Intramuscular midazolam, olanzapine, or haloperidol for the management of acute agitation: A multi-centre, double-blind, randomised clinical trial.

Background: The safety and effectiveness of intramuscular olanzapine or haloperidol compared to midazolam as the initial pharmacological treatment for acute agitation in emergency departments (EDs) has not been evaluated.

Methods: A pragmatic, randomised, double-blind, active-controlled trial was conducted from December 2014 to September 2019, in six Hong Kong EDs. Patients (aged 18-75 years) with undifferentiated acute agitation requiring parenteral sedation were randomised to 5 mg intramuscular midazolam ( = 56), olanzapine ( = 54), or haloperidol ( = 57).

Walking Route-Based Calculation is Recommended for Optimizing Deployment of Publicly Accessible Defibrillators in Urban Cities.

Background A straight line-based model is often used to calculate the distance between an out-of-hospital cardiac arrest (OHCA) and the location of an automated external defibrillator (AED). This model may be inaccurate as it overlooks any obstacles between the OHCA and AED. This study aimed to elucidate the effect of the straight line-based and walking route-based calculation on the average distance between an historical OHCA and the closest AED and the coverage rate of AEDs, ie, the proportion of historical OHCAs that were within 100 meters of an AED.

A cluster of patients with rhabdomyolysis after eating crayfish.

Crayfish or Procambarus clarkii is a freshwater crustacean with worldwide distribution. Tons of crayfish are consumed each year. In this report, four adult patients with rhabdomyolysis after consuming crayfish were described.

Urban disaster preparedness of Hong Kong residents: A territory-wide survey.

Objective: To assess the state of community disaster preparedness of Hong Kong residents and to identify factors associated with adequate preparedness behaviors.

Design: A cross-sectional survey using random Global Positioning System (GPS) spatial sampling conducted from the 8 August 2015 to 6 September 2015.

Participants: Hong Kong residents aged 18 years or more.

Therapeutic Hypothermia for Asphyxial Out-of-Hospital Cardiac Arrest Due to Drowning: A Systematic Review of Case Series and Case Reports.

The objective of this review was to summarize published evidence of the effectiveness of therapeutic hypothermia in patients with drowning-associated asphyxial out-of-hospital cardiac arrest (OHCA) and to explore any preliminary favorable factors in the management of therapeutic hypothermia to improve survival and neurological outcome. Drowning may result in asphyxial OHCA or hypothermic OHCA, but the former does not provide any potential neuroprotective effect as the latter may do. Electronic literature searches of Ovid Medline, Embase, Cochrane Library, and Scopus were performed for all years from inception to July 2016.

Outcomes of Cardiac Arrest in Residential Care Homes for the Elderly in Hong Kong.

Objective: Studies done in the 1990's suggested nursing home residents with cardiac arrest had minimal chance of survival and resuscitation was not recommended. More recent studies showed opposing results. In Hong Kong, the proportion of elderly living in the residential care homes for the elderly is increasing.

Delayed Antitoxin Treatment of Two Adult Patients with Botulism after Cosmetic Injection of Botulinum Type A Toxin.

Background: Injection of botulinum toxin type A for cosmetic purposes is common. It is believed to be safe, but adverse reactions have been reported, including dysphagia, generalized paralysis, respiratory depression, and death caused by focal injection of the toxin. Early administration of antitoxin in patients with adverse reactions is the mainstay of management, but the time window for its clinical efficacy is not well defined.

Utilization of the Accident & Emergency Departments by Chinese elderly in Hong Kong.

Background: The epidemiological data on elderly patients attending Accident and Emergency Departments (AEDs) in Hong Kong is lacking. The study aimed to examine the epidemiology of geriatric patient visits to AEDs in Hong Kong, including demographic data and predictors of life-saving interventions (LSI) and admission.

Methods: A retrospective cross-sectional study of geriatric patients older than 64 years old attending three AEDs during the year 2012, with a sample of 1 200 patient visits recruited.

Performance of a prehospital trauma diversion system in Hong Kong, China.

Purpose: To evaluate the performance of a prehospital trauma diversion system in Hong Kong, China.

Methods: A retrospective analysis of prospectively collected data in the trauma registry of Queen Mary Hospital, Hong Kong from 1 January 2009 to 31 December 2013 was done. All adult patients aged 18 years or above, either primarily or secondarily diverted to Queen Mary Hospital according to the trauma patient diversion protocol, were recruited.

Management of acute agitation in Hong Kong and comparisons with Australasia.

Background: Little is known about the use of sedation drugs for the management of acute agitation in Hong Kong's Accident and Emergency Departments (AEDs) and how it compares with Australasian practice.

Objective: The aim of this study was to determine drug preferences, clinicians' perceived confidence in management, barriers/gaps in training and perceived usefulness of existing clinical practice guidelines (CPGs) in Hong Kong.

Method: A validated questionnaire was used, with case vignettes typical of patients presenting to AEDs with acute agitation.

Can prehospital Modified Early Warning Score identify non-trauma patients requiring life-saving intervention in the emergency department?

Objective: We aim to investigate whether prehospital Modified Early Warning Score (MEWS) can identify non-trauma patients requiring life-saving intervention (LSI) within 4 h of presentation to the ED.

Methods: It was a prospective study of non-trauma ED patients by ambulance who were 16 years or older from 1 to 27 November 2013. Prehospital MEWS was calculated according to vital signs measured by the ambulance crew.

Methylphenidate and the risk of trauma.

Background And Objective: Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) are prone to sustaining trauma that requires emergency department (ED) admission. Methylphenidate (MPH) can reduce ADHD symptoms and may thus theoretically reduce the risk of trauma-related ED admission, but previous studies do not make this association clear. This study examines this association.

Short-Term Prognosis of Transient Ischemic Attack and Predictive Value of the ABCD(2) Score in Hong Kong Chinese.

Background: Literature on prognosis of transient ischemic attack (TIA) in Chinese is scarce. The short-term prognosis of TIA and the predictive value of the ABCD(2) score in Hong Kong Chinese patients attending the emergency department (ED) were studied to provide reference for TIA patient management in our ED.

Methods: A cohort of TIA patients admitted through the ED to 13 acute public hospitals in 2006 was recruited through the centralized electronic database by the Hong Kong Hospital Authority (HA).

Diagnostic accuracy of Focused Abdominal Sonography for Trauma in blunt abdominal trauma patients in a trauma centre of Hong Kong.

Objective: Focused Abdominal Sono-graphy for Trauma (FAST) is widely used for the detection of intraperitoneal free fluids in patients suffering from blunt abdominal trauma (BAT). This study aimed at assessing the diagnostic accuracy of this investigation in a designated trauma centre.

Methods: This was a retrospective study of BAT patients over a 6 year period seen in a trauma centre in Hong Kong.

A potentially life-threatening complication of university orientation activities.

Background: This case report describes a university student who participated in an orientation activity and developed exertional rhabdomyolysis.

Methods: With prompt intravenous volume expansion started in the accident and emergency department, he made an uneventful recovery despite a marked elevation of creatine kinase. The riskfactors of developing exertional rhabdomyolysis were reviewed.