Prehospital Care for Road Traffic Injury Victims.

Introduction: Prehospital capabilities are inadequately developed to meet the growing needs for emergency care in most low- and middle-income countries. This study aims to describe the prehospital care received by the road traffic injury (RTI) victims presenting to a level I Trauma Care Center in Central Kerala, India.

Methods: This was a hospital-based prospective observational study, which included consecutive victims of RTI attending the emergency department within 24-h of the event.

Barriers to Effective Prehospital and Hyperacute Stroke Care in India: A Physician Perspective.

Introduction: The incidence of stroke is increasing in India. Prehospital stroke care is crucial for reducing stroke morbidity and mortality, but its implementation in India faces several challenges. Limited original research exists on prehospital stroke care in India, making it essential to identify the problems in implementing effective prehospital stroke care.

Challenges in Snakebite Management in India: Insights from a Physician Survey with Special Focus on Kerala and treatment of bites by Hump-nosed Pit Vipers (Hypnale spp.).

Background: India has a high incidence of snakebite-related mortality, making effective snakebite management crucial. This study aimed to explore current practices, challenges, and opportunities for improvement in snakebite management across India.

Methods: A cross-sectional survey was conducted among physicians in India covering aspects such as scope of practice, snake identification, first aid measures, institutional management, and specific management practices for hump-nosed pit viper () bites.

Prehospital Factors Associated with Delayed Hospital Arrival of Stroke Patients: A Regional Single-Center Study from India.

Background: Only a small percentage of patients with acute stroke are currently eligible for thrombolysis, partly due to severe delays in hospital arrival. We had previously conducted the first regional study to assess the factors delaying acute stroke care in India. The present study aims to understand and describe in depth the variables associated with prehospital delay among patients admitted with an acute ischemic stroke.

Comparing modified Lee and White method against 20-minute whole blood clotting test as bedside coagulation screening test in snake envenomation victims.

Background: Twenty-minute whole blood clotting test (20WBCT) and Modified Lee and White (MLW) method are the most routinely employed bedside tests for detecting coagulopathic snake envenomation. Our study compared the diagnostic utility of MLW and 20WBCT for snakebite victims at a tertiary care hospital in Central Kerala, South India.

Methods: This single-center study recruited 267 patients admitted with snake bites.

Results of an international survey on the status of prehospital care.

Background: Prehospital care including recognition of stroke symptoms by the public and professionals combined with an efficient and effective emergency medical service (EMS) is essential to increase access to effective acute stroke care. We undertook a survey to document the status of stroke prehospital care globally.

Methods: A survey was distributed via email to the World Stroke Organization (WSO) members.

Retrospective review of case records of snakebite presenting to a single tertiary care centre over a 5-year period.

Background Snakebite is a disease of the poor, and hospitals catering to these individuals are often resource-constrained. Lack of electronic medical records in these resource-limited settings makes the capture of data even harder. Methods Before establishing a snakebite registry in the region, we did a retrospective case record review of all snakebite victims (n=3229) over 5 years who presented to a single tertiary care centre, catering to one of the largest number of snakebite victims in the country.

Indigenously Developed Ultrasound Phantom Model versus a Commercially Available Training Model: Randomized Double-blinded Study to Assess Its Utility to Teach Ultrasound Guided Vascular Access in a Controlled Setting.

Background: The commercially available training phantoms being expensive, homemade models are popular surrogates for training. We intended to study how comparable our indigenously developed ultrasound phantom (IDUP) was with the commercially available model for ultrasound-guided vascular access (USGVA) training. We also assessed the change in confidence among trainees using a 21-h standardized program.

Chest Compression Fraction and Factors influencing it.

Introduction: Chest compression fraction (CCF) is the cumulative time spent providing chest compressions divided by the total time taken for the entire resuscitation. Targeting a CCF of at least 60% is intended to limit interruptions in compressions and maximize coronary perfusion during resuscitation. We aimed to identify the mean CCF and its relationship with various factors affecting it.

Door to balloon time in patients presenting with acute ST elevation myocardial infarction and time factors influencing it; an observational study from a tertiary care teaching hospital in India.

The objective of this prospective observational study was to assess the door-to-balloon time (D2B), in acute ST-segment elevation myocardial infarction (STEMI) patients and the time factors influencing it. The following timeframes were measured during the study: ED to ECG time, ED to coronary care unit time (ED2CCU), consent time, post-consent to balloon time (POSTCONSENT2B) and D2B. Effective D2B was 54 ± 12.

Afibrinogenemia Diagnosed During Pregnancy Successfully Managed with Targeted Cryoprecipitate Transfusion: A Case Report.

Background: We report a case of afibrinogenemia in a lady, which was detected for the first time during her pregnancy.

Case: A 24-year-old G4A3 was referred as a case of vaginal bleeding, after a cervical cerclage at 14 weeks of gestation. Elastometry targeted correction of coagulopathy was done initially, and targeted cryoprecipitate transfusion was done to maintain her gestation.

In Response to the Letter to the Editor Submitted Titled "Lack of CPR Knowledge among Young Medical Doctors: A Worldwide Issue".

Chandran KV, Abraham SV. In Response to the Letter to the Editor Submitted Titled "Lack of CPR Knowledge among Young Medical Doctors: A Worldwide Issue". Indian J Crit Care Med 2021;25(1):107.

The Curious Case of the "Neurotoxic Skink": Scientific Literature Points to the Absence of Venom in Scincidae.

In contrast to the clearly documented evolution of venom in many animal lineages, the origin of reptilian venom is highly debated. Historically, venom has been theorised to have evolved independently in snakes and lizards. However, some of the recent works have argued for the common origin of venom in "Toxicofera" reptiles, which include the order Serpentes (all snakes), and Anguimorpha and Iguania lizards.

Hematotoxic Snakebite Victim with Trauma: The Role of Guided Transfusion, Rotational Thromboelastometry, and Tranexamic Acid.

Hematotoxic snake bite is a leading cause of mortality in South India. However, it is rare for the emergency physician to encounter a patient with trauma associated with snakebite. Management of such a patient differs substantially from the routine management of either a trauma patient or a snakebite victim.

Survival following intentional succinylcholine injection for self-harm.

Succinylcholine is a short-acting depolarizing neuromuscular blocking agent. We describe a case where the above drug was employed for self-harm by a health-care worker. The patient, a 28-year-old female, was brought to the emergency department (ED) in impending respiratory arrest and altered mental status.

Laryngeal Edema, Metabolic Acidosis, and Acute Kidney Injury Associated with Large-Volume Kohrsolin TH® Ingestion.

Background: Glutaraldehyde is a commonly used disinfectant in most hospitals. It is known to be an irritating agent to the airway. With the exception of one small-quantity (75 mL) ingestion, no large-volume ingestion has been previously reported.

Basic Life Support: Need of the Hour-A Study on the Knowledge of Basic Life Support among Young Doctors in India.

Introduction: Knowledge about basic life support (BLS) is mandatory for healthcare professionals. This study aims to evaluate the knowledge among medical students who have completed their MBBS course and have enrolled for internship.

Materials And Methods: A questionnaire pertaining to BLS before and after the BLS workshop (pretest and posttest 1) was distributed among the 50 participants consented for the study.

An Analysis of the Efficacy of Different Teaching Modalities in Imparting Adult Cardiopulmonary Resuscitation Skills among First-year Medical Students: A Pilot Study.

Introduction: Our current medical curriculum devotes a large percentage of time to knowledge acquisition by means of didactic lectures. Psychomotor skill acquisition takes a back seat. Certain lifesaving skills like basic life support skill training have not even made an appearance in the current curriculum.

Utility of Point-of-Care Lung Ultrasound for Initial Assessment of Acute Respiratory Distress Syndrome Patients in the Emergency Department.

Aim: Lung ultrasound (LUS) has been extensively used in the evaluation of acute respiratory distress syndrome (ARDS) in the critical care setting. In our study, we aim to assess the utility of point-of-care ultrasound (POCUS)-LUS in the initial assessment of ARDS patients presenting to the emergency department (ED).

Subjects And Methods: We evaluated a prospective convenience sample of 73 adult patients presenting to the ED.

Factors Affecting Early Treatment Goals of Sepsis Patients Presenting to the Emergency Department.

Background And Objectives: Sepsis is a major cause of emergency medicine admission. It is associated with high mortality and morbidity. Even though sepsis is common in the Indian subcontinent, there is a paucity of data on the management of sepsis in India.