Emergency Care Journal 2019-11-14T17:51:54+01:00 Francesca Baccino 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> Mind in emergency: Needs, criteria, priorities and methods 2019-11-14T17:51:49+01:00 Fabio Sbattella <p>Not available.</p> 2019-10-30T17:23:38+01:00 ##submission.copyrightStatement## Transient global amnesia: Isolated event or healthy predictor? Clinical experience of an Italian Emergency Department 2019-11-14T17:51:50+01:00 Greta Barbieri Alessandro Cipriano Simona Luly Viola Del Nista Eugenio Orsitto Massimo Santini <p>Transient global amnesia (TGA) is a clinical syndrome characterized by reversible anterograde amnesia, in which the patient is alert, self-awareness appears intact and other neurological symptoms are absent. The diagnosis is based on the following criteria: i) witnessed event; ii) acute onset of anterograde amnesia; iii) no accompanying neurological symptoms; iv) no alteration of consciousness; v) no epileptic features; vi) resolution within 24 hours; vii) exclusion of other causes. We conducted a cohort study at the Department of Emergency Medicine on 119 patients with TGA diagnosis from 2010 to 2014, with follow-up evaluation by telephone interview. The objectives of our study were to evaluate the frequency of subsequent episodes, to identify predisposing factors, and to investigate whether TGA is a possible predictor of neurological disease. The frequency of comorbidity in our population was in line with literature. We observed a recurrence rate of 9.5%, with a prevalence for the male gender, while no other factor correlates with TGA recurrence. TGA was not a predictor of further neurological diseases. In conclusion, TGA is a benign pathology with a low probability of relapse. Accordingly, management in Emergency Department should be based on a correct initial clinical classification for rapid discharge.</p> 2019-10-25T12:32:49+02:00 ##submission.copyrightStatement## qSOFA score and LqSOFA score as predictors of outcome in an elderly population with chest infection treated in the Emergency Department. A case series 2019-11-14T17:51:51+01:00 Dimitrios Velissaris Vasileios Karamouzos Nikolaos Dimitrios Pantzaris Loukas Kakoullis Charalampos Pierrakos Menelaos Karanikolas Charalampos Gogos <p>The objective of this study is to assess the prognostic value regarding 28-day outcome of the quick sequential organ failure assessment (qSOFA) score and the combined score calculated from blood lactate levels + qSOFA (LqSOFA) score in elderly patients initially treated in the Emergency Department (ED) for sepsis due to pneumonia or other chest infections. This is a prospective observational study, conducted at the ED in a Greek University Hospital. Forty-one patients with sepsis due to chest infection were enrolled in the study. All patients were treated in the Resuscitation Room of the ED according to the international treatment protocols for sepsis. The qSOFA score was calculated on admission for all patients, and one point was added in the calculation of the LqSOFA score in patients with blood lactate levels &gt;2 mmol/L. Both the qSOFA and the LqSOFA scores had high sensitivity and specificity in predicting unfavorable outcome in elderly patients with chest infection and sepsis. In the ongoing debate of early diagnosis of sepsis and identification of prognostic indexes of the syndrome, qSOFA score alone or in combination with lactate levels could serve as a reliable predictor of outcome. Large prospective studies are needed to further evaluate the role and prognostic validity of these scores in the ED.</p> 2019-10-17T17:57:33+02:00 ##submission.copyrightStatement## A case of successful organ donation after extremely prolonged manual cardiopulmonary resuscitation in a buried hypothermia victim of avalanche 2019-11-14T17:51:52+01:00 Rosanna Varutti Giulio Trillò Adriana Di Silvestre Roberto Peressutti Flavio Bassi Nicola Latronico <p>We report a case of a 41-year-old man, victim of accidental avalanche burial, who donated his organs for transplantation after prolonged cardiopulmonary resuscitation and extracorporeal membrane oxygenation.</p> 2019-10-17T10:35:40+02:00 ##submission.copyrightStatement## An early diagnosis of Mondini-like dysplasia in the Emergency Department at the first episode of bacterial meningitis 2019-11-14T17:51:53+01:00 Jeong Ho Kang Sung Wook Song Sung Kgun Lee Seo Young Ko Ji Hwan Bu <p>Mondini-like dysplasia is a rare congenital inner ear malformation (IEM) and the most common anomaly associated with recurrent bacterial meningitis in children. Early diagnosis of Mondinilike dysplasia is crucial for preventing recurrent bacterial meningitis. We report a case of a 15-year-old girl with unrecognized Mondini-like dysplasia that was early diagnosed in the Emergency Department at the first episode of bacterial meningitis. Assessing hearing function in children who have their first episode of meningitis is crucial. Abnormal hearing test results are critical diagnostic findings that help to suspect an IEM. In addition, high-resolution computed tomography of the temporal bones is an excellent diagnostic tool for IEM.</p> 2019-10-17T10:25:50+02:00 ##submission.copyrightStatement## Time from triage to initial physician assessment: A 5-year retrospective analysis 2019-11-14T17:51:54+01:00 Mor Saban Nadav Armoni Heli Patito Tal Shachar Aziz Darawsha Ari Lipsky <p>The aim of the study is to examine whether physicians adhere to the urgency classification as determined by the Canadian Triage and Acuity Scale. A retrospective-archive study was conducted in a tertiary hospital from January 2011 to December 2015. For each patient, we examined the relation between the urgency rating set by the triage nurse and the waiting time for the physician. Additionally, we explored the relationships between waiting times for physicians and several subgroups: patient arrival time, season of the year, assigned care area, and first consultant to examine the patient, using Analysis of Variance (ANOVA) analysis. There were 392,687 unique visits during the study period. The distribution of the classification was heterogeneous: 7,133 (1.8%) patients were classified as Priority (P) P1; 17,318 as P2 (4.4%); 148,657 as P3 (37.8%); 113,502 as P4 (28.9%); and 106,077 as P5 (27%). Median and interquartile ranges for time from triage until physician assessment, by triage group, were: P1, 0.7 minutes (0.2-24); P2, 35 minutes (13-76); P3, 44 minutes (21-88); P4, 45 minutes (20-87); and P5, 46 minutes (22-88). Percentages of visits that met the evaluation time goals, by triage classification, were: P1, 61%; P2, 27%; P3, 37%; P4, 61%; and P5, 85%. ANOVA test for the four subgroups revealed statistically significant differences (P&lt;.001). In conclusion, the standard goals for time to physician evaluation are not being met, and there is little difference in time to evaluation between the P3, P4, and P5 classifications. Initiation of system-wide changes in physician workflow and awareness may improve physician adherence to triage classification, shorten time lags, and improve patient evaluation. Further research may allow for better understanding of the factors influencing triage adherence and reinforce teamwork among Emergency Department triage nurses and physicians.</p> 2019-10-17T09:51:52+02:00 ##submission.copyrightStatement##