Author(s): Robertson, Sarah Kathryn; Manson, Kristina; Fioratou, Evridiki
Source: BMC Health Services Research; Dec 2018; vol. 18 (no. 1)
Publication Date: Dec 2018
Publication Type(s): Academic Journal
PubMedID: 30594185
Available  at BMC Health Services Research -  from EBSCO (MEDLINE Complete)
Abstract:Background: Integrated Management of Childhood Illness (IMCI) and Emergency Triage, Assessment and Treatment (ETAT) are guidelines developed by the World Health Organization to reach targets for reducing under-5 mortality. They were set out in the Millennium Development Goals. Each guideline was established separately so the purpose of this study was to understand how these systems have been integrated in a primary care setting and identify barriers and facilitators to this integration using a systems approach.Method: Interviews were carried out with members of staff of different levels within a primary healthcare clinic in Malawi. 

​Author(s): El Muntasar A.; Toner E.; Alkhazaaleh O.A.; Arumugam D.; Shah N.; Hajibandah S.; Hajibandeh S.
Source: World Journal of Emergency Medicine; 2018; vol. 9 (no. 2); p. 85-92
Publication Date: 2018
Publication Type(s): Review
Available  at World Journal of Emergency Medicine -  from Europe PubMed Central - Open Access
Abstract:BACKGROUND: The management of complex pattern of bleeding associated with pelvic trauma remains a big challenge for trauma surgeons. We aimed to conduct a comprehensive meta-analysis to compare the outcomes of angioembolisation and pelvic packing in patients with pelvic trauma. METHODS: We conducted a systematic search of electronic information sources, including MEDLINE; EMBASE; CINAHL; the CENTRAL; the World Health Organization International Clinical Trials Registry; ClinicalTrials.gov; ISRCTN Register, and bibliographic reference lists. The primary outcome was defined as mortality. Combined overall effect sizes were calculated using randomeffects models. Results are reported as the odds ratio (OR) and 95% confi dence interval (CI). RESULTS: We identified 3 observational studies reporting a total of 120 patients undergoing angioembolisation (n=60) or pelvic packing (n=60) for pelvic trauma. Reporting of the Injury Severity Score (ISS) was variable, with higher ISS in the pelvic packing group. The risk of bias was low in two studies, and moderate in one. The pooled analysis demonstrated that angioembolisation did not signifi cantly reduce mortality in patients with pelvic trauma compared to surgery (OR=1.99; 95% CI= 0.83-4.78, P=0.12). There was mild between-study heterogeneity (I2=0%, P=0.65). CONCLUSION: Our analysis found no signi f icant di fference in mortal i ty between angioembolisation and pelvic packing in patients with traumatic pelvic haemorrhage. The current level of evidence in this context is very limited and insuffi cient to support the superiority of a treatment modality. Future research is required.Copyright © 2017 World Journal of Emergency Medicine.
Database: EMBASE

​Author(s): Yap D.; Chaudhury M.; Mbakada N.; Ng M.
Source: American Journal of Emergency Medicine; Jan 2018; vol. 36 (no. 1); p. 171
Publication Date: Jan 2018
Publication Type(s): Article
PubMedID: 29079373
Available  at American Journal of Emergency Medicine -  from ProQuest (Hospital Premium Collection) - NHS Version
Abstract:Introduction Blunt chest injury is a common presentation to the emergency department. However, a delayed hemothorax after blunt trauma is rare; current literature reports a delay of up to 30 days. We present a case of 44-day delay in hemothorax which has not been previously reported in current literature. Case report A 52-year-old Caucasian male first presented to the emergency department complaining of persistent right sided chest pain 2 weeks after having slipped on a wet surface at home. His initial chest X-ray showed fractures of the right 7th and 8th ribs without a hemothorax or pneumothorax. He returned 30 days after the initial consultation (44 days post-trauma) having increasing shortness of breath. A chest X-ray this time revealed a large right hemothorax and 1850 ml of blood drained from his chest. There was a complete resolution of the hemothorax within 48 h and the patient was discharged after a 6-week follow-up with the chest physicians. Discussion Delayed hemothorax after blunt trauma is a rare clinical occurrence but associated with significant morbidity and mortality. The management of delayed hemothorax includes draining the hemothorax and controlling the bleeding. Why should an emergency physician be aware of this? Emergency physicians should be vigilant and weary that hemothorax could be a possibility after a chest injury despite a delay in presentation. A knowledge of delayed hemothorax will prompt physicians in providing important advice, warning signs and information to patients after a chest injury to avoid a delay in seeking medical attention. Copyright © 2017 Elsevier Inc.
Database: EMBASE

Author(s): How E.H.; Yap D.; Mbakada N.
Source: Journal of Medical Case Reports; Nov 2017; vol. 11 (no. 1)
Publication Date: Nov 2017
Publication Type(s): Article
Available  at Journal of Medical Case Reports -  from BioMed Central
Abstract:Background: Furuncular myiasis is a parasitic infection of a live mammal by fly larvae commonly seen in Africa. However, with an increase in international tourism, there is a significant rise in exotic infection in non-endemic areas which can pose a diagnostic challenge to doctors and potentially lead to delay in treatment. From the current literature, only 12 cases were reported in the UK. Case presentation: We report an unusual case of multiple abscesses in a 32-year-old white British woman presenting to our Emergency department in the UK after returning from a holiday in The Gambia, West Africa. She did not complain of systemic symptoms and was otherwise fit and healthy with no significant past medical history. During examination, two maggots were expressed from the abscesses by applying lateral pressure to each lesion. The larvae were found to be Cordylobia anthropophaga. She was discharged with antibiotics to prevent secondary infection with no further follow-up. Conclusion: With globalization, the need for increasing awareness of tropical diseases has become important to win the battle against future epidemics.Copyright © 2017 The Author(s).
Database: EMBASE

​Author(s): Yap D.; Chaudhury M.; Mbakada N.; Ng M.
Source: American Journal of Emergency Medicine; 2017
Publication Date: 2017
Publication Type(s): Article In Press
Abstract:Introduction: Blunt chest injury is a common presentation to the emergency department. However, a delayed hemothorax after blunt trauma is rare; current literature reports a delay of up to 30. days. We present a case of 44-day delay in hemothorax which has not been previously reported in current literature. Case report: A 52-year-old Caucasian male first presented to the emergency department complaining of persistent right sided chest pain 2. weeks after having slipped on a wet surface at home. His initial chest X-ray showed fractures of the right 7th and 8th ribs without a hemothorax or pneumothorax.He returned 30. days after the initial consultation (44. days post-trauma) having increasing shortness of breath. A chest X-ray this time revealed a large right hemothorax and 1850. ml of blood drained from his chest.There was a complete resolution of the hemothorax within 48. h and the patient was discharged after a 6-week follow-up with the chest physicians. Discussion: Delayed hemothorax after blunt trauma is a rare clinical occurrence but associated with significant morbidity and mortality. The management of delayed hemothorax includes draining the hemothorax and controlling the bleeding. Why should an emergency physician be aware of this?: Emergency physicians should be vigilant and weary that hemothorax could be a possibility after a chest injury despite a delay in presentation. A knowledge of delayed hemothorax will prompt physicians in providing important advice, warning signs and information to patients after a chest injury to avoid a delay in seeking medical attention.Copyright © 2017 Elsevier Inc.
Database: EMBASE

Author(s): Hajibandeh S.

Source: Western Journal of Emergency Medicine; Apr 2017; vol. 18 (no. 3); p. 331-332

Publication Date: Apr 2017

Publication Type(s): Letter

Available in full text at Western Journal of Emergency Medicine -  from National Library of Medicine
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Database: EMBASE