Burnout is common among professionals and not exclusively among doctors. This article should be considered as a cautionary reference for Accident and Emergency Doctors, Senior Managers and Heads of Department, not to overuse young medical professionals to an extent that they fall sick and even die.

Objectives: Dizziness is a common acute emergency complain which can present in isolation. Diagnosing a stroke in patient complains of dizziness only is major challenge to the practicing emergency physician as this symptom nor sensitive neither specific. The purpose of this study was to measure the prevalence of stroke as a diagnosis in patient who present to the emergency department with dizziness base on brain CT. Methods: This is Retrospective, Cross sectional study was carried out at the Armed Force Hospital (adult ED) in Muscat, Oman, from between August 2019 -August 2020. All patients who underwent head CT during this period where review both indication and the CT finding. Result: out of 1000 CT brain request, 115 patients meet the inclusion criteria, and 13 patients from the inclusion criteria have stroke with isolated dizziness. 80% of brain CT was normal, while 11% showed acute stroke. Conclusion: patient present with dizziness carry the risk to have stroke and head CT brain can help in diagnosis. Adding further imaging, such as, brain perfusion study and MRI can lower the chance of missing stroke case in isolated dizziness presentation.

The aim of this paper is to ascertain whether training in insertion of chest drain given to nurses, Emergency Medical Professionals of Eastern Cape and Paramedics would reduce the time period of morbidity and mortality. Survival of patients due to insertion of chest drains in pre-hospital settings will definitely increase, and thus, reduce the number of deaths due to chest injuries.

Apprenticeship has always been the model of nurturing younger clinicians and medical students with “on the job” training. This period of experiential learning, astute observations and instructions are valuable in helping the growth and development of the next generation of professionals. The apprenticeship model is applicable across many disciplines of Medicine, including Emergency Medicine. This is also the model in use in the development of “Clinicians First; Clinicians Plus” program. Emergency physicians must be good, astute clinicians first. Then, based on their inclination, interest and talent, they have the option to select training tracks such as The Clinician-Educator, The Clinician-Scientist, The ClinicianInnovator or The Clinician-Entrepreneur tracks. These are just a few examples of the specialized training available. Each of the track will have a structured curriculum and training guidelines to ensure the necessary exposure, knowledge and information acquisition, immersive experiential learning with appropriate, dedicated mentors. For senior residents in Emergency Medicine, their growth in these different areas can be monitored using established frameworks. Commencing this immersion earlier, at the medical student level, is also possible. This is what is being done at Duke NUS Graduate Medical School. This unique approach helps prepare students not just to practice Medicine, but also, how to improve patients’ lives and make a difference, whilst at the same be allowed to pursue and develop in an area they find exciting and stimulating. Not only that, but their contributions, innovations, research and educational prowess will help shape the future of Emergency Medicine and how it is practiced.

Surgeons and anesthesiologists play a critical role in emergency medicine, where timely intervention can mean the difference between life and death. The success of emergency medical interventions often relies heavily on the coordinated efforts of these two professions, who work in close collaboration to provide safe and effective care. Surgeons perform the necessary surgical procedures, while anesthesiologists administer anesthesia and monitor the patient’s vital signs throughout the procedure. In this paper, we explore the vital role of surgeons and anesthesiologists in emergency medicine. We review the various situations where their expertise is needed, such as trauma cases, organ failure, and life-threatening infections. We also examine the challenges and opportunities for collaboration that exist in emergency medicine, including the need for effective communication, teamwork, and coordination. Moreover, we highlight the importance of advanced training and experience for both professions, as they face unique challenges and stressors in emergency situations. We discuss the need for ongoing education and professional development to ensure that they are equipped with the knowledge and skills

Hollow organ perforation is a life-threatening condition and early diagnosis of perforation is important in improving the prognosis of these patients. The physical phenomenon that then occurs in the abdominopelvic cavum is the presence of extraluminal gas. The basic methods of detecting free gas in the peritoneal cavity are radiological: plain abdominal radiography, ultrasound and computed tomography. In the radiological literature, there is still no clear consensus which technique is optimal for the detection of pneumoperitoneum – plain abdominal radiography, ultrasound or computed tomography. CT is the gold standard for diagnosis but is often preceded by long wait times and unnecessary radiation exposure. Abdominal ultrasound can also be used as an adjunct in decision-making for justifying the risks of transporting a critically ill patient for further imaging. Based on the data presented, it can be assumed that ultrasonography should be treated as the basic method in diagnosing pneumoperitoneum. CT is the gold standard for the diagnosis of pneumoperitoneum, which can also help detect the cause of pneumoperitoneum.

Objectives: Occupational or work-related injuries are frequently seen in the Emergency Department (ED). In this single center study, we aimed to explore the pattern of Occupational Injuries (OIs) that presented to an academic ED, so as to assess the extent to which the workers are protected from work-related hazards and risks in the region. Setting: This was a retrospective cohort study involving patients who attended an academic ED at King Hamad University Hospital (KHUH) in the Kingdom of Bahrain from January 2017 to December 2020 after an OI. Participants: Data of 404 participants were collected after they fulfilled the inclusion criteria. Results: OI incidence was significantly higher among males (88.1% p = 0.000) and non-Bahrainis (58.2%, p = 0.000). Most of the injuries (48.2%) were associated with work in the fields of manufacturing, construction, and transport. Slipping/ tripping was the most frequent mechanism of injury at work (22.5%). OIs were more likely to occur on Sundays (19.3%) and during the morning hours 7:00 a.m. to 3:00 p.m. (54.0%, p = 0.000). Among those who do a job that requires wearing Personal Protective Equipment (PPE), a significantly low number of workers were wearing it at the time of injury (p = 0.03). The mean length of the stay for admitted cases in the hospital was 8.15 ± 11.23 (range: 1–64) days. Rehabilitation was required in 33.9% cases. Conclusion: The mortality was very low, and most patients were discharged after treatment in the ED, with a low percentage requiring admission. However, the days of work lost were significant, representing a high socioeconomic burden. A significant relationship between the injury and not using PPE was found, stressing the fact that the enforcement of strict safety regulations and the use of PPE should be mandatory. Further studies are needed to determine the true burden of work-related injuries in Bahrain with a focus on prevention strategies.

This article presents a comprehensive approach imbedded into the evolving Digital Health infrastructure and how diagnostic excellence in emergencies and primary prevention of the most significant pathologies regarding morbidity and mortality could be pursued. Tools of Medical Cybernetics are introduced here which could enable: 1. Collection of large amounts of data from wearable sensors. 2. Fitting dynamic process models to the data which have their power to predict the next measurement. 3. Creation of automated risk profile with indicators of morbidity and mortality of diseases which carry the highest risk and feedback of information to the user. 4. Creation of a network between users, providers, and other health services. We propose a Personal Health Data Organizer App Service working in unison with a Cyber Physical System and its extension the Integrated Cyber Physical System cloud-based computer platform realizing long-term observation and continuous risk assessment for measuring quality and effectiveness of the diagnostic process and supporting diagnostic excellence. A list of principles of primary prevention is compiled which is fully supported by the same system. Example is shown how primary prevention of atherosclerotic heart diseases could be implemented. The significance of the system is to recognize early developing risks at subclinical stages of the highest-risk conditions that result in the most harm and potential lawsuits if the correct diagnosis is missed or delayed.

It began with a cry, interrupted by forceful vomiting. Then came a gasp. The first from an elderly Chinese woman forgotten in a dry storage room. The second from her daughter in the kitchen of the Chinese restaurant they owned. Herein, we discuss a toxicological case of cyanide poisoning from uncooked bamboo soup. Symptoms, identification, and treatment.

Nepal was on a brink of a humanitarian crises during the peak of delta wave of the COVID-19 Pandemic. As an effort to mitigate the strain on already overstretched health system, a local non-governmental organization, HAPSA Nepal, designed and distributed a home isolation kit to encourage care from home. The kit included items like pulse oximeters, detailed instructions for home COVID 19 management, and a COVID-19 support hotline information. This rapid response in coordination with the local governments across Nepal supported nearly 7000 people in home isolation during the height of the pandemic in Nepal.