Advanced Journal of Emergency Medicine最新文献

{"title":"Sample Size Calculation Guide - Part 3: How to Calculate the Sample Size for an Independent Case-control Study.","authors":"Nadien Khaled Fahim, Ahmed Negida, Ahmed Khaled Fahim","doi":"10.22114/AJEM.v0i0.138","DOIUrl":"https://doi.org/10.22114/AJEM.v0i0.138","url":null,"abstract":"","PeriodicalId":7290,"journal":{"name":"Advanced Journal of Emergency Medicine","volume":"3 2","pages":"e20"},"PeriodicalIF":0.0,"publicationDate":"2019-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/82/be/AJEM-3-e20.PMC6548115.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40550300","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":"Iranian Emergency Medical Service Response in Disaster; Report of three Earthquakes.","authors":"Peyman Saberian,&nbsp;Pir-Hossein Kolivand,&nbsp;Parisa Hasani-Sharamin,&nbsp;Fatemeh Dadashi,&nbsp;Amir Reza Farhoud","doi":"10.22114/AJEM.v0i0.121","DOIUrl":"https://doi.org/10.22114/AJEM.v0i0.121","url":null,"abstract":"<p><strong>Introduction: </strong>The earthquake is one of the most natural catastrophic crises that can cause a lot of casualties. Considering an earthquake-prone country, Iran is ranked as one of the world's most dangerous countries.</p><p><strong>Objective: </strong>In this article, we describe the actions taken by emergency medical service (EMS) after the earthquake in Kermanshah, Varzaghan, and Bam and compared the strengths and weaknesses of the emergency response program and the limitations and challenges of this system in dealing with these major crises.</p><p><strong>Method: </strong>This study is a cross-sectional study that compares some of the information and findings related to three earthquakes that occurred in Iran, including Bam, Varzaghan and Sarpol-e-Zahab earthquakes. The data reported in the present article is descriptive and is based on various independent sources such as National Emergency Operation Center, Local Emergency Operations Center (EOC), the EMS of the country, the World Health Organization, the United Nations, the statistics website, the Forensic Data website, the International Institute of Seismology and Earthquake Engineering, conferences and personal interviews. To ensure the credibility of the information, the authors reported data that had been verified by two or more sources.</p><p><strong>Results: </strong>The characteristics of the geographic area of the 3 earthquakes has been described. Post-earthquake response activities were described in details in subheadings including rapid warning and response, surge capacity plan, rapid response teams, emergency medical teams, increasing the capacity of health facilities, increasing transfer capacity, and handling, transportation and distribution of injuries.</p><p><strong>Conclusion: </strong>In the recent earthquake, had been occurred in Sarpol-e-Zahab, the health response of the country was largely satisfactory. The existence of structures such as EOC at various levels, the unified incident command system, emergency operations plan, and Medical Care Monitoring Center are among the most important reasons for satisfactory performance.</p>","PeriodicalId":7290,"journal":{"name":"Advanced Journal of Emergency Medicine","volume":"3 2","pages":"e13"},"PeriodicalIF":0.0,"publicationDate":"2019-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/17/0d/AJEM-3-e13.PMC6548112.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40449505","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":"Future Direction of Emergency Medicine Research; Can We Overcome the Difficulties and Fill in Knowledge Gaps?","authors":"Zinat Nadia Hatmi","doi":"10.22114/AJEM.v3i1.120","DOIUrl":"https://doi.org/10.22114/AJEM.v3i1.120","url":null,"abstract":"Pace of medical research development heralded an escalation in recent years. Groundbreaking evidences have been provided for managing dyslipidemia in 2017. Beside statins, alternatives of Anti PCSK-9 monoclonal antibodies in human and AT04A anti PCSK-9 vaccine in mice have shown to significant decrease in total cholesterol level. Wonderful! Apart from this, dual pathway inhibition by using aspirin with very low dose Rivaroxaban has been shown to be more effective in mitigating ischemic event rate than aspirin alone in patients with stable coronary artery disease or peripheral artery disease. Furthermore, patients with atrial fibrillation undergo percutaneous coronary intervention will benefit more from double antithrombotic therapy than triple one. Besides, a novel risk score of PRECISE-DAPT has determine the optimal duration of antiplatelet therapy in patients implanting coronary stents; and many other medical research advances which grabs our attention on 2018. \u0000 In order to translate recent advances in medical research into clinical practice we need to design, conduct and apply high quality research in different medical subspecialties. The emergency medicine (EM) environment defined as overburdened with inability to afford more than a few minutes per patients. Where, time for research might be considered as a potential risk of interruption in clinical practice. EM is a broad field involving multiple disciplines and crosscutting themes with the unique features in research including urgency and location of the treatment. Art of research in EM comprises hybridization of clinical research, basic science and health services research. Accordingly, research priority setting should be put forwarded based on these three areas, examining existing gaps in EM knowledge, system design issues, educational predicament and disparities between diagnostic skills and clinical decisions. Where the most appropriate research questions arise? Definitely, it comes from critical thinking in patient care setting, regular reading habit, teaching, journal clubs, collaborations and society. To alleviate the issue of immense question and limited time in EM field which tangles decision makers mind we recommend to prioritize questions in line with; patients well- being, learners need, feasibility to answer, inquiries that most likely to recur in your practice and most interesting foreground research query. A research need has been defined as a gap in existing knowledge on practice, learner‚s education, patient values and societal demands. To examine the gaps in EM research knowledge we can provide research time and facilities, training new investigators, develop multicenter research networks, improve research coordination and involving funding agencies to make practical attempts for filling pre specified gaps. In conclusion, since patient oriented outcome research will provide us with the most important endpoints for clinical policy making and patient care standard setting, ","PeriodicalId":7290,"journal":{"name":"Advanced Journal of Emergency Medicine","volume":" ","pages":"e1"},"PeriodicalIF":0.0,"publicationDate":"2019-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2c/d8/AJEM-3-e1.PMC6548078.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40449508","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":"Correlation of Patients' Baseline Characteristics with Success Rate of Cardiopulmonary Resuscitation; a Cross-Sectional Study.","authors":"Ehsan Hajzargarbashi,&nbsp;Elahe Omidi,&nbsp;Mehrdad Esmailian","doi":"10.22114/AJEM.v0i0.115","DOIUrl":"https://doi.org/10.22114/AJEM.v0i0.115","url":null,"abstract":"<p><strong>Introduction: </strong>Many advances have been made in method, applied medications and the skill of the treatment staff for performing cardiopulmonary resuscitation (CPR), yet the rate of mortality following cardiac arrest is still high, which is affected by many factors.</p><p><strong>Objective: </strong>This study was designed and performed aiming to evaluate the effective factors in the success rate of CPR.</p><p><strong>Method: </strong>This cross-sectional study was performed on patients who had undergone CPR in Dr. Shariati Hospital, Isfahan, Iran, from March 2017 to March 2018. A pre-designed checklist was used for data gathering, which included questions regarding demographic data and medical history of the patients, data related to CPR and the final outcome of resuscitation.</p><p><strong>Results: </strong>A total of 190 patients with the mean age of 69.4±17.7 years were evaluated in the present study, 115 (60.5%) of which were male. Overall, 28.9% of CPRs were initially successful and 5.3% of the cases were finally discharged from the hospital. There was no significant correlation between CPR success and age, sex, hospitalization ward, time interval between hospitalization and cardiac arrest, the number of CPR attempts, or working shift (p > 0.05). On the other hand, CPR success significantly correlated with underlying illnesses and the first cardiac rhythm recorded before the initiation of resuscitation (p < 0.05).</p><p><strong>Conclusion: </strong>Based on the findings of the present study, it seems that underlying illness and the initial cardiac rhythm recorded correlate with the probability of CPR success.</p>","PeriodicalId":7290,"journal":{"name":"Advanced Journal of Emergency Medicine","volume":" ","pages":"e6"},"PeriodicalIF":0.0,"publicationDate":"2018-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e3/9f/AJEM-3-e6.PMC6548081.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40450340","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":"Nebulized Budesonide vs. Placebo in Adults with Asthma Attack; a Double Blind Randomized Placebo-Controlled Clinical Trial.","authors":"Hojat Sheikh-Motahar-Vahedi,&nbsp;Maryam Habibi-Samadi,&nbsp;Elnaz Vahidi,&nbsp;Morteza Saeedi,&nbsp;Mehdi Momeni","doi":"10.22114/AJEM.v0i0.112","DOIUrl":"https://doi.org/10.22114/AJEM.v0i0.112","url":null,"abstract":"<p><strong>Introduction: </strong>Asthma is one of acute respiratory diseases leading to emergency department (ED) referral. Management of acute attack plays an important role in its outcome.</p><p><strong>Objective: </strong>This trial was designed to evaluate the effectiveness of nebulized budesonide versus placebo in moderate to severe acute asthma attack in adults in the ED.</p><p><strong>Method: </strong>In this clinical trial, we enrolled patients with acute exacerbation of asthma and standard treatment of acute asthma attack was administered to all of them. 41 patients in our study were randomly entered into 2 groups. In one group, we prescribed nebulized budesonide and in the other group nebulized placebo (normal saline) was administered. Patients' demographic data, vital signs, symptoms' acuity and the time of symptom relief, patient and physician satisfaction were all recorded and compared between the 2 groups. All cases were followed and disease outcome, readmission, mortality and morbidity rates were documented.</p><p><strong>Results: </strong>In this study, 20 patients were entered the budesonide group and 19 patients were enrolled in the placebo group. The mean age ranges were 55.70±15.30 and 60.32±18.41 years old respectively. Heart rate, respiratory rate and O2 saturation in the first group were improved significantly after the treatment in comparison to the second group (p<0.05). The mean time of recovery and length of hospital stay were better in the first group than the second group but this difference was not significant (p>0.05).</p><p><strong>Conclusion: </strong>The addition of nebulized budesonide to standard asthma treatment might result in more improvement in O2 saturation and less patient's distress.</p>","PeriodicalId":7290,"journal":{"name":"Advanced Journal of Emergency Medicine","volume":" ","pages":"e4"},"PeriodicalIF":0.0,"publicationDate":"2018-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.22114/AJEM.v0i0.112","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40540920","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 Effective Method for Controlling Bleeding in a Ruptured Hepatic Hemangioma: A Case Report.","authors":"Mohammad Talebpour,&nbsp;Hossein Zabihi-Mahmoudabadi,&nbsp;Pooya Payandemehr,&nbsp;Maryam Momen,&nbsp;Zahra Zali","doi":"10.22114/AJEM.v0i0.114","DOIUrl":"https://doi.org/10.22114/AJEM.v0i0.114","url":null,"abstract":"<p><strong>Introduction: </strong>Hepatic hemangioma is the most common benign tumor in the liver. Although intra-abdominal bleeding associated with its rupture is rare, but life-threatening. Here we report a case of ruptured hepatic hemangioma and applied method for controlling its bleeding.</p><p><strong>Case report: </strong>The patient was a 45-year-old man who was referred after crashing his motorcycle into a car. The patient's primary survey revealed intra-abdominal free fluid, but stable vital signs. Thirty minutes later, the patient's systolic blood pressure dropped to 85 mmHg. Laparotomy was performed a large hemangioma was observed involving almost the entire left lobe of the liver. Using a liver needle and 2-0 chromic suture, we entered the hemangioma at the perforation site of the lower portion of the liver and exit from the upper part. Then, we entered the upper part of the liver and exited from the lower part, and then it was tied. According to this approach, hemangioma was packed from the lower segment of the liver.</p><p><strong>Conclusion: </strong>In this case, the patient's abdomen was primarily closed without extra packing and embolization. The proposed method thus may be more effective compared to conventionally used methods.</p>","PeriodicalId":7290,"journal":{"name":"Advanced Journal of Emergency Medicine","volume":" ","pages":"e10"},"PeriodicalIF":0.0,"publicationDate":"2018-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.22114/AJEM.v0i0.114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40450020","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":"Management of Violence and Aggression in Emergency Environment; a Narrative Review of 200 Related Articles.","authors":"Maryam Ziaei, Ali Massoudifar, Ali Rajabpour-Sanati, Ali-Mohammad Pourbagher-Shahri, Ali Abdolrazaghnejad","doi":"10.22114/AJEM.v0i0.117","DOIUrl":"10.22114/AJEM.v0i0.117","url":null,"abstract":"<p><strong>Context: </strong>The aim of this study is to reviewing various approaches for dealing with agitated patients in emergency department (ED) including of chemical and physical restraint methods.</p><p><strong>Evidence acquisition: </strong>This review was conducted by searching \"Violence,\" \"Aggression,\" and \"workplace violence\" keywords in these databases: PubMed, Scopus, EmBase, ScienceDirect, Cochrane Database, and Google Scholar. In addition to using keywords for finding the papers, the related article capability was used to find more papers. From the found papers, published papers from 2005 to 2018 were chosen to enter the paper pool for further review.</p><p><strong>Results: </strong>Ultimately, 200 papers were used in this paper to conduct a comprehensive review regarding violence management in ED. The results were categorized as prevention, verbal methods, pharmacological interventions and physical restraint.</p><p><strong>Conclusion: </strong>In this study various methods of chemical and physical restraint methods were reviewed so an emergency medicine physician be aware of various available choices in different clinical situations for agitated patients.</p>","PeriodicalId":7290,"journal":{"name":"Advanced Journal of Emergency Medicine","volume":" ","pages":"e7"},"PeriodicalIF":0.0,"publicationDate":"2018-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8d/e2/AJEM-3-e7.PMC6548084.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40450424","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":"The Cost Analysis of Patients with Traffic Traumatic Injuries Presenting to Emergency Department; a Cross-sectional Study.","authors":"Farhad Rahmati,&nbsp;Mohammad Doosti,&nbsp;Maryam Bahreini","doi":"10.22114/AJEM.v0i0.108","DOIUrl":"https://doi.org/10.22114/AJEM.v0i0.108","url":null,"abstract":"<p><strong>Introduction: </strong>Road traffic traumatic injuries are the leading cause of death especially among young men who are mostly vulnerable victims. This catastrophe is more complicated in low to middle-income countries.</p><p><strong>Objective: </strong>This study assessed the financial costs of traffic casualties in a level-1 trauma university hospital.</p><p><strong>Method: </strong>One thousand trauma patients presenting to the emergency department of Shohaday-e-Tajrish Hospital were included in the study. The prehospital and hospital costs as well as the expenses of physiotherapy, rehabilitation, outpatient visits and further surgical interventions were considered as direct expenses. The costs of productivity loss were estimated as indirect expenses.</p><p><strong>Results: </strong>The direct and indirect costs were assessed 27.4% and 72.6% of total, respectively. The mean age of permanent disability was 43 years old. The average expenses of temporary and permanent disabilities were 2934.4 million rials, equal to 106 thousand $ (nearly 4.2 million rials or 153 $ per patient) and 23.9 billion rials, equal to 866.3 thousand $ (1.1 billion rials or 39.2 thousand $ per person), respectively.</p><p><strong>Conclusion: </strong>The national burden of traffic injuries in Iran is significantly destructive as it consists of 2.19 % of Gross Domestic Product annually. Besides, young men are involved in most of the traffic accidents representing the need to establish rigorous preventive instructions and reduce human, and financial costs.</p>","PeriodicalId":7290,"journal":{"name":"Advanced Journal of Emergency Medicine","volume":" ","pages":"e2"},"PeriodicalIF":0.0,"publicationDate":"2018-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.22114/AJEM.v0i0.108","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40449511","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":"Vitamin B12 Deficiency in a Patient Presenting with Dyspnea: A Case Report.","authors":"Atasi Bhattacharjee,&nbsp;Arpith Easo Samuel","doi":"10.22114/AJEM.v0i0.103","DOIUrl":"https://doi.org/10.22114/AJEM.v0i0.103","url":null,"abstract":"<p><strong>Introduction: </strong>Pancytopenia can be caused by underlying disorders such as certain autoimmune conditions, leukemia or even a few nutritional deficiencies such as vitamin B12 deficiency. Vitamin B12 deficiency most commonly presents as megaloblastic anemia but can also be associated with pancytopenia. It can present with a range of symptoms associated with anemia and gastrointestinal or neurological systems. Understanding the etiology of the deficiency is crucial for initiating proper treatments.</p><p><strong>Case report: </strong>A 19-year-old patient presented with complaints of dyspnea and fever, myalgia and generalized tiredness. Examinations found him to suffer pancytopenia and esophageal candidiasis caused by vitamin B12 deficiency. This deficiency can be associated to inadequate intake and the diet of the patient as a vegetarian. Parenteral B12 treatment led the patient to symptomatically improve.</p><p><strong>Conclusion: </strong>Vitamin B12 deficiency is a reversible cause of bone marrow failure and can be easily treated if diagnosed early enough. Eggs and animal-derived foods constitute the usual source of this vitamin. Vitamin B12 deficiency should therefore be of high index suspicion to a clinician if the patient presents in similar conditions with a vegetarian diet. In the event of the deficiency being caused by inadequate intake or intrinsic factor deficiency, the treatment can be started quickly leading to the dramatic improvement of the patient's condition.</p>","PeriodicalId":7290,"journal":{"name":"Advanced Journal of Emergency Medicine","volume":"3 2","pages":"e19"},"PeriodicalIF":0.0,"publicationDate":"2018-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a4/4b/AJEM-3-e19.PMC6548118.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40450396","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 Cerebral Venous Sinus Thrombosis Presenting with Delirium.","authors":"Mahnaz Pejman-Sani,&nbsp;Mahbube Ebrahimpur","doi":"10.22114/AJEM.v0i0.113","DOIUrl":"https://doi.org/10.22114/AJEM.v0i0.113","url":null,"abstract":"","PeriodicalId":7290,"journal":{"name":"Advanced Journal of Emergency Medicine","volume":" ","pages":"e11"},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/56/34/AJEM-3-e11.PMC6548075.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40562488","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}