Journal of Emergencies, Trauma, and Shock最新文献

{"title":"Assessing the Clinical Impact of Emergency Physician-performed Ultrasound-guided Peripheral Nerve Blocks in a Level 1 Trauma Center: A Retrospective Analysis.","authors":"Sanjeev Bhoi, Bharath Gopinath, Utkarsh Khandelwal, Rakesh Nayaka, Jyothiswaroop Bhaskararayuni, Devansh Gupta, Ayush Srivastava, Anisha Anshu, Aaditya Katyal, Tej Prakash Sinha","doi":"10.4103/jets.jets_8_24","DOIUrl":"10.4103/jets.jets_8_24","url":null,"abstract":"<p><strong>Introduction: </strong>Effective pain management is crucial in the emergency department (ED), particularly for trauma patients. Ultrasound-guided regional analgesia (UGRA) has emerged as a promising technique for acute pain relief. The objective of this study is to describe the various UGRA performed and assess their effectiveness among trauma patients in our Level 1 Trauma Center ED over the past 2.5 years.</p><p><strong>Methods: </strong>Data from 485 trauma patients who underwent UGRA over 2.5 years were analyzed retrospectively. The primary outcome was the median Defense and Veterans Pain Rating Scale (DVPRS) reduction at 30 min and 1 h after nerve block administration. Patient characteristics, types of nerve blocks administered, procedural details, and outcomes were also noted. Statistical analysis was performed to determine the median reduction in pain scores and evaluate the success of UGRA.</p><p><strong>Results: </strong>UGRA demonstrated a significant reduction in pain scores, with a median DVPRS decrease from 9 (interquartile range [IQR]: 9-10) preprocedure to 4 (IQR: 2-5) at 30 min and 1 (IQR: 0-2) at 1 h postprocedure. Sixteen types of nerve blocks were administered in our ED, with the serratus anterior block (<i>n</i> = 91) and fascia iliaca compartment block (<i>n</i> = 58) being the most common. Pain relief was the most common indication for block administration. A higher volume was injected for plane blocks compared to nerve-specific blocks. No complications or failed blocks were reported.</p><p><strong>Conclusion: </strong>This study describes 16 different UGRA that can be performed by emergency physicians (EPs) in ED for trauma patients. UGRA is effective in providing substantial pain relief for trauma patients in the ED. UGRA performed by EPs offers a safe and feasible approach for managing acute pain in the ED.</p>","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"17 4","pages":"193-200"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255768","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":"Blunt Trauma without Elevated Fibrin Degradation Product.","authors":"Youichi Yanagawa, Michika Hamada, Chihiro Maekawa, Noriko Tanaka, Kenji Kawai, Soichiro Ota","doi":"10.4103/jets.jets_107_24","DOIUrl":"10.4103/jets.jets_107_24","url":null,"abstract":"","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"17 4","pages":"255-256"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255769","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: Point-of-Care Ultrasound-guided Pain Management in Emergency Departments.","authors":"Siju V Abraham, Julio Arrieta","doi":"10.4103/jets.jets_153_24","DOIUrl":"10.4103/jets.jets_153_24","url":null,"abstract":"","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"17 4","pages":"191-192"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255784","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":"Identification of Predictive Factors for Massive Transfusion Activation in Trauma Patients: A Systematic Review and Meta-analysis.","authors":"Thosapol Ueamsaranworakul, Ratcharin Niamjumnong, Kumpol Kornthatchapong, Winchana Srivilaithon","doi":"10.4103/jets.jets_19_24","DOIUrl":"10.4103/jets.jets_19_24","url":null,"abstract":"<p><strong>Introduction: </strong>Acute blood loss and uncontrolled hemorrhage in trauma require quick identification and action to restore circulating volume and save the patient. These patients have the opportunity to receive massive transfusion (MT) to reduce mortality rates and avoid overtransfusion using a suitable ratio of blood components. This study aims to systematically review and analyze the predictive factors for the activation of MT protocol (MTP) in trauma patients, which is critical for improving clinical decision-making and patient outcomes.</p><p><strong>Methods: </strong>PubMed, ScienceDirect, Cochrane, and other sources were searched for articles from 2007 to 2020. Conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, this systematic review included original studies published in English, involving trauma patients aged 15 years or older who received MTP. The risk of bias (RoB) was assessed using the RoB in Nonrandomized Studies of Interventions-I and RoB 2 tools, and statistical analysis was performed, focusing on the homogeneity of effect sizes across trials.</p><p><strong>Results: </strong>The articles search identified a total of 424 studies. Nine studies met all inclusion criteria. The most common predictors were age, sex, systolic blood pressure (SBP), heart rate (HR), hemoglobin (Hb) levels, international normalized ratio (INR), base excess (BE), and lactate levels. The analysis showed that parameters such as SBP, HR, Hb, INR, BE, and lactate were significantly associated with the activation of MTP. However, age and sex were not significant predictors. The survival rate was notably lower in the MTP group compared to the non-MTP group. There was no evidence of publication bias.</p><p><strong>Conclusion: </strong>Several physiological parameters: low SBP, elevated HR, reduced Hb, increased INR, diminished BE, and elevated lactate are significantly correlated with an increased likelihood of necessitating MTP in trauma patients. Among those who received MTP, the survival rate was lower compared to the non-MTP group.</p>","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"17 4","pages":"212-220"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254753","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":"Does Real-time Feedback Guide Devices Improve the Quality of Chest Compressions in the Bystander (Naves) Provider?","authors":"Thamir AlSayed, Samer Al Haliq, Faisal Katbi, Mohannad Alghamdi, Mohammed Almulhim","doi":"10.4103/jets.jets_35_24","DOIUrl":"10.4103/jets.jets_35_24","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiopulmonary resuscitation (CPR) is an important lifesaving technique that must taught to everyone. As most cardiac arrests occur outside of the hospital, training the general population in the recognition of cardiac arrest and performing high-quality CPR is vital. Thus, this study aimed to compare the chest compression quality data (rate, depth, and fraction) with and without the use of feedback devices during CPR.</p><p><strong>Methods: </strong>A crossover observational study was carried out at a tertiary hospital in September 2021. Five hundred and seventeen 1^st-year university students were recruited, and the response rate was 90% (465). A feedback device was used to collect data. The data were numerically coded and statistical software (SPSS 21) was used to perform descriptive and inferential statistical analysis, including a paired <i>t</i>-test.</p><p><strong>Results: </strong>The mean compression rate with feedback was statistically significantly lower after performing one cycle of CPR (mean difference: -5.610; 95% confidence interval [CI]= -7.987--3.233; <i>P</i> < 0.001), the difference between mean compression depth with and without feedback was not statistically significant (mean difference: = -0.006; 95% CI = -0.190-0.177; <i>P</i> = 0.944), and the mean compression target (%) with feedback was statistically significantly higher (mean difference: -15.951; 95% CI = -17.894--14.009; <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>We found that the use of feedback devices during layperson-simulated CPR scenarios significantly improved the quality of chest compression in terms of depth and rate and resulted in more guidelines adherence. Moreover, national programs for CPR education should be implemented.</p>","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"17 4","pages":"221-224"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254442","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":"Intestinal Ischemia Unveiling Takayasu Arteritis: A Rare Encounter.","authors":"Dhamodhara Kannan Shivarajan, Bhupendra Mehra, Soumya Ghoshal, Siddharth P Dubhashi","doi":"10.4103/jets.jets_53_24","DOIUrl":"10.4103/jets.jets_53_24","url":null,"abstract":"","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"17 4","pages":"248-249"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254940","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":"Rapid Spontaneous Regression of Traumatic Subdural Hematoma.","authors":"Prashant Punia, Ashish Chugh, Sarang Gotecha, Neeraj Singh, Jayant Gaud, Ishant Rege, Ramis Abdul Aziz","doi":"10.4103/jets.jets_46_24","DOIUrl":"10.4103/jets.jets_46_24","url":null,"abstract":"<p><p>Acute subdural hematoma (ASDH) is a type of intracranial hemorrhage and is due to the collection of blood below the inner layer of the dura but external to the brain and arachnoid membrane. It tends to occur in the temporal parietal regions. Early intervention is the key for better outcome of the patient. Management depends on neurological status and imaging. Large SDH collects along the convexity of the brain causing compression over the brain stem with midline shift. In cases of conservatively managed ASDH, spontaneous resolution usually takes weeks to months depending on the size of the bleed. In rare cases, spontaneous rapid resolution of the SDH occurs. So here, we are presenting an 11-month-old baby girl who was brought to our Emergency room/department (ER) with a history of fall and computed tomography scan was suggestion of an ASDH in the left temporoparietal region which resolves on its own in 6 h which is a rare phenomenon and needs to be highlighted.</p>","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"17 4","pages":"245-247"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255688","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":"Mitigating Latent Safety Threats in Cardiac Arrest Management: The Role of Simulation-based Training.","authors":"Hritika Sharma, Kalyani S Thakare","doi":"10.4103/jets.jets_98_24","DOIUrl":"10.4103/jets.jets_98_24","url":null,"abstract":"","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"17 4","pages":"251-252"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255319","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: 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}