International Journal of

Critical Care and Emergency MedicineISSN: 2474-3674

Early Online

 Open Access DOI:10.23937/2474-3674/1510166

Nurses' Experiences in Caring Diabetic Ketoacidosis Patients in the Emergency Departments: A Qualitative Study

Ipyana Mbaga Kajembula, Kornel Izidory Matheo, Peter Damian Simchimba, Elizabeth Habili Masasi, Victor Chikwala and Joel Seme Ambikile

Article Type: Research Article | First Published: 2024/09/06

Diabetic ketoacidosis (DKA) is a critical complication of diabetes mellitus requiring prompt and effective management to prevent adverse outcomes. Despite the increasing burden of diabetes in Africa, limited research focuses on nurses' experiences with DKA management within this context, particularly in Tanzania. This qualitative case study aims to explore nurses' experiences and challenges, on DKA management within the emergency department (ED) of a Regional Referral Hospital (RRHs) in Dar es S...

 Open Access DOI:10.23937/2474-3674/1510165

Challenges in the Diagnosis and Treatment of Invasive Candidiasis in India

Yatin Mehta

Article Type: Review Article | First Published: 2024/08/07

Invasive candidiasis (IC) is a serious candidal infection often associated with high rates of morbidity and mortality. The timely initiation of appropriate antifungal therapy is important to reduce the risk of mortality....

 Open Access DOI:10.23937/2474-3674/1510164

Sepsis Due to Shewanella putrefaciens: A Rare Bacterium in the Blood of an Immuno-Compromised Patient

Yudhyavir Singh, Pratik Tuppad and Babita Gupta

Article Type: Letter to Editor | First Published: 2024/08/07

Immunocompromised patients are susceptible to various infections, the spectrum ranging from infections by skin commensals to various multi drug resistant organisms. Here we would like to highlight one such rare infection by Shewanella putrefaciens isolated from the bloodstream of a patient diagnosed with HIV....

 Open Access DOI:10.23937/2474-3674/1510163

The Role of Neutrophils in ARDS and Drugs that Modify their Formyl Peptide Receptor Activity

Veronica A Varney, BSc hons, MBBS, FRCP, MD, Gopal Chattopadhyay, MBBS, MRCP, Vishnu Bharadwaj Sai, MBBS, Samina Monir, MBBS, Abhishek Ray, MBBS, Alex Nicholas, BSc, MSc, FIBMS, Brian Ford, BSc hons, MSc, PhD, Ginny Quirke, RN, Dip N, BSc (Hons), Amolak Bansal, BM, FRCP, FRCPath, DM and Syed Rehan Quadery, MBBS, FRCP, MD

Article Type: Original Article | First Published: 2024/08/02

Adult Respiratory Distress Syndrome (ARDS) represents a sustained neutrophil driven attack on the lung, where raised alveolar neutrophil numbers are known to predict severity and mortality. Neutrophil infiltration to the lung is in response to released Formyl Peptides from infected and damaged tissue which can drive oxidant and protease release with toxic effects. Formyl Peptides can stimulate neutrophils directly via their surface Formyl Peptide Receptors (FPR’S), escalating their activation ...

 Open Access DOI:10.23937/2474-3674/1510162

Type B Lactic Acidosis Associated with T - Cell Acute Lymphoblastic Leukemia: A Pediatric Case Study

Priyanka Kharayat, MD, Rhea Hans, MD, Alexandra Walsh, MD, JJ Zaritsky, MD, Danielle Sebbens, DNP and Michelle Munkwitz, MD

Article Type: Case Report | First Published: 2024/07/25

Aerobic glycolysis or Warburg effect (WE) is a common cause of hyperlactatemia in adults with cancer, uncommonly seen in the pediatric population. We describe an unusual case of a teenager with lactic acidosis as the presenting lab abnormality with no other abnormality suggestive of an oncologic process, who was later diagnosed with T-cell acute lymphoblastic leukemia (ALL)....

 Open Access DOI:10.23937/2474-3674/1510161

Serratus Anterior Plane Block for Multiple Rib Fractures- A Novel Pain Management Technique

Aaron Dsouza and Divya Vincent

Article Type: Original Article | First Published: 2024/05/31

Rib fractures are mostly traumatic. Commonly seen in patients suffering from multiple injuries due to road traffic accidents or fall from height, conventional treatment is with intravenous/oral analgesics or opioid patches. The innervation of the ribs passes through the Serratus Anterior Plane and hence we aim to administer anaesthetic in this plane to achieve reliable and quality pain relief....

 Open Access DOI:10.23937/2474-3674/1510160

Therapeutic Plasma Exchange for Acute Pancreatitis Secondary to Hypertriglyceridemia: Case Report and Review of the Literature

Giorgio Berlot, Ariella Tomasini and Michele Contadini

Article Type: Case Report | First Published: 2024/03/30

A patient with acute pancreatitis was admitted to our Intensive Care Unit due to arterial hypotension and hypoxemia that responded to fluid resuscitation and supplemental oxygen; the blood chemistries revealed extremely elevate triglycerides and cholesterol levels. A therapeutic plasma exchange was performed on an emergency basis and determined their sharp decrease. The patient was transferred to a regular ward 6 days later, and a CT-scan obtained after one more week at demonstrated a large pseu...

 Open Access DOI:10.23937/2474-3674/1510159

A Rare Cause of Acute Chest Pain

Cátia Ribeiro Santos, Carolina Roriz and Vera Frazão Vieira

Article Type: Patient Care | First Published: 2024/02/09

Chest pain is one of the most common symptoms for which adults seek medical care, making chest pain the second most common complaint [1]. A central goal in the emergency department is to determine whether acute chest pain is a life-threatening condition for the patient [1,2]. Acute onset of chest may also be seen with disorders such as aortic aneurysm dissection, myocardial infarction, spontaneous pneumothorax, pneumonia, pancreatitis, peptic ulcer perforation, or esophageal perforation....

 Open Access DOI:10.23937/2474-3674/1510158

Systemic Air Embolism: A Rare Complication of Transthoracic Computed Tomography-Guided Lung Biopsy

Patrícia Varela Ramos, Marco Fernandes, António Costa and Paula Rosa

Article Type: Case Report | First Published: 2023/12/09

Systemic air embolism (SAE) is a rare but potentially life-threatening complication of transthoracic computed tomography (CT)-guided lung biopsy [1-6], with reported incidence rates of 0.02-0.07% to 0.21-4.8% [3,5,7,8]. However, the incidence might be underestimated due to failure to diagnose this adverse event in asymptomatic patients as its early recognition is difficult ....

 Open Access DOI:10.23937/2474-3674/1510154

More than a Persistent Urinary Tract Infection: The Usefulness of Ultrasound in the Emergency Department in a Clinical Case

Joaquín Asensio Sánchez and Cristina Asensio Sánchez

Article Type: Clinical Case | First Published: April 13, 2023

A 65-year-old male, hypertensive and non-insulin-dependent type 2 diabetes mellitus as the only personal history of interest, who came to the Emergency Department of our hospital with micturition symptoms consisting of dysuria and pollakiuria associated with mild hematuria and hypogastric pain of 14 days of evolution. The patient did not report fever or any other associated symptoms. In addition, he told us that, at first, he had gone to his Health Center and consulted his Primary Care Physician...

 Open Access DOI:10.23937/2474-3674/1510153

Most Frequent Cause of Dialysis Emergency and Precipitating Factor in Patients with Chronic Kidney Disease Attending the Emergency Department of HGZ 50 in San Luis Potosí, Mexico

Karen Janeth Marroquín Morales and Alberto Ruiz Mondragon

Article Type: Original Article | First Published: February 28, 2023

Chronic kidney disease (CKD) represents a worldwide public health problem, Mexico has a prevalence of 12.2%, of which 52,000 patients are in renal replacement therapy and 80% are treated at the Mexican Social Security Institute, it is associated with early mortality with a higher incidence after 40 years of age. The literature mentions severe metabolic acidosis, severe hyperkalemia and hyperphosphatemia, water overload and uremic syndrome as frequent causes of dialysis urgency. However, the most...

 Open Access DOI:10.23937/2474-3674/1510152

Constrictive Cardiomyopathy Secondary to Calcified Pericardium

Vinaya Sermadevi, MD and Connor S Shaw, DO

Article Type: Case Report | First Published: January 20, 2023

Calcification of the pericardium due to recurrent inflammation is a rare condition which can lead to severe restrictive cardiomyopathy. This case demonstrates severe circumferential pericardial calcification leading to cardiogenic shock and death. It is proposed that the patient’s history of repeat cardiac interventions, including cardiac ablation, and open valve repair procedures precipitated this....

 Open Access DOI:10.23937/2474-3674/1510150

Factors Affecting Mortality in Patients with Acute Pancreatitis and Serum Calcipressin-1 (RCAN-1) Levels

Emrah Savaş, Mustafa Burak Sayhan, Ömer Salt and İlker Dibirdik

Article Type: Original Article | First Published: November 30, 2022

Acute pancreatitis (AP) is one of the most common diseases of the gastrointestinal tract. AP is a pancreatic disease with high mortality and morbidity, which can cause local and systemic complications This study aimed to determine factors that effect mortality in this patient group and whether serum RCAN-1 level can be used as a novel marker for predicting diagnosis and mortality in patients with AP and to investigate the factors affecting mortality in this patient group....

 Open Access DOI:10.23937/2474-3674/1510149

Reduced Length of Stay after Implementation of a Clinical Pathway following Repair of Ventricular Septal Defect

Tracey L Ogdon, DNP, Rohit S Loomba, MD and Jamie S. Penk, MD

Article Type: Original Article | First Published: November 16, 2022

There is variation in care and hospital length of stay following surgical repair of ventricular septal defects. The use of clinical pathways in a variety of pediatric care settings have been shown to reduce practice variability and overall length of stay without increasing the rate of adverse events....

 Open Access DOI:10.23937/2474-3674/1510148

An Evaluation of Pediatric Airway Management Training for Suspected/Confirmed COVID-19 Patients Utilizing Medical Simulation at King Fahad Medical City, Riyadh, Saudi Arabia

Sawsan Alyousef, MD, CAPB, FCCP, Raed Khafajeh, Ali Alharbi, Aseel Alayed, Najd Fawaz Alnojaidi and Abdulaziz Alsoqati

Article Type: Brief Report | First Published: November 07, 2022

The novel coronavirus disease 2019 (COVID-19) can be transmitted to clinicians involved in their care, particularly during aerosol-generating procedures. In spite centers for disease control and prevention (CDC) had put clear standards for precaution when dealing with such patients but unfortunately several health care providers had lost their lives around the world....

 Open Access DOI:10.23937/2474-3674/1510146

What Happens When it Comes to Triage? A Study Evaluating the Effects of a Prioritisation of Intensive Care Unit Patients in Case of Scarce Resources

Hannes Lienhart MD, EMDM, Wolfgang List MD, Klaus Rheinberger PhD, and Moran Bodas PhD MPH

Article Type: Brief Report | First Published: October 31, 2022

Comparison of the SOFA score with a newly developed “triage score” and evaluation of the consequences of simulated triage of ICU patients on the outcome. Retrospective explorative data analysis of 213 patients treated on Intensive Care Units of community hospitals in Western Austria during the first and second wave of the COVID-19 pandemic....

 Open Access DOI:10.23937/2474-3674/1510146

What Happens When it Comes to Triage? A Study Evaluating the Effects of a Prioritisation of Intensive Care Unit Patients in Case of Scarce Resources

Hannes Lienhart MD, EMDM, Wolfgang List MD, Klaus Rheinberger PhD, and Moran Bodas PhD MPH

Article Type: Brief Report | First Published: October 31, 2022

Comparison of the SOFA score with a newly developed “triage score” and evaluation of the consequences of simulated triage of ICU patients on the outcome. Retrospective explorative data analysis of 213 patients treated on Intensive Care Units of community hospitals in Western Austria during the first and second wave of the COVID-19 pandemic....

 Open Access DOI:10.23937/2474-3674/1510145

Euglycemic Diabetic Keto Acidosis Presentation in Association with SGLT-2 Inhibitor- Dapagliflozin

Lajeesh Jabbar Vettikkat MBBS, MRCEM, FRCEM, FEBEM, DCH and Yoosuf Viju Cheriyalingal Paramba MBBS, MRCEM, FRCEM

Article Type: Case Report | First Published: August 24, 2022

Euglycemic Diabetic Keto Acidosis is a rare form of DKA seen in patients who are taking SGLT-2 inhibitor medication for the treatment of diabetes mellitus. It is a life-threatening condition and should be diagnosed early. The absence of hyperglycemia poses challenges to the treating Emergency physicians in diagnosing this entity at an early stage....

 Open Access DOI:10.23937/2474-3674/1510144

Anaerobic Lung Abscess with Complex Empyema

Joseph Shiber, MD, FACEP, FCNS, FCCM

Article Type: Clinical Image | First Published: August 11, 2022

A 51-year-old man with advanced ALS and home mechanical ventilator dependence presented with fever, tachycardia, hypotension and leukocytosis. Chest radiograph showed a large left pleural effusion (Figure 1) and an unenhanced chest CT confirmed a loculated effusion with gas bubbles (Figure 2) and large air-fluid level (Figure 3)....

 Open Access DOI:10.23937/2474-3674/1510143

Comparison of High-Dose, Short-Term Steroid and Low-Dose Long Term Steroid Use in ARDS Caused by COVID-19

Suna KOC, MD and Ilke KUPELI, MD

Article Type: Original Article | First Published: March 19, 2022

We aimed to compare the 15-day continuous hemodynamic, laboratory and clinical course of patients with ARDS due to COVID-19 who received short-term highdose and long-term low-dose systemic methylprednisolone. Two hundred and two patients were recorded to be diagnosed with ARDS due to COVID 19 in the intensive care unit between June 1, 2020 and February 1, 2021. Patients were received systemic methylprednisolone for the short or long term and high or low doses were applied. Age, gender, APACHE II...

 Open Access DOI:10.23937/2474-3674/1510142

Chest X-Ray Findings in Asthma Exacerbation and the Association with Acute Asthma Management among Children

Gul Sher, Fernanda E Kupferman and Mohamed Gaffoor

Article Type: Original Article | First Published: March 19, 2022

The National Heart and Lung Institute’s guidelines advise against routine use of chest X-ray (CXR) for acute asthma exacerbation. Despite this recommendation, unnecessary CXR are still being performed. The objective of this study is to assess the association between abnormal CXR findings and the severity of asthma exacerbation and its impact on acute asthma management. A retrospective chart review was performed of all pediatric patients 2-17 years of age who presented to the emergency departme...

 Open Access DOI:10.23937/2474-3674/1510141

Cardiovascular Collapse, Progressive Lactic Acidosis, Pulmonary Hypertension and Polyuria: Think Thiamine Deficiency!

Gul Sher, MBBS, Mona Nourani, DO, Kristen Beebe, PA-C, Peggy Fullenkamp Oomens, MS, RDN, CNSC, Megan Land, MD and Alexander Ngwube, MD

Article Type: Original Article | First Published: March 13, 2022

Shock is a pathological condition characterized by imbalance between oxygen demand and supply. Irrespective of the cause, shock leads to a state of energy failure due to a decrease in adenosine triphosphate (ATP) production, creation of lactic acidosis, and as a consequence, multiple organ dysfunction. Lactic acidosis is an ominous finding in critically ill patients. The severity and increased duration of lactic acidosis are associated with increased mortality. Lactic acidosis can result from hy...

Volume 8
Issue 2