Journal of Emergency Practice and Trauma

Letter to Editor Surgery

Abdominal Sepsis: What is the best score ?

Mirko Barone; Massimo Ippoliti; Felice Mucilli

Volume 9, Issue 2 , July 2023, Pages 79-80

Abstract

Intra-abdominal infections still represent a challenge for surgeons. The systemic physiopathological effects of infection rapidly progress, leading to sepsis and multiorgan failure, whose prognosis is often dramatic. Mortality risk stratification using scoring systems would unequivocally aid the early ... Read More

Review Article Clinical Toxicology

The approach to the treatment of venomous and poisonous arthropod bites and stings in ancient medicine: A narrative review

Rouhullah Dehghani; Shahrad Tajaddini; masoomeh varzandeh

Volume 9, Issue 2 , July 2023, Pages 81-86

Abstract

Objective: Arthropod bites and stings have always been of interest to humans; therefore, researchers have always been interested in their prevention and timely treatment. Considering the brilliance of ancient Iranian physicians, especially Avicenna, this study was conducted based on their views on diagnosing ... Read More

Original Article Critical Care

Comparison of the diagnostic value of ultrasound with chest CT scan in patients with unspecified pulmonary pneumonia in the emergency department

Moloud Balafar; Mahboub Pouraghaei; Mahnaz Ranjkesh; Mahshid Dehghan; Ali Delkhorrami; Samad Shams Vahdati

Volume 9, Issue 2 , July 2023, Pages 87-91

Abstract

Objective: According to the most recent guidelines, the recommended imaging approaches for the diagnosis of pneumonia are chest X-ray (CXR) and computed tomography (CT) scan. However, there are limitations to these approaches. Lung ultrasound (LUS) has attracted a lot of attention in intensive care units ... Read More Objective: According to the most recent guidelines, the recommended imaging approaches for the diagnosis of pneumonia are chest X-ray (CXR) and computed tomography (CT) scan. However, there are limitations to these approaches. Lung ultrasound (LUS) has attracted a lot of attention in intensive care units (ICUs) and emergency departments. Considering the importance of the timely diagnosis and proper treatment of pneumonia, this study aimed to determine the diagnostic value of bedside LUS in comparison to chest CT scans in patients with suspected pneumonia or unspecified CXR findings in the emergency department.Methods: This prospective descriptive-analytic study was conducted in the emergency department of Imam Reza hospital. Patients aged 3 years and older with early diagnosis of pneumonia or any unspecified CXR findings with an indication of CT scan were included in the study. LUS was performed with a deep curved and linear surface probe. The results obtained from the chest ultrasound were compared with the results obtained by CT scan as the diagnostic gold standard.Results: A total of 175 patients were included in this study. According to the results, the sensitivity and specificity of LUS in the diagnosis of subpleural consolidation were 94.1% and 100%, respectively, and the positive predictive value and the negative predictive value were 100% and 33.3%, respectively. The sensitivity and specificity of LUS in diagnosing pleural effusion were 69.2% and 100%, respectively, and the positive predictive value and the negative predictive value were 100% and 90.7%, respectively. Furthermore, the sensitivity of LUS in diagnosing dynamic airbronchogram was 98%.Conclusion: According to the findings of the present study, in patients suspected of pneumonia, LUS is more sensitive and specific in the diagnosis of pneumonia and is less time-intensive and costly. Additionally, the ultrasound device is easily portable and accessible. It can be widely used and does not have the secondary side effects of ionizing radiation in patients. However, the technician’s skill in performing ultrasound is a matter of importance.

Original Article Clinical Toxicology

Determining hematological indices in patients admitted to a poisoning referral center: A 10-year cross-sectional study

Nastaran Eizadi-mood; laaya mokhtar; shiva samsamshariat; Gholamali dorooshi; arman otroshi; mohammad naghizadeh; Ali Mohammad Sabzghabaee

Volume 9, Issue 2 , July 2023, Pages 92-96

Abstract

Objective: Poisoning is one of the most common methods of suicide in developing countries. We assessed the frequency of impaired hematological indices in patients with acute poisoning.Methods: The present study was a cross-sectional retrospective. Using the census sampling method, all patients who had ... Read More

Original Article Anesthesiology

Evaluation of the efficacy of the valsalva maneuver and fentanyl administration for attenuating etomidate injection pain: A double-blind clinical trial

Behzad Nazemroaya; Azim Honarmand; Golshan Mazaheri Tehrani

Volume 9, Issue 2 , July 2023, Pages 97-103

Abstract

Objective: Etomidate is mentioned as one of the rapid intravenous anesthetic drugs whose unique characteristics include hemodynamic stability, negligible respiratory depression, and brain protection. The most common complication of etomidate is intravenous pain during injection. The purpose of this study ... Read More

Original Article Emergency medicine

Is Clavicular Fracture Associated with Accompanying Injuries in Multi Trauma Patients?

Shiva Salmasi; Sadaf Dilmaqani; Hanieh Ebrahimi Bakhtavar; Alireza Ala; Farzad Rahmani

Volume 9, Issue 2 , July 2023, Pages 104-108

Abstract

Objective: This study aimed to evaluate the relationship between clavicular fracture and associated injuries in multi-traumatic patients.Methods: In this prospective cohort study, 185 multi-traumatic patients referred to the Emergency Department of Imam Reza (AS) Hospital of Tabriz University of Medical ... Read More

Original Article Pediatrics

Severity of organ dysfunction in pediatric intensive care using PELOD-2

Sangeetha Shenoy; Shruti Patil

Volume 9, Issue 2 , July 2023, Pages 109-113

Abstract

Objective: Organ dysfunction is an important factor determining the severity and outcome of critical illness in children. Organ dysfunction scores are based on the number of organs involved and the severity of dysfunction in each. This study aimed to evaluate organ dysfunction using PELOD-2 in critically ... Read More Objective: Organ dysfunction is an important factor determining the severity and outcome of critical illness in children. Organ dysfunction scores are based on the number of organs involved and the severity of dysfunction in each. This study aimed to evaluate organ dysfunction using PELOD-2 in critically ill children.Methods: This prospective observational study included all consecutive critically ill children with organ dysfunction aged one month to 15 years admitted to pediatric intensive care unit of a Ramaiah Medical College Hospital, Bangalore between January 2018 and December 2020. The severity of organ dysfunction was scored using Pediatric logistic organ dysfunction-2 (PELOD-2) and evaluated based on the outcome using SPSS and PASW statistics for Windows version 18.0. The sample size required for the study with 95% confidence level and 10% relative precision was 149 critically ill children. The children were classified based on the presence of single and multiple organ dysfunction. Demographics and laboratory parameters were compared between the two groups using non parametric tests. The factors affecting mortality among children with multiple organ dysfunction were assessed using univariate and multivariate analysis.Results: Of the 550 children admitted with critical illness during the study period, organ dysfunction was present in 84% of the patients. Of these, 43% had multiple-organ dysfunction. The median (interquartile range) of the patients was 5.5 (1, 11) years with a male-to-female ratio of 1.7:1. The mortality rate was 14.4%. The PELOD-2 score and mortality steadily increased with the number of organs involved. The presence of more than two organ dysfunctions had an odd ratio (OR) of 45.7 for mortality (95% CI: 18.9–110.6, P value<0.001). The area under the receiver operating curve(ROC) for predicting mortality using the number of organs affected was 0.96 (95% CI: 0.94–0.97, P value<0.001). Dysfunction in more than two organs had a sensitivity of 92.5% and a specificity of 91% in predicting mortality. The presence of cardiovascular dysfunction and the need for ventilation were found to be independent predictors of mortality.Conclusion: The presence of more than two organ dysfunctions in PELOD-2 increased the risk of mortality; the need for ventilation and the presence of cardiovascular dysfunction were independent predictors of mortality.

Original Article Infectious disease

Comparison of high-flow nasal cannula and conventional oxygen therapy in treating COVID-19 patients referred to the emergency department: A randomized, single-blind clinical trial

Farhad Heydari; Majid Zamani; Mohammad Nasr-Esfahani; Fatemehsadat Mirmohammad Sadeghi; Faezeh Hedayati

Volume 9, Issue 2 , July 2023, Pages 114-119

Abstract

Objective: Recently, high-flow nasal cannula (HFNC) oxygen therapy has been implicated in the treatment of patients with acute respiratory failure. In this study, the effect of this treatment on COVID-19 patients was investigated.Methods : This was a prospective, randomized, single-blind clinical trial ... Read More

Original Article Trauma

Nurses’ Attitude toward Trauma-Informed Care at Critical Care Units

Hashem AlKotaifan; Raghad H Abdelkader; Mohammad Alshloul; Shaher H. Hamaideh; Mohammed S. ALBashtawy; Nazzal M Alshloul; Doha M Alshloul

Volume 9, Issue 2 , July 2023, Pages 120-126

Abstract

Objective: Trauma-informed care (TIC) is an innovative concept that recognizes the lasting impactof psychological trauma. Critical care nurses’ attitude toward TIC plays an essential role in assessing,monitoring, and addressing trauma experienced by patients. This study aimed to describe criticalcare ... Read More

Case Report OB/GYN

Spontaneous uterine artery rupture in a non-pregnant woman: A case report

Jessica Ann Nathan; Valerie Sze Yen Chew; Nur Fazlin Ab Manan

Volume 9, Issue 2 , July 2023, Pages 127-129

Abstract

Objective: Spontaneous uterine artery rupture in a non-pregnant woman is an extremely uncommon event. To date, there have only been a few cases. Patients often present with acute abdomen and are hemodynamically unstable.Case Presentation: A 42-year-old female presented with multiple episodes of syncopal ... Read More

Case Report Trauma

Penetrating maxillofacial injury: A case report

Mamatha Siddalingappa Nanjappa; Anjan kumar shah; Susheen Dutt; Narahari Ranganath

Volume 9, Issue 2 , July 2023, Pages 130-133

Abstract

Objective: Penetrating injuries in the maxillofacial region pose a great challenge due to the anatomical complexity inherent to the area compounded with vital functions such as vision and airway. This paper highlights the importance of meticulous preoperative planning and a concerted effort of a multidisciplinary ... Read More

Case Report Cardiology

Metastatic liver mass with heart failure presentation: A Case Report

Asghar Mohamadi; Nazanin Davari; Elham Sepahvand; Maryam Aliramezany

Volume 9, Issue 2 , July 2023, Pages 134-137

Abstract

Objective: Dyspnea is a common symptom of heart disease that can also be related to otherdisorders, such as liver disease. In this case report, we aim to describe a rare case of metastatic livermass that presented with heart failure.Case Presentation: A 50-year-old woman without a past medical history ... Read More

Case Report Emergency medicine

Fatal Triad: Spontaneous Pneumothorax, Pneumomediastinum, and Pneumorrhachis in a Case of Paraquat Ingestion

Zainab Mehdi; Daljinderjit Kaur; Parv kamra; Nidhi Arora; Narinder kaur; Shivam Bansal

Volume 9, Issue 2 , July 2023, Pages 138-141

Abstract

Objective: Dependency on agriculture and the unregulated sale of paraquat makes it an easy alternative for homicidal and suicidal use in developing nations. It kills by multiorgan failure, predominantly pulmonary fibrosis, and ARDS. We report a case of alleged paraquat ingestion with spontaneous pneumothorax, ... Read More Objective: Dependency on agriculture and the unregulated sale of paraquat makes it an easy alternative for homicidal and suicidal use in developing nations. It kills by multiorgan failure, predominantly pulmonary fibrosis, and ARDS. We report a case of alleged paraquat ingestion with spontaneous pneumothorax, spontaneous pneumomediastinum, and pneumorrhachis. Aim is to reinforce the importance of a high index of suspicion in early diagnosis when the above findings are present with ARDS in absence of trauma and a history of alleged substance ingestion.Case Presentation: A 35-year-old male presented with loose stool occasionally bloody, oral ulcers, yellow discoloration of eyes with fever, and decreased urine output for three days after consuming some substance with his seafood. On examination, he had yellow discoloration of eyes and oral mucosa along with multiple ulcers on the buccal region as well as the dorsum of the tongue and lateral margins with generalized subcutaneous emphysema. In addition, decreased air entry in the bilateral lung field and muffled heart sounds were present. He had an acute hepatorenal failure and severe metabolic acidosis with respiratory failure. Urine tested positive for myoglobin and muscle enzymes (creatinine kinase and lactate dehydrogenase (LDH)) were raised. He was intubated and shifted to the intensive care unit. Injectable N-acetyl cysteine (NAC) for acute liver failure was started with empirical antibiotics and intravenous fluids. We supplemented thiamine and vitamin K, and hemodialysis was done in view of progressive renal failure. Radiological evaluation showed spontaneous pneumothorax, pneumomediastinum, and pneumorrhachis which were managed conservatively. His respiratory parameters worsened despite maximal ventilatory support. Renal failure and metabolic acidosis worsened in spite of hemodialysis. He succumbed to his illness on day five of admission and seven days after toxin ingestion.Conclusion: We recommend that the sale of paraquat be restricted and regulated to avoid its use for suicidal and homicidal purposes. More research is required to find measures to intervene early and prevent pulmonary fibrosis. We propose that paraquat toxicity be considered early in a patient with the triad in an atraumatic setting with acute respiratory distress syndrome (ARDS).

Case Report Emergency Medical Services

Emergency transfusion of different rhesus blood type: Will there be complications?

Albert Hardy Wu; Mariza Fitriati; Disa Edralyn; Adriana Jardine

Volume 9, Issue 2 , July 2023, Pages 142-145

Abstract

Objective: Antepartum hemorrhage (APH) is one of the leading causes of maternal and fetalmortality worldwide, complicating 2–4% of pregnancies. Considering the probability of bloodtransfusion, blood testing and cross-matching are essential for the anesthesiologist duringperioperative management. ... Read More

Cardiology

Hyperkalemia-induced complete heart block

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 ... Read More

Ethics

A road to ethics: a new experience of retraction

Hafez Mohammadhassanzadeh; Amin Beigzadeh; Mehrdad Nazarieh

Volume 2, Issue 1 , January 2016, , Pages 1-2

Abstract

Every journal finds its fundamentals in the course of time by the validity and originality of its published literature. This is validated if authors keep diligence and honesty when they conduct their research and submit their work in a journal. But at times what comes out of a scientific research is ... Read More

Emergency medicine

Using risk factors to help in the diagnosis of acute myocardial infarction in patients with non-diagnostic electrocardiogram changes in emergency department

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 ... Read More

emergency nursing

Factors influencing decisions on organ donation in brain death patients

Amin Beigzadeh; Bahareh Bahmanbijari; Mahla Salajegheh; Ali Akbar Haghdoost; Habibolah Rezaei

Volume 1, Issue 2 , July 2015, , Pages 60-66

Abstract

Organ donation is an integral part of the health care system. Many patients who have had an accident or have undergone a progressive disease are in need of an organ transplant and if they do not receive the required organ they would die. It is important to know that the most important source of organ ... Read More

Clinical Toxicology

Evaluation of suicide attempts with drug poisoning in North-West of Iran

Samad Shams Vahdati; Narges Moradi; Jamil Hemat Ghadim; Shahrad Tajoddini

Volume 1, Issue 1 , January 2015, , Pages 1-2

Abstract

Deliberate Self-Poisoning (DSP) or drug induced suicide is the most common method of suicide in the developed countries and is associated with significant morbidity and mortality (1-3). Factors associated with DSP include economic and social factors, culture, religion, and health (4-6). Other symptoms ... Read More

Original Article Surgery

A study on abdominal emergencies presenting during COVID-19 at a tertiary care center in Central India

Bharati Pandya; Vishnu Vardhan P. Reddy; Srujan Dharap; Reyaz Ahmad; Meena Kumari; Ajeet Pratap Maurya

Articles in Press, Accepted Manuscript, Available Online from 07 May 2024

Abstract

View Article

short communication Surgery

Fecal incontinence after ileal pouch-anal anastomosis in patients with ulcerative colitis

maryam kouhestani; Seyed Vahid Hossein; Alimohammad Bananzadeh; ali reza safarpour; khadije gorgi; mohammad masoud andalib

Articles in Press, Accepted Manuscript, Available Online from 05 June 2024

Abstract

Objective: Total proctocolectomy with ileal pouch-anal anastomosis (IPAA) has become the restorative procedure of choice for medically refractory ulcerative colitis (UC). In patients who undergo proctocolectomy with IPAA, fecal continence outcomes are an issue. The present study evaluated fecal incontinence ... Read More

Case Report Pediatrics

Where is the diagnostic key? Sudden weakness in a 4-year-old child. A case report

Anahita Alizadeh Ghamsari; Nafiseh Pourbadakhshan

Articles in Press, Accepted Manuscript, Available Online from 09 April 2024

Abstract

Objective: Snake bites represent a significant public health issue worldwide, as venomous snake bites can result in dangerous and sometimes lethal consequences. Sometimes, the diagnosis is difficult. Herein, we present the case of a 4-year-old child who posed a challenge to diagnosis.Case Presentation: ... Read More

Case Report Emergency medicine

Splenic injury in pregnancy requiring urgent splenectomy: A rare surgical emergency

Aloysius Ugwu-Olisa Ogbuanya; Daniel AA Umezurike; Bieda Fongue; Ifeoma Ekwunife

Articles in Press, Accepted Manuscript, Available Online from 05 April 2024

Abstract

Objective: The spleen is the most frequently injured organ in blunt abdominal trauma (BAT). We present an interesting case of traumatic splenic rupture in pregnancy managed successfully by emergency splenectomy in a low-resource setting.Case Presentation: A 27-year old multiparous woman at 23 weeks gestational ... Read More

Case Report Trauma

Superficial femoral artery rupture after open distal third femoral shaft fracture: A case report

Em Thong Huynh; Khai Duong; Duy Khai Lam; Tung Thanh Thach; Duoc Minh Le; Bao Tu Thai Nguyen

Articles in Press, Accepted Manuscript, Available Online from 03 June 2024

Abstract

Objective: This case report aims to demonstrate an instance of superficial femoral artery (SFA) rupture after an open femoral shaft fracture.Case Presentation: Our patient was a 22-year-old man admitted to the emergency department after a motorbike accident with a deformity at the distal third of the ... Read More

Emergency medicine

Penetrating abdominal injuries in an emerging semi-urban teaching hospital

Julius Gbenga Olaogun; Amarachukwu Chiduziem Etonyeaku; Joshua Taye Ige; Obafemi Kayode Wuraola

Volume 6, Issue 1 , January 2020, , Pages 7-12

Abstract

Objective: There has been a worldwide rise in the prevalence of penetrating abdominal injury (PAI), and there are both inter-country and intra-country variations in frequencies. This study evaluates the mechanisms and pattern of penetrating abdominal injuries and the treatment outcome in our center.Methods: ... Read More Objective: There has been a worldwide rise in the prevalence of penetrating abdominal injury (PAI), and there are both inter-country and intra-country variations in frequencies. This study evaluates the mechanisms and pattern of penetrating abdominal injuries and the treatment outcome in our center.Methods: This descriptive study of adult patients managed for PAI was conducted at the Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti from January 2015 to December 2018. Data were prospectively collected and analyzed by using descriptive statistics from Statistical Package for Social Sciences (SPSS) version 20.0.Results: There were 96 patients managed for abdominal injuries during the study period. Forty-six (47.9%) of them had PAI, while 50 (52.1%) others sustained blunt trauma. Patients ages ranged from 17-72 years (mean = 34.2±10.8 years; median = 34 years). Majority, 42 (91.3%), were males, while 4 (8.7%) were females (M: F=11:1). The most afflicted age group was in the 4th decade. Majority of the injuries were due to gunshot (60.9%) followed by stab (26.1%), unsafe abortion (6.5%), road traffic injury (4.3%) and fall (2.2%). Gastrointestinal injuries were the most common with small bowel perforations predominating. Solid organ injuries were only seen in 3 (7.9%) patients. Eight (17.4%) had associated extra-abdominal injuries. Thirty-eight (82.6%) patients required exploratory laparotomy, while 8 (17.4%) were managed non-operatively. The negative laparotomy rate was 2.6%. Seven (15.2%) patients developed complications which were mostly wound infection (10.8%). The duration of hospital stay was 1-58 days (mean 12.7±10.5). Three patients (6.5%) with gunshot injuries died.Conclusion: Gunshot wounds were the major variant of PAI, and the highest cause of mortality from it. Gut injuries were most common, and exploratory laparotomy remains the main-stay of treatment, while non-operative management is practicable in carefully selected cases.

Volume 9 (2023)

Volume 8 (2022)

Volume 7 (2021)

Volume 6 (2020)

Volume 5 (2019)

Volume 4 (2018)

Volume 3 (2017)

Volume 2 (2016)

Volume 1 (2015)

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