Emergency Care Journal

Two silent epidemics: air pollution and climate change. “Slow and sustainable medicine” as part of the solution

Erika Poggiali, Lorenzo Ghiadoni, Daniele Coen — Tue, 26 Mar 2024 00:00:00 +0000

Human health is one of the earliest biosensors of climate change, which increases the frequency and severity of many diseases, as reported by Bellone.¹ In Europe, air pollution is becoming a severe health problem that needs to be addressed by physicians of all specialties as well as governments and the general public.

Unfortunately, it is acknowledged that the Po Valley in Italy is among the most polluted areas in Europe. As physicians practicing in this area, we feel we must remind our colleagues of the increasing impact of the environment on the health of ourselves and our patients. Along with having a substantial negative influence on both human and environmental health, air pollution also has a financial cost since it raises medical expenses and reduces productivity due to missed workdays. We can define this situation as a silent epidemic that affects all people, regardless of age. [...]

AREA CRITICA | ROMA, Centro Congressi Fontana di Trevi 30 novembre - 1 dicembre 2023

The Editors — Tue, 27 Feb 2024 00:00:00 +0000

Abstract from the AREA CRITICA congress in Rome, Centro Congressi Fontana di Trevi, November 30th - December 1st 2023

Emergency medicine residents in the war zone: organizing humanitarian expeditions to train healthcare personnel during the conflict in Ukraine

Fri, 05 Apr 2024 00:00:00 +0000

Dear Editor,

When faced with a crisis, particularly when it involves humanitarian aid, emergency medicine (EM) practitioners push themselves to question, “How can we help?” and “To the best of our knowledge and skills, what can we truly do?”. The mindset of EM personnel is presumably one of "How can I help in these situations?" and, more crucially, "How can I help the most effectively?". To answer these questions, we present our experience in Ukraine. [...]

A slow and dangerous swelling of the tongue and the face

Erika Poggiali, Laura Pagani, Benedetta Pergolotti, Andrea Vercelli — Mon, 11 Mar 2024 00:00:00 +0000

A 91-year-old man presented at our emergency room complaining of sialorrhea and facial edema, especially around his lips and palpebral region. The symptoms started in the morning and got worse over two hours. He had a history of hypertension and hypokinetic ischemic cardiomyopathy treated with ramipril, doxazosin, aspirin, furosemide, amiodarone, ranolazine, atorvastatin, and pantoprazole. He referred an allergy to clopidogrel. He did not introduce any novel medications or foods. His vital signs were BP 150/70, HR 57 bpm, sO2 97% in room ambient, RR 18/min, and BT 36.4 °C. He presented a severe edema of the tongue with tirage and cornage. He was immediately treated IV with hydrocortisone 1 g chlorpheniramine maleate 10 mg, and icatibant 30 mg SC and he was intubated through the nose.

Emergency service health care workers’ opinions and experiences on the practice of family-witnessed resuscitation: a cross-sectional study during the COVID-19 pandemic in Türkiye

Tuğba Güney, Leyla Dinç — Fri, 05 Apr 2024 00:00:00 +0000

Despite the evidence and recommendations regarding the benefits of family-witnessed resuscitation, the opinions and attitudes of healthcare professionals vary widely. This descriptive cross-sectional study was conducted on 154 healthcare professionals working at the emergency departments of four hospitals within the borders of Ankara, Türkiye to examine their opinions and experiences on the practice of family-witnessed resuscitation. Data were collected by using the demographic form and the Family Presence Risk-Benefit Scale. Descriptive statistical analyses, t-test for samples, Mann-Whitney U test and Kruskal-Wallis tests were used in the evaluation of the data. Results indicated that majority of emergency department healthcare workers (85.8%) had no previous experience of family witnessed resuscitation, and most of them (96.8%) opposed the practice of resuscitation with family presence. Although nurses tended to favour family witnessed resuscitation more than physicians, most of the participants expressed their concerns about the presence of family during the CPR. It is recommended that institutional policies be developed on family-witnessed resuscitation, and inter-professional education be provided to increase the awareness of families and to change the opinions and attitudes of health care professionals.

A rare symptom of foodborne botulism: dysgeusia. Case report and clinical review

Tue, 09 Apr 2024 00:00:00 +0000

Clostridium botulinum has become one of the most well-known microorganisms in medical history, thanks to both fatal botulism epidemics and the recent medical use of botulinum neurotoxin. It is a Gram-positive, anaerobic, spore-forming bacterium that causes classic foodborne botulism, infant botulism, wound botulism, and intestinal colonization botulism, a serious neuroparalytic disease. The most common type of botulism is foodborne botulism, which is caused by eating botulinum toxin-contaminated foods. Just a few micrograms of toxin are enough to cause symptoms and, if untreated, death. Rapid diagnosis of the condition is critical to avoiding fatal outcomes. This article describes a clinical case of a patient who presented to us in June with typical symptoms of botulism. Early clinical diagnosis is based on a thorough medical history, including a meticulous reconstruction of the patient's food history in the days preceding symptom onset, as well as a careful physical examination, which can be highly suggestive of botulinum intoxication. Botulism treatment consists of symptom control, mechanical respiratory support, and Botulinum Antitoxin (BAT) administered intravenously. Epidemiological investigation is critical for quickly identifying the food vehicle causing the intoxication.