Emergency最新文献_第2页

Screening performance of Ultrasonographic B-lines in Detection of Lung Contusion following Blunt Trauma; a Diagnostic Accuracy Study 目的探讨超声B线在诊断钝性创伤后肺挫伤中的应用价值；诊断准确性研究

Emergency Pub Date : 2018-09-02 DOI: 10.22037/EMERGENCY.V6I1.20828

S. Abbasi, H. Shaker, Fariba Zareiee, D. Farsi, P. Hafezimoghadam, M. Rezai, B. Mahshidfar, Mani Mofìdi

{"title":"Screening performance of Ultrasonographic B-lines in Detection of Lung Contusion following Blunt Trauma; a Diagnostic Accuracy Study","authors":"S. Abbasi, H. Shaker, Fariba Zareiee, D. Farsi, P. Hafezimoghadam, M. Rezai, B. Mahshidfar, Mani Mofìdi","doi":"10.22037/EMERGENCY.V6I1.20828","DOIUrl":"https://doi.org/10.22037/EMERGENCY.V6I1.20828","url":null,"abstract":"Introduction\u0000Chest ultrasonography is routinely used in evaluation of chest trauma for diagnosis of pulmonary injury. This study aimed to evaluate the accuracy of B-Lines for diagnosing lung contusion in patients with blunt trauma of the chest.\u0000\u0000\u0000Methods\u0000Trauma patients who met the inclusion criteria were enrolled in the study and underwent ultrasonography by trained emergency medicine residents. Ultrasound results were recorded in terms of number of B-lines and the existence of peripheral parenchymal lesion (PPL). After ultrasound, the patient underwent chest x-ray and chest CT scan (as reference test) and screening performance of B-lines and PPL were evaluated.\u0000\u0000\u0000Results\u0000147 patients underwent chest ultrasound. The mean age of the patients was 40.74 ± 18.6 (78.9% male). B-lines˃3 had 94.0% (95% CI: 83.45-98.75) sensitivity and 57.7% (95% CI: 47.3-67.7) specificity, B-lines˃6 had 90.0% (95% CI: 78.2-96.7) sensitivity and 93.81% (95% CI: 87.0-97.7) specificity, and PPL had 34.0% (95% CI: 21.2-48.8) sensitivity and 100% (95% CI: 96.3-100.0) specificity. Composite findings of B-lines˃6 + PPL had 92.0% (95% CI: 80.8-97. 8) sensitivity and 93.8% (95% CI: 87.0-97.7) specificity in the diagnosis of lung contusion.\u0000\u0000\u0000Conclusion\u0000PPL and B-Lines˃6 had the highest accuracy in detecting lung contusion. B-Line˃6 had high sensitivity and specificity and was easy to perform; thus, it seems that B-Line˃6 could be considered as an alternative screening tool in detection of lung contusion.","PeriodicalId":11681,"journal":{"name":"Emergency","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44748144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Intravenous versus Subcutaneous Midazolam Using Jet-injector in Pediatric Sedation; a Randomized Clinical Trial 静脉注射咪达唑仑与皮下注射咪达唑仑在小儿镇静中的应用随机临床试验

Emergency Pub Date : 2018-08-31 DOI: 10.22037/EMERGENCY.V6I1.21211

M. Hajimaghsoudi, M. Bagherabadi, E. Zarepur, Vahid Ahmadi Hanzaei

{"title":"Intravenous versus Subcutaneous Midazolam Using Jet-injector in Pediatric Sedation; a Randomized Clinical Trial","authors":"M. Hajimaghsoudi, M. Bagherabadi, E. Zarepur, Vahid Ahmadi Hanzaei","doi":"10.22037/EMERGENCY.V6I1.21211","DOIUrl":"https://doi.org/10.22037/EMERGENCY.V6I1.21211","url":null,"abstract":"Introduction: The quality of interventions in children is largely dependent on their control. Hence, this study compared the sedative effects of subcutaneous (SC) and intravenous (IV) Midazolam in pediatric sedation induction. Methods: This randomized clinical trial was conducted on children aged 1-6 years presenting to emergency departments of Shahid Sadoughi and Shahid Rahnemoon Hospitals, Yazd, Iran. Participants were randomly assigned to IV or SC midazolam using a jet injector and success rate, degree of sedation, and satisfaction of parents and physician were compared between groups. Results: 60 cases with the mean age of 3.15±1.43 (1-6) years were randomly assigned to the SC (30 cases) or IV (30 cases) groups (56.7% female). SC and IV groups were similar regarding the mean age (p = 0.165) and sex (p = 0.121). Depth of sedation (p=0.900), control of child (p=0.711), in-charge physician’s satisfaction (p=0.467), successful sedation and need for rescue dose (p=0.519) were not different between groups. IV midazolam group had a significantly shorter recovery time (about 10 minutes; p=0.040) and SC midazolam group had a significantly higher level of parent satisfaction (p=0.001). Conclusion: The findings indicate no significant difference in depth of sedation, control of child, in-charge physician’s satisfaction, successful sedation (reaching stage 1 of sedation or higher), and need for rescue dose of SC and IV midazolam. Parents’ satisfaction was significantly greater with SC administration and IV injection had shorter recovery time.","PeriodicalId":11681,"journal":{"name":"Emergency","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.22037/EMERGENCY.V6I1.21211","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68079917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Burn-induced Oxidative Stress and Serum Glutathione Depletion; a Cross Sectional Study 烧伤氧化应激与血清谷胱甘肽耗竭的关系横断面研究

Emergency Pub Date : 2018-08-31 DOI: 10.22037/EMERGENCY.V6I1.21125

Arash Beiraghi-Toosi, Roya Askarian, Faezeh Sadrabadi Haghighi, M. Safarian, Fereshteh Kalantari, S. Hashemy

{"title":"Burn-induced Oxidative Stress and Serum Glutathione Depletion; a Cross Sectional Study","authors":"Arash Beiraghi-Toosi, Roya Askarian, Faezeh Sadrabadi Haghighi, M. Safarian, Fereshteh Kalantari, S. Hashemy","doi":"10.22037/EMERGENCY.V6I1.21125","DOIUrl":"https://doi.org/10.22037/EMERGENCY.V6I1.21125","url":null,"abstract":"Introduction: Several studies have shown the role of oxidative stress in pathophysiology of burn injuries. This study aimed to evaluate the changes of oxidant-antioxidant levels during the week following burn injuries and its correlation with grade of burn. Methods: In this prospective cross-sectional study, changes of total glutathione, reduced glutathione (GSH), oxidized GSH (GSSG), GSH/GSSG ratio, as well as Pro-oxidant-antioxidant balance (PAB) were investigated on the 1st, 2nd and 7th days of admission in patients with > 15 % burns. Results: 40 patients with the mean age of 21.1 ± 14.5 were studied (47.5% male). More than 50% of patients were in the 18 – 55 years age range and over 70% had 20% – 60% grade of burn. Total serum glutathione level and GSH had significant decreasing trends (P < 0.001) and GSSG and GSH/GSSG ratio had increasing trends (p < 0.001). No significant correlation was observed between serum GSH level and the total body surface area (TBSA) of burn injury (r = 0.047; p = 0.779). The evaluation of PAB and its correlation with TBSA showed a significant and direct association between them on the 1st (coefficient = 0.516; p = 0.001), 2nd (coefficient = 0.62; p <0.001), and 3rd (coefficient = 0.471; p = 0.002) day of follow up. Conclusion: According to this study, the redox perturbation occurred in burn injury which was measured and proved by decreased GSH/GSSG ratio as well as the shift of PAB in favour of oxidants. Besides, since PAB positively correlated with the severity of dermal damage, it might suggest the application of antioxidants as a part of therapeutic protocol for which the dosage should be proportionate to the surface area of the damaged skin.","PeriodicalId":11681,"journal":{"name":"Emergency","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44876367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 11

Correlation of Hyperchloremic Metabolic Acidosis and Renal Function in Critically ill Patients of Emergency Department: an Observational Study 急诊危重病人高氯血症代谢性酸中毒与肾功能相关性的观察研究

Emergency Pub Date : 2018-08-25 DOI: 10.22037/EMERGENCY.V6I1.21610

M. Giordano, T. Ciarambino, P. Castellino, L. Malatino, G. Signoriello, G. Paolisso, L. Adinolfi

{"title":"Correlation of Hyperchloremic Metabolic Acidosis and Renal Function in Critically ill Patients of Emergency Department: an Observational Study","authors":"M. Giordano, T. Ciarambino, P. Castellino, L. Malatino, G. Signoriello, G. Paolisso, L. Adinolfi","doi":"10.22037/EMERGENCY.V6I1.21610","DOIUrl":"https://doi.org/10.22037/EMERGENCY.V6I1.21610","url":null,"abstract":"Introduction: Early detection is crucial for prompt management of acute kidney injury (AKI) patients in emergency department (ED). This study aimed to investigate the usefulness of hyperchloremic metabolic acidosis (HCMA) levels in this regard. Methods: In this retrospective observational study, > 18 years old critically ill patients presenting to ED of Marcianise Hospital, Italy, were divided into non-AKI and AKI group according to KDIGO guideline. The level of HCMA ((arterial pH x bicarbonate)/chloride) was compared between groups and correlation of HCMA with estimated glomerular filtration rate (e-GFR) in ARF patients was evaluated. Results: 134 patients with the mean age of 76.5 ± 3.1 years were enrolled (64 non-AKI and 70 AKI; 64% female). Two groups were similar regarding mean age (p = 0.251), sex (p = 0.091), APACHII score (p = 0.215), Charlson Comorbidity Index (p= 0.187), and body mass index (p = 0.129). The mean HCMA level was 1.98 ± 0.09 in the non-AKI group and 1.56 ± 0.07 in the AKI group (p=0.039). There was a positive correlation between HCMA and e-GFR levels in AKI group (r: 0.467, p=0.0092). Conclusions: If confirmed and validated in a future study, ABG derived formula for HCMA may be a useful tool for early detection of AKI patients in emergency department.","PeriodicalId":11681,"journal":{"name":"Emergency","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42506725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Serum Procalcitonin and Lactoferrin in Detection of Acute Appendicitis; a Diagnostic Accuracy Study 血清降钙素原和乳铁蛋白检测急性阑尾炎的研究诊断准确性研究

Emergency Pub Date : 2018-08-25 DOI: 10.22037/EMERGENCY.V6I1.21056

M. Motie, Anvar Soleimani, Arash Soltani, S. Hashemy

{"title":"Serum Procalcitonin and Lactoferrin in Detection of Acute Appendicitis; a Diagnostic Accuracy Study","authors":"M. Motie, Anvar Soleimani, Arash Soltani, S. Hashemy","doi":"10.22037/EMERGENCY.V6I1.21056","DOIUrl":"https://doi.org/10.22037/EMERGENCY.V6I1.21056","url":null,"abstract":"Introduction\u0000Finding an accurate diagnostic test can reduce the rate of unnecessary abdominal surgery in cases of suspected acute appendicitis (AA). This study aimed to evaluate the diagnostic value of serum lactoferrin (LF) and procalcitonin (PCT) in detection of patients with acute appendicitis.\u0000\u0000\u0000Methods\u0000In this diagnostic accuracy study, screening performance characteristics of PCT and LF were calculated in patients suspected with acute appendicitis and healthy volunteers as control group.\u0000\u0000\u0000Results\u0000131 cases participated (61 as case and 70 as control). The mean serum level of LF (0.9±0.14 vs 0.2±0.13 µg/ml; p 0.0001) and PCT (0.15±0.21 vs 0.11±0.02 ng/dl; p = 0.02) were significantly higher in patients suspected with AA. The AUC of PCT and LF were 0.46 (95% CI: 0.31-0.61) and 0.61 (95%CI: 0.47 - 0.76), respectively. At a 0.90 µg/ml cut-off value, LF had 77% (95 % CI: 63 - 91) sensitivity and 43% (95 % CI: 31 - 55) specificity. Also, at a 0.11 ng/dl cut-off value, PCT had 41% (95 % CI: 26 - 56) sensitivity and 69% (95 % CI: 53 - 85) specificity.\u0000\u0000\u0000Conclusion\u0000Based on the main finding of present study, the overall accuracy of serum PCT and LF in detection of patients with acute appendicitis are in poor to failed range and it seems that they could not be considered as good screening tools for this purpose.","PeriodicalId":11681,"journal":{"name":"Emergency","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43893229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Paradoxical Embolism in a Patient with Patent Foramen Ovale; a Case Report 卵圆孔未闭患者的矛盾栓塞一份病例报告

Emergency Pub Date : 2018-08-08 DOI: 10.22037/EMERGENCY.V6I1.22435

M. Khani, Fariba Bayat, A. Rohani, Mehdi Pishgahi

引用次数: 1

Characteristics of Mortalities related to Pulmonary Embolism following Multiple Trauma; a Brief Report 多发创伤后肺栓塞相关死亡的特点简短报告

Emergency Pub Date : 2018-08-07 DOI: 10.22037/EMERGENCY.V6I1.18900

F. Najari, B. Mostafazadeh, A. Akbari, Ideh Baradaran kaya, Dorsa Najari

{"title":"Characteristics of Mortalities related to Pulmonary Embolism following Multiple Trauma; a Brief Report","authors":"F. Najari, B. Mostafazadeh, A. Akbari, Ideh Baradaran kaya, Dorsa Najari","doi":"10.22037/EMERGENCY.V6I1.18900","DOIUrl":"https://doi.org/10.22037/EMERGENCY.V6I1.18900","url":null,"abstract":"Introduction\u0000Pulmonary embolism (PE) is introduced as the third major cause of death after trauma in those who survive more than 24 hours. This study aimed to describe the characteristics of mortalities due to trauma related PE in cases referred to the forensic medicine department.\u0000\u0000\u0000Methods\u0000The present cross sectional study was conducted on medical profiles of cadavers that were registered as trauma related mortality in the dissection department of the Forensic Medicine Organization, Tehran, Iran, during 2011 to 2016.\u0000\u0000\u0000Results\u0000The cause of death for 92 of the 10800 (0.85%) evaluated cadavers was diagnosed as trauma related PE. The mean age of these patients was 58.37 ± 19.39 years (66.3% male). Only 14 (15.2%) hospitalized patients had received anticoagulant agents. The most frequent trauma related PE mortality cases were male (p = 0.003) and aged > 55 years (p = 0.005), with trauma to death time of < 3 weeks (p = 0.004), lower limb injury (p = 0.003), car crash trauma mechanism (p = 0.003), and no anticoagulant prescribed (p = 0.001).\u0000\u0000\u0000Conclusion\u0000According to the results of the present study, the prevalence of trauma related PE mortality was 0.85%. It seems that, having a clear anticoagulation therapy protocol in trauma centers could be helpful in decreasing the prevalence of traumatic thromboembolism and its' related mortality.","PeriodicalId":11681,"journal":{"name":"Emergency","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43262299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Quetiapine versus Haloperidol in Controlling Conversion Disorder Symptoms; a Randomized Clinical Trial 喹硫平与氟哌啶醇对转换障碍症状的控制作用；随机临床试验

Emergency Pub Date : 2018-08-02 DOI: 10.22037/EMERGENCY.V6I1.22344

S. Ghanbarizadeh, Hossein Dinpanah, R. Ghasemi, Yaser Salahshour, Samaneh Sardashti, M. Kamali, S. Khatibi

{"title":"Quetiapine versus Haloperidol in Controlling Conversion Disorder Symptoms; a Randomized Clinical Trial","authors":"S. Ghanbarizadeh, Hossein Dinpanah, R. Ghasemi, Yaser Salahshour, Samaneh Sardashti, M. Kamali, S. Khatibi","doi":"10.22037/EMERGENCY.V6I1.22344","DOIUrl":"https://doi.org/10.22037/EMERGENCY.V6I1.22344","url":null,"abstract":"Introduction\u0000About 5% of visits to emergency departments are made up of conversion disorder cases. This study was designed with the aim of comparing the effectiveness of quetiapine and haloperidol in controlling conversion disorder symptoms.\u0000\u0000\u0000Methods\u0000The present single-blind clinical trial has been performed on patients with conversion disorder (based on the DSM-IV definition) presenting to emergency department of 9-Day Hospital, Torbat Heydariyeh, Iran, from January 2017 until May 2018.\u0000\u0000\u0000Results\u000073 patients were allocated to haloperidol and 71 to quetiapine group. Mean age of these patients was 32.03 ± 12.80 years (62.50% female). Two groups were similar regarding the baseline characteristics. Within 30 minutes, 90.41% of haloperidol cases and 91.55% of quetiapine cases were relieved (p=0.812). The most common side effects after 30 minutes were extrapyramidal symptoms (9.59%) in the haloperidol group and fatigue and sleepiness (7.04%) in the quetiapine group. Extrapyramidal symptoms was significantly higher than the quetiapine group (p=0.013).\u0000\u0000\u0000Conclusion\u0000The results of the present study showed that although quetiapine and haloperidol have a similar effect in relieving the patients from conversion disorder symptoms, the prevalence of extrapyramidal symptoms is significantly lower in the group under treatment with quetiapine. Therefore, it seems that quetiapine is a safer drug compared to haloperidol.","PeriodicalId":11681,"journal":{"name":"Emergency","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47728376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Quality of Cardiopulmonary Resuscitation in Emergency Department Based on the AHA 2015 Guidelines; a Brief Report 基于AHA 2015指南的急诊科心肺复苏质量；简要报告

Emergency Pub Date : 2018-07-21 DOI: 10.22037/EMERGENCY.V6I1.22233

A. Vafaei, Amin shams akhtari, Kamran Heidari, S. Hosseini

{"title":"Quality of Cardiopulmonary Resuscitation in Emergency Department Based on the AHA 2015 Guidelines; a Brief Report","authors":"A. Vafaei, Amin shams akhtari, Kamran Heidari, S. Hosseini","doi":"10.22037/EMERGENCY.V6I1.22233","DOIUrl":"https://doi.org/10.22037/EMERGENCY.V6I1.22233","url":null,"abstract":"Introduction: Adhering to existing guidelines on cardiopulmonary resuscitation (CPR) can increase the survival rate of the patients. The present study has been designed with the aim of determining the quality of CPR performed in the emergency department based on the latest protocol by the American heart association (AHA). Methods: In this prospective cross-sectional study CPR process was audited in patients above 18 years old in need of CPR presenting to the emergency departments of 3 teaching hospitals based on the AHA 2015 guidelines. Less than 60% agreement was considered as fail, 60-70% as poor, 70-80% as moderate, 80-90% as good, and 90-100% as excellent. Results: 80 cases of CPR were audited (55% male). Location of arrest was the hospital in 58 (72.5%) cases and 48 (60.0%) of the cases happened during the day. 28 (35.0%) cases had orotracheal intubation before the initiation of CPR. 30 (37.5%) patients had a shockable rhythm at the initiation of CPR. Based on the findings, out of the 31 studied items, 9 (29.03%) had excellent agreement, 10 (32.25%) had good, 4 (12.90%) had moderate, 2 (6.45%) had poor, and 6 (19.35%) had fail agreement rate. Conclusion: Based on the findings of the present study, the quality of applying the principles of basic and advanced CPR in the emergency department of the studied hospital had intermediate, poor and fail agreement with the recommendations of the AHA 2015 in at least one third of the cases.","PeriodicalId":11681,"journal":{"name":"Emergency","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44653214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Hyper Acute Quadriplegia with Chronic Lead Toxicity; a Case Report 超急性四肢疼痛伴慢性铅中毒；病例报告

Emergency Pub Date : 2018-07-15 DOI: 10.22037/EMERGENCY.V6I1.21609

M. Mesri, F. Najari, Ideh Baradaran Kayal, Dorsa Najari

引用次数: 2