1
10
16
-
https://repository.horizon.ac.id/files/original/92df9e928a8cd292c9956b30c545d01d.PDF
756b2bdca63caa8ad02b9da0563df8d8
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Title
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VOLUME 21 ISSUE 1 MARET 2021
Text
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Title
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Prospective study of emergency medicine provider wellness across ten academic and community hospitals during the initial surge of the COVID-19 pandemic
Subject
The topic of the resource
Physician wellness, Well-being, Burnout, Emergency medicine, COVID-19 wellness
Description
An account of the resource
Background: While COVID-19 has had far-reaching consequences on society and health care providers, there is a
paucity of research exploring frontline emergency medicine (EM) provider wellness over the course of a pandemic.
The objective of this study was to assess the well-being, resilience, burnout, and wellness factors and needs of EM
physicians and advanced practice providers (e.g., nurse practitioners and physician assistants; APPs) during the initial
phase of the COVID-19 pandemic.
Methods: A descriptive, prospective, cohort survey study of EM physicians and APPs was performed across ten
emergency departments in a single state, including academic and community settings. Participants were recruited
via email to complete four weekly, voluntary, anonymous questionnaires comprised of customized and validated
tools for assessing wellness (Well Being Index), burnout (Physician Work Life Study item), and resilience (Brief
Resilience Scale) during the initial acceleration phase of COVID-19. Univariate and multivariate analysis with Chi�squared, Fisher’s Exact, and logistic regression was performed.
Results: Of 213 eligible participants, response rates ranged from 31 to 53% over four weeks. Women comprised 54
to 60% of responses. Nonrespondent characteristics were similar to respondents. Concern for personal safety
decreased from 85 to 61% (p < 0.001). Impact on basic self-care declined from 66 to 32% (p < 0.001). Symptoms of
stress, anxiety, or fear was initially 83% and reduced to 66% (p = 0.009). Reported strain on relationships and feelings
of isolation affected > 50% of respondents initially without significant change (p = 0.05 and p = 0.30 respectively).
Women were nearly twice as likely to report feelings of isolation as men (OR 1.95; 95% CI 1.82–5.88). Working part�time carried twice the risk of burnout (OR, 2.45; 95% CI, 1.10–5.47). Baseline resilience was normal to high. Provider
well-being improved over the four weeks (30 to 14%; p = 0.01), but burnout did not significantly change (30 to 22%;
p = 0.39).
Conclusion: This survey of frontline EM providers, including physicians and APPs, during the initial surge of COVID-
19 found that despite being a resilient group, the majority experienced stress, anxiety, fear, and concerns about
personal safety due to COVID-19, putting many at risk for burnout. The sustained impact of the pandemic on EM
provider wellness deserves further investigation to guide targeted interventions.
Creator
An entity primarily responsible for making the resource
Heather Kelker, Kyle Yoder, Paul Musey Jr, Madison Harris, Olivia Johnson, Elisa Sarmiento, Punit Vyas, Brooke Henderson, Zachary Adams and Julie Welch
Publisher
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BMC Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
(2021) 21:36
Contributor
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Fajar bagus W
Format
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PDF
Language
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Indonesia
Type
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Text
Burnout
COVID-19 wellness
Emergency medicine
Jurnal Internasional Keperawatan
Physician wellness
Well-being
-
https://repository.horizon.ac.id/files/original/5a51f98ec49b32ed00abbf5209e7204c.PDF
a188b6b6ef365416ba6acdd0c371b521
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The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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VOLUME 21 ISSUE 1 MARET 2021
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
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Title
A name given to the resource
Prediction of a time-sensitive condition among patients with dizziness assessed by the emergency medical services
Subject
The topic of the resource
Prehospital, Dizziness, Outcome, Diagnosis, Time sensitive
Description
An account of the resource
Background: Dizziness is a relatively common symptom among patients who call for the emergency medical
services (EMS).
Aim: To identify factors of importance for the early identification of a time-sensitive condition behind the symptom
of dizziness among patients assessed by the EMS.
Methods: All patients assessed by the EMS and triaged using Rapid Emergency Triage and Treatment (RETTS) for
adults code 11 (=dizziness) in the 660,000 inhabitants in the Municipality of Gothenburg, Sweden, in 2016, were
considered for inclusion. The patients were divided into two groups according to the final diagnosis (a time�sensitive condition, yes or no).
Results: There were 1536 patients who fulfilled the inclusion criteria, of which 96 (6.2%) had a time-sensitive
condition. The majority of these had a stroke/transitory ischaemic attack (TIA). Eight predictors of a time-sensitive
condition were identified. Three were associated with a reduced risk: 1) the dizziness was of a rotatory type, 2) the
dizziness had a sudden onset and 3) increasing body temperature. Five were associated with an increased risk: 1)
sudden onset of headache, 2) a history of head trauma, 3) symptoms of nausea or vomiting, 4) on treatment with
anticoagulants and 5) increasing systolic blood pressure.
Conclusion: Among 1536 patients who were triaged by the EMS for dizziness, 6.2% had a time-sensitive condition.
On the arrival of the EMS, eight factors were associated with the risk of having a time-sensitive condition. All these
factors were linked to the type of symptoms or to clinical findings on the arrival of the EMS or to the recent clinical
history
Creator
An entity primarily responsible for making the resource
C. Magnusson, J. Gärskog, E. Lökholm, J. Stenström, R. Wetter, C. Axelsson, M. Andersson Hagiwara, N. Packendorff, K. Jood, T. Karlsson and J. Herlitz
Publisher
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BMC Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
(2021) 21:38
Contributor
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Fajar bagus W
Format
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PDF
Language
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Indonesia
Type
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Text
Diagnosis
Dizziness
Jurnal Internasional Keperawatan
Outcome
Prehospital
Time sensitive
-
https://repository.horizon.ac.id/files/original/42ecda937576a34415fb43a32cb12bcd.PDF
ebefafa61887f0c5e1b1e392a1270353
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Title
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VOLUME 21 ISSUE 1 MARET 2021
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Perceived occupational stressors among emergency medical service providers: a qualitative study
Subject
The topic of the resource
Stress, Emergency medical services, Qualitative study
Description
An account of the resource
Introduction: Emergency medical services (EMS) providers are at continuous exposure to occupational stressors
which negatively affect their health and professional practice. This study explored perceived occupational stressors
among EMS providers.
Methods: This qualitative study was conducted from December 2019 to April 2020 using conventional content
analysis. Sixteen EMS providers were purposively selected from EMS stations in Hamadan, Iran. Semi-structured
interviews (with length of 45–60 min) were held for data collection. Data were analyzed through Graneheim and
Lundman’s conventional content analysis approach.
Findings: Data analysis resulted in the development of two themes, namely critical conditions of EMS provision, and
personal and professional conflicts. The six categories of these two themes were complexity of patients’ clinical conditions,
interruption of EMS provision, health hazards, interpersonal problems, interprofessional interactions, and legal conflicts.
Conclusion: Besides the stress associated with emergency patient care, EMS providers face many different occupational
stressors. EMS managers can use the findings of the present study to develop strategies for reducing occupational stress
among EMS providers and thereby, improve their health and care quality
Creator
An entity primarily responsible for making the resource
Ali Afshari , Seyed Reza Borzou , Farshid Shamsaei , Eesa Mohammadi and Leili Tapak
Publisher
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BMC Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
(2021) 21:35
Contributor
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Fajar bagus W
Format
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PDF
Language
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Indonesia
Type
The nature or genre of the resource
Text
Emergency medical services
Jurnal Internasional Keperawatan
Qualitative study
stress
-
https://repository.horizon.ac.id/files/original/98367c17592064706a10656de2af5229.PDF
698de500f1370f5cf31b2b48d8077a5e
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Title
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VOLUME 21 ISSUE 1 MARET 2021
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
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Title
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Management quality indicators and in�hospital mortality among acute coronary syndrome patients admitted to tertiary hospitals in Ethiopia: prospective observational study
Subject
The topic of the resource
Acute coronary syndrome, Myocardial infarction, Management quality indicators, Mortality, Sub-Saharan
Africa
Description
An account of the resource
Background: Acute coronary syndrome (ACS) remains the leading cause of cardiovascular disease mortality and
morbidity worldwide. While the management quality measures and clinical outcomes of patients with ACS have
been evaluated widely in developed countries, inadequate data are available from sub-Saharan Africa countries. So,
this study aimed to assess the clinical profiles, management quality indicators, and in-hospital outcomes of patients
with ACS in Ethiopia.
Methods: A Prospective observational study was conducted at two tertiary hospitals in Ethiopia from March 2018
to November 2018. The primary outcome of the study was in-hospital mortality. Data were analyzed using SPSS
version 23.0. Multivariable cox-regression was conducted to identify predictors of time to in-hospital mortality.
Variable with p -value < 0.05 was considered statistically significant.
Results: Among 181 ACS patients enrolled, about (61%) were presented with ST-elevation myocardial infarction
(STEMI). The mean age of the study participant was 55.8 ± 11.9 years and 62.4% were males. The use of guideline�directed medications within 24 h of hospitalization were sub-optimal (57%) [Dual antiplatelet (73%), statin (74%),
beta-blocker (67%) and ACEI (61%)]. Only (7%) ACS patients received the percutaneous coronary intervention (PCI).
Discharge aspirin and statin were high (> 90%) while other medications were sub-optimal (< 80%). The all-cause in�hospital mortality rate was 20.4% and the non-fatal MACE rate was 25%. Rural residence (AHR: 3.64, 95% CI: 1.81–
7.29), symptom onset to hospital arrival > 12 h (AHR: 4.23, 95% CI: 1.28–13.81), and Cardiogenic shock (AHR: 7.20,
95% CI: 3.55–14.55) were independent predictors of time to in-hospital death among ACS patients.
Conclusion: In the present study, the use of guideline-directed in-hospital medications was sub-optimal.
The overall in-hospital mortality rate was unacceptably high and highlights the urgent need for national quality�improvement focusing on timely initiation of evidence-based medications, reperfusion therapy, and strategies to
reduce pre-hospital delay.
Creator
An entity primarily responsible for making the resource
Korinan Fanta, Fekede Bekele Daba, Elsah Tegene, Tsegaye Melaku, Ginenus Fekadu and Legese Chelkeba
Publisher
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BMC Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
(2021) 21:41
Contributor
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Fajar bagus W
Format
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PDF
Language
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Indonesia
Type
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Text
Jurnal Internasional Keperawatan
Management quality indicators
mortality
Sub-Saharan Africa
-
https://repository.horizon.ac.id/files/original/f3f4b38e3c67414a0b641bc9a5c003ca.PDF
dc36c5fcf4597554c8d2f4a1396a5631
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Title
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VOLUME 21 ISSUE 1 MARET 2021
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
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Title
A name given to the resource
Lessons learned from reviewing a hospital’s disaster response to the hydrofluoric acid leak in Gumi city in 2012
Subject
The topic of the resource
Disasters, Surge capacity, Hydrogen fluoride, Review
Description
An account of the resource
Background: This study analyzed the characteristics of hydrogen fluoride-exposed patients (HFEPs) treated in the
emergency department (ED) of a local university hospital, and reviewed the hospital’s disaster response according
to space, staff, supplies, and systems (4Ss).
Methods: This retrospective observational chart review and descriptive study included 199 HFEPs among 2588 total
ED patients who visited a local university emergency medical center for treatment between September 27, 2012
and October 20, 2012, following a hydrofluoric acid leak at the Hube Globe factory in Gumi City, Republic of Korea.
Descriptive results concerning the 4Ss were obtained by interviewing ED specialist staff physicians on duty during
the study period. In accordance with American Burn Association criteria, patients requiring burn center referral were
assigned to the major burn group (MBG) as severe condition.
Results: During the acute phase (within 8 h after leak initiation), there were 43 patients in the ED, which was
staffed with 3 doctors and 3 nurses, without 4S resources. Of these 43 patients, there were 8 HFEPs (100%) in the
MBG and 0 in the non-MBG (NMBG). During the subacute phase (24 h after the acute phase), there were 262
patients in the ED including 167 HFEPs, of whom 45 (26.95%) were in the MBG and 122 (73.05%) were in the
NMBG. The ED was then staffed with 6 doctors (3 on day shift and 3 on night shift) and 10 nurses (3 on day shift, 4
on evening shift, and 3 on night shift), and no 4S resources were available. Throughout the study period, no 4Ss
were available. First, there was no expansion of ED space or secured disaster reserve beds. Second, there was no
increase in manpower with duty time adjustments or duty relocation for ED working personnel. Third, there was no
logistics reinforcement (e.g., antidote or personal protective equipment). Fourth, there were no disaster-related
measures for the administration department, decontamination zone setup, safety diagnostic testing, or designated
disaster triage implementation.
Conclusions: The hospital’s disaster response was insufficient for all aspects of the 4Ss. Detailed guidance
concerning a hospital disaster management plan is required
Creator
An entity primarily responsible for making the resource
Heejun Shin, Se Kwang Oh, Han You Lee, Heajin Chung, Seong Yong Yoon, Sung Yong Choi and Jae Hyuk Kim
Publisher
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BMC Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
(2021) 21:34
Contributor
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Fajar bagus W
Format
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PDF
Language
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Indonesia
Type
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Text
disasters
Hydrogen fluoride
Jurnal Internasional Keperawatan
Review
Surge capacity
-
https://repository.horizon.ac.id/files/original/01edebc6f1bfab515a34df332288fb74.pdf
1d1dcea73f053974d5058e58c79270d3
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Title
A name given to the resource
VOLUME 21 ISSUE 1 MARET 2021
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
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Title
A name given to the resource
Outpatient care in acute and prehospital emergency medicine by emergency medical and patient transport service over a 10-year period: a retrospective study based on dispatch data from a German emergency medical dispatch centre (OFF-RESCUE).
Subject
The topic of the resource
OFF-Mission, ON-Mission, Emergency medical control center, Triaged, Dispatched, Rural, Urban, Job
cycle time, Prehospital emergency care, Emergency medical dispatch
Description
An account of the resource
Background
The number of operations by the German emergency medical service almost doubled between 1994 and 2016.
The associated expenses increased by 380% in a similar period. Operations with treatment on-site, which
retrospectively proved to be misallocated (OFF-Missions), have a substantial proportion of the assignment of the
emergency medical service (EMS). Besides OFF-Missions, operations with patient transport play a dominant role
(named as ON-Missions). The aim of this study is to work out the medical and economic relevance of both
operation types.
Methods
This analysis examined N = 819,780 missions of the EMS and patient transport service (PTS) in the catchment
area of the emergency medical dispatch centre (EMDC) Bad Kreuznach over the period from 01/01/2007 to
12/31/2016 in terms of triage and disposition, urban-rural distribution, duration of operations and economic
relevance (p < .01).
Results
53.4% of ON-Missions are triaged with the indication non-life-threatening patient transport; however, 63.7% are
processed by the devices of the EMS. Within the OFF-Mission cohort, 78.2 and 85.8% are triaged or dispatched
for the EMS. 74% of all ON-Missions are located in urban areas, 26% in rural areas; 81.3% of rural operations
are performed by the EMS. 66% of OFF-Missions are in cities. 93.2% of the remaining 34% of operations in rural
locations are also performed by the EMS. The odds for both ON- and OFF-Missions in rural areas are
significantly higher than for PTS (OR.sub.ON 3.6, 95% CI 3.21-3.30; OR.sub.OFF 3.18, 95% CI 3.04-3.32). OFF�Missions last 47.2 min (SD 42.3; CI 46.9-47.4), while ON-Missions are processed after 79.7 min on average (SD
47.6; CI 79.6-79.9). ON-Missions generated a turnover of more than [euro] 114 million, while OFF-Missions
made a loss of almost [euro] 13 million.
Conclusions
This study particularly highlights the increasing utilization of emergency devices; especially in OFF-Missions, the
resources of the EMS have a higher number of operations than PTS. OFF-Missions cause immensely high costs
due to misallocations from an economic point of view. Appropriate patient management appears necessary from
both medical and economic perspective, which requires multiple solution approaches.
Creator
An entity primarily responsible for making the resource
Marc S. Schehadat, Guido Scherer, David A. Groneberg, Manfred Kaps and Michael H. K. Bendels
Publisher
An entity responsible for making the resource available
BMC Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
Mar. 9, 2021
Contributor
An entity responsible for making contributions to the resource
Fajar bagus w
Format
The file format, physical medium, or dimensions of the resource
PDF
Language
A language of the resource
Indonesia
Type
The nature or genre of the resource
Text
Dispatched
Emergency medical control center
Emergency medical dispatch
Job cycle time
Jurnal Internasional Keperawatan
OFF-Mission
ON-Mission
Prehospital emergency care
Rural
Triaged
Urban
-
https://repository.horizon.ac.id/files/original/7f897a4d962d8228f9bb8492fb09f9d6.pdf
37af391d46bb38de1b4bd2ab89d6a08a
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
VOLUME 21 ISSUE 1 MARET 2021
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Multi-centre implementation of an Educational program to improve the Cardiac Arrest diagnostic accuracy of ambulance Telecommunicators and survival outcomes for sudden cardiac arrest victims: the EduCATe study design and methodology.
Subject
The topic of the resource
Cardiac arrest, Agonal breathing, Telecommunicators, Cardiopulmonary resuscitation, Resuscitation,
Emergency medical services
Description
An account of the resource
Background
Sudden cardiac death remains a leading cause of mortality in Canada, resulting in more than 35,000 deaths
annually. Most cardiac arrest victims collapse in their own home (85% of the time) and 50% are witnessed by a
family member or bystander. Survivors have a quality of life similar to the general population, but the overall
survival rate for out-of-hospital cardiac arrest (OHCA) rarely exceeds 8%. Victims are almost four times more
likely to survive when receiving bystander CPR, but bystander CPR rates have remained low in Canada over the
past decade, not exceeding 15-25% until recently. Telecommunication-assisted CPR instructions have been
shown to significantly increase bystander CPR rates, but agonal breathing may be misinterpreted as a sign of life
by 9-1-1 callers and telecommunicators, and is responsible for as much as 50% of missed OHCA diagnoses.
We sought to improve the ability and speed with which ambulance telecommunicators can recognize OHCA over
the phone, initiate timely CPR instructions, and improve survival.
Methods
In this multi-center national study, we will implement and evaluate an educational program developed for
ambulance telecommunicators using a multiple baseline interrupted time-series design. We will compare
outcomes 12 months before and after the implementation of a 20-min theory-based educational video addressing
barriers to recognition of OHCA while in the presence of agonal breathing. Participating Canadian sites
demonstrated prior ability to collect standardized data on OHCA. Data will be collected from eligible 9-1-1
recordings, paramedic documentation and hospital medical records. Eligible cases will include suspected or
confirmed OHCA of presumed cardiac origin in patients of any age with attempted resuscitation.
Discussion
The ability of telecommunication-assisted CPR instructions to improve bystander CPR and survival rates for
OHCA victims is undeniable. The ability of telecommunicators to recognize OHCA over the phone is
unequivocally impeded by relative lack of training on agonal breathing, and reluctance to initiate CPR instructions
when in doubt. Our pilot data suggests the potential impact of this project will be to increase absolute OHCA
recognition and bystander CPR rates by at least 10%, and absolute out-of-hospital cardiac arrest survival by 5%
or more.
Creator
An entity primarily responsible for making the resource
Christian Vaillancourt, Manya Charette, Sarika Naidoo, Monica Taljaard, Matthew Church and Stephanie Hodges
Publisher
An entity responsible for making the resource available
BMC Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
Mar. 4, 2021
Contributor
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Fajar bagus W
Format
The file format, physical medium, or dimensions of the resource
PDF
Language
A language of the resource
Indonesia
Type
The nature or genre of the resource
Text
Agonal breathing
Cardiac arrest
Cardiopulmonary resuscitation
Emergency medical services
Jurnal Internasional Keperawatan
resuscitation
Telecommunicators
-
https://repository.horizon.ac.id/files/original/a64d4e0809aa766c6c9cb03fd8a3e6c9.pdf
c5c77f9a8cd492e407173e7301d3e67c
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
VOLUME 21 ISSUE 1 MARET 2021
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Dublin Core
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Title
A name given to the resource
Clinical factors associated with bloodstream infection at the emergency department.
Subject
The topic of the resource
Bloodstream infection, Bacteremia, Blood cultures, Rapid diagnosis, Emergency department
Description
An account of the resource
Background
Bloodstream infection (BSI) is a common urgent condition at the emergency department (ED). However, current
guidelines for diagnosis do not specify the juncture at which blood cultures should be taken. The decision
whether or not to obtain hemoculture is based solely upon clinical judgment and potential outcomes of
inappropriately ordered cultures. This study aimed to find clinical factors present on ED arrival that are predictive
of bloodstream infection.
Methods
This study was conducted retrospectively at the ED of a single tertiary care hospital in Thailand. We included
adult patients with suspected infection based on blood culture who were treated with intravenous antibiotics
during their ED visit. Independent positive predictors for positive blood culture were calculated by logistic
regression analysis.
Results
A total of 169,578 patients visited the ED during the study period, 12,556 (7.40%) of whom were suspected of
infection. Of those, 8177 met the study criteria and were categorized according to blood culture results (741
positive; 9.06%). Six clinical factors, including age over 55 years, moderate to severe CKD, solid organ tumor,
liver disease, history of chills, and body temperature of over 38.3 [degrees]C, were associated with positive blood
culture.
Conclusions
Clinical factors at ED arrival can be used as predictors of bloodstream infection
Creator
An entity primarily responsible for making the resource
Pariwat Phungoen, Nunchalit Lerdprawat, Kittisak Sawanyawisuth, Verajit Chotmongkol, Kamonwon Ienghong and Sumana
Sumritrin
Publisher
An entity responsible for making the resource available
BMC Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
Mar. 12, 2021
Contributor
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Fajar bagus W
Format
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PDF
Language
A language of the resource
Indonesia
Type
The nature or genre of the resource
Text
bacteremia
Blood cultures
Bloodstream infection
Emergency department
Jurnal Internasional Keperawatan
Rapid diagnosis
-
https://repository.horizon.ac.id/files/original/4be2b13a3532767185de0a41df6b23ad.pdf
2dd19eed90230d8280e8babc5069e5c9
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
VOLUME 21 ISSUE 1 MARET 2021
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Dublin Core
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Title
A name given to the resource
Bomb blast: imaging findings, treatment and clinical course of extremity traumas.
Subject
The topic of the resource
Terror-related trauma, Blast injury, Improvised explosive device (IED), Gustilo-Anderson, Damage
control surgery (DCS)
Description
An account of the resource
Background
To describe the severity and types of blast-related extremity injuries and the presence of accompanying vascular
injuries (VI) and amputation, and to identify the associated factors affecting the treatment management and
clinical course.
Methods
The study included 101 patients with extremity injuries caused by a bomb explosion. The radiographs and
computed tomography angiographies of the patients were evaluated in terms of injury patterns, presence of
penetrating fragments and fractures, and localization (upper or lower extremity) and type (open or closed) of
injury. The Gustilo-Anderson classification was used for open fractures. According to their severity, open
fractures classified as types 1 and 2 were included in Group 1 and those classified as type 3A, 3B and 3C in
Group 2.
Results
As a result of blast exposure, 101 (57.7%) patients had extremity injuries, of which 76 (75.2%) presented with at
least one fracture. Of the total of 103 fractures, nine (8.8%) were closed and 94 (91.2%) were open. Thirty-eight
(40.4%) of the open fractures were located in the upper extremities, and 56 (59.6%) in the lower extremities and
pelvis. Open fractures were most frequently localized in the femur (n = 20; 21.2%), followed by the tibia (n = 18;
19.1%). The majority of patients with open fractures were in Group 1 (71.4%). The duration of hospital stay was
longer in Group 2 (12.1 [+ or -] 5.8 vs. 6.3 [+ or -] 6.7 days, p < 0.0001, respectively). Mortality among patients in
Group 2 (45.0%) was significantly higher than in Group 1 (8.0%) (p < 0.0001). Similarly, the injury severity score
(ISS) was higher in Group 2 (median 20 vs. 9, p < 0.0001). VI was present in 13 (12.9%) of all patients, and
amputation in seven (7.9%).
Conclusion
The presence of severe open fractures, VI, and high ISS score can be considered as important factors that
increase morbidity and mortality. In extremity traumas, through the secondary blast mechanism, contaminated�fragmented tissue injuries occur. Therefore, we believe that it will be beneficial to apply damage control surgery
in places with low socioeconomic level and poor hygienic conditions.
Creator
An entity primarily responsible for making the resource
Mehmet Tahtabasi, Sadettin Er, Recep Karasu and Erhan Renan Ucaroglu
Publisher
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BMC Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
Mar. 6, 2021
Contributor
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Fajar bagus W
Format
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PDF
Language
A language of the resource
Indonesia
Type
The nature or genre of the resource
Text
Blast injury
Damage control surgery (DCS)
Gustilo-Anderson
Improvised explosive device (IED)
Jurnal Internasional Keperawatan
Terror-related trauma
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https://repository.horizon.ac.id/files/original/a64e745536ca1f1c860587429a267adf.pdf
164ff085aa20c0729ebddd5c9b282749
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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VOLUME 21 ISSUE 1 MARET 2021
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Anterior-posterior view by full-body digital X-ray to rule out severe spina injuries in Polytraumatized patients
Subject
The topic of the resource
Spinal injuries, LODOX-Statscan, Diagnostic accuracy, Full-body digital X-ray, Radiography
Description
An account of the resource
Background
Spinal injuries are present in 16-31% of polytraumatized patients. Rapid identification of spinal injuries requiring
immobilization or operative treatment is essential. The Lodox-Statscan (LS) has evolved into a promising time�saving diagnostic tool to diagnose life-threatening injuries with an anterior-posterior (AP)-full-body digital X-ray.
Methods
We aimed to analyze the diagnostic accuracy and the interrater reliability of AP-LS to detect spinal injuries in
polytraumatized patients. Therefore, within 3 years, AP-LS of polytraumatized patients (ISS [greater than or
equai to] 16) were retrospectively analyzed by three independent observers. The sensitivity and specificity of
correct diagnosis with AP-LS compared to CT scan were calculated. The diagnostic accuracy was evaluated by
using the area under the ROC (receiver operating characteristic curve) for sensitivity and specificity. Interrater
reliability between the three observers was calculated using Fleiss' Kappa. The sensitivity of AP-LS was further
analyzed by the severity of spinal injuries.
Results
The study group included 320 patients (48.5 years [+ or -]19.5, 89 women). On CT scan, 207 patients presented
with a spinal injury (65%, total of 332 injuries). AP-LS had a low sensitivity of 9% (31 of 332, range 0-24%) and
high specificity of 99% (range 98-100%). The sensitivity was highest for thoracic spinal injuries (14%). The
interrater reliability was slight (κ = 0.02; 95% CI: 0.00, 0.03). Potentially unstable spinal injuries were more likely
to be detected than stable injuries (sensitivity 18 and 6%, respectively).
Conclusion
This study demonstrated high specificity with low sensitivity of AP-LS in detecting spinal injuries compared to CT
scan. In polytraumatized patients, AP-LS, implemented in the Advanced Trauma Life Support-algorithm, is a
helpful tool to diagnose life-threatening injuries. However, if spinal injuries are suspected, performing a full-body
CT scan is necessary for correct diagnosis.
Creator
An entity primarily responsible for making the resource
Sonja Häckel, Elena Hofmann, Helen Anwander, Christoph E. Albers, Jasmin Basedow and Sebastian F. Bigdon
Date
A point or period of time associated with an event in the lifecycle of the resource
Mar. 5, 2021
Contributor
An entity responsible for making contributions to the resource
Fajar bagus W
Format
The file format, physical medium, or dimensions of the resource
PDF
Language
A language of the resource
Indonesia
Type
The nature or genre of the resource
Text
Diagnostic accuracy
Full-body digital X-ray
Jurnal Internasional Keperawatan
LODOX-Statscan
Radiography
Spinal injuries