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Relationships between trauma death, disability, and geographic factors: a systematic review. 外伤死亡、残疾与地理因素之间的关系:系统回顾。
IF 1.9 Q2 Nursing Pub Date : 2023-12-01 Epub Date: 2023-08-01 DOI: 10.15441/ceem.23.009
Bona Hwang, Taewook Jeong, Jiyeon Jo

Objective: Trauma is a global health problem. The causes of trauma-related deaths are diverse and may depend in part on socioeconomic and geographical factors; however, there have been few studies addressing such relationships. The aim of this study was to investigate the relationships between trauma and geographical factors in order to support policy recommendations to reduce trauma-related deaths and disability.

Methods: In accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched international and Korean databases to retrieve relevant literature published between 2000 and 2020.

Results: Thirty-two studies showed a positive relationship between the outcomes of major trauma and geographical factors. The study investigated regional factors including economic factors such as size of urban areas, gross domestic product, and poverty rate, as well as hospital parameters, such as presence of trauma centers and number of hospital beds. There was a tendency toward higher mortality rates in rural and low-income areas, and most of the studies reported that the presence of trauma centers reduced trauma-related mortality rates.

Conclusion: Our study showed that geographic factors influence trauma outcomes. The findings suggest geographical considerations be included in care plans to reduce death and disability caused by trauma.

目的:创伤是一个全球性的健康问题。与创伤有关的死亡原因多种多样,部分可能取决于社会经济和地理因素;然而,很少有研究涉及这种关系。本研究旨在调查创伤与地理因素之间的关系,以支持减少创伤相关死亡和残疾的政策建议:根据 PRISMA(系统综述和元分析的首选报告项目)指南,我们搜索了国际和韩国数据库,以检索 2000 年至 2020 年间发表的相关文献:32项研究显示,重大创伤的结果与地理因素之间存在正相关关系。研究调查的地区因素包括城市规模、国内生产总值和贫困率等经济因素,以及创伤中心的存在和病床数量等医院参数。农村和低收入地区的死亡率呈上升趋势,大多数研究报告称,创伤中心的存在降低了与创伤相关的死亡率:我们的研究表明,地理因素会影响创伤结果。结论:我们的研究表明,地理因素会影响创伤的治疗效果。研究结果表明,护理计划中应考虑地理因素,以减少创伤导致的死亡和残疾。
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引用次数: 0
A case report of furosemide extravasation in the hand: a rare cause of compartment syndrome. 手部呋塞米外渗病例报告:引起隔室综合征的罕见病因。
IF 1.9 Q2 Nursing Pub Date : 2023-12-01 Epub Date: 2022-11-22 DOI: 10.15441/ceem.22.325
Sertaç Güler, Dilber Üçöz Kocaşaban

In emergency departments, many drugs, fluids, and materials for medical examinations and treatment are typically administered to patients intravenously. One of the most common complications of the intravenous bolus or infusion of drugs is extravasation injuries. These injuries may cause certain morbidities for the patient, increase the cost of treatment, and prolong hospital stays. At the same time, these injuries also carry medicolegal risks for health personnel. Furosemide is a potent diuretic that is commonly used in emergency departments for volume overload conditions. To the best of our knowledge, there have been no cases reported in the literature of furosemide-induced extravasation injury with subsequent compartment syndrome that has required surgical intervention. Presented herein is the case of a 70-year-old female patient who was administered intravenous furosemide from the dorsum of the left hand and whose extravasation injury progressed to compartment syndrome requiring an emergency fasciotomy.

在急诊科,许多用于医学检查和治疗的药物、液体和材料通常都是通过静脉注射给病人的。静脉注射或输注药物最常见的并发症之一是外渗损伤。这些损伤可能会导致患者出现某些病症,增加治疗费用,延长住院时间。同时,这些损伤也会给医务人员带来医疗法律风险。呋塞米是一种强效利尿剂,在急诊科常用于治疗容量超负荷情况。据我们所知,文献中还没有关于呋塞米诱发外渗损伤并继发室间隔综合征而需要手术治疗的病例报道。本文介绍的病例是一名 70 岁的女性患者,她从左手手背静脉注射呋塞米,结果外渗损伤发展为室间综合征,需要进行紧急筋膜切开术。
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引用次数: 0
Perinatal carbon monoxide poisoning with fetal and maternal carboxyhemoglobin measurements. 围产期一氧化碳中毒与胎儿和母亲的碳氧血红蛋白测量。
IF 1.9 Q2 Nursing Pub Date : 2023-12-01 Epub Date: 2023-11-28 DOI: 10.15441/ceem.23.097
Dean T Odegard, Michael E Mullins
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引用次数: 0
An expert consensus–based checklist for quality appraisal of educational resources on adult basic life support: a Delphi study 基于专家共识的成人基本生命支持教育资源质量评估清单:德尔菲研究。
IF 1.9 Q2 Nursing Pub Date : 2023-12-01 Epub Date: 2023-08-25 DOI: 10.15441/ceem.23.049
Alexei Birkun, Adhish Gautam, Bernd W. Böttiger

Objective: Given the lack of a unified tool for appraising the quality of educational resources for lay-rescuer delivery of adult basic life support (BLS), this study aimed to develop an appropriate evaluation checklist based on a consensus of international experts.

Methods: In a two-round Delphi study, participating experts completed questionnaires to rate each item of a predeveloped 72-item checklist indicating agreement that an item should be utilized to evaluate the conformance of an adult BLS educational resource with resuscitation guidelines. Consensus on item inclusion was defined as a rating of ≥7 points from ≥75% of experts. Experts were encouraged to add anonymous suggestions for modifying or adding new items.

Results: Of the 46 participants, 42 (91.3%) completed the first round (representatives of 25 countries with a median of 16 years of professional experience in resuscitation) and 40 (87.0%) completed the second round. Thirteen of 72 baseline items were excluded, 55 were included unchanged, four were included after modification, and four new items were added. The final checklist comprises 63 items under the subsections “safety” (one item), “recognition” (nine items), “call for help” (four items), “chest compressions” (12 items), “rescue breathing” (12 items), “defibrillation” (nine items), “continuation of CPR” (two items), “choking” (10 items) and “miscellaneous” (four items).

Conclusions: The produced checklist is a ready-to-use expert consensus–based tool for appraising the quality of educational content on lay-rescuer provision of adult BLS. The checklist gives content developers a tool to ensure educational resources comply with current resuscitation knowledge, and may serve as a component of a prospective standardized international framework for quality assurance in resuscitation education.

目的:考虑到外行救援人员成人基本生命支持教育资源质量评价缺乏统一的工具,本研究旨在根据国际专家共识制定相应的评价清单。方法:在两轮德尔菲研究中,参与的专家完成问卷,对预先开发的72项清单中的每个项目进行评分,表明一个项目应该用于评估成人BLS教育资源与复苏指南的一致性的同意程度。项目纳入的共识定义为≥75%的专家给出≥7分的评分。专家们被鼓励匿名提出修改或增加新项目的建议。结果:在46名参与者中,42名(91.3%)完成了第一轮(代表25个国家,中位复苏专业经验为16年),40名(87.0%)完成了第二轮。72个基线项目中有13个被排除,55个未改变,4个被修改。另外增加了4个新项目。最终的清单包括63个项目,分别属于“安全”(1项)、“识别”(9项)、“呼叫帮助”(4项)、“胸部按压”(12项)、“抢救呼吸”(12项)、“除颤”(9项)、“心肺复苏术继续”(2项)、“窒息”(10项)和“杂项”(4项)。结论:生成的清单代表了基于专家共识的现成工具,用于评估非专业救援人员成人BLS教育内容的质量。建议内容开发者使用清单来确保教育资源符合当前的复苏知识,并可作为复苏教育质量保证的未来标准化国际框架的组成部分。
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引用次数: 0
Expert opinion on evidence after the 2020 Korean Cardiopulmonary Resuscitation Guidelines: a secondary publication. 2020年韩国心肺复苏指南》发布后的专家证据意见:二次出版。
IF 1.9 Q2 Nursing Pub Date : 2023-12-01 Epub Date: 2023-08-25 DOI: 10.15441/ceem.23.102
Sung Phil Chung, Youdong Sohn, Jisook Lee, Youngsuk Cho, Kyoung-Chul Cha, Ju Sun Heo, Ai-Rhan Ellen Kim, Jae Guk Kim, Han-Suk Kim, Hyungoo Shin, Chiwon Ahn, Ho Geol Woo, Byung Kook Lee, Yong Soo Jang, Yu Hyeon Choi, Sung Oh Hwang

Considerable evidence has been published since the 2020 Korean Cardiopulmonary Resuscitation Guidelines were reported. The International Liaison Committee on Resuscitation (ILCOR) also publishes the Consensus on CPR and Emergency Cardiovascular Care Science with Treatment Recommendations (CoSTR) summary annually. This review provides expert opinions by reviewing the recent evidence on CPR and ILCOR treatment recommendations. The authors reviewed the CoSTR summary published by ILCOR in 2021 and 2022. PICO (patient, intervention, comparison, outcome) questions for each topic were reviewed using a systemic or scoping review methodology. Two experts were appointed for each question and reviewed the topic independently. Topics suggested by the reviewers for revision or additional description of the guidelines were discussed at a consensus conference. Forty-three questions were reviewed, including 15 on basic life support, seven on advanced life support, two on pediatric life support, 11 on neonatal life support, six on education and teams, one on first aid, and one related to COVID-19. Finally, the current Korean CPR Guideline was maintained for 28 questions, and expert opinions were suggested for 15 questions.

自《2020 年韩国心肺复苏指南》发布以来,已有大量证据发表。国际复苏联络委员会(ILCOR)每年还发布《心肺复苏和心血管急救护理科学共识与治疗建议》(CoSTR)摘要。该综述通过回顾心肺复苏术和 ILCOR 治疗建议的最新证据来提供专家意见。作者回顾了 ILCOR 于 2021 年和 2022 年发布的 CoSTR 摘要。采用系统或范围审查方法对每个主题的 PICO(患者、干预、比较、结果)问题进行了审查。每个问题都指定了两名专家,并对该主题进行了独立审查。评审专家建议对指南进行修订或补充说明的主题在共识会议上进行了讨论。共审查了 43 个问题,其中 15 个涉及基本生命支持,7 个涉及高级生命支持,2 个涉及儿科生命支持,11 个涉及新生儿生命支持,6 个涉及教育和团队,1 个涉及急救,1 个涉及 COVID-19。最后,对 28 个问题保留了现行的韩国心肺复苏指南,对 15 个问题提出了专家意见。
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引用次数: 0
Challenges surrounding the emergency physician workforce and their impact on the Emergency Medicine Match. 围绕急诊医生队伍的挑战及其对急诊医学匹配的影响。
IF 1.9 Q2 Nursing Pub Date : 2023-12-01 Epub Date: 2023-11-28 DOI: 10.15441/ceem.23.118
Christopher L Bennett, Michelle Lin, Carlos A Camargo
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引用次数: 0
Colonic high-pressure barotrauma with tension pneumoperitoneum. 结肠高压气压创伤伴张力性腹腔积气
IF 1.9 Q2 Nursing Pub Date : 2023-12-01 Epub Date: 2023-08-25 DOI: 10.15441/ceem.23.038
Sasikumar Mahalingam, Gunaseelan Rajendran, Saravanan Muthusamy, Manu Ayyan, Shirshendu Dhar, Shivani Karn, Mounika Gara, Vignesh Anandharaj
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引用次数: 0
Echocardiographic features of myocardial rupture after acute myocardial infarction on emergency echocardiography. 急诊超声心动图显示急性心肌梗死后心肌破裂的超声心动图特征。
IF 1.9 Q2 Nursing Pub Date : 2023-12-01 Epub Date: 2023-06-02 DOI: 10.15441/ceem.23.037
Byung Wook Lee, Yong Sung Cha, Sung Oh Hwang, Yoon-Seop Kim, Sun Ju Kim

Objective: Myocardial rupture is a fatal complication of acute myocardial infarction (AMI). Early diagnosis of myocardial rupture is feasible when emergency physicians (EPs) perform emergency transthoracic echocardiography (TTE). The purpose of this study was to report the echocardiographic features of myocardial rupture on emergency TTE performed by EPs in the emergency department (ED).

Methods: This was a retrospective and observational study involving consecutive adult patients presenting with AMI who underwent TTE performed by EPs in the ED of a single academic medical center from March 2008 to December 2019.

Results: Fifteen patients with myocardial rupture, including eight (53.3%) with free wall rupture (FWR), five (33.3%) with ventricular septal rupture (VSR), and two (13.3%) with FWR and VSR, were identified. Fourteen of the 15 patients (93.3%) were diagnosed on TTE performed by EPs. Diagnostic echocardiographic features were found in 100% of the patients with myocardial rupture, including pericardial effusion for FWR and a visible shunt on the interventricular septum for VSR. Additional echocardiographic features indicating myocardial rupture were thinning or aneurysmal dilatation in 10 patients (66.7%), undermined myocardium in six patients (40.0%), abnormal regional motions in six patients (40.0%), and pericardial hematoma in six patients (40.0%).

Conclusion: Early diagnosis of myocardial rupture after AMI is possible using echocardiographic features on emergency TTE performed by EPs.

目的:心肌破裂是急性心肌梗死(AMI)的致命并发症:心肌破裂是急性心肌梗死(AMI)的致命并发症。如果急诊医生(EP)能进行急诊经胸超声心动图(TTE)检查,就能早期诊断心肌破裂。本研究的目的是报告急诊科(ED)的急诊医师在急诊经胸超声心动图检查中发现的心肌破裂的超声心动图特征:这是一项回顾性观察研究,涉及2008年3月至2019年12月期间在一家学术医疗中心急诊科由急诊科医师进行TTE检查的连续成人AMI患者:共发现15例心肌破裂患者,其中8例(53.3%)为游离壁破裂(FWR),5例(33.3%)为室间隔破裂(VSR),2例(13.3%)为FWR和VSR。15 名患者中有 14 名(93.3%)是由 EPs 进行 TTE 诊断的。100%的心肌破裂患者都具有诊断性超声心动图特征,包括FWR患者的心包积液和VSR患者室间隔上的可见分流。表明心肌破裂的其他超声心动图特征包括:10 名患者(66.7%)心肌变薄或动脉瘤样扩张;6 名患者(40.0%)心肌受损;6 名患者(40.0%)区域运动异常;6 名患者(40.0%)心包血肿:结论:急诊心电图医生通过急诊 TTE 超声心动图特征可早期诊断急性心肌梗死后的心肌破裂。
{"title":"Echocardiographic features of myocardial rupture after acute myocardial infarction on emergency echocardiography.","authors":"Byung Wook Lee, Yong Sung Cha, Sung Oh Hwang, Yoon-Seop Kim, Sun Ju Kim","doi":"10.15441/ceem.23.037","DOIUrl":"10.15441/ceem.23.037","url":null,"abstract":"<p><strong>Objective: </strong>Myocardial rupture is a fatal complication of acute myocardial infarction (AMI). Early diagnosis of myocardial rupture is feasible when emergency physicians (EPs) perform emergency transthoracic echocardiography (TTE). The purpose of this study was to report the echocardiographic features of myocardial rupture on emergency TTE performed by EPs in the emergency department (ED).</p><p><strong>Methods: </strong>This was a retrospective and observational study involving consecutive adult patients presenting with AMI who underwent TTE performed by EPs in the ED of a single academic medical center from March 2008 to December 2019.</p><p><strong>Results: </strong>Fifteen patients with myocardial rupture, including eight (53.3%) with free wall rupture (FWR), five (33.3%) with ventricular septal rupture (VSR), and two (13.3%) with FWR and VSR, were identified. Fourteen of the 15 patients (93.3%) were diagnosed on TTE performed by EPs. Diagnostic echocardiographic features were found in 100% of the patients with myocardial rupture, including pericardial effusion for FWR and a visible shunt on the interventricular septum for VSR. Additional echocardiographic features indicating myocardial rupture were thinning or aneurysmal dilatation in 10 patients (66.7%), undermined myocardium in six patients (40.0%), abnormal regional motions in six patients (40.0%), and pericardial hematoma in six patients (40.0%).</p><p><strong>Conclusion: </strong>Early diagnosis of myocardial rupture after AMI is possible using echocardiographic features on emergency TTE performed by EPs.</p>","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":"393-399"},"PeriodicalIF":1.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10790066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9588457","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}
引用次数: 0
Frequency of posttrauma complications during hospital admission and their association with Injury Severity Score. 入院期间创伤后并发症的发生频率及其与受伤严重程度评分的关系。
IF 1.9 Q2 Nursing Pub Date : 2023-12-01 Epub Date: 2023-07-13 DOI: 10.15441/ceem.23.053
Shayan Dasdar, Mahmoud Yousefifard, Mehri Farhang Ranjbar, Mehdi Forouzanfar, Hamid Mazloom, Saeed Safari

Objective: Multiple trauma is associated with a remarkable risk of in-hospital complications, which harm healthcare services and patients. This study aimed to assess the incidence of posttrauma complications, their relationship with poor outcomes, and the effect of the Injury Severity Score (ISS) on their occurrence.

Methods: This retrospective cohort study was conducted at a pair of trauma centers, between January 2020 and December 2022. All hospitalized adult patients with multiple trauma were included in this study. Multivariable logistic regression was used to identify factors related to posttrauma complications.

Results: Among 727 multiple trauma patients, 90 (12.4%) developed in-hospital complications. The most frequent complications were pneumonia (4.8%), atelectasis (3.7%), and superficial surgical site infection (2.5%). According to multivariable logistic regression, ISS, the length of stay in the intensive care unit (ICU), the length of stay in the hospital, and mortality were significantly associated with complications. The complication rate increased by 17% with every single-unit increase in ISS (adjusted odds ratio [OR], 1.17; 95% confidence interval [CI], 1.00-1.38). Per every 1-day increase in the ICU or hospital stay, the complication rate increased by 65% (adjusted OR, 1.65; 95% CI, 1.00-2.73) and 20% (adjusted OR, 1.20; 95% CI, 1.03-1.41), respectively. Posttrauma complications were also significantly more common in patients with mortality (adjusted OR, 163.30; 95% CI, 3.04-8,779.32). In multiple trauma patients with a higher ISS, the frequency, severity, and number of complications were significantly increased.

Conclusion: In-hospital complications in multiple trauma patients are frequent and associated with poor outcomes and mortality. ISS is an important factor associated with posttrauma complications.

目的:多发性创伤与院内并发症的显著风险相关,而院内并发症会对医疗服务和患者造成损害。本研究旨在评估创伤后并发症的发生率、并发症与不良预后的关系以及损伤严重程度评分(ISS)对并发症发生的影响:这项回顾性队列研究于 2020 年 1 月至 2022 年 12 月期间在一对创伤中心进行。所有住院的多发性创伤成人患者均被纳入研究范围。研究采用多变量逻辑回归法确定与创伤后并发症相关的因素:在 727 名多发性创伤患者中,有 90 人(12.4%)出现了院内并发症。最常见的并发症是肺炎(4.8%)、肺不张(3.7%)和浅表手术部位感染(2.5%)。多变量逻辑回归显示,ISS、重症监护室(ICU)住院时间、住院时间和死亡率与并发症有显著相关性。ISS每增加一个单位,并发症发生率就会增加17%(调整后的几率比[OR]为1.17;95%置信区间[CI]为1.00-1.38)。重症监护室或住院时间每增加 1 天,并发症发生率分别增加 65%(调整后 OR,1.65;95% CI,1.00-2.73)和 20%(调整后 OR,1.20;95% CI,1.03-1.41)。在死亡率较高的患者中,创伤后并发症的发生率也明显更高(调整后 OR,163.30;95% CI,3.04-8779.32)。在ISS较高的多发性创伤患者中,并发症的频率、严重程度和数量都明显增加:结论:多发性创伤患者院内并发症频发,且与不良预后和死亡率相关。ISS是与创伤后并发症相关的一个重要因素。
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引用次数: 0
Factors affecting patients who attempted suicide in the emergency department due to the prolonged pandemic of COVID-19. COVID-19持续大流行对急诊室自杀未遂患者的影响因素
IF 1.9 Q2 Nursing Pub Date : 2023-12-01 Epub Date: 2023-11-28 DOI: 10.15441/ceem.23.143
Hyunji Kim, Areum Durey, Soo Kang, Won Kyung Lee, Ji Hye Kim, Seung Baik Han, Yu Jin Lee

Objective: This study examined the characteristics of patients who attempted suicide in the emergency department before and during the COVID-19 pandemic.

Methods: We compared data from patients in the emergency department following suicide attempts between January 2018 and December 2021. The patients were categorized into two groups: "pre-COVID-19" and "during COVID-19" pandemic.

Results: The findings revealed an increasing trend of suicide attempts during the study period. Suicide attempts were reported at 1,107 before the COVID-19 pandemic and 1,356 during the COVID-19 pandemic. Patients who attempted suicide during the COVID-19 pandemic were younger (38.0±18.5 years vs. 40.7±18.4 years, P<0.01), had a smaller proportion of men (36% vs. 44%, P<0.01), and had fewer medical comorbidities (20.2% vs. 23.6%, P<0.05). The group during the COVID-19 pandemic reported better hygiene conditions (50.5% vs. 40.8%, P<0.01) and lower alcohol consumption (27.7% vs. 37.6%, P<0.01). Patients who attempted suicide during the COVID-19 pandemic had higher rates of use of psychiatric medications and previous suicide attempts. The most common reasons for the suicide attempt were unstable psychiatric disorders (38.8%), poor interpersonal relationships (20.5%), and economic difficulties (14.0%). Drug poisoning (44.1%) was the most common method of suicide attempts. Subgroup analysis with patients who attributed their suicide attempts to COVID-19 revealed a higher level of education (30.8%) and employment status (69.2%), with economic difficulties (61.6%) being the primary cause of suicide attempts.

Conclusion: These findings suggest that the prolonged duration of the COVID-19 pandemic and its effects on social and economic factors have influenced suicide attempts.

目的:探讨2019冠状病毒病(COVID-19)大流行前和期间急诊科自杀未遂患者的特征。方法:我们比较了2018年1月至2021年12月期间急诊室自杀未遂患者的数据。这些患者被分为“COVID-19前”和“COVID-19大流行期间”两组。结果:研究结果显示,在研究期间,自杀企图呈上升趋势。据报道,在COVID-19大流行之前有1107人自杀,在COVID-19大流行期间有1356人自杀。新冠肺炎大流行期间企图自杀的患者年龄较轻(38.0±18.5岁vs. 40.7±18.4岁)。结论:新冠肺炎大流行持续时间的延长及其对社会经济因素的影响影响了自杀企图。
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引用次数: 0
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Clinical and Experimental Emergency Medicine
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