Approach to pneumothorax in emergency department

Pneumothorax is the collection of air in the pleural space. Most of these patients are admitted to emergency services first. If pneumothorax is left untreated, it can progress to a life-threatening clinical condition. All emergency physicians must have a detailed knowledge about it and its treatment

Is it possible to objectify the visual pain scale?

Objectives: To test our hypothesis that a new modified VAS [mVAS] is superior and more objective than VAS in evaluating pain perception and treatment response between genders who have renal colic pain

Methods: The individuals in patient and control groups were first asked to mark the pain perceived during access of IV line [VAS[IV] score]. Then the patients with renal colic were asked to mark the pain they experienced before treatment [VAS[RC] score] and at 15 and 30 minutes after the administration of the first analgesic drug. The modified VAS scores [mVAS score] were obtained by subtracting the VASIV score from VAS[RC] score

Results: When VAS was used, the female patients had significantly higher level of pain at 0, 15, and 30th minutes than men [p = 0.012, p = 0.001, and p = 0.003, respectively]. However, there was not any significant difference at 0 and 30[th] min between sexes while female patients had significantly higher level of pain scores only at 15[th] minute according to mVAS scores [p = 0.027]

Conclusion: We think that the mVAS is superior and more objective than VAS in evaluating pain perception and abolished the difference in the perceived level of pain due to gender

new development in emergency department ultrasonography: pleural Sliding Sound [PSS]

Ultrasonography [USG] is widely used in emergency departments to assist in the diagnosis and treatment of patients. An increasing number of studies in the unconventional use of USG in thorax and lung examination have been conducted in recent years. Sliding lung sound [SLS] has been researched extensively during the last decade was accepted as a radiologic sign in 2008. However, determining SLS requires a certain degree of clinical experience since it is a subjective indicator. We have discovered the "pleural sliding sign [PSS]", which is as valuable as the SLS, but more objective sign. PSS is present at any time when SLS is present; furthermore, it can be used as a diagnostic sign even when the SLS is doubtful. In this study, we present our views on PSS and in particular wish to share this information with clinicians who are interested in performing emergency USG. We also aim to stimulate further research on this subject.