Journal of Emergencies, Trauma, and Shock最新文献

When it comes to battlefield resuscitation, the advent of damage control surgery has birthed the concept of damage control resuscitation (DCR). It consists of rapid hemorrhage control, which need not be definitive, early blood product transfusion, blood volume restoration, and achieving physiological stability. Acute traumatic coagulopathy, which is the primary cause of mortality, is the main target of battlefield resuscitation. This concept of the DCR and its implementation in the battlefield are discussed in this review.

Introduction: Musculoskeletal disorders (MSDs) are a prevalent occupational health concern, especially among long-term automobile factory workers. They can affect anyone and negatively impact quality of life and work performance. Major risk factors include heavy lifting and poor working conditions, which can worsen these disorders and pose serious health and labor rights issues.

Methods: A cross-sectional study was conducted at UNITECH PLASTO Components Pvt. Ltd. to evaluate MSDs among workers employed for over a year. Ergonomic risks were assessed using the Standard Nordic Questionnaire, Rapid Entire Body Assessment (REBA), and the Rapid Upper Limb Assessment (RULA) were used to evaluate workplace ergonomics. Data were analyzed in Microsoft Excel, with results presented in percentages and odds ratio to determine the risk levels.

Results: The overall prevalence of MSDs was 63.7%, affecting various body parts: the highest observed in lower back (37 workers, 29.6%), shoulder (22 workers, 17.6%), wrist (20 workers, 16.0%), ankle (18 workers, 14.4%), neck (16 workers, 12.8%), hand (13 workers, 10.4%), elbow (12 workers, 9.6%), and knee (12 workers, 9.6%). REBA ergonomic assessments revealed medium risk in 88 (44.9%) workers, high risk in 81 (41.4%) workers, and very high risk in 18 (9.1%) workers. RULA assessments showed medium risk in 83 (42.3%) workers and very high risk in 14 (7.2%) workers. Workers with travel history and working in standing position and working of more than 8 h had more MSDs.

Conclusion: Implementing measures to reduce work-related physical strain and fostering a supportive work environment can yield significant improvements in employee health and productivity.

Introduction: Overcrowded emergency departments (EDs) are a critical issue globally, exacerbating delays and impacting care quality. Stroke patients, who often experience acute care encounters postdischarge, represent a significant challenge. This study evaluated the impact of early outpatient follow-up on ED visits and readmission rates within 30 days of discharge among stroke patients at King Abdulaziz Medical City (KAMC) in Riyadh, Saudi Arabia.

Methods: We conducted a retrospective cohort study of stroke patients treated at KAMC between January 1, 2021, and February 29, 2024. Data were extracted from electronic health records, including patient demographics, stroke type, treatment, and postdischarge care. We analyzed the association between early outpatient follow-up (within 30 days of discharge) and subsequent ED visits or readmissions using statistical tests.

Results: Of the stroke patients included, 22.2% experienced acute care encounters within 30 days postdischarge, with 32.9% of these being readmissions. Early outpatient follow-up was significantly associated with reduced acute care encounters (50.3% of patients with follow-up did not require additional acute care, compared to 30.9% of those without follow-up; P = 0.006). Factors such as stroke type, length of hospital stay, and comorbidities did not show significant differences between groups.

Conclusion: Early outpatient follow-up significantly reduces the need for acute care among stroke patients. This underscores the importance of implementing effective postdischarge follow-up strategies to improve patient outcomes and alleviate pressure on emergency services. Future research should explore the specific components of follow-up care that contribute most to these benefits and evaluate broader implications for healthcare systems.

Bittern has been used as the main ingredient of tofu coagulant, and poisoning events usually occurred in the rural of North China. Bittern intoxication may induce electrolyte imbalances, the most important of which is hypermagnesemia, and may be fatal if ingested. The patient without any medical history presented with sinoatrial block, atrioventricular block, paroxysmal atrial tachycardia, and atrial fibrillation on electrocardiography over a short period. The initial diagnosis was unclear and the treatment was difficult. Arterial blood gas analysis indicated severe metabolic acidosis. Her serum concentration of magnesium and chlorine attained 15.14 mEq/L and 130 mEq/L, respectively. After supportive therapy and continuous veno-venous hemofiltration sessions, we observed full recovery without any sequelae. After regaining consciousness, the patient reported ingesting "brine," confirming the diagnosis of "brine poisoning." To the best of our knowledge, such sever hyperchloremia after bittern intoxication has not been previously reported in the literature. However,successful rescue of severe hypermagnesemia in Chinese patients by treatment has only rarely been reported in the current literature.

Introduction: In cases of mild head trauma, there have been no comprehensive studies on cases that resulted in death. This study aims to conduct a factor analysis of mild head trauma cases resulting in death. Patients with Glasgow Coma Scale (GCS) scores of 14 or 15 in the Japan Doctor Helicopter (DH) Registration System were studied.

Methods: Variables included age, sex, DH request timing, vital signs at DH contact (GCS, blood pressure, heart rate, respiratory rate), head trauma severity, hospitalization, and 1-month outcomes (survival or death). Wilcoxon rank-sum test and median test were used.

Results: Analysis involved 26 deaths and 2256 survivals. No significant differences were found in sex, request timing, pulse rate, systolic blood pressure, or AIS. The death group had higher mean age, respiratory rate and hospitalization rate, and lower GCS scores. Age and respiratory rate cutoffs for mortality were 78 years and 21 breaths/min, respectively. No deaths occurred below 21 breaths/min or at the age of 78 or younger. For those over 79 with 22 or more breaths per minute, 7.8% died.

Conclusions: The study identifies increased mortality risk in elderly patients with mild head trauma, high respiratory rates, and GCS scores of 14 at the scene. This emphasizes the need for careful monitoring and prompt treatment in these cases.

Eye complaints are common presentations to the emergency department that require prompt diagnosis and appropriate care to prevent visual impairment. Uveitis is a serious cause of visual problems needing urgent treatment. An uncommon etiology of uveitis is secondary to a systemic autoimmune reaction to dermal tattoos, whereby tattoo ink serves as an antigenic trigger that targets the eye. In this case, we describe a 22-year-old male who presented with 2 weeks of eye pain and blurred vision. Physical examination revealed conjunctival injection with decreased visual acuity bilaterally and skin peeling with elevation exactly along the lines of his tattoos. Based on these unusual but concomitant findings, a diagnosis of tattoo-associated uveitis was made. The patient received an emergency ophthalmology consultation and was treated with topical steroids. When presented with clinical findings of uveitis, physicians should ask about and inspect tattoos as a possible etiology of systemic inflammation, which may be overlooked.