Bulletin of emergency and trauma最新文献

{"title":"Factors Affecting the Functional Preparedness of Hospitals in Response to Disasters: A Systematic Review.","authors":"Behrouz Samei,&nbsp;Javad Babaie,&nbsp;Jafar Sadegh Tabrizi,&nbsp;Homayoun Sadeghi-Bazargani,&nbsp;Saber Azami-Aghdash,&nbsp;Naser Derakhshani,&nbsp;Ramin Rezapour","doi":"10.30476/BEAT.2023.97841.1414","DOIUrl":"https://doi.org/10.30476/BEAT.2023.97841.1414","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to comprehensively determine the factors that affect the hospitals' functional preparedness in response to disasters.</p><p><strong>Methods: </strong>A systematic review of studies published in English and Persian up to the end of 2022 was performed by searching PubMed Central, Web of Science, Scopus, ProQuest, SID, and Elmnet databases. Articles that assessed hospitals' functional preparedness were searched by using a combination of medical subject heading terms and keywords including disaster, emergency, preparedness, hospital preparedness, health care facilities preparedness, hospital functional preparedness, health care facilities functional preparedness, readiness, and effective factors. Additionally, journals and gray literature were manually searched. Two independent reviewers screened the eligible papers. The inclusion criteria were the full text should be published up to the end of 2022, in both Persian and English, and focus on hospital preparedness. The extracted data were manually analyzed, summarized, and reported using the content analysis method.</p><p><strong>Results: </strong>Of the 3465 articles, 105 studies were eventually included in the final analysis. Eighty-two influential factors were identified and classified into seven categories: government, coordination, control, and commanding (7 factors), existing guidelines and preparedness plans (12 factors), regulations (6 factors), supplying of resources (37 factors), education and training (8 factors), multi-layered information management and communication systems (8 factors), and contextual factors (4 factors).</p><p><strong>Conclusion: </strong>There are different dimensions of hospital preparedness for disasters, each of which is influenced by several independent factors. Addressing these factors will enhance the actual functional preparedness of hospitals encountering disasters.</p>","PeriodicalId":9333,"journal":{"name":"Bulletin of emergency and trauma","volume":"11 3","pages":"109-118"},"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/c0/b9/bet-11-109.PMC10387338.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9919991","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":"Characteristics of Traumatic Patients Referring to the Emergency Department and their Association with Mortality and Incidence of Surgery Performance.","authors":"Maryam Hosseini,&nbsp;Leila Shayan,&nbsp;Mahnaz Yadollahi,&nbsp;Mehrdad Karajizadeh","doi":"10.30476/BEAT.2023.97729.1413","DOIUrl":"https://doi.org/10.30476/BEAT.2023.97729.1413","url":null,"abstract":"<p><strong>Objective: </strong>To identify the distinctive features of acutely injured patients who were presented to the emergency department (ED) and their association with mortality and surgical intervention outcomes.</p><p><strong>Methods: </strong>This cross-sectional study was conducted on all trauma patients resuscitated in the ED of Shahid Rajaee (Emtiaz) Trauma Hospital (Shiraz, Iran) from May 2018 to June 2019. Demographic information, the mechanism of trauma, trauma type, injured body regions, criteria of abbreviated injury scale (AIS) score, injury severity score (ISS), and surgical intervention were all taken into consideration. The items related to the mortality and surgical performance outcomes among the patients were analyzed.</p><p><strong>Results: </strong>Of all 1281 cases, 82.9% were men, and the mean age of the patients was 37.9±19.1 years. The most common mechanism of injury was a car accident, and the thorax was the most prevalent injured area of the body. The majority of the patients had moderate blunt trauma. The mechanism of trauma, ISS, and the severity of head trauma were all significantly correlated with operation interventions. Moreover, age, the mechanism and type of trauma, ISS, and the necessity for the surgery were significantly associated with death occurrence. Additionally, head, thorax, and abdomen trauma were significantly related to a high mortality rate.</p><p><strong>Conclusion: </strong>Age, trauma mechanism and type, ISS, and the necessity for surgery were significantly associated with the mortality rate of injured patients. The severity of the trauma, particularly head injuries and the mechanism of damage were important determinants in concern for surgery the necessity.</p>","PeriodicalId":9333,"journal":{"name":"Bulletin of emergency and trauma","volume":"11 3","pages":"132-137"},"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/d9/ff/bet-11-132.PMC10387339.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9974179","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":"Death Trends and Years of Life Lost Due to Social Harms Such as Suicide, Homicide, and Addiction, Ilam Province, 2009-2019.","authors":"Zahra Jalilian, Fathola Mohamadian, Sasan Ahmadi, Yousef Veisani","doi":"10.30476/BEAT.2023.97876.1447","DOIUrl":"https://doi.org/10.30476/BEAT.2023.97876.1447","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the death trend and years of life lost (YLL) caused by social harm in Ilam province.</p><p><strong>Methods: </strong>This cross-sectional study was conducted in Ilam province from 2009 to 2019. To estimate YLL, all deaths caused by suicide, homicide, and addiction were included in the study. The data were collected from the Forensic Medicine Organization. The analysis was carried out using SPSS software (version 23.0). A <i>p</i>-value of <0.05 was considered statistically significant.</p><p><strong>Results: </strong>Between 2009 and 2019, there were 1712 occurrences of suicide, homicide, and addiction, which resulted in a total of 62,605 years of lost life (53,934 per 100,000 people). The highest frequency was related to the age group of 15-29 years, while the lowest was related to the age group of 0-14 years (<i>p</i><0.001). During the studied period, men were more likely than women to commit suicide, homicide, and addiction in Ilam (<i>p</i>>0.439). Between 2009 and 2019, the number of suicides and homicides in Ilam province started a decreasing trend for both sexes, while the number of deaths caused by addiction was increasing.</p><p><strong>Conclusion: </strong>The results of this study indicated that the age groups of 15-29 years had the highest rate of YLL caused by suicide, homicide, and addiction for both sexes. Furthermore, the findings showed that YLL decreased for suicide and homicide, but increased for addiction<b>.</b></p>","PeriodicalId":9333,"journal":{"name":"Bulletin of emergency and trauma","volume":"11 4","pages":"167-172"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10743323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032175","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":"Health Stewardship in Polar Regions: A Gateway to Establish Emergency Medicine in Extreme Environment.","authors":"Hossein Akbarialiabad, Rowena Christiansen, Mohsen Farjoud Kouhanjani, Milad Ahmadi Marzaleh, Mohammad Hossein Taghrir","doi":"10.30476/BEAT.2023.99614.1454","DOIUrl":"https://doi.org/10.30476/BEAT.2023.99614.1454","url":null,"abstract":"","PeriodicalId":9333,"journal":{"name":"Bulletin of emergency and trauma","volume":"11 4","pages":"202-203"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10743319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032178","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":"Leech Application-related Upper Gastrointestinal Bleeding: A Case Report.","authors":"Umit Can Dolek,&nbsp;Serdar Ozdemir,&nbsp;Kumissay Babayeva,&nbsp;Murat Gol","doi":"10.30476/BEAT.2023.97246.1403","DOIUrl":"https://doi.org/10.30476/BEAT.2023.97246.1403","url":null,"abstract":"<p><p>Leech therapy (Hirudotherapy) is a method used in the treatment of many diseases since ancient times. Although many complications have been reported following the use of this method, no systemic life-threatening bleeding has yet been described. A-43-year-old male patient was diagnosed with upper gastrointestinal bleeding following leech application that he had received for infertility one week earlier. The complications of hirudotherapy typically spontaneously improve due to the local effects of this treatment. The most frequently reported complications are local infections, and less commonly allergies and prolonged local bleeding can occur. However, in this case report, we describe a life-threatening upper gastrointestinal bleeding as a new complication. Gastrointestinal bleeding appearing a week after leech therapy does not necessarily mean that leeches caused gastrointestinal bleeding in this case. Nevertheless, considering the development time of gastrointestinal bleeding, it can be deduced that it was possibly due to hirudotherapy. Patients should be informed about alarming symptoms that can indicate complications following leech application.</p>","PeriodicalId":9333,"journal":{"name":"Bulletin of emergency and trauma","volume":"11 1","pages":"47-50"},"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/c0/3b/bet-11-47.PMC9923036.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10756231","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 Impact of Chlorhexidine Mucoadhesive Gel in the Prevention of Ventilator-Associated Pneumonia: A Randomized Clinical Trial.","authors":"Faramarz Dobakhti,&nbsp;Ali Zargar,&nbsp;Taraneh Naghibi","doi":"10.30476/BEAT.2023.97509.1406","DOIUrl":"https://doi.org/10.30476/BEAT.2023.97509.1406","url":null,"abstract":"<p><strong>Objective: </strong>Ventilator-associated pneumonia is the common cause of morbidity and mortality in the intensive care unit. Due to the antimicrobial effect of chlorhexidine, and the long-lasting result of mucoadhesive drugs, this study aimed to determine the effect of chlorhexidine mucoadhesive gel on the prevention of ventilator-associated pneumonia in critical patients.</p><p><strong>Method: </strong>In this clinical trial, 64 ventilated patients were selected and randomly allocated into two groups. The first group received 0.2% chlorhexidine mucoadhesive gel and the second group received 0.2% chlorhexidine solution as a mouthwash. Every three days, the incidence of ventilator-associated pneumonia was evaluated by the clinical score of pulmonary infection. The data were analyzed by SPSS statistical software version 20.</p><p><strong>Results: </strong>There was no statistically significant difference in demographic characteristics between the two groups. In the control group, 25% of the patients had ventilator-associated pneumonia, while it was only 15.6% in the intervention group; however, the incidence of ventilator-associated pneumonia revealed no significant difference between the two groups (HR ratio, 0.86; 95% confidence interval, 0.49 to 1.83 <i>p</i> <i>=</i>0.356).In addition, there was no statistically significant difference between the number of days connected to the ventilator (<i>p</i> <i>=</i>0.854), the number of days hospitalized in the intensive care unit (<i>p</i> <i>=</i>0.423), and the death rate (<i>p</i> <i>=</i>0.634) between the two groups.</p><p><strong>Conclusion: </strong>Although no significant statistical difference was detected between chlorhexidine mucoadhesive gel and chlorhexidine solution in the prevention of ventilator-associated pneumonia, the incidence of pneumonia in the mucoadhesive gel group was clinically less than in the control group. It is better to repeat the study with a larger statistical population.</p>","PeriodicalId":9333,"journal":{"name":"Bulletin of emergency and trauma","volume":"11 1","pages":"26-31"},"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/78/f4/bet-11-26.PMC9923030.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10768276","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":"Wunderlich Syndrome: Early Misdiagnosis with Acute Renal Colic During COVID-19 Pandemic.","authors":"Reza Mohammadian,&nbsp;Afsoon Afsoon,&nbsp;Mohmmadjavad Rajabi,&nbsp;Saman Nikeghbalian,&nbsp;Mahmood Shariat,&nbsp;Ahmad Monabati,&nbsp;Seyed Hamidreza Hosseinialhashemi","doi":"10.30476/BEAT.2023.97913.1415","DOIUrl":"https://doi.org/10.30476/BEAT.2023.97913.1415","url":null,"abstract":"<p><p>Wunderlich syndrome, also known as the spontaneous non-traumatic retroperitoneal hemorrhage, is an uncommon condition characterized by acute, spontaneous, non-traumatic renal hemorrhage into the subcapsular or perirenal spaces. The majority of the cases are caused by renal cell carcinoma or renal angiomyolipoma. Other causes are arteriovenous malformation, cystic renal disease, and anticoagulation medications. The classic presentation is \"Lenk's triad\" of acute flank pain, palpable flank mass, and hypovolemia. The diagnosis is based on clinical suspicion and confirmed by a CT scan, which is the preferred imaging modality. Due to the rarity of these cases and the wide range of clinical manifestations, the treatment is divergent ranging from conservative management to nephrectomy. Herein, we present a case of massive right renal hemorrhage caused by warfarin toxicity that was initially misdiagnosed as acute renal colic due to the patient's refusal to refer to the clinic during Corona Virus Disease- 19 era and was later managed with a right nephrectomy.</p>","PeriodicalId":9333,"journal":{"name":"Bulletin of emergency and trauma","volume":"11 2","pages":"102-105"},"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/5b/6d/bet-11-102.PMC10182722.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9857362","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":"Isolated Adrenal Gland Hemorrhage: A Case of a Car Accident.","authors":"Hossein Abdolrahimzadeh Fard,&nbsp;Soheil Bolandi,&nbsp;Zahra Mohammadi","doi":"10.30476/BEAT.2023.98940.1446","DOIUrl":"https://doi.org/10.30476/BEAT.2023.98940.1446","url":null,"abstract":"<p><p>Due to the specific features of the adrenal glands, traumatic adrenal injury is a rare phenomenon. The majority of these rare types of traumas are caused by blunt force injuries and rarely by penetrating mechanisms. In such cases, a whole-body computed tomography scan is essential for early diagnosis. This paper describes an uncommon case of adrenal hematoma and contusion followed by blunt abdominal trauma. A 35-year-old woman was admitted to the emergency department after a high-speed vehicle-pedestrian collision. She presented with decreasing level of consciousness. Additionally, a thoracoabdominal CT scan revealed a left flank hematoma. Blunt adrenal injury, often accompanied by multiorgan damage, is a rare occurrence resulting from severe accidents. Accurate diagnosis based on clinical symptoms requires high clinical suspicion, particularly in isolated cases, and treatment depends on the patient's condition.</p>","PeriodicalId":9333,"journal":{"name":"Bulletin of emergency and trauma","volume":"11 3","pages":"162-165"},"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/61/7e/bet-11-162.PMC10387335.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9974177","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":"Investigating the Rate and Affecting Factors of Unnecessary Cervical Collar Use in Trauma Patients.","authors":"Mohamad Hoseini Kasnavieh, Keihan Kookli, Mohamad Veisi, Mohammad Amerzadeh, Hossein Hosseinifar, Ali Tahmasebi","doi":"10.30476/BEAT.2023.98793.1441","DOIUrl":"https://doi.org/10.30476/BEAT.2023.98793.1441","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the necessity of cervical collars in patients with neck problems.</p><p><strong>Methods: </strong>This cross-sectional study was conducted on 114 patients who were admitted to the Haft Tir and Rasoul Akram Hospitals (Tehran, Iran) from August to September 2022. The Nexus protocol was used to select the patients with cervical collars. According to the protocol, a cervical collar was required for individuals who had at least one symptom. If none of these symptoms existed, the cervical collar was deemed unnecessary. The data were analyzed using the Chi-square test and Fisher's exact test.</p><p><strong>Results: </strong>Of the 114 trauma patients, the cervical collar was used unnecessarily by 49 (43%) patients. Tenderness was the most common complication in 62 patients (54.4%). The prevalence of unnecessary cervical collar use was 37.5% in female trauma patients and 43.88% in male trauma patients, which was not statistically significant (p=0.63). The prevalence of unnecessary cervical collar use in trauma patients with multiple trauma was 39.42% and 80% in patients without multiple trauma, which was statistically significant (p=0.018). Patients with a medical history had a higher rate of unnecessary use of the cervical collar (47.96%) than those without a history (12.5%), and this difference was statistically significant (p=0.008).</p><p><strong>Conclusion: </strong>The guidelines for using cervical collars need to be updated by the EMS. Due to the large number of trauma patients in Iran, cervical collars for necessary conditions can help to reduce the healthcare expenses and injuries caused by unnecessary cervical collars.</p>","PeriodicalId":9333,"journal":{"name":"Bulletin of emergency and trauma","volume":"11 4","pages":"178-183"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10743316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032179","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":"Effects of Flaxseed Oil and Olive Oil on Markers of Inflammation and Wound Healing in Burn Patients: A Randomized Clinical Trial.","authors":"Atefeh Ghanbari,&nbsp;Sanaz Masoumi,&nbsp;Ehsan Kazemnezhad Leyli,&nbsp;Marjan Mahdavi-Roshan,&nbsp;Mohammadreza Mobayen","doi":"10.30476/BEAT.2022.97070.1399","DOIUrl":"https://doi.org/10.30476/BEAT.2022.97070.1399","url":null,"abstract":"<p><strong>Objectives: </strong>To study the anti-inflammatory and antioxidant effects of flaxseed oil and olive oil on inflammatory markers for facilitating wound healing.</p><p><strong>Methods: </strong>One hundred and twelve patients were randomly selected to four groups with a total burn surface area (TBSA) of 20-50%. The four groups includes olive oil (OO), flaxseed oil (FO), mixture of olive oil and flaxseed oil (OF), and control group and received 30g of oils for three weeks. Serum high-sensitivity C-reactive protein (hs-CRP), ferritin and albumin level as inflammatory markers, as well as cholesterol, triglyceride, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) as the lipid profile were explored. Wound healing was assessed by photographing on days 2, 8, 15, and 22 (during three weeks of intervention) and were analyzed in imageJ software.</p><p><strong>Results: </strong>The greatest reduction in the level of hs-CRP and ferritin was observed in the OF (-21.38±44.41) (-132.79±165.36), while the lowest reduction was reported in the control group (-36.36±79.03) (141.08±262.36). Compared to control group, OO significantly increased albumin (0.88±0.65). Reduction of wound healing at the end of the first week of intervention was not significant in the study groups. However, the stereology examination showed significant improvement in wound healing at the end of the second and third weeks in the OF.</p><p><strong>Conclusion: </strong>Based on the findings, combination of herbal oils reduce inflammation and improve wound healing and showed positive effects on the size of wounds in burn patients.</p>","PeriodicalId":9333,"journal":{"name":"Bulletin of emergency and trauma","volume":"11 1","pages":"32-40"},"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/bc/ef/bet-11-32.PMC9923033.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10768278","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}