International Journal of Emergency Medicine最新文献

{"title":"New Fresnel lens loupe for nystagmus observation suitable for use by medical staff in emergency departments.","authors":"Reiko Tsunoda, Yumi Dobashi, Masao Noda, Hiroaki Fushiki","doi":"10.1186/s12245-024-00791-2","DOIUrl":"10.1186/s12245-024-00791-2","url":null,"abstract":"<p><strong>Background: </strong>Reduction of spontaneous nystagmus by fixation, a characteristic feature of peripheral nystagmus, is important for differentiating between peripheral and central vestibular disorders. In the emergency room, Frenzel goggles are recommended to observe spontaneous nystagmus for the differential diagnosis of acute vestibular syndrome. We developed a portable loupe with a Fresnel lens to observe nystagmus. The loupe does not require power supply and can be used under ceiling lights. The aim of this study was to quantitatively and objectively compare the abilities of the loupe and conventional Frenzel goggles to observe spontaneous nystagmus and to verify that the loupe can detect peripheral nystagmus that cannot be observed with the naked eye.</p><p><strong>Methods: </strong>Visual impact susceptibility was compared between the loupe and Frenzel goggles using the slow-phase velocity of nystagmus induced by the caloric test in 15 participants. Subsequently, under lighting, the nystagmus observations under the naked eye condition and with the use of the loupe were compared. Furthermore, the visibility of nystagmus was evaluated from recorded videographic images.</p><p><strong>Results: </strong>In observations of nystagmus induced by the caloric test, the visual impact of the loupe was not inferior to that of Frenzel goggles. The mean slow-phase velocity of nystagmus recorded with the loupe was significantly higher than that observed with the naked eye. Nystagmus weakened under bright lighting could be recovered by the loupe as fixation was blocked and the direction of the nystagmus could be defined.</p><p><strong>Conclusions: </strong>The results showed that the loupe is helpful in observing nystagmus, which is weakly observed with the naked eye under bright light. This portable, low-cost loupe, which yields superior results, can serve as an alternative to conventional Frenzel goggles in emergency medical settings where rapid assessment is required.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"17 1","pages":"197"},"PeriodicalIF":2.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Describing trauma patient characteristics and care provided at a referral hospital in Mwanza, Tanzania: a prospective cross-sectional study.","authors":"Shahzmah Suleman, Vihar Kotecha, Doug Lorenz, Charles Uttoh, Rebecca Yalimo, Colleen Fant","doi":"10.1186/s12245-024-00775-2","DOIUrl":"10.1186/s12245-024-00775-2","url":null,"abstract":"<p><strong>Background: </strong>Over 90% of trauma deaths occur in low- and middle-income countries (LMICs). The trauma burden in Tanzania is similar to the global rate of 10% and road traffic injuries result in a 40% mortality. To understand epidemiology of trauma referrals and care we aimed to describe the patients presenting to a tertiary, referral hospital in Tanzania for trauma care, their injuries and mechanism of injury, and describe the care received.</p><p><strong>Methods: </strong>A cross-sectional study was done at the emergency department of this tertiary referral hospital in the northwestern zone of Tanzania between March - August 2023. All patients presenting to the emergency for trauma were approached and those who could consent or assent were enrolled. Data was collected on the WHO Trauma form and injury severity was calculated with Kampala trauma score II. Data was entered into Redcap and analyzed using R statistical software. Descriptive statistics and frequency tables and charts were used to present data.</p><p><strong>Results: </strong>At the Emergency department, 12% of the patients were categorized as trauma. Median age was 29 years (IQR 20-41 years) with a 79% male predominance. Most patients (78%) presented with major injuries resulting from road traffic accidents. There was high acuity, with 57% had Kampala trauma score < 6. The most prevalent injuries were musculoskeletal and skin. Most patients (84%) attended one prior hospital before being referred. Mwanza region contributed the highest to the trauma referrals (53%) and the most common intervention was intravenous canulation (98%).</p><p><strong>Conclusions: </strong>Trauma-related referrals are common in the young with the majority presenting from the Mwanza region. Most patients were referred from another health facility in line the with Tanzanian referral channel. Most patients had severe injury and amongst all IV cannulation was the most prevalent lifesaving intervention at EMD.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"17 1","pages":"196"},"PeriodicalIF":2.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma exchange as a rescue therapy for treatment-resistant thyroid storm with concurrent heart failure: a literature review based on a case report.","authors":"Pouya Ebrahimi, Moloud Payab, Maryam Taheri, Salma Sefidbakht, Neda Alipour, Taha Hasanpour, Pedram Ramezani, Mahbube Ebrahimpur, Hamid Reza Aghaei Meybodi","doi":"10.1186/s12245-024-00783-2","DOIUrl":"10.1186/s12245-024-00783-2","url":null,"abstract":"<p><strong>Introduction: </strong>Thyroid storm or severe hyperthyroidism can present with various signs and symptoms. They are mostly controlled by general treatment, such as anti-thyroid drugs and other medications to control clinical features. However, in rare cases, they are more severe, and they only respond to more aggressive treatments, such as plasmapheresis and total thyroidectomy. The final histopathological features, such as the loci of differentiated thyroid carcinoma, are sometimes surprising.</p><p><strong>Case presentation: </strong>Here, we present a 40-year-old female who presented with severe palpitation, diaphoresis, and chest pain. After taking the initial steps of treatment and stabilizing the patient, the history, physical exam, and laboratory results confirmed the diagnosis of a thyroid storm in the background of Graves' disease that is accompanied by heart failure with reduced ejection fraction (HFrEF). She was admitted to an ICU setting and received principal treatment of thyroid storm. However, the systematic treatment was not effective, and finally, plasmapheresis and total thyroidectomy were performed. Histopathologic evaluation following surgery confirmed the presence of foci of papillary thyroid carcinoma (PTC) in the background of the grave's disease. This case underscores the complexity of managing Grave's induced thyroid storm in severe cases, which might lead to plasmapheresis and total thyroidectomy. Urgent and invasive treatment may be necessary in rare cases when normally applied treatment modalities are not able to control the situation and result in life-threatening critical health conditions. In such a severe case, it can result in serious cardiovascular complications such as decompensated heart failure with a high rate of mortality.</p><p><strong>Key clinical message: </strong>Thyroid storm, though rare, can be accompanied by severe medical conditions such as heart failure and death. In cases in which primary medical and symptomatic therapies do not work, more aggressive treatment (such as plasmapheresis and total thyroidectomy) should be considered. On the other hand, precise histopathologic evaluation of the thyroid tissue is necessary.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"17 1","pages":"195"},"PeriodicalIF":2.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of time to neurosurgical or neuroradiological intervention therapy on outcomes and quality of care after traumatic brain injury, a registry-based observational study.","authors":"Wasin Pansiritanachot, Sattha Riyapan, Sang Do Shin, Jirayu Chantanakomes, Netiporn Thirawattanasoot, Wichayada Rangabpai, Bongkot Somboonkul, Joo Jeong, Kyoung Jun Song, Wen-Chiu Chiang, Sabariah Faizah Jamaluddin, Kentaro Kajino","doi":"10.1186/s12245-024-00787-y","DOIUrl":"10.1186/s12245-024-00787-y","url":null,"abstract":"<p><strong>Background: </strong>Evidence regarding the effect of time to neurosurgical and neuroradiological intervention on outcomes in traumatic brain injury (TBI) across Asia-Pacific region is limited. This study evaluates the quality of care and outcomes for TBI patients undergoing neurosurgical and neuroradiological procedures at different timings.</p><p><strong>Methods: </strong>Adult TBI patients who received any neurosurgical or neuroradiological interventions during the year 2015-2022 in the Pan-Asian Trauma Outcome Study database were analyzed. The time to intervention, as the main exposure, was classified into three groups (Early, Intermediate, and Delayed) using Restricted Cubic Spline (RCS) analysis. The outcomes were in-hospital mortality and unfavorable neurological outcomes. W score was utilized to compare the quality of care among exposure groups. Multivariable logistic regression analysis and interaction analysis were performed to identify the association between the exposure groups and outcomes, reported as adjusted odds ratios (AOR) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>A total of 1,780 patients were included. From the RCS analysis, patients were classified into three groups according to time to intervention: Early (< 1.9 h), Intermediate (1.9-4.1 h), and Delayed (> 4.1 h). According to the time to intervention, W score was - 8.6 in the early group, -1.1 in the intermediate group, and + 0.4 in the delayed group. Patients receiving intermediate and delayed intervention showed significantly lower mortality (AOR 0.64, 95% CI 0.47-0.86 and AOR 0.66, 95%CI 0.48-0.90, respectively).</p><p><strong>Conclusion: </strong>Early neurosurgical and neuroradiological interventions in TBI patients in the Asia-Pacific region were associated with lower quality of care and higher mortality. The quality of care should be focused and improved during the early hours of TBI.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"17 1","pages":"193"},"PeriodicalIF":2.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of decision-making for the initiation of resuscitation: a mixed-methods systematic review of barriers and facilitators.","authors":"Golshan Moghbeli, Fariborz Roshangar, Amin Soheili, Fazlollah Ahmadi, Hossein Feizollahzadeh, Hadi Hassankhani","doi":"10.1186/s12245-024-00788-x","DOIUrl":"10.1186/s12245-024-00788-x","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to comprehensively examine the factors influencing healthcare providers' decision-making for initiation of resuscitation (IOR).</p><p><strong>Background: </strong>In-hospital resuscitation survival hinges on timely and effective interventions. Despite guidelines, decision-making during resuscitation remains challenging, impacted by both clinical and non-clinical factors.</p><p><strong>Methods: </strong>A mixed-methods systematic review (MMSR) was conducted, searching PubMed, Web of Science, Scopus, and Embase in May 2024. Twenty peer-reviewed studies of adult in-hospital resuscitation decision-making (≥ 18 years) were included. Data were extracted and synthesized using the Joanna Briggs Institute (JBI) convergent integrated approach.</p><p><strong>Results: </strong>A database search yielded 4398 studies, of which 1216 were duplicates. After screening 3182 unique studies, 20 articles (five qualitative, 12 quantitative, three mixed methods) were included. Data synthesis identified three overarching themes: patient, provider, and system factors. These themes encompassed barriers and facilitators to IOR.</p><p><strong>Conclusion: </strong>This review underscores the importance of understanding patient-related, provider-related, and system-related factors influencing IOR. By addressing these factors, healthcare organizations can improve resuscitation practices and outcomes. Future research should focus on enhancing collaboration, communication, and resource availability while considering non-medical factors in decision-making for IOR.</p><p><strong>Relevance to clinical practice: </strong>Understanding the multifaceted barriers and facilitators identified in this study can enhance the effectiveness of resuscitation protocols and ultimately improve patient outcomes during critical care situations.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"17 1","pages":"194"},"PeriodicalIF":2.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventable diagnostic errors of lower gastrointestinal perforation: a secondary analysis of a large-scale multicenter retrospective study.","authors":"Taku Harada, Takashi Watari, Satoshi Watanuki, Seiko Kushiro, Taiju Miyagami, Syunsuke Syusa, Satoshi Suzuki, Tetsuya Hiyoshi, Suguru Hasegawa, Shigeki Nabeshima, Hidetoshi Aihara, Shun Yamashita, Masaki Tago, Fumitaka Yoshimura, Kotaro Kunitomo, Takahiro Tsuji, Masanori Hirose, Tomoya Tsuchida, Taro Shimizu","doi":"10.1186/s12245-024-00781-4","DOIUrl":"10.1186/s12245-024-00781-4","url":null,"abstract":"<p><strong>Background: </strong>Lower gastrointestinal perforation (LGP) is an acute abdominal condition associated with a high mortality rate. Timely and accurate diagnosis is crucial. Nevertheless, a diagnostic delay has been estimated to occur in approximately one-third of the cases, and the factors contributing to this delay are yet to be clearly understood. This study aimed to evaluate the diagnostic process for appropriate clinical reasoning and availability of image interpretation in cases of delayed diagnosis of LGP.</p><p><strong>Methods: </strong>A secondary data analysis of a large multicenter retrospective study was conducted. This descriptive study analyzed data from a multicenter, observational study conducted across nine hospitals in Japan from January 2015 to December 2019. Out of 439 LGP cases, we included 138 cases of delayed diagnosis, excluding patients with traumatic or iatrogenic perforations, or those secondary to mesenteric ischemia, appendicitis, or diverticulitis. Clinical history and computed tomography (CT) imaging information were collected for 138 cases. Additionally, information on the clinical course of 50 cases, which were incorrectly diagnosed as gastroenteritis, constipation, or small bowel obstruction, was also collected.</p><p><strong>Results: </strong>In 42 (30.4%) cases of delayed diagnosis of LGP, CT imaging was performed before diagnosis, indicating a missed opportunity for timely diagnosis. Moreover, 33 of the 50 patients initially diagnosed with gastroenteritis, constipation, or small bowel obstruction at the time of initial examination had atypical findings that were not consistent with the initial diagnosis. Of the 138 cases with delayed diagnosis in our study, 67 cases (48.6%) showed problems with either the interpretation of CT scans or with the process of clinical reasoning.</p><p><strong>Conclusion: </strong>Our retrospective study results indicate that approximately half of the cases with delayed diagnosis of LGP were due to problems in interpreting CT images or in clinical reasoning. This finding suggests that clinical reasoning and image interpretation by radiologists are important in improving the diagnostic process for LGP.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"17 1","pages":"192"},"PeriodicalIF":2.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apelin-13 as a novel diagnostic laboratory biomarker in thromboembolic disorders: a review of literature with prospective insights.","authors":"Mehdi Karimi, Niyousha Shirsalimi, Eshagh Sedighi","doi":"10.1186/s12245-024-00774-3","DOIUrl":"10.1186/s12245-024-00774-3","url":null,"abstract":"<p><p>Thromboembolic disorders, including deep vein thrombosis (DVT) and pulmonary embolism (PE), are major global health concerns, causing significant morbidity and mortality. Early diagnosis is crucial for effective treatment and improved patient outcomes. Recent research has identified Apelin-13, a bioactive peptide in the apelin family, as a promising diagnostic biomarker for Thromboembolic disorders. Apelin-13 supports vascular health by regulating protease balance through plasminogen activator inhibitors and modulating endothelial cell function. Additionally, it plays a vital role in coagulation, with elevated levels associated with an increased risk of clot formation, suggesting its utility in predicting thrombosis risk, particularly in preoperative evaluations. Findings indicate that the Apelin-13 pathway shows significant promise as a biomarker for Thromboembolic disorders, underscoring its potential therapeutic applications and the need for further investigation. This review synthesizes current literature on thromboembolic disorders and associated laboratory biomarkers, with a particular focus on Apelin-13. It examines Apelin-13's role in disease mechanisms, its physiological functions, and its potential as a diagnostic biomarker in thromboembolic conditions.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"17 1","pages":"190"},"PeriodicalIF":2.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carbon monoxide poisoning: a clinical case report.","authors":"Deimante Baksevice, Aida Mankute-Use, Austeja Bernotaite-Morkune, Egle Zelbiene","doi":"10.1186/s12245-024-00777-0","DOIUrl":"10.1186/s12245-024-00777-0","url":null,"abstract":"<p><strong>Background: </strong>Carbon monoxide (CO) poisoning is a serious yet frequently overlooked condition with diverse and nonspecific clinical presentations. The analysis of Lithuanian statistics reveals fluctuations in patient admissions and consultations through the poisoning center over a four-year period, with notable variations in fatality rates. Despite these trends, CO poisoning remains a significant public health concern due to its potential for severe long-term sequelae or death.</p><p><strong>Case: </strong>This case report focuses on two distinct presentations of CO poisoning in a young couple, illustrating the varied manifestations and outcomes of this toxic exposure. The first case describes a 23-year-old male presenting with altered consciousness and neurological symptoms, while the second case involves a 21-year-old pregnant female presenting with cardiovascular symptoms, including Takotsubo cardiomyopathy.</p><p><strong>Discussion: </strong>Highlights include the challenges in diagnosing CO poisoning; factors influencing the severity and symptoms of CO poisoning; potential complications; and considerations for hyperbaric oxygen therapy (HBO) in severe cases and pregnancy.</p><p><strong>Conclusion: </strong>These cases illustrate the importance of recognizing CO poisoning, advocating for oxygen therapy as the first-line treatment, and calling for further research to improve understanding, treatment, and prevention of this potentially fatal condition.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"17 1","pages":"186"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awareness and knowledge of cardiopulmonary resuscitation (CPR) among the general public in West-Bank in Palestine.","authors":"Alhareth M Amro, Osama J Makhamreh, Hamdah Hanifa, Tarek A Owais, Afnan W M Jobran","doi":"10.1186/s12245-024-00778-z","DOIUrl":"10.1186/s12245-024-00778-z","url":null,"abstract":"<p><strong>Background: </strong>Sudden cardiac death (SCD) is a leading cause of cardiovascular-related deaths, often occurring outside hospitals in undiagnosed individuals. Our study aims to assess the baseline awareness and skills in performing CPR among the population in Palestine.</p><p><strong>Methods: </strong>A cross-sectional study was conducted using an online questionnaire to assess CPR knowledge among residents of the West Bank, Palestine. Convenience sampling targeted 300 participants via social media. Data were analyzed using descriptive statistics and chi-square tests to examine associations.</p><p><strong>Results: </strong>The study surveyed 555 participants, revealing that 58.2% lacked CPR training. Awareness of cardiac arrest signs varied, with chest pain being the most recognized 19%. CPR training significantly improved participants' recognition and response to cardiac emergencies.</p><p><strong>Conclusion: </strong>Addressing the fear of legal consequences is crucial to encourage bystander assistance. We recommend increasing first aid awareness through scientific conferences, free training courses, media campaigns, and incentivized competitions.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"17 1","pages":"191"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Audit of preparedness of selected military hospital in the face of biological threats: action research study.","authors":"Ali Mohammdi Sehdeh, Abbas Ebadi, Abdollah Saghafi, Alireza Basiri, Esmail Heidaranlu","doi":"10.1186/s12245-024-00786-z","DOIUrl":"10.1186/s12245-024-00786-z","url":null,"abstract":"<p><strong>Introduction: </strong>In today's societies, the threats caused by chemical, biological, radiological and nuclear accidents, whether accidental or intentional, have become a great concern. Acquiring knowledge about how to respond to the management of these incidents and the complications caused by them in order to preserve societies and ensure stability is essential. Due to the fact that hospitals play an important role in dealing with the victims of biological threats, this study was conducted with the aim of auditing the preparedness of selected military Hospital in facing biological threats in 2023-2024.</p><p><strong>Methods: </strong>This applied research was conducted with the participatory action research method in all departments of selected military Hospital during one year from July 2023 to July 2024. The level of biological preparedness of the hospital was investigated using the hospital's preparedness tool in biological events with 147 items in 8 main dimensions and 20 sub-dimensions, and the weak areas of the hospital (9 areas) were identified. Then, in the hospital audit cycle, using the FOCUS-PDCA model, a program to improve work processes and improve the biological preparedness of different departments of the hospital in the face of accidents and disasters was implemented. The level of biological preparedness of the hospital before and after the implementation of the change was compared and analyzed using SPSS. version 22 software.</p><p><strong>Results: </strong>The preparedness in the studied hospital in facing biological threats before the change was 196 out of 294 and the hospital's biological preparedness percentage was 66.66%, which was in the average range, and after the change, the preparedness score reached 228 and the hospital's preparedness percentage was 77.55%, which was in the range Well classified. In 9 fields where the level of biological preparedness was moderate and weak, the highest preparedness was created in the field of employees and volunteers with 86.36% and the lowest preparedness was related to the field of corpse management with 50%.</p><p><strong>Conclusion: </strong>Considering the impact of training in improving the hospital's preparedness program in the face of biological threats, it is suggested that other medical centers include audits in their work plan.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"17 1","pages":"187"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}