Emergency Treatment Unit Research Articles

A Scientific Approach for Optimizing Patient Bed Occupancy in an Overcrowded Teaching Hospital in Sri Lanka

Background: In Sri Lanka, the healthcare system predominantly relies on the public sector, which delivers nearly 95% of inpatient care and approximately 50% of outpatient care. Effective monitoring of bed occupancy rates is crucial for optimizing resource allocation amidst limited hospital resources and fluctuating patient demands.Objectives: This study aims to develop a scientific approach to enhance patient bed utilization at Colombo South Teaching Hospital (CSTH) in Sri Lanka.Methodology: A mixed-method approach was employed, integrating quantitative analysis of historical patient data from CSTH's medical record room with qualitative insights from key stakeholders, including hospital administrators, consultants, medical officers, and nursing staff.Results and Discussion: In 2023, CSTH reported an overall bed occupancy rate of 80%, surpassing both national and global averages, indicating strain on healthcare delivery. The study identifies disparities in occupancy rates across different wards, highlighting overcrowding in medical and surgical units alongside underutilization in other specialities.Recommendations and Conclusions: Revising the consultant-based ward allocation system, implementing patient-centric ward clustering based on occupancy rates, appointing bed managers, and expanding facilities in high-demand units like Medical, Accident Service Unit, Emergency Treatment Unit, and Nephrology. Implementing these strategies could mitigate overcrowding, improve bed availability, and enhance the quality and safety of patient care services at CSTH.

Review of EmPATH Units for Behavioral Health Casualties in Prolonged Field Care Environments.

Psychiatric conditions are one of the leading non-battle injury diseases resulting in medical evacuation (MEDEVAC) from combat environments. The challenge of limited MEDEVAC capability necessitating prolonged field care in future large-scale combat operations must be addressed. Therefore, a robust program is needed to address frontline care of behavioral health (BH), maximizing service members returning to duty and minimizing MEDEVAC. This review summarizes the literature on the impacts of the Emergency Psychiatric Assessment, Treatment, and Healing (EmPATH) Unit program as a solution to the challenges of treating behavioral health in future wars. We conducted a systematic literature search and review, and a non-systematic literature critique. We then used the Johns Hopkins evidence appraisal tool to appraise the strength and quality of the evidence. The following electronic databases were utilized for the search: Google Scholar, Embase, CINAHL, and PubMed. Search terms included: included "EmPATH," "prolonged field care," and "operational," alone and combined. The literature review found that the EmPATH unit, a recently developed civilian hospital-based program, can work with higher acuity psychiatric crisis patients who would otherwise be admitted to an inpatient unit, showing promising results in avoiding the need for inpatient hospitalization. EmPATH units help decrease hospitalization rates, reduce restraints and violence, and shorten the patients' boarding time in a holding area. Such findings support the use of the EmPATH unit as a tactic for prolonged field care of psychiatric patients in a combat operational environment. This is the first literature review to consider EmPATH units for psychiatric prolonged field care based on its advantages demonstrated in the civilian sector. Studies have yet to be done on EmPATH units' usefulness in the military, showing a knowledge gap in current evidence supporting its suitability. Thus, this review recommends further studies of EmPATH units in military settings, especially prolonged field care environments.

Respiratory infection transmission risk and indoor air quality at outpatient departments and emergency treatment units of Sri Lankan teaching hospitals.

Indoor carbon dioxide (CO2) concentration has been used as a proxy of the degree of ventilation and, by extension, as an indicator of the risk of contracting respiratory infections. No publications exist regarding indoor air quality (IAQ) parameters of Sri Lankan hospitals.We measured the levels of CO2 and seven other IAQ parameters during morning rush hours for three days, in outpatient departments (OPDs) and emergency treatment units (ETUs) of all 21 teaching hospitals of Sri Lanka. We measured the same parameters of outdoor air also. We calculated the mean values of those parameters. We looked for correlations between outdoors and OPD and ETU levels of selected air quality parameters.The average CO2 levels of outdoors, OPDs and ETUs respectively were 514ppm (ppm = parts per million), 749ppm and 795ppm. The average levels of PM2.5 (particulate matter with diameters <2.5μm) outdoors, OPDs and ETUs respectively, were 28.7μg/m3,32μg/m3 and 25.6 μg/m3. The average levels of PM10 (particulate matter with diameters <10μm) outdoors, OPDs and ETUs respectively, were 49.4μg/m3, 55.5μg/m3 and 47.9 μg/m3. The median levels of formaldehyde outdoors, OPDs and ETUs respectively, were 0.03mg/m3, 0.04mg/m3 and 0.08mg/m3. The median levels of total volatile organic compounds (VOC) outdoors, OPDs and ETUs respectively were 0.12mg/m3, 0.19mg/m3 and 0.38mg/m3.CO2 levels of air in OPDs and ETUs generally were below the national ceilings but above the ceilings used by some developed countries. Outdoors, OPDs and ETUs air contain PM10, PM2.5 levels higher than WHO ceilings, although below the national ceilings. VOC and formaldehyde levels are generally below the national ceilings. Air in OPDs and ETUs is hotter and humid than national ceilings. Outdoor PM10, PM2.5 levels influence OPDs and ETUs levels. We propose methods to reduce the risk of nosocomial respiratory infections and to improve IAQ of Sri Lankan OPDs and ETUs.

An Open-Access Dataset of Hospitalized Cardiac-Arrest Patients: Machine-Learning-Based Predictions Using Clinical Documentation

Cardiac arrest is a sudden loss of heart function with serious consequences. In developing countries, healthcare professionals use clinical documentation to track patient information. These data are used to predict the development of cardiac arrest. We published a dataset through open access to advance the research domain. While using this dataset, our work revolved around generating and utilizing synthetic data by harnessing the potential of synthetic data vaults. We conducted a series of experiments by employing state-of-the-art machine-learning techniques. These experiments aimed to assess the performance of our developed predictive model in identifying the likelihood of developing cardiac arrest. This approach was effective in identifying the risk of cardiac arrest in in-patients, even in the absence of electronic medical recording systems. The study evaluated 112 patients who had been transferred from the emergency treatment unit to the cardiac medical ward. The developed model achieved 96% accuracy in predicting the risk of developing cardiac arrest. In conclusion, our study showcased the potential of leveraging clinical documentation and synthetic data to create robust predictive models for cardiac arrest. The outcome of this effort could provide valuable insights and tools for healthcare professionals to preemptively address this critical medical condition.

Trends and Patterns of Long Bone Fractures in Relation to The Road Traffic Accidents, Assaults, and Falls Among Patients Admitted to Emergency Treatment Unit in Teaching Hospital Karapitiya

Trends and Patterns of Long Bone Fractures in Relation to The Road Traffic Accidents, Assaults, and Falls Among Patients Admitted to Emergency Treatment Unit in Teaching Hospital Karapitiya

Vibrio vulnificus pneumonia with multiorgan failure: a case report and review of the literature

BackgroundVibrio vulnificus is a gram-negative bacterium causing three clinical syndromes namely, gastrointestinal symptoms, skin sepsis and primary sepsis. Primary sepsis exhibits mortality rates exceeding 50%, particularly in the immunocompromised. Vibrio vulnificus is transmitted via consumption of contaminated seafood and contaminated seawater skin exposure. We describe a rare case of an immunocompetent male presenting with an atypical Vibrio vulnificus infection, culminating in severe pneumonia requiring intensive care.Case presentationA 46 year old Indian male dockyard worker, a non-smoker and teetotaler, of Indian origin presented to the emergency treatment unit of a tertiary care hospital in Sri Lanka, with fever, productive cough with yellow sputum, pleuritic chest pain and tachypnea for five days. He had no gastrointestinal or skin manifestations. His respiratory rate was 38 breaths/min, pulse rate was 120 bpm, blood pressure was 107/75 mmHg and pulse oximetry was 85% on air. Chest X-ray revealed consolidation of the left lung. Empiric intravenous Piperacillin-tazobactam and Clarithromycin were commenced after obtaining blood and sputum cultures. Over the next 24 h, his oxygen requirement rose and as he required vasopressor support, he was admitted to the intensive care unit. He was intubated and bronchoscopy was performed on day two, which demonstrated thick secretions from left upper bronchial segments. His antibiotics were changed to intravenous ceftriaxone and doxycycline following a positive blood culture report of Vibrio vulnificus. He was ventilated for ten days and his intensive care stay was complicated with a non-oliguric acute kidney injury, with serum creatinine rising up to 8.67 mg/dL (0.81–0.44 mg/dL). He developed mild thrombocytopenia with platelets dropping to 115 × 103 /uL (150–450 × 103/uL) which resolved spontaneously. Vasopressors were weaned off by day eight and the patient was extubated on day ten. He was discharged from intensive care on day twelve and made a full recovery.ConclusionsPneumonia itself is an atypical manifestation of Vibrio vulnificus and furthermore, this patient was immunocompetent and did not exhibit the classical gastro-intestinal and skin manifestations. This case highlights the occurrence of atypical Vibrio sp. infections in patients with high exposure risks and the need for early supportive and appropriate antibiotic therapies.

Knowledge and practice of prescription and administration of correct dose of paracetamol to children among a selected group of doctors and nurses

Introduction: In children, paracetamol is the most common agent involved in drug toxicity. Therefore, accurate prescription of paracetamol in healthcare facilities is important in paediatric patients. This study aimed to explore the knowledge and practice of doctors and nurses on administration of correct dose of paracetamol. Methods: A descriptive cross-sectional study was carried out recruiting doctors and nurses from paediatric units and Emergency Treatment Unit (ETU) at Teaching Hospital, Karapitiya, Galle. A self-administered pre-tested questionnaire and bed head tickets were used to collect data. Results: There were 100 participants in the study. Majority (98%) knew correct single therapeutic dose of paracetamol. Ninety three percent of them did not know the maximum daily dose of paracetamol for children. Statistically significant association was seen being a doctor (χ2 = 11.4, p = 0.004) and a doctor in ETU (χ2= 9.02, p = 0.009) on- the knowledge of maximum dose of paracetamol to a child/24 hours. Half of the participants (56%) knew the acute toxic single dose of paracetamol. There was a significant association between work experience in paediatric unit/ ETU with the knowledge of acute single toxic dose of paracetamol (χ2 = 14.8, p = 0.04). Almost all participants (99%) were aware that paracetamol dose calculation depends on the weight of the child. Eighty three percent of prescriptions for inward patients were prescribed with therapeutic doses. Conclusion: Even though paracetamol is a common drug there is a knowledge gap among nurses and doctors on prescription of paracetamol in the selected setting.

Hospital preparedness for COVID-19 at a base level hospital in Galle District, Sri Lanka

COVID-19 is a contagious respiratory illness caused by SARS-CoV-2. As such, it is challenging to maintain the safety of healthcare workers while delivering care to patients during the COVID-19 pandemic. The health sector has thus implemented various strategies to enhance hospital preparedness and ensure safety. The aim of this study is then to assess the hospital’s preparedness for COVID-19 at a base hospital in Galle District, to ensure safety. A descriptive cross-sectional study was conducted among medical officers and nursing officers in Galle district. A self-administered questionnaire and an observational checklist were used to collect data. Response rate was 90.52%. Majority were female 88.8% (n=221). Majority of the participants were between 30-39 years of age (n=144 %). Study sample consisted of 62 (24%) medical officers and 196 (76%) nursing officers and the majority (n=152, 58.9%) had more than 10 years of work experience. Furthermore, the majority 81.4% (n=210) were aware of updates about guidelines and circulars regarding COVID-19 issued by the Ministry of Health. Frequent hand washing was practiced by 96.9% (n=250) while social distancing was not practiced by a considerable number of participants (n=77, 29.8%). 90.7% (n=234) participants were not exposed to training on outbreak management. A considerable proportion was not confident about the correct practice of donning and doffing (n=60, 23.2%). The absence of a dedicated respiratory ward and a separate venue at emergency treatment unit to manage patients with respiratory symptoms were noted. There were deficiencies of adherence to social distancing, training, self-confidence and physical arrangement of hospital. Ergo, it is noted that implementing training programs on outbreak response and building trust between the institution and staff on safety will improve the preparedness in future outbreaks.

Impact of COVID-19 related lockdown on hospital admissions, hospital burden and deaths due to non- COVID illnesses in a tertiary care centre in Southern Sri Lanka

Background: Sri Lanka imposed an aggressive curfew to prevent the spread of COVID-19, which led to major changes in population behaviour. It was presumed that these measures could affect the morbidity patterns and management of other medical conditions. We aimed to study the impact of the pandemic on hospital admissions, morbidity patterns and mortality from non-COVID illnesses during the period of lockdown.Methods: A retrospective study was conducted to gather data related to all non- COVID medical admissions from four medical wards and emergency treatment unit (ETU) of the Teaching Hospital Karapitiya for a six-week period during the lockdown. Data on the total number of admissions, reasons for admission, diagnoses, duration of hospital stay and outcome including deaths were obtained. Corresponding data from the same period of the previous year (pre COVID period) were compared.Results: The total number of admissions during the pre- COVID period was 2939 and that reduced to 1491 during the lockdown period. There was a significant reduction of admissions due to infectious illnesses including respiratory tract infections (p &lt;0.001), dengue (p= 0.01) and leptospirosis (p=0.02) during the lockdown period. There was a significant increase in requested admissions (p=0.002) including admissions for procedures, investigations, referrals and transfers. The mortality during the two periods did not change significantly (pre-covid period 5.1 %, lockdown period 4.2%, p=0.16).Conclusions: The results of the study showed that social distancing and travel restriction had a significant impact on health seeking behaviour, disease patterns and outcome. Reduction in hospital admissions and changes in disease patterns, especially reduction in respiratory tract infections could be a positive effect of preventive measures: physical distancing, wearing masks and travel restriction. Total lockdown of the country had no significant effect on total deaths as well as deaths related to NCDs.

Manual immature reticulocyte fraction; a surrogate marker to assess post traumatic blood loss

Introduction: Erythropoietic response following chemotherapy and stem cell transplant is assessed by reticulocytosis and immature reticulocyte fraction (IRF). They are not used to assess erythropoiesis following acute haemorrhage even though it is known to cause reticulocytosis. This study was performed to evaluate the use of IRF as a marker of degree of post-traumatic haemorrhage. Methods: A cross sectional descriptive study was performed using routine anticoagulated blood samples collected from patients admitted with acute traumatic haemorrhage to an emergency treatment unit. Differential and total reticulocyte counts were performed manually using standard techniques with bright field microscopy. The data on severity of blood loss were extracted from clinical records. Results: There were total of 38 patients. Mean IRF of patients with mild (n = 14), moderate (n = 19) and severe (n = 05) haemorrhage were 1.86 ± 1.0%, 3.26 ± 1.8% and 10.2 ± 3.6% respectively. Mean manual IRF of group with severe haemorrhage was significantly higher than those of all the others (p = 0.000). The mean manual IRF of moderate haemorrhage group was significantly higher than that of mild group (p = 0.01). Manual IRF and severity of haemorrhage were significantly positively correlated (r = 0.71, p &lt; 0.01, n = 38). Immature reticulocytes of stage I was observed only in patients with severe haemorrhage. Conclusion: The manual IRF can be used as a reliable marker of severity of post-traumatic acute haemorrhage.

Dancing swan in left hemithorax

A 67-yrs-old, diabatic,hypertensive individual was admitted for multivessel coronary artery bypass graft surgery . Off-Pump CABG was performed using Left Internal Thoracic Artery to Left Anterior Descending Artery, left radial artery to first Obtuse Marginal branch, and reversed saphenous vein graft to Posterior Descending Artery as conduits. His total chest drainage was 430 ml. His was discharged on 8th postoperative day. He was brought to emergency treatment unit on 28th postoperative day with cough and dyspoea.On examination he was dyspnoic, oxygen saturation was 88% on room air. Point of care Transthoracic Echocardiogram demonstrated “dancing swan in left hemi thorax” . (VIDEO). The TTE which included lung ultrasonography, showed left sided heterogeneously anechoic effusion with partial thin septation &amp; floating echoes. The partially collapsed left lower lobe dances during each cardiac pulsation due to propagation of a waveform across this moderate effusion. Exudate effusions often demonstrate punctate, hyper echoic foci floating within the effusion, referred to as Plankton sign. Intercostal drain was inserted on left side and 1.8 liters of hemorrhagic fluid was drained, total chest drainage was 2.4 liters.

Emergency psychiatric assessment, treatment, and healing (EmPATH) unit decreases hospital admission for patients presenting with suicidal ideation in rural America.

The objective was to evaluate the impact of an emergency psychiatric assessment, treatment, and healing (EmPATH) unit in the emergency department (ED) on hospital admissions, ED length of stay, and 30-day follow-up for patients presenting with suicidal ideation or attempt. This study was a before-and-after analysis of introducing the EmPATH unit within a Midwestern academic medical center on outcomes of adult patients (≥18years) presenting with suicidal ideation or suicidal attempt. The primary outcome in this study was the change in proportion of inpatient psychiatric admission of suicidal patients presenting to the ED before and after implementation of the EmPATH unit. Secondary outcomes compared were changes in proportion of any admission, incomplete admission defined as discharge from the ED after admission request placed, outpatient follow-up, return ED visits within 30days of admission, and ED boarding time. Association between the EmPATH unit implementation and categorical outcomes were determined using log-binomial regression to estimate relative risks (RRs) and 95% confidence intervals (CIs). Continuous outcomes were log-transformed and generalized estimating equations were used to examine as the mean difference by time period. There were 962patients presenting with suicidal ideation (n=435 before EmPATH unit, n=527 after EmPATH unit). Compared to the pre-EmPATH-unit period, there was a reduction in psychiatric admission (RR= 0.48, 95% CI= 0.40 to 0.56), any admission (RR= 0.65, 95% CI= 0.58 to 0.73), incomplete admission (RR= 0.22, 95% CI= 0.11 to 0.43), and 30-day return to the ED (RR= 0.74, 95% CI= 0.56 to 0.98). ED boarding time among admitted patients was reduced by approximately two-thirds both in admitted patients (RR= 0.34, 95% CI= 0.30 to 0.39) and among those with incomplete admissions (RR= 0.37, 95% CI= 0.23 to 0.61). There was a 60% increase in a 30-day follow-up care established at the time of discharge (RR= 1.60, 95% CI= 1.40 to 1.82). The introduction of the EmPATH unit has improved management of patients presenting to the ED with suicidal attempts/ideation by reducing ED boarding and unnecessary admissions and establishing post-ED follow-up care.

Advance Resource Planning in Hospital Emergency Departments Using Machine Learning Techniques

Accidents are likely to happen at workplaces which requires employees to rush to the hospitals for emergency treatment. Due to increase in population, treating various medical cases has led to longer waiting times at emergency treatment units (ETUs). The reasons being the ambulance divergence, less staff, and reduced management. An approach to decrease overcrowding at ETU can be the application of modern techniques. Machine learning (ML) is the one which is used to find patients with high illness, therefore developing models that can avoid jams at ETU. In this paper, a new ML technique, light GBM (LGBM), is implemented to increase the predictions rate based on data gathered from hospitals of Northern Ireland. In addition, the proposed model is compared to other ML models such as decision tree and gradient boosted machines (GBM). Test results indicate that LGBM is more efficient with an accuracy of 86.07%. Also, the time taken to produce future predictions by LGBM was 12 milliseconds, whereas decision tree and GBM took 16 milliseconds and 20 milliseconds, respectively.

New Emergency treatment Unit for Base Hospital, Elpitiya: A better approach to save the golden hour

New Emergency treatment Unit for Base Hospital, Elpitiya: A better approach to save the golden hour

Evaluation of an Emergency Treatment Unit – in a District General Hospital – Sri Lanka – A case Study

Emergency Treatment Unit of a hospital is the place where, acutely unwell patients admitted to the hospital, are given the immediate treatment in the critical stage. DGH – Gampaha – Sri Lanka is a tertiary care hospital with a bed strength of 795 with a well - recognized Emergency Treatment Unit. Objective of this study was to evaluate the Emergency Treatment Unit of District General Hospital, Gampaha, Sri Lanka. Data was collected through oobservations, key informant interviews and reviewing registers and records. Findings were subjected to SWOT analysis. 1) Identified strengths included accessibility, Infrastructure, ETU concept, 24 hour service, competent staff, availability of equipment and investigation facilities and Information management. 2) Some weaknesses identified were; shortage of staff, absenteeism, gaps in competency, shortage of equipment and inadequate quality management system. 3) Receiving priority attention by the provincial, regional and the hospital management, Administration Support Team, Hospital Management Committee, Hospital Clinical Society, Hospital Development Committee, Hospital Development Foundation and regular donations were recognized as opportunities. 4) Finally, Unnecessary transfers from peripheral hospitals, by pass of peripheral hospitals by patients, frequently changing of the management and delay in procurement, repairing and condemning processes were noted as threats. TOWS analysis using a TOWS matrix was performed and strategies were developed for further improvement.

Emergency Department Psychiatric Observation Units: Good Care and Good Money?

The boarding of Psychiatric Emergency Department patients continues to be a crisis across our country. As healthcare leaders navigate the challenges of COVID -19 there is an amplified urgency for novel solutions to this complex problem. Congested waiting rooms and hallways, the unfortunate byproduct of boarding, result in emergency departments becoming a potential focal point for disease transmission. Given the financial losses that many health care institutions have incurred due to the pandemic, understanding the fiscal implications of any intervention is paramount.

Economic Evaluation of the Emergency Department After Implementation of an Emergency Psychiatric Assessment, Treatment, and Healing Unit.

We sought to evaluate the impact of an emergency psychiatric assessment, treatment, and healing (EmPATH) unit on emergency department (ED) revenue, psychiatric boarding time, and length of stay (LOS). We conducted a before-and-after economic evaluation of a single academic midwestern ED (60,000 annual visits) for all adult (≥18years) patients before (December 2017-May 2018) and after (December 2018-May 2019) opening an EmPATH unit. These are outpatient hospital-based programs that provide emergent treatment and stabilization for mental health emergencies from ED patients. The Holt-Winters method was used to forecast pre-EmPATH expected ED levels of patients leaving without being seen, leaving against medical advice, eloping, or being transferred using 3years of ED visits. ED revenues were calculated by finding the difference of pre-EmPATH expected and post-EmPATH observed values and multiplying by the revenue per visit. ED boarding time and LOS were obtained from the hospital's electronic medical record. There were 23,231 and 23,336 ED visits evaluated during the pre- and post-EmPATH unit periods. The ED generated an estimated additional $404,954 in the 6months and $861,065 annually after the implementation of the EmPATH unit. The median (interquartile range [IQR]) psychiatric boarding time decreased from 212 (119-536) minutes to 152 (86-307)minutes (mean difference= 189minutes, 95% confidence interval [CI]= 150 to 228 minutes) and median (IQR) LOS decreased from 351 (204-631) minutes to 334 (212-517)minutes (mean difference= 114 minutes, 95% CI= 87 to 143 minutes). The EmPATH unit had a positive impact on ED revenue and decreased ED boarding time and LOS for psychiatric patients.

ANTIBIOTICS UTILIZATION PATTERNS AND DIRECT COST IN AN EMERGENCY TREATMENT UNIT IN SRI LANKA

Objective: Anecdotal evidence suggested that antibiotics are frequently used in the Emergency Treatment Units in Sri Lanka, mostly for the respiratory tract, soft tissue or urinary tract infections. This study aimed to describe the utilization patterns of antibiotics in terms of most common type, indication and associated direct cost in ETU at the Teaching Hospital Karapitiya, Sri Lanka.&#x0D; Methods: In this study, utilization patterns and the direct cost of antibiotics in an emergency treatment unit was evaluated by checking the bed-head tickets of all patients admitted to the unit from 1/5/16 to 15/5/16. Out of the 414 bed-head tickets checked 156 patients were receiving antibiotic treatment. Socio-demographic characteristics were analyzed. The prices of antibiotics in SriLankan government hospitals were taken from the hospital medical supply division price list. Data were analyzed by Microsoft Excel™.&#x0D; Results: In this study, 45.5% (out of 156 patients) were aged between 61-80years. The most used antibiotic was amoxicillin/clavulanic acid (18.1%) and clarithromycin (15.5%). Generic antibiotics were used for most patients (95.58%). Fixed-dose combinations were used in 18.5% of cases, including amoxicillin/clavulanic acid and piperacillin/tazobactam. The common indications for prescribing antibiotics were respiratory tract infections (31.2%) and soft tissues injuries (12.1%).&#x0D; Conclusion: This study revealed that there is apparent overuse of antibiotics and reveals that antibiotic stewardship programme could reduce antibiotic use, antibiotic resistance, and cost. Improved understanding of the rationale for antibiotic use would contribute optimising their use. Further studies are needed to establish the extent of sub-optimal prescribing of antibiotics in Sri Lankan hospitals.

Anaphylaxis in infants

Anaphylaxis is defined as a serious generalized allergic or hypersensitivity reaction that is rapid in onset and might cause death. Number of patients with anaphylaxis is increased over the last years in all age groups. However, data of anaphylaxis in infants is limited. The knowledge of anaphylaxis in this group of patients is based only on the description of clinical case-report, a retrospective analysis of registers for severe allergic reactions of emergency treatment units. However, children of the first years of life are extremely vulnerable and they have clinical features of the development of anaphylaxis. This article summarizes information on various aspects of anaphylaxis in infants.

The delivery of emergency medicine at the Teaching Hospital Karapitiya emergency treatment unit – an Australian Perspective

The delivery of emergency medicine at the Teaching Hospital Karapitiya emergency treatment unit – an Australian Perspective