Archives of Trauma Research Archives of Trauma Research Arch Trauma Res http://www.archtrauma.com 2251-953X 2251-9599 10.5812/atr. en jalali 2018 1 24 gregorian 2018 1 24 3 2
en 10.5812/atr.10526 Application of the Queuing Analytic Theory in Emergency Department Application of the Queuing Analytic Theory in Emergency Department letter letter Emergency Department;Queuing Theory Analysis Emergency Department;Queuing Theory Analysis http://www.archtrauma.com/index.php?page=article&article_id=10526 Nabil Tachfouti Nabil Tachfouti Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy, University Sidi Mohammed Ben Abdallah, Fez, Morocco; Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy, University Sidi Mohammed Ben Abdallah, Fez, Morocco. Tel: +212-615293711, Fax: +212-535619120 Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy, University Sidi Mohammed Ben Abdallah, Fez, Morocco; Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy, University Sidi Mohammed Ben Abdallah, Fez, Morocco. Tel: +212-615293711, Fax: +212-535619120
en 10.5812/atr.18161 Readability of Patient Education Materials on the American Association for Surgery of Trauma Website Readability of Patient Education Materials on the American Association for Surgery of Trauma Website research-article research-article Background

Because the quality of information on the Internet is of dubious worth, many patients seek out reliable expert sources. As per the American Medical Association (AMA) and the National Institutes of Health (NIH) recommendations, readability of patient education materials should not exceed a sixth-grade reading level. The average reading skill of U.S. adults is at the eighth-grade level.

Objectives

This study evaluates whether a recognized source of expert content, the American Association for Surgery of Trauma (AAST) website’s patient education materials, recommended readability guidelines for medical information.

Materials and Methods

Using the well-validated Flesch-Kincaid formula to analyze grade level readability, we evaluated the readability of all 16 of the publicly-accessible entries within the patient education section of the AAST website.

Results

Mean ± SD grade level readability was 10.9 ± 1.8 for all the articles. All but one of the articles had a readability score above the sixth-grade level. Readability of the articles exceeded the maximum recommended level by an average of 4.9 grade levels (95% confidence interval, 4.0-5.8; P < 0.0001). Readability of the articles exceeded the eighth-grade level by an average of 2.9 grade levels (95% confidence interval, 2.0-3.8; P < 0.0001). Only one of the articles had a readability score below the eighth-grade level.

Conclusions

The AAST’s online patient education materials may be of limited utility to many patients, as the readability of the information exceeds the average reading skill level of adults in the U.S. Lack of patient comprehension represents a discrepancy that is not in accordance with the goals of the AAST’s objectives for its patient education efforts.

Background

Because the quality of information on the Internet is of dubious worth, many patients seek out reliable expert sources. As per the American Medical Association (AMA) and the National Institutes of Health (NIH) recommendations, readability of patient education materials should not exceed a sixth-grade reading level. The average reading skill of U.S. adults is at the eighth-grade level.

Objectives

This study evaluates whether a recognized source of expert content, the American Association for Surgery of Trauma (AAST) website’s patient education materials, recommended readability guidelines for medical information.

Materials and Methods

Using the well-validated Flesch-Kincaid formula to analyze grade level readability, we evaluated the readability of all 16 of the publicly-accessible entries within the patient education section of the AAST website.

Results

Mean ± SD grade level readability was 10.9 ± 1.8 for all the articles. All but one of the articles had a readability score above the sixth-grade level. Readability of the articles exceeded the maximum recommended level by an average of 4.9 grade levels (95% confidence interval, 4.0-5.8; P < 0.0001). Readability of the articles exceeded the eighth-grade level by an average of 2.9 grade levels (95% confidence interval, 2.0-3.8; P < 0.0001). Only one of the articles had a readability score below the eighth-grade level.

Conclusions

The AAST’s online patient education materials may be of limited utility to many patients, as the readability of the information exceeds the average reading skill level of adults in the U.S. Lack of patient comprehension represents a discrepancy that is not in accordance with the goals of the AAST’s objectives for its patient education efforts.

Patient Education Materials; Online Health Information; Readability; Comprehension, Flesch-Kincaid Formula Patient Education Materials; Online Health Information; Readability; Comprehension, Flesch-Kincaid Formula http://www.archtrauma.com/index.php?page=article&article_id=18161 Adam E. M. Eltorai Adam E. M. Eltorai Warren Alpert Medical School, Brown University, Providence, USA; Warren Alpert Medical School, Brown University, Box G-9247, Providence, RI 02903, USA. Tel: +1-4018633330, Fax: +1-4018635096 Warren Alpert Medical School, Brown University, Providence, USA; Warren Alpert Medical School, Brown University, Box G-9247, Providence, RI 02903, USA. Tel: +1-4018633330, Fax: +1-4018635096 Soha Ghanian Soha Ghanian Warren Alpert Medical School, Brown University, Providence, USA Warren Alpert Medical School, Brown University, Providence, USA Charles A. Adams, Jr Charles A. Adams, Jr Warren Alpert Medical School, Brown University, Providence, USA; Division of Trauma and Surgical Critical Care, Department of Surgery, Rhode Island Hospital, Providence, USA Warren Alpert Medical School, Brown University, Providence, USA; Division of Trauma and Surgical Critical Care, Department of Surgery, Rhode Island Hospital, Providence, USA Christopher T. Born Christopher T. Born Warren Alpert Medical School, Brown University, Providence, USA; Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, Rhode Island Hospital, Providence, USA Warren Alpert Medical School, Brown University, Providence, USA; Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, Rhode Island Hospital, Providence, USA Alan H. Daniels Alan H. Daniels Warren Alpert Medical School, Brown University, Providence, USA; Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, Rhode Island Hospital, Providence, USA Warren Alpert Medical School, Brown University, Providence, USA; Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, Rhode Island Hospital, Providence, USA
en 10.5812/atr.17917 Quality of Life Among Veterans With Chronic Spinal Cord Injury and Related Variables Quality of Life Among Veterans With Chronic Spinal Cord Injury and Related Variables research-article research-article Background

In recent decades, the incidence of spinal cord injuries has increased. In a systemic review on epidemiology of traumatic spinal cord injury in developing countries reported 25.5/million cases per year.

Objectives

To assess the quality of life (QOL) of the veterans among Iran-Iraq war with chronic spinal cord injuries (SCI) and to evaluate long-term impressions of SCI on their quality of life.

Patients and Methods

Fifty-two veterans, all male, with chronic spinal cord injury from Iran-Iraq war (1980-1988) were interviewed and examined. The mean age of veterans at the time of interview was 49.3 years (38 to 80 years). Veterans were assessed by using a 36-item short-form (SF-36), hospital anxiety and depression scale (HADS) and the Barthel index. The presence or absence of pressure sores and spasticity were documented as well.

Results

The mean age of veterans at the time of study was 49.3 years. Pearson's correlation test showed that depression and anxiety have a reverse association with mental component summary (MCS) scale and physical component summary (PCS) scale scores, respectively. Regression analysis showed a negative effect of depression and pressure sore on PCS. Moreover, no association was found between the duration of injury and age with quality of life.

Conclusions

Lower QOL was found among veterans with chronic SCI. More researches on health-related quality of life (HRQOL) are needed to give us a better understanding of changes in life of patients with SCI and the ways to improve them.

Background

In recent decades, the incidence of spinal cord injuries has increased. In a systemic review on epidemiology of traumatic spinal cord injury in developing countries reported 25.5/million cases per year.

Objectives

To assess the quality of life (QOL) of the veterans among Iran-Iraq war with chronic spinal cord injuries (SCI) and to evaluate long-term impressions of SCI on their quality of life.

Patients and Methods

Fifty-two veterans, all male, with chronic spinal cord injury from Iran-Iraq war (1980-1988) were interviewed and examined. The mean age of veterans at the time of interview was 49.3 years (38 to 80 years). Veterans were assessed by using a 36-item short-form (SF-36), hospital anxiety and depression scale (HADS) and the Barthel index. The presence or absence of pressure sores and spasticity were documented as well.

Results

The mean age of veterans at the time of study was 49.3 years. Pearson's correlation test showed that depression and anxiety have a reverse association with mental component summary (MCS) scale and physical component summary (PCS) scale scores, respectively. Regression analysis showed a negative effect of depression and pressure sore on PCS. Moreover, no association was found between the duration of injury and age with quality of life.

Conclusions

Lower QOL was found among veterans with chronic SCI. More researches on health-related quality of life (HRQOL) are needed to give us a better understanding of changes in life of patients with SCI and the ways to improve them.

Quality of Life;Spinal Cord Injury;Veteran;Iran Quality of Life;Spinal Cord Injury;Veteran;Iran http://www.archtrauma.com/index.php?page=article&article_id=17917 Mohammad Hosein Ebrahimzadeh Mohammad Hosein Ebrahimzadeh Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Seyed Hosein Soltani-Moghaddas Seyed Hosein Soltani-Moghaddas Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran; Orthopedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Ahmad-Abad Street, Mashhad, IR Iran. Tel/Fax: +98-5118417453 Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran; Orthopedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Ahmad-Abad Street, Mashhad, IR Iran. Tel/Fax: +98-5118417453 Ali Birjandinejad Ali Birjandinejad Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Farzad Omidi-Kashani Farzad Omidi-Kashani Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Shahram Bozorgnia Shahram Bozorgnia Department of Orthopedic Surgery, Georgia Regents University, Augusta, USA Department of Orthopedic Surgery, Georgia Regents University, Augusta, USA
en 10.5812/atr.18950 The Serum Lead level in Patients With Retained Lead Pellets The Serum Lead level in Patients With Retained Lead Pellets research-article research-article Background

Patients, who survived from shotgun injuries, often have some retained lead pellets in their bodies. Several cases of lead toxicity have been reported regarding these patients.

Objectives

This study seeks to compare the serum lead level in patients who have retained lead pellets in their bodies with the control group.

Patients and Methods

In this case-control study, we gathered the serum lead levels of 25 patients with some retained lead pellets in their bodies due to shotgun and 25 volunteers without similar lead exposure and compared them in view of the age, gender, and living place.

Results

While the mean serum lead level in both groups was lower than the standard level (i.e. 40 µg/dL) , the mean ± SD of serum lead level were 29 ± 12.8 µg/dL and 25.3 ± 6.4 µg/dL in the case and control groups, respectively without any significant difference (P = 0. 30) . However, a positive relationship was seen between serum lead level, and the number of retained lead pellets (r = 0.447, P = 0. 025) .

Conclusions

Although extensive surgery to remove the lead pellets is not recommended in patients injured with shotguns, those with many retained lead pellets in their bodies should be considered at risk for lead poisoning and monitored carefully.

Background

Patients, who survived from shotgun injuries, often have some retained lead pellets in their bodies. Several cases of lead toxicity have been reported regarding these patients.

Objectives

This study seeks to compare the serum lead level in patients who have retained lead pellets in their bodies with the control group.

Patients and Methods

In this case-control study, we gathered the serum lead levels of 25 patients with some retained lead pellets in their bodies due to shotgun and 25 volunteers without similar lead exposure and compared them in view of the age, gender, and living place.

Results

While the mean serum lead level in both groups was lower than the standard level (i.e. 40 µg/dL) , the mean ± SD of serum lead level were 29 ± 12.8 µg/dL and 25.3 ± 6.4 µg/dL in the case and control groups, respectively without any significant difference (P = 0. 30) . However, a positive relationship was seen between serum lead level, and the number of retained lead pellets (r = 0.447, P = 0. 025) .

Conclusions

Although extensive surgery to remove the lead pellets is not recommended in patients injured with shotguns, those with many retained lead pellets in their bodies should be considered at risk for lead poisoning and monitored carefully.

Serum;Toxicity;Shotguns Serum;Toxicity;Shotguns http://www.archtrauma.com/index.php?page=article&article_id=18950 Mohammad Moazeni Mohammad Moazeni Department of Surgery, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, IR Iran; Department of Surgery, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, IR Iran. Tel: +98-3812224825, Fax: +98-3812269800 Department of Surgery, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, IR Iran; Department of Surgery, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, IR Iran. Tel: +98-3812224825, Fax: +98-3812269800 Faramarz Mohammad Alibeigi Faramarz Mohammad Alibeigi Department of Surgery, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, IR Iran Department of Surgery, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, IR Iran Masoud Sayadi Masoud Sayadi Kashani Hospital, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, IR Iran Kashani Hospital, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, IR Iran Ebrahim Poorya Mofrad Ebrahim Poorya Mofrad Department of Anesthesiology, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, IR Iran Department of Anesthesiology, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, IR Iran Soleiman Kheiri Soleiman Kheiri Social Health Determinants Research Center, Shahrekord University of Medical Sciences, Shahrekord, IR Iran Social Health Determinants Research Center, Shahrekord University of Medical Sciences, Shahrekord, IR Iran Malihe Darvishi Malihe Darvishi Kashani Hospital, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, IR Iran Kashani Hospital, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, IR Iran
en 10.5812/atr.18182 Burn Patients Infected With Metallo-Beta-Lactamase-Producing Pseudomonas aeruginosa: Multidrug-Resistant Strains Burn Patients Infected With Metallo-Beta-Lactamase-Producing <italic>Pseudomonas aeruginosa</italic>: Multidrug-Resistant Strains research-article research-article Background

Metallo-beta-lactamase (MBL) producing Pseudomonas aeruginosa in the burn patients is a leading cause of morbidity and mortality and remains a serious health concern among the clinicians.

Objectives

The aim of this study was to detect MBL-producing P. aeruginosa in burn patients and determine multidrug-resistant (MDR) strains, and respective resistance patterns.

Patients and Methods

In this cross-sectional study, 270 strains of P. aeruginosa were isolated from the burn patients referred to Ghotbeddin Burn Hospital, Shiraz, Iran. Among them, 55 MBL-producing P. aeruginosa strains were isolated from 55 patients hospitalized in burn unit. Minimum inhibitory concentrations (MICs) and MBLs were determined by the E-test method.

Results

Of the 55 burn cases, 29 (53%) were females and 26 (47%) males. Injured burn patients’ ages ranged from 16 to 87 years, with maximum number of cases in the age group of 16 to 36 years (n, 40; 72.7%). Overall, 32 cases were accidental (60%), and 22 were suicidal burns (40%). Of the 55 burn patients, 17 cases were expired (30%). All deaths were due to chemical exposures. In antibiotic susceptibility testing by E-test method, ceftazidime was the most effective one and 35 isolates (63.5%) were resistant to all the 11 tested antibiotics.

Conclusions

Routine microbiological surveillance and careful in vitro testing of antibiotics prior to prescription and strict adherence to hospital antibiotic policy may help to prevent, treat, and control MDR and pandrug-resistant (PDR) P. aeruginosa strains in burn units.

Background

Metallo-beta-lactamase (MBL) producing Pseudomonas aeruginosa in the burn patients is a leading cause of morbidity and mortality and remains a serious health concern among the clinicians.

Objectives

The aim of this study was to detect MBL-producing P. aeruginosa in burn patients and determine multidrug-resistant (MDR) strains, and respective resistance patterns.

Patients and Methods

In this cross-sectional study, 270 strains of P. aeruginosa were isolated from the burn patients referred to Ghotbeddin Burn Hospital, Shiraz, Iran. Among them, 55 MBL-producing P. aeruginosa strains were isolated from 55 patients hospitalized in burn unit. Minimum inhibitory concentrations (MICs) and MBLs were determined by the E-test method.

Results

Of the 55 burn cases, 29 (53%) were females and 26 (47%) males. Injured burn patients’ ages ranged from 16 to 87 years, with maximum number of cases in the age group of 16 to 36 years (n, 40; 72.7%). Overall, 32 cases were accidental (60%), and 22 were suicidal burns (40%). Of the 55 burn patients, 17 cases were expired (30%). All deaths were due to chemical exposures. In antibiotic susceptibility testing by E-test method, ceftazidime was the most effective one and 35 isolates (63.5%) were resistant to all the 11 tested antibiotics.

Conclusions

Routine microbiological surveillance and careful in vitro testing of antibiotics prior to prescription and strict adherence to hospital antibiotic policy may help to prevent, treat, and control MDR and pandrug-resistant (PDR) P. aeruginosa strains in burn units.

Burn patients;Pseudomonas aeruginosa;Metallo-Beta-Lactamase;Drug Resistance Burn patients;Pseudomonas aeruginosa;Metallo-Beta-Lactamase;Drug Resistance http://www.archtrauma.com/index.php?page=article&article_id=18182 Mojtaba Anvarinejad Mojtaba Anvarinejad Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Aziz Japoni Aziz Japoni Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Noroddin Rafaatpour Noroddin Rafaatpour Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Jalal Mardaneh Jalal Mardaneh Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran; Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel: +98-7116474304 Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran; Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel: +98-7116474304 Pejman Abbasi Pejman Abbasi Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Maneli Amin Shahidi Maneli Amin Shahidi Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Mohammad Ali Dehyadegari Mohammad Ali Dehyadegari Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Ebrahim Alipour Ebrahim Alipour Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran
en 10.5812/atr.17351 Doubt About Prediction Role of S100B Protein in Brain Death Doubt About Prediction Role of S100B Protein in Brain Death letter letter Brain Death;S100b Protein, Human;Control Groups;Decision Support Techniques Brain Death;S100b Protein, Human;Control Groups;Decision Support Techniques http://www.archtrauma.com/index.php?page=article&article_id=17351 Ali Kabir Ali Kabir Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, IR Iran; Department of Epidemiology, Faculty of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Faculty of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-2144471350, Fax: +98-2144471349 Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, IR Iran; Department of Epidemiology, Faculty of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Faculty of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-2144471350, Fax: +98-2144471349 Mehrdad Moghimi Mehrdad Moghimi Department of Surgery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Surgery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Afshin Amini Afshin Amini Department of Toxicology and Emergency Medicine, Faculty of Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Toxicology and Emergency Medicine, Faculty of Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
en 10.5812/atr.17610 Diabetic Foot Due to Anaphylactic Shock: A Case Report Diabetic Foot Due to Anaphylactic Shock: A Case Report case-report case-report Introduction

Diabetic foot is a clinical disorder, which is commonly seen in patients with diabetes mellitus. It is also the major cause of below knee amputation in the world. There are many underlying causes such as neuropathic, ischemic, and infectious causes for diabetic foot. Local or systemic complications may develop after snake bite.

Case Presentation

We reported a very rare case, involving a 78-year-old male admitted to the Emergency Department, who developed anaphylactic shock and diabetic foot after the snake bite.

Conclusions

Reviewing the literature, this is the second reported case of snake bite associated with diabetic foot.

Introduction

Diabetic foot is a clinical disorder, which is commonly seen in patients with diabetes mellitus. It is also the major cause of below knee amputation in the world. There are many underlying causes such as neuropathic, ischemic, and infectious causes for diabetic foot. Local or systemic complications may develop after snake bite.

Case Presentation

We reported a very rare case, involving a 78-year-old male admitted to the Emergency Department, who developed anaphylactic shock and diabetic foot after the snake bite.

Conclusions

Reviewing the literature, this is the second reported case of snake bite associated with diabetic foot.

Snake Bite;Anaphylactic Shock;Diabetic Foot Snake Bite;Anaphylactic Shock;Diabetic Foot http://www.archtrauma.com/index.php?page=article&article_id=17610 Ali Karakus Ali Karakus Department of Emergency Medicine, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey; Department of Emergency Medicine, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey. Tel: +90-5052540433, Fax: +90-3262455654 Department of Emergency Medicine, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey; Department of Emergency Medicine, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey. Tel: +90-5052540433, Fax: +90-3262455654 Mustafa Ozkan Mustafa Ozkan Department of Plastic Surgery, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey Department of Plastic Surgery, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey Murat Karcioglu Murat Karcioglu Department of Anesthesia, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey Department of Anesthesia, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey Raif Ozden Raif Ozden Department of Orthopedic Surgery, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey Department of Orthopedic Surgery, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey Ihsan Ustun Ihsan Ustun Department of Endocrinology, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey Department of Endocrinology, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey Koca Caliskan Koca Caliskan Department of Emergency Medicine, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey Department of Emergency Medicine, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey Cumali Gokce Cumali Gokce Department of Endocrinology, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey Department of Endocrinology, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey Mustafa Sahan Mustafa Sahan Department of Emergency Medicine, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey Department of Emergency Medicine, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey
en 10.5812/atr.21639 Ocular Trauma: An Overview Ocular Trauma: An Overview editorial editorial WHO; Blindness WHO; Blindness http://www.archtrauma.com/index.php?page=article&article_id=21639 Dawood Aghadoost Dawood Aghadoost Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran; Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3615342020; +98-9131613628, Fax: +98-36153389 Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran; Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3615342020; +98-9131613628, Fax: +98-36153389
en 10.5812/atr.17150 Epidemiology of Patients With Multiple Trauma and the Quality of Their Prehospital Respiration Management in Kashan, Iran: Six Months Assessment Epidemiology of Patients With Multiple Trauma and the Quality of Their Prehospital Respiration Management in Kashan, Iran: Six Months Assessment research-article research-article Background

Respiration management is an important and critical issue in prehospital transportation phase of multiple trauma patients. However, the quality of this important care has not been assessed in Iran Emergency Medical Services’ (EMS).

Objectives

This study was conducted to investigate the quality of prehospital respiration management in patients with multiple trauma, referred to the Shahid Beheshti Trauma Center, Kashan, Iran.

Patients and Methods

This cross-sectional study was conducted in the first six months of 2013. All the 400 patients with multiple trauma, transferred by EMS to the Shahid Beheshti Medical Center, were recruited. The study instrument was a checklist, which was completed through observation. Descriptive statistics were presented.

Results

Out of all included individuals, 301 were males (75.2%) and 99 were females (24.8%). The most common mechanism of trauma was traffic accident (87.25%). Furthermore, 71.7% of the patients were injured in head and neck and chest areas. The quality of consciousness monitoring and airway management was desirable in 95% of the cases. However, the quality of monitoring patients’ respiration was only desirable in 42% of the cases. Only 18.6% of the patients received oxygen therapy during prehospital transportation.

Conclusions

The quality of monitoring patients’ respiration and oxygen therapy was undesirable in most patients with multiple trauma. Therefore, the EMS workers should be retrained to apply proper respiration management in patients with multiple trauma.

Background

Respiration management is an important and critical issue in prehospital transportation phase of multiple trauma patients. However, the quality of this important care has not been assessed in Iran Emergency Medical Services’ (EMS).

Objectives

This study was conducted to investigate the quality of prehospital respiration management in patients with multiple trauma, referred to the Shahid Beheshti Trauma Center, Kashan, Iran.

Patients and Methods

This cross-sectional study was conducted in the first six months of 2013. All the 400 patients with multiple trauma, transferred by EMS to the Shahid Beheshti Medical Center, were recruited. The study instrument was a checklist, which was completed through observation. Descriptive statistics were presented.

Results

Out of all included individuals, 301 were males (75.2%) and 99 were females (24.8%). The most common mechanism of trauma was traffic accident (87.25%). Furthermore, 71.7% of the patients were injured in head and neck and chest areas. The quality of consciousness monitoring and airway management was desirable in 95% of the cases. However, the quality of monitoring patients’ respiration was only desirable in 42% of the cases. Only 18.6% of the patients received oxygen therapy during prehospital transportation.

Conclusions

The quality of monitoring patients’ respiration and oxygen therapy was undesirable in most patients with multiple trauma. Therefore, the EMS workers should be retrained to apply proper respiration management in patients with multiple trauma.

Quality of Health Care; Respiration; Prehospital Emergency Care; Multiple Trauma; Accident Quality of Health Care; Respiration; Prehospital Emergency Care; Multiple Trauma; Accident http://www.archtrauma.com/index.php?page=article&article_id=17150 Mohsen Adib-Hajbaghery Mohsen Adib-Hajbaghery Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, IR Iran; Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3615550021, Fax: +98-3615556633 Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, IR Iran; Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3615550021, Fax: +98-3615556633 Farzaneh Maghaminejad Farzaneh Maghaminejad Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran
en 10.5812/atr.15433 Surgical Stabilization of Femur Fractures in Post-Traumatic Hypoxemic Patients: When and Why? Surgical Stabilization of Femur Fractures in Post-Traumatic Hypoxemic Patients: When and Why? research-article research-article Conclusions

Appropriate surgical stabilization can be safely performed during established post-traumatic hypoxemia using a multidisciplinary approach, continuous monitoring, and serial investigations to diagnose fulminant pathology and associated injuries.

Results

A total of 31 adults (26 males and 5 females) with LIS of 0.1 to 2.5 (26 patients) and > 2.5 (five patients) at admission were recruited. Sixteen patients were admitted within 24 hours and 15 between 24 and 90 hours after injury. Thirteen patients were operated within 24 hours. Post-operative LIS was improved. No adverse sequels or mortality were seen.

Patients and Methods

In this prospective observational study, post-traumatic adults with PaO2 < 70 mmHg in room air were enrolled. Physiological parameters, O2 saturation (SO2), arterial blood gas (ABG) analysis, Schonfeld fat embolism index score (SS), and Murray’s lung injury scores (LIS) were assessed. The management protocol was femur surgery when patient was hemodynamically stable with LIS < 2.5 and PaO2/FiO2 > 200 mmHg (FiO2 < 0.5, PEEP < 8 cm H2O).

Background

Post-traumatic hypoxemia can deteriorate during operative manipulations.

Objectives

In the present study, criteria-based approach was applied to determine optimum conditions for femur surgery. The aim of this study was to optimize perioperative management of post-traumatic hypoxemia.

Conclusions

Appropriate surgical stabilization can be safely performed during established post-traumatic hypoxemia using a multidisciplinary approach, continuous monitoring, and serial investigations to diagnose fulminant pathology and associated injuries.

Results

A total of 31 adults (26 males and 5 females) with LIS of 0.1 to 2.5 (26 patients) and > 2.5 (five patients) at admission were recruited. Sixteen patients were admitted within 24 hours and 15 between 24 and 90 hours after injury. Thirteen patients were operated within 24 hours. Post-operative LIS was improved. No adverse sequels or mortality were seen.

Patients and Methods

In this prospective observational study, post-traumatic adults with PaO2 < 70 mmHg in room air were enrolled. Physiological parameters, O2 saturation (SO2), arterial blood gas (ABG) analysis, Schonfeld fat embolism index score (SS), and Murray’s lung injury scores (LIS) were assessed. The management protocol was femur surgery when patient was hemodynamically stable with LIS < 2.5 and PaO2/FiO2 > 200 mmHg (FiO2 < 0.5, PEEP < 8 cm H2O).

Background

Post-traumatic hypoxemia can deteriorate during operative manipulations.

Objectives

In the present study, criteria-based approach was applied to determine optimum conditions for femur surgery. The aim of this study was to optimize perioperative management of post-traumatic hypoxemia.

Post-traumatic hypoxemia;Damage-control surgery Post-traumatic hypoxemia;Damage-control surgery http://www.archtrauma.com/index.php?page=article&article_id=15433 Ramesh Kumar Sen Ramesh Kumar Sen Department of Orthopedic Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India Department of Orthopedic Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India Goverdhan Dutt Puri Goverdhan Dutt Puri Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India Indu Mohini Indu Mohini Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India; Department of Anesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, 160012, Chandigarh, India. Tel: +91-1722686677 Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India; Department of Anesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, 160012, Chandigarh, India. Tel: +91-1722686677 Anil Pratap Anil Pratap Department of Orthopedic Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India Department of Orthopedic Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India Nirmal Raj Nirmal Raj Department of Orthopedic Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India Department of Orthopedic Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India