Volume 22, Issue 2, Pages 57 – 108 (2023)

Emergency department crowding and older patients: a nationwide retrospective cohort study

Original Articles, Volume 22, Issue 2, Pages 57 – 108 (2023)

Emergency department (ED) crowding is a worldwide problem and one of the main causes internationally is an increase in presentations by older patients with complex and chronic care needs. Although there has been a 4,3% reduction in total ED visits from 2016-2019 in the Netherlands, the EDs still experience crowding.

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Point of care ultrasound: Current and future directions for Acute Medicine

Review Articles, Volume 22, Issue 2, Pages 57 – 108 (2023)

Point of care ultrasound (POCUS) represents an exciting tool for current and future acute care practitioners. POCUS has come a long way in a short space of time and its widespread implementation may well be one of the biggest changes seen in acute medicine across the next decade.

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Ultrasound for Lumbar Punctures – An Invaluable tool for the Acute Physician

Correspondence, Volume 22, Issue 2, Pages 57 – 108 (2023)

The traditional procedure of identifying anatomical landmarks when performing lumbar punctures can lead to a failure rate of 19%.
The Society of Hospital Medicine have published a statement, recommending use of ultrasound (US) guidance for all adult lumbar punctures (LP).
A recent meta-analysis found several advantages of point of care US guided LP: higher success rate and diminished pain.
US assisted LP is easy to learn, integrating ultrasound guided LP into Acute Medicine curriculum, could lead to better patient outcome.

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Listeria Meningitis, one of your five a day? A case report of Listeria Monocytogenes Meningitis in a fit and well 62-year-old woman

Case Reports, Volume 22, Issue 2, Pages 57 – 108 (2023)

Listeria Monocytogenes is transmitted via ingestion of contaminated food products and can cause invasive disease in susceptible hosts. Risk factors include immunocompromise; pregnancy; being elderly; and new-born.

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Ethics in acute medicine

Review Articles, Volume 22, Issue 2, Pages 57 – 108 (2023)

Clinical ethics is a core part of the decision-making process. Whilst often reduced to the four principles approach, the situation is more complex. Teaching of ethics frequently focuses on quandary issues, such as assisted-suicide, but there is an ethical component to every clinical encounter. Where differences of opinion arise it is important to understand one’s own perspective and that of others. Compassion is an important starting point.

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Quantitative assessment of the relationship between body mass index and risk of pulmonary embolism: a retrospective case-control study

Original Articles, Volume 22, Issue 2, Pages 57 – 108 (2023)

In the context of a significant increase in obesity rates, quantifying the relationship between body mass index (BMI) and risk of pulmonary embolism (PE) is an essential component of accurate clinical risk assessment. This observational study is the first to explore this association by clinician-defined cause of the PE. We demonstrate that the association between BMI and PE is driven by patients with otherwise ‘unprovoked’ PE where there is a strong positive correlation with odds ratios equivalent to well-recognised major risk factors such as cancer, pregnancy and surgery. We make a case for the inclusion of BMI in risk-prediction tools.

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Real-world characteristics and outcomes of patients with intermediate high risk acute pulmonary embolism

Original Articles, Volume 22, Issue 2, Pages 57 – 108 (2023)

Exact benefits of currently recommended close monitoring in intermediate high risk acute pulmonary embolism (PE) patients are unknown.
This prospective observational cohort study determined clinical characteristics, and disease course of intermediate high risk acute PE patients in an academic hospital setting.

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Guest Editorial – Pulmonary Embolism: the risk of what we don’t yet know!

Guest Editorial, Volume 22, Issue 2, Pages 57 – 108 (2023)

Pulmonary embolism (PE) is a common and potentially life-threatening condition encountered routinely in acute care. The diagnosis and management of PE has been the topic of National Institute of Health Care Excellence and European Cardiology Society guidelines.

Guest Editorial – Pulmonary Embolism: the risk of what we don’t yet know! Read More

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