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  1. Article: Rauchgasinhalation

    Berner, Marcel / Mansella, Gregory

    Notaufnahme up2date

    2022  Volume 04, Issue 01, Page(s) 10–15

    Keywords Inhalationstrauma ; Rauchgasintoxikation ; Kohlenmonoxid ; Cyanid ; Reizgas ; Sauerstofftherapie
    Language German
    Publishing date 2022-01-01
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ISSN 2628-7609 ; 2628-7595
    ISSN (online) 2628-7609
    ISSN 2628-7595
    DOI 10.1055/a-1650-1015
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  2. Article: SOP Obere Sprunggelenks-Distorsion

    Schlachter, Eva Katharina / Mansella, Gregory

    Notaufnahme up2date

    2021  Volume 3, Issue 02, Page(s) 115–120

    Language German
    Publishing date 2021-04-01
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ISSN 2628-7609 ; 2628-7595
    ISSN (online) 2628-7609
    ISSN 2628-7595
    DOI 10.1055/a-1361-7204
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  3. Article: SOP Akutes Angioödem

    Demjaha, Merita / Mansella, Gregory

    Notaufnahme up2date

    2020  Volume 2, Issue 04, Page(s) 320–326

    Language German
    Publishing date 2020-10-01
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ISSN 2628-7609 ; 2628-7595
    ISSN (online) 2628-7609
    ISSN 2628-7595
    DOI 10.1055/a-1179-2077
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  4. Article: SOP Schädel-Hirn-Trauma beim Erwachsenen

    Hennings, Elisa / Schmachtenberg, Florian / Mansella, Gregory

    Notaufnahme up2date

    2021  Volume 3, Issue 03, Page(s) 215–220

    Language German
    Publishing date 2021-07-01
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ISSN 2628-7609 ; 2628-7595
    ISSN (online) 2628-7609
    ISSN 2628-7595
    DOI 10.1055/a-1508-3514
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  5. Article ; Online: Intravenous acetaminophen does not reduce morphine use for pain relief in emergency department patients: A multicenter, randomized, double-blind, placebo-controlled trial.

    Minotti, Bruno / Mansella, Gregory / Sieber, Robert / Ott, Alexander / Nickel, Christian H / Bingisser, Roland

    Academic emergency medicine : official journal of the Society for Academic Emergency Medicine

    2022  Volume 29, Issue 8, Page(s) 954–962

    Abstract: Background: Pain is one of the main reasons to present to emergency departments (EDs). Opioids are indispensable for acute pain management but are associated with side effects, misuse, and dependence. The aim of this study was to test whether a single ... ...

    Abstract Background: Pain is one of the main reasons to present to emergency departments (EDs). Opioids are indispensable for acute pain management but are associated with side effects, misuse, and dependence. The aim of this study was to test whether a single dose of intravenous (IV) acetaminophen (paracetamol) can reduce the use of morphine for pain relief and/or morphine-related adverse events (AEs).
    Methods: ED patients >18 years with acute pain (i.e., Numeric Rating Scale [NRS] > 4) were screened for eligibility. Patients with analgesia in the past 6 h, chronic pain, or clinical instability were excluded. Patients were randomized in a 1:1 ratio to receive either morphine 0.1 mg/kg and 1 g acetaminophen IV or morphine 0.1 mg/kg and placebo IV. The intervention was double-blinded. Additional morphine 0.05 mg/kg IV was administered every 15 minutes until pain relief (defined as NRS < 4) and whether the pain recurred. The primary outcome was the mean morphine dose for pain relief. Secondary outcomes were the total amount of morphine given, time to achieve pain relief, and AEs.
    Results: A total of 220 patients were randomized and 202 evaluated for the primary outcome. The mean morphine dose for pain relief was similar in both groups (acetaminophen 0.15 mg ± 0.07 mg/kg, placebo 0.16 ± 0.07 mg/kg). There were no differences in the total amount of morphine given (acetaminophen 0.19 ± 0.09 mg/kg, placebo 0.19 ± 0.1 mg/kg), the time to achieve pain relief (acetaminophen 30 min [95% CI 17-31 min], placebo 30 min [95% CI 30-35 min]), and the frequency of AEs (overall 27.4%). Time to pain recurrence did not differ significantly between the groups (hazard ratio 1.23 [0.76-1.98], p = 0.40).
    Conclusions: In ED patients, acetaminophen had no additional effect on pain control or morphine-sparing effect at the time of first morphine administration. Titrated morphine with the algorithm used was highly effective, with 80% of all patients reporting pain relief within 60 min of starting therapy.
    MeSH term(s) Acetaminophen/therapeutic use ; Acute Pain/diagnosis ; Acute Pain/drug therapy ; Analgesics, Non-Narcotic ; Analgesics, Opioid/therapeutic use ; Double-Blind Method ; Emergency Service, Hospital ; Humans ; Morphine ; Pain Management ; Pain Measurement ; Treatment Outcome
    Chemical Substances Analgesics, Non-Narcotic ; Analgesics, Opioid ; Acetaminophen (362O9ITL9D) ; Morphine (76I7G6D29C)
    Language English
    Publishing date 2022-05-22
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 1329813-6
    ISSN 1553-2712 ; 1069-6563
    ISSN (online) 1553-2712
    ISSN 1069-6563
    DOI 10.1111/acem.14517
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

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  6. Article: SOP Akute Dyspnoe

    Rosin, Christiane / Krähenbühl, Gilbert / Mansella, Gregory

    Notaufnahme up2date

    2019  Volume 1, Issue 01, Page(s) 9–14

    Language German
    Publishing date 2019-10-01
    Publisher © Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ISSN 2628-7609 ; 2628-7595
    ISSN (online) 2628-7609
    ISSN 2628-7595
    DOI 10.1055/a-0926-0386
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  7. Article ; Online: Hyperkalemia-induced Leg Paresis in Primary Adrenal Insufficiency.

    Mansella, Gregory / Stephan, Frank P / Bingisser, Roland / Nickel, Christian H

    Clinical practice and cases in emergency medicine

    2017  Volume 1, Issue 4, Page(s) 430–432

    Language English
    Publishing date 2017-10-06
    Publishing country United States
    Document type Case Reports
    ISSN 2474-252X
    ISSN (online) 2474-252X
    DOI 10.5811/cpcem.2017.7.35165
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: The Neurocardiogenic Spectrum in Subarachnoid Hemorrhage: A Case Report and Review of the Literature.

    Mansella, Gregory / Jeger, Raban / Bingisser, Roland / Nickel, Christian H

    Clinical practice and cases in emergency medicine

    2017  Volume 1, Issue 1, Page(s) 16–21

    Abstract: A 36-year-old man was brought to our emergency department after successful resuscitation of out-of-hospital cardiac arrest with the whole spectrum of neurocardiogenic effects in subarachnoid hemorrhage: electrocardiographic changes, regional wall motion ... ...

    Abstract A 36-year-old man was brought to our emergency department after successful resuscitation of out-of-hospital cardiac arrest with the whole spectrum of neurocardiogenic effects in subarachnoid hemorrhage: electrocardiographic changes, regional wall motion abnormalities, and elevations of cardiac enzymes. Coronary angiography revealed normal coronary arteries but showed the midventricular type of Takotsubo cardiomyopathy in the left ventriculography. Subsequently, cerebral computed tomography revealed diffuse subarachnoid hemorrhage and generalized cerebral edema with brain herniation. Brain death was diagnosed. This case highlights the possibility of an acute cerebral illness (especially subarachnoid hemorrhage) as an underlying cause of cardiac abnormalities mimicking myocardial ischemia.
    Language English
    Publishing date 2017-01-18
    Publishing country United States
    Document type Case Reports
    ISSN 2474-252X
    ISSN (online) 2474-252X
    DOI 10.5811/cpcem.2016.11.32582
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Delayed Diagnosis in Pulmonary Embolism: Frequency, Patient Characteristics, and Outcome.

    Mansella, Gregory / Keil, Christoph / Nickel, Christian H / Eken, Ceylan / Wirth, Christian / Tzankov, Alexandar / Peterson, Caspar Joyce / Aujesky, Drahomir / Bingisser, Roland

    Respiration; international review of thoracic diseases

    2020  Volume 99, Issue 7, Page(s) 589–597

    Abstract: Background: The incidence and the outcomes of pulmonary embolism (PE) missed during emergency department (ED) workup are largely unknown.: Objectives: To describe the frequency, demographics, and outcomes of patients with delayed diagnosis of PE.: ... ...

    Abstract Background: The incidence and the outcomes of pulmonary embolism (PE) missed during emergency department (ED) workup are largely unknown.
    Objectives: To describe the frequency, demographics, and outcomes of patients with delayed diagnosis of PE.
    Methods: We retrospectively compared patients diagnosed with PE during ED workup (early diagnosis) with patients diagnosed with PE thereafter (delayed diagnosis). Electronic health records (EHR) of 123,560 consecutive patients who attended a tertiary hospital ED were screened. Data were matched with radiology and pathology results from the EHR.
    Results: Of 1,119 patients presenting to the ED with early workup for PE, PE was diagnosed in 182 patients (80.5%) as early diagnosis. Delayed diagnosis was established in 44 cases (19.5%) using radiology and/or autopsy data. Median age of patients with early diagnosis was significantly lower as compared to delayed diagnosis (67 vs. 77.5 years). Main symptoms were dyspnea (109 patients [59.9%] in early, 20 patients [45.5%] in delayed diagnosis), chest pain (90 patients [49.5%] in early, 8 patients [18.2%] in delayed diagnosis), and nonspecific complaints (16 patients [8.8%] in early, 13 patients [29.5%] in delayed diagnosis). In-hospital mortality was 1.6% in early diagnosis and 43.2% in delayed diagnosis.
    Conclusions: Delayed diagnosis of PE carries a worse prognosis than early diagnosis. This discrepancy may arise from either delayed therapy, confounding variables (e.g., older age), or both. Possible reasons for delayed diagnoses are nonspecific presentations and symptoms overlapping with preexisting conditions.
    Language English
    Publishing date 2020-07-21
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 206674-9
    ISSN 1423-0356 ; 0025-7931
    ISSN (online) 1423-0356
    ISSN 0025-7931
    DOI 10.1159/000508396
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Uh II Zs.138: Show issues Location:
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  10. Article: Pneumomediastinum in blunt chest trauma: a case report and review of the literature.

    Mansella, Gregory / Bingisser, Roland / Nickel, Christian H

    Case reports in emergency medicine

    2014  Volume 2014, Page(s) 685381

    Abstract: Blunt trauma is the most common mechanism of injury in patients with pneumomediastinum and may occur in up to 10% of patients with severe blunt thoracic and cervical trauma. In this case report we present a 24-year-old man with pneumomediastinum due to ... ...

    Abstract Blunt trauma is the most common mechanism of injury in patients with pneumomediastinum and may occur in up to 10% of patients with severe blunt thoracic and cervical trauma. In this case report we present a 24-year-old man with pneumomediastinum due to blunt chest trauma after jumping from a bridge into a river. He complained of persistent retrosternal pain with exacerbation during deep inspiration. Physical examination showed only a slight tenderness of the sternum and the extended Focused Assessment with Sonography for Trauma (e-FAST) was normal. Pneumomediastinum was suspected by chest X-ray and confirmed by computed tomography, which showed a lung contusion as probable cause of the pneumomediastinum due to the "Mackling effect." Sonographic findings consistent with pneumomediastinum, like the "air gap" sign, are helpful for quick bedside diagnosis, but the diagnostic criteria are not yet as well established as for pneumothorax. This present case shows that despite minimal findings in physical examination and a normal e-FAST a pneumomediastinum is still possible in a patient with chest pain after blunt chest trauma. Therefore, pneumomediastinum should always be considered to prevent missing major aerodigestive injuries, which can be associated with a high mortality rate.
    Language English
    Publishing date 2014-07-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2684646-9
    ISSN 2090-6498 ; 2090-648X
    ISSN (online) 2090-6498
    ISSN 2090-648X
    DOI 10.1155/2014/685381
    Database MEDical Literature Analysis and Retrieval System OnLINE

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