Management Of Medical Emergencies Research Articles

Advanced Trauma Life Support training. How useful it is?

For more than 20 years, following the changes that took place in Albania in 1992, we receive information from trauma patients in the media about the delivery of trauma services. Police records are worthy of a war balance report. Trauma is estimated to be the cause of deaths in 13.7% / 100,000 people. Every two days three Albanian Citizens die because of Automobile Accidents…
 Changes have already taken place, but the question arises, who cares about the trauma and its management?
 Formerly and now the state ... ok ... but? Is this enough?
 The Ministry of Health should have a “Trauma Committee” if yes… is it active?
 Already of the three years at the heart of these medical emergency management networks is a National Center of Medical Emergency (NCME).
 The trauma service delivery is now evolving along the lines of a central and spoken model with a concentration of expertise and specialization in the center surrounded by smaller units that feed on the center.
 The study showed a 19% increase in the chances of survival since the introduction of these changes. Another 1,600 trauma victims are alive today due to developments in the administration of trauma patients in England over the past six years.
 In this system or mode of organizing what is today the NCME or organizing the transport of traumatized from the scene to the University Hospital of Trauma... by medical staff who have done a substantial part of the PhTLS® course ... How is the educational status of personal in other regions far from Capital? ATLS® student courses in our country have been implemented by few and individually… ASTES, by default rules, has acquired the right to organize ATLS® in Albania…

Impact of Electronic Medical Record Alerts on Emergency Physician Workflow and Medical Management.

Electronic medical record (EMR) alerts are automated messages that notify the physician of important information. However, little is known about how EMR alerts affect the workflow and decision-making of emergency physicians (EPs). This study aimed to quantify the number of EMR alerts EPs receive, the time required to resolve alerts, the types of alerts EPs receive, and the impact of alerts on patient management. We performed a prospective observational study at a tertiary care ED with 130,000 visits annually. Research assistants observed EPs on shift from May to December 2018. They recorded the number of EMR alerts received, time spent addressing the alerts, the types of alerts received, and queried the EP to determine if the alert impacted patient management. Seven residents and six attending physicians were observed on a total of 17 shifts and 153 patient encounters; 78% (119) of patient encounters involved alerts. These 119 patients triggered 530 EMR alerts. EPs spent a mean of 7.06s addressing each alert and addressed 3.46 alerts per total patient seen. In total, EPs spent approximately 24s per patient resolving alerts. Only 12 alerts (2.26%) changed clinical management. EPs frequently receive EMR alerts, however, most alerts were not perceived to impact patient care. These alerts contribute to the high volume of interruptions EPs must contend with in the clinical environment of the ED.

Schoolchildren with chronic diseases; What are teachers worried about?

IntroductionAs the number of schoolchildren with chronic diseases is constantly increasing, teachers must be aware of this new reality and of the special needs of these children. However, there is very little information about the knowledge, skills, and concerns of teachers when faced with a possible urgent situation that could occur in a child with a chronic disease. For this reason, this study has been conducted. MethodsAn anonymous questionnaire with simple questions about seizures, diabetes, anaphylaxis, and basic cardiopulmonary resuscitation (CPR) was completed by 244 primary and secondary school teachers. They subsequently participated in short workshops focused on the management of medical emergencies in relation to these conditions. ResultsThe majority (60%) of the teachers had at least one child in their classroom with a chronic disease, with epilepsy being the most frequent. Their main concern was not knowing how to act in a potentially serious situation. As regards hypoglycaemic crises and anaphylaxis, teachers who had at-risk pupils were not sure if they would be able to use the recommended medication, although they knew how to use it. ConclusionsTeachers of the study were concerned about not knowing what to do in an emergency event in a schoolchild with chronic illness. Although some had received information about the medication to be administered, they were not sure if they would be able to do so. The training and self-confidence of teacher should be improved in order to cope with possible critical situations in schoolchildren with chronic diseases.

Challenges faced by dental professionals during COVID-19- A cross sectional survey

Background: At the time of pandemics like COVID-19, dental professionals being one of the frontline workers must face a lot of challenges in workplace bringing about a lot of anxiety and stress. The purpose of this survey was to assess the physiological well-being of the dental professionals, the majority of challenges faced by them, , how they are dealing with it and what changes in their opinion could be implemented to be prepared in the wake of any future adversity.
 Methodology: We conducted a cross sectional survey via an online questionnaire that was sent to dentists in 4 different countries- India, US, UK, and Iran. The questionnaire comprised of closed ended questions grouped in broad categories of demographics, physiological well-being of dentists, Changes in dental practice during COVID-19 and Changes to be implemented post Covid-19. Descriptive analysis was performed to summarize the data with SPSS-19 software.
 Results: A total of 312 dentists (181 Males and 131 Females) from four countries responded to the study. Most of them (56.4 %) were in the age group of 30 to 40 years, 27.9 % in 25- 30 years, and 7.1% above 50 years. 47.5% dentists reported suffering from stress and anxiety due to the shutting down of their private dental practices. 72.5% dentists reported that they are worried about the operational and financial challenges to run their practice during Covid-19. 60% of the dentists had concerns due to the shortage of personal protective equipment. Most of the dental professionals (73.9%) are of the opinion that management of medical emergencies should be included in the dental curriculum, so that dentists can volunteer their services at the time of crisis and also can be well-prepared to take care of their patients.
 Conclusion: During the COVID-19 pandemic, dentists like medical professionals must face a lot of ethical and moral dilemma along with dealing with the operational challenges. The present study draws our attention to the fact that despite having faced pandemics like SARS, health professions like dentistry still need a lot of preparedness and requires modifications to face any such challenges in future.

Use of High-fidelity simulation training for radiology healthcare professionals in the management of acute medical emergencies.

Life-threatening emergencies are relatively uncommon in the radiology department, but when encountered, require timely intervention. With an increasing number of critically unwell patients visiting the radiology department each year for both diagnostic and interventional procedures, it is vital that radiology staff are trained to provide basic resuscitation before further assistance arrives. Simulation training is a well-validated, effective method for rehearsing low-frequency, high-acuity events in a supportive and safe environment. The aim of our study was to investigate whether the introduction of a focussed, multidisciplinary simulation course would improve healthcare professional's knowledge and confidence when managing common medical emergencies; including cardiac arrest, anaphylaxis and airway obstruction. A multidisciplinary group of radiology staff attended a dedicated simulation teaching course. Participants completed a pre- and post-test questionnaire which assessed a range of knowledge domains and their perceived confidence with dealing with the clinical scenarios. The delegates were then asked to repeat this questionnaire 6 months after taking part in the course to assess their retention of skills and knowledge. Knowledge scores increased by a mean difference of 4 points (p < 0.001). The mean pre- and post-course perceived confidence scores were 4.4/10 and 8/10, respectively. This study suggests that embedding simulation training into the radiology curriculum improves healthcare professional's knowledge and perceived confidence when dealing with common medical emergencies. Although previous studies have looked at the use of simulation training for radiology trainees in the management of selected medical emergencies, to the authors' knowledge, this is the first study to demonstrate these benefits across a range of clinical scenarios, within an interprofessional environment.

Trismus and odontogenic infection - A retrospective study

Odontogenic infections are polymicrobial, consisting of aerobic microorganisms, strict anaerobes and facultative anaerobes. It can either be localised or rapidly spread to the deep neck space causing space infection and need immediate emergency medical and surgical management. The aim of this study is to evaluate the association of odontogenic infection leading to trismus and its prevalence amongst patients visiting a university dental institution. 63 patients aged between 17 years old to 70 years old, whose details were obtained from the electronic database in Saveetha Dental College and Hospital from June 2019 till May 2020 were included in the study. All 63 patient records were assessed for the details such as age, sex, odontogenic infection type, odontogenic infection sources, space involved, and pain score (VAS). The data were analysed. Results showed that in the odontogenic infection types, pericoronitis has a higher prevalence with 42.9%. The right mandibular third molar is the most prevalent (25.4%) odontogenic infection source. Amongst space involved, Submasseteric space is the most common space infected (42.9%). When the pain score VAS is assessed, patients have a higher VAS score between 6.00 (33.5%) and 8.00 (38.1%), respectively. There is a positive correlation between pericoronitis and mandibular third molar teeth. There is also a positive correlation between pericoronitis and Submasseteric space involvement. In conclusion, our study revealed a positive association between odontogenic infection involving Submasseteric, Submandibular space and painful trismus.

Generating a spatial coverage plan for the emergency medical service on a regional scale: Empirical versus random forest modelling approach

Adequate spatial coverage by the emergency medical service and the ability to reach any location in the area of interest in the shortest possible time are crucial for the survival of patients with serious conditions. Knowledge of blind spots (i.e. sites that cannot be reached within the required time) represents key information for improving the service quality and may lead, e.g. to a relocation of bases or to other active interventions. Spatial coverage can be derived from experience based on historical data. Such an approach may be problematic if a larger area is being analysed, especially if data is not available for some parts of such areas or if no data is available. To eliminate such problems, we created a prediction model utilising the random forest ensemble learning method. The model is capable of predicting the travel time based on available historical data on ambulance movements (GPS) and the geometric and construction characteristics of individual road segments. We therefore collaborated with the regional public administration and emergency medical service authorities to deliver a time- and resource-efficient solution for emergency spatial planning practice. The outputs from the newly built model were subsequently validated against data from an empirical model currently used by the regional authorities. The results from both models were compared from the perspective of performance in various seasonal and time-of-day conditions. The prediction of travel times using the new model improved according to all the evaluated validation metrics. The importance and applicability of the foregoing model lies in the fact that it can be incorporated into the current emergency medical service management system in a simple manner in terms of data availability and the required computational resources. We conclude that the dynamic model presented in this paper represents an improvement relative to the reference data, and discuss the possibilities of further improving the proposed model.

Laser polished fused deposition poly-lactic acid objects for personalized orthopaedic application

Patient-specific surgical guides are increasingly demanded. Material Extrusion (ME) is a popular 3D printing technique to fabricate personalized surgical guides. However, the ME process usually generates deleterious surface topography which is not suitable for orthopaedic emergencies. We designed and optimized parametric combinations of a laser polishing approach as post process to improve the surface quality of ME-made poly-lactic acid (PLA) objects. In this study, we investigated the contribution of processing variables to the mechanical properties and the biocompatibilities in vitro of the ME-made PLA objects. Conventional surface grinding was conducted as comparison. The results demonstrate that the ME-made PLA samples exhibit good mechanical properties and favourable biocompatibility after being post processed using laser polishing. The post laser polishing, as a powerful tool in manufacture of ME-made PLA objects, will open a new approach with a great promise in its applications in personalized and timely management of medical emergencies.

Assessing the Status of Yazd Province Medical Emergency and Accident Management Center in Terms of Necessary Standards for Air Emergencies

Background: Air emergency medical services provide advanced medical care to patients and critically injured as soon as possible to reduce injuries and casualties. In this study, the status of the Medical Emergency and Accident Management Center in Yazd Province in terms of the necessary standards for air emergencies was investigated and compared with existing standards. Materials and Methods: The present research was a cross-sectional descriptive study. Using a researcher-made checklist, the required data, such as human resource requirements, physical and environmental space, time, communication equipment, medical equipment, equipment for traffic detection and management, and equipment for technical and safety services, were collected by asking relevant officials and experts. Finally, data analysis was performed using tables and descriptive statistics. Results: The study findings showed that in total, 2 items in the field of human resource requirements, 7 items in physical space and environmental requirements, 2 items regarding time requirements, 4 items regarding communication equipment requirements, 43 items regarding equipment and medicine requirements, including patient cabin equipment, emergency resuscitation kit and Cardiopulmonary Resuscitation (CPR), medicine and jump bag equipment, delivery set, triage bag, dressing equipment and technical and safety service equipment requirements were in accordance with the existing standards. Conclusion: Based on the existing standards, the air emergency in Yazd Province in most areas was satisfactory. Because of the importance of the issue, authorities must take the necessary measures to address the deficiencies and limitations so that the emergency missions be carried out in the best conditions.

Dental Management in Medically Compromised Patients : An Overview

There is an increasing population of apparently well, but in fact medically compromised people in the community. Most will require dental treatment at some stage and will usually seek it away from a hospital environment. In a recent survey of a general dental practice in Australia it was found that up to 55 per cent of some age groups had concurrent medical problems. Thus there is a real risk that adverse interactions between medical conditions and dental treatment may occur on some occasions, even fatal ones. It is not possible for any one individual to know the details of all medical conditions, their treatment and the possible interactions with dental treatment. However, by the application of some sound general principles the risks of any potential interactions can be evaluated. The essential steps are: knowledge of the medical history of all patients, potential drug interactions and management of medical emergencies. These principles will be discussed and illustrated by examples of medically compromised patients who may experience common or potentially serious sequelae as a result of dental treatment.

Exploring National Nursing Readiness for a Radiological or Nuclear Incident: A Cross-Sectional Study

IntroductionAs the largest component of the United States health care workforce, nurses will play a critical role in radiological or nuclear disaster medical response. Despite this, the United States’ schools of nursing are not currently providing radiation content (75% teach zero or <1 hour), and much of the current nursing workforce may not have received adequate response education and training. Nurses working in emergency departments and those who work at hospitals within the Radiation Injury Treatment Network will be relied on heavily, but little is known about whether these nurses possess the knowledge and skills needed to care for and protect patients after a radiation emergency. Current federal and state radiological/nuclear preparedness plans may be built on false assumptions of readiness, which would have serious implications for national preparedness and the National Health Security Strategy. The purpose of this study was to assess nurses' knowledge and skill in emergency radiological or nuclear response and determine their willingness to use mobile technology for education and training in response to a large-scale radiation event. MethodsDescriptive cross-sectional survey of registered nurse members of the Emergency Nurses Association and/or those employed at Radiation Injury Treatment Network centers. ResultsKnowledge scores were low for all respondents. Prior attendance at a Radiation Emergency Medical Management course, use of online resources, and having a preparedness plan were associated with higher scores. Experience with a radiation emergency was associated with the highest score. Nurses are willing to use mobile technology during a radiological or nuclear disaster response. DiscussionKey nurses may not possess adequate knowledge or clinical competence to participate in radiation response activities. The results of this assessment identified educational gaps and areas to strengthen nursing education and clinical skills.

Management of medical emergencies in orthodontic practice

BackgroundThe aims of this study were to survey the occurrence of acute medical situations in Dutch orthodontic practice and to examine the self-perceived competence of orthodontists in managing acute medical emergencies.MethodsA self-designed questionnaire was distributed among all 149 Dutch orthodontists attending the spring meeting of the Dutch Society for Orthodontists. The questionnaire was divided into three parts, addressing background information of the orthodontist, precautions against and experiences in acute medical situations, and self-perceived competence of nine common medical emergencies. The statistical analysis was performed using the chi-square test and a multiple logistic regression analysis.ResultsThe response rate was 74.5% (105 out of 149). The male to female ratio in this population was 55:50. Mean age of all participants was 46.9 years (SD 10.4 years) with on average 16.7 years of working experience (SD 10.6 years). The most common medical emergency reported by Dutch orthodontists was vasovagal collapse (n = 219), followed by acute allergic reaction (n = 163) and hyperventilation (n = 83). On average, 75% (n = 79) of the orthodontists felt competent to handle any acute medical situation with an average occurrence of 0.36 acute medical emergencies per orthodontist per year. Male participants were more likely to send patients towards the emergency department (p = 0.049). Moreover, a statistically significant negative correlation was observed between self-perceived competence handling hypoglycemia and years of clinical experience. The longer orthodontists were clinically active, the less competent they felt when encountered with a hypoglycemia (p = 0.031).ConclusionsMedical emergencies may be rare but challenging occurrences in the orthodontic practice. It is strongly recommended for all orthodontists and supporting staff to be trained regularly in the management of medical emergencies and to possess up-to-date evidence-based knowledge. Familiarity with and availability of appropriate drugs and equipment are deemed essential to the management of acute medical emergencies that may arise in the orthodontic practice.

School Nurses on the Front Lines of Healthcare: Children With Medical Devices-Shunt System Malfunctions and Infections.

An important subgroup of children with special healthcare needs are those children with medical complexities who require long-term intensive healthcare interventions and treatments. As medical technology continues to advance and children with complex medical needs survive the neonatal period and progress into school-age, it is essential for school nurses to be able to recognize and acutely manage complications and malfunctions of devices in children requiring assistance from medical devices. An example of a common medical device includes shunts systems (e.g., a ventriculoperitoneal shunt) to drain excess cerebrospinal fluid. These devices put children at serious medical or surgical risk when they malfunction or become infected, so it is important for healthcare providers, especially school nurses who are the first responders in schools, to recognize malfunctions and initiate appropriate care management. This article describes the initial assessment and management of common medical emergencies in students who have those devices.

Evaluation of Adaptive Feedback in a Smartphone-Based Game on Health Care Providers' Learning Gain: Randomized Controlled Trial.

BackgroundAlthough smartphone-based emergency care training is more affordable than traditional avenues of training, it is still in its infancy, remains poorly implemented, and its current implementation modes tend to be invariant to the evolving learning needs of the intended users. In resource-limited settings, the use of such platforms coupled with gamified approaches remains largely unexplored, despite the lack of traditional training opportunities, and high mortality rates in these settings.ObjectiveThe primary aim of this randomized experiment is to determine the effectiveness of offering adaptive versus standard feedback, on the learning gains of clinicians, through the use of a smartphone-based game that assessed their management of a simulated medical emergency. A secondary aim is to examine the effects of learner characteristics and learning spacing with repeated use of the game on the secondary outcome of individualized normalized learning gain.MethodsThe experiment is aimed at clinicians who provide bedside neonatal care in low-income settings. Data were captured through an Android app installed on the study participants’ personal phones. The intervention, which was based on successful attempts at a learning task, included adaptive feedback provided within the app to the experimental arm, whereas the control arm received standardized feedback. The primary end point was completion of the second learning session. Of the 572 participants enrolled between February 2019 and July 2019, 247 (43.2%) reached the primary end point. The primary outcome was standardized relative change in learning gains between the study arms as measured by the Morris G effect size. The secondary outcomes were the participants individualized normalized learning gains.ResultsThe effect of adaptive feedback on care providers’ learning gain was found to be g=0.09 (95% CI −0.31 to 0.46; P=.47). In exploratory analysis, using normalized learning gains, when subject-treatment interaction and differential time effect was controlled for, this effect increased significantly to 0.644 (95% CI 0.35 to 0.94; P<.001) with immediate repetition, which is a moderate learning effect, but reduced significantly by 0.28 after a week. The overall learning change from the app use in both arms was large and may have obscured a direct effect of feedback.ConclusionsThere is a considerable learning gain between the first two rounds of learning with both forms of feedback and a small added benefit of adaptive feedback after controlling for learner differences. We suggest that linking the adaptive feedback provided to care providers to how they space their repeat learning session(s) may yield higher learning gains. Future work might explore in more depth the feedback content, in particular whether or not explanatory feedback (why answers were wrong) enhances learning more than reflective feedback (information about what the right answers are).Trial RegistrationPan African Clinical Trial Registry (PACTR) 201901783811130; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=5836International Registered Report Identifier (IRRID)RR2-10.2196/13034

The dental team as part of the medical workforce during national and global crises.

In a national or global crisis, a healthcare system and its workforce should have the flexibility and resilience to deliver the required level of care for all its constituents. The current COVID-19 pandemic necessitated rapid decisions and early redeployment of staff to deliver essential healthcare. Having the dental team as part of this strategy would increase availability of healthcare workers. They have the potential to make a significant contribution as part of the medical workforce during national and global crises. The desirability of redeploying dentists at short notice is supported by several factors: they are accustomed to working in stressful situations, are effective communicators, are familiar with infection control procedures and work wearing PPE, are immunised and Disclosure and Barring Service (DBS)-checked, and undergo regular training in the management of medical emergencies. Dentists are also experienced in administrative tasks and have knowledge of legislation. They have additional resilience from working in different settings. They have the potential to make a significant contribution as part of the medical workforce during national and global crises.

Letter to the editor

Editor, “Inside the word emerging is emerge, from an emergency new things come forth. The old certainties are crumbling first, but danger and possibility are sisters.’’1 The population burden of SARS-CoV-2, in terms of number of new cases, has declined significantly since the peak of the outbreak. Concerns rightfully persist regarding a possible second wave of infection. We feel the impact upon acute medicine warrants further discussion. Acute medicine by definition; the immediate management of life-threatening medical emergencies, the initial treatment (first 72 hours) of all presenting general medical ailments, and the provision of ambulatory care2 witnessed almost overnight changes in patient cohorts, emergency department attendance numbers,3 service delivery and staffing models. Of the patients presenting with COVID pneumonitis, in our hospital, the sickest were manged by our intensivist colleagues, while those needing respiratory support were managed by respiratory consultants and members of the acute medicine multidisciplinary team. New ways of providing care emerged4 with innovation powered on by collaborative spirit and an infectious ‘yes culture’. Allowing those clinicians with frontline experience to drive through changes to better deliver care for our patients, is the heart of what many of those in acute medicine just want to get on and do. Even against the harsh clinical scenarios witnessed, for many, accomplishing what acute medicine delivered was a silver lining of opportunity, not many will see again. Where does all that tremendous effort leave us now? How exactly do we run two versions of the NHS – a hot and cold, a red and green or a COVID and non COVID – for patients presenting with acute medical problems. How do we ensure we get the right person to the right place, first time?5 Do we need to re-explore our relationship with primary care and the walls within which acute medicine is delivered? Even our medicine has changed – the sequalae of COVID pathology, the delayed presentation of disease states, the impacts of social isolation and the economic fall-out, the tidal wave of undiagnosed, late presentation cancer that is about to befall us. And we haven’t even mentioned winter. Acute Medicine has always been composed of talented, committed people, skills and attributes. Examples of good practice are often shared throughout the acute medicine community, critiqued and then taken home to implement on our own ‘turf’. It is vital that at this time of significant change and reconfiguration that this continues to happen in some way. Dr Sue Crossland (President of SAM) and Dr Nicholas Scriven (Immediate Past President) outlined some of the challenges facing our specialty to the Health and Social Care Committee.6 We hope that by acknowledging that COVID 19 has impacted on the delivery of Acute Medicine, and that by starting a dialogue about how different AMUs have managed such extraordinary times; the good, the bad, and the ugly of COVID 19 can be used to harness the best for Acute Medicine going forwards and ensure it’s place in the heart of unscheduled care.

Adherence to Professional Code of Ethics from Emergency Medical Technicians and Their Patient's Perspective: A Cross-Sectional Study

Background: Adherence of emergency medical technicians (EMTs) to a professional code of ethics is one of the most important aspects of their occupation. Objectives: The purpose of this study was to determine the degree of adherence to the professional code of ethics from the perspective of EMTs and their patients. Methods: This was a cross-sectional study. The inclusion criteria for patients were age between 18-65 years, willingness to participate in the study, normal mental status, being medically stable and absence of any chronic mental or psychiatric disorder. The inclusion criteria for EMTs were willingness to participate in the study, having an associate or bachelor’s degree in the medical emergency, working at medical emergency departments and management centers. The exclusion criteria were refusal to continue the study and the necessity of therapeutic intervention while completing the questionnaire. The patients were recruited by cluster sampling. For this reason, first, two hospitals were randomly selected among six hospitals in Arak, Markazi province (Arak, Iran). Then, the list of missions at each shift was extracted by referring to the emergency departments of these hospitals. Afterward, one of the missions in each shift was randomly selected. In this study, a two-part questionnaire was used for data gathering. In this first part, the demographic information of the participants was collected. In the second part, a professional code of ethics for EMTs' questionnaire, including 26 statements in 5 dimensions was used. Finally, the questionnaires were given and completed by the pre-hospital emergency personnel and the transferred patients. Results: A total of 105 EMTs and 109 patients were randomly selected as they transported patients to the studied hospitals. From the viewpoint of patients, adherence to the professional code of ethics was rated 2% as highly desirable, 39% as desirable, 58% as moderate, and 1% as undesirable. On the other hand, the EMTs rated themselves as 59.8% highly desirable, 37.1% as desirable, and 3.1% as moderate. There was a statistically significant difference between the average score of adherence to a professional code of ethics from the viewpoint of patients versus that of the EMTs (p <0.001). Conclusion: There was a statistically significant difference between the degrees of adherence to the professional code of ethics by EMTs from their own viewpoint versus that of the patients.

Abdominal compartment syndrome in severe acute pancreatitis (review of literature)

The study was performed for analysis of current understanding of intra-abdominal hypertension and abdominal compartment syndrome in patients with severe acute pancreatitis.The English and Russian articles about intra-abdominal hypertension and abdominal compartment syndrome in patients with severe acute pancreatitis were analyzed. The articles were found in «Russian Science Citation Index» and «PubMed».There is a pathogenetic relationship between increased intra-abdominal pressure and the development of severe acute pancreatitis.For today, it was shown that intra-abdominal hypertension in patients with severe acute pancreatitis is associated with significantly higher APACHE-II and MODS score, prevalence of pancreatic and peripancreatic tissue lesions, early infection of pancreatic necrosis and higher mortality.The article considers various variants of decompressive interventions such as decompressive laparotomy, fasciotomy and percutaneous catheter drainage. For today, there are no randomized studies devoted to researching effectiveness of different decompressive interventions.The study showed that it is necessary to regularly monitor intra-abdominal pressure in patients with severe acute pancreatitis. Patients with intra-abdominal hypertension require emergency medical management to reduce intra-abdominal pressure. Inefficiency of the medical management and development of abdominal compartment syndrome are indications for surgery. The effectiveness of different decompressive interventions requires further studies.

Integrating and maintaining automated external defibrillators and emergency planning in community sport settings: a qualitative case study

IntroductionA voluntary State Government-led programme in Victoria, Australia ‘Defibrillators for Sporting Clubs and Facilities Program’ ran from 2015 to 2019, broadly aimed at increasing access to automated external defibrillators (AEDs),...

Management of Acute Stroke During COVID-19 Global Pandemic

The COVID-19 pandemic is a serious public health emergency, which has caught the world unawares. The rapidly escalating intensity of this outbreak has overwhelmed the existent health care resources leading to major implications on the optimal management of other important medical emergencies like stroke. Timely treatment of acute stroke is imperative to prevent disability, thereby necessitating the need for guidelines so as to maintain the continuum of stroke care, while also protecting health care personnel. We have summarized the global consensus with focus on India.