Bulletin of emergency and trauma最新文献

{"title":"A Systematic Review and Meta-analysis Unveiling the Pivotal Role of Extracorporeal Membrane Oxygenation (ECMO) in Drug Overdose Treatment Optimization.","authors":"Hany A Zaki, Yavuz Yigit, Mohamed Elgassim, Eman E Shaban, Amira Shaban, Stuart A Lloyd, Mazin Sharafeldien Elsayed Mohamed, Aftab Mohammad Azad","doi":"10.30476/beat.2024.102203.1503","DOIUrl":"10.30476/beat.2024.102203.1503","url":null,"abstract":"<p><strong>Objective: </strong>The present study aimed to evaluate the clinical benefits and drawbacks of administering ECMO/ECLS therapies to drug-intoxicated patients.</p><p><strong>Methods: </strong>From inception until April 30, 2024, an extensive search was performed on four main databases: PubMed, Web of Science, Cochrane Library, and EMBASE. There was no restriction on the search period. Only the studies that reported survival to hospital discharge rates, adverse events, and the utilization of ECMO/ECLS in the treatment of intoxicated patients were included. On the other hand, articles that did not report adverse events or hospital discharge rates as outcomes, as well as studies published in languages other than English, were excluded. The evaluated outcomes were the rate of survival to hospital discharge rate and the incidence of adverse events associated with ECMO therapy. The Newcastle Ottawa scale was employed to appraise each study to determine its methodological quality. The Comprehensive Meta-Analysis (CMA) software (version 3.0) for statistical analysis was used, with the random effects model (due to high heterogeneity among the studies) and a 95% confidence interval.</p><p><strong>Results: </strong>From a total search of 2216 search results, only 10 studies were included. The pooled analysis from 10 studies indicated that ECMO therapies among drug-overdosed/poisoned patients were associated with a significant survival to hospital discharge rate of 65.6% ([95% CI: 51.5%-77.4%], <i>p</i>=0.030). However, the outcomes were highly heterogeneous (I²=83.47%), which could be attributed to the use of several medicines by different studies. In contrast, ECMO therapies among drug-overdosed patients were associated with a significant incidence rate of adverse events of 23.1% ([95% CI: 12.3%-39.2%], <i>p</i>=0.002). However, the pooled analysis had a significant heterogeneity (I²=70.27%).</p><p><strong>Conclusion: </strong>Despite various health complications, extracorporeal membrane treatment enhanced survival to hospital discharge with good neurological outcomes. Hence, it was a viable, effective, and feasible alternative for managing drug-induced intoxication in patients.</p>","PeriodicalId":9333,"journal":{"name":"Bulletin of emergency and trauma","volume":"12 3","pages":"103-110"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399472","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 Etiology of Trauma in Geriatric Traumatic Patients Refer to an Academic Trauma Center: A Cross Sectional Study.","authors":"Hosein Zakeri, Elham Pishbin, Behrang Rezvani Kakhki, Hanieh Ghashghaee, Sayyed Majid Sadrzadeh, Masumeh Sadeghi, Elnaz Vafadar Moradi","doi":"10.30476/beat.2024.102627.1512","DOIUrl":"10.30476/beat.2024.102627.1512","url":null,"abstract":"<p><strong>Objective: </strong>Geriatric trauma refers to injuries sustained by elderly individuals, typically those aged 65 years and older. The management of geriatric trauma in the Emergency Department requires a comprehensive approach that takes into account the physiological changes associated with aging, as well as the increased vulnerability and complexity of injuries in this population.</p><p><strong>Methods: </strong>This is a cross-sectional study aimed at evaluating the etiology of trauma in geriatric patients referred to the ED of level-1 an academic center. All patients with complaints of trauma are evaluated and patients over 65 years enrolled in the study. Data were analyzed by SPSS 26.</p><p><strong>Results: </strong>319 patients were investigated, 49.8% male and 50.2% female. The most common underlying diseases are high blood pressure, diabetes type 2, and ischemic heart disease. The most common trauma cause was falling from the same level (48.9%), followed by a fall from a height (16.6%), accidents with cars (16%), and motorcycles (9.1%). The most common injury was extremities trauma (71.5%) following head trauma (13.2%) and chest trauma (6%). The severity of injury in extremities was higher in women, and chest trauma was more severe in men.</p><p><strong>Conclusion: </strong>The fall and subsequent car accident had the highest frequency as a cause of trauma in elderly patients admitted to our academic trauma center. Hypertension and diabetes have also been the most common underlying diseases. Head and neck injuries are life-threatening and critical in a larger number of patients than other injuries, and protecting them can be effective in reducing mortality and serious injuries in elderly trauma patients.</p>","PeriodicalId":9333,"journal":{"name":"Bulletin of emergency and trauma","volume":"12 3","pages":"124-129"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399477","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 Great Role of Ventilator Parameters in Diagnosis of Right Main Bronchus Rupture Due to Blunt Chest Trauma.","authors":"Ramin Tajvidi, Golnaz Sabetian, Hossein Abdolrahimzadeh Fard","doi":"10.30476/beat.2024.100572.1478","DOIUrl":"10.30476/beat.2024.100572.1478","url":null,"abstract":"<p><p>Bronchial rupture following major blunt chest trauma should be suspected in any case of massive and persistent air leak through the intercostal drain tube. Chest radiographs and chest computed tomography scans (CT scans) are highly suggestive of this extremely rare tracheobronchial injury. The present study reported a patient who was a 15-year-old boy. He was a case of a motor-car accident and was brought to the emergency room (ER) of Rajaie Hospital ( Shiraz, Iran) due to dyspnea and chest pain. The physical examination revealed a few crash injuries on his upper extremities, as well as subcutaneous emphysema in his neck. The chest X-ray revealed a right clavicular fracture, multiple rib fractures, a right pneumothorax (but no complete collapse or fallen lung), and also pneumo-mediastinum and subcutaneous emphysema. The chest CT revealed severe pulmonary contusion, severe right-sided pneumothorax, significant pneumo-mediastinum, subcutaneous emphysema, multiple right-side rib fractures, and mild displacement of the right main bronchus. Furthermore, no definitive signs of bronchial rupture were detected. Using a mechanical ventilator, the following parameters were revealed. The maximum pressure (Pmax)=7cm, H₂o (was very low), plateau pressure (P. Plateau), and expiratory tidal volume (TV) were not detected due to insufficient amounts. Additionally, increasing TV did not change those values. Bronchial rupture is one of the most important and serious differential diagnoses in forceful chest traumas when the mechanical ventilator reveals low Pmax, very low P.platue, and expiratory TV, with no change in those values with increasing TV.</p>","PeriodicalId":9333,"journal":{"name":"Bulletin of emergency and trauma","volume":"12 3","pages":"142-145"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399478","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":"Surgical Treatment versus Conservative Management of Splenic Rupture: Outcomes and Risk Factors.","authors":"Reza Eshraghi, Sina Shamsi, Masoumeh Safaee","doi":"10.30476/BEAT.2024.101350.1489","DOIUrl":"https://doi.org/10.30476/BEAT.2024.101350.1489","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the outcome and risk factors in operative and non-operative management of splenic injury.</p><p><strong>Methods: </strong>This cross-sectional study was conducted on patients with traumatic splenic injuries who were hospitalized in Kashani Hospital (Isfahan, Iran) from 2017 to 2019. The studied variables were extracted from the medical records of the enrolled participants. The outcomes such as mortality complications and risk factors were compared based on treatment methods.</p><p><strong>Results: </strong>A total of 240 patients were investigated. The mean age of the patients was 29.8±12.2, with 180 (77.5%) patients being men. 154 (64.2%) patients underwent operative treatment. The mortality rate was 18.9% and 4.6% among operative and non-operative groups (<i>p</i><0.001). Complications were observed in 11.5% and 46.1% of non-operative and operative groups, respectively (<i>p</i><0.001). Operative treatment inversely correlated with mortality (<i>p</i><0.001) and complications (<i>p</i><0.05). Splenic injury severity was correlated positively with mortality (<i>p</i><0.001) and negatively with complications (<i>p</i><0.001). Unstable hemodynamic status was positively correlated with complications (<i>p</i><0.001). Age had a positive correlation with mortality (<i>p</i><0.001) and complications (<i>p</i><0.001). Male sex had a negative correlation with complications (<i>p</i><0.001). GCS score and admission were positively correlated with mortality (<i>p</i><0.001). There was no statistically significant correlation between correlated injuries and outcomes (<i>p</i>≥0.05).</p><p><strong>Conclusion: </strong>Patients who received surgery had higher rates of mortality and complications. However, after controlling for confounders, operative treatment was found to be inversely correlated with mortality and complications.</p>","PeriodicalId":9333,"journal":{"name":"Bulletin of emergency and trauma","volume":"12 1","pages":"15-20"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11057449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140850435","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":"Serum Levels of Pro-Brain Natriuretic Peptide and the Diagnosis and Prognosis of Cardiac Syncope.","authors":"Sayyed Majid Sadrzadeh, Bahram Shahri, Mostafa Kamandi, Maryam Adimolmasali, Behrang Rezvani Kakhki, Hamideh Feiz Disfani","doi":"10.30476/beat.2024.103126.1520","DOIUrl":"10.30476/beat.2024.103126.1520","url":null,"abstract":"<p><strong>Objective: </strong>Recently, different serum markers have been used for the diagnosis and prognosis of acute heart diseases in emergency departments. To determine such a role, the present study was designed and conducted.</p><p><strong>Methods: </strong>This is an analytical cross-sectional study conducted on patients with syncope complaints. The patients enrolled in the study based on the inclusion and exclusion criteria and underwent initial evaluations, including collecting a history, physical examination, ECG, blood sugar measurement, and, if necessary, brain CT scan, Doppler echocardiography, and CTA.</p><p><strong>Results: </strong>This study included 100 participants who complained of syncope. The results showed that 19% and 81% of the subjects suffered from cardiac and non-cardiac syncope, respectively. The average Pro BNP of the studied individuals was 196.06±128.45 pg/mL. According to the results, age and length of hospitalization had a positive and significant relationship with the average Pro BNP (<i>p</i><0.01). Individuals with positive TPI, cardiac syncope, and abnormal ECG or Doppler findings had significantly higher average Pro BNP levels (<i>p</i><0.01). The results of the diagnostic value of Pro BNP in diagnosing cardiac syncope also showed that its sensitivity and specificity were 94.73% and 56.79%, respectively.</p><p><strong>Conclusion: </strong>The results of this study showed that the increase in the Pro BNP values was associated with age, length of hospitalization, and ECG abnormalities. In addition, as an independent marker, Pro BNP had optimal acceptability in identifying cardiac syncope cases.</p>","PeriodicalId":9333,"journal":{"name":"Bulletin of emergency and trauma","volume":"12 3","pages":"130-135"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399476","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":"Air Gun Pellet Injury to Internal Carotid Artery: A Case Report and Review of Literature.","authors":"Abdul Hakeem, Deepak Kumar, Majid Anwer, Anurag Kumar, Abhishek Kumar","doi":"10.30476/BEAT.2024.102081.1501","DOIUrl":"10.30476/BEAT.2024.102081.1501","url":null,"abstract":"<p><p>Airgun injuries are prevalent in the pediatric population. The present study described a case of air gun pellet injury to the left carotid artery and its successful management. A 25-year-old man presented to the emergency department complaining that his son had accidentally injured him with an air gun pellet while playing. The X-ray cervical spine revealed a single foreign body (pellet) located directly anterior to the C5-C6 vertebra. A CT angiography of the neck showed a spherical hyperdense object just anterior to the C6 vertebral body on the left side, 3 mm posteromedial to the left common carotid artery, which was most likely a pellet foreign body. The patient was sent to operation theatre (OT) for exploration. There was a rent in the internal carotid artery with active bleeding. After exerting both proximal and distal control, the rent was closed. Close air gun injury could result in gunshot wounds, as in the present case. Plain X-rays in AP and lateral view are required. Nonoperative management could be employed in a restricted group of patients with satisfactory outcomes. Those who have vascular involvement will require surgical intervention.</p>","PeriodicalId":9333,"journal":{"name":"Bulletin of emergency and trauma","volume":"12 2","pages":"95-98"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142119035","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":"Road Traffic Injuries in Iran: Epidemiology and Equitable Distribution of Emergency Services.","authors":"Pirhossein Kolivand, Peyman Saberian, Samad Azari, Peyman Namdar, Fereshte Karimi, Arash Parvari, Seyed Jafar Ehsanzadeh, Behzad Raei, Mehdi Raadabadi, Soheila Rajaie","doi":"10.30476/beat.2024.103102.1518","DOIUrl":"10.30476/beat.2024.103102.1518","url":null,"abstract":"<p><strong>Objective: </strong>This study emphasized the importance of providing equal access to rescue and emergency services for all individuals involved in road accidents, regardless of their geographical location or socioeconomic status.</p><p><strong>Methods: </strong>This study involved gathering data on the number of Iranian Red Crescent Society (IRCS) and Emergency Medical Services (EMS) stations in 31 provinces of Iran. It entailed calculating the Gini coefficient and creating the Lorenz curve to assess the station distribution. To present road traffic injuries (RTIs) mortality, Disability-Adjusted Life Years (DALYs), and prevalence in Iran from 1990 to 2019, the Global Burden of Disease (GBD) 2019 estimates were utilized.</p><p><strong>Results: </strong>The findings revealed that Tehran, Khorasan Razavi, Isfahan, Fars, and Khuzestan provinces were equipped with the most stations; whereas, Ilam, Semnan, and Kohgiluyeh and Boyer Ahmad had the fewest. The Gini coefficient for the distribution of RCS and EMS stations was found to be 0.23 and 0.38, respectively. Additionally, the study examined the prevalence, DALYs, and mortalities caused by road injuries across the 31 provinces and presented the findings in the form of a geographical representation.</p><p><strong>Conclusion: </strong>The results of this study highlighted the importance of ongoing efforts to ensure the equitable allocation of RCS and emergency services, with a particular emphasis on road accidents and disaster management scenarios.</p>","PeriodicalId":9333,"journal":{"name":"Bulletin of emergency and trauma","volume":"12 4","pages":"177-184"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853009","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":"Knowledge about Prescribing Antibiotics as Prophylaxis in Patients with Open Globe Injury: A Survey in Iranian Ophthalmologists.","authors":"Mansoor Shahriari,&nbsp;Mohammad Mohammad,&nbsp;Maryam Foruzani Haghighi,&nbsp;Ghader Mohammadnezhad,&nbsp;Hadi Esmaily","doi":"10.30476/BEAT.2023.98269.1425","DOIUrl":"https://doi.org/10.30476/BEAT.2023.98269.1425","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the Iranian ophthalmologists' knowledge of prescribing prophylactic antibiotics to patients with open globe injury (OGI) in Iran.</p><p><strong>Methods: </strong>In this cross-sectional study, we utilized a questionnaire to evaluate the ophthalmologists' knowledge about prescribing antibiotics as prophylaxis. This survey was conducted in Tehran and its suburbs. The questionnaire included demographic information as well as ophthalmologists' knowledge levels. Cronbach's alpha was used to determine its validity and reliability. The obtained data were analyzed using SPSS 24.0.</p><p><strong>Results: </strong>Of 192 subjects, 111 (35 women, 76 men) were included. About 65 (58.6%) specialists and 45 (41.4%) subspecialists with different orientations completed the questionnaires. The total knowledge score was 13.04±2.96. The following are the results of ophthalmologists' responses to questions regarding the cornea/scleral injury (1.09±1.72), prophylactic antibiotics administration (2.79±1.11), the infectious agents in eye surgeries (3.21±1.49), diagnosis and treatment (2.84±0.944), and the effects of ocular antibiotics as well as their proper dosage (2.96±2.35). There was no significant relationship between some demographic information such as sex, working hours, workplace, and the number of studied articles (<i>p></i>0.05). In addition, ophthalmologists with less work experience had significantly higher levels of knowledge than those with more work experience.</p><p><strong>Conclusion: </strong>The findings indicated that the majority of ophthalmologists had a basic knowledge of prescribing prophylactic antibiotics in OGI.</p>","PeriodicalId":9333,"journal":{"name":"Bulletin of emergency and trauma","volume":"11 2","pages":"96-101"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1a/e0/bet-11-96.PMC10182719.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9840553","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":"Post-Traumatic Stress Disorder among Emergency Medical Technicians and its Relationship with Occupational Stress and Depression: Post-Corona Screening, Zanjan, 2022.","authors":"Maryam Asadi Aghajari,&nbsp;Elnaz Hashemzadeh,&nbsp;Sevda Fazlizade,&nbsp;Mansour Ojaghloo,&nbsp;Leila Ghanbari-Afra,&nbsp;Zeinab Ghahremani,&nbsp;Mohammad Abdi","doi":"10.30476/BEAT.2023.98245.1421","DOIUrl":"https://doi.org/10.30476/BEAT.2023.98245.1421","url":null,"abstract":"<p><strong>Objective: </strong>Emergency medical technicians (EMTs) are at risk of developing post-traumatic stress disorder (PTSD) as a result of seeing painful events involving suspected COVID-19 patients and being concerned about potentially infecting themselves and their families. Therefore, screening for these disorders is essential in the post-Corona era. This study aimed to investigate the prevalence of PTSD among EMTs and its relationship with occupational stress and depression when dealing with patients with suspected COVID-19.</p><p><strong>Methods: </strong>This cross-sectional study was conducted on EMTs at Zanjan University of Medical Sciences using a convenience sampling method. Data were collected using a demographic information questionnaire, PTSD checklist, occupational stress questionnaire, and the Goldberg depression scale. The data were analyzed using SPSS software. Statistical tests such as Pearson correlation and logistic regression analysis were used to evaluate the data.</p><p><strong>Result: </strong>205 EMTs participated in this cross-sectional study. The mean and standard deviation of PTSD was 37.13±12.93 (17-85), and according to the cut-off (45), the prevalence of PTSD was 30.7%. There was a direct and significant association between the total PTSD and depression scores (r=0.435, <i>p</i>=0.001). Some occupational stress domains, such as demand (r=0.306, <i>p</i>=0.001), colleague support (r=0.149, <i>p</i>=0.033), and communication (r=0.293, <i>p</i>=0.001) had a significant association with PTSD. The domains of sadness in depression (OR=1.074, <i>p</i>=0.027) and demands in occupational stress (OR=1.872, <i>p</i>=0.029) were the most important predictors of PTSD. Among demographic variables, employment status was the most important protective factor for PTSD (OR=0.378, <i>p</i>=0.038).</p><p><strong>Conclusion: </strong>PTSD affected one-third of EMTs, and it had a significant relationship with various dimensions of depression and occupational stress. Due to the chronic nature of these diseases, policymakers are advised to prioritize psychological screening of EMTs as part of the post-Corona policy.</p>","PeriodicalId":9333,"journal":{"name":"Bulletin of emergency and trauma","volume":"11 3","pages":"138-145"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ac/ce/bet-11-138.PMC10387340.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9922451","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":"Dexmedetomidine vs Ketamine for Pediatric Procedural Sedation in the Emergency Department: A Randomized Clinical Trial.","authors":"Behrang Rezvani Kakhki,&nbsp;Melika Fugerdi,&nbsp;Zahra Abbasishaye,&nbsp;Hamideh Feyz Dysfani,&nbsp;Elnaz Vafadar Moradi","doi":"10.30476/BEAT.2022.95647.1366","DOIUrl":"https://doi.org/10.30476/BEAT.2022.95647.1366","url":null,"abstract":"<p><strong>Objective: </strong>To design and conduct the effectiveness of Ketamine vs Dexmedetomidine in children's sedation at emergency department (ED).</p><p><strong>Methods: </strong>This randomized clinical trial study was carried out at the two trauma centers in Mashhad, Iran. The patients were divided into two groups by means of a random numbers table to be treated with Ketamine (N=20) or Dexmedetomidine (N=20). Their demographic information and sedation times of drugs were collected and analyzed.</p><p><strong>Results: </strong>In general, sedation time was significantly higher in the ketamine group, 14.35 minutes (IQR:9.82-19) than in the dexmedetomidine group, 9.7 minutes (8.35-14.23) (<i>p</i>=0.023). Time of injection to complete anesthesia was 45.25 (IQR:30-58) and 72 (IQR:60.25-82) minutes in ketamine and dexmedetomidine groups, respectively (<i>p</i><0.01). In the case of recovery, grade 4 of the Ramsey scale was statistically more prevalent in dexmedetomidine (45%) than in the ketamine group (<i>p</i>=0.0001).</p><p><strong>Conclusion: </strong>This study demonstrated that dexmedetomidine could be used in cases where a shorter sedation time is vital. Ketamine could be a better choice where full recovery time (from injection) matters most. Clinical Trial registration code: IR.MUMS.fm.REC.1396.534.</p>","PeriodicalId":9333,"journal":{"name":"Bulletin of emergency and trauma","volume":"11 1","pages":"13-18"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c8/0c/bet-11-13.PMC9923034.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10756228","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}