Early post-resuscitation outcomes in patients receiving norepinephrine versus epinephrine for post-resuscitation shock in a non-trauma emergency department: A parallel-group, open-label, feasibility randomized controlled trial.

Background: Post-resuscitation shock is the main cause of early death in post-cardiac arrest patients. To date, no randomized trial compares the efficacy between norepinephrine and epinephrine in post-resuscitation shock patients.

Objectives: This study aimed to assess the feasibility of the study protocol, and explore potential differences in efficacy and adverse events between norepinephrine and epinephrine in post-resuscitation shock patients.

Association between cardiopulmonary resuscitation audit results with in-situ simulation and in-hospital cardiac arrest outcomes and key performance indicators.

Introduction: In-situ simulation (ISS) is a method to evaluate the performance of hospital units in performing cardiopulmonary resuscitation (CPR). It is conducted by placing a high-fidelity mannequin at hospital units with simulated scenarios and having each unit's performance evaluated. However, little is known about its impact on actual patient outcomes.

The Incidence of Diaphragmatic Dysfunction in Patients Presenting With Dyspnea in the Emergency Department.

Objectives: Diaphragmatic dysfunction has been reported as a cause of dyspnea, and its diagnosis can be made using ultrasound. Diaphragmatic ultrasound is mainly used to predict respiratory failure in chronic conditions. The use of diaphragmatic ultrasound has also risen in acute settings, such as emergency departments (EDs).

Comparing performance measures and clinical outcomes between mobile stroke units and usual care in underserved areas.

Background: The efficacy of mobile stroke units (MSUs) in improving acute ischemic stroke (AIS) care in developing countries is unknown. We compared performance measures and stroke outcomes in AIS patients between MSU and usual care: emergency medical services (EMS) and walk-in.

Methods: We enrolled patients > 18 years of age with an AIS within 4.

Characteristics and factors associated with mortality in palliative patients visiting the Emergency Department of a large tertiary hospital in Thailand.

Background: The characteristics and outcomes of palliative patients who visited the Emergency Department (ED) in Thailand, a country in which no standard palliative care system existed, have not been comprehensively studied. We aimed to report the characteristics of ED palliative patients and investigate factors associated with mortality.

Methods: A prospective observational study was conducted at Siriraj Hospital, Bangkok, Thailand, between March 2019 and February 2021 by means of interviewing palliative patients and/or their caregivers and medical record review.

Independent risk factors of mortality in patients with sepsis receiving single-dose etomidate as an induction agent during rapid sequence intubation in a large tertiary emergency department in Thailand.

Background: There is limited evidence regarding factors associated with mortality in septic patients receiving etomidate. This study aimed to determine independent pre-intubation factors predicting 28-day mortality in septic patients receiving single-dose etomidate as an induction agent during rapid sequence intubation (RSI).

Methods: This single-center retrospective cohort study included intubated septic patients receiving etomidate as an induction agent during RSI in the emergency department of Siriraj hospital, Bangkok, Thailand, between January 1, 2016 and June 30, 2020.

The utility of the rapid emergency medicine score (REMS) compared with SIRS, qSOFA and NEWS for Predicting in-hospital Mortality among Patients with suspicion of Sepsis in an emergency department.

Background: Many early warning scores (EWSs) have been validated to prognosticate adverse outcomes secondary to sepsis in the Emergency Department (ED). These EWSs include the Systemic Inflammatory Response Syndrome criteria (SIRS), the quick Sequential Organ Failure Assessment (qSOFA) and the National Early Warning Score (NEWS). However, the Rapid Emergency Medicine Score (REMS) has never been validated for this purpose.

Nasal High-flow Oxygen Versus Conventional Oxygen Therapy for Acute Severe Asthma Patients: A Pilot Randomized Controlled Trial.

Background: Nasal high flow (NHF) has demonstrated efficacy in relieving dyspnea in various patients with hypoxemic and hypercapnic respiratory failure. It may also reduce dyspnea in patients with acute severe asthma in the emergency department (ED). The aim of the study was to compare the efficacy of NHF with conventional oxygen therapy (COT) in improving dyspnea in acute severe asthma patients with hypoxemia in the ED.

Predictors of Mortality in Elderly and Very Elderly Emergency Patients with Sepsis: A Retrospective Study.

Introduction: Elderly patients are at increased risk of developing sepsis and its adverse outcomes. Diagnosing and prognosing sepsis is particularly challenging in older patients, especially early at emergency department (ED) arrival. We aimed to study and compare the characteristics of elderly and very elderly ED patients with sepsis and determine baseline factors associated with in-hospital mortality.

Diagnostic and prognostic utility of presepsin for sepsis in very elderly patients in the emergency department.

Background: Presepsin, a biomarker for sepsis diagnosis, has not been studied in very elderly population. The study aimed to evaluate the diagnostic and prognostic value of Presepsin in very elderly patients compared to point-of-care Procalcitonin (PCT), C-reactive protein (CRP), and early warning scores (EWSs).

Methods: This study prospectively enrolled 250 patients aged at least 75 years old, presenting to the Emergency Department of Siriraj Hospital with suspected sepsis during September 2019 and January 2020.

The utility of the 1-hour high-sensitivity cardiac troponin T algorithm compared with and combined with five early rule-out scores in high-acuity chest pain emergency patients.

Background: Although the 0/1 h high-sensitivity cardiac troponin T (0/1 hs-cTnT) algorithm and many risk scores have been validated for use in emergency departments (EDs), their utility in high-acuity ED patients has not been validated. We aimed to validate the 0/1 hs-cTnT algorithm and the HEART, TIMI, GRACE, T-MACS and NOTR risk scores before and after combining the 0/1 algorithm in high-acuity ED chest pain patients.

Methods: A prospective observational study was conducted in the high-acuity ED of Siriraj Hospital, a tertiary hospital in Bangkok, Thailand.

Role of Point-of-Care Testing in Reducing Time to Treatment Decision-Making in Urgency Patients: A Randomized Controlled Trial.

Introduction: Shortening emergency department (ED) visit time can reduce ED crowding, morbidity and mortality, and improve patient satisfaction. Point-of-care testing (POCT) has the potential to decrease laboratory turnaround time, possibly leading to shorter time to decision-making and ED length of stay (LOS). We aimed to determine whether the implementation of POCT could reduce time to decision-making and ED LOS.

High-Flow Nasal Cannula Versus Conventional Oxygen Therapy in Relieving Dyspnea in Emergency Palliative Patients With Do-Not-Intubate Status: A Randomized Crossover Study.

Study Objective: Palliative patients often visit the emergency department (ED) with respiratory distress during their end-of-life period. The goal of management is alleviating dyspnea and providing comfort. High-flow nasal cannula may be an alternative oxygen-delivering method for palliative patients with do-not-intubate status.

The feasibility of the 1-h high-sensitivity cardiac troponin T algorithm to rule-in and rule-out acute myocardial infarction in Thai emergency patients: an observational study.

Background: The 3-h high-sensitivity cardiac troponin T (hs-cTnT) algorithm is the most commonly used scheme to diagnose acute myocardial infarction. The 1-h hs-cTnT algorithm has recently been approved by the European Society of Cardiology as an alternative algorithm for earlier diagnosis. If the hs-cTnT test cannot discriminate the diagnosis of the patient at 1 h, the patient is defined as observational group.

Early Use of Norepinephrine in Septic Shock Resuscitation (CENSER). A Randomized Trial.

Recent retrospective evidence suggests the efficacy of early norepinephrine administration during resuscitation; however, prospective data to support this assertion are scarce. To conduct a phase II trial evaluating the hypothesis that early low-dose norepinephrine in adults with sepsis with hypotension increases shock control by 6 hours compared with standard care. This single-center, randomized, double-blind, placebo-controlled clinical trial was conducted at Siriraj Hospital, Bangkok, Thailand.

Outcomes of Emergency Medical Service Usage in Severe Road Traffic Injury during Thai Holidays.

Introduction: Thailand has the highest mortality from road traffic injury (RTI) in the world. There are usually higher incident rates of RTI in Thailand over long holidays such as New Year and Songkran. To our knowledge, there have been no studies that describe the impact of emergency medical service (EMS) utilization by RTI patients in Thailand.

High-Flow Nasal Cannula Versus Conventional Oxygen Therapy in Emergency Department Patients With Cardiogenic Pulmonary Edema: A Randomized Controlled Trial.

Study Objective: High-flow nasal cannula is a new method for delivering high-flow supplemental oxygen for victims of respiratory failure. This randomized controlled trial compares high-flow nasal cannula with conventional oxygen therapy in emergency department (ED) patients with cardiogenic pulmonary edema.

Methods: We conducted an open-label randomized controlled trial in the ED of Siriraj Hospital, Bangkok, Thailand.

Prevalence of emergency medical service utilisation in patients with out-of-hospital cardiac arrest in Thailand.

Background: Most patients with out-of-hospital cardiac arrest (OHCA) have grave outcomes. The efficacy of emergency medical services (EMS) may affect outcomes. However, no data exists in Thailand.

Sepsis resuscitation guideline implementation in the Department of Emergency Medicine, Siriraj Hospital.

Background: Sepsis management guidelines have been implemented in the Emergency Department, Siriraj Hospital since 2005.

Objective: Assess the impact ofsepsis resuscitation guidelines on the mortality ofpatients after implementation.

Material And Method: A prospective cohort study was conducted in the Emergency Department, Siriraj Hospital between January 12 and October 2, 2011.

The Dementia and Disability Project in Thai Elderly: rational, design, methodology and early results.

Background: A strong inverse relationship of functional limitation and socioeconomic status has been established in western ageing society. Functional limitation can be related to chronic diseases, disuse, cognitive decline, and ageing. Among chronic diseases in the Thai population, cerebrovascular diseases, diabetes, and arthritis are common.

Assessment of cerebrospinal fluid (CSF) beta-amyloid (1-42), phosphorylated tau (ptau-181) and total Tau protein in patients with Alzheimer's disease (AD) and other dementia at Siriraj Hospital, Thailand.

Background: The combination of decreased cerebrospinal fluid (CSF) levels of beta-amyloid (1-42) and increased levels of phosphorylated tau (ptau-181) or total tau protein are known to be biomarkers ofAlzheimer's disease (AD). These biomarkers can also be used as predictors of disease progression in persons with mild cognitive impairment. Utilizing biomarkers to differentiate Alzheimer's disease (AD) against non-Alzheimer dementia (non-AD) needs to be explored.

Evaluation of an NS1 antigen detection for diagnosis of acute dengue infection in patients with acute febrile illness.

Diagnosis of dengue infection during the febrile stage has been challenging. We evaluated the accuracy of NS1 protein detection in diagnosing dengue infection in patients presenting with acute febrile illness in Bangkok, Thailand. Of the 235 subjects presented with fever of unknown source within 5 days, 132 (56.

Frequency of angina pectoris and coronary artery disease in severe isolated valvular aortic stenosis.

Angina pectoris is a frequent symptom of severe valvular aortic stenosis (AS), even in the presence of normal coronary arteries. To determine the prevalence of angiographically significant coronary artery disease (CAD) and its relation to angina pectoris and coronary risk factors in severe isolated valvular AS patients. All cases of symptomatic AS patients who underwent aortic valve replacement and preoperative cardiac catheterization at the Central Chest Hospital between January 1, 1986 and December 31, 1996 were retrospectively analyzed.

Transcatheter coronary revascularization registry 1995.

In 1995, from 12 participating units, there were 1108 PTCA compared to 697 in 1994, 24 rotational atherectomy and 109 intracoronary stent placements performed. These were complicated by 6 acute myocardial infarction, 10 emergency surgeries and 11 deaths. Success rate was 92 per cent.