Effective Healthcare Worker-Patient Communication in Hong Kong Accident and Emergency Departments

Objective To (1) describe the epidemiology of household rodenticides poisoning in Hong Kong, (2) evaluate the proportion of patients who have develop coagulopathy after rodenticide poisoning, (3) identify the risk factors for developing coagulopathy in rodenticide poisoning. Design Case series study. Setting Sixteen accident and emergency departments in Hong Kong. Patients Patients with household rodenticide ingestion who presented to accident and emergency departments during the period from July 2008 to February 2012. Results 110 patients were reported to have rodenticide exposure during the study period. Eighty-seven patients were included in the final analysis. The mean age was 40.1 and the male-to-female ratio was 1.29:1 (49:38). Most patients (91%) took the rodenticide intentionally. Sixty-nine patients (79%) exposed to anticoagulants type of rodenticide based on history or laboratory findings. The ingredient of the rodenticide ingested in 18 patients (21%) was untraceable. The only clinically significant presentation reported after rodenticide exposure was coagulopathy. Thirty-one patients (36%) developed coagulopathy with an international normalised ratio greater or equal to 1.3. Clinical significant bleeding was only observed in one patient. Presence of coagulopathy in rodenticide poisoning was significantly associated with older patient, intentional ingestion, ingestion of warfarin, ingestion of more than one pack and presence of co-ingestion. Multiple logistic regression analysis showed that only two factors were independent predictor of coagulopathy: Ingestion of warfarin rodenticide (p=0.001, odds ratio [OR] = 18.20, 95% confidence interval [CI]=3.44-96.42), and ingestion of more than one pack of rodenticide (p=0.02, OR=10.01, 95% CI=1.43-69.87). Conclusions Clinically significant household rodenticide poisoning in Hong Kong is solely related to ingestion of anticoagulant type of rodenticide. Patients who have ingested warfarin rodenticide and higher ingestion dose are more likely in developing coagulopathy. (Hong Kong j.emerg.med. 2014;21:339-345)

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Injury patterns of mass casualty incidents involving high-speed passenger ferries presenting to accident and emergency departments in Hong Kong: a retrospective review

Injury ◽

10.1016/j.injury.2019.12.001 ◽

2020 ◽

Vol 51 (2) ◽

pp. 252-259 ◽

Cited By ~ 1

Author(s):

Rex Pui Kin Lam ◽

Ronald Tat Ming Wong ◽

Eric Ho Yin Lau ◽

Kin Wa Wong ◽

Arthur Chi Kin Cheung ◽

...

Keyword(s):

Hong Kong ◽

Retrospective Review ◽

Emergency Departments ◽

High Speed ◽

Mass Casualty ◽

Mass Casualty Incidents ◽

Injury Patterns ◽

Accident And Emergency

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Communication in Hong Kong Accident and Emergency Departments

Global Qualitative Nursing Research ◽

10.1177/2333393615576714 ◽

2015 ◽

Vol 2 ◽

pp. 233339361557671 ◽

Cited By ~ 1

Author(s):

Eloise Chandler ◽

Diana Slade ◽

Jack Pun ◽

Graham Lock ◽

Christian M. I. M. Matthiessen ◽

...

Keyword(s):

Hong Kong ◽

Emergency Departments ◽

Accident And Emergency

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Medical Social Services in Accident and Emergency Departments of Hospitals in Hong Kong: Their Utilisation Patterns, Functions, and Outcomes

Asia Pacific Journal of Social Work and Development ◽

10.1080/21650993.2002.9755897 ◽

2002 ◽

Vol 12 (2) ◽

pp. 8-24

Author(s):

Daniel F.K. Wong ◽

Cecilia L.W. Chan ◽

C. K. Law ◽

Tirana Y.W. Au

Keyword(s):

Hong Kong ◽

Social Services ◽

Emergency Departments ◽

Accident And Emergency

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Hepatitis B vaccination: uptake by medical staff in accident and emergency departments.

Emergency Medicine Journal ◽

10.1136/emj.12.4.282 ◽

1995 ◽

Vol 12 (4) ◽

pp. 282-285 ◽

Cited By ~ 2

Author(s):

P A Nee ◽

P E Randall ◽

J Heyworth

Keyword(s):

Hepatitis B ◽

Emergency Departments ◽

Medical Staff ◽

Hepatitis B Vaccination ◽

Vaccination Uptake ◽

Accident And Emergency

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Radiological features of body packers: An experience from a regional accident and emergency department in close proximity to the Hong Kong International Airport

Hong Kong Journal of Emergency Medicine ◽

10.1177/1024907918770083 ◽

2018 ◽

Vol 25 (4) ◽

pp. 202-210

Author(s):

Ho Kai Patrick Tsang ◽

Cheuk Kei Kathy Wong ◽

Oi Fung Wong ◽

Wing Lun William Chan ◽

Hing Man Ma ◽

...

Keyword(s):

Emergency Department ◽

Hong Kong ◽

Body Packing ◽

Radiological Features ◽

International Airport ◽

Accident And Emergency ◽

Accident And Emergency Department ◽

Body Packers ◽

Solid Form ◽

Hong Kong International Airport

Background: Body packing is a frequently used method for drug trafficking. Local information about the clinical and radiological features of body packing is lacking. Objectives: To evaluate the radiological features of body packers presenting to a hospital near to the Hong Kong International Airport and to compare the radiological features of solid form versus liquid cocaine. Methods: This was a retrospective cohort study. Medical notes of 269 suspected body packers, presenting to the Accident and Emergency Department of North Lantau Hospital under the detention by the law enforcement personnel from 1st January 2015 to 28th February 2017, were reviewed. The radiological features of body packing were retrospectively evaluated. Results: Sixty-nine cases were confirmed body packers radiographically. Majority of them (81%, 56/69) were cocaine packers. Powder form cocaine (67%, 49/69) was the most popular drug packed, followed by liquid cocaine (15%, 10/69). There was a trend of increasing incidence of liquid cocaine packers. The classical ‘double condom’, ‘tic tac’ and ‘halo’ signs were present in 94%, 72.5% and 42% of cases with radiologically confirmed body packing respectively. The ‘rosette’ sign was only identified in 1 case. Three new radiological signs, the ‘bag of eggs’, ‘lucent triangle’ and ‘black crescent’ sign, were suggested to aid identification of drug packets. The classical ‘tic tac’ sign was absent in all liquid cocaine packing cases (p<0.05). The liquid cocaine packets appeared irregular with indistinct border in majority of cases (p<0.05). The solid form packets were mostly opaque to faeces while liquid cocaine had variable density (p<0.05). Most solid form packets had homogeneous content which was in contrast to the heterogeneous content in liquid cocaine (p<0.05). Conclusion: Failure in detecting drug body packing may result in medicolegal consequences. Emergency physicians need to be aware of subtle radiological signs of liquid cocaine packets in the plain abdominal radiography.

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