Journal of Emergencies, Trauma, and Shock最新文献

{"title":"Erratum: Barriers to Effective Prehospital and Hyperacute Stroke Care in India: A Physician Perspective.","authors":"","doi":"10.4103/jets.jets_128_24","DOIUrl":"https://doi.org/10.4103/jets.jets_128_24","url":null,"abstract":"<p><p>[This corrects the article on p. 129 in vol. 17.].</p>","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"17 3","pages":"188"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142650522","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":"Triad of Clubbing, Boot-shaped Heart, and Brain Abscess in Tetralogy of Fallot.","authors":"Anterpreet Kaur, Harpreet Singh, Deba Prasad Dhibar","doi":"10.4103/jets.jets_21_24","DOIUrl":"10.4103/jets.jets_21_24","url":null,"abstract":"","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"17 3","pages":"187-188"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648170","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":"What is the Optimal Treatment Protocol for Traumatic Popliteal Artery Injury? A Comparative Study between Two Institutions.","authors":"Sadaki Mitsuzawa, Shinnosuke Yamashita, Yoshihiro Tsukamoto, Hisataka Takeuchi, Satoshi Ota, Eijiro Onishi, Kenji Kusakabe, Shota Nakao, Tetsuya Matsuoka, Tadashi Yasuda","doi":"10.4103/jets.jets_164_23","DOIUrl":"10.4103/jets.jets_164_23","url":null,"abstract":"<p><strong>Introduction: </strong>While rare, popliteal artery injury is a potentially devastating complication of knee trauma. Delayed diagnosis or inadequate management of popliteal artery injury can result in limb ischemia, amputation, and long-term disability. This study aimed to compare the treatment outcomes of popliteal artery injury between different medical centers and to reconsider the optimal protocol at our institution.</p><p><strong>Methods: </strong>Medical records of patients sustaining traumatic popliteal artery injury from 2011 to 2022 at two institutions (one hospital: Group A; the other hospital: Group B) were retrospectively reviewed. Demographic data, radiological assessment, time course and content of initial treatment, clinical outcomes, and follow-up period were recorded.</p><p><strong>Results: </strong>Group A included seven patients (dislocations, <i>n</i> = 3; fractures, <i>n</i> = 2; and glass penetration injuries, <i>n</i> = 2), with a mean follow-up period of 39 months. Group B included five patients (dislocations, <i>n</i> = 3 and fractures, <i>n</i> = 2), with a mean follow-up period of 36 months. Two patients in Group A and four patients in Group B exhibited contrast-medium resumption (average deficit: 57 mm and 60 mm, respectively). The time from injury to reperfusion was significantly shorter in Group A than in Group B (300 min vs. 749 min, <i>P</i> < 0.05). Group A underwent four temporary vascular shunting procedures, four external fixations, six fasciotomies, and five bypass grafting procedures. In Group B, temporary vascular shunt (TVS) was not used in any patient; however, three, two, and three patients underwent external fixation, fasciotomy, and bypass grafting, respectively. One patient in each group required above-the-knee amputation. The mean Lysholm score was 80.4 points in Group A and 72.0 points in Group B.</p><p><strong>Conclusions: </strong>TVS considerably reduces the reperfusion time. Various options for the content and sequence of treatment must be carefully considered in advance. Early diagnosis, prompt intervention, and comprehensive management can improve the quality of care and patient outcomes.</p>","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"17 3","pages":"178-183"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648179","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":"Erratum: Transfusion Practices in Severely Injured Patients at a Level 1 Trauma Center.","authors":"","doi":"10.4103/jets.jets_104_24","DOIUrl":"10.4103/jets.jets_104_24","url":null,"abstract":"<p><p>[This corrects the article on p. 84 in vol. 17, PMID: 39070866.].</p>","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"17 3","pages":"189"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142650523","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":"A Systematic Review and Meta-Analysis of Prehospital Plasma Administration for Hemorrhagic Shock.","authors":"Nasser A AlJoaib, Faisal A AlGhamdi, Annas Ghafoor, Fandi Z AlAnazi, Nisreen H Maghraby","doi":"10.4103/jets.jets_124_23","DOIUrl":"10.4103/jets.jets_124_23","url":null,"abstract":"<p><strong>Introduction: </strong>Hemorrhagic shock demands swift intervention. Management involves the rapid infusion of blood products to restore circulation and uphold tissue perfusion. The aim of this study was to evaluate the effectiveness of prehospital plasma administration in trauma patients, comparing outcomes with normal saline. This was a meta-analysis of randomized controlled trials.</p><p><strong>Methods: </strong>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline, searches were conducted in PubMed, MEDLINE, and the Cochrane Central Register of Controlled Trials from August 1, 2018, to April 4, 2023. The PubMed search string included terms related to blood plasma, prehospital care, emergency medical services, and hemorrhagic shock: (Blood Plasma [MeSH Terms] OR fresh frozen plasma [MeSH Terms] OR plasma OR fresh frozen plasma OR FFP) AND (Prehospital OR emergency care, prehospital [MeSH Terms] OR prehospital emergency care [MeSH Terms] OR prehospital OR prehospital OR EMS OR emergency medical service [MeSH Terms]) AND (hemorrhagic shock [MeSH Terms] OR hemorrhage OR hemorrhage OR hemorrhagic shock OR hemorrhagic shock). Results from the trials were pooled using a random effects model, presented as risk ratios with 95% confidence intervals.</p><p><strong>Results: </strong>In the analysis of 760 patients from three studies, outcomes included mortality at 24 h and 28 days, multi-organ failure (MOF), acute lung injury, and vasopressor use within 24 h. Patients were divided into plasma (363) and normal saline (397) groups.</p><p><strong>Conclusion: </strong>There is no distinction between prehospital plasma administration and normal saline concerning mortality at 24 and 28 days or the need for vasopressors within 24 h. Moreover, plasma administration did not appear to influence rates of acute lung injury or MOF.</p>","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"17 3","pages":"136-141"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648103","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":"Factors Influencing Treatment Delays in Trauma Patients: A Three-delay Model Approach.","authors":"Mayank Badkur, Marina Kharkongor, Naveen Sharma, Saurabh Singh, Pushpinder Khera, Ashok Puranik, Mahaveer Singh Rodha","doi":"10.4103/jets.jets_9_24","DOIUrl":"10.4103/jets.jets_9_24","url":null,"abstract":"<p><strong>Introduction: </strong>Identifying factors causing treatment delays is essential for guiding decisions on resource allocation within trauma systems. The three-delay model categorizes delays into: (i) deciding to seek medical care (Phase 1), (ii) recognizing the need for transporting to a medical facility (Phase 2), and (iii) receiving suitable and timely treatment (Phase 3). We seek to investigate factors influencing delays in trauma patients using the three-delay model.</p><p><strong>Methods: </strong>We conducted an 18-month prospective observational study at a tertiary hospital, involving consenting adults (age >18 years) admitted for various traumas. We conducted a detailed interview and extracted objective patient data from medical records using a predetermined form. We observed and analyzed factors influencing the duration of the three phases.</p><p><strong>Results: </strong>Phase 1 delays were observed in 83 patients, Phase 2 delays in 200 patients, and Phase 3 delays in 233 patients. In Phase 3 delays, a shortage of human resources was the most frequently identified cause of delay, affecting 68 out of 233 patients (29%). In severe trauma cases (injury severity score ≥16), any phase delay showed a significant association with poor outcomes (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>The three-delay model offers a valuable framework for understanding and pinpointing the factors contributing to delays in both prehospital and inhospital services.</p>","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"17 3","pages":"172-177"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648116","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":"A Randomized Trial Assessing the Effectiveness of High-fidelity Simulation Training in Managing Maternal Cardiac Arrest among Emergency Medical Professionals in India.","authors":"Parag Rishipathak, Shrimathy Vijayaraghavan","doi":"10.4103/jets.jets_161_23","DOIUrl":"10.4103/jets.jets_161_23","url":null,"abstract":"<p><strong>Introduction: </strong>Maternal cardiac arrest is a rare but critical event that poses significant risks to both the mother and the fetus. As majority of population in India lives in the rural areas, Emergency Medical Professionals assist in childbirth in transit in ambulances. This timely assistance ensures the safe transportation of both mother and new born baby to the hospital. The aim of this study was to assess the effectiveness of high-fidelity simulation training in the management of maternal cardiac arrest among emergency medical professionals.</p><p><strong>Methods: </strong>The randomized simulation study aimed to assess the effectiveness of high-fidelity simulation in managing maternal cardiac arrest. Two hundred and fifty emergency medical professionals were randomly assigned to 50 groups. Participants underwent a prebriefing session before engaging in simulation scenarios. After the initial scenarios, participants received a debriefing session emphasizing the standardized algorithm for maternal cardiac arrest management. A week later, participants engaged in a second simulation scenario, and their adherence to the algorithm was assessed. The data were analyzed using statistical tests, and the entire simulation session was video recorded for reliability.</p><p><strong>Results: </strong>The results showed that participants demonstrated an improvement in managing both maternal and obstetric interventions in the posttraining scenario compared to the pretraining scenario. The successful implementation of the advanced cardiac life support algorithm and the debriefing session were key factors in improving participants' performance. However, continuous exposure and practice are necessary to maintain and enhance these skills.</p><p><strong>Conclusion: </strong>Health-care professionals should actively seek opportunities for ongoing training and education to stay updated with the latest guidelines and advancements in managing maternal cardiac arrest.</p>","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"17 3","pages":"153-158"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648099","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":"What's New in Emergencies, Trauma, and Shock: Prehospital and Hyperacute Stroke Care in India - Hurdles We Need to Cross.","authors":"Tarun Sharma, Steve Kamm","doi":"10.4103/jets.jets_125_24","DOIUrl":"10.4103/jets.jets_125_24","url":null,"abstract":"","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"17 3","pages":"127-128"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648201","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":"Convulsive Patients Transported by a Physician-staffed Helicopter in Japan Had Better Outcomes in the Keyword-triggered Dispatch Compared to Postcontact Emergency Medical Technician-triggered Dispatch.","authors":"Kenji Kawai, Hiroki Nagasawa, Tomohisa Nomura, Manabu Sugita, Youichi Yanagawa","doi":"10.4103/jets.jets_152_23","DOIUrl":"10.4103/jets.jets_152_23","url":null,"abstract":"<p><strong>Introduction: </strong>We retrospectively analyzed convulsive patient outcomes transported by a physician-staffed Helicopter Emergency Medical Service (doctor helicopter [DH]) using the keyword-triggered dispatch with data from the Japan DH Registry System (JDRS). Upon receiving an emergency call containing critical keywords, such as an ongoing convulsion at the firefighting central command room, immediate dispatch of the DH is requested, in addition to dispatching an ambulance. The keyword-triggered dispatch relied on data obtained from the JDRS.</p><p><strong>Methods: </strong>Details from the JDRS database included patient age, sex, cardiac arrest presence upon DH contact, vital signs, DH dispatch timing (keyword-triggered dispatch/emergency medical technician [EMT]-triggered dispatch), medical intervention details, and 1-month outcomes (cerebral performance category [CPC]; CPC1, 2: Good; CPC 3-5: Poor). Subjects were divided into keyword (keyword-triggered dispatch) and control (EMT-triggered dispatch) groups for comparison.</p><p><strong>Results: </strong>Of 1201 patients, all evacuated from the scene, 617 were in the keyword group, and 584 in the control group. No significant differences existed between groups for cardiac arrest, respiratory and heart rates, CPC, or mortality. The keyword group had lower average age, systolic blood pressure, and medical intervention ratio but a higher median Glasgow Coma Scale and good outcome ratio.</p><p><strong>Conclusion: </strong>This first report on the keyword-triggered dispatch as a prognostic factor for convulsive patients evacuated by DH using the JDRS.</p>","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"17 3","pages":"142-145"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648130","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":"Impact of Lactate on Disseminated Intravascular Coagulation in Patients with Severe Trauma.","authors":"Chao Nan, Fujing Liu, Tijun Gu, He Zhang, Jinhai Wang, Lijun Meng","doi":"10.4103/jets.jets_122_23","DOIUrl":"10.4103/jets.jets_122_23","url":null,"abstract":"<p><strong>Introduction: </strong>The association between elevated lactate levels and the development of disseminated intravascular coagulation (DIC) in patients with severe trauma remains unclear. Hence, this study aimed to explore the association between lactate and the development of DIC in patients with severe trauma.</p><p><strong>Methods: </strong>This prospective cohort study was conducted on consecutive patients with severe trauma who were hospitalized in the intensive care unit from January 2020 to January 2023. The primary outcome measured was the occurrence of DIC in patients in the emergency department or posthospitalization. Logistic regression analysis evaluating the risk values for lactate and DIC, the receiver operating characteristic (ROC) curve, and decision curve analysis (DCA) examinations studying the predictive efficiency of lactate for DIC. The Kaplan-Meier survival curve was used to assess patient survival. Sensitivity robustness analysis included modified Poisson regression, <i>E</i>-value, subgroup analysis, and numerical variable transformation analysis.</p><p><strong>Results: </strong>Logistic regression analysis corrected for confounding factors showed that lactate was a risk factor for DIC in patients with severe trauma (adjusted odds ratio [OR]: 1.374, 95% confidence interval [CI]: 1.206-1.566). Lactate predicted DIC risk with a 0.8513 area under the ROC curve (95% CI: 0.7827-0.9199), 4.8 cutoff value, 0.8333 sensitivity, and 0.8014 specificity. DCA showed the correlation between lactate and DIC. The mortality rate of patients with a high risk of DIC was significantly higher than that of patients with a low risk (log-rank test, <i>P</i> < 0.001). The modified Poisson regression showed that lactate was a risk factor for DIC (risk ratio: 1.188, 95% CI: 1.140-1.237). <i>E</i>-value was 1.645, and the lower limit of 95% CI was 1.495. The logistic regression analysis after subgroup analysis and transformation of numerical variables showed that lactate remained a risk factor for DIC.</p><p><strong>Conclusions: </strong>Elevated lactate is closely associated with the occurrence of DIC in patients with severe trauma. Lactate seems to be a good predictive factor for DIC manifestation in patients with severe trauma.</p>","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"17 3","pages":"146-152"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648152","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}