Background: Emergency departments (EDs) are becoming one of the most overcrowded departments globally. This study aims to investigate the frequency and causes of unscheduled patient return to the ED in King Fahad Specialist Hospital in Dammam (KFSH-D) within 72 hours of discharge.Method: This study is a cross-sectional retrospective study done between February and May, of 2023 at KFSH-D, Saudi Arabia. A total of 295 patients were included. Patients were selected using a simple random sampling technique. Medical record numbers (MRNs) of patients with unscheduled return visits within 72 hours were gathered from the hospital’s electronic medical record-integrated database (Medica Cloudcare) which were then entered into a random number generator; 295 MRNs were selected and included in the study. This study includes male and female patients older than 16 years who returned to the ED within 72 hours. Results: Results showed cancer as the most common comorbidity resulting in revisits within 72... Continue Reading

Background: Emergency Departments (ED) are becoming one of the most overcrowded departments globally. This study aims to investigate the frequency and causes of unscheduled patient return to the ED in King Fahad Specialist Hospital in Dammam (KFSH-D) within 72 hours of discharge. Method: This study is a cross-sectional retrospective study done between February and May, of 2023 at KFSH-D, Saudi Arabia. A total of 295 patients where included. Patients were selected using a simple random sampling technique. Medical record numbers (MRNs) of patients with unscheduled return visits within 72 hours were gathered from the hospital's electronic medical record-integrated database (Medica Cloudcare) which were then entered on a random number generator. 295 MRNs were selected and included in the study. This study includes male and female patients older than 16 years who returned to the ED within 72 hours. Results: Results showed cancer as the most common comorbidity resulting in revisits... Continue Reading

Objective: This study aimed to examine the characteristics and outcomes of adult traumatic cardiac arrest (TCA) patients treated at King Abdulaziz Medical City in Riyadh, Saudi Arabia, a center notably impacted by traumatic injuries. Methods: This was a retrospective cohort chart review study designed to analyze the characteristics and outcomes of adult traumatic cardiac arrest in a level 1 trauma center, including all patients aged above 14 years, who were involved in in-hospital traumatic cardiac arrest between 2017 and 2023. Results: A total of 92 patients were included in the study, with a majority being males (96.7%). The average age was 30.74 years, with 58.2% under 30 years. Further, 52.2% of the patients were Saudi nationals. And 82.4% of patients had a Glasgow Coma Scale (GCS) score of 3 upon arrival. In 81.5% of cases, the initial rhythm observed was pulseless electrical activity (PEA). Returning of spontaneous circulation was noted... Continue Reading

Background: Acute appendicitis is a common surgical emergency, with diagnostic challenges that can lead to unnecessary surgeries. This study aims to compare the diagnostic accuracy of the Appendicitis Inflammatory Response (AIR) score and the Alvarado score in a clinical setting, examining the influence of demographic variables on their performance. Methods: A retrospective analysis was conducted on 166 patients at National Guard Health Affairs Hospital, Saudi Arabia, from May 2016 to April 2022. Patients were categorized into two groups: 83 with appendicitis and 83 with acute abdominal symptoms but without appendicitis. We evaluated the diagnostic accuracy of the AIR and Alvarado scores through risk probability of developing appendicitis, sensitivity, and specificity. We also examined the effects of age and gender on the scores' accuracy. Results: The AIR score demonstrated higher overall sensitivity (95.7%) and specificity (90.5%) than the Alvarado score, which showed a sensitivity of 87.3% and a specificity of 52.4%.... Continue Reading

Pediatric gastroenteritis, characterized by acute diarrheal illness, poses a significant global health challenge due to its potential to cause severe dehydration and electrolyte imbalance, especially in children under five years old. Effective management of dehydration is crucial, yet there is ongoing debate regarding the comparative effectiveness of oral rehydration therapy (ORT) versus intravenous (IV) therapy. This systematic review aimed to critically analyze and compare the effectiveness, safety, and clinical outcomes of ORT and IV therapy in the management of pediatric gastroenteritis. A comprehensive literature search was conducted across PubMed, Cochrane, ResearchGate, Cureus, and ScienceDirect databases, covering the period from the year 2004 to 2024. Studies were selected based on predefined inclusion and exclusion criteria. From an initial pool of 1,287 studies, 25 met the inclusion criteria and were included in this systematic review. The findings suggested that ORT was highly effective in managing mild to moderate dehydration in pediatric gastroenteritis,... Continue Reading

Background: Risk communication during public health emergencies is a demanding and dynamic public policy process. In this paper, we provide an overview of risk communication during public health emergencies by discussing the theoretical foundations of risk perception. While communication is a complex art and a science that helps to facilitate daily life, it may also be misused, leading to a multitude of problems. Communication is essential in situations that involve threats to public health and safety. Methodology: An extensive literature review was performed, and various databases, including PubMed, Scopus, and Google Scholar, were consulted to identify relevant peer-reviewed articles. A two-stage analysis of the collected literature was then conducted: In the first stage, a comprehensive examination was carried out to identify and categorize the factors affecting risk communication, such as media effectiveness, public trust, and governmental policies. The second stage focused specifically on Saudi Arabia as a case study to... Continue Reading

Freestanding Emergency Departments (FSEDs) have become increasingly important in healthcare, especially in rural and hospital-consolidated areas. This review evaluates their impact on emergency care, focusing on patient satisfaction, the work environment for healthcare professionals, and their potential to reduce overcrowding in hospital-based emergency departments (H-EDs). It acknowledges the challenges in these areas, particularly in ensuring standardized, high-quality care. The review advocates for state-level legislation to establish uniform standards for FSEDs, incorporating criteria from the American College of Emergency Physicians (ACEP). It also addresses the need for FSEDs in underserved areas, noting their current tendency to be located in more affluent regions. Additionally, the review highlights the necessity for increased price transparency to differentiate FSEDs from other acute care options and to avoid contributing to higher healthcare costs. By addressing these issues and implementing recommended changes, FSEDs can enhance healthcare access while maintaining quality and efficiency in emergency care delivery. Continue Reading

Musculoskeletal pain (MSP) is highly prevalent and impacts productivity, leading to significant economic and social burdens. Combining non-steroidal anti-inflammatory drugs (NSAIDs) with Vitamin B supplements has shown promising results in reducing MSP more effectively than NSAIDs alone. This meta-analysis aimed to assess the efficacy and safety of NSAIDs with Vitamin B, paving the way for future studies on the potential of Vitamin B as an add-on therapy for various MSP conditions. The relevant records up to June 2024 were retrieved from PubMed, Scopus, Web of Science, and the Cochrane Library. Two independent reviewers extracted data from eligible studies, including baseline data and information about the safety and efficacy of mixture regimens compared to using NSAIDs alone. Around 2,326 records were collected from four databases, excluding 189 duplicates. After screening titles and abstracts, 15 records were assessed for eligibility, resulting in eight included articles. Of these, six provided sufficient data for... Continue Reading

Pediatric sepsis remains a significant cause of morbidity and mortality, necessitating efficient screening tools for early detection. This study addressed the evolving landscape of pediatric sepsis screening strategies, emphasizing the importance of nuanced approaches and technological advancements. With a focus on sensitivity, specificity, and positive predictive value, this study explored the performance of diverse screening tools and their impact on timely interventions. A systematic review was conducted using PubMed, Embase, and Cochrane Library, following defined inclusion criteria. Studies involving pediatric populations, sepsis screening, and reporting performance metrics were included. A two-step screening process, quality assessment, and data extraction were undertaken. The synthesis adopted a narrative approach, considering the anticipated heterogeneity in study designs, populations, and screening tools. Diverse screening tools exhibited variable outcomes. The current study findings underscored the complexity of balancing sensitivity and specificity, which is crucial for avoiding false positives and ensuring timely interventions. This study contributed to... Continue Reading

Background: Morel-Lavallee lesions (MLLs), also known as degloving injuries, are uncommon traumatic soft tissue injuries resulting from the separation of the superficial fascia from the deep fascia, typically due to high-energy trauma or shear forces. This separation leads to fluid accumulation and disruption of skin vascularity, placing the overlying skin at risk for necrosis and infection. MLLs can mimic other soft tissue injuries, such as hematomas, and are often associated with delayed diagnosis and treatment. Case Presentation: A 46-year-old man presented with left thigh swelling persisting for three weeks following a motorcycle crash. Initial imaging with X-rays revealed no fractures, and point-of-care ultrasound identified a large encapsulated fluid collection consistent with MLL. Subsequent computed tomography angiography ruled out vascular injury and confirmed a subcutaneous fluid collection measuring 10.6 cm × 32.0 cm. Conservative management, including compression bandaging and prophylactic antibiotics, was initially recommended; however, after surgical review, ultrasound-guided drainage was... Continue Reading

Background: Jellyfish stings, though often perceived as benign encounters of the sea, can precipitate severe complications, particularly in the pediatric population engaging in aquatic activities. While these injuries are rare in Saudi Arabia, they can still present as a distressing condition and warrant preparedness. Case presentation: This case report presents a rare occurrence of cellulitis induced by a jellyfish sting in a 3-year-old boy from Jazan, Saudi Arabia. Following the initial sting, the patient exhibited distressing symptoms, including intense pain, erythema, and pronounced swelling in his left leg. Despite initial medical intervention, his condition worsened, necessitating hospitalization and a comprehensive treatment regimen involving antipyretic, corticosteroid, and antibiotic therapies. Conclusion: This case report underscores the imperative of timely and efficacious management of jellyfish sting injuries, particularly in regions where such incidents are infrequent. It also advocates for heightened awareness among healthcare practitioners regarding potential complications and the formulation of standardized protocols... Continue Reading

Background: Methemoglobinemia is a condition in which the iron in hemoglobin is oxidized from the ferrous to ferric state, resulting in oxygen desaturation and cyanosis. It can be congenital or acquired, with acquired causes including the ingestion of certain medications or chemical products or infections such as sepsis or gastroenteritis. Case Presentation: Herein, we report the case of a young infant who presented with diarrhea and cyanosis and was found to have significant methemoglobinemia which most likely was secondary to severe diarrhea. It was managed successfully with methylene blue, he was diagnosed later as case of food protein-induced enterocolitis syndrome.Conclusion: Clinicians should consider profound diarrhea as a potential cause of methemoglobinemia to enhance early intervention. Continue Reading

Background: The COVID-19 pandemic has significantly impacted education, necessitating a massive shift towards digital learning. As a result, healthcare, medical and nursing education have had to swiftly transfer and adapt to online (OL) instruction despite the substantial challenges this has presented, given that healthcare education involves crucial hands-on skills, laboratory practice and clinical experience. Previous research investigated healthcare students’ experiences with online learning for various healthcare professions during the COVID-19 pandemic; however, scarce evidence was found for the population of paramedic students. Therefore, this study aimed to explore the paramedic students’ experiences with online learning during COVID-19, particularly by examining their facilitators and barriers to this new learning modality.  Objectives: This study has two intended outcomes. First, instructors and stakeholders will gain increased insights regarding students’ OL experiences and identify the facilitators and barriers to their learning to initiate additional improvements. As a result, the instructional methods, learner competency and... Continue Reading

Background: Acute disseminated encephalomyelitis (ADEM) is a rare immune-mediated condition affecting the central nervous system, characterized by acute encephalopathy and multifocal neurological deficits. This disorder predominantly impacts children but here, we document a rare adult case, emphasizing the necessity for considering organic causes in psychiatric symptomatology. Methods: A detailed review of literature was conducted through PubMed focusing on the atypical presentations of ADEM and the incidence of organic diseases manifesting psychiatric complaints. This approach informed our diagnostic strategy and management of an unusual adult case of ADEM, underscoring the importance of maintaining a wide differential diagnosis in emergency medicine. Case Description: A 22-year-old female presented with generalized weakness, confusion, apathy, and reduced appetite, following an upper respiratory tract infection and a distressing dental visit. Her neurological examination revealed dysarthria, dysmetria, and ataxia, with a significant reduction in motor strength and generalized hyperreflexia. Laboratory tests were largely unremarkable except for elevated ESR and CRP. MRI findings were... Continue Reading