Shima Farokhi; Azim Azizi; Masoud Khodaveisi; Eesa Mohammadi; Khodayar Oshvandi
Volume 13, Issue 1 , January 2025, , Pages 37-46
Abstract
Objectives: This study aimed to identify strategies for enhancing the quality of home care for trauma patients.Methods: Using a conventional qualitative content analysis approach, this study was conducted from September 2023 to September 2024 in Hamadan, located in northwest Iran. A total of 18 participants, ...
Read More
Objectives: This study aimed to identify strategies for enhancing the quality of home care for trauma patients.Methods: Using a conventional qualitative content analysis approach, this study was conducted from September 2023 to September 2024 in Hamadan, located in northwest Iran. A total of 18 participants, including home care managers, nurses, trauma patients, and the family members of trauma patients, were selected through purposive sampling. Data were collected using semi-structured interviews and analyzed using Graneheim and Lundman’s method with the assistance of MAXQDA software (version 20).Results: Analysis of the data yielded 430 initial codes, which were categorized into 36 subcategories and 6 main categories: patient-centered care, safe care provision, spiritual care, effective educational program development, service effectiveness enhancement, and dynamic service delivery.Conclusion: The study results showed that nurses employed various strategies to improve the quality of home care services for trauma patients. Key strategies included adhering to the principle of patient-centered care, providing safe care for trauma patients, providing spiritual care, developing effective educational programs, enhancing service effectiveness, and ensuring dynamism in service delivery. Implementing these strategies could guide policymakers and home care nurses to improve care quality for trauma patients and increase satisfaction. The findings of the present study can enhance the planning and implementation of home care services, facilitating the transition from hospital to home for trauma patients.
Ramin Ebrahimian; Zoubin Souri; Alireza Feizkhah; MohammadReza Mobayen; Habib Eslami; Mojdeh Esmailzadeh; Mohsen Ghorbani; Soroush Mirhedayati; Parissa Bagheri
Volume 11, Issue 1 , January 2023, , Pages 19-25
Abstract
Objective: To evaluate the spiral chest computed tomography (CT) scan findings in patients with multipletrauma during the COVID-19 pandemic.Methods: This retrospective study was performed on multiple trauma patients admitted to a tertiary hospital inthe north of Iran in 2020. All patients with multiple ...
Read More
Objective: To evaluate the spiral chest computed tomography (CT) scan findings in patients with multipletrauma during the COVID-19 pandemic.Methods: This retrospective study was performed on multiple trauma patients admitted to a tertiary hospital inthe north of Iran in 2020. All patients with multiple trauma who had undergone a chest spiral CT were includedin this study. Furthermore, the data analysis was performed through descriptive and analytical statistics usingSPSS software.Results: A total of 600 patients were included over the study period. The mean age of patients was 48.2±20.3years. Of the total, 496 (65.3%) patients had blunt chest injuries, and 104 (34.7%) had penetrating chest injuries.Falling was the most common mechanical cause of chest trauma in 270 patients (45%). Surgical interventionswere performed in 110 (18.3%) patients. A total of 276 (46%) patients had chest injuries identified by CTscans. Many patients (15.6%) had ground-glass lung opacity in the CT scan reports. Lung consolidation,pneumothorax, lung contusion, hemothorax, and rib fractures were the most common.Conclusion: Due to the high frequency of typical findings in spiral CT scan examinations, obtaining a reliablehistory of trauma severity, injury mechanism, and a detailed physical examination is recommended beforeprescribing a CT scan for patients.
Mehdi Torabi
Volume 10, Issue 2 , April 2022, , Pages 92-94
Abstract
Endotracheal intubation is more commonly performed in the right main bronchus; however, it may rarely be performed in the left side. A 52-years-old man was brought to the emergency department by emergency medical services (EMS) after multiple trauma injury. There was a decrease in the right lung’s ...
Read More
Endotracheal intubation is more commonly performed in the right main bronchus; however, it may rarely be performed in the left side. A 52-years-old man was brought to the emergency department by emergency medical services (EMS) after multiple trauma injury. There was a decrease in the right lung’s sound. Lung computed tomography (CT) scan revealed total pulmonary atelectasis. This scan was at the time that patient did not mention any recent history or complaint of pulmonary problems or diseases. In CT scan, we observed the white lung in the right side, the trachea which was deviated to the right, and the collapse-consolidation of the right lung was seen. The endotracheal tube image was observed in the left main bronchus which is a rare phenomenon. Decreasing of the right lung sound may not always be due to pneumothorax or hemothorax in trauma patients. In these patients, the rare phenomenon of left lung intubation should be considered as well. Left lung intubation may occur because of the lesion presence in the right lung.
Elham Safari; Mehdi Torabi
Volume 8, Issue 2 , April 2020, , Pages 83-88
Abstract
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 ...
Read More
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.
Hamidreza Habibpour; Mehdi Torabi; Moghaddameh Mirzaee
Volume 7, Issue 1 , January 2019, , Pages 55-59
Abstract
Objective: To investigate the role of red cell distribution width (RDW) in comparison with Trauma-Associated Severe Hemorrhage (TASH) system in predicting the mortality of multiple trauma patients, referred to the hospital emergency department.Methods: This follow-up study was conducted on multiple trauma ...
Read More
Objective: To investigate the role of red cell distribution width (RDW) in comparison with Trauma-Associated Severe Hemorrhage (TASH) system in predicting the mortality of multiple trauma patients, referred to the hospital emergency department.Methods: This follow-up study was conducted on multiple trauma patients (age ≥ 18 years) with Injury Severity Scores (ISS) of ≥ 16, who were referred to the emergency department from March 1, 2017, to December 1, 2017. First, all patients were evaluated based on the Advanced Trauma Life Support (ATLS) guidelines, and then, their blood samples were sent for RDW measurements at baseline and 24 hours after admission. The ISS, Revised Trauma Score (RTS), and TASH were measured in the follow-ups and recorded by third-year emergency medicine residents. Hospital mortality was considered as the outcome of the study.Results: In this study, 200 out of 535 multiple trauma patients were recruited. The frequency of hospital mortality was 19 (9.5%). In the univariate analysis, there was no significant relationship between hospital mortality and RDW at baseline, RDW on the first day, and ΔRDW (RDW at baseline - RDW on the first day), unlike ISS, RTS, TASH (p=0.97, P= 0.28, and p=0.24, respectively). On the other hand, in the multivariate analysis, ISS, RTS, and TASH showed a significant relationship with hospital mortality. The greatest area under the ROC curve (AUC) was attributed to TASH and RTS systems (0.94 and 0.93, respectively).Conclusion: TASH scoring system, which was mainly designed to predict the need for massive transfusion, may be of prognostic value for hospital mortality in multiple trauma patients, similar to ISS and RTS scoring systems.
