Journal of Emergency Medicine, Trauma and Acute Care - 2 - International Conference in Emergency Medicine and Public Health-Qatar Proceedings, October 2016

Introduction: Diagnosis of patients in a pre-hospital setting is a challenging process that depends primarily on clinical evaluation. The pre-hospital environment presents particular challenges such as scanty information and limited diagnostic tools. Nonetheless, accurate diagnosis is key to activate the appropriate cascade of management, level(s) of dispatch and disposition. This study aims to compare the ambulance paramedic diagnosi Read More

Background: Despite the great success in controlling infectious disease in children, house accidents have increased, especially in developing countries, in the last years. WHO has reported that more than 20% of hospital cases involve children under 5 years of age and are caused by house accidents. Foreign body aspiration (FBA) is a preventable accident with a high risk of mortality. The objective of this study is to identify the epidemiology Read More

Background: The emergency department physicians rarely see high-pressure injection injuries (HPI) to the hand. These work-related injuries can have a devastating effect on hand function, particularly if not treated early. These injuries are usually caused by the introduction of chemicals into the wound. Chemicals under high-pressure cause local tissue damage, ischemia, and acute and chronic inflammation. The initial assessment may sugges Read More

Introduction: Renal colic is one of the common abdominal emergency presentations to an ED. The cost of imaging, health care resources and time spent in the Emergency Department (ED) is huge. There is good evidence supporting the role of ED bedside ultrasound in detecting hydronephrosis.1,2 We plan to study the role of bedside ultrasound in renal colic as a pilot audit for the QIP. Method: A convenience sample was selected prospective Read More

Background: Today, e-learning is of strategic importance to teaching and learning in Emergency Medicine (EM). We adopted an interactive e-learning platform based on the open source software called MOODLEa using a blended learning strategy to assist the implementation of a dedicated faculty development program known as the EM consolidation program. This 12-month program was designed to meet the developmental needs of 2 Read More

Background: Procedural sedation (PS) is commonly used in the Emergency Department (ED) to lessen pain, apprehension, and agony for patients during medical procedures. PS encompasses administering of sedative medications with or without the simultaneous delivery of analgesic agents. Safe and effective PS in the ED is a skill that is fundamental to practice of Emergency Medicine. Patients undergoing PS in ED should have a document Read More

Background: Delays in clinical handover can compromise a patient's care. The handover is not the sole responsibility of the ambulance personnel or the emergency departments. Reducing delays requires the working together of the entire organization, as well as designing efficient emergency and ambulance departments. Objectives: The study aims at exploring the quality of clinical handover between the emergency department person Read More

Background: This study is a quality improvement project that aimed at improving patient flow in Male Urgent Area (MUA), one of the busiest areas in the largest emergency department in the state of Qatar. Methods: The baseline process was designed by mapping and drawing a cause-and-effect diagram. Pre- and post-auditing was done after careful intervention of introducing a phlebotomy room in Male See and Treat area, the main feeder to Read More

Introduction: Sepsis is a major cause of hospitalization with a high mortality rate. Early recognition and management of sepsis have shown to improve mortality outcomes. A proactive alert system for improving the response of the interdisciplinary team may decrease the time to intervention and improve patient outcomes. Objective: The study evaluated the impact of an early alert system, “CODE SEPSIS”, on adherence to the sepsis m Read More

Background: Rhabdomyolysis, which can be defined as a CPK level greater than five times the upper limit of normal, is related to muscle breakdown and hypovolemia in heat stroke patients.1 CPK levels will likely be higher because of increased muscle breakdown in exertional heat stroke when compared with classic heat stroke. Methods: We reviewed 50 patients who came into the Emergency Department of Hamad General Hospital during the Read More

Background: Although the majority of sudden cardiac deaths (SCD) are due to CAD and poor LVEF, there is a considerable fraction of idiopathic ventricular fibrillation (IVF) causing SCD that is secondary to channelopathies and other inherited arrhythmias. Objective: The present report aims to raise awareness about the prevalence of inherited arrhythmogenic disorders, besides the commonly attributed CAD causing SCD. Case repor Read More

Background: Peripheral oxygen saturation (SpO2) and heart rate (HR) are important indicators for various medical conditions such as cardiopulmonary disorders and respiratory diseases. The main objectives of this study is to design and implement a portable embedded medical system. This system wirelessly obtains SpO2 and HR data from a patient as well as his/her coordination, and sends a short messaging service (SMS) alarm to the e Read More

Background: Qatar Hamad Medical Corporation Ambulance Service (HMCAS) major incident response guide is intended to address techniques in field operations that must be utilized in the event of a major incident. This guide standardizes operations during major incidents, regardless of what caused the incident, number of patients, severity of the injuries or the complexity of the incident. Methods: This plan was tested and implemented ac Read More

Background:Neisseria meningitidis (NM) is a leading cause of meningitis and septicemia. NM has an overall dispersion at rate of 11%, assuming that 10%–20% of the population carries NM in their throat at any given time, and increased carriage rate may be seen during epidemics. Objective: This study aimed to describe the incidence and epidemiological characteristics NM in Qatar. Methods: A retrospective review of epidemiological d Read More

Introduction: Acute aortic dissection (AAD) is one of the most challenging cardiovascular emergencies presenting to the Emergency Department (ED). Prompt diagnosis and treatment is the key to patient survival. Though most AADs present with typical symptoms, it has been reported to present with a myriad of symptoms. We report a case of an AAD, which presented to our ED with predominant neurological symptoms. Case description: A Read More

Background: Injuries from air bag deployment have long been documented and studied like orbital blowout fractures, auditory injuries, etc. However, we report here a case of an alveolar process fracture associated with dental injuries and clear history of face-to-air bag impact only, which has rarely been documented and hence important to be reported. Case report: A 25-year old female front-seat passenger was involved in a head-on collision Read More

Background: In the past 3 years, average length of stay in the emergency department has increased by 20–30%. It was found that one of the most important factor causing this was increased number of X-rays done. At an average one x-ray adds 4–5 hours to disposition time. An observational study was done to find out reasons for the low compliance with usage of Ottawa ankle rules. Methods: Initially observational study was done where Read More

Introduction: We present a case of bilateral ureteric colic that causes anuric acute renal failure. Bilateral ureteric colic causing acute renal failure is not a new presentation. However, the patient had only 3 mm calculi, making our case unique. Background: Bilateral renal calculi are an uncommon cause of acute kidney injury (AKI). Obstructing ureteroliths rarely lead to AKI without any underlying renal disease or anatomic abnormalities, such as Read More

Background: The South West London & Surrey Trauma Network has one major trauma centre (MTC) and seven acute trauma units (TUs) over a wide geographical area. Seventy-five percent of the major trauma patients (injury severity score >15) were taken to MTC. However, many were admitted in trauma units. Available data indicates that there is a possibility that patients in TU rather than MTC may receive less than optimal care. Aims: Read More

Background: Management of serious paracetamol overdose with N-acetylcysteine (NAC) is an effective strategy. Early treatment with NAC prevents the formation of a toxic metabolite that leads to hepatic injury. However, inappropriate treatment with NAC and overtreatment with NAC can lead to potential adverse side effects and unnecessary hospital admission. The aim of the study was to assess the administration of NAC in the settin Read More