Emergency of outpatient anaphylactic shock: Review article

Background: Anaphylaxis is a severe, potentially life-threatening allergic reaction triggered by substances such as food, medications, insect stings, or environmental factors. It presents a range of symptoms, including respiratory, cardiovascular, dermatological, and gastrointestinal manifestations, which can develop rapidly. Misdiagnosis is common, as symptoms overlap with conditions such as septic shock or asthma. The immediate administration of intramuscular epinephrine is critical for treatment, along with airway management, antihistamines, and glucocorticoids. Aim: This review aims to explore the outpatient management of anaphylactic shock, focusing on symptoms, treatment strategies, and emergency preparedness. The review emphasizes the importance of rapid intervention and staff training for successful management. Methods: Methods involve analyzing current literature on anaphylaxis, its clinical presentation, and emergency treatment protocols. Results: Results show that early epinephrine administration is crucial for improving outcomes, with delayed treatment contributing to increased fatality risks. Regular preparedness, such as maintaining an anaphylaxis cart and conducting staff drills, is vital for effective outpatient care. Conclusion: The conclusion underscores the necessity of equipping outpatient settings with proper protocols and emergency supplies to manage anaphylactic emergencies and the need for patient education on recognizing and managing future episodes

Addressing acute gastrointestinal emergencies: From hemorrhage to obstruction

Background: Gastrointestinal bleeding (GIB) has traditionally been divided into upper and lower gastrointestinal bleeding (UGIB and LGIB). Advances in diagnostic technologies, including capsule endoscopy and balloon-assisted enteroscopy, have refined our understanding of small bowel bleeding, leading to a revised classification system encompassing upper, mid, and lower GIB. The rising incidence of LGIB is attributed to an aging population and increased antithrombotic use. Despite improvements in UGIB management, effective preventive strategies for LGIB remain insufficient, with significant hospitalization and mortality rates. Aim: This review aims to consolidate current knowledge on the initial management of acute LGIB, addressing advancements in predictive scoring systems, risk stratification, and the role of early colonoscopy. Methods: A comprehensive literature review was conducted, focusing on recent advancements and guidelines, including the 2016 American College of Gastroenterology guidelines for acute LGIB and the American Society for Gastrointestinal Endoscopy guidelines on antithrombotic management. Results: The review highlights the challenges in managing acute LGIB, including the diverse etiology of bleeding, the need for effective risk stratification tools, and the optimization of colonoscopy timing. New predictive models, such as the NOBLADS score and other risk scoring systems, provide valuable insights into severe LGIB outcomes.&nbsp

Advances in emergency care for burn disorders: Treatment strategies and outcomes

Background: Effective management of burn injuries is crucial for optimizing patient outcomes, yet challenges remain in prehospital care and accurate assessment. This article reviews the advancements in emergency burn care, focusing on the prehospital management by Helicopter Emergency Medical Services (HEMS) in Switzerland and the implications for North American practices. Aim: To explore and compare burn care strategies, particularly in prehospital and initial hospital settings, and to evaluate updates in fluid resuscitation protocols and burn size estimation techniques. Methods: The study incorporates a decade-long review of HEMS data from Switzerland and examines North American practices, including referral criteria and transport strategies. Analysis of recent studies on air transport overtriage and updated fluid resuscitation formulas, such as the Parkland and Modified Brooke formulas, is also included. Results: Findings indicate a high degree of consistency in burn size assessment in Switzerland, contrasting with varying results in North America where overtriage and inaccuracies in burn size estimation are prevalent. Fluid resuscitation protocols have been refined to address these issues, with updated ABLS guidelines reflecting advancements in technology and evidence-based practices. Conclusion: Enhanced prehospital care and accurate burn size estimation are critical for effective burn management.&nbsp

Management of acute spinal cord injuries: Emergency view

Background: Acute spinal cord injuries (SCIs) are devastating events often leading to irreversible neurological damage and significant long-term disabilities. SCIs affect young, otherwise healthy individuals, contributing to a considerable economic and quality-adjusted life years (QALY) burden. Aim: This review aims to provide an overview of current acute management strategies for SCI and to explore emerging therapeutic approaches that may mitigate injury progression and improve outcomes. Methods: The study reviewed existing literature on SCI management, including established protocols and experimental therapies. A comprehensive analysis of surgical and medical treatments, such as early decompression, hemodynamic management, and novel interventions targeting ischemia, inflammation, and cytotoxicity, was conducted. Results: Early surgical decompression, within 24 hours of injury, has been shown to enhance neurological recovery, reduce hospital stays, and lower complication rates. Hemodynamic management, aiming to maintain a mean arterial pressure of 85–90 mmHg, was crucial in improving functional outcomes. Experimental treatments such as cerebrospinal fluid diversion, spinal cooling, and minocycline demonstrated promising results, though further clinical trials are necessary to establish efficacy. Conclusion: While significant advances have been made in the surgical management of SCI, challenges remain in optimizing medical treatments.&nbsp

Management of acute psychiatric emergencies: Approaches and challenges in emergency departments

Background: The prevalence of psychiatric emergencies increases significantly during public disasters, highlighting the need for effective management strategies. Disasters, including pandemics and epidemics, exacerbate mental health conditions and strain healthcare systems. Despite established models for psychiatric emergency management, there remains a crucial need to ensure accessibility and effectiveness in such high-stress scenarios. Aims: This article aims to review and propose strategies for managing psychiatric emergencies in the context of public disasters. It focuses on evaluating the impact of crises on mental health and the capacity of healthcare systems to address these needs effectively. Methods: A comprehensive review of literature was conducted, examining psychiatric emergencies in disaster settings, including pandemics and natural disasters. The review involved analyzing current management models, assessing their effectiveness, and identifying gaps in healthcare provision. Results: The study finds that the prevalence of mental disorders during disasters is significantly higher compared to normal conditions. Key challenges include inadequate infrastructure, limited staff, and the need for specialized psychiatric interventions. Effective strategies include enhanced triage systems, increased availability of outpatient and inpatient care, and the use of telepsychiatry where applicable.