فهرست مطالب

Emergency Practice and Trauma - Volume:4 Issue: 2, Summer - Autumn 2018

Journal of Emergency Practice and Trauma
Volume:4 Issue: 2, Summer - Autumn 2018

  • تاریخ انتشار: 1397/04/30
  • تعداد عناوین: 9
|
  • Luis Rafael Moscote-Salazar *, Guru Dutta Satyarthee, Nidia Escobar Hernandez, Jorge Aquino Matus, Willem Guillermo Calderon-Miranda, Marco Antonio Blancas-Varas, Johana Maraby, Joulen Mo-Carrascal Pages 53-54
    Scuba diving is associated with an important risk of devel­oping decompression sickness secondary to formation of gas bubbles inside the body. The latter is formed mainly by nitrogen in the body on the diver’s way to the surface (1,2). In some cases, it might injure the central nervous system. Several decompression cases that have been asso­ciated with neurologic symptoms are described in the lit­erature; however, brain multi-infarct with lethal outcome has never been described.
    Keywords: Brain multi-infarct, Decompression sickness, Emergency department
  • Ali Sadrollahi *, Adeleh Gharataghani, Mehdi Mahmoudi, Fardaneh Gholipour Pages 55-61
    Objective
    The key point to detect patients’ need in pre-hospital emergency is to have high ability to take medical history. All research findings show that this ability is low. The objective of this research is to investigate the ability to take medical history of patients among the personnel of pre-hospital emergency medical service (EMS) in Golestan province, Iran.
    Methods
    This research was a descriptive cross-sectional study carried in 2016. The population included non-staff technicians and an operator working in the message center (N = 171). The samples were selected using multi-stage cluster sampling. Data were collected by a researcher-developed questionnaire. The collected data were analyzed by SPSS software version 16 conducting descriptive and inferential statistics. All tests were administered at a significance level of P
    Results
    One hundred sixty-five (96.5%) participants were male. The mean score of the ability to take medical history was 58.4 ± 11.1. Therefore, 95 participants (58.3 %) had poor ability and 64 participants (39.3 %) owned moderate ability. The highest score concerning the ability to take medical history was for the aspect of professional knowledge (mean rank = 5). The most influential aspect in the ability was respectively for ‘professional knowledge’ (P = 0.0001, Beta = 0.509). Pearson correlation coefficient indicated a relationship (r=-0.149, P = 0.05) between the ability to take medical history and age.
    Conclusion
    The results of the current study indicated that the ability to take medical history among the personnel of pre-hospital medical emergency of Golestan province was low. Therefore, a thorough review of trainings promoting personnel’s professional knowledge is urgently required.
    Keywords: Medical history, Emergency, Patient, Pre-hospital
  • Arman Taheri, Morteza Hashemian, Mehrdad Noroozi *, Mohammad Bakhtiari, Mohammad Reza Doroodian, Shirin Salajegheh Pages 62-66
    Objective
    In order to prolong the duration of intrathecal lidocaine, various drugs are used along with it. Due to the promising effects of tizanidine on central nervous system, it can be assumed that tizanidine can have a positive effect on increasing the anesthesia duration too. Thus, we aimed to investigate the effect of oral tizanidine on the duration of lidocaine spinal anesthesia.
    Methods
    This double blind clinical trial was conducted on 40 male patients waiting for elective leg surgery with the age range of 20-60 years in one of the educational hospitals of Kerman University of Medical Sciences, Iran. We used simple random sampling and our participants were assigned into 2 groups (placebo and oral tizanidine receivers). Spinal anesthesia with 1 mg/kg of hyperbaric lidocaine 5% was performed in both groups. In tizanidine group, patients received 4 mg of oral tizanidine one hour before spinal anesthesia. Sensory block was examined by pin prick test and all anesthetic duration including start block until reduction of sensory level was calculated at 2 lower dermatomes.
    Results
    Findings showed that oral tizanidine compared to placebo can cause a 10-15 minute increase in patients’ lidocaine spinal anesthesia. Therefore, the average anesthesia time for tizanidine group increased meaningfully (P = 0.03). In addition, tizanidine can sedate patients during surgery (P = 0.00) or in recovery (P = 0.003).
    Conclusion
    Based on the results, tizanidine increased the duration of lidocaine so oral tizanidine can be used to prolong the duration of lidocaine spinal anesthesia.
    Keywords: Tizanidine, Intrathecal lidocaine, Spinal anesthesia
  • Julius Gbenga Olaogun *, Olusoga Olusola Akute, Amarachuku Chiduziem Etonyeaku, Joshua Taye Ige, David Brown Ajibola, Jide Michael Afolayan, Eyitayo Ebenezer Emmanuel Pages 67-72
    Objective
    There has been a global increase in the incidence of abdominal trauma in surgical patients. We conducted this study to evaluate the pattern of abdominal injuries, patient characteristics and the management outcome in our setting.
    Methods
    It was a descriptive (combined retrospective and prospective) study of all patients with abdominal trauma admitted and managed at Ekiti State University Teaching Hospital, Ado-Ekiti between January 2013 and December 2016. Data on socio-demographics, clinical profile, investigations, treatments and outcome were entered into a spread sheet and analyzed using SPSS version 20.0.
    Results
    A total of 2728 trauma patients presented during the study period. Of these, 68 (2.5%) suffered from abdominal injuries. Their ages ranged from 6 to 72 years (mean 30.3±13.2). Fifty-nine (86.8%) were males while 9 (13.2%) were females (M: F ratio = 6.6:1). Forty-nine (72.1%) sustained blunt trauma while 19 (27.9%) had penetrating injuries. Road traffic incident (RTI) (n=41; 60.3%) was the most common source of trauma, followed by assault: gunshot (n=9; 13.2%), and stab (n=7; 10.3%). Spleen (n=23; 33.8%) was the most common solid organ injured followed by the liver (n=7; 10.3%) while small bowel (n=8; 11.8%) was the most common hollow viscous injured. Forty-seven (69.1%) required operative intervention. Post-operative complication rate was 17% with wound infection (12.5%) predominating. The mortality rate was 4 (5.9%).
    Conclusion
    RTI and assault are major causes of abdominal injury. Measures to reduce RTI, youth restiveness and criminal activities will stem the tide.
    Keywords: Abdominal trauma, Semi-urban tertiary institution, Treatment outcome
  • Lawson Ekpe *, Kingsley Osuji Pages 73-76
    Objective
    Hypertension is a major risk factor for stroke, renal failure, and heart failure globally. This trend of complications has been seen even among our rural and urban dwellers in the tropics. This study aims at determining the prevalence and pattern of hypertension and body mass index (BMI) in six rural communities in Southern Nigeria.
    Methods
    Adult participants, aged 18-80 years of age from six rural Biase communities who presented for a health screening were recruited. This was a rural community-based cross-sectional study involving 419 adults. Information was obtained from questionnaires which were administered to assess and obtain demographic data. Blood pressure and anthropometric indices were measured from participants to assess the BMI and risk factors associated with hypertension, and pattern of blood pressure.
    Results
    A total of 419 enrolled for the study, but 137 had hypertension (systolic blood pressure ≥140 mm Hg and diastolic blood pressure ≥90 mm Hg) and this was made up of 86 females (62.8%) and 51 males (37.2%). Only 29 of the hypertensives (21.1%) were aware of their condition. The prevalence of hypertension was 32.7%. Moderate hypertension was the commonest presentation. High blood pressure, obesity and overweight was common among the women folk compared to the men that had isolated systolic hypertension (P
    Conclusion
    In recent times, hypertension is seen to be high even in rural settings; hence strict screening should be enhanced to allow for quicker diagnosis and early intervention.
    Keywords: Hypertension, Rural, blood pressure, prevalence, Nigeria
  • Hammoda Abu-Odah *, Akram Abu Salah, Ali El-Khateeb, Khawla El-Nems Pages 77-81
    Objective
    Patients’ satisfaction (PS) is recognized as an important emergency department service design and it has received a high interest and attention in the health management where many studies have focused on determining factors affecting PS in health-related circumstances. In this study, we aimed to examine PS in emergency department (ED) of the European Gaza Hospital (EGH) in the Gaza Strip (GS).
    Methods
    A descriptive-analytical cross sectional study was performed at ED-EGH between March, 15 and June 20, 2015. Press Ganey questionnaire was used as a tool for data collection. For each patient, a self-administered questionnaire including 22 questions was filled based on a Likert scale. Results were analyzed using SPSS version 22.
    Results
    Overall, 200 respondents were included in the study. About 73% of respondents were satisfied with overall medical services. The term of nurses’ concern provided to patients elicited the highest score (83.1%), followed by physicians’ concern with patients (72.0%) and communication skills with patients (71.4%), while the lowest score was reported in waiting time and security staff. Furthermore, our findings show an association between PS and level of education, gender differences, living area, and work shifts.
    Conclusion
    The study results conclude that areas of medical and nursing care, respects of staff, physical comfort and waiting time ED-EGH is highly acceptable and offer in appropriate manners.
    Keywords: Patient's Satisfaction, Emergency care, Emergency department, European Gaza Hospital
  • Behnam Behnush, Roya Kordrostami, Nahid Dadashzadeh, Maryam Ameri * Pages 82-85
    This study aimed to evaluate the shoulder dislocation following tramadol-induced seizure and its potential difference with other shoulder dislocations. We evaluated six cases that used tramadol tablets and some of them had a history of seizure. All of the cases had shoulder dislocation. According to the findings, tramadol use and tramadol-induced seizure may increase the risk of shoulder dislocation.
    Keywords: Tramadol, Seizure, Shoulder dislocation
  • Reza Bidaki, Mehrdad Roozbeh *, Mohammad Amin Sharifi, Seyed Nader Mostafavi, Mohammad Ali Abdolkarimi Davarani Pages 86-88
    Factitious disorder as Munchausen syndrome is a time and money consuming condition that is presented with different signs and symptoms. In emergent situations, it is not a differential diagnosis with high priority, but when it becomes recurrent with atypical symptoms, factitious disorder and malingering should be considered as well. In this survey, we report an odd and interesting presentation of a factitious disease as a scorpion sting which misled some professional healthcare providers until the patient finally confessed that she used turmeric to mimic the signs of a scorpion sting. She exaggerated her symptoms when asked about the details of the mechanism of the scorpion bite. When encountering an emergent condition, after ruling out the critical conditions especially when the symptom is recurrent, factitious disorders should be considered. Consultation with a psychiatrist help the team manage the patient properly.
    Keywords: Factitious disorder, Scorpion sting, Turmeric
  • Krishna Prasad*, Susan Tharian, Jebu A. Thomas Pages 89-91
    Traumatic spinal epidural hematoma (TSEH) is a neurosurgical emergency which is considered as one of the rare causes of back pain. The onset of symptoms presentation can vary especially following a trauma. Here, we report a case where a young girl had a trivial fall and presented symptoms of back pain three days later. She developed abrupt onset of lower limb weakness during her stay in the emergency department (ED). X-ray and computed tomography (CT) imaging of the spine did not show any obvious abnormality whereas, Magnetic resonance imaging (MRI) imaging revealed hyper-intense lesions in the thoracic spinal segment which led to the diagnosis of TSEH. Our case highlights the importance of the atypical and varied nature of presentation and the choice of investigation which would help in the early diagnosis of this entity.
    Keywords: Traumatic spinal epidural hematoma, Back pain, Paraperesis, Emergency department