20 10 248 https://repository.horizon.ac.id/files/original/43dc1ca101ba98224fcb75dbf15d87aa.pdf aa27a3de99ca47d9b2e98aff0f84d10c 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 Volume 18 Issue 1 2025 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 Predictive value of venous bicarbonate levels for survival to hospital discharge in out-of- hospital cardiac arrest patients Subject The topic of the resource Out-of-hospital cardiac arrest, Metabolic acidosis, Venous bicarbonate levels, Survival, Resuscitation strategies Description An account of the resource Abstract Background Acid-base disturbances significantly impact cardiac function and prognostic outcomes in cardiac arrest. Previous studies have highlighted the correlation between pH levels from arterial blood gas (ABG) analyses during cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest (OHCA) and survival outcomes. However, ABG measurements are often impractical in resource-limited settings. This study explores the relationship between serum bicarbonate levels and survival outcomes in patients with OHCA. Methods This retrospective cohort study examined patients with OHCA who presented at Srinagarind Hospital (Thailand) between 2015 and 2021. We analyzed venous bicarbonate levels and other laboratory markers (Na+, K+, BUN, Creatinine). Demographic and clinical data were extracted from electronic medical records. The primary objective was to assess the association between venous bicarbonate levels and survival and to determine the optimal cutoff values for predicting survival in these patients. Results Of the 461 identified patients, 19% survived hospital discharge. Survivors exhibited higher bicarbonate and BUN levels but lower potassium levels. Bicarbonate levels≥12.6 demonstrated a sensitivity of 74% and specificity of 47%, with an 88.44% negative predictive value (NPV) for survival. A sensitivity analysis, which reclassified patients who left against medical advice as non-survivors, revealed that a bicarbonate cutoff of 13.9 mmol/L yielded the best predictive value, with a sensitivity of 93.8% and a specificity of 52.1%. Factors associated with increased survival included BUN≥19.5, bicarbonate≥12.6, private transport, and initial PEA or VT/VF rhythms, while potassium≥5.1 decreased survival likelihood. Conclusion Bicarbonate levels, particularly with a threshold greater than 12.6 mmol/L, may be effective prognostic indicators. Other factors influencing survival include BUN, potassium levels, private transport, and initial cardiac rhythm. These insights can help clinicians improve resuscitation strategies and prognosis assessment, especially in resource-limited settings. Creator An entity primarily responsible for making the resource Pariwat Phungoen1 , John M. O’Donnell2,3, Jirat Tosibphanom1 , Praew Kotruchin1 , Thummasorn Phurisetthasak1 and Thanat Tangpaisarn1* Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-00851-1 Date A point or period of time associated with an event in the lifecycle of the resource 2025 Contributor An entity responsible for making contributions to the resource Peri Irawan 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 Out-of-hospital Cardiac Arrest https://repository.horizon.ac.id/files/original/aac8ac7d31a5975a870db1760f85c01f.pdf f4e540c6e121bfe3ad108f4648cd3635 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 Volume 18 Issue 1 2025 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 comparison of SIEVE, SORT, and START triage training effectiveness between immersive interactive 3D learning materials using virtual reality (VR-SSST) and traditional methods in mass casualty incidents Subject The topic of the resource Virtual reality, Disaster triage, Sieve triage, Sort triage, Start triage, Mass casualty incidents, ARCS model Description An account of the resource Abstract Introduction Disaster triage is a crucial competency for paramedics. Traditional training methods, such as lectures and tabletop exercises (TTx), may not provide immersive and high-pressure experience necessary for optimal skill development. Virtual reality (VR) is innovative, allowing trainees to engage in realistic triage simulations in a controlled, interactive environment. Objective The study aimed to compare the effectiveness of VR-based triage training and traditional methods by assessing knowledge, learner motivation, and practical skills through pre-and post-tests, the ARCS model, and live simulations. Methods This method-oriented, randomized study was conducted over a 2-week intervention among 83 paramedic students and compared traditional lecture-based (n=41) with VR-based (n=42) training for MCI triage education among paramedic students at the Faculty of Medicine, Ramathibodi Hospital, Mahidol University. Both groups attended lectures. Knowledge was assessed through validated pre- and post-tests in four domains: memory, comprehension, application and analysis. Learner motivation was evaluated using the ARCS model (Attention, Relevance, Confidence, Satisfaction), and practical skills were measured during live simulations, assessing time use and a validated accuracy score that included triage steps, proper sequencing, and the correctness of triage judgment. Results Both groups demonstrated significant improvements in post-test knowledge scores. The VR group scored higher across all ARCS model dimensions: attention (4.78 vs. 4.17, p<0.001), relevance (4.79 vs. 4.37, p<0.001), confidence (4.74 vs. 4.24, p<0.001), and satisfaction (4.71 vs. 4.34, p<0.001). In the practical triage assessment, the VR group achieved higher accuracy in SORT triage (14.39 vs. 12.09, p=0.001) than the traditional group. Creator An entity primarily responsible for making the resource Kritsada Chumvanichaya1 , Chaiyaporn Yuksen1 , Promphet Nuanprom2 and Kasamon Aramvanitch1* Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-00850-2 Date A point or period of time associated with an event in the lifecycle of the resource 2025 Contributor An entity responsible for making contributions to the resource Peri Irawan 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 Virtual reality, Disaster triage, Sieve triage, Sort triage, Start triage, Mass casualty incidents, ARCS model https://repository.horizon.ac.id/files/original/e53ec7ea40a8d559b0457f93cd47655d.pdf 98211ba83937a7765530ca81606b9895 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 Volume 18 Issue 1 2025 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 survey of emergency medicine physicians’ knowledge, attitude, and practice towards esophagogastric variceal bleeding Subject The topic of the resource Emergency physicians, Esophagogastric variceal bleeding, Knowledge, Attitude, Practice Description An account of the resource Abstract Background Esophageal-gastric variceal bleeding (EVB) is one of the leading causes of mortality in patients with cirrhotic portal hypertension. Rapid, accurate, and effective emergency care is crucial for successful patient outcomes. Aims This study aims to evaluate the knowledge, attitudes, and practices of Chinese emergency physicians regarding EVB, with the goal of improving the diagnosis and treatment of gastrointestinal bleeding in emergency settings. Methods A self-designed questionnaire based on clinical guidelines was developed to assess EVB knowledge, attitudes, and practices of Chinese emergency physicians in treating EVB. An online survey was conducted among emergency physicians nationwide. Data were analyzed using descriptive statistics and correlation analysis. Results The knowledge score for EVB was 11.2±3.5 (total score was 22), indicating a relatively low level of understanding. Statistically significant differences in knowledge scores were observed across hospital grades, educational backgrounds, years of experience, professional titles, and participation in relevant training programs (P<0.05). The mean attitude score for EVB was above 4 (total score was 5), reflecting a generally positive attitude among physicians. In terms of practices, the score for treatment behavior of EVB was 2.7±1.2, and behavior was positively correlated with knowledge and attitude (P<0.05). Conclusion Chinese emergency physicians demonstrate a low level of knowledge about EVB treatment, although their attitudes remain positive. Their clinical practices in EVB management are also insufficient. Enhancing education on EVB and standardizing treatment protocols are necessary to improve patient outcomes. Keywords Emergency physicians, Esophagogastric variceal bleeding, Knowledge, Attitude, Practice Creator An entity primarily responsible for making the resource Zhenzhen Gao1†, Yusong Gao2†, Shuai Ma1 , Tianpeng Zhang3 , Junyuan Wu1 , Shubin Guo1 and Xue Mei1* Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-00849-9 Date A point or period of time associated with an event in the lifecycle of the resource 2025 Contributor An entity responsible for making contributions to the resource Peri Irawan 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 Emergency physicians, Esophagogastric variceal bleeding, Knowledge, Attitude, Practice https://repository.horizon.ac.id/files/original/11dc45d851c0accca1d7780c8d452f28.pdf 78d65d9f3461e309ce37edd699e1189e 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 Volume 18 Issue 1 2025 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 comparison of outcomes between transferred patients versus patients wh o presented directly to the emergency department with necrotizing fasciitis Subject The topic of the resource Necrotizing fasciitis, Operative report, Soft tissue infection, Cellulitis, Skin abscess Description An account of the resource Abstract Introduction Necrotizing Fasciitis (NF) is a rare life-threatening bacterial infection that necessitates emergent resuscitation and operative intervention. Most of the literature has emphasized the need for early surgical intervention. This is problematic for patients being treated at a facility lacking surgical support, with concerns for increasing mortality and morbidity rates. Methods This is a 10-year retrospective study of emergency department (ED) documentation and surgical operative reports of patients seen at Arrowhead Regional Medical Center from January 1, 2011, to December 31, 2020. The patients were divided into two groups: the Transfer Group (TG), consisting of those transferred from another facility, and the Direct Admit Group (DAG), comprising those who presented directly to the ED. A comparison was conducted to identify statistically significant differences between the 2 groups of patients with a final diagnosis of NF, with specific emphasis on mortality rate, hospital length of stay (LOS), and intensive care unit (ICU) LOS. Results A total of 134 patients with a confirmed diagnosis of NF were included in the final analysis. More than half (50.8%, n=68) of the patients presented as transfers from area hospitals. Compared to the DAG, the TG had a significantly higher percentage of patients undergoing surgical intervention within six hours of ED presentation (95.6% vs. 10.6%, respectively; p<0.0001). The TG had a lower mortality rate compared to the DAG (11.8% vs. 22.7%), though the difference did not reach statistical significance. There was no statistically significant difference in hospital LOS (13 days vs. 13.5 days, p=0.9046) or ICU LOS (3 days for both groups, p=0.4845) between these two groups. Conclusion Aggressive management with broad-spectrum antibiotics and intravenous fluid resuscitation may mitigate the effect on mortality in patients with necrotizing fasciitis when prompt surgical intervention is not available. Keywords Necrotizing fasciitis, Operative report, Soft tissue infection, Cellulitis, Skin abscess Creator An entity primarily responsible for making the resource Michael M. Neeki1,2,3*, Fanglong Dong1,2,3, Louis Tran1,2,3, Aldin Malkoc1,2,3, Joseph Kim1,2,3, Sarah C. Neeki1,2,3, Suraj Patel1,2,3, Niluk Leon Senewiratne1,2,3, Mariel Ma1,2,3, Cynthis Wong1,2,3, Rodney Borger1,2,3 and David Wong1,2,3 Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-00848-w Date A point or period of time associated with an event in the lifecycle of the resource 2025 Contributor An entity responsible for making contributions to the resource Peri Irawan 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 Necrotizing fasciitis, Operative report, Soft tissue infection, Cellulitis, Skin abscess https://repository.horizon.ac.id/files/original/658918b7995a28361f9a594bbb6c5a05.pdf 76b2ef7de99325b1d7d27d989c4dd8ad 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 Volume 18 Issue 1 2025 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 Critical revisits after discharge from the emergency department Subject The topic of the resource Revisits, Triage, Patient safety, Ed administration Description An account of the resource Abstract Aims Emergency department (ED) revisits within 72 h is a standard quality measure for emergency care but most revisits are managed and discharged. However, a sub-group of revisits are due to clinical deterioration resulting in admissions to higher acuity care or even mortality. We aimed to identify these critical revisits and their associated risk factors. Identification of these factors would allow development of strategies to reduce incidence of post discharge deterioration. Methods A retrospective cohort study was conducted on all patients who had a revisit within 72 h of discharge from the ED of a tertiary hospital in Singapore from 2008 to 2020. Deidentified data were extracted from the electronic health records (EHR). We identified critical revisits, defined as a revisit that resulted in death or admission to Intensive Care Unit or High Dependency. These patients were compared to patients who had a revisit that resulted in discharge or admission to general ward. The main outcome was the rate of critical revisit. We also determined the commonest index and critical revisit ED diagnosis as well as factors associated with critical revisits. Results Out of 1,057,533 discharges from the ED over the study period, 44,506 (4.2%) had a revisit within 72 h, of which 1321 (0.12%) were critical revisits. Adjusted odds ratios from multivariable logistic regression analysis indicated that higher heart rate, higher mean arterial pressure, and several lab abnormalities were associated with critical revisits. Diagnosis categories at the initial visit with the highest contribution to the likelihood of a critical revisit included “acute cerebrovascular disease” (OR: 38.00, 95%CI: 27.04–53.39), “other gastrointestinal disorders” (OR: 3.10, 95%CI: 2.41–3.99) and “residual codes; unclassified” (OR: 2.69, 95%CI: 2.01–3.60). Conclusion Critical revisits after discharge were rare in our study population, most prevalent amongst the elderly with multiple comorbidities. Future research should focus on diagnoses at higher risk of a critical revisit to develop practical approaches to follow up these patients. Keywords Revisits, Triage, Patient safety, Ed administration Creator An entity primarily responsible for making the resource Zhenghong Liu1*†, Raziyeh Mohammadi2†, Seyed Ehsan Saffari2 , Wei Lin Tallie Chua1 , Mingwei Ng1 , Fahad Javaid Siddiqui3 and Marcus Eng Hock Ong1,4 Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-00847-x Date A point or period of time associated with an event in the lifecycle of the resource 2025 Contributor An entity responsible for making contributions to the resource Peri Irawan 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 Revisits, Triage, Patient safety, Ed administration https://repository.horizon.ac.id/files/original/945c5fbf2a53f9bd6be4998e7c7d2735.pdf 60dccca07ca1e52c6863b0e5a3d4f6c0 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 Volume 18 Issue 1 2025 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 Remifentanil use in critically Ill patients requiring mechanical ventilation is associated with increased delirium‐free days: a retrospective study Subject The topic of the resource Remifentanil, Delirium, Critical illness Description An account of the resource Abstract Intraoperative remifentanil reduces postoperative delirium incidence, unlike other opioids; however, its efficacy in medical emergencies with organ failure is unknown. We hypothesized that remifentanil use in nonoperative inten- sive care unit (ICU) patients requiring ventilatory management would improve delirium outcomes. This retrospec- tive study included 95 nonoperative patients with unplanned ICU admissions requiring ventilatory opioids. Delirium was assessed using the Intensive Care Delirium Screening Checklist. Patients were divided into remifentanil and non- remifentanil groups; statistical adjustments were made using propensity score matching and inverse probability weighting. After matching, the remifentanil group had significantly more delirium-free days (DFDs) within 14 days than the non-remifentanil group (8 [5–11] vs. 5 [3–9], p<.001). Adjusted multivariate analysis showed that DFD was significantly increased in the remifentanil group (Odds ratio=2.639 [95% CI 1.279–5.445]; p=0.009). Remifentanil use in nonoperative ventilated ICU patients may reduce delirium duration. Keywords Remifentanil, Delirium, Critical illness Creator An entity primarily responsible for making the resource Junpei Haruna1 , Aki Sasaki2 and Satoshi Kazuma1* Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-00846-y Date A point or period of time associated with an event in the lifecycle of the resource 2025 Contributor An entity responsible for making contributions to the resource Peri Irawan 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 Remifentanil, Delirium, Critical illness https://repository.horizon.ac.id/files/original/951c0b791a53f3b3179f167f9132ae6a.pdf c3adcfa2de44d831ea391a5facbf8cc1 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 Volume 18 Issue 1 2025 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 Posterior STEMI presenting as painless, isolated left arm numbness and weakness: a case report Subject The topic of the resource case describes an atypical presentation of isolated posterior Description An account of the resource Abstract This case describes an atypical presentation of isolated posterior ST-segment elevation myocardial infarction (STEMI), who presented with left arm numbness and weakness, mimicking an acute stroke. Diagnosis was confirmed with coronary angiogram showing occlusion in proximal left circumflex artery, as well as rise in troponin. This atypical presentation highlights the importance of maintaining high index of suspicion and casting a wide net of differential diagnoses in initial assessment of patient in the emergency department. Creator An entity primarily responsible for making the resource Annisa Dewi Utami Rakun1* and Mathew Yi Wen Yeo1 Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-00845-z Date A point or period of time associated with an event in the lifecycle of the resource 2025 Contributor An entity responsible for making contributions to the resource Peri Irawan 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 case describes an atypical presentation of isolated posterior https://repository.horizon.ac.id/files/original/0b77cbea8bdd3e0d78bb603120b2e017.pdf 47d94a0f1aceb55926e1dc6c0d9809cb 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 Volume 18 Issue 1 2025 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 Rapid testicular salvage in the emergency department using point of care ultrasound [POCUS] Subject The topic of the resource Testicular torsion, Point-of-care ultrasound, Emergency Medicine, Manual detorsion, Urological emergency Description An account of the resource Abstract Background Testicular torsion is a time-sensitive urological emergency characterized by twisting of the spermatic cord, leading to ischaemia and, if untreated, necrosis. Young males under 25 are at the highest risk due to congenital defects like the Bell Clapper deformity. Prompt diagnosis and management are crucial. Case presentation A 30-year-old male presented with severe right testicular pain, and point-of-care ultrasound (POCUS) in the Emergency Department confirmed torsion within a few minutes upon arrival to Emergency Depart- ment. Manual detorsion restored blood flow, confirmed by bedside Doppler imaging using POCUS within 15 min of arrival. The patient underwent successful bilateral orchidopexy. Conclusion This case emphasizes the importance of early targeted emergency POCUS in recognizing and managing testicular torsion, ensuring optimal outcomes. Keywords Testicular torsion, Point-of-care ultrasound, Emergency Medicine, Manual detorsion, Urological emergency Creator An entity primarily responsible for making the resource Khaled Taha1 , Adrian Bonachera2 , Nicholas Hegarty2 , Edel Tivnan1 , Etimbuk Umana1 , Dimitris Smith Diakidis1*, Jawad Mustafa1 , Tomás Breslin1 , Bassem Alhadi1 and Erin Devlin1 Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-00844-0 Date A point or period of time associated with an event in the lifecycle of the resource 2025 Contributor An entity responsible for making contributions to the resource Peri Irawan 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 Testicular torsion, Point-of-care ultrasound, Emergency Medicine, Manual detorsion, Urological emergency https://repository.horizon.ac.id/files/original/edd719665621a4ffac6d1a77bbf26a5d.pdf 87572cb1267e6911d5445359d87cf63f 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 Volume 18 Issue 1 2025 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 Tension pneumothorax from large bowelherniation and perforation as a late presentation of traumatic diaphragmatic hernia during pregnancy: a case report Subject The topic of the resource Diaphragmatic hernia, Large bowel perforation, Empyema, Tension pneumothorax, Pregnancy, Dyspnea Description An account of the resource Abstract Background Diaphragmatic hernias can be congenital or acquired, with trauma being the primary cause of the latter. Both types may have delayed presentations, with abdominal organs protruding into the thoracic cavity, causing symptoms of varying severity. Pregnancy can sometimes precipitate the condition. Tension pneumothorax resulting from bowel perforation into the thorax is exceptionally rare, with only a few cases reported. To the best of the authors knowledge, this is the third documented case of a late-presenting trauma-related diaphragmatic hernia during pregnancy, complicated by tension pneumothorax. Case presentation A 30-year-old woman, 29 weeks pregnant, was referred to Semmelweis University emergency department with moderate dyspnea. Initial investigation revealed tension pneumothorax. Chest tube placement released air, pus, and feces. Computer tomography identified a diaphragmatic hernia with bowel incarceration and perforation as the underlying cause. The patient underwent a delayed cesarean section and surgical repair, with a good outcome. A history of thoracic trauma eight years prior was later revealed. Conclusion Evaluating pregnant patients with shortness of breath in the emergency department is challenging. Identifying a history of thoracic or abdominal trauma is crucial, as this can raise the suspicion of diaphragmatic hernia, which can present with a wide range of symptoms. Spontaneous tension pneumothorax in pregnant women is extremely rare and requires cautious management. A multidisciplinary approach is crucial for the successful treatment of maternal diaphragmatic hernia. Keywords Diaphragmatic hernia, Large bowel perforation, Empyema, Tension pneumothorax, Pregnancy, Dyspnea Creator An entity primarily responsible for making the resource Ákos Sóti1*, Gábor Nagy1 , Zoltán Győri2 , Tamás Vass3 , László Hetzman1 , Bánk Gábor Fenyves1 and Csaba Varga1 Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-00843-1 Date A point or period of time associated with an event in the lifecycle of the resource 2025 Contributor An entity responsible for making contributions to the resource Peri Irawan 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 Diaphragmatic hernia, Large bowel perforation, Empyema, Tension pneumothorax, Pregnancy, Dyspnea https://repository.horizon.ac.id/files/original/2b6016f845f2f2a038915eae58c84846.pdf 5f4ef8c123422cf3de5017db5cfa997c 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 Volume 18 Issue 1 2025 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 Tension pneumothorax from large bowel herniation and perforation as a late presentation of traumatic diaphragmatic hernia during pregnancy: a case report Subject The topic of the resource Diaphragmatic hernia, Large bowel perforation, Empyema, Tension pneumothorax, Pregnancy, Dyspnea Description An account of the resource Abstract Background Diaphragmatic hernias can be congenital or acquired, with trauma being the primary cause of the latter. Both types may have delayed presentations, with abdominal organs protruding into the thoracic cavity, causing symptoms of varying severity. Pregnancy can sometimes precipitate the condition. Tension pneumothorax resulting from bowel perforation into the thorax is exceptionally rare, with only a few cases reported. To the best of the authors knowledge, this is the third documented case of a late-presenting trauma-related diaphragmatic hernia during pregnancy, complicated by tension pneumothorax. Case presentation A 30-year-old woman, 29 weeks pregnant, was referred to Semmelweis University emergency department with moderate dyspnea. Initial investigation revealed tension pneumothorax. Chest tube placement released air, pus, and feces. Computer tomography identified a diaphragmatic hernia with bowel incarceration and perforation as the underlying cause. The patient underwent a delayed cesarean section and surgical repair, with a good outcome. A history of thoracic trauma eight years prior was later revealed. Conclusion Evaluating pregnant patients with shortness of breath in the emergency department is challenging. Identifying a history of thoracic or abdominal trauma is crucial, as this can raise the suspicion of diaphragmatic hernia, which can present with a wide range of symptoms. Spontaneous tension pneumothorax in pregnant women is extremely rare and requires cautious management. A multidisciplinary approach is crucial for the successful treatment of maternal diaphragmatic hernia. Keywords Diaphragmatic hernia, Large bowel perforation, Empyema, Tension pneumothorax, Pregnancy, Dyspnea Creator An entity primarily responsible for making the resource Ákos Sóti1*, Gábor Nagy1 , Zoltán Győri2 , Tamás Vass3 , László Hetzman1 , Bánk Gábor Fenyves1 and Csaba Varga1 Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-00843-1 Date A point or period of time associated with an event in the lifecycle of the resource 2025 Contributor An entity responsible for making contributions to the resource Peri Irawan 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