Aims and background: Out-of-hospital cardiac arrest (OHCA) poses a significant global public health challenge, particularly in India where the absence of an official registry complicates understanding the true scope of the issue. This study aims to provide insights into OHCA in South India, focusing on survival rates and key influencing factors, with a specific emphasis on young cardiac arrest patients. Materials and methods: Conducted as a registry-based observational study in an urban South Indian tertiary care hospital's emergency department, data from January to December 2023 were analysed using the Utstein OHCA registry. Inclusion criteria covered non-traumatic OHCA patients of all ages transported to the hospital. Results: Among 123 non-traumatic OHCA cases, laypersons performed bystander cardiopulmonary resuscitation (CPR) in 8.1% of cases. The overall survival rate was 0.8%, with a 3.1% survival rate among young adults (18–49 years). Notably, continuous CPR was associated with higher survival rates. Conclusion: Addressing low survival rates, especially among young individuals experiencing OHCA in India, requires immediate action. Recognising the time-intensive nature of citizen education, our primary recommendation emphasises prompt and targeted, interventions in raising public awareness and training. Placing emergency physicians at the forefront of these efforts allows them to address multifaceted challenges, optimise immediate outcomes and contribute to the continuous improvement of OHCA care in India.

Introduction: When a patient enters the emergency room in a non-traumatic coma, immediate medical or surgical action must be taken. Therefore, understanding the most common causes of non-traumatic altered mental status (AMS) and related mortality may help with these patients’ care. Aim: The study aimed to examine the clinical characteristics of adult patients who report to the emergency room in an AMS but have no prior head injury. Materials and methods: A total of 112 patients who presented to our hospital with AMS were enrolled in this prospective observational study, which was conducted over a one-year and six-month period in the emergency department of a tertiary-care hospital. A previously created case registration form was used to gather clinical records of patients with AMS in the emergency room, including their demographics, medical history, signs and symptoms upon admission, diagnosis, clinical assessment techniques, and emergency management and outcome. Results: Most patients were men aged >40 years. The reasons for AMS were neurological, followed closely by metabolic and viral factors. The study indicates that bacterial meningoencephalitis, hepatic coma, organophosphorus (OP) poisoning, intoxication, infarcts, and intracerebral haemorrhage are the main causes of AMS and are associated with lower mortality. Conclusion: The most frequently encountered diagnostic categories causing AMS were primarily neurological, but they differed from similar studies, indicating significant variability in the aetiologies in studies conducted in diverse demographic settings and the need for large-scale, multicenter studies.

Diaphragmatic paralysis, often stemming from neurological disorders like GBS or chronic inflammatory demyelinating polyneuropathy (CIDP), poses significant challenges in respiratory management. While bilateral phrenic nerve involvement can result in acute respiratory failure necessitating mechanical ventilation has been documented, instances of alternating hemidiaphragmatic paralysis are rare. Herein, we describe a case displaying this distinctive presentation of CIDP.

A 12-year-old male child was presented to the emergency medicine department with common symptoms like fever and cough but with some probable abnormalities that we commonly miss out on. What makes this case interesting is that by using point-of-care ultrasound (POCUS) in the emergency medicine department itself, a massive lung abscess could be diagnosed within a very short period of time, thereby helping in the decision for further imaging with computed tomography (CT) against the risks of radiation exposure, especially in paediatric patients. Although chest radiography and CT are mandatory procedures to diagnose pulmonary abscess, POCUS is a very useful tool, especially in the emergency department.

Sickle cell disease (SCD) is a genetic disorder with unusual shaped haemoglobin that potentially causes red blood cells contorted. Patients with SCD are severely prone to acute chest symptoms, particularly among paediatric patients. The present case study article explores the causes, mechanisms, and management of acute chest syndrome (ACS) through a case study of a boy (19 age) with SCD presenting ACS. Multidisciplinary collaboration and adherence to established guidelines are crucial in optimising patient outcomes. The case highlights the importance of early recognition, comprehensive evaluation, and prompt intervention in ACS management.

Amid the coronavirus disease-2019 (COVID-19) pandemic, frontline nurses, who tirelessly apply their expertise and knowledge to enhance patient outcomes in intensive care units (ICUs), must comprehensively understand ventilators. Given the variety of ventilators, each produced by different manufacturers and featuring distinct operational protocols, navigating their use can be challenging for nurses. This complexity often leads to confusion regarding the functionality and setup of these critical devices in a clinical setting. This article aims to clarify and provide a general overview of common ventilator setups and operating principles, specifically tailored for nurses. This article aims to explain or clarify ventilator technology, thereby empowering nurses with the knowledge and confidence needed to manage ventilatory support effectively for their patients.