ORIGINAL_ARTICLE
Mortality Predictors in Covid-19 Positive Patients with Fractures: A Systematic Review
Objective: To analyze the factors associated with mortality in fracture patients with concomitant COVID-19 infection based on the available published data. Methods: Keywords such as “fracture” and “COVID or COVID-19” were searched through three major databases includes PubMed, EMBASE, and Google Scholar. Selection criteria were all published reports providing the mortality related information of COVID-19 positive fracture patients. Published papers containing mortality data of COVID-19 positive fracture patients were considered for qualitative review. For meta-analysis, the presenting individual’s data were considered to study the different parameters association with mortality. Results: The rate of mean mortality in COVID-19 positive fracture patients was 34%, and 91.7% of patients had hip fractures. Older age and hip fractures had a significant association with higher mortality rates in COVID-19 positive fracture patients.Conclusion: The mortality rates are considerably higher in COVID-19 positive patients with fractures compared to COVID-19 positive patients without fractures and to the COVID-19 negative fracture patients. Early surgical intervention should be preferred in hip fractures among COVID-19 positive patients for general stabilization and improved respiratory function. Older age and hip fractures are the main predictors of mortality in these patients.
https://beat.sums.ac.ir/article_47377_b234e7ab3f99fe053dea909010c5abb6.pdf
2021-04-01
51
59
10.30476/beat.2021.87742
COVID 19
Fractures
Mortality
Predictors
Risk factors
Arvind
Kumar
arvindmamc@gmail.com
1
Department of Orthopaedics, Hamdard Institute of Medical Sciences and Research, New Delhi, India
AUTHOR
Yawar
Haider
yawerhimsr@gmail.com
2
Department of Orthopaedics, Hamdard Institute of Medical Sciences and Research, New Delhi, India
AUTHOR
Jigyasa
Passey
jigyasapassey@gmail.com
3
Department of Anatomy, Maulana Azad Medical College, New Delhi, India
AUTHOR
Rizwan
Khan
drrizwan85@gmail.com
4
Department of Orthopaedics, Hamdard Institute of Medical Sciences and Research, New Delhi, India
AUTHOR
Sahil
Gaba
dr.sahigaba@gmail.com
5
Department of Orthopaedics Surgery, Woodend Hospital, Aberdeen, Complete Abbreviation (GBR), City, Country
AUTHOR
Mukesh
Kumar
mukeshhimsr@gmail.com
6
Department of Orthopaedics, Hamdard Institute of Medical Sciences and Research, New Delhi, India
LEAD_AUTHOR
In World Health Organization. Coronavirus disease 2019 (COVID-19): situation report -73. (2020). [Accessed: June 26, 2020]. Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200402-sitrep-73-covid-19.pdf.
1
Lei S, Jiang F, Su W, Chen C, Chen J, Mei W, et al. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. EClinicalMedicine. 2020;21:100331.
2
Flemming S, Hankir M, Ernestus RI, Seyfried F, Germer CT, Meybohm P, et al. Surgery in times of COVID-19-recommendations for hospital and patient management. Langenbecks Arch Surg. 2020;405(3):359-364.
3
Cheung ZB, Forsh DA. Early outcomes after hip fracture surgery in COVID-19 patients in New York City. J Orthop. 2020;21:291-296.
4
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
5
Kumar A, Kumar A, Das S. Perioperative COVID-19 testing for orthopaedic patients: Current evidence. J Clin Orthop Trauma. 2020;11(Suppl 3):S296-S297.
6
Klestil T, Röder C, Stotter C, Winkler B, Nehrer S, Lutz M, et al. Impact of timing of surgery in elderly hip fracture patients: a systematic review and meta-analysis. Sci Rep. 2018;8(1):13933.
7
Tian W, Jiang W, Yao J, Nicholson CJ, Li RH, Sigurslid HH, et al. Predictors of mortality in hospitalized COVID-19 patients: A systematic review and meta-analysis. J Med Virol. 2020;92(10):1875-1883.
8
Catellani F, Coscione A, D’Ambrosi R, Usai L, Roscitano C, Fiorentino G. Treatment of Proximal Femoral Fragility Fractures in Patients with COVID-19 During the SARS-CoV-2 Outbreak in Northern Italy. J Bone Joint Surg Am. 2020;102(12):e58.
9
Muñoz Vives JM, Jornet-Gibert M, Cámara-Cabrera J, Esteban PL, Brunet L, Delgado-Flores L, et al. Mortality Rates of Patients with Proximal Femoral Fracture in a Worldwide Pandemic: Preliminary Results of the Spanish HIP-COVID Observational Study. J Bone Joint Surg Am. 2020;102(13):e69.
10
Mi B, Chen L, Xiong Y, Xue H, Zhou W, Liu G. Characteristics and Early Prognosis of COVID-19 Infection in Fracture Patients. J Bone Joint Surg Am. 2020;102(9):750-758.
11
LeBrun DG, Konnaris MA, Ghahramani GC, Premkumar A, DeFrancesco CJ, Gruskay JA, et al. Hip Fracture Outcomes During the COVID-19 Pandemic: Early Results From New York. J Orthop Trauma. 2020;34(8):403-410.
12
Egol KA, Konda SR, Bird ML, Dedhia N, Landes EK, Ranson RA, et al. Increased Mortality and Major Complications in Hip Fracture Care During the COVID-19 Pandemic: A New York City Perspective. J Orthop Trauma. 2020;34(8):395-402.
13
Maniscalco P, Poggiali E, Quattrini F, Ciatti C, Magnacavallo A, Vercelli A, et al. Proximal femur fractures in COVID-19 emergency: the experience of two Orthopedics and Traumatology Departments in the first eight weeks of the Italian epidemic. Acta Biomed. 2020;91(2):89-96.
14
Rizkallah M, Melhem E, Sadeqi M, Meyblum J, Jouffroy P, Riouallon G. Letter to the editor on the outcomes in fracture patients infected with COVID-19. Injury. 2020;51(10):2333-2334.
15
Hernigou J, Morel X, Callewier A, Bath O, Hernigou P. Staying home during “COVID-19” decreased fractures, but trauma did not quarantine in one hundred and twelve adults and twenty-eight children and the “tsunami of recommendations” could not lockdown twelve elective operations. Int Orthop. 2020;44(8):1473-1480
16
Garcia-Portabella M, Nuñez JH, Batalla L, Plomer M, Lakhani K, Massons J. Patient outcomes after humeral fracture surgery during the COVID-19 outbreak in Spain. J Shoulder Elbow Surg. 2020;29(8):1513-1521.
17
Song SK, Choi WK, Cho MR. Surgical intervention in patients with proximal femoral fractures confirmed positive for COVID-19-a report of 2 cases. Acta Orthop. 2020;91(5):567-570.
18
In: National Health Commission of the People’s Republic of China. Latest on the novel coronavirus outbreak. [Accessed: June 24, 2020]. Available from: http://en.nhc.gov.cn/2020-01/29/c_76043.htm.
19
Al-Tawfiq JA, Leonardi R, Fasoli G, Rigamonti D. Prevalence and fatality rates of COVID-19: What are the reasons for the wide variations worldwide? Travel Med Infect Dis. 2020;35:101711.
20
Kang SJ, Jung SI. Age-Related Morbidity and Mortality among Patients with COVID-19. Infect Chemother. 2020;52(2):154-164.
21
Du RH, Liang LR, Yang CQ, Wang W, Cao TZ, Li M, et al. Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2: a prospective cohort study. Eur Respir J. 2020;55(5):2000524.
22
Guan WJ, Liang WH, Zhao Y, Liang HR, Chen ZS, Li YM, et al. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J. 2020;55(5):2000547.
23
Zhu Y, Chen W, Xin X, Yin Y, Hu J, Lv H, et al. Epidemiologic characteristics of traumatic fractures in elderly patients during the outbreak of coronavirus disease 2019 in China. Int Orthop. 2020;44(8):1565-1570.
24
Kastanis G, Topalidou A, Alpantaki K, Rosiadis M, Balalis K. Is the ASA Score in Geriatric Hip Fractures a Predictive Factor for Complications and Readmission? Scientifica (Cairo). 2016;2016:7096245.
25
COVIDSurg Collaborative. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. Lancet. 2020;396(10243):27-38.
26
Al-Jabir A, Kerwan A, Nicola M, Alsafi Z, Khan M, Sohrabi C, et al. Impact of the Coronavirus (COVID-19) pandemic on surgical practice - Part 1. Int J Surg. 2020;79:168-179.
27
Wang X, Zhou Q, He Y, Liu L, Ma X, Wei X, et al. Nosocomial outbreak of COVID-19 pneumonia in Wuhan, China. Eur Respir J. 2020;55(6):2000544.
28
Ross GL. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. What are the implications for the commencement of elective surgery? EClinicalMedicine. 2020;23:100385.
29
ORIGINAL_ARTICLE
Impact and modifications of in-hospital trauma care workflow due to COVID 19 pandemic: Lessons learnt for the future
Objective: To describe the restructuring if in-hospital systems of care at a Level -1 trauma center in India and to analyze volume and patterns of injury for future preparedness as well as to institute preventive measures for specific injuries during health emergencies like COVID-19.Methods: The data were extracted from a prospectively managed trauma registry at level-1 trauma center in India. We compared data of lockdown period with data of the same number of days from the pre-lockdown period. Patients were grouped according to age, gender, cause of injury, place of injury, injury severity, and injury outcome for comparative analysis between two periods.Results: Total emergency department (ED) footfall due to trauma decreased significantly by 73% during lockdown period. Injuries resulting due to blunt forces, increased significantly. There was a significant decrease in the percentage of patients having major injury. The road traffic injuries (RTIs) cases were less, but number of falls reported increased significantly during lockdown. Significantly less number of patients presented without receiving primary care. Majority of the patients were transported using private cars, police vehicle, and two wheelers during lockdown, however, as expected significantly less number of patients were transported by three wheelers. The comparative analysis between quantitative data points shows significant difference in median ISS and length of stay during lockdown. Conclusion: This study highlighted that the preparedness during health emergencies should not focus solely on the response to treatment of infectious disease but also on ensuring access and provision of reasonable quality of care for non-infectious illnesses, especially acute conditions like trauma.
https://beat.sums.ac.ir/article_47378_c63afa989bf380d14ed06aa0d2664f86.pdf
2021-04-01
60
66
10.30476/beat.2021.88507
COVID-19
Emergency department
Injury
Infectious Disease
Trauma care
Gaurav
Kaushik
gauravkaushik.aiims@gmail.com
1
Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India
AUTHOR
Ankita
Sharma
doctor.ankita1@gmail.com
2
Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India
AUTHOR
Dinesh
Bagaria
dr_bagaria@yahoo.co.in
3
Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India
AUTHOR
Subodh
Kumar
subodh6@gmail.com
4
Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India
AUTHOR
Sushma
Sagar
sagar.sushma@gmail.com
5
Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India
AUTHOR
Amit
Gupta
amitguptaaiims@gmail.com
6
Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India
LEAD_AUTHOR
In: Ministry of Health and Family Welfare of Indian Government. Guidelines on Preventive Measures to Contain Spread of COVID-19. [Accessed: February 19, 2021]. Available from: www.mohfw.gov.in.
1
Forrester JD, Liou R, Knowlton LM, Jou RM, Spain DA. Impact of shelter-in-place order for COVID-19 on trauma activations: Santa Clara County, California, March 2020. Trauma Surg Acute Care Open. 2020;5(1):e000505.
2
Nuñez JH, Sallent A, Lakhani K, Guerra-Farfan E, Vidal N, Ekhtiari S, et al. Impact of the COVID-19 Pandemic on an Emergency Traumatology Service: Experience at a Tertiary Trauma Centre in Spain. Injury. 2020;51(7):1414-1418.
3
Christey G, Amey J, Campbell A, Smith A. Variation in volumes and characteristics of trauma patients admitted to a level one trauma centre during national level 4 lockdown for COVID-19 in New Zealand. N Z Med J. 2020;133(1513):81-88.
4
Comelli I, Scioscioli F, Cervellin G. Impact of the COVID-19 epidemic on census, organization and activity of a large urban Emergency Department. Acta Biomed. 2020;91(2):45-49.
5
Gok AFK, Eryılmaz M, Ozmen MM, Alimoglu O, Ertekin C, Kurtoglu MH. Recommendations for Trauma and Emergency General Surgery Practice During COVID-19 Pandemic. Ulus Travma Acil Cerrahi Derg. 2020;26(3):335-342.
6
ORIGINAL_ARTICLE
The Possible Factors Correlated with The Higher Risk of Getting Infected by COVID-19 in Emergency Medical Technicians; A Case-Control Study
Objective: To assess the possible factors associated with increasing risk of COVID-19 among EMTs. Methods: This study was a case-control study conducted in Tehran, Iran. Case group was consisted of confirmed COVID-19 EMTs based on the results of reverse transcriptase polymerase chain reaction and/or lung computed tomography scan. Healthy EMTs were randomly selected as control group. Patients were asked to fill out a checklist including demographic data, data related to the work situation (such as number of missions and type of mask and cloth) and PPE precautions. Results: Sixty-eight patients and 148 healthy persons took part in this study as case and control group, respectively. Having two EMTs involved directly in taking care of patients (p <0.001) and working with a confirmed case teammate (p <0.001), considering the precautions such as seal check after wearing the mask (p=0.015), covering the hair with a medical hat (p <0.001), not using personal items despite protective clothing (p <0.001), and avoiding contact with the outer surface of clothing while removing (p <0.001) had significant difference in two groups. Conclusion: We found that the type and method of use of PPE were correlated with the increasing risk of COVID-19 in EMTs. Also, we found that when two EMTs were involved directly in taking care of the patients, and those who worked with a confirmed case teammate, more frequently affected.
https://beat.sums.ac.ir/article_47314_2a2001188bb31e597c30cb8c864d7dbd.pdf
2021-04-01
67
72
10.30476/beat.2021.89713
COVID-19
Emergency medical technician
Personal protective equipment
Mostafa
Sadeghi
sadeghim@tums.ac.ir
1
Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran
AUTHOR
Peyman
Saberian
peymansaberian61@gmail.com
2
Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran
LEAD_AUTHOR
Parisa
Hasani-Sharamin
parisahasaniems@gmail.com
3
Tehran Emergency Medical Service Center, Tehran, Iran
AUTHOR
Fatemeh
Dadashi
fdadashi.ac@gmail.com
4
Tehran Emergency Medical Service Center, Tehran, Iran
AUTHOR
Sepideh
Babaniamansour
sepideh_babania@yahoo.com
5
School of Medicine, Islamic Azad University of Medical Sciences, Tehran, Iran
AUTHOR
Ehsan
Aliniagerdroudbari
eag1368@yahoo.com
6
School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
AUTHOR
Kalkeri R, Goebel S, Sharma GD. SARS-CoV-2 Shedding from Asymptomatic Patients: Contribution of Potential Extrapulmonary Tissue Reservoirs. Am J Trop Med Hyg. 2020;103(1):18-21.
1
van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, et al. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. N Engl J Med. 2020;382(16):1564-1567.
2
Niazkar HR, Niazkar M. COVID-19 international outbreak and the need for a suitable estimation model: a second-order polynomial equation with constant coefficients based on imported infected cases seems inadequate. Asian Pacific Journal of Tropical Medicine. 2020;13(4):185-6.
3
Cook TM. Personal protective equipment during the coronavirus disease (COVID) 2019 pandemic - a narrative review. Anaesthesia. 2020;75(7):920-927.
4
Escombe AR, Oeser CC, Gilman RH, Navincopa M, Ticona E, Pan W, et al. Natural ventilation for the prevention of airborne contagion. PLoS Med. 2007;4(2):e68.
5
Frieden TR, Lee CT. Identifying and Interrupting Superspreading Events-Implications for Control of Severe Acute Respiratory Syndrome Coronavirus 2. Emerg Infect Dis. 2020;26(6):1059-1066.
6
Kalantary S, Khadem M, Golbabaei F. Personal Protective Equipment for Protecting Healthcare Staff during COVID-19 Outbreak: A Narrative Review. Advanced Journal of Emergency Medicine. 2020;4(2s):e61-e.
7
Pourdowlat G, Panahi P, Pooransari P, Ghorbani F. Prophylactic recommendation for healthcare workers in COVID-19 pandemic. Frontiers in Emergency Medicine. 2020;4(2s):e39.
8
Aghaghazvini L, Radmard AR, Rasuli B, Naybandi S. Incidental Findings of COVID-19 Pneumonia in Chest CT scan of Trauma Patients; a Case Series. Advanced Journal of Emergency Medicine. 2020;4(2s):e52.
9
Naderpour Z, Saeedi M. A Primer on COVID-19 for Clinicians: Clinical Manifestation and Natural Course. Advanced Journal of Emergency Medicine. 2020;4(2s):e62.
10
Organization WH. Rational use of personal protective equipment for COVID-19 and considerations during severe shortages: interim guidance, 23 December 2020. World Health Organization; 2020.
11
Saberian P, Mireskandari SM, Baratloo A, Hasani-Sharamin P, Babaniamansour S, Aliniagerdroudbari E, et al. Antibody Rapid Test Results in Emergency Medical Services Personnel during COVID-19 Pandemic; a Cross Sectional study. Arch Acad Emerg Med. 2020;9(1):e2.
12
Organization WH. Coronavirus disease ( COVID-19) outbreak: rights, roles and responsibilities of health workers, including key considerations for occupational safety and health: interim guidance, 19 March 2020. World Health Organization; 2020.
13
Jalili M. How should emergency medical services personnel protect themselves and the patients during COVID-19 pandemic? Frontiers in Emergency Medicine. 2020;4(2s):e37-e.
14
Organization WH. Health workers exposure risk assessment and management in the context of COVID-19 virus: interim guidance, 4 March 2020. World Health Organization; 2020.
15
Lau JT, Fung KS, Wong TW, Kim JH, Wong E, Chung S, Ho D, Chan LY, Lui SF, Cheng A. SARS transmission among hospital workers in Hong Kong. Emerg Infect Dis. 2004;10(2):280-6.
16
Organization WH. Rational use of personal protective equipment for COVID-19 and considerations during severe shortages: interim guidance, 23 December 2020. World Health Organization; 2020.
17
Herron JBT, Hay-David AGC, Gilliam AD, Brennan PA. Personal protective equipment and Covid 19- a risk to healthcare staff? Br J Oral Maxillofac Surg. 2020;58(5):500-502.
18
Wang X, Pan Z, Cheng Z. Association between 2019-nCoV transmission and N95 respirator use. J Hosp Infect. 2020;105(1):104-105.
19
Bartoszko JJ, Farooqi MAM, Alhazzani W, Loeb M. Medical masks vs N95 respirators for preventing COVID-19 in healthcare workers: A systematic review and meta-analysis of randomized trials. Influenza Other Respir Viruses. 2020;14(4):365-373.
20
Seto WH, Tsang D, Yung RW, Ching TY, Ng TK, Ho M, et al. Effectiveness of precautions against droplets and contact in prevention of nosocomial transmission of severe acute respiratory syndrome (SARS). Lancet. 2003;361(9368):1519-20.
21
Tompkins BM, Kerchberger JP. Personal protective equipment for care of pandemic influenza patients: a training workshop for the powered air purifying respirator. Anesthesia & Analgesia. 2010;111(4):933-45.
22
Lee S-A, Chen Y-L, Hwang D-C, Wu C-C, Chen J-K. Performance evaluation of full facepiece respirators with cartridges. Aerosol and Air Quality Research. 2017;17(5):1316-28.
23
Belingheri M, Paladino ME, Riva MA. Beyond the assistance: additional exposure situations to COVID-19 for healthcare workers. J Hosp Infect. 2020;105(2):353.
24
ORIGINAL_ARTICLE
Ketamine Sub-Dissociative Dose Vs. Morphine Sulfate for Acute Pain Control in Patients with Isolated Limb Injuries in the Emergency Department: A Randomized, Double-blind, Clinical Trial
Objective: To compare the ketamine efficacy at a sub-dissociative morphine dose to reduce pain in isolated limb traumatic injuries. Methods: A double-blind randomized clinical trial study was carried out on patients referred to emergency departments (EDs) due to isolated limb traumatic injuries. Eligible patients were divided into two groups which one group received 0.1 mg/kg ketamine and the other group received 0.05 mg/kg morphine, intravenously. An observed side effect includes pain scores and vital signs were recorded at baseline of every 5 minutes for 30 minutes. Results: Totally, 73 patients with the mean age of 32.9±10.4 were enrolled of whom 59 (80.8%) individuals were men. The baseline characteristics difference of the two study groups was not statistically significant. The results showed that the change of mean pain score was -6.2 (95% CI: -5.72 to -6.69) points in the group receiving ketamine compared to -5.8 (95%CI: -5.15 to – 6.48) in the group who were administered morphine. At all assessed checkpoints, the pain mean score was lower in the ketamine group than in the morphine group (p <0.05); the mean of total pain reduction was greater in the ketamine group during the observation period compared with patients who received morphine (p=0.002). Conclusion: The study findings suggest that the sub-dissociative ketamine efficacy in controlling of the acute pain is not lower than morphine sulfate in patients with isolated limb trauma in ED’s. Thus, it can be considered as a safe and effective alternative approach.
https://beat.sums.ac.ir/article_47389_0fac5b6c6a2567242d0c4059cd89e21e.pdf
2021-04-01
73
79
10.30476/beat.2021.85949
Acute pain
analgesics
Ketamine
Pain management
Trauma
Hooman
Esfahani
hooman_105@yahoo.com
1
Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran
AUTHOR
Zahra
Khazaeipour
khazaeipour@tums.ac.ir
2
Brain and Spinal Cord Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran
AUTHOR
Arash
Safaie
a-safaie@sina.tums.ac.ir
3
Prehospital and Hospital Emergency Research Center, Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
AUTHOR
Seyed Mojtaba
Aghili
m-aghili@tums.ac.ir
4
Prehospital and Hospital Emergency Research Center, Department of Emergency Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
LEAD_AUTHOR
Abdolrazaghnejad A, Banaie M, Tavakoli N, Safdari M, Rajabpour-Sanati A. Pain Management in the Emergency Department: a Review Article on Options and Methods. Adv J Emerg Med. 2018;2(4):e45.
1
Janati M, Kariman H, Memary E, Davarinezhad-Moghadam E, Arhami-Dolatabadi A. Educational Intervention Effect on Pain Management Quality in Emergency Department; a Clinical Audit. Adv J Emerg Med. 2018;2(2):e16.
2
Baratloo A, Mirbaha S, Delavar Kasmaei H, Payandemehr P, Elmaraezy A, Negida A. Intravenous caffeine citrate vs. magnesium sulfate for reducing pain in patients with acute migraine headache; a prospective quasi-experimental study. Korean J Pain. 2017;30(3):176-182.
3
Wakai A, O’Sullivan R, Staunton P, Walsh C, Hickey F, Plunkett PK. Development of key performance indicators for emergency departments in Ireland using an electronic modified-Delphi consensus approach. Eur J Emerg Med. 2013;20(2):109-14.
4
Puntillo K, Neighbor M, O’Neil N, Nixon R. Accuracy of emergency nurses in assessment of patients’ pain. Pain Manag Nurs. 2003;4(4):171-5.
5
Gupta A, Bodin L, Holmström B, Berggren L. A systematic review of the peripheral analgesic effects of intraarticular morphine. Anesth Analg. 2001;93(3):761-70.
6
Bounes V, Barniol C, Minville V, Houze-Cerfon CH, Ducassé JL. Predictors of pain relief and adverse events in patients receiving opioids in a prehospital setting. Am J Emerg Med. 2011;29(5):512-7.
7
Bijur PE, Kenny MK, Gallagher EJ. Intravenous morphine at 0.1 mg/kg is not effective for controlling severe acute pain in the majority of patients. Ann Emerg Med. 2005;46(4):362-7.
8
Bounes V, Charriton-Dadone B, Levraut J, Delangue C, Carpentier F, Mary-Chalon S, et al. Predicting morphine related side effects in the ED: An international cohort study. Am J Emerg Med. 2017;35(4):531-535.
9
Alimohammadi H, Baratloo A, Abdalvand A, Rouhipour A, Safari S. Effects of pain relief on arterial blood o2 saturation. Trauma Mon. 2014;19(1):e14034.
10
Richards JR, Rockford RE. Low-dose ketamine analgesia: patient and physician experience in the ED. Am J Emerg Med. 2013;31(2):390-4.
11
Yousefifard M, Askarian-Amiri S, Rafiei Alavi SN, Sadeghi M, Saberian P, Baratloo A, et al. The Efficacy of Ketamine Administration in Prehospital Pain Management of Trauma Patients; a Systematic Review and Meta-Analysis. Arch Acad Emerg Med. 2019;30;8(1):e1.
12
Sotoodehnia M, Farmahini-Farahani M, Safaie A, Rasooli F, Baratloo A. Low-dose intravenous ketamine versus intravenous ketorolac in pain control in patients with acute renal colic in an emergency setting: a double-blind randomized clinical trial. Korean J Pain. 2019;32(2):97-104.
13
Mohammadshahi A, Abdolrazaghnejad A, Nikzamir H, Safaie A. Intranasal Ketamine Administration for Narcotic Dose Decrement in Patients Suffering from Acute Limb Trauma in Emergency Department: a Double-Blind Randomized Placebo-Controlled Trial. Adv J Emerg Med. 2018;2(3):e30.
14
Bell RF, Kalso EA. Ketamine for pain management. Pain Rep. 2018;3(5):e674.
15
Motov S, Rockoff B, Cohen V, Pushkar I, Likourezos A, McKay C, et al. Intravenous Subdissociative-Dose Ketamine Versus Morphine for Analgesia in the Emergency Department: A Randomized Controlled Trial. Ann Emerg Med. 2015;66(3):222-229.e1.
16
Majidinejad S, Esmailian M, Emadi M. Comparison of Intravenous Ketamine with Morphine in Pain Relief of Long Bones Fractures: a Double Blind Randomized Clinical Trial. Emerg (Tehran). 2014;2(2):77-80.
17
Miller JP, Schauer SG, Ganem VJ, Bebarta VS. Low-dose ketamine vs morphine for acute pain in the ED: a randomized controlled trial. Am J Emerg Med. 2015;33(3):402-8.
18
Lester L, Braude DA, Niles C, Crandall CS. Low-dose ketamine for analgesia in the ED: a retrospective case series. Am J Emerg Med. 2010 Sep;28(7):820-7.
19
ORIGINAL_ARTICLE
Gender Differences in COVID-19 Deceased Cases in Jahrom City, South of Iran
Objective: To evaluate the clinical and epidemiological features of deceased patients and comparing the discrepancies between male and female patients based on high prevalence of coronavirus disease 2019 (COVID-19), its irreversible effects and the rising mortality rate in Jahrom city. Methods: This is a descriptive-analytical retrospective study that was conducted from the beginning of March 2020 to the end of November 2020. The study population were included all patients with COVID-19 who admitted to Peymaniyeh Hospital in Jahrom and died of COVID-19. Clinical and demographic data were collected from medical records and analyzed by SPSS software. Results: In this study, 61 patients (57.54%) were men and 45 patients (42.36%) were women. The mean age was 68.7±18.33 in men and 68.82±14.24 in women. The mean hospitalization length was 9.69±7.75 days in men and 9.69±7.75 days in women patients. There was no statistically significant difference between men and women patients (p>0.05). The results showed that 17 (27.87%) men and 28 (45.9%) of women patients had hypertension and the prevalence of this disease was significantly higher in women than men (p=0.01). In this study, 7 (11.48%) men and 13 (21.31%) women had hyperlipidemia. The frequency of hyperlipidemia in women caseswas significantly higher than in men patients (p=0.024). Men cases’ diastolic blood pressure (mean=77.53) was significantly higher than women’s diastolic blood pressure at the same time with a mean of 71.42 (p <0.05). Conclusion: The findings of the study represented the mortality rate in men which is higher than women patients. The prevalence of underlying diseases such as hypertension and hyperlipidemia were higher in women than men. Despite higher mortality among women, symptoms such as fever and dyspnea were less common in women than men.
https://beat.sums.ac.ir/article_47376_dabdba6ee0e2d708575f7bf90b27e58e.pdf
2021-04-01
80
85
10.30476/beat.2021.89206
Blood pressure
COVID-19
Hyperlipidemia
Sex
Temperature
Fatemeh
Rahmanian
rahmanian1185@gmail.com
1
Department of Emergency Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
AUTHOR
Naser
Hatami
naserohatami@gmail.com
2
Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran
AUTHOR
Marzieh
Haghbeen
drhaghbeenoncosurg@gmail.com
3
Women’s Health and Disease Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
AUTHOR
Rahim
Raofi
sarahim1513@gmail.com
4
Department of Infectious Disease, Jahrom University of Medical Sciences, Jahrom, Iran
AUTHOR
Alireza
Abbasi
abbasiinfection@gmail.com
5
Department of Infectious Disease, Jahrom University of Medical Sciences, Jahrom, Iran
AUTHOR
Heshmatollah
Shakeri
shakeri13@gmail.com
6
Department of Infectious Disease, Jahrom University of Medical Sciences, Jahrom, Iran
AUTHOR
Poyan
Keshavarz
mirpouyan10@gmail.com
7
Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran
AUTHOR
Elham
Rafiee
elhamrafiee1367@yahoo.com
8
Women’s Health and Disease Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
AUTHOR
Mahdi
Chegin
mehdi.chegin@gmail.com
9
Department of Emergency Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
AUTHOR
Esmaeel
Rayad doost
e.rayat.dost@gmail.com
10
Department of Emergency Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
AUTHOR
Samaneh
Abiri
samaneh.abiri@gmail.com
11
Department of Emergency Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
AUTHOR
Navid
Kalani
navidkalani@ymail.com
12
Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
LEAD_AUTHOR
Mahdi
Foroughian
foroughianmh@mums.ac.ir
13
Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical sciences, Mashhad, Iran
AUTHOR
Mohsen
Ebrahimi
ebrahimimn@mums.ac.ir
14
Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical sciences, Mashhad, Iran
AUTHOR
Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270-273.
1
Rezaeian M. World and the novel coronavirus disease (COVID-19). Journal of Rafsanjan University of Medical Sciences. 2020;19(1):1-2.
2
Hazbavi Z, Mostfazadeh R, Alaei N, Azizi E. Spatial and temporal analysis of the COVID-19 incidence pattern in Iran. Environ Sci Pollut Res Int. 2020:1–11.
3
Peiris JS, Chu CM, Cheng VC, Chan KS, Hung IF, Poon LL, et al. Clinical progression and viral load in a community outbreak of coronavirus-associated SARS pneumonia: a prospective study. Lancet. 2003;361(9371):1767-72.
4
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
5
Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8(5):475-481.
6
Yang W, Cao Q, Qin L, Wang X, Cheng Z, Pan A, et al. Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19):A multi-center study in Wenzhou city, Zhejiang, China. J Infect. 2020;80(4):388-393.
7
Milovanovic L, Hessey E, Sebastianski M, Keto-Lambert D, Vandermeer B, Bagshaw SM, et al. Epidemiology, clinical characteristics and treatment of critically ill patients with COVID-19): a protocol for a living systematic review. BMJ Open. 2021;11(1):e042008.
8
Chen J, Bai H, Liu J, Chen G, Liao Q, Yang J, et al. Distinct clinical characteristics and risk factors for mortality in female inpatients with coronavirus disease 2019 (COVID-19): a sex-stratified, large-scale cohort study in Wuhan, China. Clinical Infectious Diseases. 2020;71(12):3188-95.
9
Chen J, Ye J, Li H, Xia Z, Yan H. Changes in the Clinical Characteristics of 62 Patients Who Died from Coronavirus Disease 2019. Biomed Res Int. 2020;2020:3280908.
10
Marcon G, Tettamanti M, Capacci G, Fontanel G, Spanò M, Nobili A, et al. COVID-19 mortality in Lombardy: the vulnerability of the oldest old and the resilience of male centenarians. Aging (Albany NY). 2020;12(15):15186-15195.
11
Pérez-López FR, Tajada M, Savirón-Cornudella R, Sánchez-Prieto M, Chedraui P, Terán E. Coronavirus disease 2019 and gender-related mortality in European countries: A meta-analysis. Maturitas. 2020;141:59-62.
12
Meng Y, Wu P, Lu W, Liu K, Ma K, Huang L, et al. P. Sex-specific clinical characteristics and prognosis of coronavirus disease-19 infection in Wuhan, China: A retrospective study of 168 severe patients. PLoS Pathog. 2020;16(4):e1008520.
13
Jin JM, Bai P, He W, Wu F, Liu XF, Han DM, et al. Gender Differences in Patients With COVID-19: Focus on Severity and Mortality. Front Public Health. 2020;8:152.
14
Qiu P, Zhou Y, Wang F, Wang H, Zhang M, Pan X, et al. Clinical characteristics, laboratory outcome characteristics, comorbidities, and complications of related COVID-19 deceased: a systematic review and meta-analysis. Aging Clin Exp Res. 2020;32(9):1869-1878.
15
Zhao XY, Xu XX, Yin HS, Hu QM, Xiong T, Tang YY, et al. Clinical characteristics of patients with 2019 coronavirus disease in a non-Wuhan area of Hubei Province, China: a retrospective study. BMC Infect Dis. 2020;20(1):311.
16
Zhang B, Zhou X, Qiu Y, Song Y, Feng F, Feng J, et al. Clinical characteristics of 82 cases of death from COVID-19. PLoS One. 2020;15(7):e0235458.
17
Li J, Zhang Y, Wang F, Liu B, Li H, Tang G, et al. Sex differences in clinical findings among patients with coronavirus disease 2019 (COVID-19) and severe condition. MedRxiv. 2020.
18
ORIGINAL_ARTICLE
Exploring Barriers and Facilitators of Inter-Organizational Management in Response to Mass Casualty Traffic Incidents: A Qualitative Study
Objective: To investigate and understand the current status of inter-organizational management in relief organizations as well as the relief organizations personnel behavior when facing mass traffic incidents (MCTI). The inter-organizational barriers and facilitators are also discussed in response to MCTI management and in order to help direct future actions to improve pre-hospital emergency services. Methods: The current qualitative study was performed through face-to-face, semi-structured interviews with 31 individuals from pre-hospital emergency services authorities and personnel, Red Crescent and Yazd, Kohgiluyeh and Boyer-Ahmad, Fars, and Qom provinces police. These provinces were selected by purposive sampling in 2018-2019. The conventional content analysis method was applied to analyze the data in this research. Results: Three main categories and 14 subcategories were determined. The categories are including relief organizations coordination (having four subcategories: independent relief organizations, interdepartmental services integration, insufficient knowledge of organizations about one other, and performance based on job descriptions), resource and infrastructure management (having four subcategories: adverse information management, proper information management, lack of medical resources and capacities considered, and upgrading of medical resources and capacities considered), and response management of relief organizations (having six subcategories: incomplete assessment, improving the quality of assessment, weakness in establishing scene security, scene security management, poor response, and cooperation in response). Conclusion: Relief organizations need to perform under a unified command. It has inter-organizational cooperation and provide integration of interdepartmental services in order to manage responsiveness at the scene. It also prevents an independent, chaos, and inability of the injured to properly understand and needs in MCTI.
https://beat.sums.ac.ir/article_47393_0bb98619c0b3ce8a5b0c9f23d3240914.pdf
2021-04-01
86
95
10.30476/beat.2021.89416
Inter-organizational management
Mass casualty
Traffic incidents
Seyed Javad
Sadat
sadatsaiedjavad@gmail.com
1
Department of Health in Emergencies and Disasters, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
AUTHOR
ardashir
afrasiabifar
afrasiabifar@yahoo.com
2
School of Nursing, Yasuj University of Medical Sciences, Yasuj, Iran
AUTHOR
Davoud
Khorasani-zavareh
davoud.khorasani@gmail.com
3
Skull Base Research Center, Loghman Hakim Hospital; Department of Health in Emergencies and Disasters, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
AUTHOR
Mohammad Javad
Moradian
moradianshiraz@gmail.com
4
Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Mohammadreza
Vafaeenasab
rzvafaee@yahoo.com
5
Yazd Accident Prevention and Crisis Research Center, Shahid Sadoughi university of Medical Sciences, Yazd, lran
AUTHOR
Abbas Ali
Dehghani Tafti
aadtafti@yahoo.com
6
Department of Health in Emergencies and Disasters, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
AUTHOR
Hossein
Fallahzadeh
hofaab@yahoo.com
7
Healthcare Data Modeling Center, Departments of biostatistics and Epidemiology, School of public health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
AUTHOR
Mahsa
Khodayarian
mahsa.khodayarian6@gmail.com
8
Department of Health in Emergencies and Disasters, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
LEAD_AUTHOR
Lomaglio L, Ansaloni L, Catena F, Sartelli M, Coccolini F. Mass Casualty Incident: Definitions and Current Reality. WSES Handbook of Mass Casualties Incidents Management: Springer; 2020. p. 1-10.
1
MoHaM E. Centre DaEM, editor. Reportable special events Iran: Disaster and Emergency Management Centre; 2015.
2
Fararoei M, Sadat SJ, Zoladl M. Epidemiology of trauma in patients admitted to an emergency ward in Yasuj. Trauma Monthly. 2017;22(3):e30572.
3
Sadeghniiat-Haghighi K, Yazdi Z, Moradinia M, Aminian O, Esmaili A. Traffic crash accidents in Tehran, Iran: Its relation with circadian rhythm of sleepiness. Chin J Traumatol. 2015;18(1):13-7.
4
Balikuddembe JK, Ardalan A, Khorasani-Zavareh D, Nejati A, Raza O. Weaknesses and capacities affecting the Prehospital emergency care for victims of road traffic incidents in the greater Kampala metropolitan area: a cross-sectional study. BMC Emerg Med. 2017;17(1):29.
5
Autrey AW, Hick JL, Bramer K, Berndt J, Bundt J. 3 Echo: concept of operations for early care and evacuation of victims of mass violence. Prehosp Disaster Med. 2014;29(4):421-8.
6
Balikuddembe JK, Ardalan A, Khorasani-Zavareh D, Nejati A, Kasiima S. Factors affecting the exposure, vulnerability and emergency medical service capacity for victims of road traffic incidents in Kampala Metropolitan Area: a Delphi study. BMC Emerg Med. 2017;17(1):1.
7
Holgersson A. Review of on-scene management of mass-casualty attacks. Journal of Human Security. 2016;12(1):91-111.
8
Juffermans J, Bierens JJ. Recurrent medical response problems during five recent disasters in the Netherlands. Prehosp Disaster Med. 2010;25(2):127-36.
9
Dean MD, Nair SK. Mass-casualty triage: Distribution of victims to multiple hospitals using the SAVE model. European Journal of Operational Research. 2014;238(1):363-73..
10
Aitken P, Leggat P. Considerations in mass casualty and disaster management. Emergency medicine: an international perspective. 2012:145-82.
11
Anderson PD, Suter RE, Mulligan T, Bodiwala G, Razzak JA, Mock C; International Federation for Emergency Medicine (IFEM) Task Force on Access and Availability of Emergency Care. World Health Assembly Resolution 60.22 and its importance as a health care policy tool for improving emergency care access and availability globally. Ann Emerg Med. 2012;60(1):35-44.e3.
12
Pan American Health Organization. Mass Casualty Management System. Course Manual. Washington, DC: PAHO; 2019.
13
Hitti EA, El Sayed MJ, Cheaito MA, Kellermann AL, Kazzi AA. Mass Casualty Management in the Emergency Department-Lessons Learned in Beirut, Lebanon-Part I. Mediterranean Journal of Emergency Medicine & Acute Care. 2020;1(2).
14
Chaffee M. Willingness of health care personnel to work in a disaster: an integrative review of the literature. Disaster Med Public Health Prep. 2009;3(1):42-56.
15
Sadat SJ, Âli Mohammadi N, Alamdari A. Phenomenological study of family and social relationships of patients with multiple sclerosis. Journal of Mazandaran University of Medical Sciences. 2012;21(1):244-52.
16
Elo S, Kääriäinen M, Kanste O, Pölkki T, Utriainen K, Kyngäs H. Qualitative content analysis: A focus on trustworthiness. SAGE open. 2014;4(1):2158244014522633.
17
Organization WH. Hospital safety index: Guide for evaluators: PAHO; 2019.
18
Burns N, Grove SK. Understanding nursing research-eBook: Building an evidence-based practice: Elsevier Health Sciences; 2010.
19
Speziale HS, Streubert HJ, Carpenter DR. Qualitative research in nursing: Advancing the humanistic imperative: Lippincott Williams & Wilkins; 2011.
20
Raeisi AR, Mohajervatan A, Mehraein Nazdik Z. Mass casualty response to mine explosion: a case report in Iran. Health in Emergencies and Disasters. 2019;4(3):173-8.
21
Veenema TG, Boland F, Patton D, O’Connor T, Moore Z, Schneider-Firestone S. Analysis of Emergency Health Care Workforce and Service Readiness for a Mass Casualty Event in the Republic of Ireland. Disaster Med Public Health Prep. 2019;13(2):243-255.
22
Oveisi N, Farsad H, Sarikhani N, Najafi M, Mousavi AS, Zaretousi Z. Studying the managers’viewpoint of east azerbaijan province about earthquake relief operation in red crescent society in 2012. 2014.
23
Bigdeli M, Khorasani-Zavareh D, Mohammadi R. Pre-hospital care time intervals among victims of road traffic injuries in Iran. A cross-sectional study. BMC Public Health. 2010;10:406.
24
Khorram-Manesh A, Plegas P, Högstedt Å, Peyravi M, Carlström E. Immediate response to major incidents: defining an immediate responder! Eur J Trauma Emerg Surg. 2020;46(6):1309-1320.
25
Yu W, Lv Y, Hu C, Liu X, Chen H, Xue C, et al. Research of an emergency medical system for mass casualty incidents in Shanghai, China: a system dynamics model. Patient Prefer Adherence. 2018;12:207-222.
26
Andreassen N, Borch OJ, Sydnes AK. Information sharing and emergency response coordination. Safety Science. 2020;130:104895.
27
Bazeli J, Aryankhesal A, Khorasani-Zavareh D. Exploring the perception of aid organizations’ staff about factors affecting management of mass casualty traffic incidents in Iran: a grounded theory study. Electron Physician. 2017;9(7):4773-9.
28
Eftekhari A, DehghaniTafti A, Nasiriani K, Hajimaghsoudi M, Fallahzadeh H, Khorasani-Zavareh D. Management of Preventable Deaths due to Road Traffic Injuries in Prehospital Phase; a Qualitative Study. Arch Acad Emerg Med. 2019;7(1):32.
29
Pedersen MJ, Gjerland A, Rund BR, Ekeberg Ø, Skogstad L. Emergency Preparedness and Role Clarity among Rescue Workers during the Terror Attacks in Norway July 22, 2011. PLoS One. 2016;11(6):e0156536.
30
Hill B. Diagnosing co-ordination problems in the emergency management response to disasters. Interacting with Computers. 2010;22(1):43-55.
31
Zhang Y, Zheng J, Yi M, Ma H. Influencing factors and mechanisms of inter-organization collaboration obstacles in emergency rescue for urban rail transit. Advances in Mechanical Engineering. 2017;9(4):1687814017698640.
32
Bahadori M, Khankeh HR, Zaboli R, Ravangard R, Malmir I. Barriers to and Facilitators of Inter-Organizational Coordination in Response to Disasters: A Grounded Theory Approach. Disaster Med Public Health Prep. 2017;11(3):318-325.
33
Murota T, Takeda F. A Discussion on the Nation’s Command and Coordination Regarding Emergency Fire Response Teams. Journal of Disaster Research. 2019;14(7):978-90.
34
Mehmood A, Rowther AA, Kobusingye O, Hyder AA. Assessment of pre-hospital emergency medical services in low-income settings using a health systems approach. Int J Emerg Med. 2018;11(1):53.
35
Lukumay GG, Outwater AH, Mkoka DA, Ndile ML, Saveman BI. Traffic police officers’ experience of post-crash care to road traffic injury victims: a qualitative study in Tanzania”. BMC Emerg Med. 2019;19(1):51.
36
Tannvik TD, Bakke HK, Wisborg T. A systematic literature review on first aid provided by laypeople to trauma victims. Acta Anaesthesiol Scand. 2012;56(10):1222-7.
37
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.
38
Pramanik R, Hassel H, Tehler H, editors. Motivating factors towards willingness to contribute in collaborative tasks: A crisis cooperation perspective. ESREL 25th European Safety And Reliability Conference; 2015: Taylor & Francis.
39
Pramanik R, Ekman O, Hassel H, Tehler H. Organizational adaptation in multi‐stakeholder crisis response: An experimental study. Journal of Contingencies and Crisis Management. 2015;23(4):234-45.
40
ORIGINAL_ARTICLE
Scrub Sponge as A Wound Debridement Device
Introduction: Wound debridement is necessary before skin grafting or wound closure. Inappropriate wound bed preparation will led to graft rejection and sometimes catastrophic results, especially in large wounds,. Usage of popular debridement and excision devices such as dermatomes has some difficulties and disadvantages. In this study we will introduce metallic scrub sponge as a safe and effective debridement device.Methods: The surgeon usually uses a sterile metallic scrub sponge over the wound with transverse or rotational repeated movement. Wound preparing with metallic sponge should be stopped when pinpoint bleeding occurs. We used sterile metallic sponge for more than 2500 burn patients.Results: The results are excellent for deep second degree burn (and deeper burns at least 5-10 days after burn when some eschar loosening occurs). Work with scrub sponge was effective, fast and safe.Discussion: Metallic scrub sponge is a useful device for wound preparation due to its some special characteristics. Debridement of the burn wound with metallic sponge can preserve the spontaneous epithelialization potential of skin in second degree burns and reduce additional injury to the viable tissue that is inevitable by surgical debridement. Cost effectiveness, easy accessibility, safety, softness, inertness and some others are among the other advantages of metallic sponge usage for wound preparation.Conclusion: Due to metallic sponge’s simplicity and capability to remove necrotic loose tissues and easy accessibility everywhere and minimal adverse effects, it is a good first line tool for wound preparation and debridement.
https://beat.sums.ac.ir/article_47388_0399e7dc683ba9a0ec04cecea5f4b210.pdf
2021-04-01
96
100
10.30476/beat.2021.85912
Debridement
Sponge
Wound
Preparation
Burn
Mehdi
Ayaz
ayazm@sums.ac.ir
1
Amiralmomenin Hospital, Shiraz Burn Research Center, Department of Surgery, Shiraz university of medical science, Shiraz, Iran
LEAD_AUTHOR
Ayaz M. Why aren’t our work results in burn care excellent? Burns. 2017;43(3):681.
1
Ayaz M, Bahadoran H, Arasteh P, Keshavarzi A. Early Excision and Grafting versus Delayed Skin Grafting in Burns Covering Less than 15% of Total Body Surface Area; A Non- Randomized Clinical Trial. Bull Emerg Trauma. 2014;2(4):141-5.
2
Ayaz M, Keshavarzi A, Bahadoran H, Arasteh P, Moslemi S. Comparison of the Results of Early Excision and Grafting between Children and Adults; A Prospective Comparative Study. Bull Emerg Trauma. 2017;5(3):179-183.
3
Ayaz M, Karami MY, Deilami I, Moradzadeh Z. Effects of Early Versus Delayed Excision and Grafting on Restoring the Functionality of Deep Burn-Injured Hands: A Double-Blind, Randomized Parallel Clinical Trial. J Burn Care Res. 2019;40(4):451-456.
4
van Zuijlen PP, Kreis RW, Vloemans AF, Groenevelt F, Mackie DP. The prognostic factors regarding long-term functional outcome of full-thickness hand burns. Burns. 1999;25(8):709-14.
5
Lee JO, Dibildox M, Jimenez CJ, Gallagher JJ, Sayeed S, Sheridan RL, et al. Operative wound management. Total burn care 4th ed. USA: Elsevier Saunders; 2012. P.157-61.
6
Rosenberg L, Herndon D. Enzymatic debridement of burn wounds. Total burn care. 2012;2:131.
7
AIDS. EAGo. Guidance for Clinical Health Care Workers: Protection Against Infection with Blood-borne Viruses; Recommendations of the Expert Advisory Group on AIDS and the Advisory Group on Hepatitis: Department of Health; 1998.
8
Gurfinkel R, Rosenberg L, Cohen S, Cohen A, Barezovsky A, Cagnano E, et al. Histological assessment of tangentially excised burn eschars. Can J Plast Surg. 2010;18(3):e33-6.
9
Rosenberg L, Lapid O, Bogdanov-Berezovsky A, Glesinger R, Krieger Y, Silberstein E, et al. Safety and efficacy of a proteolytic enzyme for enzymatic burn debridement: a preliminary report. Burns. 2004;30(8):843-50.
10
ORIGINAL_ARTICLE
Meckel's Diverticulum Perforation by Foreign Body: A Case Report
Meckel’s diverticulum is the most common gastrointestinal congenital defect, which, although asymptomatic in adults, may present symptoms in obstruction, inflammation, bleeding and foreign body perforation. There are only 8 cases reported of Meckel’s diverticulum perforation by chicken bone. We report a case of a 24-yearold man presenting a 2-day-history of periumbilical pain that shifted to the right lower quadrant in 24 hours. Clinical and laboratory findings led to an appendicitis diagnosis, followed by laparotomy. Normal appendix was found intraoperatively along with an incidental finding of an inflamed and perforated Meckel’s diverticulum by chicken bone. Diverticulectomy and enteroanastomosis were performed and the patient had a successful recovery, being discharged 5 days after. Although rare, its clinical presentation might be similar to acuteappendicitis, which restate the importance of collecting a detailed clinical history and examining the small bowel towards to investigate a possible Meckel’s diverticulum complication in the differential diagnosis.
https://beat.sums.ac.ir/article_47312_9b7a36c0c87abddf428efdd1c17cfd32.pdf
2021-04-01
101
104
10.30476/beat.2021.86253
Meckel’s diverticulum
Perforation
Chicken bone
Acute Appendicitis
José Roberto
Alves
joserobertoalves1980@gmail.com
1
Diseases of the Abdominal Wall and Digestive System Research Group of the Federal University of Santa Catarina, Florianópolis, SC, Brazil
AUTHOR
Gustavo
Busch Justino
gustavobjustino@gmail.com
2
Diseases of the Abdominal Wall and Digestive System Research Group of the Federal University of Santa Catarina, Florianópolis, SC, Brazil
LEAD_AUTHOR
Leonardo
Busch Justino
bjustinoleo@gmail.com
3
Diseases of the Abdominal Wall and Digestive System Research Group of the Federal University of Santa Catarina, Florianópolis, SC, Brazil
AUTHOR
Caique
Martins Pereira Ternes
caiquempereira@hotmail.com
4
Diseases of the Abdominal Wall and Digestive System Research Group of the Federal University of Santa Catarina, Florianópolis, SC, Brazil
AUTHOR
João Vítor
Ternes Rech
jv.rech@hotmail.com
5
Diseases of the Abdominal Wall and Digestive System Research Group of the Federal University of Santa Catarina, Florianópolis, SC, Brazil
AUTHOR
Fabrissio
Portelinha Graffunder
fportelinha.g@gmail.com
6
Diseases of the Abdominal Wall and Digestive System Research Group of the Federal University of Santa Catarina, Florianópolis, SC, Brazil
AUTHOR
Bidarmaghz B, McGregor H, Raufian K, Tee CL. Perforation of the Meckel’s diverticulum with a chicken bone: a case report and literature review. Surg Case Rep. 2019;5(1):15.
1
Araújo LM, Araújo FM, Alves ACS, Monteiro ACF, Paula BC de, Xavier DSS, et al. Meckel’s diverticulum: a literature review. Rev Med Minas Gerais. 2014;24(1):93-7. [in Brazil]
2
Brásio R, Malaquias R, Gil I, Rama N, Ferraz S, Faria V. Meckel’s diverticulum-A case of lower gastrointestinal bleeding. Revista Portuguesa de Coloproctologia. 2015;12(1):45-8. [in Brazil]
3
Chan KW. Perforation of Meckel’s diverticulum caused by a chicken bone: a case report. J Med Case Rep. 2009;3:48.
4
Choi SY, Hong SS, Park HJ, Lee HK, Shin HC, Choi GC. The many faces of Meckel’s diverticulum and its complications. J Med Imaging Radiat Oncol. 2017;61(2):225-231.
5
Merayo-Álvarez M, Fernández-Martínez D, Gonzales-Stuva J, Sanz-Álvarez L, Álvarez-Pérez JA. Foreign body perforation of Meckel’s diverticulum. Rev Gastroenterol México. 2019;84(1):112–4. [in Brazil]
6
Farah RH, Avala P, Khaiz D, Bensardi F, Elhattabi K, Lefriyekh R, et al. Spontaneous perforation of Meckel’s diverticulum: a case report and review of literature. Pan Afr Med J. 2015;20:319.
7
Cotirlet A, Anghel R, Tincu E, Rau S, Motoc I, Popa E. Perforation of Meckel’s diverticulum by foreign body, a rare complication. Chirurgia (Bucur). 2013;108(3):411-3.
8
Canelas AL, Neto AN, Rodrigues AL, Meguins LC, Rolo DF, Lobato MF. Perforation of Meckel’s diverticulum by a chicken bone mimicking acute appendicitis. Case report. G Chir. 2009;30(11-12):476-8.
9
Borovoĭ SV. Perforatsiia divertikula Mekkelia kurinoĭ kost’iu [Perforation of Meckel’s diverticulum by a chicken bone]. Klin Khir. 1990;(2):58. [in Russian]
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