Introduction: Inflammation of the infrapatellar bursa results from various causes like trauma, infection and overuse. Superficial skin or soft tissue infection can also lead to occasional septic bursitis. Infrapatellar bursa has two parts, superficial and deep bursae. Superficial bursa inflammation reactive to adjacent superficial skin infection may occasionally lead to secondary bursitis. Case Presentation: We report a rare finding of acute right knee pain with extraordinary amount of fluid collection within superficial part of infrapatellar bursa in an elderly male patient. A secondary, septic and massive superficial infrapatellar bursitis was unusual in its appearance mimicking neoplastic lesion. Judicious use of clinical assessment and imaging helped to diagnose the condition. Conclusion: Early diagnosis and treatment of bursitis can ensure optimal outcome and it can be used to check further complications. Atypical presentation of any bursitis should be acknowledged and the judicious use of clinical assessment and imaging is critical for prompt diagnosis and treatment.
{"title":"How much can a small bursa stretch? A curious case of massive superficial infrapatellar bursitis in the emergency department","authors":"G. Dharmshaktu, T. Pangtey","doi":"10.34172/JEPT.2021.23","DOIUrl":"https://doi.org/10.34172/JEPT.2021.23","url":null,"abstract":"Introduction: Inflammation of the infrapatellar bursa results from various causes like trauma, infection and overuse. Superficial skin or soft tissue infection can also lead to occasional septic bursitis. Infrapatellar bursa has two parts, superficial and deep bursae. Superficial bursa inflammation reactive to adjacent superficial skin infection may occasionally lead to secondary bursitis. Case Presentation: We report a rare finding of acute right knee pain with extraordinary amount of fluid collection within superficial part of infrapatellar bursa in an elderly male patient. A secondary, septic and massive superficial infrapatellar bursitis was unusual in its appearance mimicking neoplastic lesion. Judicious use of clinical assessment and imaging helped to diagnose the condition. Conclusion: Early diagnosis and treatment of bursitis can ensure optimal outcome and it can be used to check further complications. Atypical presentation of any bursitis should be acknowledged and the judicious use of clinical assessment and imaging is critical for prompt diagnosis and treatment.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69815280","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: Numerous drugs and medications from various pharmacological classes can lead to seizures as an unwanted side effect. Midwakh is a pipe commonly used to smoke tobacco blend in small quantities. Midwakh use is increasing, especially among young people. Case Presentation: A 17-year-old patient with a history of seizures was provoked by smoking midwakh, despite having no previous disease history. Conclusion: Although the patient had a negative workup for epilepsy, midwakh should be classified as an epileptogenic drug. More studies need to be conducted on the effects of midwakh on the neurological system.
{"title":"Midwakh (pipe) and seizure: The overlooked link","authors":"M. Eid","doi":"10.34172/JEPT.2021.16","DOIUrl":"https://doi.org/10.34172/JEPT.2021.16","url":null,"abstract":"Objective: Numerous drugs and medications from various pharmacological classes can lead to seizures as an unwanted side effect. Midwakh is a pipe commonly used to smoke tobacco blend in small quantities. Midwakh use is increasing, especially among young people. Case Presentation: A 17-year-old patient with a history of seizures was provoked by smoking midwakh, despite having no previous disease history. Conclusion: Although the patient had a negative workup for epilepsy, midwakh should be classified as an epileptogenic drug. More studies need to be conducted on the effects of midwakh on the neurological system.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44791876","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}
P. Asadi, Seyyed Mahdi Zia Ziabari, Vahid Monsef-Kasmaei
Objective: Awareness of the changes concerning the clinical guidelines for cardiopulmonary resuscitation (CPR) is essential for nurses. This study aimed at assessing the nurses’ knowledge of the 2015 American Heart Association basic life support guideline algorithm. Methods: In a cross-sectional study, the knowledge of 183 nurses working in emergency departments, intensive care unit (ICU) and coronary care unit (CCU) regarding the 2015 American Heart Association basic life support guideline algorithm was investigated. Data were collected by a 20-item questionnaire regarding the knowledge needed for resuscitation operations as well as the identification of the early stages of cardiac arrest. Nurses with a score of 10 and less were put in the poor group, 11-15 in the fair group, and score of more than 15 in the good group. Results: Results showed that the highest percentage of the right answer was observed in questions 20 (98.4%), 11 (93.4%), and 1 (88%), while the lowest percentage of the correct answer was found in questions 13 (30.6%), 2 (31.1%), and 3 (32.8%). Mean ± SD of knowledge score was 12.3±2.2. A statistically significant difference was observed between knowledge of ICU nurses with an experience of basic life support educational course and those with no experience of such education. The knowledge score of educated and non-educated nurses was 11.5±2.2 and 13.2±2.5, respectively. Conclusion: This study indicated that ICU nurses do not have enough knowledge about basic life support of the 2015 American Heart Association guideline. Development of knowledge is one of the important components of professional expansion in nursing education programs.
{"title":"Exploring nurses’ knowledge of basic life support guideline of American Heart Association: a local study","authors":"P. Asadi, Seyyed Mahdi Zia Ziabari, Vahid Monsef-Kasmaei","doi":"10.34172/JEPT.2021.02","DOIUrl":"https://doi.org/10.34172/JEPT.2021.02","url":null,"abstract":"Objective: Awareness of the changes concerning the clinical guidelines for cardiopulmonary resuscitation (CPR) is essential for nurses. This study aimed at assessing the nurses’ knowledge of the 2015 American Heart Association basic life support guideline algorithm. Methods: In a cross-sectional study, the knowledge of 183 nurses working in emergency departments, intensive care unit (ICU) and coronary care unit (CCU) regarding the 2015 American Heart Association basic life support guideline algorithm was investigated. Data were collected by a 20-item questionnaire regarding the knowledge needed for resuscitation operations as well as the identification of the early stages of cardiac arrest. Nurses with a score of 10 and less were put in the poor group, 11-15 in the fair group, and score of more than 15 in the good group. Results: Results showed that the highest percentage of the right answer was observed in questions 20 (98.4%), 11 (93.4%), and 1 (88%), while the lowest percentage of the correct answer was found in questions 13 (30.6%), 2 (31.1%), and 3 (32.8%). Mean ± SD of knowledge score was 12.3±2.2. A statistically significant difference was observed between knowledge of ICU nurses with an experience of basic life support educational course and those with no experience of such education. The knowledge score of educated and non-educated nurses was 11.5±2.2 and 13.2±2.5, respectively. Conclusion: This study indicated that ICU nurses do not have enough knowledge about basic life support of the 2015 American Heart Association guideline. Development of knowledge is one of the important components of professional expansion in nursing education programs.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41333238","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}
Nazanin Jannati, Vahid Yazdi-Feyzabadi, Roghayeh Ershad Sarabi, S. Salehinejad
The coronavirus disease (COVID-19) pandemic is a global health crisis of our time. The mental health and wellbeing of whole societies have been severely impacted by this crisis and are a priority to be addressed urgently. In addition, the COVID-19 pandemic has disrupted or halted critical mental health services in many countries worldwide. One way to overcome this situation is to use Telemental health services and people can take advantage of these services to meet their mental health needs. However, there are some barriers to provide Telemental health services, which should be considered by policymakers before the crisis.
{"title":"How to deal with the mental health consequences of global health emergencies? A nutshell of telemental health services and its requirements","authors":"Nazanin Jannati, Vahid Yazdi-Feyzabadi, Roghayeh Ershad Sarabi, S. Salehinejad","doi":"10.34172/jept.2021.14","DOIUrl":"https://doi.org/10.34172/jept.2021.14","url":null,"abstract":"The coronavirus disease (COVID-19) pandemic is a global health crisis of our time. The mental health and wellbeing of whole societies have been severely impacted by this crisis and are a priority to be addressed urgently. In addition, the COVID-19 pandemic has disrupted or halted critical mental health services in many countries worldwide. One way to overcome this situation is to use Telemental health services and people can take advantage of these services to meet their mental health needs. However, there are some barriers to provide Telemental health services, which should be considered by policymakers before the crisis.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45295035","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}
Arash Amirrafiei, Seyyed Mahdi Zia Ziabari, Fatemeh Haghshenas-Bakerdar, E. Kazemnejad-Leili, P. Asadi
Objective: Evaluating the abilities of emergency medical services (EMS) staff who are in the frontline of the diseases could be an excellent reflection of the accuracy of curriculum both before and after graduation. This study was done to determine the clinical competencies of Guilan EMS staff in responding to emergency conditions using Objective Structured Clinical Examination (OSCE). Methods: In this descriptive study, 70 EMS staff from selected Emergency Centres in Guilan were recruited. Data were collected using a questionnaire and a checklist which included 9 different skills. Validity of the checklist was assessed by obtaining the opinions of 10 experts. The content validity index (CVI) and content validity ratio (CVR) of the checklist were 0.7 and 0.8, respectively. The reliability of the checklist was obtained using the test-retest method (r=0.89). In order to collect data, observations were done using the designated checklist. Data were analysed using SPSS software version 22 and descriptive statistical tests. Results: Findings showed that 56.3% of the paramedics got good scores for trauma competency but the mean scores for two competencies of spinal cord immobilization and vehicle extrication were low, indicating major skills problem. There was a statistically significant relationship between education (P=0.02) and work experience (P=0.03) as well as clinical skills in confronting trauma. Conclusion: Although the EMS staff had an acceptable range of performance in most of the skills, it seems that there is a need for training of performance-based competencies in which paramedics had a poor performance.
{"title":"Clinical competencies of emergency medical services paramedics in responding to emergency conditions using Objective Structured Clinical Examination (OSCE) in Guilan","authors":"Arash Amirrafiei, Seyyed Mahdi Zia Ziabari, Fatemeh Haghshenas-Bakerdar, E. Kazemnejad-Leili, P. Asadi","doi":"10.34172/JEPT.2021.03","DOIUrl":"https://doi.org/10.34172/JEPT.2021.03","url":null,"abstract":"Objective: Evaluating the abilities of emergency medical services (EMS) staff who are in the frontline of the diseases could be an excellent reflection of the accuracy of curriculum both before and after graduation. This study was done to determine the clinical competencies of Guilan EMS staff in responding to emergency conditions using Objective Structured Clinical Examination (OSCE). Methods: In this descriptive study, 70 EMS staff from selected Emergency Centres in Guilan were recruited. Data were collected using a questionnaire and a checklist which included 9 different skills. Validity of the checklist was assessed by obtaining the opinions of 10 experts. The content validity index (CVI) and content validity ratio (CVR) of the checklist were 0.7 and 0.8, respectively. The reliability of the checklist was obtained using the test-retest method (r=0.89). In order to collect data, observations were done using the designated checklist. Data were analysed using SPSS software version 22 and descriptive statistical tests. Results: Findings showed that 56.3% of the paramedics got good scores for trauma competency but the mean scores for two competencies of spinal cord immobilization and vehicle extrication were low, indicating major skills problem. There was a statistically significant relationship between education (P=0.02) and work experience (P=0.03) as well as clinical skills in confronting trauma. Conclusion: Although the EMS staff had an acceptable range of performance in most of the skills, it seems that there is a need for training of performance-based competencies in which paramedics had a poor performance.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43487467","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: Perforation peritonitis is a common surgical emergency which is treated by surgery and antibiotics. Candida isolation in peritoneal fluid and antifungal treatment is not a norm. The aim of this study was to determine the incidence of Candida in peritoneal fluid and its role in the outcome of patients with perforation peritonitis. Methods: This prospective observational study was conducted on 70 patients with perforation peritonitis from October 2016 to February 2018. Intraoperatively, peritoneal fluid was taken and sent for microbiological culture and sensitivity. Perforation was managed according to the site of perforation and condition of bowel. Results: The mean age of the patients was 38.74 years with male predominance (58, 82.85%). Forty-seven (67.14%) patients had positive peritoneal cultures. Escherichia coli was the most common bacteria (n=29), while Candida was found to be the most common fungi and was found in 18 patients. The incidence of Candida was higher in upper gastro-duodenal perforation (30, 42.85%). Patients found positive for Candida had APACHE II severity score 10 or more which was higher than the rest of the patients. The mortality was higher in patients with positive peritoneal cultures (10/47) as compare to negative ones (2/23, P<0.001). The mortality in mixed bacterial and fungal-positive cultures (7/18) was also higher as compared to isolated bacterial culture (3/29, P<0.001). The overall mortality rate was 17.14%. Conclusion: Patients with Candida positive peritoneal culture had a significant mortality and morbidity as compared to Candida negative. Peritoneal fluid culture and sensitivity for bacterial and fungal were helpful in the early diagnosis and treatment.
{"title":"Candida isolation from peritoneal fluid: Its role in the outcome of patients with perforation peritonitis","authors":"S. Lal, Vinod Kumar Singh, Suhas Agarwal","doi":"10.34172/jept.2021.20","DOIUrl":"https://doi.org/10.34172/jept.2021.20","url":null,"abstract":"Objective: Perforation peritonitis is a common surgical emergency which is treated by surgery and antibiotics. Candida isolation in peritoneal fluid and antifungal treatment is not a norm. The aim of this study was to determine the incidence of Candida in peritoneal fluid and its role in the outcome of patients with perforation peritonitis. Methods: This prospective observational study was conducted on 70 patients with perforation peritonitis from October 2016 to February 2018. Intraoperatively, peritoneal fluid was taken and sent for microbiological culture and sensitivity. Perforation was managed according to the site of perforation and condition of bowel. Results: The mean age of the patients was 38.74 years with male predominance (58, 82.85%). Forty-seven (67.14%) patients had positive peritoneal cultures. Escherichia coli was the most common bacteria (n=29), while Candida was found to be the most common fungi and was found in 18 patients. The incidence of Candida was higher in upper gastro-duodenal perforation (30, 42.85%). Patients found positive for Candida had APACHE II severity score 10 or more which was higher than the rest of the patients. The mortality was higher in patients with positive peritoneal cultures (10/47) as compare to negative ones (2/23, P<0.001). The mortality in mixed bacterial and fungal-positive cultures (7/18) was also higher as compared to isolated bacterial culture (3/29, P<0.001). The overall mortality rate was 17.14%. Conclusion: Patients with Candida positive peritoneal culture had a significant mortality and morbidity as compared to Candida negative. Peritoneal fluid culture and sensitivity for bacterial and fungal were helpful in the early diagnosis and treatment.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69815162","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}
Seyyed Meysam Amini, Mehriyar Yoldashkhan, S. Zohari, M. Nasiri, Z. Mousavi, S. Amini
Objective: Pain is usually one of the most common symptoms among all traumatic injuries. One of the drugs that has recently entered the Iranian prehospital emergency system is ketorolac. Ketorolac is a non-steroidal anti-inflammatory drug (NSAID) that inhibits prostaglandin synthesis by inhibiting cyclooxygenase activity and reduces pain and inflammation. It can be considered as the strongest analgesic drug in this category. The aim of this study was to evaluate the effectiveness of ketorolac in pain management of traumatic injuries in a prehospital setting. Methods: This descriptive cross-sectional study was undertaken to evaluate the effectiveness of a treatment method in the pain management of traumatic injuries in the prehospital environment of Lorestan province in Iran. We included 134 injured patients from road emergency bases of Lorestan province. In order to control the pain of these injured patients, 30 mg of ketorolac was injected slowly intravenously in one minute. Pain was measured in the time interval of zero minutes (before injection), 15 minutes, 30 minutes, and 45 minutes by visual acuity scale (VAS). The analysis of the obtained data was performed by SPSS software version 23. Results: The mean age of participants was 37.42±23.6. There were 47 female injuries (35.1%) and 87 male injuries (64.9%). In terms of pain intensity, 49 patients (36.6%) had moderate pain (VAS=4-6) and 85 patients (63.4%) had severe pain (VAS=7-10). The average of pain relief in the injured group with severe and moderate pain 15 minutes after the injection was 0.471 and 0.878 (P=0.001), respectively. In addition, the mean of pain relief in the injured group with severe and moderate pain 30 minutes after the injection was 1.124 and 1.796, respectively (P=0.001). Pain reduction in the group of severely injured patients with moderate pain in the first 30 minutes was statistically significant. Conclusion: Findings revealed that ketorolac is a suitable drug in pain management for trauma patients with moderate and severe pain in trauma patients. On the other hand, due to the peak effect (more than 30 minutes), it is not an effective drug for trauma patients with severe pain in a short period transferred to the prehospital environment.
{"title":"Assessing the effectiveness of ketorolac in pain management of traumatic injuries in prehospital emergency care services","authors":"Seyyed Meysam Amini, Mehriyar Yoldashkhan, S. Zohari, M. Nasiri, Z. Mousavi, S. Amini","doi":"10.34172/JEPT.2021.01","DOIUrl":"https://doi.org/10.34172/JEPT.2021.01","url":null,"abstract":"Objective: Pain is usually one of the most common symptoms among all traumatic injuries. One of the drugs that has recently entered the Iranian prehospital emergency system is ketorolac. Ketorolac is a non-steroidal anti-inflammatory drug (NSAID) that inhibits prostaglandin synthesis by inhibiting cyclooxygenase activity and reduces pain and inflammation. It can be considered as the strongest analgesic drug in this category. The aim of this study was to evaluate the effectiveness of ketorolac in pain management of traumatic injuries in a prehospital setting. Methods: This descriptive cross-sectional study was undertaken to evaluate the effectiveness of a treatment method in the pain management of traumatic injuries in the prehospital environment of Lorestan province in Iran. We included 134 injured patients from road emergency bases of Lorestan province. In order to control the pain of these injured patients, 30 mg of ketorolac was injected slowly intravenously in one minute. Pain was measured in the time interval of zero minutes (before injection), 15 minutes, 30 minutes, and 45 minutes by visual acuity scale (VAS). The analysis of the obtained data was performed by SPSS software version 23. Results: The mean age of participants was 37.42±23.6. There were 47 female injuries (35.1%) and 87 male injuries (64.9%). In terms of pain intensity, 49 patients (36.6%) had moderate pain (VAS=4-6) and 85 patients (63.4%) had severe pain (VAS=7-10). The average of pain relief in the injured group with severe and moderate pain 15 minutes after the injection was 0.471 and 0.878 (P=0.001), respectively. In addition, the mean of pain relief in the injured group with severe and moderate pain 30 minutes after the injection was 1.124 and 1.796, respectively (P=0.001). Pain reduction in the group of severely injured patients with moderate pain in the first 30 minutes was statistically significant. Conclusion: Findings revealed that ketorolac is a suitable drug in pain management for trauma patients with moderate and severe pain in trauma patients. On the other hand, due to the peak effect (more than 30 minutes), it is not an effective drug for trauma patients with severe pain in a short period transferred to the prehospital environment.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44636607","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}
M. Eshraghi, E. Noori, Ahmad Kachoie, Moien Zolmafakher
Objective: Bronchopleural fistula (BPF) is a pathological communication between the bronchial tree and pleural space. BPFs are commonly seen after lung surgery, and are less common in trauma, lung abscess, and radiation therapy. In this study, we describe the clinical course and surgery of a case of pulmonary necrosis and BPF in a patient infected with coronavirus disease 2019 (COVID-19). Case Presentation: The patient was a 54-year-old man with multiple myeloma and end-stage renal disease from the last 8 years. He had a history of coronary artery bypass grafting from the last 3 years. He also suffered from progressive shortness of breath and dry cough since March 2019. Conclusion: The results of this study showed that BPF is one of the most severe complications after thorax surgery, and there is no effective prevention method particularly in this patient who had COVID-19 pneumonia. Therefore, early intervention, especially when diagnosed at an early stage, by strengthening the stump inside the thorax or thoracotomy in the open window may eventually accelerate the closure of the BPF and improve the survival.
{"title":"Pulmonary necrosis and bronchopleural fistula in a patient infected with COVID-19: A case report","authors":"M. Eshraghi, E. Noori, Ahmad Kachoie, Moien Zolmafakher","doi":"10.34172/jept.2021.07","DOIUrl":"https://doi.org/10.34172/jept.2021.07","url":null,"abstract":"Objective: Bronchopleural fistula (BPF) is a pathological communication between the bronchial tree and pleural space. BPFs are commonly seen after lung surgery, and are less common in trauma, lung abscess, and radiation therapy. In this study, we describe the clinical course and surgery of a case of pulmonary necrosis and BPF in a patient infected with coronavirus disease 2019 (COVID-19). Case Presentation: The patient was a 54-year-old man with multiple myeloma and end-stage renal disease from the last 8 years. He had a history of coronary artery bypass grafting from the last 3 years. He also suffered from progressive shortness of breath and dry cough since March 2019. Conclusion: The results of this study showed that BPF is one of the most severe complications after thorax surgery, and there is no effective prevention method particularly in this patient who had COVID-19 pneumonia. Therefore, early intervention, especially when diagnosed at an early stage, by strengthening the stump inside the thorax or thoracotomy in the open window may eventually accelerate the closure of the BPF and improve the survival.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43100748","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}
Malek Moradi, Amir Motamedi, A. Pouyafard, Mostafa Gavahi, Mohsen Barzegar
Objective: Narcotic and alcohol use are recognized as the two important underlying factors in all types of trauma. In this study, the prevalence of opium consumption was investigated in traumatic patients who referred to Shahid Rahnemoon hospital in Yazd in 2018. Methods: In this descriptive cross-sectional study, 252 patients with trauma admitted to Shahid Rahnemoon Hospital from October to December 2018 were studied. In order to collect the data, a checklist was administered including the patients’ demographic information (age and gender), opium consumption, location of trauma, day of occurrence of trauma and cause of trauma. Results: The mean of patients’ age was 31.33±19.46 years ranging from 2 to 90 years and 71.4% of them were males. The most common causes of trauma included accidents with motor vehicles (56%), falls from height (19.8%), and intimate partner violence (6%), respectively. Regarding opium consumption, 87.3% of patients did not use it, while 10.3% consumed opium. Narcotic abuse was significantly different with regard to the patients’ gender (P=0.000) and age (P=0.000). Conclusion: Opium consumption increases the risk of error and accident while driving. People on methadone treatment also show high-risk behaviors and are at greater risk of accidents.
{"title":"Frequency of opium use in traumatic patients admitted to Shahid Rahnemoon hospital","authors":"Malek Moradi, Amir Motamedi, A. Pouyafard, Mostafa Gavahi, Mohsen Barzegar","doi":"10.34172/jept.2021.15","DOIUrl":"https://doi.org/10.34172/jept.2021.15","url":null,"abstract":"Objective: Narcotic and alcohol use are recognized as the two important underlying factors in all types of trauma. In this study, the prevalence of opium consumption was investigated in traumatic patients who referred to Shahid Rahnemoon hospital in Yazd in 2018. Methods: In this descriptive cross-sectional study, 252 patients with trauma admitted to Shahid Rahnemoon Hospital from October to December 2018 were studied. In order to collect the data, a checklist was administered including the patients’ demographic information (age and gender), opium consumption, location of trauma, day of occurrence of trauma and cause of trauma. Results: The mean of patients’ age was 31.33±19.46 years ranging from 2 to 90 years and 71.4% of them were males. The most common causes of trauma included accidents with motor vehicles (56%), falls from height (19.8%), and intimate partner violence (6%), respectively. Regarding opium consumption, 87.3% of patients did not use it, while 10.3% consumed opium. Narcotic abuse was significantly different with regard to the patients’ gender (P=0.000) and age (P=0.000). Conclusion: Opium consumption increases the risk of error and accident while driving. People on methadone treatment also show high-risk behaviors and are at greater risk of accidents.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49545744","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}
E. Pishbin, H. Reihani, Bahram Zarmehri, Mahdi Foroughian
Objective: Methanol poisoning is a dangerous life-threatening event, manifested with various symptoms, sometimes very rare ones, that all should be addressed to prevent misdiagnosis of the methanol-poisoned patients. Case Presentation: A 21-year-old young man was brought to the emergency department (ED) with a generalized tonic-clonic (GTC) seizure and he was diagnosed with methanol intoxication. A non-contrast computed tomography (NCCT) of the brain demonstrated findings similar to subarachnoid hemorrhage (SAH). After the brain CT, he had a Glasgow Coma Score (GCS) of 3 and all brainstem reflexes were absent. Neurology consultant agreed with the diagnosis of pseudo-SAH. Brain death was confirmed by a positive apnea test within 24 hours of presentation. Conclusion: It is suggested that compression of dural sinuses due to severe brain edema, reduces the venous drainage and leads to venous engorgement, which appears high attenuated in the background of low-density edematous brain matter.
{"title":"Pseudo-SAH in a patient with methanol poisoning","authors":"E. Pishbin, H. Reihani, Bahram Zarmehri, Mahdi Foroughian","doi":"10.34172/JEPT.2021.05","DOIUrl":"https://doi.org/10.34172/JEPT.2021.05","url":null,"abstract":"Objective: Methanol poisoning is a dangerous life-threatening event, manifested with various symptoms, sometimes very rare ones, that all should be addressed to prevent misdiagnosis of the methanol-poisoned patients. Case Presentation: A 21-year-old young man was brought to the emergency department (ED) with a generalized tonic-clonic (GTC) seizure and he was diagnosed with methanol intoxication. A non-contrast computed tomography (NCCT) of the brain demonstrated findings similar to subarachnoid hemorrhage (SAH). After the brain CT, he had a Glasgow Coma Score (GCS) of 3 and all brainstem reflexes were absent. Neurology consultant agreed with the diagnosis of pseudo-SAH. Brain death was confirmed by a positive apnea test within 24 hours of presentation. Conclusion: It is suggested that compression of dural sinuses due to severe brain edema, reduces the venous drainage and leads to venous engorgement, which appears high attenuated in the background of low-density edematous brain matter.","PeriodicalId":36499,"journal":{"name":"Journal of Emergency Practice and Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42462276","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}
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