Journal of Emergency Practice and Trauma最新文献

{"title":"Final triage methods to decide on home-isolation versus hospitalization in COVID-19 pandemic: a challenge for clinicians","authors":"Mojtaba Miladinia, F. Abolnezhadian, J. Voss, Kourosh Zarea, N. Hatamzadeh, Mandana, Ghanavati","doi":"10.34172/JEPT.2020.37","DOIUrl":"https://doi.org/10.34172/JEPT.2020.37","url":null,"abstract":"Objective: Final patient triage determines which patients can be home-isolated and which patients require hospitalization on the basis to predict the patient’s prognosis most accurately. Final triage is an important link in the clinical management chain of the coronavirus disease 2019 (COVID-19) pandemic, and a comprehensive review of various patient triage methods is very important to guide decision making and triage efficiency. Decision by clinicians about hospitalization or home-discharge is one of the main challenges in places with limited hospital facilities compared to the high volume of COVID-19 patients. This review was designed to guide clinicians on how to address this challenge. Methods: In this mini review we searched scientific databases to obtain the final triage methods of COVID-19 patients and the important criteria in each method. In order to conducted searches a period from December 2019 to July 2020 was considered. All searches were done in electronic databases and search engines. Results: Findings revealed four current methods for final triage (decision-making regarding home-isolation or hospitalization of COVID-19 patients). These methods included 1) demographic and background information, 2) clinical information, 3) laboratory indicators and 4) initial chest CT-scan. Each of the aforementioned methods encompassed significant criteria according to which decisions on the patient’s prognosis and final triage were made. Finally, by evaluating each final triage method, we found that each method had some limitations. Conclusion: An effective and quick final triage requires simultaneous complementary use of all four methods to compensate for each other’s weaknesses and add to each other’s strengths. It is therefore suggested to assure that clinicians are trained in all four COVID-19 patient’s triage methods and their useful criteria in order to achieve evidence-based performance for better triage (decision between home-isolation versus hospitalization).","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46496682","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":"Medical errors during COVID-19 pandemic: the role of emergency medicine","authors":"S. Rahmani, Kosar Deldar, Sara Hemati Ali","doi":"10.34172/JEPT.2020.28","DOIUrl":"https://doi.org/10.34172/JEPT.2020.28","url":null,"abstract":"Objective: Nowadays, many countries all over the world are involved with COVID-19 and the number of new cases and deaths are on a rise. The role of emergency medicine and physician-led triage is important in this period. We report some near missed cases in our academic center related to this pandemic. Case Presentation: We report 5 cases that missed triage or received delayed diagnosis because of COVID-19 suspicion. Some cases are life threatening. Conclusion: Although COVID-19 is the main health concern these days, other critical conditions should be considered. Stabilizing patients before transferring them between hospitals should be the essential goal of emergency department whether the patient is Corona virus infected or not. And before any intervention, the safety of healthcare workers must be ensured.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48714001","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":"Trauma in pregnant women: an experience from a level 1 trauma center","authors":"M. Gillani, S. Saqib, R. Martins, H. Zafar","doi":"10.34172/jept.2020.20","DOIUrl":"https://doi.org/10.34172/jept.2020.20","url":null,"abstract":"\u0000 Objective: Trauma is the significant non-obstetrical cause of maternal mortality in women aged 35 years or younger. It is expected to complicate around 1 in 12 pregnancies and accounts for 46% of such deaths. In this study, we present our experience of trauma during pregnancy at a tertiary care hospital in Karachi. Methods: A standardized form was used to extract data from online records for all pregnant women who presented with traumatic injuries to the Aga Khan University Hospital from 2014 to 2019. Analysis was performed using SPSS v. 21. Chi-squared tests were performed for comparison of categorical data. Results: A total of 48 pregnant females with a mean age of 28.80 ± 6.50 years were included in this study. Road traffic accidents (RTA) accounted for the commonest cause of injury in the first (66.7%) and second (65%) trimesters. However, fall (45.5%) followed by RTA (27.3%) was the most frequent mechanism of injury during the third trimester. Gunshot injuries were seen in 4 patients only. Overall, fetal ultrasound was the most commonly performed imaging (87.5%) followed by limb X-ray and focused abdominal sonography for trauma (FAST) ultrasound. Out of total, 52.1% of the patients were surgically managed. Fetal demise in utero and spontaneous abortion was reported in 2 patients only. Conclusion: Road traffic accidents and falls comprise a significant burden of maternal and fetal morbidity and mortality. In terms of prevention, several policies and interventions at the government level need to be introduced in order to reduce the incidence of traumatic events.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45444771","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":"A study of the factors associated with non-traumatic intracerebral hemorrhage (ICH) in patients with chronic systemic hypertension","authors":"Mozhgan Taghizadeh, Mahdi Foroughian, Hamidreza Vakili, Seyed Reza Habibzadeh, R. Boostani, N. Morovatdar, Ehsan Bolvardi","doi":"10.34172/jept.2020.15","DOIUrl":"https://doi.org/10.34172/jept.2020.15","url":null,"abstract":"\u0000 Objective: Intracerebral hemorrhage (ICH) following systemic and chronic hypertension is one of the main causes of acute stroke leading to disability and death. Identifying the risk factors in ICH patients can be effective in reducing bleeding and the rates of mortality and disability in these patients. This study was carried out to investigate the factors associated with ICH. Methods: A total of 134 patients with chronic systemic hypertension who had ICH were enrolled in this study. The amount of ICH was measured through computed tomography (CT scan). The subjects were divided into two groups of high (>30 mL) and low (<30 mL) ICH volume, and the related risk factors in the two groups were studied and compared using SPSS software version 21. Results: The mean age of the subjects was 66.04 years, and 71 (52.99%) individuals were females. The mean volume of ICH was 24.47 mL, with 29.10% of the subjects (39 patients) having >30 mL and 70.90% (95 patients) having <30 mL of ICH. The results of studying ICHrelated factors in the multiple logistic regression showed that ischemic heart disease (IHD) (odds ratio [OR] = 2.243, P value <0.05) and cardiovascular disease (OR = 3.294, P value <0.05) were the co-existing diseases that increased the odds of developing ICH. Conclusion: The results of this study showed that less than 30% of the subjects had high volumes of bleeding, and the co-existence of IHD was considered as a strong independent risk factor affecting the volume of ICH associated with worse prognosis.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42509758","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":"Painless aortic dissection with slurred speech (Neurologic symptom)","authors":"E. R. Dost, Saeed Barazandehpour, N. Kalani, S. Abiri","doi":"10.34172/JEPT.2020.18","DOIUrl":"https://doi.org/10.34172/JEPT.2020.18","url":null,"abstract":"Objective: Aortic dissection is an uncommon disorder with a high mortality rate, especially if misdiagnosis and mistreatment are not considered. Case Presentation: We present a 67-year old female with slurred speech and left sided plegia during her brother’s funeral. The patient did not have any chest pain. she was referred to our emergency department by EMS due to being suspicious of cerebrovascular accident (CVA) )as code 724). However, owing to low blood pressure and atypical symptoms of the patient, we did RUSH exam in the emergency department to detect aortic dissection. After doing the Computed tomography (CT) angiography, the diagnosis of aortic dissection was confirmed. As the vascular surgeon was not present in our surgery department, we transferred the patient to Namazi hospital by air ambulance to undergo the surgery. She was discharged from hospital with complete recovery.Conclusion: Aortic dissection symptoms can be manifested in different ways such as pulmonary embolism, ACS, and CVA. Therefore, clinicians must always have the differential diagnosis of aortic dissection in their mind and be aware of its various manifestations.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44705631","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":"COVID-19 epidemic: What happens to other routine patients admitted in the emergency department?","authors":"S. Rahmani","doi":"10.34172/jept.2020.19","DOIUrl":"https://doi.org/10.34172/jept.2020.19","url":null,"abstract":"<jats:p>\u0000 </jats:p>","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47944793","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":"Pediatric upper gastrointestinal bleeding in children: etiology and treatment approaches","authors":"E. Polat, Nevzat Aykut Bayrak, G. Kutluk, H. Civan","doi":"10.34172/jept.2020.10","DOIUrl":"https://doi.org/10.34172/jept.2020.10","url":null,"abstract":"\u0000 Objective: Upper gastrointestinal bleeding (UGB) is one of the most important and serious cause of emergency admission in childhood. The aim of the study was to evaluate the etiological factors and the treatment approaches in patients with UGB. Methods: In this retrospective study, children with UGB admitted to emergency clinics of Istanbul Health Sciences University Kanuni Sultan Suleyman Research and Training Hospital, Istanbul Bakirkoy Sadi Konuk Research and Training Hospital and Diyarbakir Children’s Hospital were evaluated between January 2014 and August 2017. Results: Of the 198 children, 14.6% had non-steroid anti-inflammatory drug (NSAID) history, and 12.6% had chronic liver disease. We detected esophagitis, esophagus varices and peptic ulcer with upper gastrointestinal endoscopic evaluation (47%, 11.1%, 18.1%, respectively). Helicobacter pylori was found in 61.6% of patients. Endoscopic therapeutic procedures (band ligation therapy, sclerotherapy, and adrenaline injection) were appied in 11.1% of patients. Eighty-four (42.4%) patients were hospitalized, and erythrocyte transfusion (ET) was ordered in 29 (14.6%) patients. Conclusion: Approximately in 20% of the pediatric patients, the source of gastrointestinal bleeding is the upper gastrointestinal system. The cause of UGB varies with age. Appropriate diagnostic and therapeutic approaches are very important for management and to reduce mortality.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41803726","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":"Non-visible penetrating brain trauma: a case report","authors":"R. Varutti, A. Mosca, N. Latronico","doi":"10.15171/jept.2019.20","DOIUrl":"https://doi.org/10.15171/jept.2019.20","url":null,"abstract":"\u0000 Objective: One of the most frequent causes of death and acquired disability in the pediatric population is the Traumatic Brain Injury (TBI). TBI is secondary to falls, road traffic and vehicle collisions, child abuse and assaults. Penetrating brain injury is a severe form of traumatic brain injury. Blunt head injury is more frequent than TBI in children, but the second one carries a poor prognosis and a worse outcomes. Case Presentation: We report a pediatric case of penetrating craniofacial trauma, caused by a pencil in to the eye, and the successful of multidisciplinary management. Conclusion: Traumatic head injuries in children are frequently seen in the emergency ward, but the penetrating head injuries are unusual in young children. This case shows the importance of the ‘first golden hour’ after head trauma. The collaboration between team members, added to a promptly and invasive strategy, allowed to reduce neurological sequelae.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":"119 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41248330","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":"A case report of an isolated traumatic dental injury in an 8-year-old child","authors":"Seyed Reza Habibzadeh, Hamid Zamani Moghadam, N. Mehramiz, Mahdi Foroughian","doi":"10.15171/JEPT.2019.18","DOIUrl":"https://doi.org/10.15171/JEPT.2019.18","url":null,"abstract":"Objective: Anterior teeth are of utmost importance with regard to chewing, speaking, and beauty. Therefore, any traumatic dental injury has psychologically undesirable effects on children and their parents. The present study reported a case of a traumatic dental injury induced by falling off a bike and referral to an emergency department as well as measures taken for dental reconstruction and patient’s improvement.Case Presentation: An 8-year-old child was taken to an emergency department due to falling off a bike following imbalance, while suffering from dental pain in his upper jaw due to dental subluxation. Afterwards, dental retaining paste along with a fixer wire was used to maintain the position of the teeth. The patient also received oral non-steroidal analgesia (acetaminophen) for proper control of the pain and was subsequently referred to a dentist to repair the teeth. The initial examinations revealed that the child was fully conscious. Considering the patient’s severe pain and intrusion of the superior left primary first tooth and the subluxation of the superior right primary first tooth. Local anesthesia was performed using 1% lidocaine in the location of the given teeth using infiltration technique. Then they were brought into an alignment by extracting the plunged tooth and the child was referred to a dentist for advanced dental trauma care.Conclusion: Dentists are not always present in hospital emergency departments; therefore, an emergency medicine specialist should be able to diagnose common traumatic dental injuries in order to manage them appropriately at the early stages, and if necessary, refer patients to dentists for further complementary treatments. This important fact will bedone after full examination and ruling out critical causes of trauma in the emergency department.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42342657","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":"A brief review of some strange and unusual poisoning in children","authors":"Mohammad Hossein Kamaloddini, A. Ghamsari, B. Dadpour","doi":"10.15171/JEPT.2019.17","DOIUrl":"https://doi.org/10.15171/JEPT.2019.17","url":null,"abstract":"The Clinical Toxicology Center in Imam Reza hospital in Mashhad is the referral center of poisonings in the East of Iran and many cases of poisoned children are referred to this center and some cases are admitted.In this letter we report some specific, strange and unusual poisonings in children admitted in our center.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48734026","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}