Journal of emergencies, trauma, and shock
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Trauma, a major public health concern in remote highlands of Nepal, has led to considerable morbidity and mortality. The study elucidates the pattern and characteristics of trauma at the only tertiary care hospital in the Karnali province, Nepal. ⋯ Trauma in Karnali is a predominantly early age male occurrence, with fall injury being the leading etiological factor, followed by injuries due to RTC and physical assaults. Soft tissue, head, and extremities were the major sites of injuries. Reducing fall injuries, RTC, and physical assaults will likely reduce mortality and morbidity due to trauma in this province.
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J Emerg Trauma Shock · Oct 2019
Utility of Point-of-Care Lung Ultrasound for Initial Assessment of Acute Respiratory Distress Syndrome Patients in the Emergency Department.
Lung ultrasound (LUS) has been extensively used in the evaluation of acute respiratory distress syndrome (ARDS) in the critical care setting. In our study, we aim to assess the utility of point-of-care ultrasound (POCUS)-LUS in the initial assessment of ARDS patients presenting to the emergency department (ED). ⋯ LUS in the initial assessment of patients' with ARDS yielded significant findings in the three clinically designated categories. This study opens up the possibility of using POCUS as an adjunct in the initial assessment of ARDS patient in the ED.
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J Emerg Trauma Shock · Oct 2019
Emergency Department Interventions and Their Effect on Delirium's Natural Course: The Folly May be in the Foley.
Delirium frequently affects older emergency department (ED) patients and has been associated with accelerated cognitive and functional decline, increased length of stay (LOS), and higher in- and out-of-hospital mortality. ⋯ ED bladder catheter placement was significantly associated with delirium duration and may present an opportunity for intervention.
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J Emerg Trauma Shock · Oct 2019
Is Emergency Department Thoracotomy Effective in Trauma Resuscitation? The Retrospective Study of the Emergency Department Thoracotomy in Trauma Patients at Thammasat University Hospital, Thailand.
The survival rate after the emergency department thoracotomy (EDT) in trauma patients varies from the previous study as 1.6% in blunt injury and 11.2% in penetrating injury. Most of the data came from Europe, the US, South Africa, and Japan. This study aims to identify the success of EDT of trauma patients at Thammasat University Hospital, Thailand, and to evaluate the effectiveness of EDT. This study may be representative data for Southeast Asia. ⋯ The ROSC rate of EDT in this study was 35%, but with no survival benefit. Therefore, we cannot guarantee that EDT serves as an effective life-saving procedure. However, EDT may play a significant role in treating extremis injured patients.
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J Emerg Trauma Shock · Apr 2019
A Comprehensive Analysis of Traumatic Rib Fractures in an Acute General Hospital in Singapore.
Rib fractures are common sequelae after blunt chest wall trauma. They can occur in isolation or association with life-threatening injuries to the head, thorax, and abdomen and may be complicated by hemothorax, pneumothorax, or lung contusions. Contiguous rib fractures can result in flail chest, which is associated with increased morbidity and mortality. This study aims to compare the risk factors, treatment modalities, and outcomes between patients with flail chest and nonflail chest postblunt trauma. ⋯ Flail chest is associated with higher morbidity and mortality. Proactive management from a multidisciplinary team such as identification of high-risk patients in particular patients with flail chest, early admission to critical care, and protocols including multimodal pain management, respiratory support, and rehabilitation should be instituted.