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Emergency and Critical Care Medicine 2024年第1期4卷 35-38页

作者： fatimah lateef Department of Emergency Medicine Singapore General HospitalSingaporeEmergency Medicine ResidencySingHealthSingaporeDuke-NUS Graduate Medical SchoolYong Loo Lin School of MedicineNational University of Singapore and Lee Kong Chian Medical SchoolNanyang Technological UniversitySingHealth Duke NUS Institute of Medical Simulation(SIMS)SingaporeDuke NUS Global Health InstituteSingapore.

Training of emergency physicians through an emergency medicine residency program takes 5 years,that is,3 years in junior residency and 2 years in senior *** this period,residents will be exposed to a variety of educational methodologies and meet a spectrum of faculty,supervisors,and teachers,who will have different personalities,styles,and approaches to teaching and nurturing *** is important to ensure the maintenance of psychological safety for these residents throughout their training journey and into the future years of practice s an emergency ***,interactions(which involve questioning),and presentations will be an important part of this training *** article looks at two modes of questioning:advocacy inquiry and circular questioning,which can be applied as *** two methods are examples in which faculty may consider adopting in their many interactions,follow-up,feedback,tutorials,facilitation,partnerships,and counseling sessions with *** two techniques offer options to maintain psychological safety,which can facilitate learners sharing and opening *** can be included in the faculty’s armamentarium of questioning techniques and applied where applicable.

关键词： Advocacy Circular questions Emergency medicine Inquiry Residents

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World Journal of Emergency Medicine 2024年第4期15卷 256-262页

作者： Jie Er Janice Soo Yuan Helen Zhang Gek Hsiang Lim fatimah lateef Department of Emergency Medicine Singapore General HospitalSingapore 168753Singapore Health Services Research Unit Singapore General HospitalSingapore168753Singapore

BACKGROUND:This study aimed to review bicycle-related injuries during the COVID-19 pandemic to assist with reinforcement or implementation of new policies for injury ***:This is a retrospective descriptive analysis of injuries sustained during cycling for patients 18 years old and above who presented to Singapore General Hospital from January to June *** records were reviewed and *** analyses were used to summarize patient characteristics,and differences in characteristics subgrouped by triage acuity and discharge status were ***:The study included 272 patients with a mean age of 43 years and a male predominance(71.7%).Most presented without referrals(88.2%)and were not conveyed by ambulances(70.6%).Based on acuity category,there were 24(8.8%)Priority 1(P1)patients with 7 trauma activations,174(64.0%)and 74(27.2%)P2 and P3 patients *** most common injuries were fractures(34.2%),followed by superficial abrasion/contusion(29.4%)and laceration/wound(19.1%).Thirteen(4.8%)patients experienced head injury and 85 patients(31.3%)were documented to be wearing a *** majority occurred on the roads as traffic accidents(32.7%).Forty-two patients(15.4%)were admitted with a mean length of stay of 4.1 d and 17(6.3%)undergone surgical *** of 214(78.7%)discharged patients,no re-attendances or mortality were *** the subgroup analysis,higher acuity patients were generally older,with higher proportions of head injuries leading to ***:Our study highlights significant morbidities in bicycle-related *** is also a high proportion of fractures in the young healthy male *** prevention is paramount and we propose emphasizing helmet use and road user safety.

关键词： Cycling Injuries Emergency department

The Relationship between ABO Blood Group Type and the COVID-19 Susceptibility in Qatif Central Hospital, Eastern Province, Saudi Arabia: A Retrospective Cohort Study

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Open Journal of Internal Medicine 2020年第2期10卷 232-238页

作者： Ghada Ali Aljanobi Alya Hassan Alhajjaj fatimah lateef alkhabbaz Jumana Mansour Al-Jishi Internal Medicine Department Qatif Central Hospital Qatif KSA

Introduction: It has been found that the viral infection is linked to the ABO blood group. Limited studies investigated the relationship of the ABO blood group and susceptibility to COVID-19 infection. Objective: To investigate the association between the ABO blood group and the COVID-19 susceptibility. Material & Methods: The study is a retrospective cohort study. It included all hospitalized confirmed COVID-19 patients in Qatif central hospital, Eastern province, Saudi Arabia. We included both genders and people who are older than 14 years of age. The study was conducted in the period between 15th March, and 15th April, 2020. Results: Our sample consists of 72 patients;we found a percentage distribution of 23.62%, 33.33%, 9.72%, and 33.33% for blood groups A, B, AB and O, respectively. Our results showed significantly increased risk for AB blood groups (P Conclusion: Our findings suggest that among confirmed COVID-19 patients, patients with AB blood group have higher susceptibility while patients with O blood group have lower susceptibility to COVID-19 infection. Our study has limitations and further studies are needed.

关键词： ABO Group Saudi Qatif COVID-19

Psychological and Mental Health among Isolated Hospitalized Suspected and Confirmed COVID-19 Patients, Qatif Central Hospital, Eastern Province, Saudi Arabia: A Single-Center Descriptive Study

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Open Journal of Internal Medicine 2020年第3期10卷 245-255页

作者： Alya Hassan Alhajjaj Taaweel Hussain Al Abduljaber Zainab Ali Alsadeq fatimah lateef alkhabbaz Hoor Hussain Alobaidan fatimah Ali Al Saeed Jumana Mansour Al-Jishi Ghada Ali Aljanobi Internal Medicine Department Qatif Central Hospital Al Qatīf Saudi Arabia Psychiatry Department Erada Complex for Mental Health Al Dammam Saudi Arabia

Introduction: During COVID-19 pandemic, isolation and quarantine as preventive measures have been implemented. Isolation is often a bad experience for isolated people and it could affect the psychological and mental health. Objectives: To study the impact of isolation on the psychological and mental health of isolated hospitalized suspected and confirmed COVID-19 patients. Material & Methods: A single-center cohort, descriptive survey involving isolated confirmed and suspected COVID-19 patients in Qatif central hospital, Eastern province, Saudi Arabia. The study was conducted between March 22 and April 18, 2020. Information was collected through an online Arabic-language questionnaire. Our sample included both male and female. Anxiety and depression symptoms during hospitalization were evaluated with the Hospital Anxiety and Depression Scale. Results: A total of 52 questionnaires were returned completed. The majority of the respondents were females (65.4%). Most of the participants were less than 60 years of age (90.4%). Three patients were known to have previous mental illness. About two-thirds of the participants were isolated in shared rooms. The duration of isolation was less than 10 days in 72.3% of our sample. Borderline and abnormal scores for depression and anxiety were observed in about 38.4%, and 17.3% of patients, respectively. Three patients had both abnormal depression and anxiety scores. Conclusion: Isolation for contagious infections such as COVID-19 could cause severe psychological health problems, though this was not supported by our study due to the small sample size. Further studies are needed to address this important issue which results from isolation during infectious outbreaks.

关键词： COVID-19 Psychological Isolation Qatif Saudi

Management of difficult intravenous access: a qualitative review

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World Journal of Emergency Medicine 2022年第6期13卷 467-478页

作者： Mingwei Ng Leong Kwok Fai Mark lateef fatimah Department of Emergency Medicine Singapore General Hospital

BACKGROUND: A perennial challenge faced by clinicians and made even more relevant with the global obesity epidemic, difficult intravenous access(DIVA) adversely impacts patient outcomes by causing significant downstream delays with many aspects of diagnoses and therapy. As most published DIVA strategies are limited to various point-of-care ultrasound techniques while other “tricks-of-the-trade” and pearls for overcoming DIVA are mostly relegated to informal nonpublished material, this article seeks to provide a narrative qualitative review of the iterature on DIVA and consolidate these strategies into a practical algorithm. METHODS: We conducted a literature search on PubMed using the keywords “difficult intravenous access”, “peripheral vascular access” and “peripheral venous access” and searched emergency medicine and anaesthesiology resources for relevant material. These strategies were then categorized and incorporated into a DIVA algorithm. RESULTS: We propose a Vortex approach to DIVA that is modelled after the Difficult Airway Vortex concept: starting off with standard peripheral intravenous cannulation(PIVC) techniques, progressing sequentially on to ultrasound-guided cannulation and central venous cannulation and finally escalating to the most invasive intraosseous access should the patient be in extremis or should best efforts with the other lifelines fail. CONCLUSION: DIVA is a perennial problem that healthcare providers across various disciplines will be increasingly challenged with. It is crucial to have a systematic stepwise approach such as the DIVA Vortex when managing such patients and have at hand a wide repertoire of techniques to draw upon.

关键词： Difficult intravenous access Venepuncture Vortex Peripheral intravenous cannulation

Management of difficult intravenous access:a qualitative revie

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World Journal of Emergency Medicine 2022年第6期13卷 467-478页

作者： Mingwei Ng Leong Kwok Fai Mark lateef fatimah Department of Emergency Medicine Singapore General HospitalSingapore 169608Singapore

BACKGROUND:A perennial challenge faced by clinicians and made even more relevant with the global obesity epidemic,difficult intravenous access(DIVA)adversely impacts patient outcomes by causing significant downstream delays with many aspects of diagnoses and *** most published DIVA strategies are limited to various point-of-care ultrasound techniques while other“tricks-of-the-trade”and pearls for overcoming DIVA are mostly relegated to informal nonpublished material,this article seeks to provide a narrative qualitative review of the iterature on DIVA and consolidate these strategies into a practical ***:We conducted a literature search on PubMed using the keywords“difficult intravenous access”,“peripheral vascular access”and“peripheral venous access”and searched emergency medicine and anaesthesiology resources for relevant *** strategies were then categorized and incorporated into a DIVA ***:We propose a Vortex approach to DIVA that is modelled after the Difficult Airway Vortex concept:starting off with standard peripheral intravenous cannulation(PIVC)techniques,progressing sequentially on to ultrasound-guided cannulation and central venous cannulation and finally escalating to the most invasive intraosseous access should the patient be in extremis or should best efforts with the other lifelines ***:DIVA is a perennial problem that healthcare providers across various disciplines will be increasingly challenged *** is crucial to have a systematic stepwise approach such as the DIVA Vortex when managing such patients and have at hand a wide repertoire of techniques to draw upon.

关键词： Difficult intravenous access Venepuncture Vortex Peripheral intravenous cannulation

Think muscle;Think rhabdomyolysis

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Journal of Acute Disease 2018年第5期7卷 213-216页

作者： fatimah lateef Arunima Gupta Department of Emergency Medicine Singapore General HospitalSingapore Singhealth Duke NUS Institute of Medical Simulation Singapore Dukes-NUS Graduate Medical School and Yong Loo Lin School of Medicine National University of SingaporeSingapore

Rhabdomyolysis is the breakdown of striated muscle cells resulting in leakage of cell matter into the extra-cellular *** can present with myalgia,muscle weakness and *** of passing of dark tea-coloured urine have also been *** creatinine kinase is diagnostic of *** serum myoglobin levels and presence of myoglobin in the urine (myoglobinuria) help to support the *** actiology for rhabdomyolysis can be both traumatic and *** the case of trauma,individuals with crush injuries trapped in cars or under collapsed buildings,struggling against restraints,immobilized and in the same position for hours due to injuries,comatosed states or positioning during prolonged surgeries and those with high voltage electrical injuries are at increased risk of ***-traumatic causes of rhabdomyolysis include hyperthermia,metabolic myopathies,drugs and toxins ingestions,clectrolyte abnormalities and *** mechanism of rhabdomyolysis is often *** the case of trauma,direct injury to cell membranes as well as hypoxia from direct compression leading to adenosine triphosphate depletion leads to breakdown of striated muscle cells..The lysed cells release myoglobin,creatine kinase,urate and phosphate into the *** heme protein-induced toxicity on nephrons can result in acute kidney *** report a case of traumatic rhabdomyolysis and share the latest in the literature on the understanding of the subject as well as that of *** which it is often associated with.

关键词： Rhabdomyolysis Myoglobinuria Acute kidney injury

Diagnostic value of biomarkers for sepsis in adult patients in the emergency department: Don't forget the neutrophil-lymphocyte count ratio

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Journal of Acute Disease 2019年第2期8卷 45-52页

作者： G Visveswari Bernadette Tan Qiao Min fatimah lateef Year 4 Medical Students Yong Loo Lin School of MedicineNational University of SingaporeSingapore MBBS FRCS(Edin)(A&E)FAMS(Em Med)Senior Consultant/Director of Training and EducationDepartment of Emergency MedicineSingapore General HospitalSingapore Professor Dukes-NUS Graduate Medical School and Yong Loo Lin School of MedicineNational University of SingaporeSingapore Director Singhealth Duke NUS Institute of Medical SimulationSingapore

Objective: To determine and compare the diagnostic efficiency of various biomarkers [C-reactive protein, neutrophil percentage, neutrophil-lymphocyte ratio (NLCR), lactate, procalcitonin, blood culture] in the identification of septic patients in emergency department (ED), and to assess the predictive value of combination of markers. Methods: This was a prospective, single centre study conducted in the ED of an urban, tertiary care hospital. We included patients who were admitted to the ED with symptoms of a possible infection. Blood cultures and serum measurement of the biomarkers were collected from 131 patients. Patients were determined to be septic or non-septic, based on the systemic inflammatory response syndrome criteria and the diagnosis was made at the ED. Sensitivity, specificity, positive predictive value, negative predictive value and area under curves (AUC) were calculated. Results: A total of 126 patients, 61 with sepsis and 65 without sepsis were eventually included in the study. Neutrophil to lymphocyte ratio displayed the highest accuracy in diagnosing sepsis (AUC 0.735, 95% CI=0648-0.822, P<0.001). The best combination of markers in predicting sepsis was NLCR and white blood cell (AUC: 0.801, 95% CI=0.724-0.878, P<0.001). Conclusions: The results of this small study showed that NLCR outperforms other markers in diagnosing sepsis in ED. It is readily available, cost efficient, non invasive and independent. It may be insufficient to rely on this single marker to diagnose sepsis, so some other diagnostic utilities should be taken into account as one part of the overall assessment. Our study also showed that combination of NLCR and white blood cell provides the highest diagnostic accuracy. More large scale studies across different population groups will be needed to confirm this finding.

关键词： Biomarkers Emergency department Sepsis Systemic inflammatory response to infection Neutrophil lymphocyte count ratio

The chest X ray in pulmonary embolism: Westermark sign, Hampton's Hump and Palla's sign. What's the difference?

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Journal of Acute Disease 2018年第3期7卷 99-102页

作者： Tan Si Hong Shawn Lim Xin Yan fatimah lateef Dukes-NUS Graduate Medical School and Yong Loo Lin School of Medicine National University of Singapore DirectorSinghealth Duke NUS Institute of Medical SimulationSingapore Department of Emergency Medicine Singapore General Hospital Singapore

Pulmonary embolism (PE), with the incidence of about 60 per 100000 annually, can be a life-threatening disease if it is not treated promptly. It has been estimated that some 10% of PE patients die within the first hour of the event. Untreated PE has a mortality of about 30%. PE is a condition that is treatable if suspected and diagnosed early. The chest radiograph is still the first investigation that is ordered in patients presenting with cardiorespiratory symptoms or symptoms suggestive of PE. The CXR is also helpful in identifying or excluding other conditions or diagnoses. Thus, knowing and understanding some of the more specific CXR signs can be useful. We suggest that physicians to be aware of and utilize CXR findings such as Palla's sign, Westermark sign and Hamptons hump to help with the diagnosis of PE and to exclude other conditions that can mimic venous thrombo-embolism. Even if these signs are not common, their presence, even in an unsuspected patient without a high pretest probability of PE, should prompt further investigations such as a D-dimer test, lung scintigraphy or computed tomography pulmonary angiography as required.

关键词： Pulmonary embolism Palla's sign Hamptom's Hump Westermark sign