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Management of difficult intravenous access: a qualitative review Mingwei Ng, Leong Kwok Fai Mark, Lateef Fatimah World Journal of Emergency Medicine    2022, 13 (6): 467-478.   DOI: 10.5847/wjem.j.1920-8642.2022.104 Abstract （681）   HTML （1211118192）    PDF（pc） （1306KB）（1558）       Knowledge map    Save BACKGROUND: A perennial challenge faced by clinicians and made even more relevant with the global obesity epidemic, difficult intravenous access (DIVA) adversely impacts patient outcomes by causing significant downstream delays with many aspects of diagnoses and therapy. As most published DIVA strategies are limited to various point-of-care ultrasound techniques while other “tricks-of-the-trade” and pearls for overcoming DIVA are mostly relegated to informal nonpublished material, this article seeks to provide a narrative qualitative review of the iterature on DIVA and consolidate these strategies into a practical algorithm. METHODS: We conducted a literature search on PubMed using the keywords “difficult intravenous access”, “peripheral vascular access” and “peripheral venous access” and searched emergency medicine and anaesthesiology resources for relevant material. These strategies were then categorized and incorporated into a DIVA algorithm. RESULTS: We propose a Vortex approach to DIVA that is modelled after the Difficult Airway Vortex concept: starting off with standard peripheral intravenous cannulation (PIVC) techniques, progressing sequentially on to ultrasound-guided cannulation and central venous cannulation and finally escalating to the most invasive intraosseous access should the patient be in extremis or should best efforts with the other lifelines fail. CONCLUSION: DIVA is a perennial problem that healthcare providers across various disciplines will be increasingly challenged with. It is crucial to have a systematic stepwise approach such as the DIVA Vortex when managing such patients and have at hand a wide repertoire of techniques to draw upon. Table and Figures | Reference | Related Articles | Metrics

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Intestinal microcirculation dysfunction in sepsis: pathophysiology, clinical monitoring, and therapeutic interventions A-ling Tang, Mei-jia Shen, Guo-qiang Zhang World Journal of Emergency Medicine    2022, 13 (5): 343-348.   DOI: 10.5847/wjem.j.1920-8642.2022.031 Abstract （615）   HTML （1424497274）    PDF（pc） （183KB）（1208）       Knowledge map    Save BACKGROUND: Intestinal microcirculation dysfunction is an important factor that causes poor prognosis in sepsis patients and is an important pathophysiological basis for the occurrence and development of sepsis. DATA RESOURCES: PubMed, Web of Science, and China National Knowledge Infrastructure (CNKI) were searched from inception to August 1, 2021. The search was limited to the English language only. Two reviewers independently identified studies related to intestinal microcirculation dysfunction in sepsis. Exclusion criteria were duplicate articles according to multiple search criteria. RESULTS: Fifty articles were included, and most of them were animal studies. These studies reported pathogenesis, including endothelial dysfunction, leukocyte recruitment and adhesion, microthrombus formation, microcirculation hypoperfusion, and redistribution of intestinal wall blood flow. The monitoring methods of intestinal microcirculation were also diverse, including handheld microscopes, intravital microscopy (IVM), laser Doppler blood flow instruments, laser speckle contrast imaging, tissue reflectance spectrophotometry, biochemical markers of intestinal ischemia, and histopathological examination. In view of the related pathogenesis of intestinal microcirculation disorder in sepsis, existing studies also have different opinions on its treatment. CONCLUSIONS: Limited by monitoring, there are few clinical studies on intestinal microcirculation dysfunction in sepsis. Related research mainly focuses on basic research, but some progress has also been made. Therefore, this review may provide a reference for future research on intestinal microcirculation dysfunction in sepsis. Table and Figures | Reference | Related Articles | Metrics

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Global research trends in cardiac arrest research: a visual analysis of the literature based on CiteSpace Shi-jiao Yan, Mei Chen, Jing Wen, Wen-ning Fu, Xing-yue Song, Huan-jun Chen, Ri-xing Wang, Mei-ling Chen, Xiao-tong Han, Chuan-zhu Lyu World Journal of Emergency Medicine    2022, 13 (4): 290-296.   DOI: 10.5847/wjem.j.1920-8642.2022.071 Abstract （467）   HTML （1325139194）    PDF（pc） （839KB）（1195）       Knowledge map    Save BACKGROUND: The high morbidity, high mortality and low survival rate of cardiac arrest (CA) cause a heavy global burden. We aimed to analyze the changes in scientific output related to CA over the past two decades. METHODS: We analyzed the scientific output related to CA from 2000 to 2020 via the Web of Science. The data were analyzed using CiteSpace software. RESULTS: In total, 28,312 articles relating to CA were identified in the Web of Science. The volume of scientific research output in the field of global CA research was mainly distributed in the Americas, Europe and Asia, covering a wide range. Of the 28,312 articles, the research content of the highly cited literature mainly focused on CA, mild hypothermia treatment, and prognosis of CA patients. CONCLUSION: Various scientific methods were applied to reveal scientific productivity, collaboration, and research hotspots in the CA research field. Cardiopulmonary resuscitation (CPR), extracorporeal membrane oxygenation (ECMO), survival and target temperature management are research hotspots. Future research on CA will continue to focus on its treatment and prognosis to improve the survival rate of CA patients. Table and Figures | Reference | Supplementary Material | Related Articles | Metrics

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Serial blood concentration of polyethoxylated tallow amine and clinical presentations in acute herbicide poisoning Jungsoo Park, Sun Cheun Kim, Youngjoon Jeon, Yong Chul Cho, Changshin Kang, Yeonho You, Hong Joon Ahn, Seung Ryu, Jihan Lee, Wonjoon Jeong World Journal of Emergency Medicine    2022, 13 (4): 305-308.   DOI: 10.5847/wjem.j.1920-8642.2022.061 Abstract （280）   HTML （1610613128）    PDF（pc） （559KB）（1090）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics

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Neutrophils inhibit CD8 + T cells immune response by arginase-1 signaling in patients with sepsis Xiao-kang Dai, Zhen-xing Ding, Yuan-yuan Tan, Hua-rui Bao, Dong-yao Wang, Hong Zhang World Journal of Emergency Medicine    2022, 13 (4): 266-273.   DOI: 10.5847/wjem.j.1920-8642.2022.068 Abstract （425）   HTML （1246232659）    PDF（pc） （1952KB）（1061）       Knowledge map    Save BACKGROUND: Patients with sepsis often exhibit an acute inflammatory response, followed by an immunosuppressive phase with a poor immune response. However, the underlying mechanisms have not been fully elucidated. METHODS: We sought to comprehensively characterize the transcriptional changes in neutrophils of patients with sepsis by transcriptome sequencing. Additionally, we conducted a series of experiments, including real-time quantitative polymerase chain reaction (RT-qPCR) and flow cytometry to investigate the role of arginase-1 signaling in sepsis. RESULTS: Through the analysis of gene expression profiles, we identified that the negative regulation of T cell activation signaling was enriched, and the expression of arginase-1 was high in neutrophils from patients with sepsis. Furthermore, we conducted flow cytometry and found that the function of CD8+ T cells in septic patients was impaired. Moreover, neutrophils from septic patients inhibited the percentage of polyfunctional effector CD8+ T cells through arginase-1. Additionally, the proportions of granzyme B+IFN-γ+CD8+ T and TNF-α+IFN-γ+CD8+ T cells increased after inhibition of arginase-1 signaling. CONCLUSION: The impaired effector function of CD8+ T cells could be restored by blocking arginase-1 signaling in patients with sepsis. Table and Figures | Reference | Supplementary Material | Related Articles | Metrics

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Comparing the precision of the pSOFA and SIRS scores in predicting sepsis-related deaths among hospitalized children: a multi-center retrospective cohort study Chun Zhao, Mei-yun Xin, Jing Li, Jin-fang Zhao, Yu-juan Wang, Wei Wang, Qian Gao, Jie Chen, Qi-wei Wang, You-peng Jin World Journal of Emergency Medicine    2022, 13 (4): 259-265.   DOI: 10.5847/wjem.j.1920-8642.2022.060 Abstract （437）   HTML （1357905939）    PDF（pc） （508KB）（990）       Knowledge map    Save BACKGROUND: The latest sepsis definition includes both infection and organ failure, as evidenced by the sequential organ failure assessment (SOFA) score. However, the applicability of the pediatric SOFA score (pSOFA) is not yet determined. This study evaluated the effectiveness of both pSOFA and system inflammatory reaction syndrome (SIRS) scores in predicting sepsis-related pediatric deaths. METHODS: This is a retrospective multi-center cohort study including hospitalized patients <18 years old with diagnosed or not-yet-diagnosed infections. Multivariate analyses were carried out to evaluate risk factors for in-hospital mortality. According to Youden index (YI), three sub-categories of pSOFA were screened out and a new simplified pSOFA score (spSOFA) was formed. The effectiveness and accuracy of prediction of pSOFA, SIRS and spSOFA was retrieved from the area under the receiver operating characteristic curve (AUROC) and Delong’s test. RESULTS: A total of 1,092 participants were eligible for this study, and carried a 23.4% in-hospital mortality rate. The 24-h elevated pSOFA score (24 h-pSOFA), bloodstream infection, and mechanical ventilation (MV) requirement were major risk factors associated with sepsis-related deaths. The AUROC analysis confirmed that the spSOFA provided good predictive capability in sepsis-related pediatric deaths, relative to the 24 h-pSOFA and SIRS. CONCLUSIONS: The pSOFA score performed better than SIRS in diagnosing infected children with high mortality risk. However, it is both costly and cumbersome. We, therefore, proposed spSOFA to accurately predict patient outcome, without the disadvantages. Nevertheless, additional investigations, involving a large sample population, are warranted to confirm the conclusion of this study. Table and Figures | Reference | Supplementary Material | Related Articles | Metrics

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Patient care during interfacility transport: a narrative review of managing diverse disease states Quincy K. Tran, Francis O’Connell, Andrew Hakopian, Marwa SH Abrahim, Kamilla Beisenova, Ali Pourmand World Journal of Emergency Medicine    2023, 14 (1): 3-9.   DOI: 10.5847/wjem.j.1920-8642.2023.009 Abstract （516）   HTML （1448175643）    PDF（pc） （220KB）（953）       Knowledge map    Save BACKGROUND: When critically ill patients require specialized treatment that exceeds the capability of the index hospitals, patients are frequently transferred to a tertiary or quaternary hospital for a higher level of care. Therefore, appropriate and efficient care for patients during the process of transport between two hospitals (interfacility transfer) is an essential part of patient care. While medical adverse events may occur during the interfacility transfer process, there have not been evidence-based guidelines regarding the equipment or the practice for patient care during transport. METHODS: We conducted searches from the PubMed, Cumulative Index of Nursing and Allied Health (CINAHL), and Scopus databases up to June 2022. Two reviewers independently screened the titles and abstracts for eligibility. Studies that were not in the English language and did not involve critically ill patients were excluded. RESULTS: The search identified 75 articles, and we included 48 studies for our narrative review. Most studies were observational studies. CONCLUSION: The review provided the current evidence-based management of diverse disease states during the interfacility transfer process, such as proning positioning for respiratory failure, extracorporeal membrane oxygenation (ECMO), obstetric emergencies, and hypertensive emergencies (aortic dissection and spontaneous intracranial hemorrhage). Table and Figures | Reference | Supplementary Material | Related Articles | Metrics

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The successful use of extracorporeal membrane oxygenation combined with continuous renal replacement therapy for a cardiac arrest patient with refractory hypokalemia and diabetic ketoacidosis Yang Li, Rui Xu, Chun-Shui Cao, Liang Huang World Journal of Emergency Medicine    2022, 13 (4): 337-340.   DOI: 10.5847/wjem.j.1920-8642.2022.066 Abstract （282）   HTML （1485014042）    PDF（pc） （1537KB）（935）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics

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A case of persistent refractory hypoglycemia from polysubstance recreational drug use Jie Er Janice Soo, Mingwei Ng, Terence Kee Liem Chong, Boon Kiat Kenneth Tan, R Ponampalam World Journal of Emergency Medicine    2023, 14 (1): 75-77.   DOI: 10.5847/wjem.j.1920-8642.2022.088 Abstract （385）   HTML （1225797647）    PDF（pc） （152KB）（912）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics

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Asparaginase-associated pancreatitis in chemotherapy- treated pediatric patients: a five-year retrospective study Chen-xi Liu, Yun-yu Zhang, Qiu-shi Yang, Shu-hong Shen, Jing Chen, Yan-jing Tang, Chang-cheng Chen, Zhuo Wang, Bi-ru Li, Juan Qian, Ying Wang, Wen-ting Hu, Bo-tao Ning World Journal of Emergency Medicine    2022, 13 (4): 313-321.   DOI: 10.5847/wjem.j.1920-8642.2022.062 Abstract （261）   HTML （1879311623）    PDF（pc） （544KB）（912）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics

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Hepatocellular carcinoma-derived exosomal miRNA-761 regulates the tumor microenvironment by targeting the SOCS2/JAK2/STAT3 pathway Xiao-hu Zhou, Hao Xu, Chang Xu, Ying-cai Yan, Lin-shi Zhang, Qiang Sun, Wei-lin Wang, Yan-jun Shi World Journal of Emergency Medicine    2022, 13 (5): 379-385.   DOI: 10.5847/wjem.j.1920-8642.2022.089 Abstract （228）   HTML （1409417228）    PDF（pc） （480KB）（879）       Knowledge map    Save BACKGROUND: Exosomes and exosomal microRNAs have been implicated in tumor occurrence and metastasis. Our previous study showed that microRNA-761 (miR-761) is overexpressed in hepatocellular carcinoma (HCC) tissues and that its inhibition affects mitochondrial function and inhibits HCC metastasis. The mechanism by which exosomal miR-761 modulates the tumor microenvironment has not been elucidated. METHODS: Exosomal miR-761 was detected in six cell lines. Cell counting kit-8 (CCK-8) and transwell migration assays were performed to determine the function of exosomal miR-761 in HCC cells. The luciferase reporter assay was used to analyze miR-761 target genes in normal fibroblasts (NFs). The inhibitors AZD1480 and C188-9 were employed to determine the role of the Janus kinase 2/signal transducer and activator of transcription 3 (JAK2/STAT3) signaling pathway in the transformation of cancer-associated fibroblasts (CAFs). RESULTS: In this study, we characterized the mechanism by which miR-761 reprogrammed the tumor microenvironment. We found that HCC-derived exosomal miR-761 was taken up by NFs. Moreover, HCC exosomes affected the tumor microenvironment by activating NFs via suppressor of cytokine signaling 2 (SOCS2) and the JAK2/STAT3 signaling pathway. CONCLUSIONS: These results demonstrated that exosomal miR-761 modulated the tumor microenvironment via SOCS2/JAK2/STAT3 pathway-dependent activation of CAFs. Our findings may inspire new strategies for HCC prevention and therapy. Table and Figures | Reference | Related Articles | Metrics

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The effectiveness of emotion-focused art therapy on the resilience and self-image of emergency physicians Soo Kyung Eo, Chanwoong Kim, Kyung Hye Park, Eun Kyung Eo World Journal of Emergency Medicine    2022, 13 (6): 479-484.   DOI: 10.5847/wjem.j.1920-8642.2022.098 Abstract （326）   HTML （1478543368）    PDF（pc） （384KB）（860）       Knowledge map    Save Table and Figures | Reference | Supplementary Material | Related Articles | Metrics

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Development and validation of a predictive model for patients with post-extubation dysphagia Jia-ying Tang, Xiu-qin Feng, Xiao-xia Huang, Yu-ping Zhang, Zhi-ting Guo, Lan Chen, Hao-tian Chen, Xiao-xiao Ying World Journal of Emergency Medicine    2023, 14 (1): 49-55.   DOI: 10.5847/wjem.j.1920-8642.2023.021 Abstract （276）   HTML （1291857961）    PDF（pc） （278KB）（858）       Knowledge map    Save BACKGROUND: Swallowing disorder is a common clinical symptom that can lead to a series of complications, including aspiration, aspiration pneumonia, and malnutrition. This study aimed to investigate risk factors of post-extubation dysphagia (PED) in intensive care unit (ICU) patients with endotracheal intubation, and to develop a risk-predictive model for PED, which could serve as an assessment tool for the prevention and control of PED. METHODS: Patients retrospectively selected from June to December 2021 in a tertiary hospital served as the derivation cohort. Patients recruited from the same hospital from March to June 2022 served as the external validation cohort for the predictive model. We used a combination of variable screening and least absolute shrinkage and selection operator (LASSO) regression to select the most useful candidate predictors and checked the multicollinearity of independent variables using the variance inflation factor method. Multivariate logistic regression analysis was performed to calculate the odds ratio (OR; 95% confidence interval [95% CI]) and P-value for each variable to predict diagnosis. The screened risk factors were introduced into R software to build a nomogram model. The performance of the model, including discrimination ability, calibration, and clinical benefit, was evaluated by plotting the receiver operating characteristic (ROC), calibration, and decision curves. RESULTS: A total of 305 patients were included in this study. Among them, 235 patients (53 PED vs. 182 non-PED) were enrolled in the derivation cohort, while 70 patients (17 PED vs. 53 non-PED) were enrolled in the validation cohort. The independent predictors included age, pause of sedatives, level of consciousness, activities of daily living (ADL) score, nasogastric tube, sore throat, and voice disorder. These predictors were used to establish the predictive nomogram model. The model demonstrated good discriminative ability, and the area under the ROC curve (AUC) was 0.945 (95% CI 0.904-0.970). Applying the predictive model to the validation cohort demonstrated good discrimination with an AUC of 0.907 (95% CI 0.831-0.983) and good calibration. The decision-curve analysis of this nomogram showed a net benefit of the model. CONCLUSION: A predictive model that incorporates age, pause of sedatives, level of consciousness, ADL score, nasogastric tube, sore throat, and voice disorder may have the potential to predict PED in ICU patients. Table and Figures | Reference | Supplementary Material | Related Articles | Metrics

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Arctigenin attenuates paraquat-induced human lung epithelial A549 cell injury by suppressing ROS/p38 mitogen-activated protein kinases-mediated apoptosis Chao Liu, Zhao-rui Sun, Meng-meng Wang, Zhi-zhou Yang, Wei Zhang, Yi Ren, Xiao-qin Han, Rui Liu, Quan Li, Shi-nan Nie World Journal of Emergency Medicine    2022, 13 (5): 373-378.   DOI: 10.5847/wjem.j.1920-8642.2022.086 Abstract （244）   HTML （1074135303）    PDF（pc） （273KB）（857）       Knowledge map    Save BACKGROUND: Paraquat (PQ)-induced acute lung injury (ALI) and pulmonary fibrosis are common diseases with high mortality but without effective antidotes in emergency medicine. Our previous study has proved that arctigenin suppressed pulmonary fibrosis induced by PQ. We wondered whether arctigenin could also have a protective effect on PQ-induced ALI. METHODS: A PQ-induced A549 cell injury model was used, and the effect of arctigenin was determined by a cell counting kit-8 (CCK-8) cell viability assay. In addition, terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick-end labelling (TUNEL) staining assays and mitochondrial membrane potential assays were performed to evaluate the level of cell apoptosis. The generation of reactive oxygen species (ROS) was reflected by dihydroethidium (DHE) staining and a 2’,7’-dichlorodihydrofluorescein diacetate (DCFH-DA) assay. Moreover, immunoblotting studies were used to assess the expression of mitogen-activated protein kinases (MAPKs) and p38 MAPK. RESULTS: Arctigenin attenuated PQ-induced inhibition of A549 cell viability in a dose-dependent manner. Arctigenin also significantly reduced PQ-induced A549 cell apoptosis, as reflected by the TUNEL assay and mitochondrial membrane potential assay, which may result from suppressed ROS/p38 MAPK signaling because we found that arctigenin dramatically suppressed ROS generation and p38 MAPK phosphorylation. CONCLUSION: Arctigenin could attenuate PQ-induced lung epithelial A549 cell injury in vitro by suppressing ROS/p38 MAPK-mediated cell apoptosis, and arctigenin might be considered a potential candidate drug for PQ-induced ALI. Table and Figures | Reference | Supplementary Material | Related Articles | Metrics

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Endothelial cell metabolism in sepsis Jue-xian Wei, Hui-lin Jiang, Xiao-hui Chen World Journal of Emergency Medicine    2023, 14 (1): 10-16.   DOI: 10.5847/wjem.j.1920-8642.2023.019 Abstract （320）   HTML （2103515961）    PDF（pc） （346KB）（855）       Knowledge map    Save BACKGROUND: Endothelial dysfunction in sepsis is a pathophysiological feature of septic organ failure. Endothelial cells (ECs) exhibit specific metabolic traits and release metabolites to adapt to the septic state in the blood to maintain vascular homeostasis. METHODS: Web of Science and PubMed were searched from inception to October 1, 2022. The search was limited to the English language only. Two reviewers independently identified studies related to EC metabolism in sepsis. The exclusion criteria were duplicate articles according to multiple search criteria. RESULTS: Sixty articles were included, and most of them were cell and animal studies. These studies reported the role of glycolysis, oxidative phosphorylation, fatty acid metabolism, and amino acid metabolism in EC homeostasis. including glycolysis, oxidative phosphorylation, fatty acid metabolism and amino acid metabolism. However, dysregulation of EC metabolism can contribute to sepsis progression. CONCLUSION: There are few clinical studies on EC metabolism in sepsis. Related research mainly focuses on basic research, but some scientific problems have also been clarified. Therefore, this review may provide an overall comprehension and novel aspects of EC metabolism in sepsis. Table and Figures | Reference | Related Articles | Metrics

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Predicting factors for the need of extracorporeal membrane oxygenation for suicide attempts by cardiac medication: a single-center cohort study David Vandroux, Thomas Aujoulat, Bernard-Alex Gaüzère, Bérénice Puech, Bertrand Guihard, Olivier Martinet World Journal of Emergency Medicine    2022, 13 (4): 283-289.   DOI: 10.5847/wjem.j.1920-8642.2022.070 Abstract （438）   HTML （1963622412）    PDF（pc） （479KB）（835）       Knowledge map    Save BACKGROUND: Severe poisoning due to the overdosing of cardiac drugs can lead to cardiovascular failure. In order to decrease the mortality rate, the most severe patients should be transferred as quickly as possible to an extracorporeal membrane oxygenation (ECMO) center. However, the predictive factors showing the need for venous-arterial ECMO (VA-ECMO) had never been evaluated. METHODS: A retrospective, descriptive, and single-center cohort study. All consecutive patients admitted in the largest ICU of Reunion Island (Indian Ocean) between January 2013 and September 2018 for beta-blockers (BB), calcium channel blockers (CCB), renin-angiotensin-aldosterone system blockers, digoxin or anti-arrythmic intentional poisonings were included. ECMO implementation was the primary outcome. RESULTS: A total of 49 consecutive admissions were included. Ten patients had ECMO, 39 patients did not have ECMO. Three patients in ECMO group died, while no patients in the conventional group died. The most relevant ECMO-associated factors were pulse pressure and heart rate at first medical contact and pulse pressure, heart rate, arterial lactate concentration, liver enzymes and left ventricular ejection fraction (LVEF) at ICU-admission. Only pulse pressure at first medical contact and LVEF were significant after logistic regression. CONCLUSION: A transfer to an ECMO center should be considered for a pulse pressure < 35 mmHg at first medical contact or LVEF < 20% on admission to ICU. Table and Figures | Reference | Supplementary Material | Related Articles | Metrics

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Is rosuvastatin protective against sepsis-associated encephalopathy? A secondary analysis of the SAILS trial Shi-yuan Yu, Zeng-zheng Ge, Jun Xiang, Yan-xia Gao, Xin Lu, Joseph Harold Walline, Mu-bing Qin, Hua-dong Zhu, Yi Li World Journal of Emergency Medicine    2022, 13 (5): 367-372.   DOI: 10.5847/wjem.j.1920-8642.2022.072 Abstract （296）   HTML （1342447629）    PDF（pc） （243KB）（832）       Knowledge map    Save BACKGROUND: Sepsis is a common cause of death in emergency departments and sepsis-associated encephalopathy (SAE) is a major complication. Rosuvastatin may play a neuroprotective role due to its protective effects on the vascular endothelium and its anti-inflammatory functions. Our study aimed to explore the potential protective function of rosuvastatin against SAE. METHODS: Sepsis patients without any neurological dysfunction on admission were prospectively enrolled in the “Rosuvastatin for Sepsis-Associated Acute Respiratory Distress Syndrome” study (SAILS trial, ClinicalTrials.gov number: NCT00979121). Patients were divided into rosuvastatin and placebo groups. This is a secondary analysis of the SAILS dataset. Baseline characteristics, therapy outcomes, and adverse drug events were compared between groups. RESULTS: A total of 86 patients were eligible for our study. Of these patients, 51 were treated with rosuvastatin. There were significantly fewer cases of SAE in the rosuvastatin group than in the placebo group (32.1% vs. 57.1%, P=0.028). However, creatine kinase levels were significantly higher in the rosuvastatin group than in the placebo group (233 [22-689] U/L vs. 79 [12-206] U/L, P=0.034). CONCLUSION: Rosuvastatin appears to have a protective role against SAE but may result in a higher incidence of adverse events. Table and Figures | Reference | Related Articles | Metrics

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First report of polymicrobial necrotizing fasciitis caused by Eggerthia catenaformis and Finegoldia magna Claudius Illg, Jonas Kolbenschlag, Ruth Christine Schäfer, Adrien Daigeler, Sabrina Krauss World Journal of Emergency Medicine    2022, 13 (4): 326-329.   DOI: 10.5847/wjem.j.1920-8642.2022.067 Abstract （314）   HTML （1950908678）    PDF（pc） （2656KB）（830）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics

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Pseudo-Wellens syndrome secondary to postexercise syncope Shu Fang, Zhi-hao Liu, Qi Jin, Yu-xi Li, Wen-hui Ding, Hao-yu Weng, Tie-ci Yi, Jian-ping Li World Journal of Emergency Medicine    2022, 13 (4): 334-336.   DOI: 10.5847/wjem.j.1920-8642.2022.064 Abstract （269）   HTML （1544028228）    PDF（pc） （2380KB）（829）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics

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The impact of prehospital blood sampling on the emergency department process of patients with chest pain: a pragmatic non-randomized controlled trial Johan L. van Nieuwkerk, M. Christien van der Linden, Rolf J. Verheul, Merel van Loon-van Gaalen, Marije Janmaat, Naomi van der Linden World Journal of Emergency Medicine    2023, 14 (4): 257-264.   DOI: 10.5847/wjem.j.1920-8642.2023.054 Abstract （412）   HTML （1537）    PDF（pc） （414KB）（823）       Knowledge map    Save BACKGROUND: In patients with chest pain who arrive at the emergency department (ED) by ambulance, venous access is frequently established prehospital, and could be utilized to sample blood. Prehospital blood sampling may save time in the diagnostic process. In this study, the association of prehospital blood draw with blood sample arrival times, troponin turnaround times, and ED length of stay (LOS), number of blood sample mix-ups and blood sample quality were assessed. METHODS: The study was conducted from October 1, 2019 to February 29, 2020. In patients who were transported to the ED with acute chest pain with low suspicion for acute coronary syndrome (ACS), outcomes were compared between cases, in whom prehospital blood draw was performed, and controls, in whom blood was drawn at the ED. Regression analyses were used to assess the association of prehospital blood draw with the time intervals. RESULTS: Prehospital blood draw was performed in 100 patients. In 406 patients, blood draw was performed at the ED. Prehospital blood draw was independently associated with shorter blood sample arrival times, shorter troponin turnaround times and decreased LOS (P<0.001). No differences in the number of blood sample mix-ups and quality were observed (P>0.05). CONCLUSION: For patients with acute chest pain with low suspicion for ACS, prehospital blood sampling is associated with shorter time intervals, while there were no significant differences between the two groups in the validity of the blood samples. Table and Figures | Reference | Supplementary Material | Related Articles | Metrics