scholarly journals Intubation Ergonomics and Effectiveness using Aerosol Box

2021 ◽  
pp. 30-36
Author(s):  
Shaik Farid Abdull Wahab ◽  
Rohayu Othman ◽  
Ahmad Rasdan Ismail
Keyword(s):  
Emergency Department ◽  
Direct Observation ◽  
Healthcare Workers ◽  
Entire Body ◽  
Accident And Emergency ◽  
Current Design ◽  
Life Threatening ◽  
Accident And Emergency Department ◽  
Rapid Entire Body Assessment ◽  
Intubation Procedure

The pandemic COVID-19 has caused a rupture and disturbance in many ecosystems, especially in healthcare.  Although previously patients were treated and given first-hand treatment especially during life threatening event, currently, the safety of healthcare workers have also become the utmost priority.  Due to the nature of COVID-19 virus that is able to spread easily via respiratory droplets and aerosols, using mouth and eyes as the route of entry, healthcare workers need to protect themselves while saving the patients at the same time. Therefore, the most common lifesaving procedure at accident and emergency department was chosen, i.e. the intubation procedure. The aerosol box is introduced and used widely during the intubation procedure, especially in accident and emergency department.  The study has three objectives. First, to determine whether the aerosol box can provide protection to its users, secondly to suggest an improvement based on the current design of the aerosol box and thirdly to determine the risk of musculoskeletal injuries among healthcare workers using Rapid Entire Body Assessment (REBA). In this study, direct observation was made during the assessment before suggesting the required recommendation on how to improve the existing aerosol box. The first objective was achieved by conducting a direct observation when participants were conducting the intubation procedure. Any possibility of participants getting exposed to the risk of COVID-19 due to the failure of the box in guarding, was noted by the observer. Recommendation for improvement was made based on these findings, and served the second objective of the study. To achieve the third objective, ergonomics assessment using Rapid Entire Body Assessment (REBA) was conducted. REBA scores represent the severity of musculoskeletal risk imposed to healthcare workers during intubation procedure. Two participants took part in the study voluntarily. Results showed that the aerosol box used in this study does not protect healthcare workers from COVID-19. The current design of aerosol box used must be improvised in order to increase its effectiveness.  As for body postures, REBA scores were between medium and high, thus it required immediate corrective actions. With modification, the aerosol box may better protect healthcare workers from being exposed to the COVID-19 virus.

scholarly journals Potential life-threatening complication of tonsillectomy: cervicofacial surgical emphysema

2019 ◽  
Vol 12 (1) ◽  
pp. e228377
Author(s):  
Kirsten Shoemaker ◽  
Christopher SG Thompson ◽  
Rupali Sawant ◽  
Gundula Thiel
Keyword(s):  
Emergency Department ◽  
Neck Movement ◽  
Tonsillar Fossa ◽  
Accident And Emergency ◽  
Experienced Pain ◽  
Facial Swelling ◽  
Life Threatening ◽  
Surgical Emphysema ◽  
Accident And Emergency Department ◽  
Safety Netting

A 30-year-old woman presented to the accident and emergency department 3 days post-tonsillectomy with bleeding from the tonsillar fossa and left-sided facial swelling. The patient denied any dysphagia or breathing difficulties but experienced pain on neck movement. On examination, although the bleeding had stopped on reaching the emergency department, a small clot was noted in her left tonsillar fossa. A left facial/submandibular swelling was seen, which had been present since her operation and was slowly enlarging. Flexible nasendoscopy showed a mild left sided oropharyngeal swelling but was otherwise normal. She was treated initially with antibiotics and hydrogen peroxide gargles. After 24 hours of observation and a slight worsening of the swelling she underwent a CT of the neck. This showed widespread indurated subcutaneous surgical emphysema, originating from the left tonsillar bed. Following a period of observation and improvement in her symptoms, she was discharged home with safety netting.

Use of an accident and emergency department observation ward in the management of head injury

1993 ◽  
Vol 80 (8) ◽  
pp. 1079-1079 ◽  
Author(s):  
A. F. T. Brown ◽  
G. J. Wilkes ◽  
C. T. Myers ◽  
R. E. Maclaren
Keyword(s):  
Emergency Department ◽  
Head Injury ◽  
Accident And Emergency ◽  
Accident And Emergency Department

Hand Infections: An Audit of 160 Infections Treated in an Accident and Emergency Department

1993 ◽  
Vol 18 (1) ◽  
pp. 115-118 ◽  
Author(s):  
J. STEVENSON ◽  
I. W. R. ANDERSON
Keyword(s):  
Emergency Department ◽  
Complete Resolution ◽  
Wound Care ◽  
Duration Of Treatment ◽  
Mean Delay ◽  
Accident And Emergency ◽  
Accident And Emergency Department ◽  
The Mean ◽  
Careful Assessment

160 consecutive hand infections presented to an Accident and Emergency department over a four-month period. All but one were treated solely on an out-patient basis. The mean delay to presentation was three days, the mean duration of treatment was six days. Follow-up to complete resolution was achieved in 89% of cases. No patients were treated with parenteral antibiotics. The need for careful assessment, early aggressive surgery, and meticulous attention to the principles of wound care by experienced clinicians is emphasized.

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

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.

scholarly journals A Retrospective Review of Patients with Radiological Missed Fractures in an Emergency Department in Hong Kong

2003 ◽  
Vol 10 (4) ◽  
pp. 215-222 ◽  
Author(s):  
VCH Ng ◽  
FL Lau
Keyword(s):  
Emergency Department ◽  
Management Plan ◽  
Lower Limbs ◽  
X Rays ◽  
Accident And Emergency ◽  
Assessment And Treatment ◽  
Spinal Region ◽  
Accident And Emergency Department ◽  
Clinical Records ◽  
Christian Hospital

Aim To review the clinical spectrum and outcome of radiological missed fractures in the Accident and Emergency Department of United Christian Hospital (UCH) in 2002. Method In UCH, radiologists report all X-Rays taken in the Accident and Emergency Department (AED) within 48 hours. The study period was from 1st January 2002 to 31st December 2002. AED notes, relevant clinical records and all X-rays of patients with suspected missed fractures as reported by radiologists were reviewed for information on clinical features, treatments and outcomes. Results A total of 286 cases of missed fractures were found. Fourteen (4.9%) involved the skull and maxillofacial region, 83 (29.0%) involved the chest region, 53 (18.5%) involved the spinal region, 72 (25.2%) involved the upper limbs and 64 (22.4%) involved the lower limbs. Of these 286 cases, 137 (47.9%) were followed up in AED, 90 (31.5%) were referred to specialist clinics for further management, 26 (9.1%) required admission to hospital for further assessment and treatment, and 33 (11.5%) defaulted follow up. Furthermore, 87 (30.4%) of these 286 missed fractures required a change in management plan: 3 missed fractures required operative intervention (internal fixation) and 84 missed fractures required some form of external immobilisation. This group of patient did not lodge any complaint or claim. Conclusion A&E doctors missed quite a number of fractures that might result in significant morbidity. However, a reporting system by radiologists within 48 hours from discharge can pick up all these missed fractures, and may prevent complaints and litigations.

Overdose of Dologesic with a Fatal Outcome: A Case Report

2001 ◽  
Vol 8 (4) ◽  
pp. 207-211 ◽  
Author(s):  
CY Man
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Case Report ◽  
Drug Overdose ◽  
Fatal Outcome ◽  
Common Cause ◽  
Accident And Emergency ◽  
Accident And Emergency Department

Dologesic is a commonly prescribed analgesic in accident and emergency department. Yet report of overdose with this drug is not common. We report a case in which the patient developed cardiac arrest within an hour of ingestion. Dextropropoxyphene, a component of the drug Dologesic, used to be a common cause of fatalities after drug overdose in the seventies. It is highly toxic in overdose and therefore caution should be exercised when prescribing this drug.

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