Emergency Care Journal 2020-07-07T20:56:35+00:00 Francesca Savio Open Journal Systems <p><strong>Emergency Care Journal </strong> is the official Journal of the <a href="" target="_blank" rel="noopener">Academy of Emergency Medicine and Care</a> (AcEMC). The journal is an international, peer-reviewed journal dedicated to improve the quality of care by publishing the highest quality science for acute medical care and related medical specialties. The journal welcomes submissions from international contributors and researchers of all specialties involved in acute medical conditions. <strong>Emergency Care Journal</strong> publishes <em>Original Articles, Review Articles, Opinion Reports, Case Reports, Images in Emergency, Letters to the Editors, Commentaries, Book Reviews, Editorials</em> and other educational information related to the practice, teaching, and environment of emergency medicine. In addition to general topics, ECJ also publishes articles on out-of-hospital emergency medical services, pediatric emergency medicine, injury and disease prevention, health policy and ethics, disaster management, toxicology, and related topics. Although most of published research is clinical, there is also strong interest for basic science research pertinent to emergency medicine, thus including all clinical, diagnostics and therapeutic areas of medicine involved in the emergency care management.</p> <p>This journal does not apply charge for publication to Authors as it is fully supported by institutional funds (<a href="" target="_blank" rel="noopener">Academy of Emergency Medicine and Care</a>).</p> Evaluation of Paraclinical Methods in diagnosis of Foreign Body and its complications compared to operating room findings in patients with oral, pharyngeal and esophageal symptoms in Amir A’lam Hospital 2020-07-07T20:56:29+00:00 Reza Erfanian Ardavan Tajadini Saeed Sohrabpour Keyvan Aghazadeh Abdolhossein Mehdinezhad Ebrahim Karimi <p>Foreign Body (FB) swallowing is one of the most common medical emergencies in the world. This injury can cause mortality and morbidity in all age groups. This study aimed to evaluate the paraclinical methods in diagnosis of foreign body and its complications compared to operating room findings in patients with oral, pharyngeal and esophageal symptoms. This was a retrospective study. All patients referred to the ENT (Ear, Nose, Throat) department of Amir A’lam hospital with complaints of foreign body swallowing admitted in the operating room were studied. The patients’ information including demographic information, type of swallowed body, paraclinical information and operating room findings were extracted from the patients’ records. This study was performed on 219 patients admitted to ENT clinic. The mean age of the patients was 45.10±20.61 years. The highest and the lowest frequencies for foreign body type were chicken bone in 61 cases (28.31%) and disk battery in 1 case (0.5%). The most and the least frequency of complaints after foreign body type were dysphagia in 129 cases (58.9%) and neck tenderness in 7 cases (3.19%). Computerized Tomography (CT) scan findings and operative findings were almost same except in two cases. Kappa agreement for lateral neck and observation in the operating room was 50.5% (P &lt;0.001) and WBC count was significantly higher in patients with complications (P=0.010).</p> 2020-05-08T07:39:40+00:00 ##submission.copyrightStatement## Role of lung ultrasound in identifying COVID-19 pneumonia in patients with negative swab during the outbreak 2020-07-07T20:56:30+00:00 Giuseppe Aiosa Romina Gianfreda Marco Pastorino Piero Davio <p>Lung ultrasound is a reasonable tool for detection of manifestations of COVID-19, to facilitate the division of patients flow of infected with SARS-CoV-2 from those affected by other pathologies. Often, a reason for the incorrect separation of the flows is the possibility of false-negative rRT-PCR results. We aimed to evaluate the advantages of performing Lung Ultrasound (LUS) in patients with a negative swab, to confirm the suspicious of COVID-19 at the bedside, according to the recent findings of typical lung ultrasound lesions of COVID19 related pneumonia. We analyzed 11 non-critical patients admitted to Emergency Department in the Internal Medicine ward, during outbreak, as Covid-19 negative patients affected by pneumonia. The result of the ultrasound findings conditioned the consequent allocation of the patient. 9/11 patients had typical LUS findings for COVID-19, but only 3/11 patients had a second positive nasopharyngeal swab, and 2/11 had positive swab on pleural fluid. 6/11 patients remained negative with strongly suspicious LUS lesions, and so treated and isolated as Covid-19 positive. 2/11 had negative swab and none LUS findings, thus treated as affected by other pathologies. These findings clearly show how LUS plays an important role together with the chest x-ray in identifying patients with interstitial pneumonia from COVID-19.</p> 2020-05-08T07:30:23+00:00 ##submission.copyrightStatement## Thorned heart. Description of a near-fatal cardiac embolism after percutaneous Vertebroplasty 2020-07-07T20:56:32+00:00 Federica Pigna Simone Calamai Francesco Scioscioli Lorenzo Buttarelli Francesco Nicolini Gianfranco Cervellin <p>Cement extravasation is a rather common complication of vertebroplasty, which can be observed in up to 30-40% of patients undergoing this procedure, further associated with venous leakage occurring in up to 24% of cases. Pulmonary embolism may eventually develop once the cement migrates within the pulmonary artery, and is the most common complication of cement extravasation (involving ~4.6% of patients). Intra-cardiac cement embolism is considerably less frequent, but is a potentially fatal complication, mostly managed with cardiac surgery. We describe here a rare case of near-fatal cardiac cement embolism, with a large fragment perforating the right ventricle and reaching the pericardium, who presented to the Emergency Department (ED) for syncope. The patient, who displayed this severe complication after a vertebroplasty procedure performed for osteoporotic compression fracture, needed cardiac surgery.</p> 2020-05-06T08:49:59+00:00 ##submission.copyrightStatement## Young male with chest pain and abnormal T-waves 2020-07-07T20:56:33+00:00 Amrithanand Velluridathil Thazhathidathil Naman Agrawal Roshan Mathew <p>Early recognition of ECG signs of acute coronary syndrome is essential for prompt treatment. But presentation with atypical ECG changes constitute a diagnostic challenge. We here report a case of 23-year-old male who presented with chest pain having atypical ECG changes with hyper-acute T waves called de Winters T wave. This is a rare presentation of patient with acute Left Anterior Descending artery occlusion. Some authors propose that de Winters pattern should be considered as “STEMI Equivalent”.</p> 2020-04-29T08:06:45+00:00 ##submission.copyrightStatement## Lung ultrasound in COVID-19: a useful diagnostic tool 2020-07-07T20:56:34+00:00 Gianmarco Secco Marzia Delorenzo Caterina Zattera Bianca Giacomuzzi Moore Lorenzo Demitry Giulia Vezzoni Flavia Resta Bruno Barcella Giovanni Cappa Tiziano Perrone Francesco Salinaro Stefano Perlini <p>Coronavirus disease 2019 (Covid-19), caused by a novel enveloped RNA betacoronavirus, has recently been declared a public health emergency by the World Health Organization (WHO). The lack of knowledge at the beginning of the pandemics, associated with the inherent risk of infective spreading, makes initial recognition and management particularly complex, in terms of defining effective diagnostic and therapeutic protocols. In the Emergency setting, Lung Ultrasound (LUS) can play an important role in the management of patients with SARS-CoV2-related pneumonia, expanding from the initial diagnosis to the subsequent monitoring and follow-up. Among many other potential advantages (such has the absence of ionizing radiation, its inherent costeffectiveness, and bedside repeatability), LUS provides immediate diagnostic response and might prevent the risk of spreading the infection by moving the patient from the Emergency Room to the Radiology facilities. Aim of this short review is to define the potential role of lung ultrasound in Covid-19 patients, according to the evidence in the medical literature</p> 2020-04-28T10:07:43+00:00 ##submission.copyrightStatement## Italian train derailment and the civil protection emergency psychologist intervention: A case report 2020-07-07T20:56:35+00:00 Riccardo Biella Liliana Artale <p>In the last years the mind-body unity, and so giving both physical and psychological attention, is entering increasingly in the first-responder system. This paper reports the intervention done by the Psychosocial Emergency Team, the Civil Protection Emergency Psychologists, during the multi-forces’ intervention on the Limito di Pioltello train crash, a major accident occurred in Italy in 2018. The attempt is to give a photography of the psychological part of the rescue system in this scenario, showing phases, methods, and some rationales subtended in our actions. The aim is to share procedures and open a constructive dialogue that could bring to more standardized interventions among non-governmental emergency psychologist teams with the aim to always provide better care both to victims and their families.</p> 2020-04-22T00:00:00+00:00 ##submission.copyrightStatement##