Publications by authors named "Anmol Purna Shrestha"
Article Synopsis
- Traumatic pneumothorax is a serious condition that needs quick diagnosis and treatment, and lung ultrasound (LUS) is a promising method for early detection by novice physicians.
- The study involved 96 patients with chest injuries, comparing LUS accuracy against standard diagnostic methods like chest X-rays and CT scans, showing LUS had a sensitivity of 100% and specificity of 97.75%.
- The findings suggest that LUS is a practical and effective diagnostic tool for traumatic pneumothorax, making it important for physicians in various healthcare settings to be trained in its use.
Impact of implementation of the national institute for health and clinical excellence (NICE) head injury guideline in a tertiary care center emergency department: A pre and post-intervention study.
PLoS One
July 2024
Article Synopsis
- * After implementing the guideline, the rate of CT head scans significantly decreased from 92% to 70%, and guideline adherence improved by 20.3 points, indicating better compliance with recommended practices.
- * Attending physicians showed marked improvement in confidence levels post-intervention, and the NICE guideline demonstrated higher sensitivity and accuracy in detecting intracranial lesions compared to clinical judgment.
Purpose: Acute care of patients with exacerbation of chronic obstructive pulmonary disease (AECOPD) in the emergency department (ED) is crucial, however not studied extensively in Nepal. The purpose of this study is to identify the opportunities for succinct measures to optimize the AECOPD care in ED with a multifaceted bundle care approach in a resource-limited setting.
Methods: We conducted a prospective cross-sectional observational study as an initial baseline stage of the quality improvement project.
Background: Depression is prevalent but poorly recognized in the Emergency Department (ED). We aimed to identify the frequency of unrecognized geriatric depression and its possible determinants in the ED using the 15-item geriatric depression scale (GDS). We also aimed to explore the performance of the shorter, five-item GDS as compared to the 15-item GDS.
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- Thoracoabdominal trauma poses a diagnostic challenge for emergency physicians, but bedside ultrasonography (EFAST) helps in quickly identifying severe injuries like hemoperitoneum and pneumothorax during the initial assessment.
- A study conducted at Dhulikhel Hospital in Nepal evaluated the accuracy of EFAST performed by first responders on trauma patients and compared its results against more traditional imaging methods.
- The findings showed high sensitivity (94.8%) and specificity (99.5%) of EFAST, confirming its effectiveness in detecting major injuries, but noted that operator dependence could lead to potential errors, warranting a monitoring period for negative cases.
Purpose: Point-of-care ultrasound (POCUS) is a quick bedside tool that has the potential to improve emergency care in resource-limited settings due to its relatively low cost and accessibility. Effort to disseminate the knowledge and skills about POCUS is inadequate in low and middle income countries like Nepal. We conducted a two-day interdisciplinary advanced emergency ultrasound workshop that targeted physicians working in emergency department and primary care, especially in rural Nepal.
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- * Out of the patients assessed, 107 (8.9%) presented with dyspnea, with a median age of 64 years; a significant majority (69%) were aged 60 or older.
- * The findings highlight a higher prevalence of dyspnea compared to other studies, suggesting a need for better management protocols in the emergency setting to improve patient care.
Purpose: Competency to perform cardiopulmonary resuscitation is essential to improve the outcome during an event of cardiac arrest. Medical internship is a "transition phase" beyond which physicians are exposed to the unpreparedness and anxiety while dealing with life-threatening conditions which need rapid actions. Experiential learning, deliberate practice and immediate feedback are the primary advantages of simulation-based medical education.
View Article and Find Full Text PDFBackground: Children with emergency conditions require immediate life-saving intervention and resuscitation. Unlike adults, the pediatric emergency drug dose, equipment sizes, and defibrillation energy doses are calculated based on the weight of the individual child. Broselow tape is a color-coded length-based tape that utilizes height/weight correlations for children.
View Article and Find Full Text PDFBackground: Simulation is well established as an effective strategy to train health care professionals in both technical and nontechnical skills and to prevent errors. Despite its known efficacy, adequate implementation is restricted due to the financial burden in resource-limited settings like ours. We therefore pursued to introduce cost-effective in situ simulation (ISS) in the emergency department (ED) to explore its impact on perception and learning experience among multidisciplinary health care professionals and to identify and remediate the latent safety threats (LST).
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