1 10 45 https://repository.horizon.ac.id/files/original/1e2ec2fbb4dbdaf81d4122f5ab4574ea.pdf 115560defac3c2c1413139042e32a551 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Prosiding 3rd Emergency Physician's International Conference Contributor An entity responsible for making contributions to the resource Sri Wahyuni Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Traumatic hemorrhagic central cervical cord myelopathy after a minor trauma (E-Poster Presentations) Subject The topic of the resource Traumatic hemorrhagic central cervical cord myelopathy, minor trauma Description An account of the resource Introduction The classical clinical presentation and neurological findings of a traumatic central cervical spinal cord (CSS) injury could easily be missed. Case presentation An 82-year-old male with a history of cardiac amyloidosis was brought to the emergency department after an unwitnessed minor fall or collapse in the garden with a Glasgow Coma Scale (GCS) of 11. He was bradycardic, hypotensive, and showing limited movement in all four limbs. A primary CT scan showed a fracture of the C3 transverse process, and a subsequent CT angiogram revealed a traumatic vertebral artery dissection. After consulting with neurosurgeons, he was initially treated as a stroke case. However, his GCS declined from 11 to 5, which was not consistent with the diagnosis and imaging findings according to the neurology team. Additional imaging was then conducted. An MRI of the brain and cervical spine revealed hemorrhagic central cord myelopathy at the C2-4 level, deemed an unsalvageable injury. Discussion Traumatic spinal cord injury has many etiological factors, most of which involve severe trauma to the spine. Early diagnosis of patients with high cervical spine injuries is crucial. In our case, the patient was initially mistreated as only having a traumatic vertebral artery dissection after experiencing a minor trauma. Conclusion This case report emphasizes the importance of considering central cord myelopathy after minor trauma and taking into account its effect on the patient’s vital signs. Creator An entity primarily responsible for making the resource Abdelrahman, Hend Abdelmageed Source A related resource from which the described resource is derived Ibrahim, H. A. K. (Ed.). (2024). Abstract and Poster Presentations Book: 3rd Emergency Physician’s International Conference (EPIC24), 10 July 2024. From Zero to Hero Medical Education LTD Publisher An entity responsible for making the resource available From Zero to Hero Medical Education LTD Date A point or period of time associated with an event in the lifecycle of the resource 10 July 2024 Contributor An entity responsible for making contributions to the resource Sri Wahyuni Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource English Type The nature or genre of the resource Text https://repository.horizon.ac.id/files/original/7935c84c520137a422156a38bcb216c4.pdf 115560defac3c2c1413139042e32a551 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Prosiding 3rd Emergency Physician's International Conference Contributor An entity responsible for making contributions to the resource Sri Wahyuni Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Pathway for Inpatient and Outpatient Cellulitis Management (E-Poster Presentations) Subject The topic of the resource Pathway for Inpatient and Outpatient Cellulitis Management Description An account of the resource Background Cellulitis is an acute bacterial infection of the dermis and subcutaneous tissue. The infected area is characterized by pain, warmth, swelling, and erythema. Blisters and bullae may form. Fever, malaise, nausea, and rigors may accompany or precede the skin changes. Risk factors for cellulitis include previous cellulitis, trauma to the skin, lymphoedema, leg oedema, venous insufficiency, and obesity. Most cases of cellulitis resolve with treatment, but the correct treatment in the appropriate setting is important to avoid commonly occurring acute and chronic complications. NICE have published guidelines on how to classify severity of cellulitis, and how to manage based on severity and co-morbidities. Class I No signs of systemic toxicity and no uncontrolled comorbidities Class II Systemically unwell or systemically well but with a comorbidity Class III Significant systemic upset, such as acute confusion, tachycardia, tachypnoea, hypotension, or unstable comorbidities, or a limb-threatening infection due to vascular compromise Class IVSepsis or severe life-threatening infection, such as necrotizing fasciitis NICE have recommended treating for a minimum of seven days of antibiotics. They recommend treating as an inpatient when: • Class III or IV cellulitis • Class II cellulitis and unable to deliver IV Abx in the community • Class I cellulitis and risk factors including: immunocompromised, frail, lymphoedema, suspicion of osteomyelitis or septic arthritis NICE advise patients treated as an outpatient should have a review at 2-3 days depending on clinical judgement or if symptoms are deteriorating. If there is no substantial improvement at the end of a 7-day course, then antibiotics should be continued for a further 7 days. Results Our practice: We took a random sample of 19 patients seen on the RHCH medical take with a diagnosis of lower limb cellulitis between May to Nov 2023. Mean age was 73 years (SD=9.6 years), and 63% were male. Severity of cellulitis or classification of cellulitis was not mentioned in any clerking documents or clinical noting at the time of the patient’s admission. By retrospectively examining clinical noting, observations, and blood results, we classified these patients as presenting with Class I cellulitis (n=9), Class II cellulitis (n=7), Class III cellulitis (n=1), Class IV cellulitis (n=2). Of patients classified Class II-IV, all received a length of IV Abx, apart from one Class II patient with no risk factors who received 14 days of oral antibiotics as an outpatient. He was reviewed three times in SDEC during his treatment. Of the 3, Class I cellulitis patients with risk factors, 2 had IV Abx but one received only oral Antibiotics. Of the 6, Class I cellulitis patients without risk factors, half had IV antibiotics and half had orals. This demonstrates a lack of adherence to recommended NICE guidelines in a large proportion of Class I patients. Of patients classified Class II-IV, 90% (9/10) appropriately had IV Abx. The one patient who had orals only had regular follow up throughout their antibiotic course. 5 of the 19 patients had follow up arranged. Creator An entity primarily responsible for making the resource Abdul Basit Malik, Zara Ali, Mohamed Kafala, Ana-Maria Bologan Source A related resource from which the described resource is derived Ibrahim, H. A. K. (Ed.). (2024). Abstract and Poster Presentations Book: 3rd Emergency Physician’s International Conference (EPIC24), 10 July 2024. From Zero to Hero Medical Education LTD Publisher An entity responsible for making the resource available From Zero to Hero Medical Education LTD Date A point or period of time associated with an event in the lifecycle of the resource 10 July 2024. Contributor An entity responsible for making contributions to the resource Sri Wahyuni Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource English Type The nature or genre of the resource Text https://repository.horizon.ac.id/files/original/5006461e11481eafa07b6c030f7bb514.pdf 115560defac3c2c1413139042e32a551 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Prosiding 3rd Emergency Physician's International Conference Contributor An entity responsible for making contributions to the resource Sri Wahyuni Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Spontaneous Coronary Artery Dissection in a patient with a Single Coronary Artery (E-Poster Presentations) Subject The topic of the resource Spontaneous Coronary Artery Dissection, Single Coronary Artery Description An account of the resource Spontaneous coronary artery dissection (SCAD) is an uncommon non-atherosclerotic aetiology of acute coronary syndromes (ACS) characterised by the formation of a false lumen inside the arterial wall, resulting in sudden occlusion of blood flow without any trauma or intervention. The pathogenesis of SCAD is not completely understood, and the association between coronary artery anomalies and SCAD is unclear. This case study reports a unique occurrence of Non-ST-Elevation Myocardial Infarction (NSTEMI) in a 43-year-old female patient. The NSTEMI was caused by Spontaneous Coronary Artery Dissection (SCAD) affecting the Posterior Descending Artery (PDA),in the setting of a single coronary artery. This is a very rare subtype of coronary artery anomalies in which the right coronary artery (RCA) gives rise to the left anterior descending artery (LAD) and left circumflex artery (LCx). The patient was managed conservatively, taking into consideration the extent of myocardial involvement and the resolution of symptoms. This congenital anomaly may have been the primary predisposing factor for her develop SCAD. Additional research is required to determine the correlation between coronary artery anomalies and SCAD Creator An entity primarily responsible for making the resource Ali Al-Shammari, Steven Danial Amy Habib, Fredy Gad Source A related resource from which the described resource is derived Ibrahim, H. A. K. (Ed.). (2024). Abstract and Poster Presentations Book: 3rd Emergency Physician’s International Conference (EPIC24), 10 July 2024. From Zero to Hero Medical Education LTD. Publisher An entity responsible for making the resource available From Zero to Hero Medical Education LTD. Date A point or period of time associated with an event in the lifecycle of the resource 10 July 2024. Contributor An entity responsible for making contributions to the resource Sri Wahyuni Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource English Type The nature or genre of the resource Text https://repository.horizon.ac.id/files/original/5df055364596366eea3f452286d44afc.pdf 115560defac3c2c1413139042e32a551 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Prosiding 3rd Emergency Physician's International Conference Contributor An entity responsible for making contributions to the resource Sri Wahyuni Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource The Compassionate Shift: Enriching Emergency Department Clinical Handovers to Improve Clinical Performance and Safety (E-Poster Presentations) Subject The topic of the resource The Compassionate Shift: Enriching Emergency Department Clinical Handovers to Improve Clinical Performance and Safety Description An account of the resource AIMS AND OBJECTIVES 1) To introduce wellbeing into Airedale General Hospital (AGH)’s Emergency Department (ED) clinician handover. 2) To increase awareness of wellbeing, and its potential impact on clinical performance. METHOD AND DESIGN May 2023: baseline wellbeing survey distributed to AGH ED clinicians. June: STEP Handover launched. Self (Emergency Practitioner In Charge (EPIC)’s wellbeing:-2 to +2 scale), Team (challenging shift patterns highlighted, clinicians rate their wellbeing numerically with sharing opportunity). Environment (departmental issues), Patient Handover. Estimated 15 seconds/clinician. July: Survey repeated. September: Project re-launch. Wellbeing and Learning Goals Handover Huddle (WLGHH): challenging shift patterns highlighted, clinicians rate their wellbeing using traffic-light colour scale or thumbs-up scale, with sharing opportunity. October: Survey repeated. February 2024: Confidential online Wellbeing SitRep (via QR code) launched. RESULTS AND CONCLUSIONS 57% baseline/83% STEP/57% WLGHH of clinicians value sharing their wellbeing during handover. 94%/92%/78% value learning team members’ wellbeing. 44%/58%/56% of clinicians sometimes find themselves in situations they feel uncomfortable, or are not best-suited for, because their personal situation is unknown. EPICs sometimes consider clinicians' wellbeing, and how this may affect them clinically, when allocating 70%/100%/86% of cases and tasks. “Great initiative.” “Encouraging this conversation is important.” “Hesitant handover is the right environment - very ‘public’.” “Limited time in handover.” STEP implemented in 50% or fewer handovers, and WLGHH in 20% or fewer handovers due to busy department pressures (“process needs streamlining”) and sense that “there’s little we can do with [wellbeing] information…it adds a cloud to the shift”. EPICs aware of vulnerability within their team have been shown to lead compassionately. Our initiative demonstrates ED clinicians value sharing their wellbeing status. However, there are individual, cultural and departmental barriers to achieving project engagement. Through ongoing process modification we aim to create a psychologically safe working environment, improved clinician wellbeing, and an enhanced safety culture in AGH ED. EPICs aware of vulnerability within their team have been shown to lead compassionately. Our initiative demonstrates ED clinicians value sharing their wellbeing status. However, there are individual, cultural and departmental barriers to achieving engagement with this work. Through ongoing process modification we aim to create a psychologically safe working environment with better awareness of team vulnerabilities, and an enhanced safety culture in AGH ED Creator An entity primarily responsible for making the resource Alice Faulkner, Alexandra Danecki Source A related resource from which the described resource is derived Ibrahim, H. A. K. (Ed.). (2024). Abstract and Poster Presentations Book: 3rd Emergency Physician’s International Conference (EPIC24), 10 July 2024. From Zero to Hero Medical Education LTD Publisher An entity responsible for making the resource available From Zero to Hero Medical Education LTD Date A point or period of time associated with an event in the lifecycle of the resource 10 July 2024. Contributor An entity responsible for making contributions to the resource Sri Wahyuni Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource English Type The nature or genre of the resource Text https://repository.horizon.ac.id/files/original/956b3bd59a5a048cfae201d6846a0841.pdf 115560defac3c2c1413139042e32a551 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Prosiding 3rd Emergency Physician's International Conference Contributor An entity responsible for making contributions to the resource Sri Wahyuni Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource A New Case ofDe Quervain's Thyroiditis in Emergency Departement (E-Poster Presentations) Subject The topic of the resource De Quervain's Thyroiditis Description An account of the resource Introduction Thyroid toxicosis can be developed after minor infection, has to be taken seriously and start treatment urgently despite the clinical picture. It should be kept under a close observation until it has been seen by an endocrine specialist. Case presentation 31 year old lady female, NHS member . Exposed to possible nuclear radiation so she was taking iodine supplement in her childhood. No known allergies. Came to the hospital with: Sore throat, HR up to 130 , Mild sore Tenderness left side of neck + no swollen ,discomfort on swallowing, no stridor / SOB, Noted fine tremor , No rash Discussion In ED she had IV hydrocortisone and BB (tachycardic 130 bpm, HR improved to 97) then referred to medicine for discussion. ED SpR suggested discharging the patient with SDEC endocrine review. The discussion was the clinical picture stabilised, Is it safe to discharge the patient for next day SDEC review with endocrine team. Patient was given co-amoxiclav in ED. 10 minutes after that, she developed lips numbness, more tachycardia ( 180) and hypotension ( 70/40) . (given adrenalin). Moved to resus and discussed with ICU team by ED. There was doubt, is this rapid drop in observation was a reaction to co-amoxiclav or a thyrotoxicosis storm. Patient confirmed that she had co-amoxiclav many times before without any allergic reaction. On examination : on thyroid examination : no enlargement , but tender on left side of the thyroid. No eyes signs for hyperthyroidism (no protrusion , no lid leg ,no lid retraction ) Blood tests: TSH: 0.008 , T4 : 44 CRP 45, WBC 13 , neutrophils normal , lymphocytes low Burch-Warsofsky point scale 50 ( keeping with thyroid storm) Investigation and management plan: Impression was Viral infection induced thyroiditis leading to thyrotoxic state -thyroid storm Patient was admitted given IV hydrocortisone , IV BB and PTU and then discharged on oral prednisolone with endocrine follow up with US thyroid. Seen in Endocrine clinic and diagnosed with settled De Quervain's Thyroiditis. Conclusion Mild infection could result in a serious thyroid storm which should be taken seriously during out of hour shifts even though patient may look clinically well but the storm could strike at any moment. Creator An entity primarily responsible for making the resource Anwar Alkour Source A related resource from which the described resource is derived Ibrahim, H. A. K. (Ed.). (2024). Abstract and Poster Presentations Book: 3rd Emergency Physician’s International Conference (EPIC24), 10 July 2024. From Zero to Hero Medical Education LTD. Publisher An entity responsible for making the resource available From Zero to Hero Medical Education LTD. Date A point or period of time associated with an event in the lifecycle of the resource 10 July 2024. Contributor An entity responsible for making contributions to the resource Sri Wahyuni Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource English Type The nature or genre of the resource Text https://repository.horizon.ac.id/files/original/f2b3f8cea28bf24580da567e932a6495.pdf 115560defac3c2c1413139042e32a551 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Prosiding 3rd Emergency Physician's International Conference Contributor An entity responsible for making contributions to the resource Sri Wahyuni Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource A Rare association of Helicobacter Pylori induced Gastritis and Reactive Hypoglycaemia (E-Poster Presentations) Subject The topic of the resource Helicobacter Pylori, Gastritis and Reactive Hypoglycaemia Description An account of the resource Introduction Reactive hypoglycaemia happens after eating within four hours. It can occur in people with and without diabetes. It could also happen after gastric or intestinal. I could also occur in gastritis due to Helicobacter pylori infection. We present a rare case of H. Pylori induced gastritis leading to reactive hypoglycaemia. Case Presentation A 78 year old non-diabetic female with past medical history of antiphospholipid syndrome presented to the emergency department after she was found to have symptomatic hypoglycaemia especially after her morning meals. CT scans of the chest, Abdomen and Pelvis were unremarkable. Chest X-ray, blood and urine cultures were unremarkable. All reports concluded normal. Stool sample for H. Pylori Antigen came back positive. The recurrent low blood sugar readings were recorded for 4 days while the Triple therapy targeted for H. Pylori eradication started from the 5th day. A 72 hour Fasting Protocol were initiated but unable to induce any Hypoglycaemia events. On Follow up, A repeat H. pylori stool antigen was negative suggesting successful eradication while no further episodes of symptoms related to hypoglycaemia, or none recorded on glucometer. Discussion The presentation of patient to hospital following recently diagnosed H. Pylori and symptoms of reactive hypoglycaemia and otherwise negative investigations suggest a very rare but apparent relation between the two. The patient’s significant improvement in blood sugar levels and absence of symptoms post H. Pylori eradication would also support the unusual association. Cases like this have been reported in small numbers in the literature. The likely underlying mechanism could be that H. Pylori infection causes increased levels of gastrin intensifying the production of insulin. Conclusion Clinicians should be aware of this unusual relation of H. Pylori gastritis and Reactive hypoglycaemia. This case prompts clinician to keep H. Pylori as list of their differentials while assessing any patient with reactive hypoglycaemia of unclear cause. Creator An entity primarily responsible for making the resource Ashish Sahi, Chirag Subedi, Mohamed Mortagy Source A related resource from which the described resource is derived Ibrahim, H. A. K. (Ed.). (2024). Abstract and Poster Presentations Book: 3rd Emergency Physician’s International Conference (EPIC24), 10 July 2024. From Zero to Hero Medical Education LTD Publisher An entity responsible for making the resource available From Zero to Hero Medical Education LTD Date A point or period of time associated with an event in the lifecycle of the resource 10 July 2024. Contributor An entity responsible for making contributions to the resource Sri Wahyuni Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource English Type The nature or genre of the resource Text https://repository.horizon.ac.id/files/original/8566f532952236ac1db33f9a7632175c.pdf 115560defac3c2c1413139042e32a551 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Prosiding 3rd Emergency Physician's International Conference Contributor An entity responsible for making contributions to the resource Sri Wahyuni Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Coeliac Artery Thrombosis and Gastric Ischemia - An Unusual Presentation in Emergency Department (E-Poster Presentations) Subject The topic of the resource Coeliac Artery Thrombosis and Gastric Ischemia Description An account of the resource Background Acute gastric ischemia is a rare but fatal condition due to the risk of necrosis and perforation. This case report details the presentation, diagnostic process, and management of a 76-year-old male patient with acute gastric ischemia secondary to coeliac artery thrombosis. Case Presentation A 76-year-old male with multiple co-morbidities presented to the emergency department with severe abdominal pain radiating to the back, vomiting, constipation, and shortness of breath. Physical examination revealed tachypnea, tachycardia, hypotension, fever, and a distended abdomen with generalised tenderness, guarding, and absent bowel sounds. Venous gas analysis showed metabolic acidosis with elevated lactate levels. Imaging studies, including chest and abdominal radiographs, revealed dilated large bowel loops. At the same time, a CT scan of the abdomen indicated no contrast opacification of the celiac axis with collateral filling of the hepatic artery distal to a thrombus, suggesting gastric ischemia. Blood tests revealed leukocytosis, elevated C-reactive protein, and amylase levels. The patient was started on morphine, IV fluids, antibiotics, and unfractionated heparin for anticoagulation. Multidisciplinary consultations determined that the patient was not a candidate for surgical or endovascular intervention due to poor physiological status and a high mortality risk. Despite aggressive medical management, the patient died 26 hours after admission. Discussion Acute gastric ischemia, although rare, necessitates a high index of suspicion, particularly in patients with predisposing factors like systemic hypoperfusion or thrombotic conditions. Despite its robust collateral circulation, the coeliac artery can be a site for thrombosis, leading to significant gastric ischemia. Diagnosis primarily relies on radiological imaging, particularly CT angiography, which is critical for visualising vascular obstructions and ischemic changes. Management involves a combination of medical therapy aimed at resuscitation and stabilisation, with interventional radiology or surgery considered based on the patient's stability and underlying cause. Conclusion Timely recognition and diagnosis of coeliac trunk thrombosis are imperative to prevent significant morbidity and mortality. The treatment approach should be individualised, considering the patient's overall health and specific clinical presentation, with a focus on early restoration of blood flow through appropriate medical or surgical interventions. Creator An entity primarily responsible for making the resource Avikal Sharma, Vijaya Banu Mohan Source A related resource from which the described resource is derived Ibrahim, H. A. K. (Ed.). (2024). Abstract and Poster Presentations Book: 3rd Emergency Physician’s International Conference (EPIC24), 10 July 2024. From Zero to Hero Medical Education LTD Publisher An entity responsible for making the resource available From Zero to Hero Medical Education LTD Date A point or period of time associated with an event in the lifecycle of the resource 10 July 2024. Contributor An entity responsible for making contributions to the resource Sri Wahyuni Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource English Type The nature or genre of the resource Text https://repository.horizon.ac.id/files/original/dc941ee19524bbdd4431a11ecbc4724d.pdf 115560defac3c2c1413139042e32a551 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Prosiding 3rd Emergency Physician's International Conference Contributor An entity responsible for making contributions to the resource Sri Wahyuni Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Intramuscular Use of Glucagon in Esophageal Food Impaction (E-Poster Presentations) Subject The topic of the resource Intramuscular Use of Glucagon in Esophageal Food Impaction Description An account of the resource The standard management of esophageal foreign body impactions typically involves either observational strategies or endoscopic removal. In scenarios where endoscopy is not accessible, pharmacological interventions offer a viable alternative. Glucagon, when administered intravenously, represents one such pharmacological option; however, its use has been linked to a heightened risk of complications. This case study delineates the management of a patient experiencing dysphagia due to a meat bolus obstructing the lower esophagus, in a setting bereft of conventional therapeutic options. The study highlights the effectiveness of intramuscular glucagon injection as a strategy to reduce risk of complications . The intramuscular route may inspire further research in pharmacological management of food bolus impaction, which is particularly pertinent in hospitals where endoscopic facilities are scarce. The outcomes of this study indicate that the mode of glucagon administration plays a pivotal role in diminishing the complications encountered in emergency situations. Case Report Middle-aged man presented with dysphagia after eating meat, suggestive of lower esophageal obstruction. Vital signs normal, no significant medical history. Despite normal chest X-Ray, clinical signs indicated esophageal foreign body. Due to urgency and no endoscopy available, administered 1mg glucagon intramuscularly. Symptoms resolved within 12 minutes without side effects, avoiding endoscopy. Discussion This case report highlights the successful use of intramuscular glucagon in managing esophageal food impaction (EFI) when endoscopic intervention is unavailable. While intravenous glucagon has been explored in similar scenarios, the intramuscular route offers a novel approach with potential benefits. By utilizing the slower absorption rate of intramuscular delivery, this method minimizes the risk of adverse effects associated with intravenous administration, such as nausea and vomiting. Moreover, the physiological mechanism behind intramuscular glucagon’s efficacy involves gradual activation of adenylate cyclase, leading to reduced lower esophageal sphincter pressure and facilitated passage of the food bolus. This approach not only resolves the immediate issue of EFI but also underscores the importance of innovative treatment strategies in resource�constrained emergency departments. Conclusion In conclusion, intramuscular glucagon administration presents a promising alternative for managing EFI in settings where endoscopic facilities are limited. This case demonstrates its effectiveness in resolving dysphagia without the need for invasive procedures, ensuring timely patient care and potentially improving outcomes. Further research is warranted to validate the safety and efficacy of this approach, particularly in emergency care settings, to expand therapeutic options and enhance patient management strategies for EFI. Creator An entity primarily responsible for making the resource Danusha Sanchez, Raghav Gupta, Su yang Zhao Source A related resource from which the described resource is derived Ibrahim, H. A. K. (Ed.). (2024). Abstract and Poster Presentations Book: 3rd Emergency Physician’s International Conference (EPIC24), 10 July 2024. From Zero to Hero Medical Education LTD Publisher An entity responsible for making the resource available From Zero to Hero Medical Education LTD Date A point or period of time associated with an event in the lifecycle of the resource 10 July 2024. Contributor An entity responsible for making contributions to the resource Sri Wahyuni Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource English Type The nature or genre of the resource Text https://repository.horizon.ac.id/files/original/c3d6478f25a1f3cac1fb18b006ccfec3.pdf 115560defac3c2c1413139042e32a551 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Prosiding 3rd Emergency Physician's International Conference Contributor An entity responsible for making contributions to the resource Sri Wahyuni Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Using clinical photographs to improve dermatological care in the acute setting (E-Poster Presentations) Subject The topic of the resource clinical photographs, dermatological care, acute setting Description An account of the resource Introduction/ Objective The Dermatology team at our NHS DGH Trust requests that every inpatient e-referral to Dermatology, is accompanied by a clinical photo. Our Quality Improvement Project focuses on improving the referral system, by ensuring it is user-friendly and effective with the aim of reducing the time taken for specialist advice, ultimately improving patient care. Methods Using a Plan-Study-Do-Act (PDSA) methodology, we undertook a baseline audit of the electronic referrals sent to the Dermatology department over a 2-month period. We applied an exclusion and inclusion criteria. We used Microsoft excel to undertake our data analysis. We then created a survey and collected the responses from both junior doctors and the Dermatology team, so we could ensure our interventions were tailored to the needs of both the users and the team receiving the electronic referrals. As a result of our baseline audit, we worked with both IT and Dermatology to introduce a system called MedXnote, this a software within the Microsoft Teams app. It enables photographs to be taken safely within the app on a personal device, without saving to the device. These photos then upload directly to EDMS, a system which is already used in this hospital for Echocardiogram reports, which all members of the MDT can access via the online documentation system. We undertook a teaching session, created a user guide which was circulated by posters on the wards, e-mail and published on the Trust Intranet. Initial Results of Baseline Audit Our junior doctor survey identified issues with data governance and confidentiality within the current process of uploading clinical photos to e-referrals. Further to this, we found 67% of junior responses stated there could be a delay in completing dermatology referrals due to difficulties in attaching photos. Within the baseline audit undertaken over a 2 month period, only 45% of referrals were accompanied by a clinical photo. Having a photo attached was shown to significantly reduced the time taken for specialist advice to be given. Conclusions We will be undertaking our 2nd cycle of data collection post-intervention, to review the effectiveness of our initial interventions. The ability to attach clinical photos to a patient’s electronic referrals, has the scope to improve patient care, by acting as an efficient triage tool for referrals, providing virtual advice where possible and highlighting the need for an urgent face-to face review when required. Medxnote has potential to be utilised in the Acute setting to expedite advice, including discharge where appropriate and providing continuity between the MDT. Creator An entity primarily responsible for making the resource Dr Emily Taylor, Dr Nikita Cliff-Patel Source A related resource from which the described resource is derived Ibrahim, H. A. K. (Ed.). (2024). Abstract and Poster Presentations Book: 3rd Emergency Physician’s International Conference (EPIC24), 10 July 2024. From Zero to Hero Medical Education LTD Publisher An entity responsible for making the resource available From Zero to Hero Medical Education LTD Date A point or period of time associated with an event in the lifecycle of the resource 10 July 2024. Contributor An entity responsible for making contributions to the resource Sri Wahyuni Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource English Type The nature or genre of the resource Text https://repository.horizon.ac.id/files/original/a8c5bd328adaebd5e5c3d35ee3e1d240.pdf 115560defac3c2c1413139042e32a551 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Prosiding 3rd Emergency Physician's International Conference Contributor An entity responsible for making contributions to the resource Sri Wahyuni Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Can Multidisciplinary In-Situ Simulation be a useful tool in low-resource settings to identify and correct latent errors in the management of adult emergencies? (E-Poster Presentations) Subject The topic of the resource Multidisciplinary In-Situ Simulation, adult emergencies Description An account of the resource Introduction Emergency medicine is an emerging field in many areas of sub-Saharan Africa. The majority of emergency care is provided by nurses and intern doctors with little formal training in emergency medicine. In-situ simulation takes place in the clinical area with the on-duty healthcare team. It provides an opportunity to address key learning points and expose hidden system and environmental flaws, termed latent errors. The purpose of our study was to implement a programme of regular in-situ simulation and demonstrate its effectiveness as a practical method for the proactive detection and correction of latent errors. Methods In a semi-urban Emergency Department in Northern Uganda, healthcare professionals responded to 8 unanticipated simulated adult emergencies. Each simulation lasted approximately 20 minutes followed by debriefing. A standardised debriefing template was completed, documenting clear action points to address identified errors. The primary outcome measure was the number and type of latent errors identified, which were later scored on a predefined risk matrix. Proposed solutions and implemented changes were tracked. Results Throughout 8 simulations we identified 61 latent errors, an average of 7.6 per simulation. These latent errors were categorised, with the majority (63%) being related to education and training, followed by equipment (13%) and communication (13%) issues. When scoring these on a risk matrix 18 were classified as ‘high risk’ and 43 as ‘catastrophic risk’. Discussion Since emergency care is a relatively new speciality in Uganda, it is to be expected that most latent errors were related to education/training. Owing to the lack of up-to-date local guidelines, decisions around best-practice in this setting was often at the discretion of the facilitator. A good understanding of local resources and flexibility in selecting latent errors was necessary. Judging performance against expected high-resourced standards risked identifying errors that cannot be influenced by staff resulting in de-motivation. Time constraints limited discussion of all errors, hence only those that had the potential to be influenced and required urgent intervention were highlighted, explaining why all latent errors identified fell into ‘high’ and ‘catastrophic’ risk categories. Conclusion Regular in-situ simulations can provide a method to identify and correct latent errors. This can be particularly beneficial when emergency care centres are still in their infancy to prompt continual development. Whilst providing training remained a core element of the scenarios, subsequent actions led to the improvement of protocols, resources and fostered a culture of team�learning, accountability and quality improvement, ultimately improving patient care. Creator An entity primarily responsible for making the resource Emma Ridings Source A related resource from which the described resource is derived Ibrahim, H. A. K. (Ed.). (2024). Abstract and Poster Presentations Book: 3rd Emergency Physician’s International Conference (EPIC24), 10 July 2024. From Zero to Hero Medical Education LTD Publisher An entity responsible for making the resource available From Zero to Hero Medical Education LTD Date A point or period of time associated with an event in the lifecycle of the resource 10 July 2024. Contributor An entity responsible for making contributions to the resource Sri Wahyuni Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource English Type The nature or genre of the resource Text