Abstract Background The reverse shock index (rSI) combined with the Simplified Motor Score (sMS), that is, rSI-sMS, is a novel and efficient prehospital triage scoring system for patients COVID-19. In this study, we evaluated predictive accuracy of rSI-sMS general ward intensive care unit (ICU) admission among COVID-19 compared it other measures, including (SI), modified SI (mSI), rSI Glasgow Coma Scale (rSI-GCS), GCS motor subscale (rSI-GCSM). Methods All who visited emergency department...

: The Taiwan Triage and Acuity Scale (TTAS) is reliable for triaging patients in emergency departments Taiwan; however, most triage decisions are still based on chief complaints. reverse-shock index (SI) multiplied by the simplified motor score (rSI-sMS) a more comprehensive approach to that combines SI modified consciousness assessment. We investigated combination of TTAS rSI-sMS compared with either parameter alone as well SI.

Early identification of traumatic brain injury (TBI) patients at a high risk mortality is very important. This study aimed to compare the predictive accuracy four scoring systems in TBI, including shock index (SI), modified (MSI), age-adjusted (ASI), and reverse multiplied by Glasgow Coma Scale (rSIG). retrospective analysis registry from Taipei Tzu Chi trauma database. Totally, 1,791 with TBI were included. We investigated major indices for mortality. In subgroup analysis, we also analyzed...

ABSTRACT Objectives: Many prehospital trauma triage scores have been proposed, but none has emerged as a criterion standard. Therefore, rapid and accurate tool is necessary for field triage. The shock index (SI) multiplied by the AVPU (Alert, responds to Voice, Pain, Unresponsive) score (SIAVPU) reflected hemodynamic neurological conditions through combination of SI AVPU. This study aimed investigate prediction performance compare other in population with traumatic injury. Patients Methods:...

Background: Research on the impact of reduced time to emergent surgery in trauma patients has yielded inconsistent results. Therefore, this study investigated relationship between waiting (WEST) and outcomes patients. Methods: This retrospective, multicenter used data from Tzu Chi Hospital database. The primary clinical were in-hospital mortality, intensive care unit (ICU) admission, prolonged hospital length stay (LOS) ≥30 days. Results: A total 15,164 analyzed. median WEST was 444 min,...

Background: Early trauma team activation (TTA) may improve clinical outcomes through early diagnosis and timely intervention by a dedicated multidisciplinary team. Controversy seems to exist about the effect of establishing systems in traumatic injury populations. Our aim was identify factors that be associated with investigate activation. Method: This retrospective descriptive study included all patients from Taipei Tzu Chi Hospital Trauma Database. All prehospital vital signs, management,...

The shock index (SI) is a useful tool for predicting the injury severity and mortality in patients with trauma. However, pediatric physiology differs from that of adults. In trauma population, status may be obscured within normal range vital signs. Pediatric age-adjusted SI (SIPA) reported more accurately compared to SI. our study, we conducted 10 year retrospective cohort study population evaluate SIPA mortality, intensive care unit (ICU) admission, need surgery. This included 1265 January...

Abstract Objectives: Trauma is one of the leading causes death and its incidence increases annually. The “weekend effect” “holiday season on traumatic injury mortality remain controversial, whereby patients admitted during weekends and/or holiday have a higher risk in-hospital death. present study aimed to explore association between in population. Materials Methods: This retrospective descriptive included from Taipei Tzu Chi Hospital Database January 2009 June 2019. exclusion criterion was...

Background and Objectives: In the context of prehospital care, spinal immobilization is commonly employed to maintain cervical stability in head neck injury patients. However, its use cases unclear consciousness or major trauma patients often precautionary, pending exclusion unstable injuries through appropriate diagnostic imaging. The impact C-spinal these specific patient populations remains uncertain. Materials Methods: We conducted a retrospective cohort study at Taipei Tzu Chi Hospital...

Intracranial hemorrhage (ICH) is a catastrophic complication in patients with acute myeloid leukemia (AML). AML cells, especially the promyelocytic subtype, may release microparticles (MPs), tissue factor (TF), and cancer procoagulant (CP) to promote coagulopathy. Hyperfibrinolysis also triggered via of annexin II, t-PA, u-PA, u-PAR. Various inflammatory cytokines from such as IL-1β TNF-α, activate endothelial cells leukostasis. This condition increase ICH risk lead poor clinical outcomes....

Emergency air medical services (EAMS) share a common helicopter system for prehospital care and transfer in several countries. In Penghu, two systems are involved EAMS: the C130 systems. Given their features limitations, patients using have significantly different characteristics.

Internal jugular vein thrombosis is a rare critical cardiovascular emergency, which has potential catastrophic clinical outcomes by resulting in stroke and pulmonary embolism. Several etiologies have been reported; however, there are limited data on Lemierre's Trousseau's syndromes, both conditions with advanced disease progression poor outcomes. syndrome may present typical progressively infectious symptoms signs, including sore throat, neck mass, fever, whereas thrombophlebitis painful...

Post-snakebite compartment syndrome (PSCS) is an uncommon but dangerous condition. Compartment syndrome-like symptoms after snakebite by Protobothrops mucrosquamatus (P. mucrosquamatus) are not effective in guiding fasciotomy. Objective evaluation of intracompartmental pressure measurements patients with suspected PSCS recommended. However, there a lack consensus regarding and indications for surgical intervention, including the threshold value chamber pressure. In addition, may be readily...

Acute mesenteric infarction is a rare but emergency disease with high mortality rate. The rapidly restoration of intestinal blood flow the early goal vascular intervention. However, unspecific presentation may confuse physicians and delay timely diagnosis. rate failure in survivors still high. Here, we present case an 85-year-old male presenting acute onset progressive periumbilical cramping pain elevated D-dimer. abdominal computed tomography (CT) revealed severe superior artery occlusion....

Background: Early prediction of sepsis onset is crucial for reducing mortality and the overall cost burden treatment. Currently, few effective accurate tools are available sepsis. Hence, in this study, we developed an clinical decision support system (S-CDSS) to assist emergency physicians predict Methods: This study included patients who had visited department (ED) Taipei Tzu Chi Hospital, Taiwan, between January 1, 2020, June 31, 2022. The were divided into a derivation cohort (n = 70,758)...

Klebsiella pneumoniae-induced endogenous endophthalmitis is a rare but devastating disease, which usually occurs in immunosuppressed patients. Poorly controlled diabetes mellitus significant risk factor for this disease. The most common distant infection patients with K. was reported to be liver abscess. Other less commons infections were found catheter-related bloodstream infection, urinary tract soft tissue renal and psoas abscesses, endocarditis. Patients coexisting multiple sites are...

Antiphospholipid syndrome (APS) is an autoimmune disorder with characteristics of arterial and/or venous thrombosis due to hypercoagulation status. Although deep vein common, the involvement more dangerous and poses a high risk complications. Acute aorto-iliac occlusive disease (AIOD, known as Leriche syndrome) severe that associated morbidity mortality rates. Severe acute occlusion may cause spinal cord ischemia, leading neurological defects, such onset paraplegia. Co-occurrence...

Spiked helmet sign is a novel electrocardiogram marker that reflects poor prognosis, and may mimic myocardial infarction, especially in patients with an acute alteration of mental status or out-of-hospital cardiac arrest. In cases where spiked missed, there be delay surgical intervention for the underlying conditions because unnecessary catheterization. addition, antiplatelet agents coronary syndrome such can lead to catastrophic complications. Therefore, early recognition useful timely...

Retroperitoneal hemorrhage is a life-threatening clinical entity which difficult to diagnose due numerous etiology and unspecific symptoms. Spontaneous severe retroperitoneal hemorrhage, known as Wunderlich’s syndrome presented with Lenk’s triad, includes acute flank pain, mass, hypovolemic shock. Giant adrenal myelolipoma causing rare. Here, we 59-year-old woman spontaneous onset persistent left pain. The kidney, ureter, bladder (KUB) study revealed renal stones. abnormal D-dimer level...

Acute aortic dissection is a rare but lethal cardiac disease involving the aorta, which presents with typical symptoms, including severe, sharp, or tearing acute onset of chest back pain. Other unspecific such as epigastric pain, nausea, and vomiting, may be also present. Neurologic symptoms induced by are present in cases often lead to delate diagnosis because they mimic stroke intracranial hemorrhage. Therefore, it important understand dissection-induced neurologic symptoms. Here, we case...

Minocycline is a tetracycline group antibiotic that known to cause significant antibacterial and anti-inflammatory effects. has been widely used treat systemic infection, acne, dermatitis, rosacea. However, various dose-related side effects of hyperpigmentation in whole body tissues have reported. Three main types minocycline-induced identified. In rare severe cases, drug-induced can mimic local cellulitis or peripheral arterial occlusive disease (PAOD). These processes require different...