Current Issue : April - June Volume : 2021 Issue Number : 2 Articles : 7 Articles
Loss and dilution of coagulation factors have been observed following multiple trauma. Timely recognition of reduced clotting\nfactor activity might facilitate therapeutic action to restore normal coagulation function. This study investigates the potential\nrole of some well-known trauma scores in predicting coagulation factor activity after multiple injuries. A dataset comprising the\ncoagulation factor activities of 68 multiply injured adult patients was analyzed. The following trauma scores were evaluated: AIS,\nISS, NISS, GCS, RTS, TRISS, RISC, and TASH score................................
This retrospective observational case series describes a single centreâ??s preparations and experience of 53 emergency tracheal\nintubations in patients with COVID-19 respiratory failure. The findings of a contemporaneous online survey exploring technical\nand nontechnical aspects of airway management, completed by intubation team members, are also presented. Preparations\nincluded developing a COVID-19 intubation standard operating procedure and checklist, dedicated airway trolleys, a consultantled\nmobile intubation team.....................
We report the case of a 28-month-old male child with no particular history\nwho was admitted to the emergency room for severe abdominal pain associated\nwith vomiting, asthenia and fever at 39.1DegreeC that had progressed for 4\ndays. He was conscious, polypneic at 32 cycles/min on admission. On palpation\nthe abdomen was distended, painful as a whole, more pronounced in the\nepigastrium. There was abdominal contracture, generalized defense, a cry\nwith sudden decompression of the umbilicus.................................
Background: Organizational changes in out-of-hour (OOH) services may have unintended consequences for other\nprehospital services. Reports indicate an increased use of helicopter emergency medical services (HEMS) after\nchanges in OOH services in Norway due to greater geographical distances for the on-call doctors. We investigated\nwhether HEMS dispatches increased when nine municipalities in Sogn og Fjordane County merged into one large\ninter-municipal OOH district.\nMethods: All primary dispatches of the HEMS in the county between 2004 and 2013 were included. We applied\ninterrupted time series regression to monthly aggregated data to evaluate the impact of the organizational change\n1 April 2009. The nine target municipalities were compared to the rest of the municipalities in the county, which\nserved as a control group. A quasipoisson model adjusted for seasonality was found to be most applicable............................
Pediatric nonaccidental trauma (NAT) is difficult to diagnose. Several isolated injuries in NAT could happen in the\nsetting of accidental trauma (AT), and having a high index of suspicion is important to correctly identify abuse. NAT has a\nsignificant mortality rate if the sentinel event is not adequately diagnosed, and the infant is not separated from the perpetrator.\nLevel 1 pediatric trauma centers (PTC) see a significant number of NAT. We evaluated the injury patterns of NAT admissions\nat our level 1 PTC. Methods. Retrospective analysis of all cases of NAT for children under the age of two admitted at an ACS\nlevel 1 pediatric trauma center between the years of 2016 and 2018. Charts were queried for demographic data, injury patterns,\nmortality, and disposition.,.........................\n........
Background. Emergency department (ED) crowding and prolonged lengths of stay continue to be important medical issues. It is\ndifficult to apply traditional methods to analyze multiple streams of the ED patient management process simultaneously. ,e aim\nof this study was to develop a statistical model to delineate the dynamic patient flow within the ED and to analyze the effects of\nrelevant factors on different patient movement rates. Methods. ,is study used a retrospective cohort available with electronic\nmedical data. Important time points and relevant covariates of all patients between January and December 2013 were collected. A\nnew five-state Markov model was constructed by an expert panel, including three intermediate states: triage, physician management,\nand observation room and two final states: admission and discharge. A day was further divided into four six-hour\nperiods to evaluate dynamics of patient movement over time........................
Spinal epidural abscess (SEA) is a rare condition, and a delay in its diagnosis\ncauses paralysis. In this study, we report two rare cases of delayed diagnosis\nof SEA whose conditions improved after a state of complete paralysis. The\nfirst case was a 71-year-old diabetic man who received a corticosteroid injection\nfor shoulder pain that caused intensified pain. Thereafter, the patient\ndeveloped paralysis of both legs in stage IV according to Heusner staging.\nSubsequently, he was diagnosed with multiple abscesses and sepsis. He was in\na poor state of health. Therefore, we treated his epidural abscess conservatively.\nAfter a month, his muscle strength had improved to Heusner stage\nIII-A, and he was transferred to another hospital. The second case was a\n64-year-old diabetic man who received an epidural corticosteroid injection\nfor lower back pain. However, the pain intensified and was admitted to the\nhospital for pyelonephritis........................
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