A thematic analysis revealed three primary themes regarding non-emergency EMS management: the reality of EMS workloads, the need for clear direction in policy without a simple solution, and defining EMS’s future societal role. Participants proposed 16 policy suggestions, with 10 gaining broad support, including enhancing public health literacy, modifying the priority dispatch system, and fostering […]
Category: Appendix, Gallbladder and Surgical Emergencies
Frailty significantly impacts mortality and morbidity following emergency laparotomy.
A meta-analysis of 12 articles involving 5,704 patients revealed that frailty, assessed via the Clinical Frailty Scale, significantly correlates with both short- (30-day mortality odds ratio 3.84) and long-term (1-year mortality odds ratio 3.03) mortality after emergency laparotomy. Frailty prevalence was found to be 25% overall and 32% in patients aged 55 and older. Additionally, […]
Higher Fresh Frozen Plasma Ratio Linked to Improved Survival
A multicenter cohort study analyzed 1,954 adults with severe blunt trauma, revealing that a high fresh frozen plasma (FFP) to red blood cell (RBC) ratio (greater than 1) was associated with lower in-hospital mortality (OR 0.73). This suggests that patients receiving a higher FFP ratio benefitted from improved survival compared to those with a lower […]
Abdominal perfusion pressure predicts mortality in intra-abdominal hypertension.
A mortality prediction model was developed for patients with intra-abdominal hypertension (IAH) utilizing abdominal perfusion pressure (APP) and advanced AI techniques. The study analyzed 1,354 patients, revealing that APP < 60 mmHg was linked to higher mortality rates within 7 to 90 days. The machine learning model demonstrated an AUC of 0.80, outperforming traditional clinical […]
Triage-bot enhances emergency department triage efficiency in Canada.
Triage-bot, an AI-driven system based on the Canadian Triage and Acuity Scale, supports emergency department nurses by automating patient assessments. Key findings demonstrate that Triage-bot effectively measures vital signs and interprets patient expressions and tone for more accurate triage decisions. The systematic review indicates significant improvements in patient care through personalized instructions and remote monitoring. […]
Elderly patients experience worse outcomes in acute appendicitis.
Patients aged 65 and older with acute appendicitis presented later, requiring more diagnostic imaging and experiencing higher rates of complications compared to younger adults. The study revealed that elderly individuals had longer symptom durations (7.88 days vs. 3.56 days) and required CT scans more frequently (86.1% vs. 54.0%). Surgical delays were notable, with fewer elderly […]
High 30-Day Morbidity and Mortality Rates for PPU Surgery
In an international cohort study of 1,874 patients with perforated peptic ulcer (PPU), researchers found a 30-day morbidity rate of 48.5% and a mortality rate of 9.3%. Key factors affecting these rates included age over 50, female gender, shock on admission, and acute kidney injury, all significantly associated with increased morbidity and mortality. Delayed presentation […]
Foley catheter balloon compression effectively controls hemorrhage in trauma.
A retrospective review of 18,303 trauma patients in Venezuela revealed that 45% of 1,757 patients with vascular injuries utilized Foley catheter balloon compression for hemorrhage control. The majority (75%) of catheter placements occurred in emergency departments, while 53.2% were employed in non-compressible anatomical junctions. This method proves effective across various trauma care settings, preserves collateral […]
A new technique may reduce bile duct injury during surgery
The shoeshine technique enhances safety in laparoscopic cholecystectomy by achieving atraumatic exposure of the hepatocystic area and improving visibility in Calot’s triangle. This method, utilized in over 2,000 cases by the authors, demonstrated effectiveness in reducing risks of bile duct injuries. By employing a blunt dissection tool along with gauze for traction, this approach facilitates […]
Enhanced recovery protocols promote better outcomes after emergency laparotomy
A systematic review and meta-analysis of six randomized clinical trials involving 509 patients evaluated the effects of enhanced recovery after surgery (ERAS) protocols following emergency laparotomy. Findings indicated that ERAS significantly reduced postoperative nausea and vomiting (odds ratio: 0.32), time to ambulation (mean difference: 1.67 days), length of stay (mean difference: -2.92 days), and various […]