition, there were differences in psychological training and supply of epidemic prevention materials in the department among nurses with different mental workload subtypes. There was a moderate negative correlation between nurses' mental workload and public health emergency response capacity. Conclusion: Our results show that there is still a strong mental workload on a proportion of nurses, and enhanced psychological training and material supply support are beneficial in relieving nurses' mental workload. The better the nurses' capacity to cope with public health emergencies, the lower their mental workload. Impact: Nursing managers should pay ongoing attention to the mental workload status of nurses in the latter stages of a pandemic and individual differences in nurses' mental workload. In addition, nursing managers should be aware of the impact of public health emergency response capacity on nurses' mental workload. They can intervene in nurses mental workload from a new perspective. [ABSTRACT FROM AUTHOR]

The Strategic National Stockpile (SNS) is a national system maintained by the US federal government to deliver medical supplies during emergencies. In the past, the SNS has been used to mitigate public health consequences of tragedies, such as Hurricane Katrina and Ebola outbreaks. However, challenges in maintaining and utilizing the SNS for patient safety are prevalent. This article canvasses ways in which the SNS is accessed and suggests needed changes in the wake of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

In-flight medical emergencies (IMEs) are common during commercial airline flights. These events occur once every 100 to 1000 flights with pressurization corresponding to an altitude of 5000 to 8000 feet during the flight, low oxygen partial pressures and low humidity. This study was designed to evaluate the knowledge, confidence and attitudes of medical students in Saudi Arabia with regards to managing in-flight medical emergencies. A cross-sectional study targeting all medical students in Saudi Arabia was conducted using an online questionnaire. In total, we analyzed 378 medical students and interns; only 18% possessed an adequate perception of knowledge relating to IMEs; 36.8% felt assured in their IME response, 36.5% believed they could provide competent care, and only 34.5% considered their medical education was adequate for the treatment of IMEs. Our analyses showed that medical students in Saudi Arabia have inadequate confidence and knowledge in managing IMEs. Consequently, there is a significant gap in current medical school curricula in the Kingdom of Saudi Arabia that could be filled by implementing focused training on the management of IMEs. [ABSTRACT FROM AUTHOR]

Background: Following limited clinical exposure during the coronavirus disease 2019 pandemic, a simulation-based platform aimed at providing a unique and safe learning tool was established. The aim was to improve the skills, knowledge and confidence of new ENT doctors. Method: The course was developed through 5 iterations over 28 months, moving from a half-day session to 2 full-day courses with more scenarios. Participant, faculty and local simulation team feedback drove course development. High-fidelity scenarios were provided, ranging from epistaxis to stridor, using technology including SimMan3 G mannequin, mask-Ed™ and nasendoscopy simulators. Results: Participant feedback consistently demonstrated that the knowledge and skills acquired enhanced preparedness for working in ENT, with impact being sustained in clinical practice. Conclusion: Preparing healthcare professionals adequately is essential to enhancing patient safety. This simulation course has been effective in supporting new doctors in ENT and has subsequently been rolled out at a national level. [ABSTRACT FROM AUTHOR]

Sepsis is a medical emergency that describes the body's systemic immunological response to an infectious process that can result in organ dysfunction and cause death. One of the causes of sepsis is Gram-negative bacteria that produce Extended Spectrum Beta Lactamase (ESBL). Beta-Lactamase production is defined as an enzyme produced by certain bacteria that is capable of hydrolyzing a broad spectrum of cephalosporins, and is effective against beta-lactam antibiotics. There is no data on the cause of sepsis caused by ESBL-producing Gram-negative bacteria at Indramayu Regional Hospital. For this reason, the aim of this study was to determine the species and percentage of ESBL producers in sepsis patients at Indramayu Regional Hospital. This research is a descriptive research. The data obtained in the research is primary data obtained from the results of culture examinations and sensitivity tests of sepsis patient specimens carried out in the Microbiology Section of the Clinical Pathology Laboratory of Indramayu Regional Hospital, in the period September-October 2023. The results of the research obtained 38 specimens from sepsis patients in the form of blood, urine and pussy. ESBL-producing bacteria were 18,4211%, non-ESBL bacteria were 13,1579%, and there was no bacterial growth as much as 68,4211%. ESBL-producing bacteria were found to be Escherechia coli from blood by 10,5263% and urine by 2,6316%, Klebsiella pneumoniae from blood by 2,6316% and pus by 2,6316%. [ABSTRACT FROM AUTHOR]

The article presents the discussion on risk and crisis communication in health emergencies and for the management of infodemics. Topics include ancillary to the other, those related to the planning of public health choices and that of their communication; and might avoid going to a clinic or hospital for non-emergency medical services, and parents might skip routine vaccinations for their .

Risk and crisis communication (RCC) is a current ethical issue subject to controversy, mainly due to the tension between individual liberty (a core component of fairness) and effectiveness. In this paper we propose a consistent definition of the RCC process in public health emergencies (PHERCC), which comprises six key elements: evidence, initiator, channel, publics, message, and feedback. Based on these elements and on a detailed analysis of their role in PHERCC, we present an ethical framework to help design, govern and evaluate PHERCC strategies. The framework aims to facilitate RCC, incorporating effectiveness, autonomy, and fairness. It comprises five operational ethical principles: openness, transparency, inclusivity, understandability, and privacy. The resulting matrix helps understanding the interplay between the PHERCC process and the principles of the framework. The paper includes suggestions and recommendations for the implementation of the PHERCC matrix. [ABSTRACT FROM AUTHOR]

Penetrating aortic injuries represent critical medical emergencies that necessitate immediate intervention to prevent life-threatening consequences. When accompanied by the presence of an enormous right pleural false aneurysm, the clinical scenario becomes exceptionally rare and complex. This case report details the successful management of a patient who presented with a penetrating aortic ulcer and an extensive false aneurysm within the right pleura, employing an interdisciplinary approach involving cardiac surgeons, cardiologists, interventional cardiologists, and radiologists. The pivotal intervention involved the deployment of a covered and bare stent graft into the descending thoracic aorta to seal the aortic rupture. The patient's clinical condition stabilized postoperatively, with no signs of recurrent hemorrhage. This case underscores the importance of rapid diagnosis, timely intervention, and the collaborative efforts of a specialized medical team in successfully managing such complex vascular injuries. Early recognition and referral to specialized centers are essential for improving patient outcomes in cases of penetrating aortic injuries with associated giant pseudoaneurysms. [ABSTRACT FROM AUTHOR]

Agriculture is a hazardous industry with undocumented injury events. Credible surveillance measures are critical for this industry, especially to guide injury prevention programs with targeted recommendations for specific commodity groups and populations. This multi-phase study explored the feasibility for two state agency databases, the Ohio Bureau of Workers' Compensation (BWC) Program and the Emergency Medical Services Incident Reporting System (EMSIRS), to augment the state's Bureau of Labor Statistics (BLS) annual reports. BWC data described injury claims in agricultural workplaces from 1999 to 2008. State EMSIRS data described the types of medical emergencies for which EMS services were requested to Ohio farms in 2013–2014. Descriptive analyses were performed on each distinctive source. Over 14,000 BWC claims were analyzed, with primary nature of injury identified as sprains and strains of bodily extremities; falls were the most common cause of injury. The EMSIRS data provided 1,376 cases, where EMS services were requested to Ohio farms at injury onset. Some cases had possibility to be excluded in CFOI or employment claims data, with 24% patients 65 years and older and 6% children 13 years and younger. The primary cause of injury was falls, and the highest reported injury type was blunt trauma. Both BWC and EMSIRS databases showed the potential to enhance Ohio's agricultural surveillance data with viable information not found in previously used systems. Each agency database had its own merits to further clarify and quantify morbidity. When used together, these sources enrich surveillance statistics to describe Ohio's agricultural injury incidents. [ABSTRACT FROM AUTHOR]

The authors comment on the lessons that can be learned from the COVID-19 triage schemes aimed to help U.S. states be better prepared, both clinically and ethically, for the next public health emergency. Cited are when states should trigger triage protocols, how to protect the vulnerable during a health crisis, and how triage protocols should operate in practice.

Aim: To identify challenges faced by dental interns in the workforce and to suggest Pacific Island Countries (PIC) on further research in this area. Materials and Methods: A comprehensive search of Medline, Embase, Scopus and ProQuest databases was conducted using relevant keywords. All studies, published from 1st January 2000 to 31st January 2021, were taken into consideration. Removal of duplicates and screening the full-text articles using eligibility criteria were used to finalise the number of articles. The significant findings and conclusions were extracted and grouped under themes. Results: A total of 16 studies met the inclusion criteria, involving dental interns, medical interns, postgraduate and undergraduate. Five themes were identified as the main challenges faced by dental interns in the workplace including workplace bullying, handling medical emergencies, community placement, lack of interdisciplinary approach and poor record keeping. Conclusion: There is a need for PIC to conduct research and surveys, to identify the challenges its dental interns may be facing. This will create an ideal foundation from which strategies and initiatives can be implemented and enforced in the dental internship programme. Ensuring that oral health services are delivered efficiently and oral status of the Pacific is not compromised. [ABSTRACT FROM AUTHOR]

Background: Poisoning-induced shock is a serious medical emergency with a high mortality rate. Hospitalized poisoned individuals experience multiple adverse cardiovascular events that could progress to cardiac arrest. This study was designed to compare the prognostic role of the admission shock index and plasma copeptin level in shocked poisoned patients and to evaluate their associations with initial patients' characteristics and outcomes. Methods: We conducted a prospective study on acutely poisoned adult patients. Results: A total of 41 patients were enrolled in the study. The mean age of all patients was 27.05 ± 10.99 years and most of the patients were females (n = 27, 66%). Pesticides were the most common type of poisoning (n = 18, 44%), followed by cardiovascular drugs (n = 12, 29.3%). Eleven (26.8%) patients died during the hospital stay length. The initial serum copeptin level and shock index could predict organ dysfunction indexed by sequential organ assessment score (SOFA) with area under the curve (AUCs) of 0.862 and 0.755, respectively. Initial serum copeptin and lactate levels, SOFA score, and their combination can strongly differentiate between survivors and non-survivors with an AUC of 0.944, 0.885, and 0.959, and 0.994, respectively. Conclusion: We concluded that the shock index, serum lactate level, and SOFA score may help in risk stratifying patients and predicting outcomes in critically ill patients with poisoning-induced shock. Copeptin is superior to the shock index in predicting mortality among the studied patients. However, a combination of SOFA score, serum copeptin level, and serum lactate level can develop a more predominant prediction for overall clinical outcomes in these patients. [ABSTRACT FROM AUTHOR]

The objective of this study was investigate the landscape of COVID-19 risk awareness, Risk Perception and preventive behaviors, regarding COVID-19 in Quetta. The way the general public perceives biological hazards significantly influences the manner in which health emergencies are addressed. It is a cross-sectional research with 323 sample size obtained through simple random sampling, data was collected through structured survey and analyzed in SPSS (Version.23). The 78.6% respondents acknowledged the existence of COVID-19 and 54.8% attributes it to natural disasters. Most of respondents (40%) get to know about COVID-19 from television and 35% consider exerts opinion most trusted information source. 83.6%, perceived that getting infected with the coronavirus can be serious. As concerns (71.2%) about future pandemics linger, sustained public health efforts are imperative. The study recommend the need for sustained Public Health efforts, the preparedness planning, and collaborative actions to navigate the complexities of the ongoing pandemic and those that may arise in the future [ABSTRACT FROM AUTHOR]

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Purpose: Vital signs are important for predicting clinical outcomes in patients with trauma. However, their accuracy can be affected in older adults because hemodynamic changes are less obvious. This study aimed to examine the usefulness of changes in vital signs during transportation in predicting the need for hemostatic treatments in older patients with trauma. Methods: This retrospective cohort study was conducted using data from the Japan Trauma Data Bank (2004–2019). Patients aged ≥ 65 years who were hemodynamically stable at the scene were included in this study. The incidence of emergency surgery within 12 h after hospital arrival was compared between patients with delta Shock Index (dSI) > 0.1 and those with dSI ≤ 0.1. Predicting ability was examined after adjusting for patient demographics, comorbidities, vital signs at the scene and on hospital arrival, Injury Severity Score, and abbreviated injury scale in each region. Results: Among the 139,242 patients eligible for the study, 3,701 underwent urgent hemostatic surgery within 12 h. Patients with dSI > 0.1 showed a significantly higher incidence of emergency surgery than those with dSI ≤ 0.1 (871/16,549 [5.3%] vs. 2,830/84,250 [3.4%]; odds ratio (OR), 1.60 [1.48–1.73]; adjusted OR, 1.22 [1.08–1.38]; p = 0.001). The relationship between high dSI and a higher incidence of intervention was observed in patients with hypertension and those with decreased consciousness on arrival. Conclusion: High dSI > 0.1 was significantly associated with a higher incidence of urgent hemostatic surgery in older patients. [ABSTRACT FROM AUTHOR]