Emergency medicine
Pegah Sepehri Majd; Amirhossein Alimohammadi Siyabani; Haniyeh Ebrahimi Bakhtavar; Farzad Rahmani
Volume 8, Issue 2 , July 2022, , Pages 128-133
Abstract
Objective: Awareness of the severity of trauma and the outcome of patients can help physicians decide how long to treat patients. The objective of this study is to design a new score (R-GAP: Revised-GCS, Age, Pressure) for multi-trauma patients and determine its predictive value concerning in-hospital ...
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Objective: Awareness of the severity of trauma and the outcome of patients can help physicians decide how long to treat patients. The objective of this study is to design a new score (R-GAP: Revised-GCS, Age, Pressure) for multi-trauma patients and determine its predictive value concerning in-hospital outcome of these patients.Methods: This cross-sectional study was performed in the emergency ward of Imam Reza (AS) and Shohada hospitals (referral centers for trauma patients) affiliated to Tabriz University of Medical Sciences from 2019 to 2020. The sample size of this study was estimated to be 2000 people. Required information was collected and the final diagnosis of the patients was recorded. The hospital outcome was recorded at the time of discharge. Patients’ outcome was also recorded using the Glasgow Outcome Scale (GOS) system. Based on the obtained data, GAP, R-GAP, new trauma score (NTS) scores were also collected and their results were compared with the designed model. Receiver operating characteristic (ROC) curve and logistic regression were used to analyze the predictive value of the scores.Results: The mean age of the subjects was 34.09 (± 15.23) years. The highest outcome of patients based on the GOS system was recovery, moderate disability, and severe disability with 1309 cases (54.9%), 743 cases (31.2%), and 212 cases (8.9%), respectively. The mean of GAP, R-GAP, and NTS scores were 21.83 (± 3.1), 21.47 (± 3.4), and 21.27 (± 3.3), respectively. The intensity of GAP, R-GAP, and NTS in most subjects was low with 2143 cases (89.9%), 1994 cases (83.6%), and 2138 cases (89.7%). Among the significant variables included in the regression model, O2sat, primary GCS, GAP, R-GAP, and NTS with modulation on other variables, significantly equalized the mortality chance by 0.416, 0.622, 0.595, 0.601, 0.637, respectively (P value < 0.001).Conclusion: According to the study results, it seems that GAP, R-GAP, and NTS respectively, have the highest strength of predictive value in the survival of patients with multiple traumas. It is suggested that a comprehensive study be conducted to better estimate this issue.
emergency nursing
Farzad Rahmani; Pegah Sepehri Majd; Haniyeh Ebrahimi Bakhtavar; Farnaz Rahmani
Volume 4, Issue 1 , January 2018, , Pages 9-13
Abstract
Objective: Triage refers to the evaluation and categorization of patients for better management to deliver services. A good triage system should be able to accurately specify the patients who require urgent care. Thus, this study aimed to evaluate the accuracy of emergency nurses in correct triage ...
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Objective: Triage refers to the evaluation and categorization of patients for better management to deliver services. A good triage system should be able to accurately specify the patients who require urgent care. Thus, this study aimed to evaluate the accuracy of emergency nurses in correct triage using Emergency Severity Index (ESI) triage. Methods: In this descriptive cross-sectional study 750 patients, who referred to the emergency department (ED) of Sina teaching hospital, participated from 23 July to 22 August in 2015. Participants were selected using convenience sampling method. The patients’ triage level was determined by physicians and nurses separately and the results were compared. To define the level of agreement between two groups (inter-rater agreement), the kappa index was evaluated. Data were analyzed using SPSS version 17. Results: Among 750 patients, 577 patients (76.9%) were classified in correct triage group, 90 patients (12%) in undertriage group and 83 patients (11.1%) in overtriage group. Kappa agreement coefficient between the ESI triage level of physicians and nurses was 0.659 (95% CI: 0.646-0.667). There was statistically significant difference between the triage level of physicians and nurses (P < 0.001). Conclusion: This study showed that there was moderate agreement between the triages of physicians and nurses. It seems that improving nurses’ skills and knowledge might increase the accuracy of emergency nurses in patients’ correct triage. Therefore, planning programs based on training correct triage for emergency nurses is strongly suggested.
Emergency Medical Services
Seyedhossein Ojaghihaghighi; Samad Shams Vahdati; Simin Taghavi; Aydin Rahimzade Jahandari; Pegah Sepehri Majd; Mohammad Mirza-Aghazadeh-Attari
Volume 4, Issue 1 , January 2018, , Pages 44-47
Abstract
Objective: Pregnancy is an important psychological and biological phenomenon in women’s life. Pregnancy has many complications jeopardizing the well-being of the mother and the child. Methods: In this retrospective study, the data including demographic information, chief complaint, the initial ...
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Objective: Pregnancy is an important psychological and biological phenomenon in women’s life. Pregnancy has many complications jeopardizing the well-being of the mother and the child. Methods: In this retrospective study, the data including demographic information, chief complaint, the initial diagnosis, referral decision, final diagnosis, hospitalization outcome and pregnancy outcomes were studied on 239 pregnant women admitted to the emergency departments of the general hospitals of East Azerbaijan province. Results: The average age of patients was 27.54 years. The time period from the initial presentation to completely leave the emergency department was reported to be 3.66 hours on average. In this study, most patients (74.5%) did not have a history of abortion. Exploring the time of admission for all cases, most patients were admitted from 8 pm to 8 am (67.8%), and 32.2% were referred from 8 am to 8 pm. Concerning the time of pregnancy, 46.4% were at their second trimester of pregnancy. Most of the patients were admitted in cold seasons of the year. The most common chief compliant was abdominal pain with 32.2% frequency. In addition, the most frequent primary diagnoses were an acute abdomen and trauma at 25.5% and 14.2% respectively. Conclusion: Abdominal pain and acute abdomen have the most frequency as the chief compliant and initial diagnosis especially during the second trimester of pregnancy. In this regard, appropriate training and skillful staff are needed to deal with the complaints and complications of abdominal pain. More than half of pregnant women referred to the emergency departments were hospitalized or admitted to the intensive care unit (ICU). This signals the necessity of adequate facilities to provide proper care for this group.
Emergency medicine
Seyed Hossein Ojaghi Haghighi; Samad Shams Vahdati; Tarannom Mahmoudie; Pegah Sepehri Majd; Mohammad Mirza-Aghazadeh-Attari
Volume 3, Issue 2 , July 2017, , Pages 49-52
Abstract
Objective: Cardiopulmonary resuscitation (CPR) is a lifesaving technique useful in the prevention of death or delaying it in a person with cardiac arrest. In this regard, demographic information about patients who need CPR is vital. Methods: In this cross-sectional study patients with cardiopulmonary ...
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Objective: Cardiopulmonary resuscitation (CPR) is a lifesaving technique useful in the prevention of death or delaying it in a person with cardiac arrest. In this regard, demographic information about patients who need CPR is vital. Methods: In this cross-sectional study patients with cardiopulmonary arrest or arrhythmias admitted to Imam Reza and Sina educational hospitals of Tabriz University of Medical Sciences from 22 December 2013 to 21 December 2014 entered the study. Demographic information such as age, sex, cardiopulmonary resuscitation time, the place of cardiopulmonary arrest (outside or inside the hospital), the duration of resuscitation process, success or failure of the resuscitation process and the mechanism of cardiopulmonary arrest were obtained. Results: From a total of 354 cases of cardiopulmonary resuscitation, 281 cases (79%) were unsuccessful and 73 cases (21%) were successful. The average age of patients was 59 ± 22 years. The average time of the resuscitation process was 31 ± 12 minutes. There was a significant difference between the mean of age and resuscitation time in patients who had experienced successful or unsuccessful resuscitation (P = 0.0001). There was a significant relationship between sex and the success rate of resuscitation (P = 0.0001). In addition, a significant relationship between the success of the resuscitation operation and the ward of resuscitation was observed (P = 0.0001). Conclusion: The most common mechanism leading to cardiopulmonary arrest among patients was asystole. In this regard, no significant difference was observed between successful and unsuccessful resuscitation processes. It was also observed that the success of resuscitation from 8 am to 4 pm was more than any other time period.