Journal of Surgery and Trauma
Volume:10 Issue: 2, Summer 2022

Patient education in emergency departments faces complexities and challenges due to the wide variety of clinical care provided in this setting. Despite widespread recognition of the value and benefits of education, we frequently see that patient education in hospital emergency departments is less than optimal and that emergency departments are not employed as venues conducive to providing suitable and effective patient education. This study was conducted to ascertain the issues associated with patient education in emergency departments and the most relevant solutions. In this narrative review, the data were collected by searching the keywords patient education, emergency department, emergency medical services, health education, challenges of patient education, the importance of patient education, and barriers to patient education in Persian and English both separately and in combination using Boolean operators. The databases comprised Sid, Iranmedex, Magiran, Pubmed, Elsevier, Medlin, and Scopus, as well as the Google Scholar search engine. Sixty-five full-text articles were included in the study based on inclusion and exclusion criteria. Results from the review of articles revealed that hospital emergency departments face challenges in educating patients, including environmental factors (overcrowding, lack of time), patients’ low health literacy levels, communication skills, nurses’attitudes, and interest in patient education, and nurses’ scientific knowledge. To revive and enhance patient education, nursing managers and emergency department nurses should work proportionately to the current challenges by developing novel, innovative approaches or implementing appropriate practical solutions that will drastically alter how this critical issue is carried out in hospital emergency departments.

Work-family conflict is a common problem among pre-hospital emergency technicians. The present study investigates the effects of applying time management skills on family-work conflict and work-family enrichment in pre-hospital emergency technicians.

In this quasi-experimental study, eight emergency bases located in Birjand, Iran, were divided into two blocks: block A and block B (4 bases in each block). The two blocks were then randomly assigned to intervention and control groups, and 30 participants were selected from each block. Participants in both groups completed a demographic form, the work-family conflict scale, and the work-family enrichment scale. An eight-hour workshop on time management was held in one day for the intervention group. Immediately after the intervention and one month later, the two groups completed the study instruments. Data were entered into SPSS (version 19) for analysis. The independent t-test, repeated measures analysis of variance, and Bonferroni's post hoc test were applied for statistical data analysis. A P-value of less than 0.05 was considered statistically significant.

Regarding work-family conflict, family-work conflict, and total conflict, there was significantly more improvement from before the intervention to one month after the intervention in the intervention group compared to the control group (P<0.001). Improvement in work-family enrichment, family-work enrichment, and total work-family enrichment from before intervention to immediately after it in the intervention group was higher than in the control group (P<0.001). In the intervention group, family-work enrichment and work-family enrichment improvement from before intervention to one month after intervention were significantly higher than in the control group (P<0.001).

Applying time management skills is an effective tool to improve work-family conflict and work-family enrichment in pre-hospital emergency technicians.

Heart valve disease in pediatricsis an increasing global concern, especially in developing countries. This study aims to determine the clinical outcomes of pulmonary valve replacement (PVR) surgery in pediatrics.

The authors retrospectively identified all pediatrics undergoing PVR surgery at Imam Reza hospital (Mashhad, Iran) between 2000 and 2020. Their medical records were reviewed for demographic characteristics, clinical data (intra-operative and postoperative), and follow-up results. Echocardiography and electrocardiography were performedonall patients before the surgery and periodically after the surgery.

Among 50 pediatrics undergoing surgical PVR, 38 (76%) were female and others were male (14%), with a mean age of 10.39±5.31 years. The leading cause of PVR was the Tetralogy of Fallot. There was a significant relationship between age at the time of surgery and the size of the pulmonary valve(P=0.02).There were also statistically significant differences between QTc intervals before and after surgery (P=0.001). Further more, there was a significant correlation between QTc intervals before and after surgery and the ageof pediatrics at the time of surgery (P=0.01, r=-0.6).There was also a statistically significant relationship between the ICU stay (P=0.01) and the weaning time of the mechanical ventilation (P=0.03).

It is recommended that this procedure ispostponed as much as possible to decrease postoperative life-threatening events in pediatrics.In addition, if this surgery is conducted with good surgical and nursing management, it can be safe with low complications among other cardiac valve procedures.

Trauma is an injury that occurs due to the exchange of environmental energy with the body to an extent that is unbearable. In developing countries, such as Iran, trauma, especially abdominal trauma, has become increasingly important due to the enhanced development of vehicles and industries. The present study aimed to assess the frequency of intra-abdominal visceral injury due to penetrating trauma in the Emergency Department of Imam Khomeini Hospital in 2020.

This descriptive cross-sectional study was performed on 162 patients with penetrating abdominal trauma who were selected via the census method out of the patients referring to the Emergency Department of Imam Khomeini Hospital in Urmia, Iran. Data were collected using a checklist which included items on gender, age, length of hospital stay, patient's final condition, and cause of trauma, injury outcome, location of the injury, and laparotomy outcome. Data were entered into SPSS software (version 18) and analyzed using descriptive statistics (frequency, percentage, mean, and standard deviation) and chi-square test.

Out of 162 impenetrable trauma patients, 135 (83.3%) and 27 (16.7%) cases were male and female, respectively. The mean age of patients was 33.25±18.99 years. The causes of trauma were accidents (75.4%) and falls from height (24.6%). Furthermore, regarding laparotomy results, 29.6% of patients had no intra-abdominal visceral injury, while intestinal, liver, and spleen injuries were observed in 24.7%, 25.9%, and 19.8% of cases, respectively.

As evidenced by the results of this study, the majority of trauma patients were male. Moreover, the most common mechanisms of trauma in patients referring to the emergency department of this accident center and the most commonly injured organs were the spleen and intestine. Therefore, appropriate measures are required to prevent these injuries.

The intra-uterine device (Copper T) has been widely used as contraceptive method since 1965. Due to its low cost, effective and reversible nature and long-term benefits, it is widely being used in the developing world. The intra-uterine contraceptive device (IUCD) has been linked to complications like bleeding, perforation and migration to other surrounding organs. The intra-abdomen migration of IUCD is rare but a serious complication. Even in asymptomatic cases, migrated IUCD warrants removal due to its grave complications and medico-legal issues it posses. We reported a rare case of asymptomatic migrated IUCD in a young female who presented to our department with unusual presentation. Both the husband and the subject denied any recollection of indwelling IUCD. The patient was evaluated and diagnosed, and IUCD was removed with right nephrectomy. A brief review in the context is also presented.

Ruptured internal iliac artery aneurysms (IIAA) are extremely rare, and the repair can be challenging. This case reports described an 83-year-old patient who presented at our Emergency Department with acute abdominal pain based on a ruptured IIAA. He refused open repair and only wanted to be treated as minimally invasive as possible. Therefore endovascular embolization of the IIAA was performed. Repeat angiography showed that the procedure was successful. Treatment of a ruptured IIAA by an emergency coiling procedure under local anesthesia has been shown to be effective in this reported case.