Journal of Emergencies, Trauma, and Shock最新文献_第4页

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":"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":1.0,"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

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":"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":1.0,"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

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":"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":1.0,"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

Preserving Vision Postblast: The Role of Point-of-care Ultrasound and Lateral Canthotomy in Tire Explosion-related Ocular Trauma. 爆炸后视力保护：即时超声和侧眦切开术在轮胎爆炸相关眼外伤中的作用。

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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_100_25

Varsha Shinde, Aviral Ratan Srivastava, Zahid A Shaikh

引用次数: 0

Complex Management of Severe Open Pelvic Fracture in a Polytrauma Patient. 多发伤患者严重开放性骨盆骨折的复杂处理。

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Journal of Emergencies, Trauma, and Shock Pub Date : 2026-01-01 Epub Date: 2026-03-20 DOI: 10.4103/jets.jets_147_24

Anna Kusturova, Vladimir Kusturov

引用次数: 0

Prognostic Value of the Mannheim Peritonitis Index in Predicting Mortality Following Emergency Surgery for Hollow Viscus Perforation. Mannheim腹膜炎指数在预测空心粘肠穿孔急诊手术后死亡率中的预后价值。

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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_109_25

Hong Quan Dang, Van Bi Nguyen, Quoc Viet Cao, Hoai Thuong Duong, Thuong Tri Cao, Van Phu La

{"title":"Prognostic Value of the Mannheim Peritonitis Index in Predicting Mortality Following Emergency Surgery for Hollow Viscus Perforation.","authors":"Hong Quan Dang, Van Bi Nguyen, Quoc Viet Cao, Hoai Thuong Duong, Thuong Tri Cao, Van Phu La","doi":"10.4103/jets.jets_109_25","DOIUrl":"10.4103/jets.jets_109_25","url":null,"abstract":"Introduction: Perforation peritonitis is a life-threatening emergency associated with high morbidity and mortality. Early risk stratification is vital, particularly in resource-limited settings. The Mannheim peritonitis index (MPI) is a widely used prognostic tool, but its performance in Vietnamese patients remains underexplored. The objective of this study was to evaluate the prognostic accuracy of MPI in predicting inhospital mortality among patients undergoing surgery for secondary peritonitis due to hollow viscus perforation.Methods: This prospective observational study included 176 patients treated at a tertiary care center in southern Vietnam from April 2023 to May 2024. Clinical data were collected to calculate MPI scores. Mortality outcomes were analyzed using the receiver-operating characteristic curve and multivariate logistic regression.Results: The mean patient age was 64.9 ± 15.7 years; 70.5% were male. Generalized peritonitis occurred in 96%, and feculent contamination in 5.1%. The most frequent perforation sites were the stomach (43.8%) and duodenum (21%). Overall mortality was 21%. MPI demonstrated excellent predictive performance (area under the curve = 0.944; 95% confidence interval: 0.905-0.988; P < 0.001). An MPI score ≥25 yielded 91.9% sensitivity and 79.9% specificity. Feculent peritonitis (odds ratio [OR] =26.5; P = 0.020) and preoperative organ failure (OR = 51.4; P < 0.001) were independent mortality predictors.Conclusion: MPI is a reliable and efficient tool for early mortality prediction in secondary peritonitis. A threshold score ≥25 effectively identifies high-risk patients and should be integrated into clinical decision-making in emergency surgical settings.","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"19 1","pages":"30-33"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592365","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

What's New in Emergencies Trauma and Shock - Timing of Definitive Airway Management in Emergency Medical Services Patients: Is Earlier Better? 急诊创伤和休克的新进展——急诊医疗服务患者的最终气道管理时机：越早越好？

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Journal of Emergencies, Trauma, and Shock Pub Date : 2026-01-01 Epub Date: 2026-03-20 DOI: 10.4103/jets.jets_45_26

Tanmoy Ghatak, Ryan Snitowsky

引用次数: 0