Carboxyhemoglobin half-life toxicokinetic profiles during and after normobaric oxygen therapy: On a swine model.

Investigations on acute carbon monoxide (CO) poisoning struggle to highlight a relevant discriminant criterion related to CO poisoning severity for predicting complications, such as delayed neurological syndromes. In this context, it remains difficult to demonstrate the superiority of one method of oxygen (O) administration over others or to identify the optimal duration of normobaric 100% oxygen (NBO) treatment. Myoglobin, as hemoglobin, are a potential binding site for CO, which could be a source of extravascular CO storage that impacts the severity of CO poisoning.

Analysis of admissions to intensive care units that could be supported on an intermediate care unit.

Background: Only one third of European countries use intermediate care units (IMCs). An IMC makes it possible to manage patients who do not require intensive care but who need a higher level of nursing care that cannot be provided on the general ward. In Belgium, there are no national criteria for ICU admission or discharge, and no policies regarding IMC care or for differentiating ICU intensity levels.

Correlation between hypoxaemia and lung ultrasound score in patients presenting to an emergency department with interstitial syndrome: a prospective physiological study.

To assess for the presence of a correlation between lung ultrasound score (LUSS) and ratio between arterial partial pressure of oxygen (PaO) and the fraction of inspired oxygen (FiO) in patients presenting to an emergency department (ED) with interstitial syndrome (IS). Prospective, multicentre, physiological study. Four Belgian hospitals: one tertiary academic centre and three secondary centres.

Unexpected carboxyhemoglobin half-life during cardiopulmonary resuscitation: a case report.

Background: Cardiac arrest (CA) following CO poisoning (CO-induced CA) exposes patients to an extremely high risk of mortality and remains challenging to treat effectively. Terminal carboxyhemoglobin elimination half-life (COHbt) is critically affected by ventilation, oxygen therapy, and cardiac output, which are severely affected conditions in cases of CA.

Case Presentation: Asystole occurred in an 18-year-old woman after unintentional exposure to CO in her bathroom.

SARS-CoV-2 Seroprevalence among Healthcare Workers after the First and Second Pandemic Waves.

The Grand Hôpital de Charleroi is a large non-academic Belgian hospital that treated a large number of COVID-19 inpatients. In the context of this pandemic, all professions-combined healthcare workers (HCWs), and not only direct caregivers, are a frontline workforce in contact with suspected and confirmed COVID-19 cases and seem to be a high-risk group for exposure. The aim of our study was to estimate the prevalence of anti-SARS-CoV-2 antibodies in HCWs in our hospital after the first and second pandemic waves and to characterize the distribution of this seroprevalence in relation to various criteria.

Factors to improve quality for older patients in the emergency department: a qualitative study of patient trajectory.

Background: Managing older people in the emergency department remains a challenge. We aimed to identify the factors influencing the care quality of older patients in the emergency department, to fine-tune future interventions for older people, considering the naturalistic context of the ED.

Methods: This is a qualitative study of some 450 h of observations performed in three emergency departments selected for their diverse contexts.

Overlooked guide wire: a multicomplicated Swiss Cheese Model example. Analysis of a case and review of the literature.

: Central venous catheter (CVC) implementation is now usual in emergency department. The most common complications are misplacement, bleeding, pleural perforation, thrombosis and sepsis. Forgetting a guide wire in the patient's body after catheterization is an underestimated complication of this procedure; only 76 cases are described.

Climate Change Impacts on Disaster and Emergency Medicine Focusing on Mitigation Disruptive Effects: an International Perspective.

In recent decades, climate change has been responsible for an increase in the average temperature of the troposphere and of the oceans, with consequences on the frequency and intensity of many extreme weather phenomena. Climate change’s effects on natural disasters can be expected to induce a rise in humanitarian crises. In addition, it will surely impact the population’s long-term general health, especially among the most fragile.

Effect of Pressure Support Ventilation on Carboxyhemoglobin Toxicokinetic after Acute Carbon Monoxide Intoxication: a Swine Model.

Introduction: In an experimental study on carbon monoxide (CO) exposure in swine, we aimed to compare the influence of oxygen therapy using a non-rebreathing mask (NRM) to continuous positive airway pressure (CPAP) and two pressure support ventilation (PSV) devices on the decrease of the terminal elimination half-life of carboxyhemoglobin (COHb t). This was the primary outcome.

Methods: Eight spontaneously breathing pigs were sedated by propofol and exposed to 940 ppm CO several times (n = 25) to obtain COHb levels of 30%.

[Suturing a child's wound, humanising care in the emergency department].

The humanisation of the care pathway constitutes an objective for all caregivers. A visit to the emergency department by a child requiring a suture is a simple and frequent situation which highlights the different stages of the care. Several of these stages can be anticipated in the waiting room, in particular the exchanging of information with the patient and the family, which helps to improve the parent-child-professional relationship.

Changes in the clinical features of older patients admitted from the emergency department.

Demographic changes and healthcare reforms may impact the profile of hospitalized older persons. In this study, we sought to compare the characteristics of two prospective cohorts recruited at a ten-year interval (1999, n=253-2009, n=355). They included older patients (≥75 years) admitted through the emergency department for at least 48 h in acute non-geriatric wards in the same university hospital.

Prehospital paediatric emergencies in Belgium: an epidemiologic study.

Objectives: In Belgium, emergency medical services (EMS) are staffed with a medical team if mandatory according to the regulation authority procedures. Children are involved in interventions, but no extensive data are available in the country. We analysed the characteristics of the children involved in EMS to gain better knowledge of the pathologies and the needs of these patients.

Capnography as a diagnostic tool for pulmonary embolism: a meta-analysis.

Study Objective: Multiple studies have evaluated capnography for the diagnosis of pulmonary embolism; accordingly, we conduct a meta-analysis of these trials.

Methods: We performed a systematic search from 1990 to 2011, using MEDLINE, EMBASE, and the Cochrane Library, including studies evaluating capnography as a diagnostic tool alone or in conjunction with other tests. After study quality evaluation, we calculated the pooled sensitivity, specificity, likelihood ratios, and diagnostic odds ratios.

Comparison of the unstructured clinician gestalt, the wells score, and the revised Geneva score to estimate pretest probability for suspected pulmonary embolism.

Study Objective: The assessment of clinical probability (as low, moderate, or high) with clinical decision rules has become a cornerstone of diagnostic strategy for patients with suspected pulmonary embolism, but little is known about the use of physician gestalt assessment of clinical probability. We evaluate the performance of gestalt assessment for diagnosing pulmonary embolism.

Methods: We conducted a retrospective analysis of a prospective observational cohort of consecutive suspected pulmonary embolism patients in emergency departments.

Performance of age-adjusted D-dimer cut-off to rule out pulmonary embolism.

Background: Age-adjusted D-dimer cut-off has recently been proposed to increase D-dimer usefulness in older patients suspected of pulmonary embolism (PE).

Objective: We externally validated this age-adjusted D-dimer cut-off using different D-dimer assays in a multicenter sample of emergency department patients.

Methods: Secondary analysis of three prospectively collected databases (two European, one American) of patients suspected of having PE.

Performance of the Pulmonary Embolism Rule-out Criteria (the PERC rule) combined with low clinical probability in high prevalence population.

Introduction: PERC rule was created to rule out pulmonary embolism (PE) without further exams, with residual PE risk<2%. Its safety is currently not confirmed in high PE prevalence populations even when combined with low clinical probability assessed by revised Geneva score (RGS). As PERC rule and RGS are 2 similar explicit rules with many redundant criteria, we hypothesized that the combination of PERC rule with gestalt clinical probability could resolve this limitation.

Secondary retroperitoneal teratoma.

Retroperitonal teratomas are rare. We report on a case of a retroperitoneal secondary localisation of a gonadal teratoma in a patient who had developed primary testicular teratoma 12 years previously. The retroperitoneal mass was detected with an abdominal CT requested for the management of a non-specific abdominal pain.

European and American suspected and confirmed pulmonary embolism populations: comparison and analysis.

Background: If the prevalence of pulmonary embolism (PE) differs significantly between the US and Europe, this observation could reduce the generalizability of diagnostic protocols for PE derived in either location.

Objective: To determine possible causes and potential clinical consequences of these PE prevalence differences.

Methods: Secondary analysis of three prospectively collected multicenter samples (two French and one from the US) including 3174 European and 7940 American PE-suspected patients in Emergency departments (ED) (117 for Europe and 12 for US).

Head-to-head comparison of the prohormone proBNP1-108 with BNP and Nt-proBNP in patients admitted to emergency department.

Objectives: B-type natriuretic peptide (BNP) and amino-terminal proBNP (Nt-proBNP) are derived from a common precursor, the proBNP(1-108) (proBNP), synthesized by cardiomyocytes. We determined proBNP concentrations in patients admitted to ED and suspected of CHF.

Design And Methods: One hundred fifty six consecutive patients admitted to ED were included.

Ventilation-associated pneumonia after intubation in the prehospital or the emergency unit.

The aim of the study was to evaluate the prevalence and the risk factors of ventilation-associated pneumonia (VAP) for out-of-hospital or in the emergency department intubated patients. This was a retrospective descriptive study. All intubated adults subsequently admitted to the ICU over 1-year period were included.

Diagnosing destabilized heart failure in the emergency setting: current and future biomarker tests.

Acute or destabilized heart failure (DHF) is characterized by new or worsening signs and symptoms of heart failure leading to admission to an emergency department. Biomarkers may support the diagnosis, the prognosis and the management of DHF patients. The aim of this review article is to discuss and evaluate the clinical usefulness of both recognized and potential new biomarker tests for use in heart failure.

Mondor disease: a case report in ED.

Mondor disease is a form of superficial thrombophlebitis affecting the subcutaneous veins, specifically of the anterolateral thoracoabdominal wall. Clinical presentation is commonly a subcutaneous, tender, painful cordlike induration, usually founded in the breast or axilla. It affects typically middle-aged women.