ABSTRACT
Com as universidades fechadas e a implementação do Ensino Remoto Emergencial, as atividades curriculares ocorreram através de plataformas digitais. O objetivo do presente trabalho foi avaliar a percepção de aprendizagem on-line na disciplina de Biomateriais da Faculdade de Odontologia da Universidade Federal Fluminense no período da pandemia. O questionário COLLES (Constructivist OnLine Learning Environment Survey) foi enviado individualmente por e-mail aos cinquenta alunos, apresentando 24 declarações divididas em seis quesitos: relevância, reflexão crítica, interatividade, apoio dos tutores, apoio entre os colegas e compreensão; e para cada declaração cinco opções de resposta: quase sempre, frequentemente, algumas vezes, raramente e quase nunca. Quarenta e um alunos responderam. A soma das médias obtidas em quase sempre e frequentemente foi de 87,2% para relevância, 70% para reflexão crítica, 33,9% para interatividade, 47,6% para apoio dos tutores, 44,2% para apoio dos colegas e 89,5% para compreensão. Concluiu-se que a relevância, a reflexão crítica e a compreensão apresentaram melhores resultados, enquanto a interatividade, o apoio entre os colegas e o apoio dos tutores demonstraram necessidade de aprimoramento. E apesar das limitações do ERE, a avaliação positiva dos alunos evidenciou esta modalidade de educação on-line como uma solução plausível.
With universities closed and the implementation of Emergency Remote Teaching, curricular activities took place through digital platforms. The objective of this study was to assess the perception of online learning in the Biomaterials course at the Dental School of the Federal Fluminense University during the pandemic. The COLLES questionnaire (Constructivist OnLine Learning Environment Survey) was individually sent via email to fifty students, presenting 24 statements divided into six aspects: relevance, critical reflection, interactivity, tutor support, peer support, and comprehension. For each statement, there were five response options: almost always, often, sometimes, rarely, and almost never. Forty-one students responded. The sum of the averages obtained for almost always and often was 87.2% for relevance, 70% for critical reflection, 33.9% for interactivity, 47.6% for tutor support, 44.2% for peer support, and 89.5% for comprehension. It was concluded that relevance, critical reflection, and comprehension showed better results, while interactivity, peer support, and tutor support demonstrated a need for improvement. Despite the limitations of Emergency Remote Teaching, the positive evaluation from the students highlighted this mode of online education as a plausible solution.
Subject(s)
Humans , Male , Female , Perception , Biocompatible Materials , Education, Distance , Education, Dental , Learning , Surveys and QuestionnairesABSTRACT
ABSTRACT Objective: To identify and characterize the population of Pediatric patients referred to our hyperbaric oxygen therapy center. Methods: Retrospective and observational study, including pediatric patients treated with hyperbaric oxygen therapy, from 2006 to 2021, at the hyperbaric medicine reference center in the north of Portugal. Variables of interest were extracted from electronic medical records. Results: Our study included 134 patients. The most frequent reasons for referral were carbon monoxide poisoning (n=59) and sudden sensorineural hearing loss (n=41). In 75 cases (56%), treatment was initiated in an urgent context. Symptom presentation at Emergency Department varied among patients, the most frequent being headache and nausea/vomiting. Concerning carbon monoxide poisoning, the most common sources were water heater, fireplace/brazier, and boiler. Regarding adverse effects, it was identified one case of intoxication by oxygen and four cases of middle ear barotrauma. Conclusions: The most frequent cause for referral was carbon monoxide poisoning. All patients evolved favorably, with few side effects being reported, emphasizing the safety of this therapy. While most pediatricians may not be aware of the potential benefits arising with hyperbaric oxygen therapy, it is of upmost importance to promote them, so that this technique is increasingly implemented.
RESUMO Objetivo: Identificar e caracterizar a população de casos pediátricos encaminhados para o nosso centro de oxigenoterapia hiperbárica. Métodos: Estudo retrospetivo e observacional, que incluiu doentes pediátricos tratados com oxigenoterapia hiperbárica, de 2006 a 2021, no centro de referência de medicina hiperbárica do norte de Portugal. As variáveis de interesse foram extraídas dos processos clínicos eletrônicos. Resultados: O nosso estudo incluiu 134 casos. Os motivos de encaminhamento mais frequentes foram intoxicação por monóxido de carbono (n=59) e surdez súbita neurossensorial (n=41). Em 75 casos (56%) o tratamento foi iniciado em contexto de urgência. Os sintomas de apresentação à admissão variaram entre os diferentes casos, sendo os mais frequentes cefaleias e náuseas/vômitos. No que diz respeito à intoxicação por monóxido de carbono, as fontes mais comuns foram o aquecedor, lareira/braseiro e caldeira. Com relação aos efeitos adversos, foram identificados um caso de intoxicação por oxigênio e quatro casos de barotrauma do ouvido médio. Conclusões: A causa mais frequente de encaminhamento foi a intoxicação por monóxido de carbono. Todos os pacientes evoluíram favoravelmente e foram registrados poucos efeitos adversos, o que enfatiza a segurança desta terapia. Uma vez que a maioria dos pediatras pode não estar informada sobre os potenciais benefícios da oxigenoterapia hiperbárica, é de extrema importância promovê-los para que esta técnica seja cada vez mais implementada.
ABSTRACT
Resumo Objetivo Determinar o grau de concordância, sensibilidade e especificidade da prioridade de atendimento determinada por enfermeiros interavaliadores, a partir do uso do protocolo de acolhimento e classificação de risco em obstetrícia, em unidade de pronto atendimento obstétrico. Métodos Estudo transversal, com abordagem metodológica, realizado em uma maternidade-escola de Belo Horizonte-MG-Brasil, no período de setembro a novembro de 2020. Realizado em duas etapas: 1) Documental com avaliação dos registros de enfermeiros classificadores nos prontuários de gestantes, parturientes ou puérperas; 2) Entrevista com enfermeiros treinados e não treinados na classificação de risco. Realizou-se análise de sensibilidade, especificidade e empregou-se o coeficiente Kappa (k) para avaliar a concordância. Resultados Evidenciou-se que o grau de concordância Interavaliadores (enfermeiros treinados e não treinados) foi considerado moderado a forte (k= 0,47 e 0,77). Verificou-se tendência na subestimação das prioridades vermelha (sensibilidade de 85%; especificidade de 99%) e amarela (sensibilidade de 54%; especificidade de 85%), bem como superestimação na prioridade verde (sensibilidade de 62%; especificidade de 84%) e azul (sensibilidade de 89%, especificidade de 98%), porém sem diferenças significativas. Apesar da concordância e especificidade satisfatória, a sensibilidade foi baixa, devido aos índices de subestimação e superestimação na classificação de risco. Conclusão O protocolo é confiável para determinação da prioridade de atendimento em obstetrícia, porém houve baixa sensibilidade, diante de sua aplicação na determinação da prioridade de atendimento por enfermeiros treinados e não treinados.
Resumen Objetivo Determinar el nivel de concordancia, sensibilidad y especificidad de la prioridad de asistencia determinada por enfermeros interevaluadores, a partir del uso del protocolo de acogida y clasificación del riesgo en obstetricia, en una unidad de servicios de emergencias obstétricas. Métodos Estudio transversal con enfoque metodológico, realizado en una maternidad escuela de Belo Horizonte, Minas Gerais, Brasil, de septiembre a noviembre de 2020. Fue realizado en dos etapas: 1) documental con análisis de los registros de enfermeros clasificadores en las historias clínicas de mujeres embarazadas, parturientas o puérperas; 2) entrevista con enfermeros capacitados y no capacitados en clasificación del riesgo. Se realizó análisis de sensibilidad, especificidad y se empleó el coeficiente Kappa (k) para evaluar la concordancia. Resultados Se observó que el nivel de concordancia entre evaluadores (enfermeros capacitados y no capacitados) fue considerado de moderado a fuerte (k= 0,47 e 0,77). Se verificó una tendencia de subestimación de la prioridad roja (sensibilidad de 85 %; especificidad de 99 %) y amarilla (sensibilidad de 54 %; especificidad de 85 %), así como una sobrestimación de la prioridad verde (sensibilidad de 62 %; especificidad de 84 %) y azul (sensibilidad de 89 %, especificidad de 98 %), pero sin diferencias significativas. A pesar de que la concordancia y la especificidad fueron satisfactorias, la sensibilidad fue baja, debido a los índices de subestimación y sobrestimación en la clasificación del riesgo. Conclusión El protocolo es confiable para determinar la prioridad de asistencia en obstetricia, pero se observó baja sensibilidad al ser aplicado por enfermeros capacitados y no capacitados para determinar la prioridad de asistencia.
Abstract Objective To determine the degree of agreement, sensitivity and specificity of the priority of care determined by inter-rater nurses, based on the use of the protocol for care and risk classification in obstetrics, in an obstetric emergency unit. Method Cross-sectional study with a methodological approach, carried out in a maternity school in Belo Horizonte-MG-Brazil, from September to November 2020. It was carried out in two stages: 1) Documental with an evaluation of the records of nurse classifiers in the medical records of pregnant women, parturients or puerperal women; 2) Interviews with trained and not trained nurses in risk classification. Sensitivity and specificity were analyzed and the Kappa coefficient (k) was used to assess agreement. Results The degree of inter-rater agreement (trained and not trained nurses) was found to be moderate to strong (k= 0.47 and 0.77). There was a tendency to underestimate the red (sensitivity of 85%; specificity of 99%) and yellow priorities (sensitivity of 54%; specificity of 85%), as well as overestimate the green (sensitivity of 62%; specificity of 84%) and blue priorities (sensitivity of 89%, specificity of 98%), although there were no significant differences. Despite satisfactory agreement and specificity, sensitivity was low, due to the rates of underestimation and overestimation in risk classification. Conclusion The protocol is reliable for determining priority of care in obstetrics, but its sensitivity was low when applied to determining priority of care by trained and not trained nurses.
ABSTRACT
A presente análise documental tem como objetivo debater as orientações publicadas on-line em sites oficiais para guiar as respostas das Redes de Atenção Psicossocial (Raps) do Sistema Único de Saúde (SUS) do Brasil diante da emergência de Saúde Pública causada pela Covid-19. Baseia-se na análise de materiais publicados on-line entre 6/2/20 e 31/8/21 nos níveis federal e estadual e em todas as capitais do país. Combina essa análise documental com orientações e publicações de entidades internacionais a fim de refletir sobre os desafios, acertos, erros e omissões das orientações dadas para as Raps no país durante o início do período pandêmico. Conclui que as orientações, apesar de existentes formalmente, foram pouco articuladas e integradas dentro das próprias redes, com outros setores e com desafios preexistentes, conforme preconizado pela comunidade internacional.(AU)
This article discusses guidance published on official websites regarding the response of the Brazilian National Health System (SUS) psychosocial care networks (RAPS) to the public health emergency caused by Covid-19. The discussion draws on the analysis of online materials published between 06/02/20 and 31/08/21 at state and federal level across all the country's state capitals. We compare the results of the document analysis with guidance published by international organizations to reflect on the challenges, successes, mistakes and omissions in the guidance given to the RAPS at the beginning of the pandemic. It is concluded that, despite being formal, the guidance was poorly coordinated and integrated into the networks and with other sectors and pre-existing challenges, as recommended by the international community.(AU)
El presente análisis documental tiene el objetivo de debatir las orientaciones publicadas online en páginas web oficiales para guiar las respuestas de las Redes de Atención Psicosociales (RAPS) del Sistema Brasileño de Salud (SUS) ante la emergencia de salud pública causada por la Covid-19. Se basa en el análisis de materiales publicados online entre el 06/02/20 y el 31/08/21 en las esferas de la federación y de los estados en todas las capitales del país. Combina este análisis documental con orientaciones y publicaciones de entidades internacionales para reflexionar sobre los desafíos, aciertos, errores y omisiones de las orientaciones dadas para las RAPS en el país durante el inicio del período pandémico. Concluye que las orientaciones, a pesar de existentes formalmente, fueron poco articuladas e integradas dentro de las propias redes con otros sectores y con desafíos preexistentes, conforme lo determina la comunidad internacional.(AU)
ABSTRACT
Introducción: La satisfacción del paciente con el cuidado de enfermería es un predictor importante para evaluar la calidad de la atención hospitalaria. Sin embargo, en Perú, la satisfacción y la experiencia del paciente sobre el cuidado de enfermería en el servicio de Emergencias sigue siendo desconocida. Objetivo: Analizar la experiencia y la satisfacción con los cuidados de enfermería percibidas por pacientes hospitalizados en el servicio de emergencia en un hospital de nivel III de Perú. Metodología: Se aplicó el Cuestionario de Calidad del Cuidado de Enfermería que se clasifica en dos dimensiones: experiencia y satisfacción. Las variables independientes fueron factores sociodemográficos y clínicos. Se utilizó la prueba de Chi-cuadrado y la regresión de Poisson para calcular la razón de prevalencia (RP) con un p-valor menor a 0.05. Resultados: De 130 pacientes relevados, el 52,08 % percibió una mala experiencia y el 54,62 % estuvo insatisfecho con los cuidados de enfermería. La edad se asoció con las dimensiones experiencia (RPa: 1.01) y la satisfacción de cuidados de enfermería (RPa: 1.02). Además, el nivel socioeconómico medio-alto (RPa: 0.52) y los días de estancia hospitalaria (RPa: 0.65) se asociaron a una mala satisfacción. Conclusiones: Más de la mitad de los pacientes manifestaron una mala experiencia e insatisfacción con los cuidados recibidos. Esto implica la necesidad de tomar en cuenta las necesidades del paciente hospitalizado en emergencias y gestionar recursos humanos y materiales.
Introdução: A satisfação do paciente com o cuidado de enfermagem é um importante preditor para avaliar a qualidade do atendimento hospitalar. No entanto, no Peru, a satisfação e a experiência do paciente com o cuidado de enfermagem no serviço de emergência ainda são desconhecidas. Objetivo: Analisar a experiência e a satisfação com os cuidados de enfermagem percebida por pacientes internados no serviço de emergência em um hospital de nível III no Peru. Metodologia: Foi aplicado o Questionário de Qualidade do Cuidado de Enfermagem, classificado em duas dimensões: experiência e satisfação. As variáveis independentes foram fatores sociodemográficos e clínicos. O teste do qui-quadrado e a regressão de Poisson foram usados para calcular a razão de prevalência (RP), com um valor de p inferior a 0,05. Resultados: De 130 pacientes pesquisados, 52,08% perceberam uma experiência ruim e 54,62% estavam insatisfeitos com os cuidados de enfermagem. A idade foi associada às dimensões experiência (RPa: 1,01) e satisfação com os cuidados de enfermagem (RPa: 1,02). Além disso, o nível socioeconômico médio-alto (RPa: 0,52) e os dias de internação hospitalar (RPa: 0,65) foram associados à baixa satisfação. Conclusões: Mais da metade dos pacientes manifestaram uma experiência ruim e insatisfação com os cuidados recebidos. Isso implica a necessidade de levar em conta as necessidades do paciente internado em emergências e gerenciar os recursos humanos e materiais
Introduction: Patient satisfaction with nursing care is an important predictor for assessing the quality of hospital care. However, in Peru, patient satisfaction and experience with nursing care in the emergency department remains unknown. Objective: To analyze the experience and satisfaction with nursing care perceived by patients hospitalized in the emergency department at a level III hospital in Peru. Methodology: The Newcastle Questionnaire Satisfaction with Nursing Scales was applied, which is classified into two dimensions: experience and satisfaction. The independent variables were sociodemographic and clinical factors. The Chi-square test and Poisson regression were used to calculate the prevalence ratio (PR) with a p-value of less than 0.05. Results: Of 130 patients surveyed, 52.08 % perceived a bad experience and 54.62 % were dissatisfied with nursing care. Age was associated with the dimensions experience (PRa: 1.01) and nursing care satisfaction (PRa: 1.02). In addition, medium-high socioeconomic level (PRa: 0.52) and days of hospital stay (PRa: 0.65) were associated with poor satisfaction. Conclusions: More than half of the patients reported a bad experience and dissatisfaction with the care received. This implies the necessity to take into account the needs of hospitalized patients in emergencies and to manage human and material resources
ABSTRACT
Resumen Introducción: Los trabajadores de primera respuesta a emergencias se encuentra expuestos a factores psicosociales que pueden incrementar el riesgo de estrés, debido, entre otras variables, a las condiciones propias de las funciones ejercidas lo cual puede menoscabar el estado de salud de esta población. Objetivo: Determinar los síntomas reveladores de la presencia de reacciones de estrés en personal de primera respuesta a emergencias y su asociación con la edad y la antigüedad en la institución. Método: Se realizó un estudio transversal que incluyó el personal de primera respuesta a emergencias de una institución de bomberos en Colombia, 215 participantes. Se realizó asociación entre el nivel de estrés y las variables edad y antigüedad. Resultados: Se encontró un nivel de estrés alto y muy alto del 50.3%. Los síntomas fisiológicos y de comportamiento social presentaron los niveles más altos. Los trabajadores con mayor edad presentaron mayor estrés. No se presentó asociación con la antigüedad en el cargo. Conclusión: Más de la mitad de la población tiene niveles de estrés alto y muy alto. Los trabajadores de primera respuesta a emergencias con mayor edad fueron los que presentaron niveles de riesgo más alto de estrés.
Abstract Introduction: First responders in emergencies are exposed to psychosocial factors that can increase the risk of stress, due, among other variables, to the conditions of the functions performed, which can undermine the health status of this population. Objective: Determine the symptoms that reveal the presence of stress reactions in first responders to emergencies and their association with age and seniority in the institution. Method: A cross-sectional study was carried out that included first responders to emergencies from a fire department in Colombia, 215 participants. An association was made between the level of stress and the variables age and seniority. Results: A high and very high stress level of 50.3% was found. Physiological and social behavior symptoms presented the highest levels. Older workers had greater stress. There was no association with length of service. Conclusion: More than half of the population has high and very high stress levels. The oldest emergency first responders were those with the highest risk levels of stress.
ABSTRACT
Background: Diabetes Mellitus is a chronic, progressive disease with serious complications, and its prevalence is rising, especially in India. This study evaluates the clinical characteristics, prehospital care, and proximity to healthcare facilities among patients presenting with diabetic emergencies at a tertiary care hospital. Methodology: A cross-sectional study was conducted with 70 diabetic emergency patients (hyperglycemia, hypoglycemia, and DKA). Data were collected using a semi-structured questionnaire assessing clinical characteristics, prehospital care, and health-seeking behavior. Geospatial analysis measured the distance from patients' residences to the hospital. Results: Among the 70 participants, 36 (51.4%) were over 60 years old, and 55 (78.6%) were male. The most common symptoms were polyuria (85.7%) and excessive thirst (57.1%). Hyperglycemia was diagnosed in 68 (97.1%) cases, with 46 (65.7%) showing high random blood sugar levels (>200 mg/dl). Severe symptoms led 55 (78.6%) to seek emergency care, with 17 (24.3%) requiring ambulance services. Geospatial analysis revealed that 50% of patients lived 1-50 km from the hospital. Conclusion: The study emphasizes the need for improved access to diabetes care near patients' homes to prevent emergencies, highlighting the importance of decentralizing services to improve health outcomes.
ABSTRACT
Resumo Fundamento A sobrevivência de uma vítima de parada cardiorrespiratória (PCR) extra-hospitalar tem relação com o fornecimento precoce de reanimação cardiopulmonar (RCP), sendo que a agilidade no reconhecimento desse evento por um médico regulador (MR) pode contribuir para a cadeia de reanimação. Atualmente, existe escassa literatura sobre o tema. Objetivos Analisar categorias e subcategorias de palavras/expressões utilizadas espontaneamente por leigos nos chamados por PCR e sua relação com o reconhecimento desse evento pelos MR. Métodos Estudo transversal, com análise de chamadas de socorro feitas por leigos, devido à PCR, em um serviço de atendimento móvel de urgência do Brasil. As expressões utilizadas foram classificadas em seis categorias e 31 subcategorias. A análise estatística empregou testes com modelos uni e multivariados para avaliação da força da associação das categorias e subcategorias das palavras/expressões com a presunção de PCR. O nível de significância estatística adotado foi de 5%. Resultados Foram incluídos 284 chamados no estudo e, após aplicados os critérios de exclusão, 101 foram analisados. As categorias de expressões "estado cardiovascular/perfusional" (p=0,019) e "estado geral" (p=0,011) foram identificadas como fatores de confusão no reconhecimento de uma PCR. Ainda, as subcategorias: "dificuldade respiratória" (p=0,023), "irresponsividade verbal" (p=0,034), "cor facial" (p=0,068) e "passando mal" (p=0,013) também foram identificadas como fatores de confusão. Por outro lado, as subcategorias de expressões: "ausência de respiração" (p=0,010); "posição espacial" (p=0,016); e "emergências cardiovasculares" (p=0,045) foram identificadas como fatores facilitadores para o reconhecimento de PCR. Conclusão Categorias e subcategorias de expressões empregadas pelos solicitantes durante o chamado por PCR podem influenciar no ágil reconhecimento dessa condição pelo médico regulador.
Abstract Background Survival of victims of out-of-hospital cardiopulmonary arrest (CA) is related to the time and quality of cardiopulmonary resuscitation (CPR).1 Considering that most CAs occur outside the hospital setting, it is evident that the early recognition of this condition is the cornerstone of the chain of survival. Current literature on the theme is still scarce. Objectives To analyze categories and subcategories of words and expressions spontaneously used by laypeople during emergency calls for CA and their relationship with the recognition of this event by the medical dispatcher. Methods This was a cross-sectional study, with analysis of calls made by laypeople due to suspected CA to emergency medical services in Brazil. The expressions used were classified into six categories and 31 subcategories. Univariate and multivariate models were used to assess the strength of the association of categories and subcategories of words and expressions with the presumption of CA. The level of significance was set at 5%. Results: A total of 284 calls were included, and after applying the inclusion criteria, 101 calls were analyzed. The categories "cardiovascular/perfusion status" (p=0.019) and "general status" (p=0.011) were identified as confounding factors for the recognition of CA, and the subcategories "breathing difficulty" (p=0.023), "verbal unresponsiveness" (p=0.034), "facial coloration" (p=0.068) and "feeling unwell" (p=0.013) were also considered as confounders. On the other hand, the subcategories "not breathing" (p=0.010); "spatial position" (p=0.016), and "cardiovascular emergencies" (p=0.045) were identified as facilitating factors for the recognition of CA. Conclusion Categories and subcategories of expressions used by emergency callers for CA can influence the timely recognition of this condition by the medical dispatcher.
ABSTRACT
Objective.To determine the influence of patient sorting done by nurses in primary care emergency services on care priorities and discharge referrals, both in general and in relation to the reasons for consultation. Methods. Descriptiveretrospective study. Variables were compared before and after the involvement of nurses in sorting patients in the primary care emergency services of the Granada Health District (Andalusia, Spain). 41,295 records were analyzed, 18,663 before and 22,632 two years after the inclusion of nurses. The reasons for consultation, priority levels, and types of discharge referral during the two study moments were compared. Results. Regarding the reasons for consultation, it was observed that the percentages of malaise (p<0.001) and diseases of the genitourinary system (p<0.001) increased, while fever (p<0.001), among others, decreased. In the two-year measurement period after sorting done by nurses was implemented, type IV priorities increased in percentage (p<0.001) and type V priorities decreased (p<0.001). Discharges to home decreased (p<0.001), while family physician referrals increased (p<0.001). Conclusion. The participation of nurses in the sorting of patients in primary care emergency services was related to significant changes in priority assignment, discharge referrals, and management of the reasons for consultation, showing an improvement in patient care autonomy and in the resolution of minor clinical problems in the emergency room.
Objetivo.Determinar la influencia de la enfermera en la clasificación de pacientes de los Servicios de Urgencias de Atención Primaria sobre las prioridades de atención y las derivaciones al alta de manera general y en relación con los motivos de consulta. Métodos. Estudio descriptivo retrospectivo. Se compararon las variables antes y después de la inclusión de la enfermera en la clasificación de pacientes de los Servicios de Urgencias de Atención Primaria de la Zona básica de Salud de Granada (Andalucía, España). Se analizaron 41.295 registros, 18.663 antes y 22.632 dos años después de la implementación de la medida. Se compararon los motivos de consulta, niveles de prioridad y derivación al alta en los dos momentos de estudio.Resultados En cuanto a los motivos de consulta se pudo observar que, aumentaron los porcentajes de malestar general (p<0.001) y enfermedades genito-urinarias Genoveva Pérez-Romer⢠Ángela Jiménez-García⢠Cesar Hueso-Montoro⢠Rafael Montoya-Juárez María Paz García-CaroInvest Educ Enferm. 2024; 42(3): e03(p<0.001), y disminuyeron, entre otras, la fiebre (p<0.001). En la medición de dos años después de implementada la clasificación por enfermería se incrementaron porcentualmente las prioridades IV (p<0.001) y descendieron las prioridades V (p<0.001). Las derivaciones al alta al domicilio disminuyeron (p<0.001), aumentaron al médico de familia (p<0.001). Conclusión La participación de la enfermera en la clasificación de pacientes en los Servicios de Urgencias de Atención Primaria se relacionó con cambios significativos en la asignación de las prioridades, las derivaciones al alta, y la gestión de los motivos de consulta evidenciando mejoría en la autonomía de la atención al paciente y en la resolución de problemas clínicos leves de las urgencias.
Objetivo.Determinar a influência do enfermeiro na classificação dos pacientes dos Serviços de Urgência da Atenção Básica nas prioridades de atendimento e encaminhamentos de alta em geral e em relação aos motivos da consulta. Métodos. Estudo descritivo retrospectivo. As variáveis foram comparadas antes e depois da inclusão do enfermeiro na classificação dos pacientes nos Serviços de Urgência de Atenção Primária da Zona Básica de Saúde de Granada (Andaluzia, Espanha). Foram analisados 41.295 registros, 18.663 antes e 22.632 dois anos depois da implementação da medida. Os motivos da consulta, níveis de prioridade e encaminhamento de alta foram comparados nos dois momentos do estudo.Resultados Quanto aos motivos da consulta, observou-se que os percentuais de mal-estar geral (p< 0.001) e doenças geniturinárias (p< 0.001) aumentaram e a febre, entre outras, diminuiu (p< 0.001). Na medição dois anos após a implementação da classificação de enfermagem, as prioridades VI aumentaram percentualmente (p< 0.001) e as prioridades V diminuíram (p< 0.001). Os encaminhamentos no momento da alta para o domicílio diminuíram (p< 0.001) e aumentaram para o médico de família (p< 0.001). Conclusão A participação do enfermeiro na classificação dos pacientes nos Pronto Socorros da Atenção Básica esteve relacionada a mudanças significativas na atribuição de prioridades, encaminhamentos para alta e gerenciamento dos motivos de consulta, evidenciando melhora na autonomia do atendimento ao paciente e a resolução de problemas clínicos menores em emergências
Subject(s)
Humans , Male , Female , Primary Health Care , Triage , Emergency Nursing , Community Health Nursing , Advanced Practice NursingABSTRACT
Background: The emergency department is a place where patients require immediate treatment and care. It is the specialty that cares for patients at risk. Doctors face challenges in rationalizing, choosing, and initiating appropriate drug therapy for patients admitted to emergency medicine. They also encounter problems with medication errors and adverse drug events. Hence, a prescription-based survey is one of the most effective methods for analyzing the prescribing patterns of drugs and the prescribing behavior of physicians. The core drug use indicators developed by the World Health Organization (WHO) are more informative and feasible. These include prescribing, patient care, and health facility indicators. Aims and Objectives: (i) The aim of this study was to study, assess, and evaluate the rationality of prescription pattern in emergency department in a particular region and (ii) to understand whether prescription pattern is in accordance with the WHO core prescribing indicators or not? Materials and Methods: Details regarding the age and gender of the patient, the reason for admission, diagnosis made, treatment given, the number of drugs per prescription, drugs prescribed by generic name, drugs prescribed from the essential drug list, dosage, refills, and dosage forms were collected. The rationality of the prescriptions was assessed and evaluated using these indicators. Results: In the present study, the average number of drugs per prescription was 4.6, injections were prescribed in 84.8%, antibiotics in 43.2%, and the generic name was mentioned in 50.8%. In addition, 72.8% of the drugs were prescribed from the essential drug list. Descriptive and inferential statistical analyses were used. The Student’s t-test was employed to compare inter-group variation for continuous variables. The Chi-square test was used to compare categorical variables. Conclusion: Among the study population, approximately three-fourths belonged to the age group of 20–60 years, and two-thirds were males. The majority of patients came due to injuries, including road traffic accidents, followed by respiratory illnesses (26.4%) and gastrointestinal ailments (15.6%). Among the prescriptions studied, all had the drug name legibly written, 93.3% had the dose mentioned, and 86.5% had the frequency mentioned. The most common route of administration was parenteral (76.6%), followed by oral (19.3%). In the present study, the average number of drugs per prescription was 4.6, injections were prescribed in 84.8%, antibiotics in 43.2%, and the generic name was mentioned in 50.8%.
ABSTRACT
SUMMARY OBJECTIVE: Falls are a serious cause of morbidity and mortality among older people. One of the underlying causes of falls is dehydration. Therefore, ultrasonography has become an essential tool for evaluating volume status in the emergency department. However, the effect of volume status on falls in older people has not been evaluated before. The aim of this study was to determine the relationship between the inferior vena cava collapsibility index and the injury severity score in older patients who presented with fall-related injuries to the emergency department. METHODS: A total of 66 patients were included in the study. The injury severity score was used as the trauma severity score, and the Edmonton Frail Scale was used as the frailty scale. Volume status was evaluated with inferior vena cava collapsibility index. The primary outcome measure was defined as the correlation between inferior vena cava collapsibility index and injury severity score. Secondary outcome measures were defined as the effect of inferior vena cava collapsibility index and injury severity score on hospitalization and mortality. RESULTS: There was no significant correlation between injury severity score and inferior vena cava collapsibility index (p=0.342). Neither inferior vena cava collapsibility index nor injury severity score was an indicator of the mortality of these patients. However, injury severity score was an indicator of hospitalization. The mean Edmonton Frail Scale score was an indicator of mortality among older people who experienced falls (p=0.002). CONCLUSION: Inferior vena cava collapsibility index cannot be used to predict trauma severity in older patients who have experienced falls admitted to the emergency department.
ABSTRACT
Traumatic abdominal wall hernia (TAWH) is a rare clinical entity resulting from blunt force trauma that disrupts the abdominal wall muscles and fascia, leading to the protrusion of intra-abdominal contents without skin penetration. It accounts for approximately 0.07% of all abdominal trauma cases and often presents diagnostic challenges due to its rarity and association with other injuries. We present a case of a 66-year-old male who presented with a TAWH and small bowel perforation after being struck by a bull. He exhibited hemodynamic instability and abdominal tenderness. Imaging revealed a strangulated hernia. Surgical exploration found a 5 cm abdominal wall defect with herniated, gangrenous small bowel, with jejunal perforation. The affected bowel segment was resected, and the abdominal wall was repaired. The patient stabilized postoperatively and was discharged on day 14. TAWH requires a high index of suspicion for diagnosis, especially in the presence of blunt abdominal trauma. Immediate surgical intervention is often necessary to prevent complications such as bowel strangulation and peritonitis. This case underscores the importance of early recognition and timely surgical management to improve outcomes in patients with TAWH complicated by bowel perforation. Early diagnosis and prompt surgical intervention are crucial in managing TAWH, particularly when accompanied by bowel perforation. This case highlights the need for vigilance and rapid response in emergency settings to mitigate the significant morbidity and potential mortality associated with this rare condition.
ABSTRACT
The overcrowding (HO) in the emergency service (SU) has been described as a patient safety issue and a global public health concern. (1) It is a phenomenon that has become a significant problem in public health management, as it leads to a significant waste of economic and human resources. The problem initially involves the emergency department, later extending to the entire hospital facility, as the failure to transfer patients to inpatient areas significantly contributes to overcrowding. Identifying the prevalent causes of overcrowding is crucial to implementing effective solutions that ensure timely and quality care for patients, thus improving safety for them in the emergency service.
El hacinamiento en el servicio de urgencia ha sido descrito como un problema de seguridad para el paciente y de relevancia en salud pública a nivel mundial. Es un fenómeno que se ha vuelto un problema importante en la gestión de la salud pública, dado que genera una gran disipación de recursos económicos, como también humanos. El problema involucra al departamento de emergencia inicialmente, vinculándose luego con todo el recinto hospitalario, ya que la falta de evacuación de los pacientes hacia dependencias intrahospitalarias contribuye en gran proporción al hacinamiento. Identificar las causas prevalentes del hacinamiento es fundamental, para implementar soluciones efectivas que garanticen una atención oportuna y de calidad para los pacientes, mejorando así la seguridad para estos en el servicio de urgencia.
Subject(s)
Humans , Emergency Service, Hospital/organization & administration , Emergency Service, Hospital/statistics & numerical data , Crowding , Models, Organizational , Efficiency, Organizational , Health Planning/organization & administrationABSTRACT
INTRODUCTION: Rectal foreign body (RFB) poses a challenge for emergency surgeons in diagnosis. Clinical suspicion is essential, along with imaging support, which will allow the most effective removal treatment to be carried out depending on the case. OBJECTIVE: To describe the procedures for an anorectal pathology commonly present in emergency services. CLINICAL CASES: Two cases are reported of men who were admitted to the emergency room with a self-inserted RFB (carrot and screwdriver). Upon admission, they gave a confusing anamnesis, and images were taken to confirm their diagnosis. They required a laparotomy to assist in its transanal removal in the first case and a protective loop colostomy in the second. DISCUSSION: RFB consultation frequently occurs in male patients who have inserted objects for sexual self-stimulation. Because of the shame and desire to conceal these cases, these patients become "special" patients. Literature reviews and case studies on the subject in particular are scarce.
INTRODUCCIÓN: El cuerpo extraño rectal (CER) plantea al cirujano de urgencias un desafío en el diagnóstico, su sospecha clínica es fundamental junto con el apoyo de imágenes, lo que permitirá realizar el tratamiento de extracción más efectivo según sea el caso. OBJETIVO: Describir los procedimientos para una patología ano rectal presente comúnmente en los servicios de urgencia. CASOS CLÍNICOS: Se reportan dos casos de hombres que ingresaron a emergencias con un CER auto insertado (zanahoria y destornillador), entregando a su ingreso una confusa anamnesis, tomándose imágenes que certificaron su diagnóstico y que requirieron una laparotomía para ayudar en su extracción transanal en el primer caso y una colostomía de protección en asa en el segundo. DISCUSIÓN: La consulta por CER se presenta frecuentemente en pacientes hombres que han introducido objetos por autoestimulación sexual. Por la vergüenza y deseo de ocultamiento en estos casos, convierte a estos pacientes, en pacientes "especiales". Las revisiones bibliográficas y la casuística sobre el tema en particular son escasas.
Subject(s)
Humans , Male , Middle Aged , Aged , Rectum/surgery , Foreign Bodies/therapy , Image Processing, Computer-Assisted , Colostomy/methods , Radiography, Abdominal , Tomography, X-Ray Computed , Imaging, Three-Dimensional , Emergencies , Emergency Service, Hospital , Laparotomy/methodsABSTRACT
Diante do crescente número de casos de Covid-19 no Brasil e a gravidade desta doença, observa-se que um elevado número de pacientes evoluem para insuficiência respiratória aguda e necessidade de intubação orotraqueal. Nesse sentido, foi instituído um time de intubação rápida, habilitado para desenvolver o procedimento de maneira eficaz, a fim de reduzir o número de intercorrências e risco de contaminação da equipe de saúde. O estudo tem como objetivo descrever o perfil dos pacientes com Covid-19 e comparar os desfechos das intubações realizadas pelo time de intubação rápida e equipe médica de um pronto-socorro. Trata-se de um estudo transversal e retrospectivo, de abordagem quantitativa, realizado em um Pronto-Socorro de um Hospital Universitário do Norte do Paraná. Os dados dos pacientes foram coletados a partir dos registros no serviço de arquivamento médico e estatístico, referentes ao período de 1 de junho a 31 de julho de 2021. Foram realizados 236 atendimentos de pacientes com Covid-19, 60% dos casos eram do sexo masculino, com idade média entre 41 a 60 anos; as principais comorbidades prévias foram, hipertensão arterial sistêmica, obesidade e diabetes mellitus. Do total de casos, 50 % evoluíram a óbito e 42% receberam alta hospitalar. O time de intubação rápida esteve presente em 49 intubações, dessas, 78% dos pacientes foram a óbito, enquanto a equipe médica do pronto-socorro participou de 38, com 82% de mortalidade. Conclui-se que a atuação do time de intubação resultou em menor letalidade, entretanto ainda se considera o número de óbitos expressivos comparado ao total de atendimentos.
Given the growing number of COVID-19 cases in Brazil and the severity of this disease, it has been observed that a high number of patients develop acute respiratory failure and require orotracheal intubation. In this sense, a rapid intubation team was established, qualified to perform the procedure effectively, in order to reduce the number of complications and the risk of contamination of the health team. The study aims to describe the profile of patients with COVID-19 and compare the outcomes of intubations performed by the rapid intubation team and the medical team of an emergency room. This is a cross-sectional and retrospective study, with a quantitative approach, carried out in an Emergency Room of a University Hospital in Northern Paraná. Patient data were collected from records in the medical and statistical archiving service, referring to the period from June 1 to July 31, 2021. A total of 236 patients with Covid-19 were treated, 60% of the cases were male, with an average age between 41 and 60 years; the main previous comorbidities were systemic arterial hypertension, obesity and diabetes mellitus. Of the total number of cases, 50% died and 42% were discharged from hospital. The rapid intubation team was present in 49 intubations, of which 78% of the patients died, while the emergency room medical team participated in 38, with 82% mortality. It is concluded that the work of the intubation team resulted in lower lethality, however, the number of significant deaths compared to the total number of treatments is still considered.
Dado el creciente número de casos de Covid-19 en Brasil y la gravedad de esta enfermedad, se observa que un elevado número de pacientes evoluciona hacia insuficiencia respiratoria aguda y necesidad de intubación orotraqueal. En este sentido, se conformó un equipo de intubación rápida, capacitado para desarrollar el procedimiento de manera efectiva, con el fin de reducir el número de complicaciones y el riesgo de contaminación del equipo de salud. El estudio tiene como objetivo describir el perfil de los pacientes con Covid-19 y comparar los resultados de las intubaciones realizadas por el equipo de intubación rápida y el equipo médico en una sala de urgencias. Se trata de un estudio transversal, retrospectivo, con abordaje cuantitativo, realizado en una Sala de Emergencia de un Hospital Universitario del Norte de Paraná. Los datos de los pacientes se recolectaron de los registros del servicio de archivo médico y estadístico, abarcando el período del 1 de junio al 31 de julio de 2021. Se brindaron 236 consultas a pacientes con Covid-19, el 60% de los casos fueron del sexo femenino, con edad promedio. entre 41 y 60 años; las principales comorbilidades previas fueron hipertensión arterial sistémica, obesidad y diabetes mellitus. Del total de casos, el 50% falleció y el 42% fue dado de alta del hospital. El equipo de intubación rápida estuvo presente en 49 intubaciones, de las cuales el 78% de los pacientes fallecieron, mientras que el equipo médico de urgencias participó en 38, con un 82% de mortalidad. Se concluye que la actuación del equipo de intubación resultó en una menor letalidad, sin embargo, aún se considera el número importante de muertes respecto al total de visitas.
ABSTRACT
ABSTRACT Introduction: Lung diseases are common in patients with end stage kidney disease (ESKD), making differential diagnosis with COVID-19 a challenge. This study describes pulmonary chest tomography (CT) findings in hospitalized ESKD patients on renal replacement therapy (RRT) with clinical suspicion of COVID-19. Methods: ESKD individuals referred to emergency department older than 18 years with clinical suspicion of COVID-19 were recruited. Epidemiological baseline clinical information was extracted from electronic health records. Pulmonary CT was classified as typical, indeterminate, atypical or negative. We then compared the CT findings of positive and negative COVID-19 patients. Results: We recruited 109 patients (62.3% COVID-19-positive) between March and December 2020, mean age 60 ± 12.5 years, 43% female. The most common etiology of ESKD was diabetes. Median time on dialysis was 36 months, interquartile range = 12-84. The most common pulmonary lesion on CT was ground glass opacities. Typical CT pattern was more common in COVID-19 patients (40 (61%) vs 0 (0%) in non-COVID-19 patients, p < 0.001). Sensitivity was 60.61% (40/66) and specificity was 100% (40/40). Positive predictive value and negative predictive value were 100% and 62.3%, respectively. Atypical CT pattern was more frequent in COVID-19-negative patients (9 (14%) vs 24 (56%) in COVID-19-positive, p < 0.001), while the indeterminate pattern was similar in both groups (13 (20%) vs 6 (14%), p = 0.606), and negative pattern was more common in COVID-19-negative patients (4 (6%) vs 12 (28%), p = 0.002). Conclusions: In hospitalized ESKD patients on RRT, atypical chest CT pattern cannot adequately rule out the diagnosis of COVID-19.
RESUMO Introdução: Doenças pulmonares são comuns em pacientes com doença renal em estágio terminal (DRET), dificultando o diagnóstico diferencial com COVID-19. Este estudo descreve achados de tomografia computadorizada de tórax (TC) em pacientes com DRET em terapia renal substitutiva (TRS) hospitalizados com suspeita de COVID-19. Métodos: Indivíduos maiores de 18 anos com DRET, encaminhados ao pronto-socorro com suspeita de COVID-19 foram incluídos. Dados clínicos e epidemiológicos foram extraídos de registros eletrônicos de saúde. A TC foi classificada como típica, indeterminada, atípica, negativa. Comparamos achados tomográficos de pacientes com COVID-19 positivos e negativos. Resultados: Recrutamos 109 pacientes (62,3% COVID-19-positivos) entre março e dezembro de 2020, idade média de 60 ± 12,5 anos, 43% mulheres. A etiologia mais comum da DRET foi diabetes. Tempo médio em diálise foi 36 meses, intervalo interquartil = 12-84. A lesão pulmonar mais comum foi opacidades em vidro fosco. O padrão típico de TC foi mais comum em pacientes com COVID-19 (40 (61%) vs. 0 (0%) em pacientes sem COVID-19, p < 0,001). Sensibilidade 60,61% (40/66), especificidade 100% (40/40). Valores preditivos positivos e negativos foram 100% e 62,3%, respectivamente. Padrão atípico de TC foi mais frequente em pacientes COVID-19-negativos (9 (14%) vs. 24 (56%) em COVID-19-positivos, p < 0,001), enquanto padrão indeterminado foi semelhante em ambos os grupos (13 (20%) vs. 6 (14%), p = 0,606), e padrão negativo foi mais comum em pacientes COVID-19-negativos (4 (6%) vs. 12 (28%), p = 0,002). Conclusões: Em pacientes com DRET em TRS hospitalizados, um padrão atípico de TC de tórax não pode excluir adequadamente o diagnóstico de COVID-19.
ABSTRACT
Objetivo: Elaborar e validar uma ferramenta digital que auxilie no diagnóstico e condutas das principais alterações eletro-cardiográficas na urgência pediátrica. Metodologia: Foi elaborada uma ferramenta que utilizou imagens de ECGs obtidas de livros-texto e exames impressos, sem identificação dos pacientes. Foram utilizados recursos como o Adobe Acrobat Reader, o iPhone 13 para gravação e o programa Capcut para edição dos vídeos. Essa tecnologia digital passou por processo de validação de juízes especialistas utilizando a escala Likert. Resultados: O produto foi avaliado por um total de 7 juízes, sendo 5 (71,4%) sendo formado por médicas da área pediátrica e cardiológica. Ao analisar de forma pormenorizada os 3 critérios: a Aplicabilidade; Objetividade, Estrutura e Organização;foi observada uma validação completa da ferramenta junto aos especialistas,obtendo um IVC (Índice de Validade de Conteúdo) total. Conclusão: Essa ferramenta educacional permitirá, por meio de sua aplicabilidade, uma melhoria dos atendimentos pediátricos de urgência.(AU)
Objective: To develop and validate a digital tool to aid in the diagnosis and management of the main electrocardiogra-phic alterations in pediatric emergencies. Methodology: A tool was developed using ECG images obtained from textbooks and printed exams, without patient identification. Resources such as Adobe Acrobat Reader, iPhone 13 for recording and the Capcut program for editing the videos were used. This digital technology underwent a validation process by expert judges using a Likert scale. Results: The product was evaluated by a total of 7 judges, 5 (71.4%) of whom were doctors in the pediatric and cardiology fields. A detailed analysis of the 3 criteria: Applicability, Objectivity, Structure and Organization, showed that the tool was fully validated by the experts, obtaining a total CVI (Content Validity Index). Conclusion: Through its applicability, this educational tool will improve pediatric emergency care.(AU)
Objetivo: Desarrollar y validar una herramienta digital de ayuda al diagnóstico y manejo de las principales alteraciones electrocardiográficas en urgencias pediátricas. Metodología: Se desarrolló una herramienta a partir de imágenes de ECG obtenidas de libros de texto y exámenes impresos, sin identificación del paciente. Se utilizaron recursos como Adobe Acrobat Reader, iPhone 13 para la grabación y el programa Capcut para la edición de los vídeos. Esta tecnología digital fue sometida a un proceso de validación por jueces expertos mediante una escala Likert. Resultados: El producto fue evaluado por un total de 7 jueces, de los cuales 5 (71,4%) eran médicos del área de pediatría y cardiología. Un análisis detallado de los 3 criterios: Aplicabilidad, Objetividad, Estructura y Organización, mostró que la herramienta fue plenamente validada por los expertos, obteniendo un IVC (Índice de Validez de Contenido) total. Conclusión: Gracias a su aplicabilidad, esta herramienta educativa mejorará la atención pediátrica de urgencias.(AU)
Subject(s)
Adult , Biomedical Technology , Electrocardiography , Pediatric Emergency MedicineABSTRACT
Lumbar hernia is a rare condition and about 325 cases reported so far, not more than 30 cases of strangulated lumbar hernia have been reported in the surgical literature since 1889. Therefore, diagnosis can be easily misdiagnosed. We present a case of a 75-year-old gentleman, who had come with acute intestinal obstruction with strangulated right inferior lumbar hernia. We did exploratory laparotomy with resection and anastomosis and repair of hernia defect. As per our observation this is 31st reported case of strangulated/obstructed lumbar hernia in literature.
ABSTRACT
A cornual pregnancy is the most dangerous type of ectopic pregnancy since it can be misdiagnosed easily and has high mortality rate. It is diagnosed when the implantation site is at the junction between the fallopian tube and the uterus. It accounts for 2� of ectopic pregnancies. In a ruptured case, patient usually presents with hypovolemia and shock. For a successful outcome, early diagnosis and management are critical. A 29 years old woman, G3P0A2L0 with 8 weeks 5 days of amenorrhea conceived by IVF-ET with a history of left salpingectomy and right cornual cauterization, presented in emergency with complaints of lower abdominal pain, vomiting, burning micturition and giddiness. Per abdominal examination- soft with mild tenderness. Resuscitation started. All necessary investigations were done. Treatment started considering provisional diagnosis as septic shock following urinary tract infection (UTI). Ultrasound report showed uterus with thickened endometrium with hyperechoic irregular small gestational sac like structure in uterine cavity with hemoperitoneum in pelvis. Emergency laparotomy done considering a diagnosis of hypovolemic shock due to ruptured cornual ectopic pregnancy. Intra-operatively she was found to have hemoperitoneum with left sided ruptured cornual ectopic pregnancy. Early diagnosis is the cornerstone of cornual pregnancy before its rupture and to reduce the chances of maternal mortality. Combination of clinical features, increased serum ?-hCG, high resolution trans-vaginal ultrasonography gives the correct diagnosis in most of the cases. While doing antenatal ultrasonography in the first trimester, high index of suspicion is needed to diagnose cornual ectopic pregnancy. Conservative medical and surgical management is decided on clinical condition of the patient. Our case represents that a history of salpingectomy does not eliminate the potential of ipsilateral ectopic pregnancy.
ABSTRACT
Background & Objectives: The Global Burden of Disease study is a systemic effort to quantify the comparative magnitude of the health loss due to diseases, injuries and risk factors by age, sex and geographies in specific point of time. Five out of ten causes of disease burden in 2017 in Nepal are Non-Communicable Disease (NCDs), ischemic heart disease (IHD), Chronic Obstructive Pulmonary Disease (COPD), Lower Respiratory Tract Infection (LRTI) and Tuberculosis (TB). We aimed to find out the demographic, clinical presentation and outcome of Emergency patients at Janaki Medical College Teaching Hospital (JMCTH) Emergency department. Materials and Methods: A descriptive observational study of patients visiting ED at Janaki Medical College, Ramdaiya, Bhawadi, Dhanusha. Distinctiveness of adult patients who entered the emergency department (ED) in a hospital in Nepal were prospectively recorded in the local emergency registry from 2023-04-15 to 2023-07-18. Post-ED mortality, patient households were followed-up by telephone interviews at 90 days. Patients were diagnosed, treated and admitted in different wards for further evaluation and treatment. Data were collected, analyzed, interpreted, using SPSS version 20. Results: The majority of patients were male (55.58%) predominantly from Dhanusha (79.4%). Common symptoms included musculoskeletal pain (16.5%), abdominal pain (13.3%), and fever (9.9%). The most common diseases were acute pain abdomen (21.26%) and hypertension (11.06%), Abrasions (35%) and cut injuries (13.59%) were the most frequent injuries. Most of the patients were admitted to the observation ward (52.9%). Conclusion: Most patients attending emergency department were young males from Dhanusha, primarily of Terai Madheshi and other castes. The results emphasize the necessity of better emergency care services and public health initiatives in Janakpurdham, as well as the critical role of emergency departments which provides services in wide range of acute and chronic diseases.