ORIGINAL_ARTICLE
Tranexamic Acid; A Glittering Player in the Field of Trauma
https://beat.sums.ac.ir/article_46443_daf69143d598961c146ce4d5a242a971.pdf
2020-04-01
53
55
10.30476/beat.2020.46443
Tranexamic acid
Trauma
Coagulopathy
Antifibrinolytics
Hemorrhage
Fariborz
Ghaffarpasand
fariborz.ghaffarpasand@gmail.com
1
MD, Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Hamid Reza
Abbasi
abbasimezy@yahoo.com
2
Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
AUTHOR
Shahram
Paydar
paydarsh@gmail.com
3
Trauma Research Center, Shiraz University of Medical Sciences
AUTHOR
Shahram
Bolandparvaz
bolandpa@yahoo.com
4
Professor of Trauma and Acute Care Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Maryam
Dehghankhalili
dehghankhaliliam@gmail.com
5
Student Research Committee, Shiraz University of Medical Sciences
LEAD_AUTHOR
1. Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18(1):56-87.
1
2. Dewan MC, Rattani A, Gupta S, Baticulon RE, Hung YC, Punchak M, et al. Estimating the global incidence of traumatic brain injury. J Neurosurg. 2018:1-18.
2
3. Eastridge BJ, Mabry RL, Seguin P, Cantrell J, Tops T, Uribe P, et al. Death on the battlefield (2001-2011): implications for the future of combat casualty care. J Trauma Acute Care Surg. 2012;73(6 Suppl 5):S431-7.
3
4. Frith D, Brohi K. The acute coagulopathy of trauma shock: clinical relevance. Surgeon. 2010;8(3):159-63.
4
5. Khalili H, Sadraei N, Niakan A, Ghaffarpasand F, Sadraei A. Role of Intracranial Pressure Monitoring in Management of Patients with Severe Traumatic Brain Injury: Results of a Large Level I Trauma Center in Southern Iran. World Neurosurg. 2016;94:120-5.
5
6. Ramirez RJ, Spinella PC, Bochicchio GV. Tranexamic Acid Update in Trauma. Crit Care Clin. 2017;33(1):85-99.
6
7. Shakur H, Beaumont D, Pavord S, Gayet-Ageron A, Ker K, Mousa HA. Antifibrinolytic drugs for treating primary postpartum haemorrhage. Cochrane Database Syst Rev. 2018;2(2):Cd012964.
7
8. Farrokhi MR, Kazemi AP, Eftekharian HR, Akbari K. Efficacy of prophylactic low dose of tranexamic acid in spinal fixation surgery: a randomized clinical trial. J Neurosurg Anesthesiol. 2011;23(4):290-6.
8
9. Cai J, Ribkoff J, Olson S, Raghunathan V, Al-Samkari H, DeLoughery TG, et al. The many roles of tranexamic acid: An overview of the clinical indications for TXA in medical and surgical patients. Eur J Haematol. 2020;104(2):79-87.
9
10. CRASH-3 trial collaborators. Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial. Lancet. 2019;394(10210):1713-1723.
10
11. Perel P, Al-Shahi Salman R, Kawahara T, Morris Z, Prieto-Merino D, Roberts I, et al. CRASH-2 (Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage) intracranial bleeding study: the effect of tranexamic acid in traumatic brain injury--a nested randomised, placebo-controlled trial. Health Technol Assess. 2012;16(13):iii-xii, 1-54.
11
12. Weng S, Wang W, Wei Q, Lan H, Su J, Xu Y. Effect of Tranexamic Acid in Patients with Traumatic Brain Injury: A Systematic Review and Meta-Analysis. World Neurosurg. 2019;123:128-35.
12
13. Morrison JJ, Dubose JJ, Rasmussen TE, Midwinter MJ. Military Application of Tranexamic Acid in Trauma Emergency Resuscitation (MATTERs) Study. Arch Surg. 2012;147(2):113-9.
13
14. Stein P, Studt JD, Albrecht R, Müller S, von Ow D, Fischer S, et al. The Impact of Prehospital Tranexamic Acid on Blood Coagulation in Trauma Patients. Anesth Analg. 2018;126(2):522-9.
14
15. Wafaisade A, Lefering R, Bouillon B, Böhmer AB, Gäßler M, Ruppert M. Prehospital administration of tranexamic acid in trauma patients. Crit Care. 2016;20(1):143.
15
ORIGINAL_ARTICLE
Distal Locked versus Unlocked Intramedullary Nailing in Intertrochanteric Fracture; A Systematic Review and Meta-Analysis of Randomized and Non-Randomized Trials
Objective: To compare the outcome of distal locked and unlocked intramedullary nailing in patients with intertrochanteric fractures through systematic review and meta-analysis of randomized and non-randomized clinical trials. Methods: Randomized or non-randomized controlled studies comparing the effects of unlocked and locked nails for treatment of intertrochanteric fractures were searched using the search strategy of Cochrane collaboration up to April 2019. Four eligible studies involving 691 patients were included. Their methodological quality was assessed, and data were extracted independently for meta-analysis. Results: The results showed that the unlocked group has significantly less operative time (MD: -8.08; 95%CI -11.36 to -4.79; P< 0.00001), fluoroscopy time (MD: -7.09, 95%CI -7.09 to -4.79; p<0.00001), length of incision (MD: -2.50, 95%CI 2.85 to -2.14; p< 0.00001) than the locked group. The complication rate was significantly higher in the locking group (OR: 0.55, 95%CI 0.26 to 1.15; p=0.03). No significant differences were found in the Harris hip score between the two groups (MD: 0.68, 95% CI -0.83 to 2.19, p<0.08). Conclusion: The present meta-analysis suggests that intramedullary nailing without distal locking is reliable and acceptable option for treating intertrochanteric fracture. The advantages are reduced operative time, decreased fluoroscopy time, smaller size of incision and decreased complication rate. However, owing to the low-quality evidence currently available, additional high quality Randomized controlled trials are needed to confirm these findings.
https://beat.sums.ac.ir/article_46444_3e0dcef0d3b4d31876abaae05f96dd8d.pdf
2020-04-03
56
61
10.30476/beat.2020.46444
Intertrochanteric fractures
Intramedullary nail
Distal unlocking
Dushyant
Chouhan
dkchouhan75@gmail.com
1
Department of Orthopaedics, Lady Hardinge Medical college and associated hospitals, New Delhi, India
LEAD_AUTHOR
Sanjay
Meena
sanjaymeena@hotmail.com
2
Department of Orthopaedics, Lady Hardinge Medical college and associated hospitals, New Delhi, India
AUTHOR
Kulbhushan
Kamboj
drkbkamboj@gmail.com
3
Department of Orthopaedics, Lady Hardinge Medical college and associated hospitals, New Delhi, India
AUTHOR
Mukesh
Meena
pmukeshmeena321725@gmail.com
4
Department of Orthopaedics, Lady Hardinge Medical college and associated hospitals, New Delhi, India
AUTHOR
Amit
Narang
draminarang@gmail.com
5
Department of Orthopaedics, Lady Hardinge Medical college and associated hospitals, New Delhi, India
AUTHOR
Siddhartha
Sinha
siddharthasinha87@gmail.com
6
Department of Orthopaedics, Lady Hardinge Medical college and associated hospitals, New Delhi, India
AUTHOR
Cummings SR, Rubin SM, Black D. The future of hip fractures in the United States. Numbers, costs, and potential effects of postmenopausal estrogen. Clin Orthop Relat Res. 1990;(252):163-6.
1
Kannus P, Parkkari J, Sievänen H, Heinonen A, Vuori I, Järvinen M. Epidemiology of hip fractures. Bone. 1996;18(1):S57-S63.
2
Heinz T, Vécsei V. Complications and errors in use of the gamma nail. Causes and prevention. Chirurg. 1994;65(11):943-52. [in German]
3
Hesse B, Gächter A. Complications following the treatment of trochanteric fractures with the gamma nail. Arch Orthop Trauma Surg. 2004;124(10):692-8.
4
Lacroix H, Arwert H, Snijders CJ, Fontijne WP. Prevention of fracture at the distal locking site of the gamma nail. A biomechanical study. J Bone Joint Surg Br. 1995;77(2):274-6.
5
Radford PJ, Needoff M, Webb JK. A prospective randomised comparison of the dynamic hip screw and the gamma locking nail. J Bone Joint Surg Br. 1993;75(5):789-93.
6
Skála-Rosenbaum J, Bartonícek J, Bartoska R. Is distal locking with IMHN necessary in every pertrochanteric fracture? Int Orthop. 2010;34(7):1041-7.
7
Li X, Zhang L, Hou Z, Meng Z, Chen W, Wang P, et al. Distal locked and unlocked nailing for perthrochanteric fractures--a prospective comparative randomized study. Int Orthop. 2015;39(8):1645-52.
8
Caiaffa V, Vicenti G, Mori C, Panella A, Conserva V, Corina G, et al. Is distal locking with short intramedullary nails necessary in stable pertrochanteric fractures? A prospective, multicentre, randomised study. Injury. 2016;47 Suppl 4:S98-S106.
9
Lanzetti RM, Caraffa A, Lupariello D, Ceccarini P, Gambaracci G, Meccariello L, et al. Comparison between locked and unlocked intramedullary nails in intertrochanteric fractures. Eur J Orthop Surg Traumatol. 2018;28(4):649-658.
10
Ciaffa V, Vicenti G, Mori CM, Panella A, Conserva V, Corina G, et al. Unlocked versus dynamic and static distal locked femoral nails in stable and unstable intertrochanteric fractures. A prospective study. Injury. 2018;49 Suppl 3:S19-S25.
11
Oremus M, Wolfson C, Perrault A, Demers L, Momoli F, Moride Y. Interrater reliability of the modified Jadad quality scale for systematic reviews of Alzheimer's disease drug trials. Dement Geriatr Cogn Disord. 2001;12(3):232-6.
12
Schipper IB, Steyerberg EW, Castelein RM, van der Heijden FH, den Hoed PT, Kerver AJ, et al. Treatment of unstable trochanteric fractures. Randomised comparison of the gamma nail and the proximal femoral nail. J Bone Joint Surg Br. 2004;86(1):86-94.
13
Robinson CM, Adams CI, Craig M, Doward W, Clarke MC, Auld J. Implant-related fractures of the femur following hip fracture surgery. J Bone Joint Surg Am. 2002;84(7):1116-22.
14
Barry TP. Radiation exposure to an orthopedic surgeon. Clinical orthopaedics and related research. 1984;(182):160-4.
15
Kane P, Vopat B, Paller D, Koruprolu S, Daniels AH, Born C. A biomechanical comparison of locked and unlocked long cephalomedullary nails in a stable intertrochanteric fracture model. J Orthop Trauma. 2014;28(12):715-20.
16
Bong MR, Kummer FJ, Koval KJ, Egol KA. Intramedullary nailing of the lower extremity: biomechanics and biology. J Am Acad Orthop Surg. 2007;15(2):97-106.
17
Skála-Rosenbaum J, Bartoníček J, Bartoška R. Is distal locking with IMHN necessary in every pertrochanteric fracture? International orthopaedics. 2010;34(7):1041-7.
18
Lacroix H, Arwert H, Snijders CJ, Fontijne WP. Prevention of fracture at the distal locking site of the gamma nail. A biomechanical study. J Bone Joint Surg Br. 1995;77(2):274-6.
19
Albareda J, Laderiga A, Palanca D, Paniagua L, Seral F. Complications and technical problems with the gamma nail. Int Orthop. 1996;20(1):47-50.
20
Saarenpää I, Heikkinen T, Jalovaara P. Treatment of subtrochanteric fractures. A comparison of the Gamma nail and the dynamic hip screw: short-term outcome in 58 patients. Int Orthop. 2007;31(1):65-70
21
ORIGINAL_ARTICLE
Factors Affecting the Effectiveness of Hospital Incident Command System; Findings from a Systematic Review
Objective: To examine all aspects affecting the functioning of the system and the most important factors in its assessment through a systematic review during 1990 to 2017. Methods: This systematic review of the current literature study was conducted during July 2017, and all articles, books, guidelines, manuals and dissertations pertaining to the Incident Command System were analyzed. A total of articles and relevant documents were identified and finally these articles, which we found, were analyzed based on the specified indicators. Results: In this research 992 articles and relevant documents were identified and eventually, 48 articles were included and analyzed. The results were categorized into 6 main groups including 65 subgroups and 221 variables: features of hospital incident command system (14 subgroups and 53 variables), strengths of the system (15 subgroups and 70 variables), weaknesses of the system (10 subgroups and 15 variables), factors influencing the system's performance improvement (12 subgroups and 42 variables), factors that reduce the effectiveness of system include 11 subgroups (10 internal factors and 1 external factor) and 22 variables and important factors in assessing system performance (2 sub-groups and 19 variables). Conclusion: According to the results, Evaluating the effectiveness of a hospital accident command system (HICS) in a valid method can improve the efficiency of this system. In this appraisal, hospital managers and health decision-makers should consider principles, characteristics, strengths and weakness of it.
https://beat.sums.ac.ir/article_46445_6a408dc064224821863ec86b14bfa167.pdf
2020-04-01
62
76
10.30476/beat.2020.46445
hospital
Incident Command System
Assessment
effectiveness
Paria
Bahrami
bahramieoc@gmail.com
1
Department of Health in Emergencies and Disasters, School of Public Health, Tehran University of Medical Sciences, Tehran,I.R.IRAN.
AUTHOR
Ali
Ardalan
aardalan@gmail.com
2
Pre-Hospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran
LEAD_AUTHOR
Amir
Nejati
nejati.am@gmail.com
3
1- Department of Emergency Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran 2- Pre-Hospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran
AUTHOR
Abbas
Ostadtaghizadeh
ostadtaghizadeh@gmail.com
4
Department of Health in Emergencies and Disasters, School of Public Health, Tehran University of Medical Sciences, Tehran,I.R.IRAN
AUTHOR
Arezoo
Yari
yariarezoorose@gmail.com
5
Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
AUTHOR
Ayers KJ. Assessing medical first responders' perceptions of disaster preparedness: Deficiencies in collaboration and communication. Ann Arbor: Capella University; 2013.
1
Rafiaian, M. Designing a model for community-based disaster risk management approach Case study durable design (Emergency response volunteer's neighborhoods). Journal of Disaster Management. 2012;1(1):5-12. [in Persian]
2
Akhavan-Moghaddam J, Adibnejad S, Mousavi-Naaeni SM. Introducing Hospital Emergency Incident Command System (HEICS) and HEICS Implementation in Iran Hospitals. Journal of Military Medicine. 2005;7(2):167-75. [in Persian]
3
Esmailzali M. Introducing Hospital Incident Command System and Proposing for Military Hospitals in Iran. Journal of the Army Medical Paramedical School. 2006;1(4). [In Persian]
4
Nekoie-Moghadam M, Kurland L, Moosazadeh M, Ingrassia PL, Della Corte F, Djalali A. Tools and Checklists Used for the Evaluation of Hospital Disaster Preparedness: A Systematic Review. Disaster Med Public Health Prep. 2016;10(5):781-788.
5
Shooshtari S, Tofighi S, Abbasi S. Benefits, barriers, and limitations on the use of Hospital Incident Command System. J Res Med Sci. 2017;22:36.
6
Molino Sr LN. Emergency incident management systems: Fundamentals and applications: John Wiley & Sons; 2006.
7
Authority CEMS, Ballay C. Hospital Incident Command System Guidebook: California Emergency Medical Services Authority; 2014.
8
Schoenthal L. A case study in the identification of critical factors leading to successful implementation of the hospital incident command system. Naval Postgraduate School Monterey CA, 2015.
9
Londorf D. Hospital application of the incident management system. Prehosp Disaster Med. 1995;10(3):184-8.
10
O'Neill PA. The ABC's of disaster response. Scand J Surg. 2005;94(4):259-66.
11
Born CT, Briggs SM, Ciraulo DL, Frykberg ER, Hammond JS, Hirshberg A, et al. Disasters and mass casualties: I. General principles of response and management. J Am Acad Orthop Surg. 2007;15(7):388-96.
12
Rimstad R, Braut GS. Literature review on medical incident command. Prehosp Disaster Med. 2015;30(2):205-15.
13
Tsai MC, Arnold JL, Chuang CC, Chi CH, Liu CC, Yang YJ. Implementation of the Hospital Emergency Incident Command System during an outbreak of severe acute respiratory syndrome (SARS) at a hospital in Taiwan, ROC. J Emerg Med. 2005;28(2):185-96.
14
Jensen J, Thompson S. The Incident Command System: a literature review. Disasters. 2016;40(1):158-82.
15
Fares S, Femino M, Sayah A, Weiner DL, Yim ES, Douthwright S, et al. Health care system hazard vulnerability analysis: an assessment of all public hospitals in Abu Dhabi. Disasters. 2014;38(2):420-33.
16
Briggs SM. Regional interoperability: making systems connect in complex disasters. J Trauma. 2009;67(2 Suppl):S88-90.
17
Shams L, Yarmohammadiyan M, Atighechian G, Haghshenas A. Hospital preparedness for Isfahan university of medical sciences to establish a hospital accident management system. Quarterly Scientific Journal of Rescue and Relief. 2010;2(1):33-42.
18
Morse SS. Disaster preparedness. Health Promotion in Practice. 2006:445.
19
Bajow NA, Alkhalil SM. Evaluation and analysis of hospital disaster preparedness in Jeddah. Health. 2014;6(19):2668.
20
Zaboli R, Sajadi HS. Assessing hospital disaster preparedness in Tehran: Lessons learned on disaster and mass casualty management system. International Journal of Health System and Disaster Management. 2014;2(4):220.
21
Yarmohammadian MH, Atighechian G, Haghshenas A, Shams L. Establishment of Hospital Emergency Incident Command System (HEICS) in Iranian Hospitals: A Necessity for Better Response to Disasters. Iran Red Crescent Med J. 2013;15(12):e3371.
22
Yarmohammadian MH, Atighechian G, Shams L, Haghshenas A. Are hospitals ready to response to disasters? Challenges, opportunities and strategies of Hospital Emergency Incident Command System (HEICS). Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences. 2011;16(8):1070.
23
Vu CH. Lessons learned in emergency preparedness. ICU Director. 2012;3(3):144-8.
24
Fishbane M, Kist A, Schieber RA. Use of the emergency Incident Command System for school-located mass influenza vaccination clinics. Pediatrics. 2012;129Suppl 2:S101-6.
25
Born CT, Monchik KO, Hayda RA, Bosse MJ, Pollak AN. Essentials of disaster management: the role of the orthopaedic surgeon. Instr Course Lect. 2011;60:3-14.
26
Powers R. Organization of a hospital-based victim decontamination plan using the incident command structure. Disaster Manag Response. 2007;5(4):119-23.
27
Adams EH, Scanlon E, Callahan JJ 3rd, Carney MT. Utilization of an incident command system for a public health threat: West Nile virus in Nassau County, New York, 2008. J Public Health Manag Pract. 2010;16(4):309-15.
28
Gulbransen WM. Development of a Mobile Application for Disaster Preparedness and Response for Healthcare Professionals: University of California, Davis; 2017.
29
Kanter RK. Critical Care in Public Health Emergencies. Pediatric Critical Care: Elsevier; 2011. p. 190-5.
30
Rendin RW, Welch NM, Kaplowitz LG. Leveraging bioterrorism preparedness for non-bioterrorism events: a public health example. Biosecur Bioterror. 2005;3(4):309-15.
31
Xu M, Li SX. Analysis of good practice of public health Emergency Operations Centers. Asian Pac J Trop Med. 2015;8(8):677-82.
32
Djalali A, Della Corte F, Segond F, Metzger MH, Gabilly L, Grieger F, et al. TIER competency-based training course for the first receivers of CBRN casualties: a European perspective. Eur J Emerg Med. 2017;24(5):371-376.
33
Powers R. Organization of a hospital-based victim decontamination plan using the incident command structure. Disaster Manag Response. 2007;5(4):119-23.
34
Ukai T. New type of preventable death. Prehospital and disaster medicine. 2005;20(3):202-.
35
Hoffner P, Keck B, Hemphill R, Wells N. Integrating physician response into an academic medical center emergency operations response plan. J Emerg Nurs. 2009;35(4):343-7.
36
Schultz CH, Koenig KL, Noji EK. A medical disaster response to reduce immediate mortality after an earthquake. N Engl J Med. 1996;334(7):438-44.
37
Yantao X. Assessment of hospital emergency management in the Beijing area. Prehosp Disaster Med. 2011;26(3):180-3.
38
Aitken P, Leggat PA, Robertson AG, Harley H, Speare R, Leclercq MG. Leadership and use of standards by Australian disaster medical assistance teams: results of a national survey of team members. Prehosp Disaster Med. 2012;27(2):142-7.
39
Andrew SA, Kendra JM. An adaptive governance approach to disaster-related behavioural health services. Disasters. 2012;36(3):514-32.
40
Autrey P, Moss J. High-reliability teams and situation awareness: implementing a hospital emergency incident command system. J Nurs Adm. 2006;36(2):67-72.
41
Sternberg E. Planning for resilience in hospital internal disaster. Prehosp Disaster Med. 2003;18(4):291-9.
42
Chamberlain AT, Seib K, Wells K, Hannan C, Orenstein WA, Whitney EA, et al. Perspectives of immunization program managers on 2009-10 H1N1 vaccination in the United States: a national survey. Biosecur Bioterror. 2012;10(1):142-50.
43
Rubinson L, Amundson D, Christian MD, Geiling J, Devereaux A. Re-envisioning mass critical care triage as a systemic multitiered process. Chest. 2009;135(4):1108-1109.
44
Buck DA, Trainor JE, Aguirre BE. A critical evaluation of the incident command system and NIMS. Journal of Homeland Security and Emergency Management. 2006;3(3).
45
Andrew SA, Kendra JM. An adaptive governance approach to disaster-related behavioural health services. Disasters. 2012;36(3):514-32.
46
Burkle FM Jr, Hsu EB, Loehr M, Christian MD, Markenson D, Rubinson L, et al. Definition and functions of health unified command and emergency operations centers for large-scale bioevent disasters within the existing ICS. Disaster Med Public Health Prep. 2007;1(2):135-41.
47
Timm NL, Gneuhs M. The pediatric hospital incident command system: an innovative approach to hospital emergency management. J Trauma. 2011;71(5Suppl 2):S549-54..
48
Djalali A, Hosseinijenab V, Peyravi M, Nekoei-Moghadam M, Hosseini B, Schoenthal L, et al. The hospital incident command system: modified model for hospitals in iran. PLoS Curr. 2015;7.
49
Seyedin H, Zaboli R, Ravaghi H. Major incident experience and preparedness in a developing country. Disaster Med Public Health Prep. 2013;7(3):313-8.
50
Thomas TL, Hsu EB, Kim HK, Colli S, Arana G, Green GB. The incident command system in disasters: evaluation methods for a hospital-based exercise. Prehosp Disaster Med. 2005;20(1):14-23.
51
ORIGINAL_ARTICLE
Comparison of Intravenous Regional Anesthesia with Single-Cuff Forearm Tourniquet and Hematoma Block and Traditional Method in Patients with Distal Radius Fractures; A Randomized Clinical Trial
Objective: To investigate the effect of intravenous regional anesthesia with single-cuff forearm tourniquet and hematoma block on intraoperative and postoperative pain intensity of patients with distal radial bone fracture. Methods: In this randomized clinical trial, a total number of 52 patients with distal radius fractures were randomly assigned to receive either a traditional Bier block with 3 mg.kg-1 lidocaine (D group) or a single-cuff forearm tourniquet intravenous regional anesthesia with 1.5 mg.kg-1 lidocaine and a hematoma block with 10 mL 0.5% bupivacaine (S group). Pain intensity score of numerical rating scale (NRS) was measured hourly for 6 hours, then every two hours till 12th hour and every 4 hours until 24th postoperative hour. Total morphine consumption in the first 24 hours after surgery, its side effects and the patients’ global satisfaction were assessed in each group. Results: Mean total morphine consumption during the first 24 hours after surgery was 11.68±7.88 mg in group D and 7.12±4.42 mg in group S (p=0.13). Pain intensity score of NRS both during recovery room and surgical ward stay was less in S group compared to D group (0.016 and 0.02, respectively). Conclusion: Intravenous regional anesthesia with single cuff forearm tourniquet and hematoma block compared to the traditional Bier block reduced intraoperative and postoperative pain intensity more effectively in patients with distal fracture of the radius bone and also reduced morphine consumption during the first 24 hours after surgery. Clinical Trial Registry: IRCT201604223213N4
https://beat.sums.ac.ir/article_46446_d541ee24a435dbaacde722cac0fe2dfc.pdf
2020-04-01
77
82
10.30476/beat.2020.46446
Pain
Postoperative
Anesthesia
Conduction
Arash
Farbood
farboda@sums.ac.ir
1
Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
LEAD_AUTHOR
Saeed
Khademi
saied.khademi@gmail.com
2
Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Ramin
Tajvidi
r.tajvidi@yahoo.com
3
Department of Anesthesiology, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Minoo
Hooshangi
mihooshangi@yahoo.com
4
Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Saeed
Salari
saeedsalari081@gmail.com
5
Department of Anesthesiology, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Mandana
Ghani
mandanaghani.4592@gmail.com
6
Acute pain Service nurse, Chamran Hospital, Shiraz, Iran
AUTHOR
Sakineh
Tahmasebi
mmohamadi48@gmail.com
7
CRNA, Chamran Hospital, Shiraz, Iran
AUTHOR
Hamid
Jamali
hamidmsa1342@gmail.com
8
CRNA, Chamran Hospital, Shiraz, Iran
AUTHOR
Mariano ER, Chu LF, Peinado CR, Mazzei WJ. Anesthesia-controlled time and turnover time for ambulatory upper extremity surgery performed with regional versus general anesthesia. J Clin Anesth. 2009;21(4):253-7.
1
Youssef MM, ElZayyat NS. Lidocaine-nalbuphine versus lidocaine-tramadol for intravenous regional anesthesia. Ain-Shams Journal of Anaesthesiology. 2014;7(2):198.
2
Bansal A, Gupta S, Sood D, Kathuria S, Tewari A. Bier's block using lignocaine and butorphanol. J Anaesthesiol Clin Pharmacol. 2011;27(4):465-9.
3
Marashi SM, Yazdanifard A, Shoeibi G, Bakhshandeh H, Yazdanifard P. The analgesic effect of intravenous neostigmine and transdermal nitroglycerine added to lidocaine on intravenous regional anesthesia (Bier's block): a randomized, controlled study in hand surgery. International Journal of Pharmacology. 2008;4(3):218-22.
4
Rivera JJ, Villecco DJ, Dehner BK, Burkard JF, Osborne LA, Pellegrini JE. The efficacy of ketorolac as an adjunct to the Bier block for controlling postoperative pain following nontraumatic hand and wrist surgery. AANA J. 2008;76(5):341-5.
5
Chan CS, Pun WK, Chan YM, Chow SP. Intravenous regional analgesia with a forearm tourniquet. Can J Anaesth. 1987;34(1):21-5.
6
Singh R, Bhagwat A, Bhadoria P, Kohli A. Forearm IVRA, using 0.5% lidocaine in a dose of 1.5 mg/kg with ketorolac 0.15 mg/kg for hand and wrist surgeries. Minerva Anestesiol. 2010;76(2):109-14.
7
Chiao FB, Chen J, Lesser JB, Resta-Flarer F, Bennett H. Single-cuff forearm tourniquet in intravenous regional anaesthesia results in less pain and fewer sedation requirements than upper arm tourniquet. Br J Anaesth. 2013;111(2):271-5.
8
Perlas A, Peng PW, Plaza MB, Middleton WJ, Chan VW, Sanandaji K. Forearm rescue cuff improves tourniquet tolerance during intravenous regional anesthesia. Reg Anesth Pain Med. 2003;28(2):98-102.
9
Bakri MH, Ismail EA, Abd-Elshafy SK. Analgesic Effect of Nalbuphine When Added to Intravenous Regional Anesthesia: A Randomized Control Trial. Pain Physician. 2016;19(8):575-581.
10
Abdel-Ghaffar HS, Kalefa MA, Imbaby AS. Efficacy of ketamine as an adjunct to lidocaine in intravenous regional anesthesia. Reg Anesth Pain Med. 2014;39(5):418-22.
11
McCartney CJ, Brill S, Rawson R, Sanandaji K, Iagounova A, Chan VW. No anesthetic or analgesic benefit of neostigmine 1 mg added to intravenous regional anesthesia with lidocaine 0.5% for hand surgery. Reg Anesth Pain Med. 2003;28(5):414-7.
12
Sethi D, Wason R. Intravenous regional anesthesia using lidocaine and neostigmine for upper limb surgery. J Clin Anesth. 2010;22(5):324-8.
13
Honarmand A, Safavi M, Adineh-Mehr L. Effect of adding 8 milligrams ondansetron to lidocaine for Bier's block on post-operative pain. Adv Biomed Res. 2013;2:52
14
ORIGINAL_ARTICLE
Relationship between End-Tidal CO2 (ETCO2) and Lactate and their Role in Predicting Hospital Mortality in Critically Ill Trauma Patients; A Cohort Study
Objective: To investigate the relationship between end-tidal CO2 (ETCO2) and serum lactate and their predictive role in hospital mortality of intubated multiple trauma patients. Methods: In a cohort study, intubated multiple trauma patients who referred to the emergency department for two years were enrolled. After orotracheal intubation using Rapid Sequence Intubation (RSI) method, ETCO2 was immediately measured by capnography. Blood samples for serum lactate measurements were sent to the laboratory, immediately after intubation. Data collection was done using the questionnaire, and the patients were followed using their medical records. Results: Totally, 250 patients were included with hospital mortality of 14.8% (n=37). Using Pearson correlation, an inverse relationship was noticed between serum lactate and ETCO2, immediately (p<0.0001, r=-0.65). In adjusted multivariate analysis, three variables including heart rate (HR), serum lactate and ETCO2 showed a significant relationship with hospital mortality, respectively (p=0.007, p=0.009, p=0.023, respectively). Receiver operating characteristic curve illustrated an area under the curve (AUC) of 0.93, 0.96, and 0.97 for HR, lactate, and ETCO2, respectively. Conclusion: ETCO2 post-intubation and serum lactate may be considered as prognostic factors for intubated multiple trauma patients referring to the emergency department, which can give the clinician an important clue in early prediction of the hospital mortality.
https://beat.sums.ac.ir/article_46447_8c3df12740cfc856e4af8e19790744d3.pdf
2020-04-01
83
88
10.30476/beat.2020.46447
Capnography
Hospital mortality
Lactate
Multiple Trauma
Elham
Safari
sssimasafari@gmail.com
1
Department of Emergency Medicine, Kerman University of Medical Sciences, Kerman, Iran
AUTHOR
Mehdi
Torabi
mtorabi1390@yahoo.com
2
Department of Emergency Medicine, Kerman University of Medical Sciences, Kerman, Iran
LEAD_AUTHOR
Saad S, Mohamed N, Moghazy A, Ellabban G, El-Kamash S. Venous glucose, serum lactate and base deficit as biochemical predictors of mortality in patients with polytrauma. Ulus Travma Acil Cerrahi Derg. 2016;22(1):29-33.
1
Stengel D, Mutze S, Güthoff C, Weigeldt M, von Kottwitz K, Runge D, et al. Association of low-dose whole-body computed tomography with missed injury diagnoses and radiation exposure in patients with blunt multiple trauma. JAMA Surg. 2020 Jan 15.
2
Chawda MN, Hildebrand F, Pape HC, Giannoudis PV. Predicting outcome after multiple trauma: which scoring system? Injury. 2004;35(4):347-58.
3
Torabi M, Mazidi Sharaf Abadi F, Baneshi MR. Blood sugar changes and hospital mortality in multiple trauma. Am J Emerg Med. 2018;36(5):816-819.
4
Movahedi A, Mirhafez SR, Behnam-Voshani H, Reihani H, Kavosi A, Ferns GA, et al. A Comparison of the Effect of Interposed Abdominal Compression Cardiopulmonary Resuscitation and Standard Cardiopulmonary Resuscitation Methods on End-tidal CO2 and the Return of Spontaneous Circulation Following Cardiac Arrest: A Clinical Trial. Acad Emerg Med. 2016;23(4):448-54.
5
Dunham CM, Chirichella TJ, Gruber BS, Ferrari JP, Martin JA, Luchs BA, et al. In emergently ventilated trauma patients, low end-tidal CO2 and low cardiac output are associated and correlate with hemodynamic instability, hemorrhage, abnormal pupils, and death. BMC Anesthesiol. 2013;13(1):20.
6
Kartal M, Goksu E, Eray O, Isik S, Sayrac AV, Yigit OE, et al. The value of ETCO2 measurement for COPD patients in the emergency department. Eur J Emerg Med. 2011;18(1):9-12.
7
Cooper CJ, Kraatz JJ, Kubiak DS, Kessel JW, Barnes SL. Utility of Prehospital Quantitative End Tidal CO 2? Prehospital and disaster medicine. 2013;28(2):87-93.
8
Touma O, Davies M. The prognostic value of end tidal carbon dioxide during cardiac arrest: a systematic review. Resuscitation. 2013;84(11):1470-9.
9
Dudaryk R, Bodzin DK, Ray JJ, Jabaley CS, McNeer RR, Epstein RH. Low End-Tidal Carbon Dioxide at the Onset of Emergent Trauma Surgery Is Associated with Nonsurvival: A Case Series. Anesth Analg. 2017;125(4):1261-1266.
10
Kim SH, Kim S, Lee JG, Chung SP, Kim SH. Usefulness of End-tidal Carbon Dioxide as a Predictor of Emergency Intervention in Major Trauma Patients. J Trauma Inj. 2014;27(4):133.
11
Andersen LW, Mackenhauer J, Roberts JC, Berg KM, Cocchi MN, Donnino MW. Etiology and therapeutic approach to elevated lactate levels. Mayo Clin Proc. 2013;88(10):1127-40.
12
Parsikia A, Bones K, Kaplan M, Strain J, Leung PS, Ortiz J, et al. The predictive value of initial serum lactate in trauma patients. Shock. 2014;42(3):199-204.
13
Hunter CL, Silvestri S, Dean M, Falk JL, Papa L. End-tidal carbon dioxide is associated with mortality and lactate in patients with suspected sepsis. Am J Emerg Med. 2013;31(1):64-71.
14
McGillicuddy DC, Tang A, Cataldo L, Gusev J, Shapiro NI. Evaluation of end-tidal carbon dioxide role in predicting elevated SOFA scores and lactic acidosis. Intern Emerg Med. 2009;4(1):41-4.
15
Bursac Z, Gauss CH, Williams DK, Hosmer DW. Purposeful selection of variables in logistic regression. Source Code Biol Med. 2008;3:17.
16
Caputo ND, Fraser RM, Paliga A, Matarlo J, Kanter M, Hosford K, et al. Nasal cannula end-tidal CO2 correlates with serum lactate levels and odds of operative intervention in penetrating trauma patients: a prospective cohort study. J Trauma Acute Care Surg. 2012;73(5):1202-7.
17
Aminiahidashti H, Shafiee S, Zamani Kiasari A, Sazgar M. Applications of End-Tidal Carbon Dioxide (ETCO2) Monitoring in Emergency Department; a Narrative Review. Emerg (Tehran). 2018;6(1):e5.
18
Childress K, Arnold K, Hunter C, Ralls G, Papa L, Silvestri S. Prehospital End-tidal Carbon Dioxide Predicts Mortality in Trauma Patients. Prehosp Emerg Care. 2018;22(2):170-174.
19
Williams DJ, Guirgis FW, Morrissey TK, Wilkerson J, Wears RL, Kalynych C, et al. End-tidal carbon dioxide and occult injury in trauma patients: ETCO(2) does not rule out severe injury. Am J Emerg Med. 2016;34(11):2146-2149.
20
Takahashi CE, Brambrink AM, Aziz MF, Macri E, Raines J, Multani-Kohol A, et al. Association of intraprocedural blood pressure and end tidal carbon dioxide with outcome after acute stroke intervention. Neurocrit Care. 2014;20(2):202-8.
21
Wiryana M, Sinardja I, GedeBudiarta I, Widnyana I, Aryabiantara W. Correlation of End Tidal CO2 (ETCO2) Level with Hyperlactatemia in Patient with Hemodynamic Disturbance. J Anesth Clin Res. 2017;8(741):2.
22
Hunter CL, Silvestri S, Ralls G, Stone A, Walker A, Papa L. A prehospital screening tool utilizing end-tidal carbon dioxide predicts sepsis and severe sepsis. Am J Emerg Med. 2016;34(5):813-9.
23
Baxter J, Cranfield KR, Clark G, Harris T, Bloom B, Gray AJ. Do lactate levels in the emergency department predict outcome in adult trauma patients? A systematic review. J Trauma Acute Care Surg. 2016;81(3):555-66.
24
Jo S, Lee JB, Jin YH, Jeong T, Yoon J, Choi SJ, et al. Comparison of the trauma and injury severity score and modified early warning score with rapid lactate level (the ViEWS-L score) in blunt trauma patients. Eur J Emerg Med. 2014;21(3):199-205.
25
Saad S, Mohamed N, Moghazy A, Ellabban G, El-Kamash S. Venous glucose, serum lactate and base deficit as biochemical predictors of mortality in patients with polytrauma. Ulus Travma Acil Cerrahi Derg. 2016;22(1):29-33.
26
Guyette F, Suffoletto B, Castillo JL, Quintero J, Callaway C, Puyana JC. Prehospital serum lactate as a predictor of outcomes in trauma patients: a retrospective observational study. J Trauma. 2011;70(4):782-6.
27
Stone ME Jr, Kalata S, Liveris A, Adorno Z, Yellin S, Chao E, et al. End-tidal CO2 on admission is associated with hemorrhagic shock and predicts the need for massive transfusion as defined by the critical administration threshold: A pilot study. Injury. 2017;48(1):51-57.
28
ORIGINAL_ARTICLE
Functional Outcome of Surgical versus Conservative Therapy in Patients with Traumatic Thoracolumbar Fractures and Thoracolumbar Injury Classification and Severity Score of 4; A Non-randomized Clinical Trial
Objective: To compare the effectiveness of surgical intervention to conservative treatment in patients with thoracolumbar fracture and thoracolumbar injury classification and severity score (TLICS) of 4. Methods: Twenty-five patients with TLICS 4 were enrolled in this non-randomized clinical trial. Based on clinical symptoms and radiologic findings, patients were considered under surgical or conservative treatments. The JOA Back Pain Evaluation Questionnaire (JOABPEQ) was assessed at baseline and at 3, 6, 12 months after treatment. A 20-point improvement from the baseline JOABPEQ scores was considered as clinical success in both the conservative and surgery groups. Additionally, residual canal, angulations and height loss were determined in all patients. Results: Eight patients received conservative and 17 surgical treatment. Both study groups were comparable regarding the baseline characteristics. Both study demonstrated treatment success, regarding functional recovery when compared to baseline (p<0.001). However, those undergoing surgical intervention had significantly better JOABPEQ score (p<0.001) and higher residual canal (p=0.042) when compared to those receiving conservative therapy. The success rate of treatment was comparable between the two study groups in 6- (p=0.998) and 12-month (p=0.852) intervals; however, surgical therapy had significantly higher success arte in 3-month interval (p=0.031). Conclusion: Our findings revealed that surgical treatment was preferred more in comparison to conservative treatment in patients with TLICS 4. Additionally, residual canal might be a modifying factor to decide the ideal therapeutic approach. Clinical Trial Registry: IRCT2017010920258N25
https://beat.sums.ac.ir/article_46448_3e03882676d7926fbcc01192bdc3afa3.pdf
2020-04-01
89
97
10.30476/beat.2020.46448
Thoracolumbar fracture
Classification score
JOABPEQ
Residual canal
Thoracolumbar Injury Classification and Severity (TLICS)
Mohsen
Koosha
1
Department of Neurosurgery, NHF hospital, Qom University of Medical Sciences, Qom, Iran
AUTHOR
Hossein
Nayeb Aghaei
2
Department of Neurosurgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
AUTHOR
Hamid Reza
Khayat Kashani
3
Department of Neurosurgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
AUTHOR
Sepideh
Paybast
sepideh.paybast@yahoo.com
4
Department of Neurology, Bou Ali Sina Hospital, Qazvin University of Medical Sciences, Qazvin, Iran
LEAD_AUTHOR
Schroeder GD, Harrop JS, Vaccaro AR. Thoracolumbar trauma classification. Neurosurgery Clinics. 2017;28(1):23-9.
1
Heary RF, Kumar S. Decision-making in burst fractures of the thoracolumbar and lumbar spine. Indian J Orthop. 2007;41(4):268-76.
2
Holdsworth F. Fractures, dislocations, and fracture-dislocations of the spine. The Journal of Bone and Joint Surgery British Volume. 1963;45(1):6-20.
3
Denis F. The three column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine (Phila Pa 1976). 1983;8(8):817-31.
4
Khurana B, Sheehan SE, Sodickson A, Bono CM, Harris MB. Traumatic thoracolumbar spine injuries: what the spine surgeon wants to know. Radiographics. 2013;33(7):2031-46.
5
Joaquim AF, Fernandes YB, Cavalcante RA, Fragoso RM, Honorato DC, Patel AA. Evaluation of the thoracolumbar injury classification system in thoracic and lumbar spinal trauma. Spine (Phila Pa 1976). 2011;36(1):33-6.
6
Sethi MK, Schoenfeld AJ, Bono CM, Harris MB. The evolution of thoracolumbar injury classification systems. Spine J. 2009;9(9):780-8.
7
Rihn JA, Anderson DT, Harris E, Lawrence J, Jonsson H, Wilsey J, et al. A review of the TLICS system: a novel, user-friendly thoracolumbar trauma classification system. Acta Orthop. 2008;79(4):461-6.
8
Vaccaro AR, Baron EM, Sanfilippo J, Jacoby S, Steuve J, Grossman E, et al. Reliability of a novel classification system for thoracolumbar injuries: the Thoracolumbar Injury Severity Score. Spine (Phila Pa 1976). 2006;31(11 Suppl):S62-9; discussion S104.
9
Vaccaro AR, Lehman RA Jr, Hurlbert RJ, Anderson PA, Harris M, Hedlund R, et al. A new classification of thoracolumbar injuries: the importance of injury morphology, the integrity of the posterior ligamentous complex, and neurologic status. Spine (Phila Pa 1976). 2005;30(20):2325-33.
10
Dhall SS, Wadhwa R, Wang MY, Tien-Smith A, Mummaneni PV. Traumatic thoracolumbar spinal injury: an algorithm for minimally invasive surgical management. Neurosurg Focus. 2014;37(1):E9.
11
Fukui M, Chiba K, Kawakami M, Kikuchi S, Konno S, Miyamoto M, et al. The report on the development of revised versions. April 16, 2007. The Subcommittee of the Clinical Outcome Committee of the Japanese Orthopaedic Association on Low Back Pain and Cervical Myelopathy Evaluation. J Orthop Sci. 2009;14(3):348-65.
12
Hitchon PW, He W, Viljoen S, Dahdaleh NS, Kumar R, Noeller J, et al. Predictors of outcome in the non-operative management of thoracolumbar and lumbar burst fractures. Br J Neurosurg. 2014;28(5):653-7.
13
In: Radiology Assistant. West C, Roosendaal S, Bot J, Smithuis F. Spine injury - TLICS Classification Thoraco-Lumbar Injury Classification and Severity score [Internet]. Delaware Valley; Thomas Jefferson University Hospital, 2015. Accessed: [May 1, 2015]. Available from: http://www.radiologyassistant.nl/en/p54885e620ee46/spine-injury-tlics-classification.html.
14
Azhari S, Azimi P, Shahzadi S, Mohammadi HR, Khayat Kashani HR. Decision-Making Process in Patients with Thoracolumbar and Lumbar Burst Fractures with Thoracolumbar Injury Severity and Classification Score Less than Four. Asian Spine J. 2016;10(1):136-42.
15
Mohamadi A, Googanian A, Ahmadi A, Kamali A. Comparison of surgical or nonsurgical treatment outcomes in patients with thoracolumbar fracture with Score 4 of TLICS: A randomized, single-blind, and single-central clinical trial. Medicine (Baltimore). 2018;97(6):e9842.
16
Nataraj A, Jack AS, Ihsanullah I, Nomani S, Kortbeek F, Fox R. Outcomes in Thoracolumbar Burst Fractures with a Thoracolumbar Injury Classification Score (TLICS) of 4 Treated with Surgery Versus Initial Conservative Management. Clin Spine Surg. 2018;31(6):E317-E321.
17
van der Roer N, de Lange ES, Bakker FC, de Vet HC, van Tulder MW. Management of traumatic thoracolumbar fractures: a systematic review of the literature. Eur Spine J. 2005;14(6):527-34.
18
Wood KB, Buttermann GR, Phukan R, Harrod CC, Mehbod A, Shannon B, et al. Operative compared with nonoperative treatment of a thoracolumbar burst fracture without neurological deficit: a prospective randomized study with follow-up at sixteen to twenty-two years. J Bone Joint Surg Am. 2015;97(1):3-9.
19
Elshahidi MH, Monir NY, Elzhery MA, Sharaqi AA, Haedaya H, Awad BI, et al. Epidemiological Characteristics of Traumatic Spinal Cord Injury (TSCI) in the Middle-East and North-Africa (MENA) Region: A Systematic Review and Meta-Analysis. Bull Emerg Trauma. 2018;6(2):75-89.
20
Azarhomayoun A, Aghasi M, Mousavi N, Shokraneh F, Vaccaro AR, Haj Mirzaian A, et al. Mortality Rate and Predicting Factors of Traumatic Thoracolumbar Spinal Cord Injury; A Systematic Review and Meta-Analysis. Bull Emerg Trauma. 2018;6(3):181-194.
21
Masoudi MS, Haghnegahdar A, Ghaffarpasand F, Ilami G. Functional Recovery Following Early Kyphoplasty Versus Conservative Management in Stable Thoracuolumbar Fractures in Parachute Jumpers: A Randomized Clinical Trial. Clin Spine Surg. 2017;30(8):E1066-E1073.
22
ORIGINAL_ARTICLE
Developing Pedestrians’ Red-light Violation Behavior Questionnaire (PRVBQ); Assessment of Content Validity and Reliability
Objective: To develop a self-completion pedestrians’ red-light violation behavior questionnaire (PRVBQ) based on the theory of planned behavior (TPB) and assess the content validity and reliability. Methods: This study was conducted in three phases of (i) PRVBQ development study; (ii) Content validity study including face validity; and (iii) Reliability assessment. The directed content analysis method was used for the analysis of the qualitative interviews. The item impact score was used for face validity. Content validity index (CVI) in the item level and average scale level, and content validity ratio (CVR) were determined. Intra-class Correlation Coefficient (ICC), and Cronbach’s alpha was assessed for test-retest reliability and internal consistency respectively. Results: Draft questionnaire including 86 items was constructed. Sixteen items were eliminated due to low face and content validity, remaining 70 items in total. The PRVBQ was rated as having good content validity (individual items CVI ranged from .80 to 1, and overall PRVBQ CVI-Average=0.95, p=0.05). The direct measures (reflective indicators) showed excellent internal consistency with Cronbach’s alpha=0.9. All items showed excellent agreement. Conclusion: This study using a comprehensive process of development and assessment of content validity and reliability developed a content valid and reliable questionnaire predicting pedestrians’ red light violation behavior.
https://beat.sums.ac.ir/article_46449_636bb3e88f0d6f924c6e5f892c959736.pdf
2020-04-01
98
106
10.30476/beat.2020.46449
Pedestrian red-light violation behavior questionnaire
Validity
reliability
Mahdi
Moshki
drmoshki@gmail.com
1
Health Education and Health Promotion Department, School of Health; Social Development & Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
AUTHOR
Abdoljavad
Khajavi
abjkhajavi@yahoo.com
2
Community Medicine Department, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
AUTHOR
Homayoun
Sadeghi-Bazargani
homayoun.sadeghi@gmail.com
3
Road Traffic Injury Research Center, Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran.
AUTHOR
Shahram
Vahedi
vahedi117@yahoo.com
4
Faculty of Education and Psychology, University of Tabriz, Tabriz, Iran
AUTHOR
Saeid
Pour-Doulati
s.pourdoulati@gmail.com
5
Social Development &amp; Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.
LEAD_AUTHOR
Kouabenan DR, Guyot J-M. Study of the causes of pedestrian accidents by severity. Journal of Psychology in Africa. 2004;14(2):119-26.
1
World Health Organization. Pedestrian safety: a road safety manual for decision-makers and practitioners. 2013.
2
Xu Y, Li Y, Zhang F. Pedestrians' intention to jaywalk: Automatic or planned? A study based on a dual-process model in China. Accid Anal Prev. 2013;50:811-9.
3
Ajzen I. From intentions to actions: A theory of planned behavior. Action control: Springer; 1985. p. 11-39.
4
Ajzen I. The theory of planned behavior. Organizational behavior and human decision processes. 1991;50(2):179-211.
5
Ajzen I. The social psychology of decision making. Social psychology: Handbook of basic principles; 1996 p. 297-325.
6
Ajzen H, Fishbein M. Understanding attitudes and predicting social behavior. 1980.
7
Barrero LH, Quintana LA, Sánchez A, Forero A, Quiroga J, Felknor S. Pedestrians' beliefs about road crossing in Bogota: questionnaire development. Universitas Psychologica. 2013;12(2):433-44.
8
Evans D, Norman P. Predicting adolescent pedestrians' road-crossing intentions: an application and extension of the Theory of Planned Behaviour. Health Educ Res. 2003;18(3):267-77.
9
Holland C, Hill R. The effect of age, gender and driver status on pedestrians' intentions to cross the road in risky situations. Accid Anal Prev. 2007;39(2):224-37.
10
Suo Q, Zhang D. Psychological Differences toward Pedestrian Red Light Crossing between University Students and Their Peers. PLoS One. 2016;11(1):e0148000.
11
Zhou H, Romero SB, Qin X. An extension of the theory of planned behavior to predict pedestrians' violating crossing behavior using structural equation modeling. Accid Anal Prev. 2016;95(Pt B):417-424.
12
Zhou R, Horrey WJ. Predicting adolescent pedestrians’ behavioral intentions to follow the masses in risky crossing situations. Transportation research part F: traffic psychology and behaviour. 2010;13(3):153-63.
13
Zhou R, Horrey WJ, Yu R. The effect of conformity tendency on pedestrians' road-crossing intentions in China: an application of the theory of planned behavior. Accid Anal Prev. 2009;41(3):491-7.
14
Francis J, Eccles MP, Johnston M, Walker A, Grimshaw JM, Foy R, et al. Constructing questionnaires based on the theory of planned behaviour: A manual for health services researchers. Centre for Health Services Research, University of Newcastle upon Tyne; 2004.
15
Fishbein M, Ajzen I. Predicting and changing behavior: The reasoned action approach: Psychology press; 2011.
16
Carmines EG, Zeller RA. Reliability and validity assessment: Sage publications; 1979.
17
Polit DF, Beck CT, Owen SV. Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Res Nurs Health. 2007;30(4):459-67.
18
Zamanzadeh V, Rassouli M, Abbaszadeh A, Majd HA, Nikanfar A, Ghahramanian A. Details of content validity and objectifying it in instrument development. Nursing Practice Today. 2014;1(3):163-71.
19
Moshki M, Khajavi A, Doshmangir L, Pour Doulati S. Red light violation and pedestrians' modal salient beliefs about unsafe road crossing behavior: a qualitative study. J Inj Violence Res. 2019;11(2):189-202.
20
Ajzen I. Constructing a TPB questionnaire: Conceptual and methodological considerations. 2002.
21
Lacasse Y, Godbout C, Sériès F. Health-related quality of life in obstructive sleep apnoea. Eur Respir J. 2002;19(3):499-503.
22
Waltz CF, Bausell BR. Nursing research: design statistics and computer analysis: Davis FA; 1981.
23
Zamanzadeh V, Ghahramanian A, Rassouli M, Abbaszadeh A, Alavi-Majd H, Nikanfar AR. Design and Implementation Content Validity Study: Development of an instrument for measuring Patient-Centered Communication. J Caring Sci. 2015;4(2):165-78.
24
Lynn MR. Determination and quantification of content validity. Nursing research. 1986.
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Cicchetti DV. Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychological assessment. 1994;6(4):284.
26
Cicchetti DV, Sparrow SA. Developing criteria for establishing interrater reliability of specific items: applications to assessment of adaptive behavior. Am J Ment Defic. 1981;86(2):127-37.
27
Fleiss JL, Levin B, Paik MC. Statistical methods for rates and proportions: john wiley & sons; 2013.
28
Henson RK. Understanding internal consistency reliability estimates: A conceptual primer on coefficient alpha. Measurement and evaluation in counseling and development. 2001;34(3):177-89.
29
Streiner DL. Starting at the beginning: an introduction to coefficient alpha and internal consistency. J Pers Assess. 2003;80(1):99-103.
30
DeVon HA, Block ME, Moyle-Wright P, Ernst DM, Hayden SJ, Lazzara DJ, et al. A psychometric toolbox for testing validity and reliability. J Nurs Scholarsh. 2007;39(2):155-64.
31
Hashemiparast M, Montazeri A, Nedjat S, Negarandeh R, Sadeghi R, Garmaroudi G. Pedestrian road crossing behavior (PEROB): Development and psychometric evaluation. Traffic Inj Prev. 2017;18(3):281-285.
32
ORIGINAL_ARTICLE
Higher Risk of Mortality in Intentional Traumatic Injuries; A Multivariate Regression Analysis of a Trauma Registry
Objectives: To assess whether intentional traumatic injuries are associated with higher mortality rate when compared to unintentional injuries. Methods: Data from SweTrau (Swedish National Trauma Registry). Information regarding age, gender, injury severity score (ISS), new injury severity score (NISS), Glasgow coma scale (GCS), systolic blood pressure, and respiratory rate were collected via “SweTrau”. “Mortality within 30 days of injury” was defined as having been registered as dead within 30 days following the injury. Intentional injuries compared to non-intentional injuries. Multivariate regression analysis was conducted. Stepwise forward and backward regression was conducted. Results: A total number of 3875 patients were included. There were 3613 (93%) non-intentional and 262 (7%) intentional patients. The 30-day mortality rate was higher in the intentional group compared to non-intentional group, 10% vs. 4% (p<0.001). Patients in the intentional group were younger than the non-intentional group, at 39±18 vs. 47±21 years old (p<0.001). In both, the forward and backward tests injury intention remained statistically significant with OR 2 (CI 1.1-3.7). Shock (OR 4.7, CI 2.9-7.8), Severe Head Injury (OR 8.9, CI 5.3-14.7), Age ≥ 60 (OR 6.7, CI 4.1-10.8), ISS ≥16 (OR 10.8, CI 6.9-16.9) and ASA (OR 3.5, CI 2.2-5.7) were other factors affecting mortality. Conclusion: Injury intention was an independent factor contributing to mortality in our study. This particular cohort needs further attention during trauma management with a holistic insight to improve their survival.
https://beat.sums.ac.ir/article_46450_97ac64d7911370be79087444ac22ba2c.pdf
2020-04-01
107
110
10.30476/beat.2020.46450
Injury
Intentional
Trauma
Mortality
Survival
Sait
Saif
1
Imperial College Health Care, St Mary´s Hospital, London UK
AUTHOR
Yahya
Ibrahim
2
Imperial College Health Care, St Mary´s Hospital, London UK
AUTHOR
Peyman
Bakhshayesh
peyman.bakhshayesh@ki.se
3
Karolinska Institute, Department of Molecular Medicine and Surgery, Imperial College Health Care, St Mary´s Hospital, London UK
LEAD_AUTHOR
Heron M, Hoyert D, Murphy S, Xu J, Kochanek K, Tejada-Vera B. Deaths: Final data for 2006 (National Vital Statistics Reports; Vol. 57, No. 14). Hyattsville, MD: National Center for Health Statistics. 2009.
1
In: Eurostat Statistics Explain. Intentional injury Mortality. [Accessed: 2019]. Available from: https://ec.europa.eu/eurostat/web/health/causes-death.
2
Rhee P, Joseph B, Pandit V, Aziz H, Vercruysse G, Kulvatunyou N, et al. Increasing trauma deaths in the United States. Ann Surg. 2014;260(1):13-21.
3
Kunitake RC, Kornblith LZ, Cohen MJ, Callcut RA. Trauma Early Mortality Prediction Tool (TEMPT) for assessing 28-day mortality. Trauma Surg Acute Care Open. 2018;3(1):e000131.
4
Champion HR, Sacco WJ, Copes WS, Gann DS, Gennarelli TA, Flanagan ME. A revision of the Trauma Score. The Journal of trauma. 1989;29(5):623-9.
5
Champion HR, Sacco WJ, Hunt TK. Trauma severity scoring to predict mortality. World J Surg. 1983;7(1):4-11.
6
Palmer CS, Gabbe BJ, Cameron PA. Defining major trauma using the 2008 Abbreviated Injury Scale. Injury. 2016;47(1):109-15.
7
Rhee P, Joseph B, Pandit V, Aziz H, Vercruysse G, Kulvatunyou N, et al. Increasing trauma deaths in the United States. Ann Surg. 2014;260(1):13-21.
8
Ringdal KG, Coats TJ, Lefering R, Di Bartolomeo S, Steen PA, Røise O, et al. The Utstein template for uniform reporting of data following major trauma: a joint revision by SCANTEM, TARN, DGU-TR and RITG. Scand J Trauma Resusc Emerg Med. 2008;16:7.
9
Bakhshayesh P, Weidenhielm L, Enocson A. Factors affecting mortality and reoperations in high-energy pelvic fractures. Eur J Orthop Surg Traumatol. 2018;28(7):1273-82.
10
Gabbe BJ, de Steiger R, Esser M, Bucknill A, Russ MK, Cameron PA. Predictors of mortality following severe pelvic ring fracture: results of a population-based study. Injury. 2011;42(10):985-91.
11
Haider AH, Young JH, Kisat M, Villegas CV, Scott VK, Ladha KS, et al. Association between intentional injury and long-term survival after trauma. Ann Surg. 2014;259(5):985-92.
12
Brooke BS, Efron DT, Chang DC, Haut ER, Cornwell EE 3rd. Patterns and outcomes among penetrating trauma recidivists: it only gets worse. J Trauma. 2006;61(1):16-9; discussion 20.
13
Smith RS, Fry WR, Morabito DJ, Organ CH Jr. Recidivism in an urban trauma center. Arch Surg. 1992;127(6):668-70.
14
Buss TF, Abdu R. Repeat victims of violence in an urban trauma center. Violence Vict. 1995;10(3):183-94.
15
Cooper C, Eslinger D, Nash D, al-Zawahri J, Stolley P. Repeat victims of violence: report of a large concurrent case-control study. Arch Surg. 2000;135(7):837-43.
16
Steele IH, Thrower N, Noroian P, Saleh FM. Understanding Suicide Across the Lifespan: A United States Perspective of Suicide Risk Factors, Assessment & Management. J Forensic Sci. 2018;63(1):162-171.
17
Ohrnberger J, Fichera E, Sutton M. The relationship between physical and mental health: A mediation analysis. Soc Sci Med. 2017;195:42-49.
18
Wiseman T, Foster K, Curtis K. Mental health following traumatic physical injury: an integrative literature review. Injury. 2013;44(11):1383-90.
19
O'Donnell ML, Creamer M, Elliott P, Bryant R, McFarlane A, Silove D. Prior trauma and psychiatric history as risk factors for intentional and unintentional injury in Australia. J Trauma. 2009;66(2):470-6.
20
ORIGINAL_ARTICLE
Diagnostic Accuracy of Physical Examination and History Taking in Traumatic Rib Fracture; A Single Center Experience
Objective: To evaluate the diagnostic accuracy of history taking and physical examination in the patients with traumatic rib fractures. Methods: In a cross-sectional study, all patients with multiple traumas who referred to the emergency department were evaluated for the mechanism of injury, chief complaints, vital signs and oxygen saturation. History taking and physical examination were performed according to Barbara Bates reference. Fracture was diagnosed based on chest x-ray results and CT scan, if needed. The results were analyzed by receiver operating characteristic (ROC) curves and area under the curve (AUC) analysis. Results: Isolated rib fractures of thoracic bones were found in 8 out of 99 subjects with mean age of 33.4±19.43 years. In the sensitivity analysis of history taking and physical exam tests, the highest sensitivity was chest tenderness and deformity with 100% sensitivity for each one and the lowest was for the dyspnea with 28.10%; however, the highest sensitivity was for dyspnea with 62.50% sensitivity; and pulmonary hearing aid and chest deformity were not specific (0%). For heart rate, AUC analysis was significant. Heart rate above 80/min was associated with 87.5% sensitivity and 62.5% specificity for rib fractures. Conclusion: Proper and physical examination and history taking can help to detect rib fractures with high sensitivity and specificity denoting to the importance of the issue; while, radiographic or surgical approval is required to diagnose rib fractures.
https://beat.sums.ac.ir/article_46451_44f7d2c2e057eee76344e51c18328ac2.pdf
2020-04-01
111
114
10.30476/beat.2020.46451
Physical examination
Rib fracture
Sensitivity
Specificity
Navid
Kalani
navidkalani@ymail.com
1
Anesthesiology, Critical Care and Pain Management Research Center, Jahrom University of Medical Sciences, Jahrom, Iran; Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
AUTHOR
Seyed Reza
Habibzade
habibzadehr@mums.ac.ir
2
Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical sciences, Mashhad, Iran.
AUTHOR
Roya
Ghahremaninezhad
ghahremaninezhadroya@yahoo.com
3
Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical sciences, Mashhad, Iran.
AUTHOR
Ayoub
Tavakolian
ayoubtavakolian@gmail.com
4
Department of Emergency Medicine, Sabzevar University of Medical sciences, Sabzevar, Iran.
AUTHOR
Naser
Hatami
naserohatami@gmail.com
5
Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran.
AUTHOR
Saeed
Barazandeh pour
saeedbarazandehpour@gmail.com
6
Department of Emergency Medicine, Kerman University of Medical Sciences, Kerman, Iran
AUTHOR
Samaneh
Abiri
samaneh.abiri@gmail.com
7
Department of Emergency Medicine, Jahrom University of Medical sciences, Jahrom, Iran.
LEAD_AUTHOR
Ebrahimi M, Vaziri M, Pishbin E, Reihani H, Akhavan R, Dost ER, et al. Comparison of Diagnostic Value of Clinical Examination and Routine Radiography in Diagnosis of Chest Injury in Stable Blunt Trauma Patients. Journal of Research in Medical and Dental Science. 2019;7(1):88-91.
1
Bakirbaevich YK, Toktosunovich YI, Muktarovich KK. Analysis of mortality cases from concomitant injuries: extracranial injuries combined with craniocerebral injuries. European journal of biomedical and life sciences. 2018(3).
2
Ngahane BHM, Kamdem F, Njonnou SRS, Chebou N, Dzudie A, Ebongue SA, et al. Epidemiology, Clinical and Paraclinical Presentations of Pulmonary Embolism: A Cross-Sectional Study in a Sub-Saharan Africa Setting. Open Journal of Respiratory Diseases. 2019;9(03):89.
3
Schulz-Drost S, Grupp S, Pachowsky M, Oppel P, Krinner S, Mauerer A, et al. Stabilization of flail chest injuries: minimized approach techniques to treat the core of instability. Eur J Trauma Emerg Surg. 2017;43(2):169-178.
4
Hasenboehler EA, Sultan S, Shaefer G, To KB, Fox AD, Ditillo M,et al. Pain management for blunt thoracic trauma: A joint practice management guideline from the Eastern Association for the Surgery of Trauma and Trauma Anesthesiol.
5
Ingoe HM, Eardley W, McDaid C, Rangan A, Lawrence T, Hewitt C. Epidemiology of adult rib fracture and factors associated with surgical fixation: Analysis of a chest wall injury dataset from England and Wales. Injury. 2020;51(2):218-223.
6
Rostas JW, Lively TB, Brevard SB, Simmons JD, Frotan MA, Gonzalez RP. Rib fractures and their association with solid organ injury: higher rib fractures have greater significance for solid organ injury screening. Am J Surg. 2017;213(4):791-797.
7
Lin FC, Li RY, Tung YW, Jeng KC, Tsai SC. Morbidity, mortality, associated injuries, and management of traumatic rib fractures. J Chin Med Assoc. 2016;79(6):329-34.
8
Prabhu FR, Bickley LS. Case Studies to Accompany Bates' Guide to Physical Examination and History Taking: Lippincott Williams & Wilkins Philadelphia; 2007.
9
Mutze S, Rademacher G, Matthes G, Hosten N, Stengel D. Blunt cerebrovascular injury in patients with blunt multiple trauma: diagnostic accuracy of duplex Doppler US and early CT angiography. Radiology. 2005;237(3):884-92.
10
Bokhari F, Brakenridge S, Nagy K, Roberts R, Smith R, Joseph K, et al. Prospective evaluation of the sensitivity of physical examination in chest trauma. J Trauma. 2002;53(6):1135-8.
11
van Haarst EP, van Bezooijen BP, Coene PP, Luitse JS. The efficacy of serial physical examination in penetrating abdominal trauma. Injury. 1999;30(9):599-604.
12
Liman ST, Kuzucu A, Tastepe AI, Ulasan GN, Topcu S. Chest injury due to blunt trauma. Eur J Cardiothorac Surg. 2003;23(3):374-8.
13
Stern T, Wolf RY, Reichart B, Harrington OB, Crosby VG. Coronary artery occlusion resulting from blunt trauma. JAMA. 1974;230(9):1308-9.
14
Ahmed Z, Mohyuddin Z. Management of flail chest injury: internal fixation versus endotracheal intubation and ventilation. J Thorac Cardiovasc Surg. 1995;110(6):1676-80.
15
Assi AA, Nazal Y. Rib fracture: Different radiographic projections. Pol J Radiol. 2012;77(4):13-6.
16
Sirmali M, Türüt H, Topçu S, Gülhan E, Yazici U, Kaya S, Taştepe I. A comprehensive analysis of traumatic rib fractures: morbidity, mortality and management. Eur J Cardiothorac Surg. 2003;24(1):133-8.
17
Zuidema GD, Rutherford RB, Ballinger WF. The management of trauma: WB Saunders Company; 1985.
18
ORIGINAL_ARTICLE
Accuracy of the Emergency Department Triage System using the Emergency Severity Index for Predicting Patient Outcome; A Single Center Experience
Objective: To evaluate the accuracy of the five-level triage system using the emergency severity index (ESI) and to determine the compliance of the triage level with patient outcomes. Methods: This was a cross-sectional study which was performed in the emergency department of Imam Reza Hospital of Mashhad during 2017. We included all the adult patients (≥15 years of age) referring to the emergency department. The data were recorded in a questionnaire containing three sections including demographic information, results of triage by ESI and final outcome of the patient. Patients referred to the triage unit were simultaneously triaged by triage nurse and some emergency medicine physicians. The triage was performed by a nurse with an emergency medicine physician (EMP) was considered as a gold standard and the outcome was compared in 24 hours later. Results: Overall, we included 400 patients with a mean age of 46.40 ± 18.52 years among whom there were 211 (52.8%) men and 189 (47.3%) women. Finally, 123 patients were hospitalized, 12 died, 256 were discharged by a physician, and 9 people left the hospital with their own consent. The calculated weight kappa was used to determine the agreement between the observers (nurse triage and physician) at 0.701 so that the agreement between the triage performed by a nurse and an EMP was in an excellent level (p<0.001). There was a significant relationship between the triage levels (determined by physicians) and the outcome of the patient (p<0.001), and the five-level system had a high overlap and significant relation with patient's outcome. Conclusion: The results of the current study revealed that the five-level triage system using the ESI has a high accuracy in triage and estimates the patient outcomes effectively and thus, could be used as an effective system in hospital triage.
https://beat.sums.ac.ir/article_46452_b8d6d397999f8e1ee6bf4a4a48f5623e.pdf
2020-04-01
115
120
10.30476/beat.2020.46452
Triage
Emergency Severity index (ESI)
Patient outcome
Raheleh
Ganjali
ganjalir2@mums.ac.ir
1
Medical Informatics, Department of medical informatics, Faculty Of Medicine , Mashhad University of Medical Sciences, Mashhad, Iran
AUTHOR
Reza
Golmakani
golmakanir1@mums.ac.ir
2
Department of Emergency Medicine, Doctor Shariati Hospital, Mashhad University of Medical Sciences, Mashhad, Iran,
AUTHOR
Mohsen
Ebrahimi
ebrahimimh3@mums.ac.ir
3
Department Of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran,
AUTHOR
Saeid
Eslami
eslamis@mums.ac.ir
4
Pharmaceutical Research Centre, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran, Pharmaceutical Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran, Department of Medical Informatics University
AUTHOR
Ehsan
Bolvardi
bolvardie@mums.ac.ir
5
Department of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
LEAD_AUTHOR
1. Bazm A, Khorasani E, Etemadi M, Nadeali H. Improving Five-level Triage Form According to the Experts Viewpoint; A Qualitative Study. Bull Emerg Trauma. 2015;3(1):16-21.
1
2. Ghafarypour-Jahrom M, Taghizadeh M, Heidari K, Derakhshanfar H. Validity and Reliability of the Emergency Severity Index and Australasian Triage System in Pediatric Emergency Care of Mofid Children's Hospital in Iran. Bull Emerg Trauma. 2018;6(4):329-33.
2
3. Daemi A. The Role of Electronic Triage System in Management of Hospital Emergency Department. Bull Emerg Trauma. 2016;4(1):62-3.
3
4. Hinson JS, Martinez DA, Schmitz PSK, Toerper M, Radu D, Scheulen J, et al. Accuracy of emergency department triage using the Emergency Severity Index and independent predictors of under-triage and over-triage in Brazil: a retrospective cohort analysis. Int J Emerg Med. 2018;11(1):3.
4
5. Pourasghar F, Daemi A, Tabrizi JS, Ala A. Inter-rater Reliability of Triages Performed by the Electronic Triage System. Bull Emerg Trauma. 2015;3(4):134-7.
5
6. Pourasghar F, Tabrizi JS, Ala A, Daemi A. Validity of the Electronic Triage System in Predicting Patient Outcomes in Tabriz, Iran: A Cross-Sectional Study. Bull Emerg Trauma. 2016;4(4):211-5.
6
7. Trinder MW, Wellman SW, Nasim S, Weber DG. Evaluation of the trauma triage accuracy in a Level 1 Australian trauma centre. Emerg Med Australas. 2018;30(5):699-704.
7
8. Varshney K, Mallows J, Hamd M. Disaster triage tags: is one better than another? Emerg Med Australas. 2012;24(2):187-93.
8
9. Stobbe K, Dewar D, Thornton C, Duchaine S, Tremblay PM, Howe D. Canadian Emergency Department Triage and Acuity Scale (CTAS): Rural Implementation Statement. Cjem. 2003;5(2):104-7.
9
10. Gilboy N, Tanabe T, Travers D, Rosenau AMJR, MD: Agency for Healthcare Research, Quality. Emergency Severity Index (ESI): A triage tool for emergency department; 2011.
10
11. McHugh M, Tanabe P, McClelland M, Khare RK. More patients are triaged using the Emergency Severity Index than any other triage acuity system in the United States. Acad Emerg Med. 2012;19(1):106-9.
11
12. Christ M, Grossmann F, Winter D, Bingisser R, Platz E. Modern triage in the emergency department. Dtsch Arztebl Int. 2010;107(50):892-8.
12
13. Dugas AF, Kirsch TD, Toerper M, Korley F, Yenokyan G, France D, et al. An Electronic Emergency Triage System to Improve Patient Distribution by Critical Outcomes. J Emerg Med. 2016;50(6):910-8.
13
14. Selker HP, Beshansky JR, Griffith JL, Aufderheide TP, Ballin DS, Bernard SA, et al. Use of the acute cardiac ischemia time-insensitive predictive instrument (ACI-TIPI) to assist with triage of patients with chest pain or other symptoms suggestive of acute cardiac ischemia. A multicenter, controlled clinical trial. Ann Intern Med. 1998;129(11):845-55.
14
15. T Tanabe P, Gimbel R, Yarnold PR, Kyriacou DN, Adams JG. Reliability and validity of scores on The Emergency Severity Index version 3. Academic emergency medicine. 2004;11(1):59-65.
15
16. Buschhorn HM, Strout TD, Sholl JM, Baumann MR. Emergency medical services triage using the emergency severity index: is it reliable and valid? J Emerg Nurs. 2013;39(5):e55-63.
16
17. Platts-Mills TF, Travers D, Biese K, McCall B, Kizer S, LaMantia M, et al. Accuracy of the Emergency Severity Index triage instrument for identifying elder emergency department patients receiving an immediate life-saving intervention. Acad Emerg Med. 2010;17(3):238-43.
17
18. Kariman H, Joorabian J, Shahrami A, Alimohammadi H, Noori Z, Safari S. Accuracy of emergency severity index of triage in Imam Hossein hospital-Tehran, Iran (2011). Journal of Gorgan University of Medical Sciences. 2013;15(1):115-20.
18
19. Storm-Versloot MN, Ubbink DT, Chin a Choi V, Luitse JS. Observer agreement of the Manchester Triage System and the Emergency Severity Index: a simulation study. Emerg Med J. 2009;26(8):556-60.
19
20. Dehnadi MA, Yousefzadeh S, Hemati H, Shaabani S. Comparison the number of triaged patients in three working shift in poursina hospital in rasht. 2008.
20
21. Wuerz RC, Milne LW, Eitel DR, Travers D, Gilboy N. Reliability and validity of a new five‐level triage instrument. Academic emergency medicine. 2000;7(3):236-42.
21
ORIGINAL_ARTICLE
The Role of Lung Ultrasonography in Etiologic Diagnosis of Acute Dyspnea in a Resource Limited Setting
The aim of the current study was to describe lung ultrasonography (LUS) characteristics and to evaluate the agreement between LUS and chest radiography (CXR) in diagnosis of four conditions causing most acute dyspnea in children, namely, pneumonia, pleural effusion, pneumothorax and acute pulmonary edema in children at a teaching hospital in Vietnam. We reviewed the records of the chidren between January and June 2018, who presented to emergency department (ED) or pediatric intensive care unit (PICU) at children hospital 1 (CH1) with acute dyspnea and had final diagnosis of one of four etiologies including pneumonia, pleural effusion, pneumothorax and acute pulmonary edema. All patients underwent CXR and LUS at the time of admission. Eighty-one children with acute dyspnea including pneumonia (n=65, 80%), pleural effusion (n=9, 11%), pneumothorax (n=3, 4%) and acute pulmonary edema (n=4, 5%) were enrolled. LUS was identified among 100% of cases with pleural effusion and pneumothorax (CXR only showed 73.3% and 50%, respectively); 92.3% of cases with pneumonia (CXR showed 93.8%) and only 75% of cases with acute pulmonary edema (CXR showed 50%). When comparing LUS with CXR, we noticed a good agreeement between the 2 methods in the diagnosis of pneumonia (kappa=0.64, p<0.001). LUS was shown to be a feasible and non-invasive technique which can help clinicians to comfirm the etiology of acute pulmonary dyspnea.
https://beat.sums.ac.ir/article_46453_674e32c64ea9bdf8dbe6d6524b179658.pdf
2020-04-01
121
124
10.30476/beat.2020.46453
Acute dyspnea
Lung ultrasound
Pneumonia
Pleural Effusion
Pneumothorax
Acute pulmonary edema
Nguyen Nguyen The
Phung
nguyenphung@ump.edu.vn
1
Pediatric department - University of Medicine and Pharmacy at HCMC Children hospital 1
AUTHOR
Trang Thi Thanh
Vo
thanhtrangvo2602@gmail.com
2
Pediatric department - University of Medicine and Pharmacy at HCMC Children hospital 1 in HCMC
AUTHOR
Kam Lun Ellis
Hon
ehon@hotmail.com
3
The Hong Kong Children's Hospital
LEAD_AUTHOR
Lui JK, Banauch GI. Diagnostic Bedside Ultrasonography for Acute Respiratory Failure and Severe Hypoxemia in the Medical Intensive Care Unit: Basics and Comprehensive Approaches. J Intensive Care Med. 2017;32(6):355-372.
1
Chang AB, Ooi MH, Perera D, Grimwood K. Improving the Diagnosis, Management, and Outcomes of Children with Pneumonia: Where are the Gaps? Front Pediatr. 2013;1:29.
2
Gereige RS, Laufer PM. Pneumonia. Pediatr Rev. 2013;34(10):438-56.
3
Pereda MA, Chavez MA, Hooper-Miele CC, Gilman RH, Steinhoff MC, Ellington LE, et al. Lung ultrasound for the diagnosis of pneumonia in children: a meta-analysis. Pediatrics. 2015;135(4):714-22.
4
Hendrikse KA, Gratama JW, Hove Wt, Rommes JH, Schultz MJ, Spronk PE. Low value of routine chest radiographs in a mixed medical-surgical ICU. Chest. 2007;132(3):823-8.
5
Raju S, Ghosh S, Mehta AC. Chest CT Signs in Pulmonary Disease: A Pictorial Review. Chest. 2017;151(6):1356-1374.
6
Brenner DJ, Hall EJ. Computed tomography--an increasing source of radiation exposure. N Engl J Med. 2007;357(22):2277-84.
7
Al Deeb M, Barbic S, Featherstone R, Dankoff J, Barbic D. Point-of-care ultrasonography for the diagnosis of acute cardiogenic pulmonary edema in patients presenting with acute dyspnea: a systematic review and meta-analysis. Acad Emerg Med. 2014;21(8):843-52.
8
Lichtenstein DA, Lascols N, Mezière G, Gepner A. Ultrasound diagnosis of alveolar consolidation in the critically ill. Intensive Care Med. 2004;30(2):276-281.
9
Caiulo VA, Gargani L, Caiulo S, Fisicaro A, Moramarco F, Latini G, et al. Lung ultrasound characteristics of community-acquired pneumonia in hospitalized children. Pediatr Pulmonol. 2013;48(3):280-7.
10
Guerra M, Crichiutti G, Pecile P, Romanello C, Busolini E, Valent F, et al. Ultrasound detection of pneumonia in febrile children with respiratory distress: a prospective study. Eur J Pediatr. 2016;175(2):163-70.
11
Darge K, Chen A. Point-of-care ultrasound in diagnosing pneumonia in children. J Pediatr. 2013;163(1):302-3.
12
Claes AS, Clapuyt P, Menten R, Michoux N, Dumitriu D. Performance of chest ultrasound in pediatric pneumonia. Eur J Radiol. 2017;88:82-87.
13
Urbankowska E, Krenke K, Drobczyński Ł, Korczyński P, Urbankowski T, Krawiec M, et al. Lung ultrasound in the diagnosis and monitoring of community acquired pneumonia in children. Respir Med. 2015;109(9):1207-12.
14
Pinotti KF, Ribeiro SM, Cataneo AJ. Thorax ultrasound in the management of pediatric pneumonias complicated with empyema. Pediatr Surg Int. 2006;22(10):775-8.
15
Lichtenstein D, Goldstein I, Mourgeon E, Cluzel P, Grenier P, Rouby JJ. Comparative diagnostic performances of auscultation, chest radiography, and lung ultrasonography in acute respiratory distress syndrome. Anesthesiology. 2004;100(1):9-15.
16
Wilkerson RG, Stone MB. Sensitivity of bedside ultrasound and supine anteroposterior chest radiographs for the identification of pneumothorax after blunt trauma. Acad Emerg Med. 2010;17(1):11-7.
17
Zhang M, Liu ZH, Yang JX, Gan JX, Xu SW, You XD, et al. Rapid detection of pneumothorax by ultrasonography in patients with multiple trauma. Crit Care. 2006;10(4):R112.
18
Alrajhi K, Woo MY, Vaillancourt C. Test characteristics of ultrasonography for the detection of pneumothorax: a systematic review and meta-analysis. Chest. 2012;141(3):703-708.
19
Martindale JL, Noble VE, Liteplo A. Diagnosing pulmonary edema: lung ultrasound versus chest radiography. Eur J Emerg Med. 2013;20(5):356-60.
20
ORIGINAL_ARTICLE
Isolated, Closed Superficial Femoral Artery Rupture without Fracture Following Blunt Trauma; A Case Report and Literature Review
Injury to the femoral artery usually occurs either in open penetrating injuries or in association with fractures, but is unlikely with closed blunt trauma without fracture. We reported a 24-year-old female with a right-sided closed complete rupture of the superficial femoral artery without any bone injury and contralateral femoral shaft fracture following riding a bike and hitting by a tractor over both lower limbs. The right thigh and knee were swollen and tender with absent distal pulses without any knee instability. The left lower limb was shorter with crepitus and abnormal movement in the left thigh and intact distal pulses. Radiographs showed left femoral shaft fracture and no bony injury on the right lower limb. Angiogram showed non-opacification of the right distal superficial femoral artery. Fogartisation of distal and proximal ends were done and femoral artery was reconstructed using reversed saphenous vein interposition graft. So the clinical necessity of looking routinely for any arterial injury, even in cases of blunt trauma without bony injury is of great importance.
https://beat.sums.ac.ir/article_46454_59f0308bdbac25588c993abaaf0a0c5d.pdf
2020-04-01
125
128
10.30476/beat.2020.46454
Blunt trauma
Femoral artery
Rupture
Deepak
Kumar
drdeepaknegimt@gmail.com
1
Assistant Professor, Department of Orthopaedics, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India
AUTHOR
Praveen
Sodavarapu
praveen.omc.2k8@gmail.com
2
Senior Resident, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India
LEAD_AUTHOR
Smith RF, Szilagyi E, Elliott JP Jr. Fracture of long bones with arterial injury due to blunt trauma. Principles of management. Arch Surg. 1969;99(3):315-24.
1
Blasier RB, Pape JM. Simulation of compartment syndrome by rupture of the deep femoral artery from blunt trauma. Clin Orthop Relat Res. 1991;(266):214-7.
2
Lindfors O, Paukku P, Tötterman S. A false aneurysm of the deep femoral artery. Acta chirurgica Scandinavica. 1982;148(2):201-2.
3
Norris CS, Zlotnick R, Silva WE, Wheeler HB. Traumatic pseudoaneurysm following blunt trauma. J Trauma. 1986;26(5):480-2.
4
Ramakantan R, Shah P. Steel coil embolization of a post-traumatic pseudoaneurysm of the superficial femoral artery. Injury. 1990;21(6):410-1.
5
Davis KA, Mansour MA, Kang SS, Labropoulos N, Esposito TJ, Silver GM, et al. Pseudoaneurysms of the extremity without fracture: treatment with percutaneous ultrasound-guided thrombin injection. J Trauma. 2000;49(5):818-21
6
Deutsch V, Sinkover A, Bank H. The motor-scooter-handlebar syndrome. Lancet. 1968;2(7577):1051-3.
7
Taneva Zaryanova GT, Arribas Díaz AB, Baeza Bermejillo C, Aparicio Martínez C, González García A. Complete femoral artery transection following handlebar trauma. Trauma Case Rep. 2017;9:1-4.
8
Angiletta D, Impedovo G, Pestrichella F, Marotta V, Perilli F, Regina G. Blunt femoropopliteal trauma in a child: is stenting a good option? J Vasc Surg. 2006;44(1):201-4.
9
Prasad R, Luthra L, Maruthu A. Posttraumatic rupture of branch pseudoaneurysm of deep femoral artery: A rare case. Int J Recent Surg Med Sci. 2020 Jan 14.
10
Nossa JM, Márquez D, Rodriguez S, Muñoz JM, Alzate R, Ospina J, et al. Pseudoaneurysm of the deep femoral artery, an unusual complication in intertrochanteric hip fracture: A case study. Curr Orthopaed Pract. 2019;30(6):577-81.
11
ORIGINAL_ARTICLE
Blunt Trauma to the Neck Presenting as Dysphonia and Dysphagia in a Healthy Young Woman; A Rare Case of Traumatic Laryngocele
Laryngocele is not a common clinical entity that presents itself in a trauma setting. In the literature, there are currently two types of laryngocele, internal and mixed. Laryngocele may be congenital or acquired, and most often will present later in life. Traumatic laryngocele has only been reported three times in the literature before. Herein, we report a rare case of a 22-year-old woman who presents with bilateral laryngocele secondary to sustained direct trauma. Neck Ct-scan revealed bilateral laryngocele being responsible for her dysphagia and dysphonia. She was monitored in the hospital for further exacerbation of her symptoms with feared airway occlusion in mind. On hospital day three, her dysphagia had resolved and her dysphonia had significantly improved. A second CT, revealed resolution of left laryngocele with the right decreased in size since the initial presentation. She was followed and had complete resolution of symptoms one week after the injury.
https://beat.sums.ac.ir/article_46455_9838ed40902e40354bf1dedf4fc34504.pdf
2020-04-01
129
131
10.30476/beat.2020.46455
Traumatic laryngocele
Blunt trauma
Conservative management
Resolution
Saptarshi
Biswas
spartabiswas@gmail.com
1
Department of Trauma and Acute Care Surgery, Forbes Hospital, Allegheny Health Network, Pennsylvania, USA
LEAD_AUTHOR
Manick
Saran
msaran51982@med.lecom.edu
2
Lake Erie College of Osteopathic Medicine(LECOM) Erie,Pennsylvania.USA
AUTHOR
Vasileiadis I, Kapetanakis S, Petousis A, Stavrianaki A, Fiska A, Karakostas E. Internal laryngopyocele as a cause of acute airway obstruction: an extremely rare case and review of the literature. Acta Otorhinolaryngol Ital. 2012;32(1):58-62.
1
Thomé R, Thomé DC, De La Cortina RA. Lateral thyrotomy approach on the paraglottic space for laryngocele resection. Laryngoscope. 2000;110(3 Pt1):447-50.
2
Nikandish R, Zareizadeh A, Motazedian S, Zeraatian S, Zakeri H, Ghaffarpasand F. Bilateral Vocal Cord Paralysis After Anterior Cervical Discectomy Following Cervical Spine Injury: A Case Report. Bull Emerg Trauma. 2013;1(1):43-5.
3
Coran AG, Caldamone A, Adzick NS, Krummel TM, Laberge J-M, Shamberger R. Pediatric surgery E-book: Elsevier Health Sciences; 2012.
4
Keles E, Alpay HC, Orhan I, Yildirim H. Combined laryngocele: a cause of stridor and cervical swelling. Auris Nasus Larynx. 2010;37(1):117-20.
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Prasad KC, Vijayalakshmi S, Prasad SC. Laryngoceles - presentations and management. Indian J Otolaryngol Head Neck Surg. 2008;60(4):303-8.
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Dray TG, Waugh PF, Hillel AD. The association of laryngoceles with ventricular phonation. J Voice. 2000;14(2):278-81.
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Çelebi İ, Öz A, Sasani M, Bayındır P, Sözen E, Vural Ç, et al. Using dynamic maneuvers in the computed tomography/magnetic resonance assessment of lesions of the head and neck. Canadian Association of Radiologists' Journal. 2013;64(4):351-7.
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Wright Jr LD, Maguda TA. Laryngocele: case report and review of the literature. The Laryngoscope. 1964;74(3):396-412.
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Zelenik K, Stanikova L, Smatanova K, Cerny M, Kominek P. Treatment of Laryngoceles: what is the progress over the last two decades? Biomed Res Int. 2014;2014:819453.
10
Mobashir MK, Basha WM, Mohamed AE, Hassaan M, Anany AM. Laryngoceles: Concepts of diagnosis and management. Ear Nose Throat J. 2017;96(3):133-8.
11
Gulia J, Yadav S, Khaowas A, Basur S, Agrawal A. Laryngocele: a case report and review of literature. Indian J Otorhinolaryngol. 2012;14(1).
12
Thomé R, Thomé DC, De La Cortina RA. Lateral thyrotomy approach on the paraglottic space for laryngocele resection. Laryngoscope. 2000;110(3 Pt1):447-50.
13