Arterial Embolization: A Superior Treatment for Massive Urinary Tract Bleeding in Emergency Care

Objective:To analyze the effect of arterial embolism(AE)in patients with massive urinary system bleeding(MBUS).Methods:From September 2018 to September 2023,175 cases of MBUS patients in the emergency department of the hospital were randomly selected and divided into groups according to the length of stay.Among them,85 cases(September 2018–September 2020)underwent bladder irrigation treatment with aluminum potassium sulfate solution through a catheter(Group A),and 90 cases(October 2020–September 2023)underwent AE treatment(Group B).The treatment effects of the two groups were compared.Results:The treatment effectiveness of Group B is higher than that of Group A(P<0.05).The urinary hemoglobin level of Group B is lower than that of Group A at 1,6,12,and 24 hours after treatment(P<0.05).Among the 90 cases treated with AE,7 cases had a fever,with body temperatures ranging from 37.3°C to 38.9℃,with a mean temperature of 38.2±0.3℃.Four cases experienced local pain,nausea,and vomiting,while two cases of intra-iliac AE showed transient buttock pain.These patients with adverse reactions were treated symptomatically for 7 days.All patients recovered after treatment.Intravenous urography of 87 patients in June showed that the renal pelvis and calyces were in good condition,the renal function returned to normal,and the blood urea nitrogen and blood creatinine test results were within the normal range.After 1 year of follow-up,no hypertension occurred.Conclusion:AE treats MBUS patients in the emergency department with remarkable efficacy.It has the advantages of less damage to the body,rapid hemostasis,high safety,and maximum preservation of organ function.

Evaluating the Effectiveness of Emergency Ventilator Treatment for Severe Acute Left Ventricular Heart Failure

Objective:To evaluate the efficacy of emergency ventilator therapy in severe acute left heart failure.Methods:A total of 75 patients with severe acute left ventricular heart failure who were admitted to the hospital from July 2020 to July 2023 were randomly divided into two groups.Group A received additional emergency ventilator treatment,and group B received conventional treatment.The efficacy was compared.Results:The curative effect of patients with severe acute left heart failure in group A was higher than that in group B(P<0.05);all blood gas indicators in group A were better than those in group B(P<0.05);all vital signs indicators in group A were better than those in group B(P<0.05);group A was more satisfied with the treatment of severe acute left ventricular heart failure than group B(P<0.05).Conclusion:Patients with severe acute left heart failure who receive emergency ventilator treatment can stabilize vital signs,improve blood oxygen supply,and enhance curative effect.

Key elements and checklist of shared decisionmaking conversation on life-sustaining treatment in emergency:a multispecialty study from China

BACKGROUND:Shared decision-making(SDM)has broad application in emergencies.Most published studies have focused on SDM for a certain disease or expert opinions on future research gaps without revealing the full picture or detailed guidance for clinical practice.This study is to investigate the optimal application of SDM to guide life-sustaining treatment(LST)in emergencies.METHODS:This study was a prospective two-round Delphi consensus-seeking survey among multiple stakeholders at the China Consortium of Elite Teaching Hospitals for Residency Education.Participants were identified based on their expertise in medicine,law,administration,medical education,or patient advocacy.All individual items and questions in the questionnaire were scored using a 5-point Likert scale,with responses ranging from"very unimportant"(a score of 1)to"extremely important"(a score of 5).The percentages of the responses that had scores of 4-5on the 5-point Likert scale were calculated.A Kendall’s W coefficient was calculated to evaluate the consensus of experts.RESULTS:A two-level framework consisting of 4 domains and 22 items as well as a ready-touse checklist for the informed consent process for LST was established.An acceptable Kendall’s W coefficient was achieved.CONCLUSION:A consensus-based framework supporting SDM during LST in an emergency department can inform the implementation of guidelines for clinical interventions,research studies,medical education,and policy initiatives.

Impact of failure mode and effects analysis-based emergency management on the effectiveness of craniocerebral injury treatment

BACKGROUND Craniocerebral injuries encompass brain injuries,skull fractures,cranial soft tissue injuries,and similar injuries.Recently,the incidence of craniocerebral injuries has increased dramatically due to the increased numbers of traffic accidents and aerial work injuries,threatening the physical and mental health of patients.AIM To investigate the impact of failure modes and effects analysis(FMEA)-based emergency management on craniocerebral injury treatment effectiveness.METHODS Eighty-four patients with craniocerebral injuries,treated at our hospital from November 2019 to March 2021,were selected and assigned,using the random number table method,to study(n=42)and control(n=42)groups.Patients in the control group received conventional management while those in the study group received FMEA theory-based emergency management,based on the control group.Pre-and post-interventions,details regarding the emergency situation;levels of inflammatory stress indicators[Interleukin-6(IL-6),C-reactive protein(CRP),and procalcitonin(PCT)];incidence of complications;prognoses;and satisfaction regarding patient care were evaluated for both groups.RESULTS For the study group,the assessed parameters[pre-hospital emergency response time(9.13±2.37 min),time to receive a consultation(2.39±0.44 min),time needed to report imaging findings(1.15±4.44 min),and test reporting time(32.19±6.23 min)]were shorter than those for the control group(12.78±4.06 min,3.58±0.71 min,33.49±5.51 min,50.41±11.45 min,respectively;P<0.05).Pre-intervention serum levels of IL-6(78.71±27.59 pg/mL),CRP(19.80±6.77 mg/L),and PCT(3.66±1.82 ng/mL)in the study group patients were not significantly different from those in the control group patients(81.31±32.11 pg/mL,21.29±8.02 mg/L,and 3.95±2.11 ng/mL respectively;P>0.05);post-intervention serum indicator levels were lower in both groups than pre-intervention levels.Further,serum levels of IL-6(17.35±5.33 pg/mL),CRP(2.27±0.56 mg/L),and PCT(0.22±0.07 ng/mL)were lower in the study group than in the control group(30.15±12.38 pg/mL,3.13±0.77 mg/L,0.38±0.12 ng/mL,respectively;P<0.05).The complication rate observed in the study group(9.52%)was lower than that in the control group(26.19%,P<0.05).The prognoses for the study group patients were better than those for the control patients(P<0.05).Patient care satisfaction was higher in the study group(95.24%)than in the control group(78.57%,P<0.05).CONCLUSION FMEA-based craniocerebral injury management effectively shortens the time spent on emergency care,reduces inflammatory stress and complication risk levels,and helps improve patient prognoses,while achieving high patient care satisfaction levels.

Current status of emergency treatment of chemical eye burns in workplaces

Chemical eye burns present an avoidable,but frequent,occupational injury with potentially detrimental consequences for the quality of life and occupational rehabilitation of the injured.A periodical review of guidelines is required to assure the optimal emergency management.We reviewed the literature with emphasis on current German guidelines,primarily MEDLINE.If the crucial first-line measure,the injury prevention has failed and an eye burn has been sustained,the immediate and copious rinsing of the eye is the pivotal emergency treatment modality.Whereas the immediacy and sufficiency of the emergency rinsing are largely unanimous,there is an ongoing debate about the benefits and risks of specific rinsing solutions,and regular updates on guidelines and recommendations for the emergency treatment are warranted.The easiest and readily available rinsing solution is tap water,which fulfils the crucial criteria conveniently in most industrialized countries:purity,sterility,and neutral p H.Other rinsing solutions are proposing higher osmolality to stabilize the physiological p H,because of their superior buffering capacity.However,there is no compelling evidence for a substantial benefit,and some reports suggest that there could be unwanted side effects.In combination with the substantially increased expenditure and a more complex handling procedure,currently a general recommendation of any other solution than tap water is not warranted.

Osteopathy and Emergency: A Model of Osteopathic Treatment Aimed at Managing the Post-Traumatic Stress—Part 1

The Complementary and Alternative Medicine Education (EDUCAM) School of Osteopathy, following the earthquake that occurred in Amatrice-Italy on August 24th 2016, promoted the project “Una mano per la salute” [One hand for health], aimed at giving therapeutic support to the population affected by this cataclysm. A review of the literature in the osteopathic field has been performed to identify a more functional approach to quickly relieve the inhabitants from the shock they suffered, and to identify the techniques with greater effectiveness on the stress axis. The protocol of ten chosen techniques will then be verified later in a pilot study, to check whether and how a protocol of osteopathic manipulative treatment (OMT) might play a clinically relevant role in the management of subjects exposed to extraordinary exogenous stress and post-traumatic stress disorder (PTSD) prevention, in addition to the psychological therapy treatments in use today.

Expert consensus on emergency diagnosis and treatment procedures for acute upper gastrointestinal bleeding

Acute upper gastrointestinal bleeding is one of the most common life-threatening diseases.Standardized diagnosis and treatment of acute upper gastrointestinal bleeding are of great importance for improving the prognosis.In 2015,the Emergency Physician Branch of the Chinese Medical Doctor Association updated an expert consensus statement on the emergency diagnosis and treatment procedures for acute upper gastrointestinal bleeding.Based on the 2015 consensus statement,members of the expert panel decided to reconvene and draw up a 2020 update on the advancements in the clinical care for acute upper gastrointestinal bleeding.The 2020 expert consensus statement is summarized in 10 sections:emergency assessment,diagnosis,stratified treatment,emergency treatment,comprehensive assessment,medication management,endoscopy,interventional radiology,multidisciplinary treatment,and evaluation of prognosis.The consensus statement is based on experts'opinions combined with the latest relevant medical evidence.

Treatment priority for suicide ideation and behaviours at an Australian emergency department

AIM: To investigate the treatment priority given to selfharmers presenting to a hospital emergency department(ED) in Queensland, Australia, over the period 2005-2010. METHODS: The main outcome measure of this study was the treatment priority given to persons presenting with suicide ideation and communication(SIC) or self-harming behaviour. Treatment priority was measured using the Australasian Triage Scale, which ranks patients from 1(in need of immediate treatment) to 5(assessment and treatment to start within 120 min). Ordered logistic regression was used to assess the broad demographic and treatment-related factors associated with more urgent triage categories and to in-vestigate which methods of non-fatal suicidal behaviour(NFSB) were prioritised as most urgent.RESULTS: Most cases of NFSB were between 15 and 34 years. A larger proportion of persons presenting for SIC were aged 35 to 44 years. Over 50% of male presentations and 38% of female presentations were for SIC. Those cases prioritised as being more urgent had significantly greater odds of being older, presented after an act of self-harm rather than SIC, and had used multiple methods of NFSB. These individuals also had greater odds of being male and having made past presentations for SIC or NFSB. Among males, those presenting after ingestion of drugs had the greatest odds of receiving immediate attention compared to SIC. "Cutters" were considered as the least "urgent" subjects, and had a greatest risk of waiting 60 to 120 min for treatment compared to suicide ideators. Among females, those presenting with chemicals, poisons and gases had the greatest odds of receiving immediate attention compared to SIC. Females who presenting after cutting themselves had lower odds of receiving immediate treatment than those who presented with SIC. CONCLUSION: ED staff seems to judge the urgency of cases based on demographic factors such as age and gender, as well as method of NFSB.

Evaluation of changes in the types of drugs administered by various treatment services in Emergency Department

Objective: To determine the amount and type of changes in the Emergency Department, in order to hasten treatment and disposition process of patients in the Emergency Department to expedite by eliminating or minimizing such changes that decreases the cost of treatment and drug resistanceMethods: In this study, 1005 patients' file admitted to emergency department of Rasool Akram Hospital were reviewed to see at least two different health services or two shifts of one service with written orders.Results: In total, the rate of drug changes studied cases was obtained as 5.47%. The largest pharmaceutical group in which the changes were developed was antibiotic (2.8% from all cases and 50% of total drug changes). Among the various health services, the internal service had imposed the most changes (67.3% of total drug changes).Conclusions: Considering that after the removal of trauma patients, the frequency of drug changes had been 11.47%, then it should be noted that the frequency was high and it was not desirable. The greatest change has been operated by internal services due to the fact that most treatments in this department was carried out by drugs.

Observations on the Preventive Effects of Anti-infective Treatment on Wound Infection in Emergency Surgery

Objective:To explore the preventive effects of anti-infective treatment on wound infection in emergency surgical trauma.Methods:180 patients in our hospital from 2019 to June to May 2020 were selected as subjects.The 180 patients were randomly divided into two groups.The control group had 90 cases and adopted the conventional treatment method,and the experimental group received anti-infective treatment.The wound healing,infection status,and patient satisfaction of the two groups of patients were analyzed.Results:The wound healing,infection status,and patient satisfaction of the experimental group were better than those of the control group.Conclusion:The application of anti-infective treatment to the prevention of wound infection in emergency surgical trauma can reduce the infection rate of the patients'incision and promote the recovery of patients.It is suitable for clinical applications.

Osteopathy and Emergency: A Model of Osteopathic Treatment Aimed at Managing the Post-Traumatic Stress—Brief and Useful Guide—Part 2

This work aims to describe a well standardized therapeutic path in reference to the article “Osteopathy and Emergency: A Model of Osteopathic Treatment Aimed at Managing the Post-Traumatic Stress—Part 1 in the form of a practical guide for manual therapist, Open Journal of Therapy and Rehabilitation, Vol. 10, No. 7, July 2018, https://doi.org/10.4236/health.2018.107074”. The osteopathic manipulative treatment (OMT) approach we propose can be complementary to the psychological therapy in use today, and consists of ten standardized techniques directed to the anatomical structures more involved in the stress answer. This protocol was designed to improve and sustain the management of subjects exposed to extraordinary exogenous stress or post-traumatic stress disorder patients (PTSD).

Appropriate treatment of acute sigmoid volvulus in the emergency setting

AIM:To investigate an appropriate strategy for the treatment of patients with acute sigmoid volvulus in the emergency setting.METHODS:A retrospective review of 28 patients with acute sigmoid volvulus treated in the Department of Colorectal Surgery,Changhai Hospital,Shanghai from January 2001 to July 2012 was performed.Following the diagnosis of acute sigmoid volvulus,an initial colonoscopic approach was adopted if there was no evidence of diffuse peritonitis.RESULTS:Of the 28 patients with acute sigmoid volvulus,19(67.9%)were male and 9(32.1%)were female.Their mean age was 63.1 ± 22.9 years(range,21-93 years).Six(21.4%)patients had a history of abdominal surgery,and 17(60.7%)patients had a history of constipation.Abdominal radiography or computed tomography was performed in all patients.Colonoscopic detorsion was performed in all 28 patients with a success rate of 92.8%(26/28).Emergency surgery was required in the other two patients.Of the 26 successfully treated patients,seven(26.9%)had recurrent volvulus.CONCLUSION:Colonoscopy is the primary emergency treatment of choice in uncomplicated acute sigmoid volvulus.Emergency surgery is only for patients in whom nonoperative treatment is unsuccessful,or in those with peritonitis.

Combination treatment of inflammatory bowel disease:Present status and future perspectives

The treatment of patients with inflammatory bowel disease(IBD),especially those with severe or refractory disease,represents an important challenge for the clinical gastroenterologist.It seems to be no exaggeration to say that in these patients,not only the scientific background of the gastroenterologist is tested,but also the abundance of“gifts”that he should possess(insight,intuition,determ-ination,ability to take initiative,etc.)for the successful outcome of the treatment.In daily clinical practice,depending on the severity of the attack,IBD is treated with one or a combination of two or more pharmaceutical agents.These combin-ations include not only the first-line drugs(e.g.,mesalazine,corticosteroids,antibiotics,etc)but also second-and third-line drugs(immunosuppressants and biologic agents).It is a fact that despite the significant therapeutic advances there is still a significant percentage of patients who do not satisfactorily respond to the treatment applied.Therefore,a part of these patients are going to surgery.In recent years,several small-size clinical studies,reviews,and case reports have been published combining not only biological agents with other drugs(e.g.,immunosuppressants or corticosteroids)but also the combination of two biologi-cal agents simultaneously,especially in severe cases.In our opinion,it is at least a strange(and largely unexplained)fact that we often use combinations of drugs in a given patient although studies comparing the simultaneous administration of two or more drugs with monotherapy are very few.As mentioned above,there is a timid tendency in the literature to combine two biological agents in severe cases unresponsive to the applied treatment or patients with severe extraintestinal manifestations.The appropriate dosage,the duration of the administration,the suitable timing for checking the clinical and laboratory outcome,as well as the treatment side-effects,should be the subject of intense clinical research shortly.In this editorial,we attempt to summarize the existing data regarding the already applied combination therapies and to humbly formulate thoughts and suggestions for the future application of the combination treatment of biological agents in a well-defined category of patients.We suggest that the application of biomarkers and artificial intelligence could help in establishing new forms of treatment using the available modern drugs in patients with IBD resistant to treatment.

Evaluation and treatment of altered mental status patients in the emergency department:Life in the fast lane

BACKGROUND： Altered mental status （AMS） is a very common emergency case, but the exact etiology of many AMS patients is unknown. Patients often manifest vague symptoms, thus, AMS diagnosis and treatment are highly challenging for emergency physicians. The aim of this study is to provide a framework for the assessment of AMS patients. This assessment should allow providers to better understand the etiology of mental status changes and therefore improve diagnostic skills and management.METHODS： This is a prospective cohort observational study. We recruited all adult patients with undifferentiated AMS at a single center tertiary care academic emergency department over 24 months （June 2009 to June 2011）. Demographic characteristics, clinical manifestations, assessment approaches, causative factors, emergency treatments and outcomes were collected prospectively.RESULTS： In 1934 patients with AMS recruited, accounting for 0.93% of all emergency department （ED） patients, 1 026 （53.1%） were male, and 908 （46.9%） female. Their average age was 51.95±15.71 years. Etiologic factors were neurological （n=641; 35.0%）, pharmacological and toxicological （n=421; 23.0%）, systemic and organic （n=266; 14.5%）, infectious （n=167; 9.1%）, endocrine/metabolic （n=145; 7.9%）, psychiatric （n=71; 3.9%）, traumatic （n=38; 2.1%）, and gynecologic and obstetric （n=35; 1.9%）. Total mortality rate was 8.1% （n=156）. The death rate was higher in elderly patients （≥60） than in younger patients （10.8% vs. 6.9%, P=-0.003）.CONCLUSION： Patients with AMS pose a challenge for ED physicians. The most frequently encountered diagnostic categories causing AMS were primary CNS disorders, intoxication, organ system dysfunction, and endocrine/metabolic diseases. AMS has a high fatality rate in the ED. AMS is an important warning signal for ED patients because of its potentially fatal and reversible effects. Prompt evaluation and treatment are essential to decreasing morbidity and mortality associated with AMS.

A comparative study of two methods for treatment of benign paroxysmal positional vertigo in the emergency department

Introduction: Posterior canal benign paroxysmal positional vertigo (PC-BPPV) is considered the mostcommon cause of peripheral vertigo in the emergency department (ED). Although the canalith repositioning maneuver (CRM) is the standard of care, the most effective method to deliver it in the ED hasbeen poorly studied.Objective: To compare two protocols of the Epley maneuver for the treatment of PC-BPPV.Patients and methods: We prospectively recruited 101 patients with unilateral PC-BPPV on physical examination, randomizing them to either a single Epley maneuver (EM) (n ¼ 46) or multiple maneuvers(n ¼ 55) on the same visit. Measured outcomes included presence/absence of positional nystagmus,resolution of vertigo, and score on the dizziness handicap inventory (DHI) at follow-up evaluations. TheDHI was stratified into mild ( 30) and moderate-severe (>30).Results: Normalization of the Dix-Hallpike maneuver at day 5 was observed in 38% of the single EMgroup and 44.4% in the multiple EM group (p ¼ 0.62). The DHI showed reduction from 42.2 (SD 18.4) to31.9 (SD 23.7) in the single EM group and from 43.7 (SD 22.9) to 33.5 (SD 21.5) in the multiple EM group(p ¼ 0.06). A higher number of patients improved from moderate-severe to mild DHI (p ¼ 0.03) in thesingle EM group compared to the multi-EM group (p ¼ 0.23).Conclusion: There was no statistically significant difference between performing a single EM versusmultiple EMs for treatment of PC-BPPV in the emergency department. The single EM approach isassociated with shorter physical contact between patients and examiner, which is logically safer in apandemic context.

Value of combining targeted emergency nursing with psychological nursing in children with febrile convulsions

BACKGROUND Febrile convulsions are a common pediatric emergency that imposes significant psychological stress on children and their families.Targeted emergency care and psychological nursing are widely applied in clinical practice,but their value and impact on the management of pediatric febrile convulsions are unclear.AIM To determine the impact of targeted emergency nursing combined with psychological nursing on satisfaction in children with febrile convulsions.METHODS Data from 111 children with febrile convulsions who received treatment at Nantong Maternal and Child Health Care Hospital between June 2021 and October 2022 were analyzed.The control group consisted of 44 children who received conventional nursing care and the research group consisted of 67 children who received targeted emergency and psychological nursing.The time to fever resolution,time to resolution of convulsions,length of hospital stays,Pittsburgh Sleep Quality Index,patient compliance,nursing satisfaction of the parents,occurrence of complications during the nursing process,and parental anxiety and depression were compared between the control and research groups.Parental anxiety and depression were assessed using the Hamilton Rating Scale for Depression(HAMD)and the Hamilton Rating Scale for Anxiety(HAMA).RESULTS The fever resolution,convulsion disappearance,and hospitalization times were longer in the control group compared with the research group(P<0.0001).The time to falling asleep,sleep time,sleep quality,sleep disturbance,sleep efficiency,and daytime status scores were significantly better in the research group compared with the control group(P<0.0001).The HAMD and HAMA scores for parents of children in the research group were lower than the scores in the control group after nursing(P<0.05).Compliance with treatment of children in the research group was higher than in the control group(P<0.05).Parental satisfaction with nursing in the research group was higher than in the control group(P<0.05).The total complication rate of children in the control group was higher than in the research group(P<0.05).CONCLUSION Combining psychological nursing with targeted emergency nursing improved the satisfaction of children’s families and compliance with treatment and promoted early recovery of clinical symptoms and improvement of sleep quality.

Significance of Primary Treatment Selection in the Efficiency of Wastewater Treatment in Constructed Wetlands (CWs)

This research explores strategies to enhance the efficiency of secondary treatment in Vertical Flow Constructed Wetlands (CW) in Montenegro. The focus is on selecting appropriate primary treatment methods alongside three distinct substrate types to improve wastewater treatment efficacy. The study examines the combination of two primary treatments with different substrate types in constructed wetlands (CW1, CW2, and CW3). The primary treatments include the existing wastewater treatment plant (WWTP) in Podgorica, involving coarse material removal through screens, inert material separation in aerated sand traps, and sediment and suspended matter removal in primary sedimentation tanks. The Extreme Separator (ExSep) was employed to evaluate its efficacy as a primary treatment method. The research demonstrates that the efficiency of CW can be significantly enhanced by selecting suitable primary treatment methods and substrates in Podgorica’s conditions. The most promising results were achieved by combining ExSep as a primary treatment with secondary treatment in CW-3. The removal efficiencies after CW3 for COD, BOD, and TSS exceeded 89%, 93%, and 91%, respectively. The outcomes underscore the significance of primary treatment in mitigating pollutant loads before discharge into the constructed wetlands, emphasizing potential areas for further optimization in wastewater treatment practices to enhance environmental sustainability and water quality management.

Dual-targeted treatment for inflammatory bowel disease:Whether fecal microbiota transplantation can be an important part of it

Inflammatory bowel disease(IBD)is a chronic gastrointestinal inflammatory disease.With the emergence of biologics and other therapeutic methods,two biologics or one biologic combined with a novel small-molecule drug has been proposed in recent years to treat IBD.Although treatment strategies for IBD are being optimized,their efficacy and risks still warrant further consideration.This editorial explores the current risks associated with dual-targeted treatment for IBD and the great potential that fecal microbiota transplantation(FMT)may have for use in combination therapy for IBD.We are focused on addressing refractory IBD or biologically resistant IBD based on currently available dual-targeted treatment by incorporating FMT as part of this dual-targeted treatment.In this new therapy regimen,FMT represents a promising combination therapy.

Cost of Medical Treatment for Primary Open-Angle Glaucoma in Relation to Patients’ Income and Its Impact on the Prognosis of the Disease, in Bouaké University Hospital

Introduction: Medical treatment for POAG is continuous and lifelong treatment. The aim of this study was to evaluate the relationship between the cost of this treatment and patients’ income and the impact of this relationship on treatment compliance. Materials and Methods: Prospective cross-sectional study with a descriptive aim covering sociodemographic data, average incomes, and direct and indirect costs of treatment of 57 patients followed for POAG during the period from January 1, 2012, to December 31, 2016 (5 years). Results: The patients were aged 25 to 77 years (mean = 54.4 years) with a male predominance (sex ratio = 1.5). Retirees were the most represented (26.32%), followed by workers in the informal sector (14.04%) and housewives (12.28%). Patients who had an annual income less than or equal to 900,000 CFA francs (€1370.83) per year represented 56.14% and those who did not have health coverage represented 57.89%. The treatment was monotherapy (64.91%), dual therapy (31.58%) or triple therapy (3.05%) and the average ratio of “annual cost of treatment to annual income” was 0.56 with for maximum 2.23 and 0.02 as minimum. Patients who considered the cost of treatment unbearable for their income represented 78.95%. Conclusion: Prevention of blindness due to glaucoma requires early detection but also the establishment of health coverage mechanisms to improve compliance with medical treatment. In addition, consideration should be given to the development of glaucoma surgery in our country, the indication of which could be the first intention in certain patients, considering for those patients, the geographical and financial accessibility of medical treatment. .