Journal of Emergencies, Trauma, and Shock最新文献

{"title":"Trauma Patients Who Exsanguinated Due to Peripheral Injury Potentially Salvageable by Stop the Bleed Techniques.","authors":"John Culhane, Raymond Okeke, Timothy Corpuz, Lauren Su, Carl Freeman","doi":"10.4103/jets.jets_36_24","DOIUrl":"10.4103/jets.jets_36_24","url":null,"abstract":"<p><strong>Introduction: </strong>Trauma patients may die of external bleeding from junctional or peripheral injuries. Most peripheral injuries are compressible allowing for temporary bleeding control in the field. Despite the availability of simple techniques to control external hemorrhage, patients still die of extremity and junctional bleeding. The American College of Surgeons stop the bleed (STB) program was designed to help members of the public control bleeding at the scene of trauma. Our study seeks to quantify trauma mortality that could have been prevented by STB techniques.</p><p><strong>Methods: </strong>This is a retrospective case series of patients from a level one trauma center and the National Trauma Data Bank (NTDB). We selected overall deaths and patients who died within 2 days of injury and reviewed every injury that these patients suffered. We classified injuries into noncompressible, possibly compressible, and definitely compressible. We analyzed the patterns of injuries and identified a group of patients that we believe could have been saved with STB techniques. To assess possible benefit of STB, we analyzed the changes in the incidence of exsanguinating distal extremity injuries and the mortality rate of patients who suffered these injuries over the years 2017 through 2022.</p><p><strong>Results: </strong>For the local data, total early deaths were 577 (3.9% of total trauma). Ten (1.73%) of these patients died of an injury judged compressible by the reviewing trauma surgeon. For the NTDB data, total trauma patients were 6,715,967. Total deaths were 244,295 (3.6%). Total early deaths were 129,723 (1.9%). The proportion of total deaths due to isolated compressible injuries was 1079/244,295 (0.4%). This last group includes the patients that we believe could have been saved by STB. Over the 6-year period examined, there was a slight but significant rise in the mortality rate of isolated distal extremity injuries, but the incidence did not change significantly.</p><p><strong>Conclusion: </strong>The problem of exsanguination from external bleeding still exists at a busy urban level one trauma center and at other trauma centers nationwide. Ongoing fatality reveals a continuing unmet need for public education that could potentially save lives.</p>","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"18 3","pages":"105-118"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149288","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":"Gender Coding in Recruitment Materials for Emergency Medicine Residency Programs.","authors":"Nicolas Andrea, Chloe Jeanmonod, Veronica Petra, Kelly O'Brien, Ankita Bassi, Jade Pace, Rebecca Jeanmonod","doi":"10.4103/jets.jets_102_24","DOIUrl":"10.4103/jets.jets_102_24","url":null,"abstract":"<p><strong>Introduction: </strong>Almost 50% of medical students are women, yet women make up only 28% of emergency medicine-trained physicians. Studies, in other industries, have shown using masculine- or feminine-coded language in job advertisements affects the numbers of male versus female applicants who apply. Our research explores gender bias in the language of emergency medicine (EM) residency recruitment materials, and assesses if this language correlates to the gender distribution within studied residencies.</p><p><strong>Methods: </strong>One hundred and one ACGME accredited EM residency programs (2021) were reviewed. Each program's website recruitment materials were decoded based upon prior research on gender bias in language. Recruitment materials were categorized as highly masculine, masculine, highly feminine, feminine, or neutral. Each program website was reviewed to determine current residency classes' gender distribution.</p><p><strong>Results: </strong>One hundred and one EM residencies were reviewed. Residency sizes ranged from 17 to 86 trainees and were comprised 10%-92% females, with the average class breakdown of 38% women. The majority of EM residency recruitment materials contained some gender coded language (<i>n</i> = 91). Forty-two programs contained masculine or strongly masculine language, 41 contained feminine or strongly feminine language, and 17 programs coded as globally neutral, although 8 of these still contained gender-coded language. Gender coding in the language of recruitment materials was not predictive of proportion of female residents within the program (<i>P</i> = 0.61).</p><p><strong>Conclusions: </strong>Gender-coded language is common in residency recruitment materials for EM but does not have a relationship to resident class demographics. Further studies should examine whether gendered language in recruitment materials impacts residents' choices during the application process.</p>","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"18 3","pages":"126-130"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149235","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":"An Insight into Damage Control Resuscitation and its Application in the Modern Battlefield: A Military Perspective.","authors":"Shalendra Singh, Venigalla Sri Krishna, Deepu K Peter","doi":"10.4103/jets.jets_154_24","DOIUrl":"10.4103/jets.jets_154_24","url":null,"abstract":"<p><p>When it comes to battlefield resuscitation, the advent of damage control surgery has birthed the concept of damage control resuscitation (DCR). It consists of rapid hemorrhage control, which need not be definitive, early blood product transfusion, blood volume restoration, and achieving physiological stability. Acute traumatic coagulopathy, which is the primary cause of mortality, is the main target of battlefield resuscitation. This concept of the DCR and its implementation in the battlefield are discussed in this review.</p>","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"18 3","pages":"131-137"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149268","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":"Musculoskeletal Disorders among Long-standing Workers Working for More Than 6-Hours a Day in an Automobile Factory in South India.","authors":"M Kumaresan, Surendra Babu Darivemula, Sudha Bala, Shashanka Kadas","doi":"10.4103/jets.jets_161_24","DOIUrl":"10.4103/jets.jets_161_24","url":null,"abstract":"<p><strong>Introduction: </strong>Musculoskeletal disorders (MSDs) are a prevalent occupational health concern, especially among long-term automobile factory workers. They can affect anyone and negatively impact quality of life and work performance. Major risk factors include heavy lifting and poor working conditions, which can worsen these disorders and pose serious health and labor rights issues.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at UNITECH PLASTO Components Pvt. Ltd. to evaluate MSDs among workers employed for over a year. Ergonomic risks were assessed using the Standard Nordic Questionnaire, Rapid Entire Body Assessment (REBA), and the Rapid Upper Limb Assessment (RULA) were used to evaluate workplace ergonomics. Data were analyzed in Microsoft Excel, with results presented in percentages and odds ratio to determine the risk levels.</p><p><strong>Results: </strong>The overall prevalence of MSDs was 63.7%, affecting various body parts: the highest observed in lower back (37 workers, 29.6%), shoulder (22 workers, 17.6%), wrist (20 workers, 16.0%), ankle (18 workers, 14.4%), neck (16 workers, 12.8%), hand (13 workers, 10.4%), elbow (12 workers, 9.6%), and knee (12 workers, 9.6%). REBA ergonomic assessments revealed medium risk in 88 (44.9%) workers, high risk in 81 (41.4%) workers, and very high risk in 18 (9.1%) workers. RULA assessments showed medium risk in 83 (42.3%) workers and very high risk in 14 (7.2%) workers. Workers with travel history and working in standing position and working of more than 8 h had more MSDs.</p><p><strong>Conclusion: </strong>Implementing measures to reduce work-related physical strain and fostering a supportive work environment can yield significant improvements in employee health and productivity.</p>","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"18 3","pages":"119-125"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149257","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 Early Outpatient Follow-up on Acute Care Utilization and Readmission Rates in Stroke Patients.","authors":"Faisal Alhusain, Wajd Almathami, Abdulrahman Alrajhi, Abeer Alfadhliah, Shouq Alayaf, Sarah Almutairi, Hadeel Alkhaneen, Sameerah Alsomali","doi":"10.4103/jets.jets_115_24","DOIUrl":"10.4103/jets.jets_115_24","url":null,"abstract":"<p><strong>Introduction: </strong>Overcrowded emergency departments (EDs) are a critical issue globally, exacerbating delays and impacting care quality. Stroke patients, who often experience acute care encounters postdischarge, represent a significant challenge. This study evaluated the impact of early outpatient follow-up on ED visits and readmission rates within 30 days of discharge among stroke patients at King Abdulaziz Medical City (KAMC) in Riyadh, Saudi Arabia.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of stroke patients treated at KAMC between January 1, 2021, and February 29, 2024. Data were extracted from electronic health records, including patient demographics, stroke type, treatment, and postdischarge care. We analyzed the association between early outpatient follow-up (within 30 days of discharge) and subsequent ED visits or readmissions using statistical tests.</p><p><strong>Results: </strong>Of the stroke patients included, 22.2% experienced acute care encounters within 30 days postdischarge, with 32.9% of these being readmissions. Early outpatient follow-up was significantly associated with reduced acute care encounters (50.3% of patients with follow-up did not require additional acute care, compared to 30.9% of those without follow-up; <i>P</i> = 0.006). Factors such as stroke type, length of hospital stay, and comorbidities did not show significant differences between groups.</p><p><strong>Conclusion: </strong>Early outpatient follow-up significantly reduces the need for acute care among stroke patients. This underscores the importance of implementing effective postdischarge follow-up strategies to improve patient outcomes and alleviate pressure on emergency services. Future research should explore the specific components of follow-up care that contribute most to these benefits and evaluate broader implications for healthcare systems.</p>","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"18 3","pages":"99-104"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149290","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 Case of Pulmonary Edema Due to Pentobarbital Poisoning.","authors":"Ayaka Tashiro, Raiki Tokutsu, Noriko Tanaka, Chihiro Maekawa, Yoshihiro Nagatake, Masashi Kato, Youichi Yanagawa","doi":"10.4103/jets.jets_58_25","DOIUrl":"10.4103/jets.jets_58_25","url":null,"abstract":"","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"18 3","pages":"146-147"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149304","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":"Successful Rescue of Deep Coma, Shock, and Arrhythmia Caused by Bittern Poisoning.","authors":"Wenhua Cui, Linchao Song, Shijuan Zhang","doi":"10.4103/jets.jets_91_24","DOIUrl":"10.4103/jets.jets_91_24","url":null,"abstract":"<p><p>Bittern has been used as the main ingredient of tofu coagulant, and poisoning events usually occurred in the rural of North China. Bittern intoxication may induce electrolyte imbalances, the most important of which is hypermagnesemia, and may be fatal if ingested. The patient without any medical history presented with sinoatrial block, atrioventricular block, paroxysmal atrial tachycardia, and atrial fibrillation on electrocardiography over a short period. The initial diagnosis was unclear and the treatment was difficult. Arterial blood gas analysis indicated severe metabolic acidosis. Her serum concentration of magnesium and chlorine attained 15.14 mEq/L and 130 mEq/L, respectively. After supportive therapy and continuous veno-venous hemofiltration sessions, we observed full recovery without any sequelae. After regaining consciousness, the patient reported ingesting \"brine,\" confirming the diagnosis of \"brine poisoning.\" To the best of our knowledge, such sever hyperchloremia after bittern intoxication has not been previously reported in the literature. However,successful rescue of severe hypermagnesemia in Chinese patients by treatment has only rarely been reported in the current literature.</p>","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"18 3","pages":"138-140"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149300","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 Case of Severe Fever with Thrombocytopenia Syndrome with Normal C-reactive Protein Levels and an Inverse Relationship between Lactate Dehydrogenase and C-reactive Protein in the Early Phase.","authors":"Youichi Yanagawa, Rino Isogai, Hiroki Nagasawa","doi":"10.4103/jets.jets_151_24","DOIUrl":"10.4103/jets.jets_151_24","url":null,"abstract":"","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"18 2","pages":"94-95"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642725","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":"Analysis of Cases of Mild Head Trauma Resulting in Fatal Outcome from the Doctor Helicopter Registry Data.","authors":"Youichi Yanagawa, Hiroaki Taniguchi, Chihiro Maekawa, Noriko Tanaka, Kenji Kawai, Michika Hamada, Soichiro Ota, Hiroki Nagasawa","doi":"10.4103/jets.jets_87_24","DOIUrl":"10.4103/jets.jets_87_24","url":null,"abstract":"<p><strong>Introduction: </strong>In cases of mild head trauma, there have been no comprehensive studies on cases that resulted in death. This study aims to conduct a factor analysis of mild head trauma cases resulting in death. Patients with Glasgow Coma Scale (GCS) scores of 14 or 15 in the Japan Doctor Helicopter (DH) Registration System were studied.</p><p><strong>Methods: </strong>Variables included age, sex, DH request timing, vital signs at DH contact (GCS, blood pressure, heart rate, respiratory rate), head trauma severity, hospitalization, and 1-month outcomes (survival or death). Wilcoxon rank-sum test and median test were used.</p><p><strong>Results: </strong>Analysis involved 26 deaths and 2256 survivals. No significant differences were found in sex, request timing, pulse rate, systolic blood pressure, or AIS. The death group had higher mean age, respiratory rate and hospitalization rate, and lower GCS scores. Age and respiratory rate cutoffs for mortality were 78 years and 21 breaths/min, respectively. No deaths occurred below 21 breaths/min or at the age of 78 or younger. For those over 79 with 22 or more breaths per minute, 7.8% died.</p><p><strong>Conclusions: </strong>The study identifies increased mortality risk in elderly patients with mild head trauma, high respiratory rates, and GCS scores of 14 at the scene. This emphasizes the need for careful monitoring and prompt treatment in these cases.</p>","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"18 2","pages":"53-55"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642727","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 - Impact of Doctor Helicopter Emergency Medical Services on Outcomes in Traumatic Brain Injury.","authors":"Neeraj Kumar, Ashley Grant","doi":"10.4103/jets.jets_81_25","DOIUrl":"10.4103/jets.jets_81_25","url":null,"abstract":"","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"18 2","pages":"51-52"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642734","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}