Maryam Hosseini; Leila Shayan; Mahnaz Yadollahi; Mehrdad Karajizadeh
Volume 11, Issue 3 , July 2023, , Pages 132-137
Abstract
Objective: To identify the distinctive features of acutely injured patients who were presented to the emergency department (ED) and their association with mortality and surgical intervention outcomes.Methods: This cross-sectional study was conducted on all trauma patients resuscitated in the ED of ShahidRajaee ...
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Objective: To identify the distinctive features of acutely injured patients who were presented to the emergency department (ED) and their association with mortality and surgical intervention outcomes.Methods: This cross-sectional study was conducted on all trauma patients resuscitated in the ED of ShahidRajaee (Emtiaz) Trauma Hospital (Shiraz, Iran) from May 2018 to June 2019. Demographic information, themechanism of trauma, trauma type, injured body regions, criteria of abbreviated injury scale (AIS) score,injury severity score (ISS), and surgical intervention was all taken into consideration. The items related to themortality and surgical performance outcomes among the patients were analyzed.Results: Of all 1281 cases, 82.9% were men, and the mean age of the patients was 37.9±19.1 years. The mostcommon mechanism of injury was a car accident, and the thorax was the most prevalent injured area of thebody. The majority of the patients had moderate blunt trauma. The mechanism of trauma, ISS, and the severityof head trauma were all significantly correlated with operation interventions. Moreover, age, the mechanismand type of trauma, ISS, and the necessity for the surgery were significantly associated with death occurrence.Additionally, head, thorax, and abdomen trauma were significantly related to a high mortality rate.Conclusion: Age, trauma mechanism and type, ISS, and the necessity for surgery were significantly associatedwith the mortality rate of injured patients. The severity of the trauma, particularly head injuries and themechanism of damage were important determinants in concern for surgery the necessity.
Afshin Goodarzi; Mahnaz Khatiban; Alireza Abdi; Khodayar Oshvandi
Volume 10, Issue 4 , October 2022, , Pages 141-156
Abstract
Objective: To investigate the relationship between outcomes and demographic-clinical variables in in-hospital cardiac arrest (IHCA).Methods: The Medline database was searched along with Google Scholar, Scopus, Web of Science, and Persian language database without time limitation until January ...
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Objective: To investigate the relationship between outcomes and demographic-clinical variables in in-hospital cardiac arrest (IHCA).Methods: The Medline database was searched along with Google Scholar, Scopus, Web of Science, and Persian language database without time limitation until January 6th, 2020. The inclusion criteria included papers published in journals or presented in English and Persian congress that reported the IHCA outcomes based on the Utstein criterion. All the descriptive, cross-sectional, and cohort studies on CPR were covered based on inclusion and exclusion criteria. Primary checks covered titles and abstracts followed by a full-text check of the remaining papers from the first screening stage. Data analysis was done using comprehensive metaanalysis (CMA) software version 2.0. The finding’s heterogeneity was checked using Q and Cochran tests with heterogeneity >50% and the random-effects model was used to estimate survival and favorable neurological outcome (FNO) in the analysis. To detect the publication bias of studies, the subgroup test, meta-regression test,sensitivity analysis test, funnel plot, and Eagger’s regression test were used.Results: Survival to discharge was 19.1% (95% CI=16.8-21.7) and FNO in the survived to discharge cases was 68.1% (95% CI=55.8-78.3). Survival to discharge and FNO were notably higher in men, CPR duration <15min, and shockable dysrhythmias.Conclusion: IHCA outcomes are poor in developing countries. The outcomes of IHCA in terms of gender were inconsistent with the result reported by other meta-analyses.
Mohammad Hosseini; Abbas Heydari; Hamidreza Reihani; Hossein Kareshki
Volume 10, Issue 3 , July 2022, , Pages 95-102
Abstract
Objective: To identify the elements of teamwork in resuscitation, an integrative review and synthesize current primary studies conducted.Methods: PubMed, Scopus, Web of Science, and Embase, as well as Google Scholar search engine were searched from November 2015 to March 2020 to review previously published ...
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Objective: To identify the elements of teamwork in resuscitation, an integrative review and synthesize current primary studies conducted.Methods: PubMed, Scopus, Web of Science, and Embase, as well as Google Scholar search engine were searched from November 2015 to March 2020 to review previously published peer‐reviewed studies. Out of the 5495 articles, 16 were finally included in the study. Search strategy implemented with these keywords (in the title/abstract) were (team* AND CPR) or (team* AND resuscitation). Six descriptive criteria was performed by using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline to analyze the articles and a modified version of Cooper’s five‐stage method.Results: Sixteen studies were included in this research. Twenty elements related to teamwork in resuscitation were identified by using data synthesis, then classified into four categories includes team interaction elements, leadership skills, individual elements and environmental elements. Communication, leadership, situation awareness and scene organization had the highest frequency of reviewed articles 10, 5, 4, 4, respectively.Conclusion: The interactions between resuscitation team members and the skills of the leader and team members along with environmental elements had attracted the most attention of researchers by focusing on teamwork in resuscitation. Due to the limited number of articles related to this subject, more research is needed to reveal all the key elements of teamwork in resuscitation.
Joao Augusto; Miguel Santos; Daniel Faria; Paulo Alves; David Roque; Jose; Morais; Victor Gil; Carlos Morais
Volume 8, Issue 3 , July 2020, , Pages 135-141
Abstract
Objective: To evaluate the impact of a real-time visual feedback device on CCs rate and depth delivered by healthcare professionals.Methods: In a simulated scenario a sensor was placed on a manikin’s chest and connected to a defibrillator which provided real-time visual feedback on the ...
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Objective: To evaluate the impact of a real-time visual feedback device on CCs rate and depth delivered by healthcare professionals.Methods: In a simulated scenario a sensor was placed on a manikin’s chest and connected to a defibrillator which provided real-time visual feedback on the rate and depth of CCs. Thirty-two healthcare professionals performed sequentially 5 cycles of 30 CCs without (FeedOFF) and with (FeedON) feedback. CCs with a depth between 50 and 60mm and a rate between 100 and 120cpm were considered optimal.Results: Visual feedback resulted in a significant increase in the proportion of CCs with optimal depth (median 8.7 [interquartile range 0.7–55.5]% FeedOFF vs 63.3 [17.6–88.1]% FeedON, p=0.002) and optimal rate (median 51.3 [1.3–81.3]% FeedOFF vs 68.3 [45.3–86.1]% FeedON, p=0.018). Overall, CCs were too shallow and too fast in the FeedOFF cycle. There was also a significant increase in optimal CCs (optimal depth and rate) with the use of the feedback device (from median 0.7 [0–26.9]% FeedOFF to 31.9 [3.6-59.9]% FeedON, p=0.001). Participants’ factors such as age, sex, body mass index, job or time since last CPR training did not have a significant impact on CPR quality.Conclusion: In the absence of visual feedback, there is a tendency towards lower depth and higher rate of CCs. The use of feedback technology significantly improves the quality of CCs.
Peyman Bakhshayesh; David Hullberg Risling; Anders Enocson
Volume 7, Issue 2 , April 2019, , Pages 156-161
Abstract
Objective: To assess the quality of applied pelvic binders using three dimensional computer tomography (3D CT).Methods: A local trauma registry was used to identify patients with pelvic fractures after high-energy trauma during 2011-2015. A 3D CT reconstruction was made from the initial trauma computer ...
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Objective: To assess the quality of applied pelvic binders using three dimensional computer tomography (3D CT).Methods: A local trauma registry was used to identify patients with pelvic fractures after high-energy trauma during 2011-2015. A 3D CT reconstruction was made from the initial trauma computer tomography images to assess the level of application, symmetricity of the binder and achieved fracture reduction. An acceptable application of the pelvic binder was deemed if it was at the trochanteric level, symmetric and minimized residual displacement.Results: We found 73 patients with a pelvic fracture and a pelvic binder on the initial trauma CT-scan. The mean (±SD) age of the patients was 46±17 years and 40% (n=29) were females. The median ISS score was 38 (IQR;29-50), the mean systolic blood pressure on arrival was 106±46 mmHg and the median GCS on arrival was 14 (IQR;7-15). We found that 59% (n=43) of the binders were correctly applied (symmetric at the trochanteric level, symmetrical and with acceptable residual displacement of the fracture). The 30-day mortality was higher in patients with non-correct application 17% (n=5/30) compared to patients with correct application of the pelvic binder 9.3% (n=4/43) however this was not statistically significant (p=0.562).Conclusion: A substantial number of patients had non-correct application of pelvic binders. Future studies using 3D technique are encouraged to further investigate clinical impacts of non-appropriate application of pelvic binders.
