Emergency Care

Point of View: A Holistic Four-Interface Conceptual Model for Personalizing Shock Resuscitation (2025)

Posted on by

Type of publication:

Journal article

Author(s):

Rola, Philippe; Kattan, Eduardo; Siuba, Matthew T; Haycock, Korbin; Crager, Sara; Spiegel, Rory; Hockstein, Max; Bhardwaj, Vimal; *Miller, Ashley; Kenny, Jon-Emile; Ospina-Tascon, Gustavo A; Hernandez, Glenn.

Citation:

Journal of Personalized Medicine. 15(5), 2025 May 20.

Abstract:

The resuscitation of a patient in shock is a highly complex endeavor that should go beyond normalizing mean arterial pressure and protocolized fluid loading. We propose a holistic, four-interface conceptual model of shock that we believe can benefit both clinicians at the bedside and researchers. The four circulatory interfaces whose uncoupling results in shock are as follows: the left ventricle to arterial, the arterial to capillary, the capillary to venular, and finally the right ventricle to pulmonary artery. We review the pathophysiology and clinical consequences behind the uncoupling of these interfaces, as well as how to assess them, and propose a strategy for approaching a patient in shock. Bedside assessment of shock may include these critical interfaces in order to avoid hemodynamic incoherence and to focus on microcirculatory restoration rather than simply mean arterial pressure. The purpose of this model is to serve as a mental model for learners as well as a framework for further resuscitation research that incorporates these concepts.

DOI: 10.3390/jpm15050207

Link to full-text [open access - no password required]

Improving CareFlow documentation in PRH Emergency Department (2025)

Posted on by

Type of publication:

Service improvement case study

Author(s):

*Luke Moss

Citation:

SaTH Improvement Hub, January 2025

Abstract:

To increase the number of ED Cas-cards that have allergy status recorded to 100% and to increase the number of Careflow allergy alerts by 100% by 23/11/24.

Link to PDF poster

Pulmonary Embolism Presenting As Shoulder and Back Pain: A Case Report (2024)

Posted on by

Type of publication:
Journal article

Author(s):
*Nwaneri, Chukwuemeka; *Race, Rebecca; *Oladele, Romoluwa; *Kumaran, Subramanian.

Citation:
Cureus. 16(7):e64016, 2024 Jul.

Abstract:
Pulmonary embolism (PE) is a common but life-threatening condition, and diagnosis can be challenging. Diagnosis is even more difficult in those patients with atypical presentations such as the absence of pleuritic chest pain, dyspnoea, tachycardia, or symptoms of deep vein thrombosis. We have delineated shoulder and back pain as an atypical sign of PE. However, the significant amount of misdiagnosis highlights the importance of other rare symptoms of this potentially fatal disease. Therefore, eliciting these rare presenting symptoms can significantly reduce morbidity and mortality. Here, we report the case of a patient who, 13 days after a laparoscopic Nissen fundoplication, presented to the emergency department (ED) with left shoulder and left-sided pleuritic back pain. She was managed in the resuscitation area in the ED and was subsequently diagnosed with a left-sided PE. Her care was taken over by the medical team, and she continued her recovery in the acute medical unit.

Link to full-text [no password required]

Altmetrics:

A QIP on the completion of the AMHT Form in the Emergency Department in SaTH (2024)

Posted on by

Type of publication:
Service improvement case study

Author(s):
*Kallum Claire

Citation:
SaTH Improvement Hub, April 2024

Abstract:
I aim to improve completion of the adult mental health triage form in SaTH ED by 20% by 31/05/2023 through the use of a poster, which will highlight the necessity of completion as well as serving as a reminder for staff to complete paperwork in the correct manner.

Link to full-text

Improvement to assessment and provision of analgesia for patients with suspected Neck of Femur Fracture in ED (2023)

Posted on by

Type of publication:
Service improvement case study

Author(s):
*Oleg Lujanschi

Citation:
SaTH Improvement Hub, November 2023

Abstract:
To improve the assessment and provision of analgesia (where required) for patients presenting in ED with a suspected Neck of Femur Fracture to ensure all patients meet the national standard by 15 December 2023. Additionally, the aim is to improve the percentage of patients who receive an x-ray when presenting to ED with a suspected Neck of Femur Fracture in line with the national standard of 90 minutes by 15 December 2023.

Link to PDF poster