Objective: Rhabdomyolysis is an important etiology for developing acute kidney injury (AKI). Among the many varying reasons for rhabdomyolysis, electrical injury seems to be a lesser-known factor. The clinical presentation of rhabdomyolysis is usually in the form of severe and widespread pain, tenderness, weakness in the muscles and dark urine. It is characterized by the disruption of cell integrity in myocytes as a result of widespread damage to skeletal muscles and the passage of intracellular components into the circulation. Case Presentation: Here we presented a case report of a young man who had rhabdomyolysis induced by electrical injury which is relatively less common among the other etiological factors with preserved renal functions. He had electrical injury related wounds on extremities. Urgent intravenous fluid therapy was initiated as soon as his admission to the emergency department (ED), without delay. Conclusion: AKI is very common due to the nephrotoxic effect of myoglobinuria and the prerenal status. It is rare that AKI does not develop in patients with a severe increase in creatinine kinase. It is a very important point to start effective fluid therapy in a short time.
{"title":"Rhabdomyolysis following electical injury without acute kidney injury","authors":"A. Alp, B. Arslan, Dilek GİBYELİ GENEK, B. Huddam","doi":"10.34172/jept.2022.33","DOIUrl":"https://doi.org/10.34172/jept.2022.33","url":null,"abstract":"Objective: Rhabdomyolysis is an important etiology for developing acute kidney injury (AKI). Among the many varying reasons for rhabdomyolysis, electrical injury seems to be a lesser-known factor. The clinical presentation of rhabdomyolysis is usually in the form of severe and widespread pain, tenderness, weakness in the muscles and dark urine. It is characterized by the disruption of cell integrity in myocytes as a result of widespread damage to skeletal muscles and the passage of intracellular components into the circulation. Case Presentation: Here we presented a case report of a young man who had rhabdomyolysis induced by electrical injury which is relatively less common among the other etiological factors with preserved renal functions. He had electrical injury related wounds on extremities. Urgent intravenous fluid therapy was initiated as soon as his admission to the emergency department (ED), without delay. Conclusion: AKI is very common due to the nephrotoxic effect of myoglobinuria and the prerenal status. It is rare that AKI does not develop in patients with a severe increase in creatinine kinase. It is a very important point to start effective fluid therapy in a short time.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42752539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Javad Seyedhosseini, Rasha Ahmadi, E. Karimialavijeh, Mehrad Aghili
Objective: Cardiopulmonary arrest is a devastating outcome of some clinical situations and requires strict implementation of cardiopulmonary resuscitation (CPR) protocols. Since ultrasound is one of the recommended tools to determine the presence of cardiac movements and may be a predictor of the outcome, this study examined the relationship between echocardiographic findings during CPR with patients’ outcomes. Methods: This cross-sectional prospective observational study was conducted on patients with cardio-respiratory arrest in the emergency department of Shariaty hospital during 2019. sampling method was random. Echocardiography was done at the patient’s bedside during the CPR process in accordance with the last advanced cardiac life support (ACLS) guidelines, on two points, after the end of the second and 10th minutes from the start of CPR. The echocardiography findings (cardiac movement vs standstill) were recorded, and patient outcomes were followed. Thirty-two patients enrolled in this study with a mean age of 56.9±15.3 years. Chi-square and Mann-Whitney U tests were used to calculate the association between heart contractions during resuscitation and the outcomes via SPSS V.22. Fisher’s exact test and Kruskal-Wallis test were used to evaluate the relationship between heart rhythm in the second and tenth minutes with the outcomes of CPR. Results: The presence of cardiac movement in the 10th minute of CPR, in contrast to the findings of the second minute, had a significant correlation with the success rate of CPR and outcomes (P<0.05). Moreover, patients with ventricular tachycardia (VT)/ventricular fibrillation (VF) cardiac rhythm had a better resuscitation rate, 24-hour survival rate, and better outcome than patients with other cardiac rhythms and asystole (P<0.05). Conclusion: Echocardiographic findings in the 10th minute of the CPR process can be used as a prognostic factor for cardiac arrest.
{"title":"Relationship between cardiac ultrasound findings during cardiopulmonary resuscitation with the outcome of patients","authors":"Javad Seyedhosseini, Rasha Ahmadi, E. Karimialavijeh, Mehrad Aghili","doi":"10.34172/jept.2022.32","DOIUrl":"https://doi.org/10.34172/jept.2022.32","url":null,"abstract":"Objective: Cardiopulmonary arrest is a devastating outcome of some clinical situations and requires strict implementation of cardiopulmonary resuscitation (CPR) protocols. Since ultrasound is one of the recommended tools to determine the presence of cardiac movements and may be a predictor of the outcome, this study examined the relationship between echocardiographic findings during CPR with patients’ outcomes. Methods: This cross-sectional prospective observational study was conducted on patients with cardio-respiratory arrest in the emergency department of Shariaty hospital during 2019. sampling method was random. Echocardiography was done at the patient’s bedside during the CPR process in accordance with the last advanced cardiac life support (ACLS) guidelines, on two points, after the end of the second and 10th minutes from the start of CPR. The echocardiography findings (cardiac movement vs standstill) were recorded, and patient outcomes were followed. Thirty-two patients enrolled in this study with a mean age of 56.9±15.3 years. Chi-square and Mann-Whitney U tests were used to calculate the association between heart contractions during resuscitation and the outcomes via SPSS V.22. Fisher’s exact test and Kruskal-Wallis test were used to evaluate the relationship between heart rhythm in the second and tenth minutes with the outcomes of CPR. Results: The presence of cardiac movement in the 10th minute of CPR, in contrast to the findings of the second minute, had a significant correlation with the success rate of CPR and outcomes (P<0.05). Moreover, patients with ventricular tachycardia (VT)/ventricular fibrillation (VF) cardiac rhythm had a better resuscitation rate, 24-hour survival rate, and better outcome than patients with other cardiac rhythms and asystole (P<0.05). Conclusion: Echocardiographic findings in the 10th minute of the CPR process can be used as a prognostic factor for cardiac arrest.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42128755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammad Nikzadian, Sima Hashemi, R. Beiranvand, Maryam Khormehr
Objective: One of the most important indicators used in the evaluation of emergency centers is the chronometric analysis of patients’ workflow. The aim of this study was to provide a chronometric analysis of patients’ workflow (patients’ waiting time in the emergency department) and related factors. Methods: This hospital-based prospective cohort study was carried out in Khatam al-Anbia hospital in Shoushtar in 2020. Random sampling was used and patients referred to the emergency ward in three shifts based on the ESI 5-level triage system. The research tools were the emergency workflow chronometry form and a questionnaire of determining the factors related to the speed of emergency services and using a stopwatch. In order to analyse the data, Stata software version 16 and Weibull model of survival analysis were used. Results: Of 468 participants, the most common cause of referral was trauma with 21.7%. The median±interquartile range duration of giving the final result was 6.06±4.48 hours, which was more than 0.54 times shorter in clients with level 3. There was a statistically significant difference in the duration of making the final decision based on the request for testing, manner of referring and the type of initial diagnosis (P<0.05). Conclusion: The duration of service provision in the studied hospital is appropriate for an Iranian hospital, but it should be closer to international standards. At level 2 triage, patients stayed longer. This can be reduced by lessening the time of consultations which can help the emergency ward.
{"title":"Using Weibull model of survival analysis workflow and its relevant factors: A prospective cohort study","authors":"Mohammad Nikzadian, Sima Hashemi, R. Beiranvand, Maryam Khormehr","doi":"10.34172/jept.2022.34","DOIUrl":"https://doi.org/10.34172/jept.2022.34","url":null,"abstract":"Objective: One of the most important indicators used in the evaluation of emergency centers is the chronometric analysis of patients’ workflow. The aim of this study was to provide a chronometric analysis of patients’ workflow (patients’ waiting time in the emergency department) and related factors. Methods: This hospital-based prospective cohort study was carried out in Khatam al-Anbia hospital in Shoushtar in 2020. Random sampling was used and patients referred to the emergency ward in three shifts based on the ESI 5-level triage system. The research tools were the emergency workflow chronometry form and a questionnaire of determining the factors related to the speed of emergency services and using a stopwatch. In order to analyse the data, Stata software version 16 and Weibull model of survival analysis were used. Results: Of 468 participants, the most common cause of referral was trauma with 21.7%. The median±interquartile range duration of giving the final result was 6.06±4.48 hours, which was more than 0.54 times shorter in clients with level 3. There was a statistically significant difference in the duration of making the final decision based on the request for testing, manner of referring and the type of initial diagnosis (P<0.05). Conclusion: The duration of service provision in the studied hospital is appropriate for an Iranian hospital, but it should be closer to international standards. At level 2 triage, patients stayed longer. This can be reduced by lessening the time of consultations which can help the emergency ward.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46122862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Hand lacerations are among the most frequent causes of visiting emergency departments (EDs). Wound infection is one of its complications. There is still an ongoing disagreement on the administration of oral versus intravenous (IV) antibiotics (ABs). The objective of this study is to compare the effectiveness of oral versus IV ABs in preventing wound infection of hand lacerations. Methods: In this double-blind, randomized clinical trial, we enrolled all patients with hand lacerations (based on the inclusion criteria) during 6 months in the EDs of 2 tertiary referral centers. Convenient sampling was done. Finally, in the first group, 382 patients received oral AB (two 500 mg cephalexin capsules) and the other 382 patients in the second group received IV AB (1 gr IV cefazolin) before wound management. Both groups were followed and received oral cephalexin during 48 hours after suturing. Rates of wound infection and different complications were compared between the two groups. T-test, Mann-Whitney U test, Chi square and Fisher analysis were used. Results: Both groups had the same age and gender distribution rate (79.8% of males with the mean age of 30.8 years in the first group, and 83.5% of males with the mean age of 32.6 years in the second group (P=0.19 and 0.39, respectively). In our study, wound infection developed in 2.6% and 1.8% of patients in the first and second groups, respectively (P=0.46). Conclusion: Based on the results of this study, oral and IV ABs were not significantly different in terms of preventing wound infection.
{"title":"Comparing the effectiveness of oral versus intravenous antibiotics in the prophylaxis of wound infection in hand laceration","authors":"M. Momeni, Elnaz Vahidi, Neda Karimi Tafti, Zeinab Naderpour, Javad Seyedhosseini, Morteza Saeedi","doi":"10.34172/jept.2022.19","DOIUrl":"https://doi.org/10.34172/jept.2022.19","url":null,"abstract":"Objective: Hand lacerations are among the most frequent causes of visiting emergency departments (EDs). Wound infection is one of its complications. There is still an ongoing disagreement on the administration of oral versus intravenous (IV) antibiotics (ABs). The objective of this study is to compare the effectiveness of oral versus IV ABs in preventing wound infection of hand lacerations. Methods: In this double-blind, randomized clinical trial, we enrolled all patients with hand lacerations (based on the inclusion criteria) during 6 months in the EDs of 2 tertiary referral centers. Convenient sampling was done. Finally, in the first group, 382 patients received oral AB (two 500 mg cephalexin capsules) and the other 382 patients in the second group received IV AB (1 gr IV cefazolin) before wound management. Both groups were followed and received oral cephalexin during 48 hours after suturing. Rates of wound infection and different complications were compared between the two groups. T-test, Mann-Whitney U test, Chi square and Fisher analysis were used. Results: Both groups had the same age and gender distribution rate (79.8% of males with the mean age of 30.8 years in the first group, and 83.5% of males with the mean age of 32.6 years in the second group (P=0.19 and 0.39, respectively). In our study, wound infection developed in 2.6% and 1.8% of patients in the first and second groups, respectively (P=0.46). Conclusion: Based on the results of this study, oral and IV ABs were not significantly different in terms of preventing wound infection.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47371658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Khadigesadat Kazemi, Hooman Esfahani, Hadis Amiri, A. Tavan, Hojjat Farahmandnia
Objectives: Pandemics would certainly have a negative impact on mental health. Positive modifications as well as negative alterations have been documented in earlier viral pandemic according to previous investigations. Teenagers face a variety of challenges during adolescence. Adolescents may become more concerned if this time coincides with other worries. This study aims to investigate the positive changes that occur in a young adolescent’s life after COVID-19 pandemic, and to see how they relate to perceived social support. Methods: This cross-sectional study was performed on adolescents who were randomly selected from high schools in Kerman, Iran 2020 during the COVID-19. the sample size was 108 and for sampling wes used multi-stage random sampling at the end the data was analyzed by Pearson correlation test. Demographic information, the Multidimensional Scale of Perceived Social Support (MSPSS) and Posttraumatic Growth Inventory short form (PTGI-SF) were used to collect data. The data were subjected to descriptive and analytical statistical tests (Pearson correlation) using SPSS software version 24. Results: Statistically a positive correlation was found between the PTG total score and young homeschooled adolescents, parents working remotely, income loss and COVID-19 experience. Moreover, during the COVID-19 pandemic, a positive association was found between perceived social support and PTG total scores in young adolescents. There were also substantial positive connections between the MSPSS subscales and the PTGI overall score. Conclusion: Based on the findings, an overall growth in all areas of PTG was observed during the COVID-19 among young adolescents. Perceived social support scores have a positive and significant relationship with COVID-19 effects. In the crises we face throughout life, intimate family members and friends play a significant supporting role in adapting to these situations.
{"title":"Post-traumatic growth and perceived social support in young adolescents during the COVID-19 pandemic","authors":"Khadigesadat Kazemi, Hooman Esfahani, Hadis Amiri, A. Tavan, Hojjat Farahmandnia","doi":"10.34172/jept.2022.27","DOIUrl":"https://doi.org/10.34172/jept.2022.27","url":null,"abstract":"Objectives: Pandemics would certainly have a negative impact on mental health. Positive modifications as well as negative alterations have been documented in earlier viral pandemic according to previous investigations. Teenagers face a variety of challenges during adolescence. Adolescents may become more concerned if this time coincides with other worries. This study aims to investigate the positive changes that occur in a young adolescent’s life after COVID-19 pandemic, and to see how they relate to perceived social support. Methods: This cross-sectional study was performed on adolescents who were randomly selected from high schools in Kerman, Iran 2020 during the COVID-19. the sample size was 108 and for sampling wes used multi-stage random sampling at the end the data was analyzed by Pearson correlation test. Demographic information, the Multidimensional Scale of Perceived Social Support (MSPSS) and Posttraumatic Growth Inventory short form (PTGI-SF) were used to collect data. The data were subjected to descriptive and analytical statistical tests (Pearson correlation) using SPSS software version 24. Results: Statistically a positive correlation was found between the PTG total score and young homeschooled adolescents, parents working remotely, income loss and COVID-19 experience. Moreover, during the COVID-19 pandemic, a positive association was found between perceived social support and PTG total scores in young adolescents. There were also substantial positive connections between the MSPSS subscales and the PTGI overall score. Conclusion: Based on the findings, an overall growth in all areas of PTG was observed during the COVID-19 among young adolescents. Perceived social support scores have a positive and significant relationship with COVID-19 effects. In the crises we face throughout life, intimate family members and friends play a significant supporting role in adapting to these situations.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44331722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Bhat, Amal Suresh, Apeksha Inamdar, A. Desai, Gopal Krishnan
Objective: Fractures of orbital rims are common and restoration of these fractures back to its normal anatomic form is essential to maintain the function and aesthetics of the eyes. Low profile miniplates are the rigid fixation device of choice for such fractures. But in case of sagittal and grossly displaced fractures of orbital rims it is difficult to achieve stability by using miniplate osteosynthesis. The low profile miniplates may not be able to withstand the forces to reduce this kind if grossly displaced fractures, another stable option needs to be considered in these situations. Case Presentation: This case report presents a simple and effective technique of reduction and fixation of an oblique fracture of infraorbital rim fracture using lag screw principle. A standard titanium screw of 2 mm diameter and 10 mm length is being used in the described technique for stable fixation of fractured segments. Conclusion: The technique is simple, hardware’s are easily available and can be practised in emergency circumstances where newer advanced technologies are not available.
{"title":"Lag screw principle to fix unstable sagittal fracture of infraorbital rim: A technical note","authors":"S. Bhat, Amal Suresh, Apeksha Inamdar, A. Desai, Gopal Krishnan","doi":"10.34172/jept.2022.23","DOIUrl":"https://doi.org/10.34172/jept.2022.23","url":null,"abstract":"Objective: Fractures of orbital rims are common and restoration of these fractures back to its normal anatomic form is essential to maintain the function and aesthetics of the eyes. Low profile miniplates are the rigid fixation device of choice for such fractures. But in case of sagittal and grossly displaced fractures of orbital rims it is difficult to achieve stability by using miniplate osteosynthesis. The low profile miniplates may not be able to withstand the forces to reduce this kind if grossly displaced fractures, another stable option needs to be considered in these situations. Case Presentation: This case report presents a simple and effective technique of reduction and fixation of an oblique fracture of infraorbital rim fracture using lag screw principle. A standard titanium screw of 2 mm diameter and 10 mm length is being used in the described technique for stable fixation of fractured segments. Conclusion: The technique is simple, hardware’s are easily available and can be practised in emergency circumstances where newer advanced technologies are not available.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45451048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Kalani, Masoud Tavasolian, K. Dehghani, S. M. Mousavi, Erfan Ghanbarzadeh, Masihallah Shakeri, Elahe Rahmanian, Poorya Aryanpoor, N. Hatami, Z. Rahmanian, S. Abiri
Objective: The goal of our study was to determine the prognostic value of CURB-65, Sequential Organ Failure Assessment (SOFA), pneumonia severity index (PSI), MuLBSTA, and Acute Physiology and Chronic Health Evaluation (APACHE) II upon admission in patients with coronavirus disease 2019 (COVID-19, as well as the prediction cut-off value for death regarding these parameters. Methods: This observational retrospective study was performed in COVID-19 triage in Peymaniyeh hospital in Jahrom in 2021. In order to calculate SOFA, APACHE II, PSI, MuLBSTA, and CURB-65, data were collected from patients who were selected by available sampling method from PCR-confirmed COVID-19 patients. Thirty-day mortality was assessed as the primary outcome. ROC analysis was conducted using the STATA software to evaluate the prognostic value of the scoring systems. DeLong test was utilized to compare AUC of scores using a web based tool. Results:Ninety-two patients were included in this study with the mean age of 51.02±17.81 years (male to female ratio was 1:1). SOFA had an AUC of 0.656 (P=0.130), but other indices had statistically significant values of AUC. Based on the comparison of the AUCs, SOFA was the worst scoring system in COVID-19 as it had significantly lower AUC than PSI and APACHE II (P<0.05); while its comparison with MULBSTA and CURB65 was not statistically significant (P>0.05). Conclusion: It seems that APACHE II and PSI are the best prognostic factors in our study with no statistical difference compared together (P>0.05). The sensitivity of APACHE II and PSI was 0.857 with the specificity of 0.927 and 0.976, respectively. The optimal cut-off point was 13 and 50 for APACHE II and PSI, respectively.
{"title":"Prognostic value of intensive care scores concerning the prediction of 30-day mortality in COVID-19","authors":"N. Kalani, Masoud Tavasolian, K. Dehghani, S. M. Mousavi, Erfan Ghanbarzadeh, Masihallah Shakeri, Elahe Rahmanian, Poorya Aryanpoor, N. Hatami, Z. Rahmanian, S. Abiri","doi":"10.34172/jept.2022.28","DOIUrl":"https://doi.org/10.34172/jept.2022.28","url":null,"abstract":"Objective: The goal of our study was to determine the prognostic value of CURB-65, Sequential Organ Failure Assessment (SOFA), pneumonia severity index (PSI), MuLBSTA, and Acute Physiology and Chronic Health Evaluation (APACHE) II upon admission in patients with coronavirus disease 2019 (COVID-19, as well as the prediction cut-off value for death regarding these parameters. Methods: This observational retrospective study was performed in COVID-19 triage in Peymaniyeh hospital in Jahrom in 2021. In order to calculate SOFA, APACHE II, PSI, MuLBSTA, and CURB-65, data were collected from patients who were selected by available sampling method from PCR-confirmed COVID-19 patients. Thirty-day mortality was assessed as the primary outcome. ROC analysis was conducted using the STATA software to evaluate the prognostic value of the scoring systems. DeLong test was utilized to compare AUC of scores using a web based tool. Results:Ninety-two patients were included in this study with the mean age of 51.02±17.81 years (male to female ratio was 1:1). SOFA had an AUC of 0.656 (P=0.130), but other indices had statistically significant values of AUC. Based on the comparison of the AUCs, SOFA was the worst scoring system in COVID-19 as it had significantly lower AUC than PSI and APACHE II (P<0.05); while its comparison with MULBSTA and CURB65 was not statistically significant (P>0.05). Conclusion: It seems that APACHE II and PSI are the best prognostic factors in our study with no statistical difference compared together (P>0.05). The sensitivity of APACHE II and PSI was 0.857 with the specificity of 0.927 and 0.976, respectively. The optimal cut-off point was 13 and 50 for APACHE II and PSI, respectively.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47244926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Kasatkin, A. Urakov, A. Shchegolev, Vadim Matreshkin, Ivan Zlobin
Objective: Ultrasound assessment of inferior vena cava (IVC) collapsibility is performed to determine the volume status of critically ill patients. We propose a new acoustic window for visualizing a vein in a prone patient. Case Presentation: A healthy volunteer took part in the study. The study protocol includes two stages: 1) performing a magnetic resonance imaging (MRI) examination to determine the projection of a certain IVC area on the posterior chest surface (holotopy), 2) performing an ultrasound scanning in the area of IVC projection in order to identify it and determine its dimensions. Conclusion: The 11th intercostal space parallel to the paraspinal line allows to visualize the IVC in the prone position. This gives a potential opportunity to use it to assess the IVC collapsibility. Its potential advantage is the ability to assess the compressibility of IVC in the antero-posterior direction.
{"title":"New acoustic window for assessing the inferior vena cava collapsibility in humans in the prone position","authors":"A. Kasatkin, A. Urakov, A. Shchegolev, Vadim Matreshkin, Ivan Zlobin","doi":"10.34172/jept.2022.30","DOIUrl":"https://doi.org/10.34172/jept.2022.30","url":null,"abstract":"Objective: Ultrasound assessment of inferior vena cava (IVC) collapsibility is performed to determine the volume status of critically ill patients. We propose a new acoustic window for visualizing a vein in a prone patient. Case Presentation: A healthy volunteer took part in the study. The study protocol includes two stages: 1) performing a magnetic resonance imaging (MRI) examination to determine the projection of a certain IVC area on the posterior chest surface (holotopy), 2) performing an ultrasound scanning in the area of IVC projection in order to identify it and determine its dimensions. Conclusion: The 11th intercostal space parallel to the paraspinal line allows to visualize the IVC in the prone position. This gives a potential opportunity to use it to assess the IVC collapsibility. Its potential advantage is the ability to assess the compressibility of IVC in the antero-posterior direction.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49600266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zahra Rahimi, M. Masoudifar, Behzad Nazemroaya, M. Norouzi, Amirali Mousavi
Objective: In general, spinal fusion surgery causes heavy bleeding. The purpose of this study was to evaluate the use of two different doses of magnesium sulfate to control the bleeding in lumbar fusion surgery. Methods: This study was carried out as a randomized double-blinded clinical trial in 2020 in Al-Zahra hospital in Isfahan. The participants were 60 patients selected using inclusion and exclusion criteria and were randomly allocated into three groups. In the first group, 50 mg/kg and in the second group, 40 mg/kg magnesium sulfate was infused. The third group received normal saline. From the beginning of anesthesia, heart rate, diastolic and systolic blood pressure, respiratory rate and blood oxygen saturation percentage were monitored and logged every 30 minutes during the operation and recovery. The volume of bleeding during the operation was calculated by counting the number of gauzes used and the amount of suctioned blood during the operation. Other required information such as the duration of operation, duration of anesthesia, time of intubation and the time period of hospitalization and recovery were determined and recorded in all patients. We used independent t-test and repeated measure ANOVA tests to compare data between different time lines and also different groups. P value<0.05 was considered as significance threshold. The collected data were analyzed by using SPSS software version 23. Results: The group receiving 50 mg/kg magnesium sulfate had a significantly lower systolic blood pressure compared to other groups within 15, 30 and 45 minutes after the injections (P=0.04 for all). The pulse rate was significantly lower in the 50 mg/kg magnesium sulfate group compared to other groups within 15, 30 and 45 minutes after the injections (P<0.05 for all). Patients that received 50 mg/kg magnesium sulfate had a lower duration of surgery (P=0.007), lower duration of anesthesia (P=0.007), lower bleeding volume (P<0.001), lower fluid intake (P=0.01) and also lower transfused blood (P=0.01). The surgeons also had a significantly higher satisfaction with these patients (P=0.001). Conclusion: Injection of 50 mg/kg magnesium sulfate had a correlation with reduced blood pressure as well as bleeding volume compared to 40 mg/kg magnesium sulfate.
{"title":"Effects of perioperative use of two doses of magnesium sulfate infusion on intraoperative blood loss in patients undergoing lumbar spinal fusion surgery","authors":"Zahra Rahimi, M. Masoudifar, Behzad Nazemroaya, M. Norouzi, Amirali Mousavi","doi":"10.34172/jept.2022.26","DOIUrl":"https://doi.org/10.34172/jept.2022.26","url":null,"abstract":"Objective: In general, spinal fusion surgery causes heavy bleeding. The purpose of this study was to evaluate the use of two different doses of magnesium sulfate to control the bleeding in lumbar fusion surgery. Methods: This study was carried out as a randomized double-blinded clinical trial in 2020 in Al-Zahra hospital in Isfahan. The participants were 60 patients selected using inclusion and exclusion criteria and were randomly allocated into three groups. In the first group, 50 mg/kg and in the second group, 40 mg/kg magnesium sulfate was infused. The third group received normal saline. From the beginning of anesthesia, heart rate, diastolic and systolic blood pressure, respiratory rate and blood oxygen saturation percentage were monitored and logged every 30 minutes during the operation and recovery. The volume of bleeding during the operation was calculated by counting the number of gauzes used and the amount of suctioned blood during the operation. Other required information such as the duration of operation, duration of anesthesia, time of intubation and the time period of hospitalization and recovery were determined and recorded in all patients. We used independent t-test and repeated measure ANOVA tests to compare data between different time lines and also different groups. P value<0.05 was considered as significance threshold. The collected data were analyzed by using SPSS software version 23. Results: The group receiving 50 mg/kg magnesium sulfate had a significantly lower systolic blood pressure compared to other groups within 15, 30 and 45 minutes after the injections (P=0.04 for all). The pulse rate was significantly lower in the 50 mg/kg magnesium sulfate group compared to other groups within 15, 30 and 45 minutes after the injections (P<0.05 for all). Patients that received 50 mg/kg magnesium sulfate had a lower duration of surgery (P=0.007), lower duration of anesthesia (P=0.007), lower bleeding volume (P<0.001), lower fluid intake (P=0.01) and also lower transfused blood (P=0.01). The surgeons also had a significantly higher satisfaction with these patients (P=0.001). Conclusion: Injection of 50 mg/kg magnesium sulfate had a correlation with reduced blood pressure as well as bleeding volume compared to 40 mg/kg magnesium sulfate.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47986155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zahra Rezaie, Shima Heidari, A. Salimzadeh, Fatemeh Sadat Pirooz, F. Najmeddin
Objective: Since the identification and spread of the novel coronavirus disease 2019 (COVID-19) in December 2019, respiratory presentations have been introduced as the main symptoms of this new type of viral disease; however, the extra-pulmonary features are raising awareness for researchers due to the vast diversity of vital organs affected by the virus. Among the wide range of clinical manifestations, limited data are available regarding rhabdomyolysis (RML) in COVID-19. Case Presentation: In this report, we present a 58-year-old woman with COVID-19 presenting with RML, with extremely elevated creatinine phosphokinase (CPK) and lactate dehydrogenase (LDH) levels (3283 and 1280 U/L, respectively) as the second sign of disease. Since the onset of the COVID-19 pandemic, several COVID-19 induced RML cases have been reported, and timely diagnosis and proper management are of paramount importance. Conclusion: Due to the findings that rhabdomyolysis can be a critical and missed cause of myalgia in COVID-19 patients, the importance of checking the serum level of CPK in patients with myalgia and fatigue in the era of COVID-19 upon their arrival will be highlighted.
{"title":"The importance of considering rhabdomyolysis as the underlying cause of myalgia in patients with COVID-19: A case report","authors":"Zahra Rezaie, Shima Heidari, A. Salimzadeh, Fatemeh Sadat Pirooz, F. Najmeddin","doi":"10.34172/jept.2022.24","DOIUrl":"https://doi.org/10.34172/jept.2022.24","url":null,"abstract":"Objective: Since the identification and spread of the novel coronavirus disease 2019 (COVID-19) in December 2019, respiratory presentations have been introduced as the main symptoms of this new type of viral disease; however, the extra-pulmonary features are raising awareness for researchers due to the vast diversity of vital organs affected by the virus. Among the wide range of clinical manifestations, limited data are available regarding rhabdomyolysis (RML) in COVID-19. Case Presentation: In this report, we present a 58-year-old woman with COVID-19 presenting with RML, with extremely elevated creatinine phosphokinase (CPK) and lactate dehydrogenase (LDH) levels (3283 and 1280 U/L, respectively) as the second sign of disease. Since the onset of the COVID-19 pandemic, several COVID-19 induced RML cases have been reported, and timely diagnosis and proper management are of paramount importance. Conclusion: Due to the findings that rhabdomyolysis can be a critical and missed cause of myalgia in COVID-19 patients, the importance of checking the serum level of CPK in patients with myalgia and fatigue in the era of COVID-19 upon their arrival will be highlighted.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43075702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：