Background: Lead toxicity in adults is rare and often presents with vague symptoms leading to diagnostic uncertainty. Occupational exposure can guide the clinician toward the correct diagnosis, but when no exposure is identified, there may be a delay in identifying the condition. Case Presentation: We present a case of lead poisoning in a patient using Ayurvedic medicines. Ayurvedic medicine is a formal traditional medical system in India and South Asia with traditions dating back over 3,000 years. Ayurvedic medications, a component of Ayurvedic practice, are considered natural but can contain heavy metals such as lead, mercury, and arsenic. Conclusion: Ayurvedic medications are an infrequent cause of lead poisoning, but this may increase as nontraditional, and natural medicines become more popular. Clinicians should consider the possibility of lead poisoning in patients who have used Ayurvedic medications and present with nonspecific symptoms. Continue Reading

Background: Effective communication between healthcare practitioners and patients in the emergency department (ED) is crucial for patient satisfaction and quality of care. This study explored patients' perspectives on communication with nurses and physicians in the ED. Methods: A cross-sectional study was conducted using a sample of 159 patients to assess the type of information relayed by nurses and doctors. The interview data were analyzed to examine nursing staff communication, physician communication, and communication difficulties. Results: Nurses were found to be less likely to inform patients about their results or disposition. While 81.2% of physicians introduced themselves to patients, only 51.6% stated their status level. Approximately 68.6% of subjects were offered analgesia or treatment, and 60% reported no communication difficulties with medical staff. Empathy was demonstrated by 54.2% of healthcare practitioners, and nearly 80% of patient encounters were conducted in understandable language. Conclusion: The study highlights the importance of effective communication... Continue Reading

Background: Focused assessment with sonography for trauma (FAST) has a role in the rapid screening of hemodynamically unstable patients to decide on management, however, its role in hemodynamically stable patients remains equivocal. Objectives: This study aimed to determine the sensitivity and specificity rate of FAST for intra-abdominal injury (IAI) in hemodynamically stable blunt abdominal trauma patients. Secondary outcomes like Glasgow coma score, length of hospital stays (LOS), head injury, and mortality were also examined for their association with FAST scan results. Settings and Design: A retrospective cross-sectional study was conducted in level-one trauma center in Bahrain. Methods: This study was conducted from January 2019 to October 2020. A total of 191 trauma codes were activated during this period, however, only 112 patients were included based on the inclusion criteria. Results: FAST scan in hemodynamically stable patients was found to have a higher specificity (96.7%) than sensitivity (30%) in this study.... Continue Reading

Background: Machine learning in the healthcare sector represents a group of technologies in all aspects of medicine, and it appears promising, especially in emergency medicine. Hence, this study aims to utilize emergency department (ED) records to train machine learning algorithms and assess medical performance and outcomes. Methods: This is a retrospective observational cohort study utilizing emergency patient records acquired from the Emergency Department of King Faisal Specialist Hospital & Research Centre in Riyadh City. Also, different machine learning models were evaluated, including regression, instance-based, regularization, tree-based, Bayesian, dimensionality reduction, and ensemble algorithms. Results: A total of 149,513 emergency patient records were acquired. Due to many outliers and mislabeled data, clinical knowledge and a confident learning algorithm were used to preprocess the dataset. This resulted in only 84,970 patient records being kept. We observed that ensemble algorithms outperformed the others in all evaluation metrics, achieving an F-1 score and quadratic weighted... Continue Reading

Background: Cardiopulmonary resuscitation (CPR) is a lifesaving procedure performed by qualified rescuers. The quality of CPR depends on effective chest compression (CC) characteristics: rate, depth, hand position, and chest recoil. Besides CC, previous research has proven that physical activity level (PAL) varies among rescuers and affects CPR quality. This study aims to assess the association between PAL and the quality of continuous chest compressions-cardiopulmonary resuscitation (CCC-CPR) for 5 minutes by qualified rescuers at the National Guard Hospital in Jeddah (NGHA-J). Methods: This is a cross-sectional study. The global physical activity questionnaire was used to measure the participants' PALs, and the SimMan 3G mannequin was used to measure the four CC characteristics. The recommended sample size is 45 of the rescuers at NGHA-J. Results: A total of 45 members were involved in the study, and most participants were 27 (60%) males. Most participants are classified as having high PAL 21(46.67%). The... Continue Reading

Background: Emergency medical services personnel are not aware of the significance and the prevalence of post-traumatic stress disorder (PTSD) among them and its effect on their mental well-being and the quality of patient care. Objective: The current study aimed to assess the prevalence of PTSD and its associated factors among emergency medical services personnel in Riyadh, Saudi Arabia. Methods: A descriptive cross-sectional study was conducted including all accessible emergency medical services personnel working at five hospitals in Riyadh during the period from November to December 2022. Data were collected using the three-phase method including identification of eligible care providers, approaching using an interview-based questionnaire, and recruitment of the questionnaires that were administered to all pre-hospital care providers. Results: A total of 138 emergency personnel were included. A total of 74 (53.6%) were emergency specialists, 12 (8.7%) were emergency technicians, 39 (28.3%) were interns or physicians, and 13 (9.4%) were nurses... Continue Reading

Background: The COVID-19 pandemic affected many aspects of medical education that were based on the traditional classroom experience. To maintain postgraduate education during the lockdown, many of these activities continued via virtual methods. We aim to assess residents' perceptions of online medical education. Methods: This is a cross-sectional study targeting emergency medicine residents in the western region of Saudi Arabia. An electronic self-administered validated survey was used to assess the residents' experiences and perceptions of online medical education. Results: A total of 125 participants were surveyed (52% response rate). There was a significant increase in hours spent in online education after COVID-19 according to Wilcoxon signed rank test (p < 0.001). On a Likert scale, most residents agreed that they found online medical education enjoyable and easy to engage with. However, most did not find it as interactive as the traditional teaching methods. The most enjoyed aspects were the ability... Continue Reading

Background: Noise pollution is a serious issue that faces healthcare centers. It is associated with detrimental effects on both the patient's and the healthcare provider's mental and physical well-being. It could also negatively impact the physician's decision-making. Aim: There are no similar studies conducted in the past 5 years in Saudi Arabia. This is the first study to measure noise levels and deem them pollutants in an emergency care center in Saudi Arabia. Method: This cross-sectional study was conducted in the emergency department (ED) of a tertiary care hospital to assess the level of noise pollution. Noise levels were evaluated in the ED by using a calibrated decibel meter device in three selected units including resuscitation, acute care, and pediatrics unit. Noise levels were only measured during weekdays. In each unit, readings were obtained over 24 hours. Results: Over 24 hours, measurements of all assessed units showed that noise levels... Continue Reading

Background: Portable radiography machines are excellent diagnostic tools, but prolonged exposure to X-rays can damage tissue. The most severe concerns include increased cancer risk, cataract development, and fetal harm in pregnant workers. This study investigates whether healthcare personnel in the emergency department (ED) are exposed to X-ray ionizing radiation in excess of the National council on radiation protection and measurements limit. Methods: A 5-month prospective cohort study was conducted. The sample population included healthcare professionals in the ED at King Abdulaziz Medical City, Saudi Arabia. All physicians and nurses were requested to wear thermoluminescent dosimeter (TLD) monitors while working in the ED. TLD monitors worn by consultants, residents, and nurses were assessed at the end of the study. Results: Sixty-one participants met the inclusion criteria, and two TLDs served as controls to quantify natural background radiation levels. One of the 61 participants measured 0.1 mSv, and the rest measured lower,... Continue Reading