emergency nursing
Sahar Mirbaha; Parvin Kashani; Ali Arhami Dolatabadi; Afshin Amini; Farahnaz Meschi; Alireza Baratloo
Volume 3, Issue 2 , July 2017, , Pages 59-63
Abstract
Objective: Personality disorder is a multi-factorial condition in which workplace stress plays a significant role. This study was undertaken due to scarcity of information regarding the role of workplace stress which can cause personality disorder among nurses. We aimed to evaluate the prevalence of ...
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Objective: Personality disorder is a multi-factorial condition in which workplace stress plays a significant role. This study was undertaken due to scarcity of information regarding the role of workplace stress which can cause personality disorder among nurses. We aimed to evaluate the prevalence of personality disorders in nurses working in different hospital departments and assess factors affecting its onset. Methods: In this cross-sectional study the personality disorders of nurses working in various hospital departments were evaluated based on Minnesota Multiphasic Personality Inventory-2 (MMPI-2) test. After the completion of questionnaires, data were entered to MMPI-2 test’s special software and the final result was interpreted based on the opinion of a clinical psychologist. Finally, multivariate logistic regression model was used to assess the independent effect of the mentioned factors on prevalence of personality disorders in nurses. Results: We gathered data from 2 groups of participants (n = 206). These groups included nurses in emergency departments and nurses in other hospital units. The mean of age was 32.5 ± 6.9 years. Overall, 54.3% (n = 38) of non-emergency nurses and 45.7% (n = 32) of emergency nurses showed symptoms of personality disorders respectively. Multivariate logistic regression analysis showed that history of a serious accident or trauma increased the odds of detecting personality disorders up to 3.8 times (odds ratio [OR] = 3.84; 95% CI: 1.33-11.06; P = 0.01). In addition, an unpleasant incident in the past year increased it up to 2.2 times (OR = 2.23; 95% CI: 1.18 – 4.22; P = 0.01) in both groups. Conclusion: The present study showed that there was no significant difference between emergency departments and other units of hospitals regarding the prevalence of personality disorders among nurses. Overall, somatization, hysteria, and pollyannaish were the most common personality disorders among the studied population
Emergency medicine
Alireza Baratloo; Marzieh Amiri; Mohammad Mehdi Forouzanfar; Sadegh Hasani; Samar Fouda; Ahmad Negida
Volume 2, Issue 1 , January 2016, , Pages 21-24
Abstract
Objective: One of nonsteroidal anti-inflammatory drugs (NSAIDs) named as ketorolac is frequently used to relieve acute pain. Current study was conducted with the aim of ketorolac efficacy measurement as a pain killer agent for controlling the primary headache in emergency departments. Methods: In this ...
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Objective: One of nonsteroidal anti-inflammatory drugs (NSAIDs) named as ketorolac is frequently used to relieve acute pain. Current study was conducted with the aim of ketorolac efficacy measurement as a pain killer agent for controlling the primary headache in emergency departments. Methods: In this study, we enrolled 50 patients with primary headache who received 60 mg ketorolac intravenously as a slow infusion in about 10 minutes. Pain scores were evaluated with visual analog scale (VAS) on arrival and also 1 hour and 2 hours after ketorolac infusion. Statistical analysis was performed on collected data by using Wilcoxon and Mann-Whitney tests to assess the differences in VAS pain scores. Results: Decreasing the VAS more than 3 points from the arrival until 1 hour (P < 0.001), and more than 5 points from the arrival until 2 hours after ketorolac administration (P < 0.001) were seen. Those with history of analgesic use before admission in emergency department in comparison with the others did not accompany with more decline in pain score after 1 hour (P = 0.34) or 2 hours (P = 0.92). Conclusion: It seems that ketorolac is assured, safe and well tolerated agent for pain control in patients presented with primary headache to the emergency departments. Based on the results achieved in this study, ketorolac illustrates its perceptible effects within 1 hour after administration that even more prominent after 2 hours.
Disaster
Alireza Baratloo; Marzieh Maleki
Volume 1, Issue 2 , July 2015, , Pages 39-39
Abstract
Today, overcrowding in emergencies has turned out to be one of the biggest problems in health systems around the world. In this case, a short and an accessible solution could not be reached. In fact, several basic reasons play a role in such a problem, and eliminating each of them would require long-term ...
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Today, overcrowding in emergencies has turned out to be one of the biggest problems in health systems around the world. In this case, a short and an accessible solution could not be reached. In fact, several basic reasons play a role in such a problem, and eliminating each of them would require long-term planning. This issue not only has a negative effect on the quality of services presented to the patients, but also produces both psychological and physical effects on the emergency staff such as physicians and nurses. In addition, it also causes increased dissatisfaction among referees as well as imposing excessive exhaustion on medical staff.
Emergency medicine
Ali Arhami Dolatabadi; Parvin Kashani; Hamidreza Hatamabadi; Hamid Kariman; Alireza Baratloo
Volume 1, Issue 1 , January 2015, , Pages 3-6
Abstract
Objective: This study aimed to determine the association of cardiac risk factors and the risk of Acute Myocardial Infarction (AMI) in Emergency Department (ED) patients with non-diagnostic ECG changes.
Methods: This cross-sectional study was conducted in the ED of Imam Hossein Hospital during a period ...
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Objective: This study aimed to determine the association of cardiac risk factors and the risk of Acute Myocardial Infarction (AMI) in Emergency Department (ED) patients with non-diagnostic ECG changes.
Methods: This cross-sectional study was conducted in the ED of Imam Hossein Hospital during a period of one year. In this study, patients with symptoms suggestive of AMI including chest pain, dyspnea, palpitation, syncope, cerebrovascular incidents, nausea, vomitting, dizziness and loss of consciousness were included. The demographic data and risk factors, such as age, gender, history of diabetes, Hypertension (HTN), Hyperlipidemia (HLP), renal failure, positive family history of Coronary Artery Disease (CAD), smoking, substance abuse, alcohol consumption within the past 24 hours and cocaine use within the past 48 hours were recorded. Non-diagnostic ECG included: normal, non-specific, abnormal without ischemic symptoms such as old bundle branch block, Left Ventricular Hypertrophy (LVH), etc. The final diagnosis of AMI was determined by Creatine Phosphokinase-MB (CPK-MB) serum markers and Troponin I. The data were analyzed by using SPSS V. 20 and the level of statistical significance was considered to be P< 0.05.
Results: HTN, HLP, family history of heart disease were significantly higher in those who had non-diagnostic ECG (P< 0.05). However, the ischemic heart diseases were significantly lower in those with non-diagnostic ECG. History of diabetes, stroke, renal failure, alcohol or opium and menopause showed no significant association with non-diagnostic or diagnostic ECG.
Conclusion: Overall, the risk factors are limitedly associated with the occurrence of Myocardial Infarction (MI) in cases where ECG is not diagnostic and it is better to use other criteria to diagnose AMI.
OB/GYN
Aboutaleb Beigi; Alireza Mazinanian; Mansour Ashrafinia; Alireza Baratloo; Saeed Safari
Volume 1, Issue 1 , January 2015, , Pages 19-21
Abstract
Objective: There are major differences in neonatal and obstetrics outcomes of labour among different ethnicities. The present study compared the neonatal and obstetrics outcomes of labour between the Iranian and Afghan ethnicities. Methods: Neonatal and obstetrics problems were evaluated in Iranian ...
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Objective: There are major differences in neonatal and obstetrics outcomes of labour among different ethnicities. The present study compared the neonatal and obstetrics outcomes of labour between the Iranian and Afghan ethnicities. Methods: Neonatal and obstetrics problems were evaluated in Iranian and Afghan pregnant women, who had referred to Arash Educational/Treatment Center for labour during a year. Results: 3020 (93.7%) Iranian and 202 (63%) Afghan women were evaluated. There were no significant differences between the two ethnicities in relation to a need for Neonatal Intensive Care Unit (NICU), the rate of live births, infant birth weight, congenital anomalies and premature births (P>0.05). The rate of Caesarian section was higher in Iranian women (P=0.001). Conclusion: It seems that the differences in neonatal problems and outcomes of labour obstetrics between Iranians and Afghans can be attributed to different cultural, economic, and social conditions in comparison to different ethnicities.
Cardiology
Alireza Baratloo; Pauline Haroutunian; Alaleh Rouhipour; Saeed Safari; Farhad Rahmati
Volume 1, Issue 1 , January 2015, , Pages 35-38
Abstract
Background: Potassium, as an extracellular ion, plays an important role in the electrophysiologic function of the myocardium and any change in extracellular concentration of this ion might have a marked impression upon myocyte electrophysiologic gain. High serum potassium levels are thought to impair ...
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Background: Potassium, as an extracellular ion, plays an important role in the electrophysiologic function of the myocardium and any change in extracellular concentration of this ion might have a marked impression upon myocyte electrophysiologic gain. High serum potassium levels are thought to impair pulse conduction in Purkinje fibers and ventricles more than that in the Atrioventricular (AV) node. Therefore, although complete AV block can occur, it is a rare initial presentation.
Case Report: We describe a 62-year-old man with a history of diabetes mellitus, ischemic heart disease and previous Coronary Artery Bypass Graft (CABG), who came to our emergency department due to generalized weakness starting 2 days before admission. The patient also had decreased force in lower limbs, exacerbating from the morning, and was finally diagnosed as a hyperkalemia-induced Complete Heart Block (CHB). It should also be noted that the patient responded dramatically to the administration of 10 mL of 10% calcium gluconate along with external pacing until potassium level correction became effective. Conclusion: In spite of the fact that Hyperkalemia can be associated with frequent Electrocardiogram (ECG) abnormality, advanced heart blocks (second- and third-degree AV blocks) are usually found only in patients with pre-existing heart failure, conduction abnormalities, or other cardiac diseases. Institution of effective treatment rapidly and forgiveness of traditional non-effective, time consumptive and sometimes risking full-adjustment modalities, such as sodium bicarbonate infusion or exchange resins that prevent their use in the emergent phase, can help minimize patient morbidity and mortality.