Selestat

Small Bowel Obstruction SBO is a common emergency condition diagnosed mainly by abdominal CT scans, which help guide treatment including medical care or surgery. However, CT scans expose patients to radiation, increase costs, and extend emergency department stays. Researchers are evaluating the use of Point of Care Ultrasound POCUS combined with clinical judgment Gestalt probability to safely exclude SBO in patients with low or moderate risk, potentially reducing the need for CT scans. In this observational study, trained emergency physicians will perform POCUS on patients with suspected SBO who have low or moderate Gestalt clinical probability. The ultrasound will look for signs like dilated, fluid-filled intestinal loops in different abdominal zones. After POCUS, all patients will receive a CT scan to confirm SBO presence or absence, serving as the gold standard. The main goal is to assess how well POCUS can rule out SBO in this specific patient group. Participants will be followed for 28 days, with data collected on the accuracy of POCUS compared to CT, time from ultrasound to CT results, and any false positives or negatives. Physicians will also evaluate the ease and usefulness of POCUS. This study aims to show that POCUS can reduce unnecessary CT scans, lowering radiation exposure, costs, emergency department length of stay, and workload for radiologists.

This research aims to evaluate in adult patients who require emergency tracheal intubation due to vital distress the effect of a combined strategy designed to reduce complications related to intubation. The study assesses how using rocuronium as a paralytic agent, providing bag face-mask ventilation before intubation, and systematically applying the Gum Elastic Bougie GEB at the first intubation attempt may impact intubation-related morbidity. Previous studies showed individual benefits of these approaches, but their combined effect in emergencies has not been assessed. The trial compares two groups one group receives a combination rapid sequence intubation RSI strategy using rocuronium, bag-mask ventilation between induction and laryngoscopy, and systematic GEB use to aid intubation. The other group follows current recommendations using succinylcholine for RSI, no routine bag-mask ventilation before intubation, and GEB use only if intubation fails under direct laryngoscopy. Emergency physicians perform intubations and record outcomes. Participants will be monitored closely during and after intubation. Data collection includes medical history, vital signs such as arterial pressure, oxygen saturation, and heart rate. Researchers will track severe intubation-related complications occurring within the first hour and assess intubation difficulty using various measures on the day of intubation. Outcomes like mortality and use of sedatives or vasopressors are recorded up to 28 days after inclusion. The overall study period extends until September 2026.

The trial investigates the management of primary spontaneous large pneumothorax, a condition where air collects in the chest cavity without trauma. Researchers aim to compare two outpatient treatments since there is no consensus on the best approach. This randomized prospective study evaluates the success rates of ambulatory care methods to better guide treatment decisions. Participants will be randomly assigned to one of two procedures simple exsufflation or insertion of a Fuhrman catheter with a unidirectional valve followed by ambulatory care. These procedures are common outpatient approaches but have not been directly compared in a prospective trial before. The study focuses on outpatient management without hospital admission. During the study, patients will be monitored to assess successful treatment outcomes by day 6 after intervention. Success is defined by the patients ability to be managed effectively in an outpatient setting. Researchers will observe the treatment progress and record outcomes related to ambulatory care effectiveness and safety during this period.