Related Articles

Can a Bayesian approach clarify if corticosteroids are beneficial for severe community-acquired pneumonia?

Despite advances in the antimicrobial treatment of sepsis and organ support in the intensive care unit (ICU), community-acquired pneumonia (CAP) remains a leading cause of mortality and disability-adjusted life years lost globally.1 Severe CAP, where CAP becomes complicated by acute hypoxaemic respiratory failure or shock, is also the most...

Corticosteroids in critically ill patients with community-acquired pneumonia: A systematic review and Bayesian meta-analysis

Community-acquired pneumonia (CAP) is a common cause of hospital mortality. Each year, in the US alone, more than 1.5 million pneumonia patients are hospitalised, and 1 in 3 of them die within 1 year.1 Mortality is the highest among patients requiring organ support in the intensive care unit (ICU)....

Emergency department falls interventions improve osteoporosis management in frail older adults

Dear Editor, Singapore’s population is ageing rapidly and by 2030, around 1 in 4 citizens will be aged 65 and above.1 Older adults represent 21–40% of emergency department (ED) users and proportionally are the highest users of ED services.2 One-third of community dwellers over 65 years of age fall each year,...

Transitional care strategies at emergency department for elderly patients: A multicentre study in Singapore

In Singapore, greater efforts are being directed towards developing an integrated health and social ecosystem under the new Healthier SG strategy announced by the Ministry of Health. This life-course approach aims to promote overall healthier living in collaboration with key community partners (e.g. intermediate and long-term care service providers)...

Safety and effectiveness of nitrous oxide procedural sedation in a paediatric emergency department

Dear Editor, Nitrous oxide (N2O) produces dissociative euphoria, amnesia and analgesia, and is a common sedative for procedural sedation in paediatric emergency departments (EDs) due to its non-parenteral administration and good safety profile.1-3 Suitable procedures include fracture reduction, toilet and suturing, incision and drainage, and application of burn dressings. The...

Clinical characteristics of macrolide-resistant Mycoplasma pneumoniae infections among hospitalised children in Singapore

Dear Editor, Mycoplasma pneumoniae has become the leading cause of paediatric community-acquired pneumonia in countries where pneumococcal vaccination is included in the national immunisation programme, including Singapore.1 M. pneumoniae is intrinsically resistant to beta-lactams due to the absence of cell walls. Macrolides, tetracyclines, and fluoroquinolones are used to treat M....

Activating Code Crimson in the emergency department: Expediting definitive care for trauma patients with severe haemorrhage in Singapore

Public healthcare institutions (PHIs) in Singapore have a range of policies and guidelines for the management of patients presenting to the emergency department (ED) with blunt or penetrating major trauma. “Trauma team activation” is initiated by the ED specialist through the hospital call-centre, and is a process that mobilises...

Frequent attenders to multiple emergency departments in Singapore

The problem of overcrowding, of which access block is one of the main causes, continues to plague emergency departments (EDs) worldwide.1 Some of its negative effects include adverse impact on patient safety, medical errors and staff burnout. In addition, high volume of patients waiting to be seen (ED input)...

Determinants of emergency department utilisation by older adults in Singapore: A systematic review

Older adults in Singapore contribute to a disproportionately higher number of visits to the emergency department (ED), mirroring trends around the world.1,2 For instance, hospital admissions among those aged ≥65 years have been on the rise from 2018 to 2020, contributing a growing burden to ED services over the...

The Acute Presentation of Pulmonary Thromboembolism: A Retrospective Viewpoint

Pulmonary thromboembolism (PE) has historically been considered a rarity in the Asian population. Although well studied in the West, Asian literature on this condition has been sporadic. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

When the Stork Arrives Unannounced – Seven Years of Emergency Deliveries in a Non-obstetric General Hospital

Emergency department (ED) deliveries are uncommon in the Singapore setting, as patients presenting with labour to the ED are sent to the obstetric suites in Kandang Kerbau Women’s and Children’s Hospital (KKH), National University Hospital (NUH) and Singapore General Hospital upon arrival. The same applies to the various private...

Observational Study to Determine Factors Associated with Blood Sample Haemolysis in the Emergency Department

Haemolysis of blood samples leads to inaccurate results and often necessitates a repeat sample. Escalating workloads and finite resources are an increasing problem in many Emergency departments (EDs), where many conditions have time-dependent outcomes, and accurate and quick blood results are thus important. This article is available only as a...

Factors Affecting the B-Type Natriuretic Peptide Levels in Stroke Patients

The term “stroke” comprises all diseases in which a region of the brain is transiently or continuously affected by ischaemia or haemorrhage, and/or in which there are pathologies in the vessels nourishing the brain. Besides being a serious health problem due to its high mortality and morbidity, stroke is...

Herpes Zoster as a Useful Clinical Marker of Underlying Cell-mediated Immune Disorders

Herpes zoster (HZ) occurs when latent virus in the dorsal-root ganglia becomes reactivated and causes a vesicular and often painful rash with a dermatomal distribution. The rash may be followed by severe neuralgia that lasts for weeks or even months. An unknown triggering mechanism possibly caused by declining or...

An Observational, Prospective Study to Determine the Ease of Vascular Access in Adults Using a Novel Intraosseous Access Device

Intravascular access is a vital component of emergency care and resuscitation. There is nothing more frustrating for the emergency physician than the inability to administer fluids or medications just because of the inability to obtain intravascular access. Rapidly securing vascular access will allow for the administration of fluids, pressor...

External Validation of the Cham Score for Ordering of Blood Cultures in Emergency Department Patients with Non-Hospital Acquired Pneumonia

Some guidelines currently promote the taking of blood cultures in patients admitted to hospital with non-hospital acquired pneumonia in order to identify pathogens and guide therapy. Previous studies have reported that the proportion of patients returning a true positive blood culture is between 2.1% and 9%. False positive cultures...

Attendance for ischaemic stroke before and during COVID-19 lockdown in Singapore

The coronavirus disease 2019 (COVID-19) outbreak has impacted healthcare systems worldwide. Globally, visits to the emergency department have fallen as much as 25% during COVID-19-related lockdowns. Notably, there have been reports that patients with acute emergencies such as strokes and heart attacks are either not seeking treatment, or are...

Decrease in emergency department attendances during COVID-19 especially in school-going children

Health-seeking behaviour varies during a pandemic. Early reports have suggested reduced attendances at emergency departments (EDs), especially in paediatric patients and in patients with minor ailments, but these observations have yet to be evaluated in Singapore. We investigated ED attendances during the coronavirus disease 2019 (COVID-19) pandemic in Singapore. This...