Emergency Medicine
Audio Summaries

Status epilepticus in patients with known epilepsy presenting to the emergency department: Predictors and mortality risk

This study aimed to determine the incidence of status epilepticus (SE) and its predictors among patients with known epilepsy presenting to emergency departments in Malaysia, as well as its association with in-hospital mortality. The findings revealed that 22.8% of the 521 patients experienced SE, which was significantly linked to a higher mortality risk, particularly in older patients and those with metabolic abnormalities or central nervous system infections. These results highlight the need for early risk assessment and monitoring in this vulnerable population.

Concordance between an artificial intelligence self-triage programme and physical triage

The authors aimed to evaluate the concordance between the Dutch National Triage Standard (NTS) and an artificial intelligence (AI) self-triage program in emergency departments. Their findings indicated a slight agreement between the two methods, with the AI program showing a tendency to overtriage and undertriage in some cases, while also identifying more patients with serious clinical outcomes. They concluded that although the AI triage demonstrated potential for improved urgency classification, further refinement and validation are necessary before its implementation in healthcare settings.

Acute urinary retention presenting as inferior pseudo-STEMI: A case report

The authors aim to highlight a case where acute urinary retention led to inferior ST-segment elevation on an electrocardiogram, mimicking a myocardial infarction, without the typical signs of sympathetic activation. They present a 73-year-old man with massive bladder distension who experienced ST-segment changes that resolved following catheterization, suggesting that mechanical factors rather than hemodynamic changes may be responsible for such electrocardiographic alterations. This case emphasizes the need for emergency physicians to consider bladder distension as a potential cause of reversible ST-segment elevation.

Diastolic blood pressure and end-tidal carbon dioxide during adult ICU cardiopulmonary resuscitation: association with return of spontaneous circulation

The authors aimed to evaluate the relationship between intra-arrest diastolic blood pressure (DBP) and end-tidal carbon dioxide (EtCO₂) levels with the return of spontaneous circulation (ROSC) during adult ICU cardiopulmonary resuscitation (CPR). Their findings indicate that both DBP and EtCO₂ are associated with ROSC, with DBP showing slightly better discrimination, although not statistically significant. The study suggests that these measures should be considered complementary indicators of physiological status during CPR rather than real-time predictors.

Prehospital Assessment and Treatment of Infants and Toddlers in Respiratory Distress: A Retrospective Analysis

The authors aim to evaluate how well emergency medical services (EMS) clinicians can distinguish between upper and lower airway diseases in infants and toddlers experiencing respiratory distress, as this differentiation is crucial for appropriate management. They analyze patient characteristics, EMS clinician assessments, and prehospital treatments for children under three years old diagnosed with conditions such as croup or acute bronchitis in the emergency department. The study seeks to understand the implications of these distinctions on care provided in the prehospital setting.

Vascular Eagle syndrome presenting with expanding cervical hematoma and acute ischemic stroke causing impending airway compromise

This case report investigates the rare and severe manifestations of vascular Eagle syndrome, specifically how it can lead to expanding cervical hematoma and acute ischemic stroke, resulting in airway compromise. The authors emphasize the importance of early recognition and multidisciplinary intervention in managing such complex presentations, as demonstrated by the successful treatment of a 26-year-old female patient who experienced these life-threatening complications.

Lumbar paraspinal compartment syndrome with concomitant rhabdomyolysis and multifidus necrosis

The authors investigate the challenges in diagnosing acute lumbar paraspinal compartment syndrome, particularly in cases that may initially appear as benign muscle strain. They present a case of a 29-year-old male who developed severe pain and rhabdomyolysis after a football game, ultimately requiring surgical intervention that revealed multifidus necrosis. This case underscores the importance of recognizing critical symptoms such as disproportionate pain and unexplained rhabdomyolysis to prevent serious complications.

Frailty stratification in the emergency department using the triage frailty and comorbidity tool

The authors aimed to evaluate the effectiveness of the Triage Frailty and Comorbidity (TFC) Tool for frailty stratification in low-acuity patients within the Emergency Department (ED). Their multicentre observational study found that incorporating the TFC Tool into routine triage reduced waiting times for medical evaluation and was associated with higher rates of hospitalisation among TFC-positive patients. This suggests that the TFC Tool can enhance the identification and management of frail patients without compromising triage efficiency.

Patterns of emergency department visits for suicidal attempts associated with toxic ingestion: A retrospective cross-sectional study

This study investigates the patterns of emergency department visits for intentional self-poisoning due to toxic ingestion in Israel, focusing on the substances involved and their clinical outcomes. The authors found that polypharmacy, particularly with CNS-acting agents, was common and associated with more severe clinical presentations, highlighting the importance of early toxicology consultation in managing these cases. The findings emphasize the role of medical toxicologists in both treatment and preventive strategies for patients at risk of self-harm.

A case of hidradenitis suppurativa complicated by necrotizing soft tissue infection

The authors aim to highlight the challenges of diagnosing necrotizing soft tissue infection (NSTI) in patients with hidradenitis suppurativa (HS), as the condition can present with subtle or nonspecific symptoms that may be mistaken for less severe issues. They present a case of a 28-year-old man with HS who exhibited rapid progression of symptoms, ultimately leading to a diagnosis of NSTI that required emergent surgical intervention. The findings emphasize the need for heightened awareness and frequent reassessment in similar cases to ensure timely diagnosis and treatment.