Journal of Emergencies, Trauma, and Shock最新文献

{"title":"A Case of Bilateral Psoas Muscle Abscesses Complicated by Inferior Vena Cava Thrombosis","authors":"Noriko Torizawa, Hiroki Nagasawa, Ikuto Takeuchi, Hiromichi Ohsaka, Youichi Yanagawa","doi":"10.4103/jets.jets_88_23","DOIUrl":"https://doi.org/10.4103/jets.jets_88_23","url":null,"abstract":"","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135321796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological Support for Earthquake Survivors in Turkey and Syria","authors":"Amani Safwat El-Barazi","doi":"10.4103/jets.jets_46_23","DOIUrl":"https://doi.org/10.4103/jets.jets_46_23","url":null,"abstract":"Abstract Introduction: Thousands of children and families are in danger after two powerful earthquakes and dozens of aftershocks struck the border between Turkey and Syria. Thus, earthquake survivors in Turkey and Syria have an urgent need for psychological help. The objectives of this study were to (1) describe the mental health support services offered to people affected by the earthquakes that ravaged parts of Turkey and Syria, (2) discuss the challenges faced by the psychological support services, and (3) highlight recommendations for improving mental health services for earthquake survivors. Methods: A questionnaire with open-ended questions was E-mailed to nongovernmental organizations that provide mental health and psychological support to earthquake-affected individuals in Turkey and Syria. The organizations were requested to describe their activities and the obstacles they had to face to deliver these psychological support services. Using content analysis, the gathered statements were examined. Results: Mental health professionals from 23 nongovernmental organizations responded. The earthquake survivors were mostly provided with Eye Movement Desensitization and Reprocessing and spiritual support. Human resources and financial issues were the most reported concerns among the organizations that responded to the current study. Conclusions: While dealing with the long-term consequences of a disaster, it is essential to coordinate the efforts of many organizations.","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"62 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135322476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Comparison of Cerebral Oxygenation among Mechanically Ventilated Children Receiving Protocolized Sedation and Analgesia versus Clinician’s Decision in Pediatric Intensive Care Unit","authors":"Yogi Prawira, None Irlisnia, Hanifah Oswari, Antonius Hocky Pudjiadi, Bambang Tridjaja Asmara Apri Parwoto, Anggi Gayatri","doi":"10.4103/jets.jets_158_22","DOIUrl":"https://doi.org/10.4103/jets.jets_158_22","url":null,"abstract":"Abstract Introduction: Adequate sedation and analgesia are two crucial factors affecting recovery of intensive care patients. Improper use of sedation and analgesia in intensive care patients may adversely lead to brain oxygen desaturation. This study aims to determine cerebral oxygenation as measured by near-infrared spectroscopy (NIRS) and inotropic interventions received among mechanically ventilated children in the pediatric intensive care unit (PICU). Methods: This study is a nested case − control study in the PICU of Indonesian tertiary hospital. Children aged 1 month to 17 years on mechanical ventilation and were given sedation and analgesia were included in the study. Subjects were divided into two groups according to the protocol of the main study (Clinical Trial ID NCT04788589). Cerebral oxygenation was measured by NIRS at five time points (before sedation, 5-min, 1, 6, and 12 h after sedation). Results: Thirty-nine of the 69 subjects were categorized into the protocol group and the rest were in the control group. A decrease of >20% NIRS values was found among subjects in the protocol group at 5-min (6.7%), 1-h (11.1%), 6-h (26.3%), and 12-h (23.8%) time-point. The mean NIRS value was lower and the inotropic intervention was more common in the control group (without protocol), although not statistically significant. Conclusion: This study found that mechanically ventilated children who received sedation and analgesia based on the protocol had a greater decrease of >20% NIRS values compared to the other group. The use of sedation and analgesia protocols must be applied in selected patients after careful consideration.","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135322472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transient Sinus Arrest after Chest Wall Injury","authors":"Chihiro Maekawa, Hiroki Nagasawa, Keiki Abe, Ikuto Takeuchi, Youichi Yanagawa","doi":"10.4103/jets.jets_75_23","DOIUrl":"https://doi.org/10.4103/jets.jets_75_23","url":null,"abstract":"Sir, Blunt cardiac injury (BCI) encompasses a spectrum of pathologies ranging from clinically silent, transient arrhythmias to deadly cardiac wall rupture. Due to the absence of clear diagnostic criteria and reliable tests, reporting BCI cases becomes challenging.[1,2] The use of troponin, in combination with ECG, is also suggested to identify patients at risk of complications resulting from myocardial contusion.[1,2] The patient was a 66-year-old man who was injured when he crashed his 50 cc motorcycle into a roadside ditch. The patient had a history of chronic hepatitis C and hypertension. He was transported to our hospital by ambulance. On arrival, he had hypertension and tachypnea with hypoxia. The patient had flail chest on the left side. Electrocardiogram (ECG) showed a complete right bundle branch block (CRBBB). Traumatic pan scan images revealed lung contusion and a flail segment with heart compression [Figure 1]. A blood analysis revealed increased troponin I. The clinical diagnosis was left flail chest, lung contusion, and heart contusion. He underwent endotracheal intubation, followed by mechanical ventilation and positive pressure ventilation to achieve internal stabilization. After admission to the intensive care unit, he underwent continuous infusion of dexmedetomidine. He showed sinus arrest, which spontaneously recovered [Figure 1]. Accordingly, dexmedetomidine was ceased on day 2, and sinus arrest was not observed. During intensive care, he developed ventilator-associated pneumonia, and atrial fibrillation and underwent tracheostomy. After the discontinuation of sedation, no evidence of sinus pauses was observed. The patient’s breathing pattern remained normal on day 14. A follow-up computed tomography scan on day 18 revealed improvement in the compression of the right ventricle due to rib fractures. His ECG findings returned to normal without CRBBB. Holter ECG on day 20 showed no sinus arrest. He was transferred to another hospital for rehabilitation on day 27.Figure 1: (a) Electrocardiogram (ECG), upper left and chest computed tomography (CT), lower left on arrival, and electrocardiography after admission (right). The ECG showed complete right bundle branch block (a). The CT showed the chest wall, with a flail segment compressing the right heart (arrow) (b). After admission to the intensive care unit, the patient showed sinus arrest (c), which spontaneously resolvedThe present case report showed transient sinus arrest, CRBBB, and AF after BCI. Arrhythmias are common after cardiac contusion, occurring in up to 70% of patients within 3 days of hospitalization for BCT. RBBB is considered the most common cardiac conduction disorder associated with BCI, potentially due to the anterior location of the right side of the heart, similar to the present case.[2] Arrhythmias that have been described include sinus tachycardia, uniform premature ventricular complexes (PVCs), multifocal PVC, AF, left BBB, atrioventricular (AV) block, ventricu","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"33 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135322477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What's New in Emergencies Trauma and Shock - Beyond Traditional Approaches for Intracerebral Hemorrhage Management.","authors":"Sunil Chhajwani","doi":"10.4103/jets.jets_158_23","DOIUrl":"10.4103/jets.jets_158_23","url":null,"abstract":"","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"16 4","pages":"143-144"},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10824219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139642279","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":"Quick Sequential Organ Failure Assessment Score, Lactate, and Neutrophil-Lymphocyte Ratio Help in Diagnosis and Mortality Prediction during Golden Hour of Sepsis in Emergency Department.","authors":"Rakesh Kumar, Babu Kattimani, Pushpanjali R Ojha, Udaykumar J Khasage","doi":"10.4103/jets.jets_37_23","DOIUrl":"10.4103/jets.jets_37_23","url":null,"abstract":"<p><strong>Introduction: </strong>Sepsis is a life-threatening condition with a very narrow golden period in which confirmatory diagnosis may change the outcome dramatically. No confirmatory biomarker is available till date for early diagnosis of sepsis. This study aimed to evaluate the combined and independent role of quick sequential organ failure assessment (qSOFA) score, lactate, and neutrophil-lymphocyte ratio (NLR) in diagnosis and mortality prediction in early sepsis.</p><p><strong>Methods: </strong>This was a hospital-based, single-center, prospective cohort study conducted in a tertiary care institute, Karnataka, India. Three hundred adult sepsis patients were recruited during 10-month period, and demographic data, qSOFA score, lactate, NLR, and culture samples were collected in ED within 1 h of admission. Outcome groups (survivor and nonsurvivor) were statistically analyzed with relative frequencies (%), median, mean ± standard deviation with 95% confidence interval (CI), univariate, bivariate, and multivariate logistic regression analysis, and Receiver -operating characteristic curve (ROC) curve to test the predictive ability of initial levels of three biomarkers.</p><p><strong>Results: </strong>Sepsis was more prevalent among middle-aged male patients. Male gender (odds ratio [OR], 6.9; 95% CI: 1.61-30.1), qSOFA (OR, 154; 95% CI: 15-1565), and lactate (OR, 1.36; 95% CI: 22-833) show 97% (area under the curve) predictive accuracy of the model for sepsis on bivariate and multivariate logistic regression analysis. A significant rise in NLR was a poor outcome indicator on univariate analysis (<i>P</i> = 0.773).</p><p><strong>Conclusion: </strong>All three biomarkers are good outcome predictors whereas qSOFA and lactate have diagnostic significance in early sepsis. These markers can be used for patient triaging, minimizing culture report dependence for treatment and ultimately the outcome.</p>","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"16 4","pages":"161-166"},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10824218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139642278","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":"Opioid Use and Disposal Patterns of Emergency Department Patients.","authors":"Valerie Hoerster, Derek Tang, Marlee Milkis, Stephanie Litzenberger, Jill Stoltzfus, Holly Stankewicz","doi":"10.4103/jets.jets_55_21","DOIUrl":"10.4103/jets.jets_55_21","url":null,"abstract":"<p><strong>Introduction: </strong>To date, there is limited literature to guide emergency providers (EPs) on the proper dosing of prescription opioids. Our study aims to assess the self-reported opioid use, storage, and disposal practices of patients presenting to the emergency department (ED) with acute pain.</p><p><strong>Methods: </strong>This prospective cohort study employed a validated, cross-sectional survey of subjects identified using electronic medical records. The survey link was e-mailed to a continuous sample of eligible participants 3-4 weeks following ED discharge. Nonrespondents were surveyed through telephone after 1 week. We used descriptive and nonparametric statistics to report survey results.</p><p><strong>Results: </strong>Of 500 eligible subjects, 97 completed the questionnaire. Only 28% of respondents reported that they took all of the prescribed pills. Of the remaining responses, 20% stated that they did not take any pills, 33% took about one-fourth, 7.2% took about half, and 12.4% took about three-fourths of the pills. Among those who did not take any pills, 42% filled the prescription. Most (71.2%) reported storing their leftover pills; among those who stored their pills, less than one-fourth (23.8%) used a locked storage location.</p><p><strong>Conclusions: </strong>Our findings suggest that less than one-third of patients who receive prescriptions in the ED for acute pain use all of their prescribed pills, suggesting that many patients are unnecessarily prescribed opioids for acute conditions. The findings of this study also suggest that many patients with unused prescription opioids do not practice safe storage or proper disposal of leftover pills. This represents a potential opportunity for EPs to improve medication safety by educating patients on proper storage and disposal practices. Limitations include low response rate and the use of self-reporting.</p>","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"16 4","pages":"177-181"},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10824224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139642277","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":"Clinical Characteristics and Outcomes of Patients with Intracerebral Hemorrhage: Nonsurgical Versus Surgical Treatment.","authors":"Warawut Kittiwattanagul, Puthachad Namwaing, Sittichai Khamsai, Kittisak Sawanyawisuth","doi":"10.4103/jets.jets_55_23","DOIUrl":"10.4103/jets.jets_55_23","url":null,"abstract":"<p><strong>Introduction: </strong>Primary intracerebral hemorrhage (ICH) is a stroke subtype with high morbidity and mortality. Surgical treatments for ICH may be one of the beneficial modalities. There are inconsistent clinical outcomes of surgical treatments in several randomized controlled trials. This study aimed to evaluate if surgical treatment can reduce mortality in patients with ICH in a real-world setting.</p><p><strong>Methods: </strong>This was a retrospective analytical study. The inclusion criteria were consecutive adult patients aged 18 years or over admitted to neurosurgery ward due to ICH, and indicated for surgical treatment according to the 2015 guideline for the management of spontaneous ICH. The outcomes of this study included mortality, length of stay, Barthel index, Glasgow Outcome Score (GOS), and Glasgow Coma Scale (GCS). Descriptive statistics were used to execute the differences between those who underwent and did not undergo surgical treatments. Factors associated with mortality were computed by multivariate logistic regression analysis.</p><p><strong>Results: </strong>There were 110 patients with ICH who met the study criteria. Of those, 34 (30.91%) patients underwent surgical treatment: mainly craniotomy (16 patients; 47.06%). The surgical treatment group had significantly higher proportions of large ICH of 30 mL or over (62.96% vs. 27.54%; <i>P</i> = 0.002) and intraventricular hemorrhage (70.59% vs. 46.05%; <i>P</i> = 0.023) than the nonsurgical treatment group. However, both groups had comparable outcomes in terms of mortality, length of stay, Barthel index, GOS, and GCS. The mortality rate in the surgery group was 47.06%, whereas the nonsurgery group had a mortality rate of 39.47 (<i>P</i> = 0.532). There were three independent factors associated with mortality, including age, GCS, and intraventricular hemorrhage. The adjusted odds ratio (95% confidence interval) of these factors was 1.06 (1.02-1.12), 5.42 (1.48-19.81), and 5.30 (1.65-17.01). Intraventricular hemorrhage was more common in the elderly than in the nonelderly group (66.00% vs. 43.33%; <i>P</i> = 0.022).</p><p><strong>Conclusions: </strong>Surgical treatment may not be beneficial in patients with severe ICH, particularly with intraventricular hemorrhage, large ICH volume, or low GCS. Elderly patients with ICH may also have high mortality if intraventricular hemorrhage is present.</p>","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"16 4","pages":"145-149"},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10824209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139642276","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":"Ultrasound-Guided Manipulation does not Prevent Malalignment Over Landmark-Based Fracture Reduction in Distal Radius Fracture (Colles).","authors":"Sandeep Kumar Nema,&nbsp;Jose Austine,&nbsp;Premkumar Ramasubramani,&nbsp;Ruchin Agrawal","doi":"10.4103/jets.jets_157_22","DOIUrl":"10.4103/jets.jets_157_22","url":null,"abstract":"<p><strong>Introduction: </strong>This systematic review aims to determine the relative risk of distal radius (Colles) fracture (DRF) malalignment between ultrasound (USG)-guided and conventional/landmark guided/blind manipulation and reduction (M&R).</p><p><strong>Methods: </strong>We searched 3932 records from major electronic bibliographic databases on USG-guided manipulation of DRF. Studies with randomized, quasi-randomized, and cross-sectional study designs meeting the inclusion criteria were included in this review. USG and landmark-guided DRF manipulations were named cases and controls, respectively. The Newcastle-Ottawa Scale was used to assess the quality of included studies.</p><p><strong>Results: </strong>Thirteen and nine studies were analysed for qualitative and quantitative analysis in this review. Nine hundred fifty-one DRF patients (475 cases and 476 controls) from 9 studies with mean ages of 51.52 ± 11.86 (22-92) and 55.82 ± 11.28 (18-98) years for cases and controls were pooled for this review. The pooled relative risk estimate from the studies included in the meta-analysis was 0.90 (0.74-1.09). There was a 10% decrease in the risk of malalignment with USG than the landmark guided M&R of DRF. The <i>I</i>² statistic estimated a heterogeneity of 83%. Sensitivity analysis revealed a relative risk of 1.00 (0.96-1.05).</p><p><strong>Conclusion: </strong>The USG-guided manipulation does not prevent malalignment over the landmark-based manipulation of DRF. The risk of bias across the included studies and heterogeneity of 83% mandates further unbiased, high-quality studies to verify the findings of this review.</p>","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"16 2","pages":"35-42"},"PeriodicalIF":1.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10424739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10366446","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":"Periodontoid Pseudotumor with Respiratory Arrest.","authors":"Eri Nakajima,&nbsp;Ikuto Takeuchi,&nbsp;Kouhei Ishikawa,&nbsp;Youichi Yanagawa","doi":"10.4103/jets.jets_144_22","DOIUrl":"10.4103/jets.jets_144_22","url":null,"abstract":"","PeriodicalId":15692,"journal":{"name":"Journal of Emergencies, Trauma, and Shock","volume":"16 2","pages":"75-76"},"PeriodicalIF":1.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10424740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10388246","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}