Objectives: To evaluate the safety and effectiveness of high-flow nasal cannula (HFNC) in patients with asthma exacerbation. Methods: PubMed, Web of Science, Scopus, Science Direct, and Clinical Key were systematically searched in April 2024 to comprise the relevant data. Comprehensive Meta-Analysis (Version 3.0) was the software used for data analyses. Results: Our results included nine studies with a total of 1,012 patients (361 in the HFNC group and 741 in the control group) and 622 (61.5%) were males (179 males in the HFNC group and 443 in the control group). A meta-analysis of three eligible comparative studies showed an overall insignificant effect with higher oxygen saturation among HFNC patients (SMD =  −0.083, 95% CI −0.768 to 0.602, and p = 0.812). The eight eligible comparative studies showed an overall insignificant longer duration of hospital stay among HFNC patients (SMD = 0.175, 95% CI −0.184 to 0.534, and p = 0.339). There is significant... Continue Reading

Objectives: To assess critically the safety and effectiveness of intranasal (IN) ketorolac in treating acute pain in both children and adults. Methods: After a comprehensive search of four databases, 1,233 pertinent papers were found. Following the Rayyan QCRI duplicate removal and relevance screening, the search produced 593 publications, 101 full-text articles of which were examined and five of which satisfied the requirements for evidence synthesis. Results: Out of the 1,417 patients in the 5 trials we included, 566 (39.9%) were men. This review provides comparable pain relief results of IN ketorolac to opioids while potentially reducing opioid use. Its administration was linked to fewer unplanned medical visits, demonstrating effective pain control. In pediatric migraine, it showed similar efficacy to intravenous (IV) ketorolac, offering a non-invasive alternative. For renal colic, it provided comparable relief to IV ketorolac and fentanyl, supporting its use in emergency care. In postoperative patients, it significantly reduced... Continue Reading

Background: Clinical laboratory services (CLSs) are essential in emergency care for diagnosis and treatment. However, misuse can result in false positives and increased costs. This study explored CLS utilization patterns in a tertiary academic Emergency Department (ED). Methods: A retrospective observational study analyzed data from 8,407 patients visiting the ED of a tertiary university hospital between January and September 2024. A total of 19,486 emergency visits and 47,951 laboratory test orders were reviewed to explore the relationship between test ordering patterns and utilization rates per patient visit. Results: The average number of test orders per patient was 5.7, with an average of 2.46 orders per visit. Female patients had more ED visits (52.8%) and test orders (53.54%) than males (47.2%; 46.46%). The differences in visits and test orders between genders across test categories were statistically significant (p < 0.0001). The average test orders per visit were slightly higher for females... Continue Reading

Background: Neuroimaging plays a critical role in the evaluation of patients presenting with new-onset seizures. This study aimed to explore the epidemiological characteristics of patients presenting to the emergency department (ED) with first-time seizures. Methods: This was a single-center, retrospective cohort study, utilizing data extracted from the electronic hospital system for adult patients who presented with new-onset seizures over a 5-year period. Results: The study included 323 patients (61% male), with a mean age of 43 years. Generalized tonic-clonic seizures were the most common seizure type (84%). Brain computed tomography (CT) scans were normal in 65% of cases, while 35% showed abnormalities, primarily post-stroke sequelae (10.5%), acute stroke (6.8%), and neoplasms (6.5%). Patients with abnormal CT findings were older and had more comorbidities. Logistic regression analysis identified age and focal seizures as significant predictors of abnormal CT findings, while a history of stroke was inversely associated. Conclusion: CT imaging identified... Continue Reading

Background: This study aimed to determine the barriers and difficulties of doing point-of-care ultrasound (POCUS) in cardiac arrest (CA) cases in the emergency department (ED). Further, to assess the awareness and appreciation of POCUS's importance and whether there was a correlation between emergency physician training and the performance of POCUS in CA. Methods: A cross-sectional study was conducted from December 2024 to February 2025 targeting all emergency physicians in various cities in Saudi Arabia. The pediatricians and obstetrics and gynecology (OB/GYNs) physicians were excluded. All selected hospitals had at least four hundred-bed capacity. Approximately 250 physicians worked in the selected centers. A Google form link to the questionnaire was sent to every participant. A response rate of 81.6% was achieved. Results: A total of 204 physicians were included in the study. Most of the participants believed in the benefits of using POCUS in CA (71.6%). Further, 85.3% of the participants... Continue Reading

Objective: This study aimed to assess whether estimations made by groups of two or three healthcare professionals were more accurate than those made by a single observer when estimating the weight of supine adult patients in the emergency department (ED). Methods: This prospective observational study was conducted in a tertiary hospital's ED in Jeddah, Saudi Arabia. Adult ambulatory patients (aged 18 years or older) were enrolled using systematic random sampling. Each patient underwent three sequential weight estimations: (1) single emergency physician, (2) physician–nurse pair, and (3) triad of physician, nurse, and another emergency provider. Observers were blinded to prior estimates and actual weight, which was measured using a calibrated hospital scale. Accuracy was defined as ±5 kg of the actual weight. Data were analyzed using repeated measures analysis of variance and Bland–Altman plots. Results: A total of 369 patients were included (52.3% female; mean age, 50.38 years). Accuracy rates were... Continue Reading

Background: The COVID-19 pandemic has significantly impacted medical practices worldwide, particularly in high-risk procedures such as endotracheal intubation. This study aimed to assess the changes in intubation practices among emergency physicians in Jeddah, Saudi Arabia, following the COVID-19 outbreak. Methods: A cross-sectional study using an online questionnaire was conducted among emergency physicians in Jeddah. The questionnaire assessed intubation preferences, comfort levels, and skill maintenance practices post the COVID-19 pandemic. Results: A total of 81 physicians completed the survey, representing a 51.5% response rate. The study revealed a substantial shift towards video laryngoscopy post-COVID-19. The percentage of physicians using video laryngoscope (VL) for more than 75% of intubations increased from 42% pre-pandemic to 65.2% post-pandemic. Concurrently, those using VL for less than 25% of cases decreased from 18.5% to 8.6%. While 69.1% of respondents reported high comfort levels with direct laryngoscopy (DL), 79% recognized the importance of maintaining DL skills. However,... Continue Reading

Background: Medical emergencies in schools require rapid and effective intervention, with teachers typically serving as first responders. However, inadequacies in first-aid expertise among school staff may threaten student safety. This study assesses the first-aid knowledge and attitudes of teachers and administrators in Jeddah, Saudi Arabia, to identify areas for improvement and inform policy recommendations. Methods: A cross-sectional survey was conducted among 367 school workers (220 female, 147 male) among public, private, and international schools in Jeddah. A validated bilingual questionnaire assessed participants' knowledge and attitudes about addressing common school emergencies, including diabetes, epilepsy, and injuries. Descriptive and inferential statistics were used for analysis. Results: While 98.9% of participants were familiar with first-aid concepts, only 49.3% had formal training. Knowledge was strongest in diabetes management (86.1% recognized hyperglycemia risks; 97% knew insulin is administered) but inadequate in epilepsy care (64.3% incorrectly believed seizures always necessitate hospitalization) and injury response (only 45.2%... Continue Reading

Background: Myocardial infarction (MI) remains a leading cause of morbidity and mortality worldwide. Early recognition of ST-elevation MI (STEMI) and prompt activation of pre-hospital percutaneous coronary intervention (PCI) are critical for improving patient outcomes. The World Health Organization defines MI based on the presence of chest discomfort, elevated troponin levels, and ECG changes. Aim: This study aimed to assess the impact of early STEMI recognition and pre-hospital PCI activation on mortality rates in Madinah, Saudi Arabia. Methods: A retrospective cohort study was conducted involving patients diagnosed with STEMI by the Saudi Red Crescent Authority (SRCA) and transported to the Madinah Cardiac Center between January 2022 and December 2023. Data were collected from hospital records, electronic patient care reports, and patient contact. Key variables included demographic data, medical history, pre-hospital interventions, time intervals (call-to-balloon [C2B], first medical contact-to-balloon [FMC2B], the time from when treatment by a healthcare provider begins to balloon... Continue Reading