Bulletin of Emergency And Trauma
Volume:11 Issue: 1, Jan 2023

To estimate the rate of driving hazard perception (HP), explicate the content of HP and determineits components.

The present study is a systematic review and a meta-analysis which is carried out to gather data,to search Science Direct, PubMed, Scopus, PROQUEST, web of knowledge databases, Google scholar searchengine and also to search manually from January 2000 to September 2021 with using related keywords. EndNoteX20 software was used to manage and screening studies. Stata16 was used for meta-analysis. Thematic contentanalysis was used to analyze the findings. The entire review process was conducted by two authors, and disputeswere referred to a third person.

Out of the 1167 founded articles, 50 were finally included in the study. According to 10 importedpapers for meta-analysis includes 2770 sample size, general HP of drivers is estimated 3.33 [4.04-2.62 with CI95, I2=89.72]. Also, HP for experienced and beginner drivers is estimated 3.26 [2.23-4.26 with CI 95, I2=89.47]and 3.42 [2.41-4.43 with CI 95, I2=89.68], respectively. Also, in the data meta-synthesis, 28 definitions of HPand 6 main components are identified to evaluate HP using thematic content analysis.

In this study, obtained results show that all people need constant and gradual training at all levels.A factor that can be effective to improve drivers’ HP is to make drivers to take training courses and to passstandard tests at the time of obtaining driving license.

To design and conduct the effectiveness of Ketamine vs Dexmedetomidine in children’s sedation atemergency department (ED). This randomized clinical trial study was carried out at the two trauma centers in Mashhad, Iran. Thepatients were divided into two groups by means of a random numbers table to be treated with Ketamine (N=20)or Dexmedetomidine (N=20). Their demographic information and sedation times of drugs were collected andanalyzed. In general, sedation time was significantly higher in the ketamine group, 14.35 minutes (IQR:9.82-19) than in the dexmedetomidine group, 9.7 minutes (8.35-14.23) (p=0.023). Time of injection to completeanesthesia was 45.25 (IQR:30-58) and 72 (IQR:60.25-82) minutes in ketamine and dexmedetomidine groups,respectively (p<0.01). In the case of recovery, grade 4 of the Ramsey scale was statistically more prevalent indexmedetomidine (45%) than in the ketamine group (p=0.0001). This study demonstrated that dexmedetomidine could be used in cases where a shorter sedationtime is vital. Ketamine could be a better choice where full recovery time (from injection) matters most.

To evaluate the spiral chest computed tomography (CT) scan findings in patients with multipletrauma during the COVID-19 pandemic. 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. 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. 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.

Ventilator-associated pneumonia is the common cause of morbidity and mortality in the intensivecare unit. Due to the antimicrobial effect of chlorhexidine, and the long-lasting result of mucoadhesive drugs,this study aimed to determine the effect of chlorhexidine mucoadhesive gel on the prevention of ventilatorassociatedpneumonia in critical patients. In this clinical trial, 64 ventilated patients were selected and randomly allocated into two groups. Thefirst group received 0.2% chlorhexidine mucoadhesive gel and the second group received 0.2% chlorhexidinesolution as a mouthwash. Every three days, the incidence of ventilator-associated pneumonia was evaluatedby the clinical score of pulmonary infection. The data were analyzed by SPSS statistical software version 20. There was no statistically significant difference in demographic characteristics between the twogroups. In the control group, 25% of the patients had ventilator-associated pneumonia, while it was only 15.6%in the intervention group; however, the incidence of ventilator-associated pneumonia revealed no significantdifference between the two groups (HR ratio, 0.86; 95% confidence interval, 0.49 to 1.83 p=0.356).In addition,there was no statistically significant difference between the number of days connected to the ventilator(p=0.854), the number of days hospitalized in the intensive care unit (p=0.423), and the death rate (p=0.634)between the two groups. Although no significant statistical difference was detected between chlorhexidine mucoadhesivegel and chlorhexidine solution in the prevention of ventilator-associated pneumonia, the incidence of pneumoniain the mucoadhesive gel group was clinically less than in the control group. It is better to repeat the study witha larger statistical population.

To study the anti-inflammatory and antioxidant effects of flaxseed oil and olive oil on inflammatorymarkers for facilitating wound healing. One hundred and twelve patients were randomly selected to four groups with a total burn surfacearea (TBSA) of 20-50%. The four groups includes olive oil (OO), flaxseed oil (FO), mixture of olive oil andflaxseed oil (OF), and control group and received 30g of oils for three weeks. Serum high-sensitivity C-reactiveprotein (hs-CRP), ferritin and albumin level as inflammatory markers, as well as cholesterol, triglyceride,high-density lipoprotein (HDL) and low-density lipoprotein (LDL) as the lipid profile were explored. Woundhealing was assessed by photographing on days 2, 8, 15, and 22 (during three weeks of intervention) and wereanalyzed in imageJ software. The greatest reduction in the level of hs-CRP and ferritin was observed in the OF (-21.38±44.41)(-132.79±165.36), while the lowest reduction was reported in the control group (-36.36±79.03) (141.08±262.36).Compared to control group, OO significantly increased albumin (0.88±0.65). Reduction of wound healing at theend of the first week of intervention was not significant in the study groups. However, the stereology examinationshowed significant improvement in wound healing at the end of the second and third weeks in the OF. Based on the findings, combination of herbal oils reduce inflammation and improve wound healingand showed positive effects on the size of wounds in burn patients.

According to the reports of the World Health Organization approximately 300,000 deaths occuryearly worldwide due to burns or burn-associated injuries. This study aims to review the epidemiology of burnsin pediatrics and adolescents in Fars province between 2017 and 2018.

This is a cross-sectional study that investigated all people ≤18 years old who suffered from burninjuries in Fars province between 2017 and 2018. We use data from the file of burn patients which was providedby pre-hospital emergency services of Fars province. This data comprises demographic information (age andgender), burn-related information (type, degree, and severity of burns), mode of transfer (outpatient surgery ortransfer to hospital) and the outcome of the disease (death before arrival to the hospital or alive).

The average age of the subjects of this study was 5.8±8.9. We also categorized the subjects into fourage groups, 1-4, 5-8, 9-13 and 15-18 years. The number of boys who suffered from burn injuries is significantlymore than the girls (p=0.011). Also, there is a remarkable correlation between burn with age (p<0.001) andburn with disease outcome (p=0.01). The Most common cause of burns in boys was nonchemical hot objectsand liquids (28.5%). Likewise, the possibility of mortality in burn patients who faced an electric shock was22.66%. ([95%CI=2.32-220.63], p<0.001 OR=22.66).

This study shows that pediatrics and adolescents ≤ 4 have the most burn injuries, and boys havetwice as many burn events as girls. More importantly, the most common cause of burns in both genders wasburning with non-chemical hot objects and liquids, in particular, in the age group of 1-4 years, in which eventhappens at home.

Leech therapy (Hirudotherapy) is a method used in the treatment of many diseases since ancient times.Although many complications have been reported following the use of this method, no systemic life-threateningbleeding has yet been described. A-43-year-old male patient was diagnosed with upper gastrointestinalbleeding following leech application that he had received for infertility one week earlier. The complications ofhirudotherapy typically spontaneously improve due to the local effects of this treatment. The most frequentlyreported complications are local infections, and less commonly allergies and prolonged local bleeding canoccur. However, in this case report, we describe a life-threatening upper gastrointestinal bleeding as a newcomplication. Gastrointestinal bleeding appearing a week after leech therapy does not necessarily meanthat leeches caused gastrointestinal bleeding in this case. Nevertheless, considering the development timeof gastrointestinal bleeding, it can be deduced that it was possibly due to hirudotherapy. Patients should beinformed about alarming symptoms that can indicate complications following leech application.