Journal of Emergencies, Trauma, and Shock最新文献

Tension Pneumoperitoneum from High-pressure Air Insufflation: An Unusual Paraphilic Injury. 高压充气引起的张力性气腹：一种不寻常的性冷淡损伤。

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Journal of Emergencies, Trauma, and Shock Pub Date : 2026-01-01 Epub Date: 2026-02-02 DOI: 10.4103/jets.jets_140_25

C K Amith, Satyendra Meena, Amarinder Singh Malhi, Sanjeev Bhoi

引用次数: 0

Training the Obstetrician on Point-of-care Ultrasound Assessment for Emergencies in Maternal Care. 对产科医生进行急诊超声评估培训。

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Journal of Emergencies, Trauma, and Shock Pub Date : 2026-01-01 Epub Date: 2026-02-02 DOI: 10.4103/jets.jets_153_25

Anish Keepanasseril, Anusha Cherian, Balamurugan Nathan, S Manu Ayyan

引用次数: 0

Factors Influencing the Time to Fibrinolysis in ST-elevation Myocardial Infarction: A Retrospective Observational Study. 影响st段抬高型心肌梗死纤溶时间的因素：一项回顾性观察研究。

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Journal of Emergencies, Trauma, and Shock Pub Date : 2026-01-01 Epub Date: 2026-02-02 DOI: 10.4103/jets.jets_98_25

Thejas Rao, Ezhilkugan Ganessane, Aashish S Raman, S Manu Ayyan, K Kalaivani, Anas Mohammed Muthanikkatt

{"title":"Factors Influencing the Time to Fibrinolysis in ST-elevation Myocardial Infarction: A Retrospective Observational Study.","authors":"Thejas Rao, Ezhilkugan Ganessane, Aashish S Raman, S Manu Ayyan, K Kalaivani, Anas Mohammed Muthanikkatt","doi":"10.4103/jets.jets_98_25","DOIUrl":"https://doi.org/10.4103/jets.jets_98_25","url":null,"abstract":"Introduction: Timely reperfusion is critical for managing ST-elevation myocardial infarction (STEMI). We aimed to quantify treatment delays and identify factors associated with delayed fibrinolysis in STEMI patients.Methods: We conducted a retrospective observational study of 174 consecutive adult patients with STEMI who received fibrinolysis at a tertiary academic emergency department in Southern India between May 2023 and January 2024. Data were abstracted from medical records, and detailed prehospital information was obtained through structured telephone interviews. Multivariable logistic regression was used to identify independent predictors of late arrival (>6 h after symptom onset) and delayed door-to-needle (D2N) time (>30 min).Results: The median time from symptom onset to fibrinolysis was 320 min (interquartile range [IQR]: 210-480), driven primarily by a median prehospital delay of 300 min (IQR: 195-464). In contrast, the median D2N time was 15 min (IQR: 10-25), with 82.2% of patients achieving a D2N time of ≤30 min. Independent predictors of late arrival were lack of formal education (adjusted odds ratio [AOR]: 2.31; 95% confidence interval [CI]: 1.21-4.41) and unemployment (AOR: 1.98; 95% CI: 1.04-3.77). Independent predictors of delayed D2N time were a chief complaint other than chest pain (AOR: 8.98; 95% CI: 1.18-68.10), prior coronary artery disease (AOR: 4.86; 95% CI: 1.68-14.09), and consent time >5 min (AOR: 9.51; 95% CI: 2.65-34.16).Conclusions: Despite excellent inhospital performance metrics, the total ischemic time in STEMI patients remains high due to substantial prehospital delays associated with socioeconomic factors.","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"19 1","pages":"20-29"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592218","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}

引用次数: 0

From Training to Practice: Addressing the Realities of Critical Care Subspecialty in Rural India. 从培训到实践：解决印度农村重症监护亚专科的现实。

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Journal of Emergencies, Trauma, and Shock Pub Date : 2026-01-01 Epub Date: 2026-02-02 DOI: 10.4103/jets.jets_111_25

Shivali Sandal, Surender Himral, Jai Bharat Sharma, Kunal Mahajan

{"title":"From Training to Practice: Addressing the Realities of Critical Care Subspecialty in Rural India.","authors":"Shivali Sandal, Surender Himral, Jai Bharat Sharma, Kunal Mahajan","doi":"10.4103/jets.jets_111_25","DOIUrl":"https://doi.org/10.4103/jets.jets_111_25","url":null,"abstract":"Critical care medicine in India has witnessed significant progress over the past two decades, with the establishment of structured training programs creating a cadre of trained intensivists. Despite these advancements, the translation of progress into rural health systems remains limited, and a large proportion of India's rural population continues to face inequities in access to quality intensive care. This review evaluates the status, challenges, and potential solutions related to the deployment and retention of trained intensivists in peripheral settings to inform equitable and sustainable healthcare policy reforms. Evidence was synthesized from peer-reviewed literature, government reports, and professional society guidelines, focusing on rural-urban disparities, workforce distribution gaps, training limitations, regulatory landscapes, and professional challenges. The findings highlight stark differences in the distribution of intensive care unit beds and availability of qualified intensivists, with rural and semiurban areas frequently under-resourced compared to well-equipped urban centers. Shortages also extend to trained nursing staff and ancillary health professionals, compounding the inequities. Intensivists face systemic hurdles, including inadequate professional recognition, poor access to mental health support, and limited exposure to interdisciplinary training, hospital administration, and research skills during formal training. Professional burnout and brain drain further weaken rural deployment. To bridge these gaps, this review emphasizes the need for targeted policy interventions that address infrastructure investment, workforce development, regulatory reforms, and professional support systems. Leveraging technology for telecritical care and ensuring recognition of intensivists as core specialists are essential steps toward achieving universal and equitable access to critical care across India.","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"19 1","pages":"34-39"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592221","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}

引用次数: 0

Outcomes of Prehospital versus Emergency Department Intubation in Patients Managed by Emergency Medical Services. 急诊医疗服务管理的患者院前插管与急诊插管的结果

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Journal of Emergencies, Trauma, and Shock Pub Date : 2026-01-01 Epub Date: 2026-02-02 DOI: 10.4103/jets.jets_156_25

Yaowapha Siripakarn, Jiraporn Singthep, Winchana Srivilaithon

{"title":"Outcomes of Prehospital versus Emergency Department Intubation in Patients Managed by Emergency Medical Services.","authors":"Yaowapha Siripakarn, Jiraporn Singthep, Winchana Srivilaithon","doi":"10.4103/jets.jets_156_25","DOIUrl":"https://doi.org/10.4103/jets.jets_156_25","url":null,"abstract":"Introduction: Prehospital endotracheal intubation (ETI) is a critical intervention in emergency care; however, its benefit compared to ETI performed in the emergency department (ED) remains uncertain. This study aims to compare survival to hospital discharge between patients who underwent ETI in the prehospital setting versus those intubated in the ED, all managed by a single emergency medical services (EMS) system.Methods: This retrospective cohort study included adult patients treated by the EMS team of Thammasat University Hospital from January 2019 to June 2021 who received ETI either at the scene or within 1 h of ED arrival. Both prehospital and ED ETIs were performed by physicians. The primary outcome was survival to hospital discharge. The secondary outcome was length of hospital stay. Multivariable and propensity score-matched analyses were performed.Results: Of 219 included patients, 106 underwent prehospital intubation, and 113 underwent ED intubation. Survival to hospital discharge was higher in the ED group than in the prehospital group (65% vs. 26%; P < 0.001). After multivariable adjustment, this difference remained significant (adjusted risk difference [RD], 28.7%; 95% confidence interval [CI], 11.1-46.6). However, after propensity score matching, the difference was no longer statistically significant (RD, 3.5%; 95%CI, -22.6 to 29.7; P = 0.789).Conclusion: Among EMS-managed patients requiring ETI, ED intubation was associated with higher crude and adjusted survival; however, this association did not persist after propensity score matching. These findings suggest that baseline differences may partly explain the observed effect and underscore the need for prospective studies to clarify the comparative effectiveness of prehospital airway strategies.","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"19 1","pages":"3-8"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592255","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}

引用次数: 0

Massive Hemothorax Resulting from Blunt Vertebral Fracture. 钝性椎体骨折导致大量血胸。

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Journal of Emergencies, Trauma, and Shock Pub Date : 2026-01-01 Epub Date: 2026-02-05 DOI: 10.4103/jets.jets_40_25

Kuo-Chang Lee, Li-Chin Cheng, Kuo-Tai Chen

{"title":"Massive Hemothorax Resulting from Blunt Vertebral Fracture.","authors":"Kuo-Chang Lee, Li-Chin Cheng, Kuo-Tai Chen","doi":"10.4103/jets.jets_40_25","DOIUrl":"https://doi.org/10.4103/jets.jets_40_25","url":null,"abstract":"Introduction: Thoracic and lumbar vertebral fractures are rare causes of hemothorax, and data on the clinical characteristics of patients with massive hemothorax caused by blunt vertebral fractures are limited.Methods: We conducted a literature search using PubMed, Embase, CENTRAL, Web of Science, and Google Scholar for case reports/series on massive hemothorax resulting from blunt vertebral fractures. Descriptive statistics were employed to analyze the study sample, providing a comprehensive understanding of the characteristics of these patients.Results: Most included cases were older adults and 96.2% patients presented with right hemothorax. The thoracolumbar junction (T10-L2) was the most common site of hemothorax (85.3%). Patients with hemothorax were divided into two groups: group 1, in which bleeding originated from fractured vertebrae, and Group 2, in which bleeding originated from the arteries associated with vertebral fractures. Surgical interventions (68.5%) were the predominant method for controlling bleeding in group 1, whereas endovascular treatments (53.3%) and surgical interventions (46.7%) were the common methods in Group 2. The mortality rate was higher in Group 1 than in Group 2 (26.3% vs. 6.7%). The incidence of massive hemothorax resulting from blunt vertebral fractures is higher in older patients. Massive hemothorax may occur in older patients even following minor traumatic events.Conclusion: Thoracotomy remains the most reliable method for controlling bleeding caused by vertebral fractures, and transarterial embolization is an effective approach for managing arterial bleeding associated with vertebral fractures. Surviving patients often require spinal fixation after the causative bleeding for hemothorax has been controlled.","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"19 1","pages":"9-14"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592266","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}

引用次数: 0

Diagnostic Accuracy of AST and ALT for Detecting Liver Injury in Blunt Abdominal Trauma. AST和ALT对钝性腹部创伤肝损伤的诊断准确性。

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Journal of Emergencies, Trauma, and Shock Pub Date : 2026-01-01 Epub Date: 2026-02-05 DOI: 10.4103/jets.jets_85_25

Jurjai Ravipol, Duongthong Patcharee, Wittayachamnankul Borwon

{"title":"Diagnostic Accuracy of AST and ALT for Detecting Liver Injury in Blunt Abdominal Trauma.","authors":"Jurjai Ravipol, Duongthong Patcharee, Wittayachamnankul Borwon","doi":"10.4103/jets.jets_85_25","DOIUrl":"https://doi.org/10.4103/jets.jets_85_25","url":null,"abstract":"Introduction: Liver injury from blunt abdominal trauma (BAT) is typically diagnosed using computed tomography (CT); however, access to CT imaging is limited in some hospitals. Liver function tests may serve as adjuncts to improve diagnostic accuracy and reduce unnecessary CT scans. This study evaluates whether thresholds of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) can assist in diagnosing liver injury in BAT patients and support clinical decision-making.Methods: A retrospective and observational study was conducted at Saraburi Hospital from 2020 to 2023, including patients over 15 years old with BAT. Exclusion criteria included penetrating injuries, pregnancy, and laboratory testing delayed beyond 24 h after admission. Diagnostic performance of AST and ALT was assessed using receiver operating characteristic (ROC) curves and Youden's J statistic to determine the optimal cutoff values. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated.Results: Of 565 patients, 160 (28.3%) were diagnosed with liver injuries confirmed by CT scan or laparotomy. AST and ALT demonstrated good discriminatory power, with area under the curve (AUC)-ROC values of 0.80 and 0.82. Using cutoff values of AST ≥120 U/L and ALT ≥105 U/L, sensitivity was 88.1% and 82.5%, while specificity was 71.4% and 81.0%. Incorporating these markers into the diagnostic model improved AUC-ROC from 0.762 to 0.891.Conclusions: AST and ALT significantly improved liver injury detection in BAT patients. Incorporating these biomarkers into early clinical assessment may reduce reliance on CT imaging, especially in the resource-limited settings.","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"19 1","pages":"15-19"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592634","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}

引用次数: 0

Erratum: Strategies to Combat Overcrowding at Emergency Departments across India: A White Paper by the Academic College of Emergency Experts, India and the World Health Organization Collaborating Centre for Emergency and Trauma, South-East Asia. 勘误：解决印度各地急诊科过度拥挤问题的战略：印度急诊科专家学术学院和世界卫生组织东南亚急诊科和创伤合作中心的白皮书。

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Journal of Emergencies, Trauma, and Shock Pub Date : 2026-01-01 Epub Date: 2026-02-05 DOI: 10.4103/jets.jets_221_25

引用次数: 0

Fatal Case of Organ Ischemia Secondary to Traumatic Stanford Type B Aortic Dissection. 外伤性Stanford B型主动脉夹层继发器官缺血致死1例。

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Journal of Emergencies, Trauma, and Shock Pub Date : 2026-01-01 Epub Date: 2026-02-02 DOI: 10.4103/jets.jets_113_25

Youichi Yanagawa, Raiki Tokutsu, Satoshi Takagi, Masashi Kato, Atsumi Oishi, Hiroki Nagasawa

引用次数: 0

Biventricular Thrombus Complicating Cardiogenic Shock: A Point-of-care Ultrasound-guided Diagnosis and Management. 双心室血栓合并心源性休克：一种即时超声引导的诊断和治疗。

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Journal of Emergencies, Trauma, and Shock Pub Date : 2026-01-01 Epub Date: 2026-02-02 DOI: 10.4103/jets.jets_110_25

Riyaz Sogiawalla, Deepak Krishnaa, Muaazh Wasil, Jeffrey Pradeep Raj, Firoze Sogiawalla

引用次数: 0