BACKGROUND: Permanent tooth avulsion is one of the severe forms of dental traumatic injuries. The immediate action taken at the site of the accident is crucial to the prognosis of the tooth. Replantation is considered...BACKGROUND: Permanent tooth avulsion is one of the severe forms of dental traumatic injuries. The immediate action taken at the site of the accident is crucial to the prognosis of the tooth. Replantation is considered as the treatment of choice. OBJECTIVE: The study was undertaken to assess the knowledge of parents who accompany their children to the pediatric dental clinic, KATH on the pre-hospital management of avulsed permanent tooth in children. METHODS: A researcher administered structured questionnaire was used to collect data on the knowledge of pre-hospital management of avulsed permanent tooth from 83 parents who accompanied their wards to the pediatric dental clinic at KATH. RESULTS: A total of 83 parents were involved in the study. 30 (36%) were males while 53 (64%) were females. The majority of the parents (57%) were either university trained or had attended college of education. Only 32 parents (39%) were aware of the possibility of replantation. Majority of the parents chose non-physiologic media as the transport media of choice and only 10% would attempt self-replantation before seeking professional help. 76 parents (92%) had no previous education on pre-hospital management of avulsed tooth. CONCLUSION: The results obtained from this study indicate that parental knowledge on pre-hospital management of avulsed permanent tooth is low hence the need for massive public educational campaigns.展开更多
Objective: To investigate the occurrence of PTSD in pre-hospital emergency nurses and its related factors, and to compare the differences of neurotransmitter and immune-related factors between pre-hospital emergency n...Objective: To investigate the occurrence of PTSD in pre-hospital emergency nurses and its related factors, and to compare the differences of neurotransmitter and immune-related factors between pre-hospital emergency nurses who experienced traumatic events and those who did not develop PTSD and healthy people. How: Post-traumatic Stress Disorder Self-Rating Scale (PCL-C) tests were performed on pre-hospital emergency nurses in PTSD group, non-PTSD group and healthy control group, and the plasma monoamine neurotransmitters and serum cytokines were determined by double-antibody sandwich ABC-ELISA assay using enzyme-linked adsorption kit provided by Shanghai Xitang Biotechnology Co., Ltd. Results: 1) There were statistically significant differences in PCL-C scores between PTSD group, non-PTSD group and healthy group (p α between PTSD group, non-PTSD group and healthy group (p Conclusion: Pre-hospital emergency nurses should have early psychological intervention and guidance to reduce the occurrence of PTSD in emergency and emergency nurses.展开更多
The management of craniocerebral trauma begins at the site of the accident. This is one of the diseases for which pre-hospital care is well codified. The objective of this study is to report the experience of the Emer...The management of craniocerebral trauma begins at the site of the accident. This is one of the diseases for which pre-hospital care is well codified. The objective of this study is to report the experience of the Emergency Aid Medical Service (EMAS) of BENIN in the pre-hospital management of craniocerebral trauma. 146 head injuries were cared for. 116 were male. The mean age was 32 years with extremes ranging from 2 to 77 years. Etiology in 68% of patients was a public road accident. And the request for the use of the EMAS was made by highway users for 41% of the injuries. About 5.5% were severe cranio-brain injuries, more than 75% of which had died in intensive care. In 77% of the EMAS interventions, there was an intensive care physician in the team. 34 wounded had been transported in a vacuum mattress. The rigid cervical collar was used in 8 major traumas. All the wounded were transported by ambulance. The duration of hospitalization varied from a few hours in the emergency department to 90 days in the hospital ward. 9 patients died. One of them, who died in an ambulance, was a woman. The prehospital medical care of head trauma in BENIN is still progressing.展开更多
BACKGROUND: Traumatic brain injury(TBI) is associated with most trauma-related deaths. Secondary brain injury is the leading cause of in-hospital deaths after traumatic brain injury. By early prevention and slowing of...BACKGROUND: Traumatic brain injury(TBI) is associated with most trauma-related deaths. Secondary brain injury is the leading cause of in-hospital deaths after traumatic brain injury. By early prevention and slowing of the initial pathophysiological mechanism of secondary brain injury, prehospital service can signifi cantly reduce case-fatality rates of TBI. In China, the incidence of TBI is increasing and the proportion of severe TBI is much higher than that in other countries. The objective of this paper is to review the pre-hospital management of TBI in China.DATA SOURCES: A literature search was conducted in January 2014 using the China National Knowledge Infrastructure(CNKI). Articles on the assessment and treatment of TBI in pre-hospital settings practiced by Chinese doctors were identified. The information on the assessment and treatment of hypoxemia, hypotension, and brain herniation was extracted from the identifi ed articles.RESULTS: Of the 471 articles identified, 65 met the selection criteria. The existing literature indicated that current practices of pre-hospital TBI management in China were sub-optimal and varied considerably across different regions.CONCLUSION: Since pre-hospital care is the weakest part of Chinese emergency care, appropriate training programs on pre-hospital TBI management are urgently needed in China.展开更多
AIM:To evaluate the performance of the specific French Vittel "Pre-Hospital(PH) resuscitation" criteria in selecting polytrauma patients during the pre-hospital stage and its potential to increase the positi...AIM:To evaluate the performance of the specific French Vittel "Pre-Hospital(PH) resuscitation" criteria in selecting polytrauma patients during the pre-hospital stage and its potential to increase the positive predictive value(PPV) of pre-hospital trauma triage.METHODS: This was a monocentric prospective cohort study of injured adults transported by emergency medi-cal service to a trauma center. Patients who met any of the field trauma triage criteria were considered "triage positive". Hospital data was statistically linked to prehospital records. The primary outcome of defining a "major trauma patient" was Injury Severity Score(ISS) > 16. RESULTS: There were a total of 200 injured patients evaluated over a 2 years period who met at least 1 triage criterion. The number of false positives was 64 patients(ISS < 16). The PPV was 68%. The sensitivity and the negative predictive value could not be evaluated in this study since it only included patients with positive Vittel criteria. The criterion of "PH resuscitation" was present for 64 patients(32%),but 10 of them had an ISS < 16. This was statistically significant in correlation with the severity of the trauma in univariate analysis(OR = 7.2; P = 0.005; 95%CI: 1.6-31.6). However,despite this correlation the overall PPV was not significantly increased by the use of the criterion "PH resuscitation"(68% vs 67.8%).CONCLUSION: The criterion of "pre-hospital resuscitation" was statistically significant with the severity of the trauma,but did not increase the PPV. The use of "prehospital resuscitation" criterion could be re-considered if these results are confirmed by larger studies.展开更多
Pain and hospitalization caused a crisis in the child’s life. At the pre-school children, the stress of the disease makes children become less able to cope with separation. As a result, many children show anxious beh...Pain and hospitalization caused a crisis in the child’s life. At the pre-school children, the stress of the disease makes children become less able to cope with separation. As a result, many children show anxious behavior though more vague than toddler age children. Various ways have been conducted by nurses to treat anxiety in children, but the most effective types of the intervention have not be found. Types of intervention that can be done are art therapy and play therapy. This study aims to compare the effects of art therapy and play therapy in reducing anxiety on children who experience hospitalization. A quasi-experimental research design with pre-post test two group design is used. The sample was 23 children pre-school age for art therapy group and 25 children for play therapy with sampling techniques performed purposive sampling. Intervention of art therapy and play therapy each performed for 3 days with duration about 30 minutes. Anxiety levels before and after the intervention were measured by using the facial affective scale. The results show that there is a difference in anxiety between before and after the action in the art therapy group (p = 0.00) and that there are differences in anxiety before and after the action in the play therapy group (0.00). But statistical tests using Man Whitney U indicate that there is no difference in anxiety levels in pre-school children who do art therapy and play therapy (p = 0.26). So, it is concluded that the art therapy and the play therapy can reduce the level of anxiety on pre-school school children that experience hospitalization. Based on these conclusions, it is recommended that the art therapy and the play therapy can be used by nurses and the choice of the intervention should be submitted to the child.展开更多
Hypertensive diseases of pregnancy, mainly PET, consist of several dise</span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style=&qu...Hypertensive diseases of pregnancy, mainly PET, consist of several dise</span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">a</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ses which are associated with increased morbidity and mortality rates both maternal and fetal wise. Its incidence among pregnant females is about 3</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">% </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">10%.</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">This study included 500 pregnant PET women, and they categorized to mild and severe forms, after exclusion of cases with essential hypertension, renal disease and SLE. All pregnant ladies underwent history taking, abdominal examination (general and local), obstetric ultrasound, Doppler ultrasound, laboratory investigations;treatment received (antihypertensive medications, magnesium sulphate (MgSO</span><sub><span style="font-family:Verdana;">4</span></sub><span style="font-family:Verdana;">) and steroids) and finally follow up till delivery. Regarding complications, PET can result in serious fetal/neonatal or maternal complications.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">By the beginning of this study we started with 380 mild cases and 120 severe cases, but the end of the study 50 cases of mild PET were lost during follow up and 70 cases of mild PET converted into severe form. The aim of this study is to evaluate the management protocols of preeclamptic cases admired to Elshatby maternity hospital to minimize maternal and fetal morbidity and mortality. RESULTS: The results showed that the incidence of PET is significant in both young and old age, higher incidence of IUGR in sever PET, the use of corticosteroids and MgSO</span><sub><span style="font-family:Verdana;">4</span></sub><span style="font-family:Verdana;"> was significantly higher in sever cases. CONCLUSION: it’s important to diagnose PET by repeated blood pressure measurement. The use of corticosteroids and MgSO</span><sub><span style="font-family:Verdana;">4</span></sub><span style="font-family:Verdana;"> is improving maternal and fetal outcomes significantly. The incidence of C.S. is higher towards prematurity in sever cases.展开更多
Background: Novel coronavirus pneumonia (NCP) and osteoporotic vertebral compression fractures (OVCF) are the high incidences of diseases in the elderly. During the epidemic period, if not treated in time, the complic...Background: Novel coronavirus pneumonia (NCP) and osteoporotic vertebral compression fractures (OVCF) are the high incidences of diseases in the elderly. During the epidemic period, if not treated in time, the complications are high and the mortality is high. If we do not pay attention to infection prevention and control in pre-hospital emergency care, it will lead to the first time infection of medical staff and in-hospital cross infection in emergency outpatient receiving area. The correct consideration of both and the establishment of perfect pre-hospital emergency treatment and infection prevention and control synchronous strategy is an important premise to ensure the stable, orderly and safe medical treatment. Objective: To explore the effect of synchronous implementation of pre-hospital emergency care, nursing and infection pre-vention and control for senile OVCF during the epidemic. In order to improve the efficiency of pre-hospital emergency care and prevent the spread of infection. Method: A total of 92 elderly patients with OVCF who received pre-hospital treatment in 18 hospitals in Zhangjiakou City during the epidemic prevention and control period from January 2020 to November 2022 and met the inclusion criteria were selected as research objects, including 24 males and 68 females, aged 65 - 82 (74.2 ± 2.2) years. All patients were associated with concomitant injuries and underlying diseases. All patients in this group underwent predictive pre-hospital rescue and infection prevention and control procedures. Results: All the 92 elderly patients with OVCF received timely pre-hospital treatment during the epidemic period, and no aggravation occurred of the 92 patients, 35 were in the high risk area, 10 were in the medium risk area, and 47 were in the low risk area. Exclude OVCF for NCP Patients were treated according to the conventional diagnosis and treatment principles. Suspected and confirmed cases are transferred to designated surgical hospitals for treatment. All patients were followed up 3 months, 6 months and 12 months after treatment. There was no death rate, high satisfaction of pre-hospital first aid, high diagnostic accuracy, and good curative effect. None of the rescue personnel had any infection rate, and no hospital infection transmission and nosocomial cross infection occurred. Conclusion: It is the first step to safely treat patients and prevent cross infection to establish a perfect synchronous strategy of pre-hospital first aid and infection prevention and control.展开更多
Objective:To elucidate the awareness and approach to pre-operative human immunodeficiency virus(HIV) testing and emphasis on the attendant components of HIV testing.Methods: The study was conducted at the theatres of ...Objective:To elucidate the awareness and approach to pre-operative human immunodeficiency virus(HIV) testing and emphasis on the attendant components of HIV testing.Methods: The study was conducted at the theatres of the University of Port Harcourt Teaching Hospital among 123 nursing,anaesthetic,and operating staff.A descriptive cross sectional design was adopted with stratified sampling.The study instrument was a structured,self administered pro forma.Results:All respondents were all aware of HIV infection and all had transmission through infected blood and tissues(100.0%).88.6%had infection through needle stick injuries, 62.6%through vertical transmission,and 98.4%through blood transfusion.Sixty three percent of respondents correctly knew what preoperative testing was,while 58.5%were aware of the preoperative testing policy of the hospital.All respondents favoured the policy of preoperative testing.Attitudinal values to seropositive patients were not very different as 72.4%of respondents claimed they treated every patient as high risk,and all respondents used personal protective equipment.Conclusions:Routine HIV testing now represents a conventional means providing patients with knowledge of their HIV status.Such testing should be accompanied by informed consent,counselling,confidentiality,protection,and access to treatment.展开更多
<strong>Objective:</strong> The purpose of this work was to determine the epidemiological, clinical and evolutionary aspects of the pulmonary embolism of the young person in the cardiology department of th...<strong>Objective:</strong> The purpose of this work was to determine the epidemiological, clinical and evolutionary aspects of the pulmonary embolism of the young person in the cardiology department of the University Hospital Center (CHU) Point G in Bamako-Mali. <strong>Methodology:</strong> This was an analytical study from January 01, 2018 to December 31, 2018 in the CHU Point G cardiology department, including all patients hospitalized during this period. <strong>Results:</strong> Of 1379 hospitalized patients, 19 patients were concerned by pulmonary embolism of the young person. The prevalence of pulmonary embolism of the young person was 1.37%. The most affected age group was 21 - 30 (47.4%) of patients. The predominance was female (89.47%) with a gender ratio of 0.11 in favour of women. The average age in the series was 29.79 years with extremes of 16 years and 40 years. Factors predisposing to pulmonary embolism were dominated by peri partum, cardiomyopathy and obesity with 47.3%, 31.57% and 21.1%, respectively. The dominant signs were chest pain and dyspnea in 94.7% and 89.5% of cases respectively. Pulmonary embolism was unlikely in 60.52% according to the Geneva and Wells score simplified. At the thoracic angioscanner, the embolism was bilateral in 52.6% of cases and distal in 36.8% of patients;in 10 patients who performed cardiac ultrasound, pulmonary arterial hypertension (70%), dilation of the right ventricle (20%) and left ventricular dilation (40%). Hyper leucocytosis (47.4%), anemia and low prothrombin rate (TP) (22.2%) were the most found biological abnormalities. More than 2/3 (68.5%) our patients had an intermediate mortality risk according to the PESI (Pulmonary Embolism Severity Index) score. The average hospital stay was 10 days. Hospital mortality was 10.5%. <strong>Conclusion:</strong> The pulmonary embolism of the young person is a frequent, serious and multifactorial pathology and the female sex is most affected especially during peri partum periods, hence the need for preventive measures. Clinical signs are not specific and based on the assessment of clinical probability. Pulmonary angioscanner remains the confirmation review in our context.展开更多
目的探讨凝视-面-臂-言语-时间(gaze-face-arm-speech-time,G-FAST)评分对院前急救卒中前循环大血管闭塞(large vessel occlusion in the anterior circulation,aLVO)的诊断价值。方法选取2019年7月至2020年12月北京急救中心直属5个分...目的探讨凝视-面-臂-言语-时间(gaze-face-arm-speech-time,G-FAST)评分对院前急救卒中前循环大血管闭塞(large vessel occlusion in the anterior circulation,aLVO)的诊断价值。方法选取2019年7月至2020年12月北京急救中心直属5个分中心送至宣武医院,且有完整院前G-FAST评分和入院诊断信息的卒中患者,根据缺血性卒中患者是否发生LVO分为LVO和非LVO组,采用ROC曲线分析G-FAST评分对院前卒中急救aLVO的诊断价值。结果纳入患者352例,其中急性缺血性卒中占比69.0%(243/352)。进行大血管评估的急性缺血性卒中患者149例,占急性缺血性卒中的61.3%(149/243);发生aLVO患者61例,占大血管病变评估的40.9%(61/149)、占急性缺血性卒中的25.1%(61/243)。149例大血管评估的急性缺血性卒中患者中,男100例,女49例;年龄18~93岁,平均70.5岁。与非aLVO组相比,aLVO组女性较多,G-FAST评分较高,差异均有统计学意义(P<0.05)。G-FAST≥3分患者的aLVO发生率显著高于G-FAST≤2分者(68.9%比31.1%),差异有统计学意义(P<0.05)。G-FAST评分诊断院前急救卒中aLVO的ROC曲线的AUC为0.675(95%CI:0.589~0.761,P=0.000),G-FAST的cut-off值为2.5分时,灵敏度为72.10%,特异度为58.00%。结论G-FAST评分在院前急救卒中可准确识别急性缺血性患者aLVO,早诊断aLVO将利于急性缺血性患者尽早送至高级别卒中中心。展开更多
动脉粥样硬化是心血管疾病重要的病理生理基础,延缓和防治动脉粥样硬化对于减少和降低心血管疾病的发病率及病死率具有重要意义。高密度脂蛋白(high density lipoprotein,HDL)通过参与介导胆固醇逆向转运(reverse cholesterol transport...动脉粥样硬化是心血管疾病重要的病理生理基础,延缓和防治动脉粥样硬化对于减少和降低心血管疾病的发病率及病死率具有重要意义。高密度脂蛋白(high density lipoprotein,HDL)通过参与介导胆固醇逆向转运(reverse cholesterol transport,RCT)在抗动脉粥样硬化的形成和进展中发挥了重要作用。Preβ-1高密度脂蛋白(prebeta-1 high density lipoprotein,Preβ-1HDL)作为HDL的一种亚类,是外周细胞移出胆固醇的最初接受体,直接参与了RCT的起始步骤,并在随后的胆固醇酯化及转运中起着重要作用。本文就Preβ-1HDL的结构、代谢及其与心血管疾病的关系作一简要综述。展开更多
目的了解我国军、地医院创伤院前救护能力现状及延时现场救护(prolonged field care,PFC)认知及能力准备情况,为相关培训提供参考。方法2021年2月—6月,采用分层抽样和便利抽样相结合的方法,选取东北、西南、中部、东南以及珠三角地区24...目的了解我国军、地医院创伤院前救护能力现状及延时现场救护(prolonged field care,PFC)认知及能力准备情况,为相关培训提供参考。方法2021年2月—6月,采用分层抽样和便利抽样相结合的方法,选取东北、西南、中部、东南以及珠三角地区242名军队及地方医护人员,采用自行设计的《中国创伤院前急救及延时现场救护(PFC)认知情况调查问卷》,借助于问卷星平台进行多中心横断面调查。结果(1)部队三甲医院年均院前救护任务显著多于地方二甲医院(P<0.05),道路交通伤在所有伤型中占比最高;(2)“途中持续监护和复苏预案”是制定最多的院前救护预案,“转运时间过长”是反映最多的问题;(3)PFC知晓率仅为35.1%;(4)“现场处理能力”和“复杂伤情评估”被分别认为是军、地医院创伤院前急救培训中最急需和最缺少的能力。结论当前我国军、地医院救护人员对创伤院前急救措施的掌握情况不容乐观,对各类预案了解不足,PFC概念知晓度普遍较低,缺乏复杂伤情评估和决策能力,亟待完善培训策略,提升整体创伤院前救护能力。展开更多
Background: Minimally invasive surgery in the field of traumatic vascular injury diagnosis and treatment has achieved good results. This study was designed to determine whether pre-hospital emergency intervention is f...Background: Minimally invasive surgery in the field of traumatic vascular injury diagnosis and treatment has achieved good results. This study was designed to determine whether pre-hospital emergency intervention is feasible for vascular injury in a field intervention cabin under the condition of war or a disaster site.Methods: Different types of animal experiments of vascular injury intervention were performed in a field intervention cabin. Treatment capacity was evaluated by data collection, including duration of surgery, clinical evaluation, image clarity, and equipment handling. Environmental adaptability and mobility were evaluated by maneuverability and long-distance mobility.Results: A total of 56 surgeries(7 types) were performed in the field intervention cabin. Digital subtraction angiography(DSA) had good imaging performance. A total of 4800 km of long-distance mobility was performed, and all the equipment operated normally without any equipment failure. We participated in the medical service maneuver twice. The cabin unfolded and worked properly. There was no equipment damage during the medical service maneuver.Conclusion: Use of a field intervention cabin under the conditions of war or disaster is feasible for pre-hospital emergency intervention of vascular injury.展开更多
文摘BACKGROUND: Permanent tooth avulsion is one of the severe forms of dental traumatic injuries. The immediate action taken at the site of the accident is crucial to the prognosis of the tooth. Replantation is considered as the treatment of choice. OBJECTIVE: The study was undertaken to assess the knowledge of parents who accompany their children to the pediatric dental clinic, KATH on the pre-hospital management of avulsed permanent tooth in children. METHODS: A researcher administered structured questionnaire was used to collect data on the knowledge of pre-hospital management of avulsed permanent tooth from 83 parents who accompanied their wards to the pediatric dental clinic at KATH. RESULTS: A total of 83 parents were involved in the study. 30 (36%) were males while 53 (64%) were females. The majority of the parents (57%) were either university trained or had attended college of education. Only 32 parents (39%) were aware of the possibility of replantation. Majority of the parents chose non-physiologic media as the transport media of choice and only 10% would attempt self-replantation before seeking professional help. 76 parents (92%) had no previous education on pre-hospital management of avulsed tooth. CONCLUSION: The results obtained from this study indicate that parental knowledge on pre-hospital management of avulsed permanent tooth is low hence the need for massive public educational campaigns.
文摘Objective: To investigate the occurrence of PTSD in pre-hospital emergency nurses and its related factors, and to compare the differences of neurotransmitter and immune-related factors between pre-hospital emergency nurses who experienced traumatic events and those who did not develop PTSD and healthy people. How: Post-traumatic Stress Disorder Self-Rating Scale (PCL-C) tests were performed on pre-hospital emergency nurses in PTSD group, non-PTSD group and healthy control group, and the plasma monoamine neurotransmitters and serum cytokines were determined by double-antibody sandwich ABC-ELISA assay using enzyme-linked adsorption kit provided by Shanghai Xitang Biotechnology Co., Ltd. Results: 1) There were statistically significant differences in PCL-C scores between PTSD group, non-PTSD group and healthy group (p α between PTSD group, non-PTSD group and healthy group (p Conclusion: Pre-hospital emergency nurses should have early psychological intervention and guidance to reduce the occurrence of PTSD in emergency and emergency nurses.
文摘The management of craniocerebral trauma begins at the site of the accident. This is one of the diseases for which pre-hospital care is well codified. The objective of this study is to report the experience of the Emergency Aid Medical Service (EMAS) of BENIN in the pre-hospital management of craniocerebral trauma. 146 head injuries were cared for. 116 were male. The mean age was 32 years with extremes ranging from 2 to 77 years. Etiology in 68% of patients was a public road accident. And the request for the use of the EMAS was made by highway users for 41% of the injuries. About 5.5% were severe cranio-brain injuries, more than 75% of which had died in intensive care. In 77% of the EMAS interventions, there was an intensive care physician in the team. 34 wounded had been transported in a vacuum mattress. The rigid cervical collar was used in 8 major traumas. All the wounded were transported by ambulance. The duration of hospitalization varied from a few hours in the emergency department to 90 days in the hospital ward. 9 patients died. One of them, who died in an ambulance, was a woman. The prehospital medical care of head trauma in BENIN is still progressing.
文摘BACKGROUND: Traumatic brain injury(TBI) is associated with most trauma-related deaths. Secondary brain injury is the leading cause of in-hospital deaths after traumatic brain injury. By early prevention and slowing of the initial pathophysiological mechanism of secondary brain injury, prehospital service can signifi cantly reduce case-fatality rates of TBI. In China, the incidence of TBI is increasing and the proportion of severe TBI is much higher than that in other countries. The objective of this paper is to review the pre-hospital management of TBI in China.DATA SOURCES: A literature search was conducted in January 2014 using the China National Knowledge Infrastructure(CNKI). Articles on the assessment and treatment of TBI in pre-hospital settings practiced by Chinese doctors were identified. The information on the assessment and treatment of hypoxemia, hypotension, and brain herniation was extracted from the identifi ed articles.RESULTS: Of the 471 articles identified, 65 met the selection criteria. The existing literature indicated that current practices of pre-hospital TBI management in China were sub-optimal and varied considerably across different regions.CONCLUSION: Since pre-hospital care is the weakest part of Chinese emergency care, appropriate training programs on pre-hospital TBI management are urgently needed in China.
文摘AIM:To evaluate the performance of the specific French Vittel "Pre-Hospital(PH) resuscitation" criteria in selecting polytrauma patients during the pre-hospital stage and its potential to increase the positive predictive value(PPV) of pre-hospital trauma triage.METHODS: This was a monocentric prospective cohort study of injured adults transported by emergency medi-cal service to a trauma center. Patients who met any of the field trauma triage criteria were considered "triage positive". Hospital data was statistically linked to prehospital records. The primary outcome of defining a "major trauma patient" was Injury Severity Score(ISS) > 16. RESULTS: There were a total of 200 injured patients evaluated over a 2 years period who met at least 1 triage criterion. The number of false positives was 64 patients(ISS < 16). The PPV was 68%. The sensitivity and the negative predictive value could not be evaluated in this study since it only included patients with positive Vittel criteria. The criterion of "PH resuscitation" was present for 64 patients(32%),but 10 of them had an ISS < 16. This was statistically significant in correlation with the severity of the trauma in univariate analysis(OR = 7.2; P = 0.005; 95%CI: 1.6-31.6). However,despite this correlation the overall PPV was not significantly increased by the use of the criterion "PH resuscitation"(68% vs 67.8%).CONCLUSION: The criterion of "pre-hospital resuscitation" was statistically significant with the severity of the trauma,but did not increase the PPV. The use of "prehospital resuscitation" criterion could be re-considered if these results are confirmed by larger studies.
文摘Pain and hospitalization caused a crisis in the child’s life. At the pre-school children, the stress of the disease makes children become less able to cope with separation. As a result, many children show anxious behavior though more vague than toddler age children. Various ways have been conducted by nurses to treat anxiety in children, but the most effective types of the intervention have not be found. Types of intervention that can be done are art therapy and play therapy. This study aims to compare the effects of art therapy and play therapy in reducing anxiety on children who experience hospitalization. A quasi-experimental research design with pre-post test two group design is used. The sample was 23 children pre-school age for art therapy group and 25 children for play therapy with sampling techniques performed purposive sampling. Intervention of art therapy and play therapy each performed for 3 days with duration about 30 minutes. Anxiety levels before and after the intervention were measured by using the facial affective scale. The results show that there is a difference in anxiety between before and after the action in the art therapy group (p = 0.00) and that there are differences in anxiety before and after the action in the play therapy group (0.00). But statistical tests using Man Whitney U indicate that there is no difference in anxiety levels in pre-school children who do art therapy and play therapy (p = 0.26). So, it is concluded that the art therapy and the play therapy can reduce the level of anxiety on pre-school school children that experience hospitalization. Based on these conclusions, it is recommended that the art therapy and the play therapy can be used by nurses and the choice of the intervention should be submitted to the child.
文摘Hypertensive diseases of pregnancy, mainly PET, consist of several dise</span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">a</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ses which are associated with increased morbidity and mortality rates both maternal and fetal wise. Its incidence among pregnant females is about 3</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">% </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">10%.</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">This study included 500 pregnant PET women, and they categorized to mild and severe forms, after exclusion of cases with essential hypertension, renal disease and SLE. All pregnant ladies underwent history taking, abdominal examination (general and local), obstetric ultrasound, Doppler ultrasound, laboratory investigations;treatment received (antihypertensive medications, magnesium sulphate (MgSO</span><sub><span style="font-family:Verdana;">4</span></sub><span style="font-family:Verdana;">) and steroids) and finally follow up till delivery. Regarding complications, PET can result in serious fetal/neonatal or maternal complications.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">By the beginning of this study we started with 380 mild cases and 120 severe cases, but the end of the study 50 cases of mild PET were lost during follow up and 70 cases of mild PET converted into severe form. The aim of this study is to evaluate the management protocols of preeclamptic cases admired to Elshatby maternity hospital to minimize maternal and fetal morbidity and mortality. RESULTS: The results showed that the incidence of PET is significant in both young and old age, higher incidence of IUGR in sever PET, the use of corticosteroids and MgSO</span><sub><span style="font-family:Verdana;">4</span></sub><span style="font-family:Verdana;"> was significantly higher in sever cases. CONCLUSION: it’s important to diagnose PET by repeated blood pressure measurement. The use of corticosteroids and MgSO</span><sub><span style="font-family:Verdana;">4</span></sub><span style="font-family:Verdana;"> is improving maternal and fetal outcomes significantly. The incidence of C.S. is higher towards prematurity in sever cases.
文摘Background: Novel coronavirus pneumonia (NCP) and osteoporotic vertebral compression fractures (OVCF) are the high incidences of diseases in the elderly. During the epidemic period, if not treated in time, the complications are high and the mortality is high. If we do not pay attention to infection prevention and control in pre-hospital emergency care, it will lead to the first time infection of medical staff and in-hospital cross infection in emergency outpatient receiving area. The correct consideration of both and the establishment of perfect pre-hospital emergency treatment and infection prevention and control synchronous strategy is an important premise to ensure the stable, orderly and safe medical treatment. Objective: To explore the effect of synchronous implementation of pre-hospital emergency care, nursing and infection pre-vention and control for senile OVCF during the epidemic. In order to improve the efficiency of pre-hospital emergency care and prevent the spread of infection. Method: A total of 92 elderly patients with OVCF who received pre-hospital treatment in 18 hospitals in Zhangjiakou City during the epidemic prevention and control period from January 2020 to November 2022 and met the inclusion criteria were selected as research objects, including 24 males and 68 females, aged 65 - 82 (74.2 ± 2.2) years. All patients were associated with concomitant injuries and underlying diseases. All patients in this group underwent predictive pre-hospital rescue and infection prevention and control procedures. Results: All the 92 elderly patients with OVCF received timely pre-hospital treatment during the epidemic period, and no aggravation occurred of the 92 patients, 35 were in the high risk area, 10 were in the medium risk area, and 47 were in the low risk area. Exclude OVCF for NCP Patients were treated according to the conventional diagnosis and treatment principles. Suspected and confirmed cases are transferred to designated surgical hospitals for treatment. All patients were followed up 3 months, 6 months and 12 months after treatment. There was no death rate, high satisfaction of pre-hospital first aid, high diagnostic accuracy, and good curative effect. None of the rescue personnel had any infection rate, and no hospital infection transmission and nosocomial cross infection occurred. Conclusion: It is the first step to safely treat patients and prevent cross infection to establish a perfect synchronous strategy of pre-hospital first aid and infection prevention and control.
文摘Objective:To elucidate the awareness and approach to pre-operative human immunodeficiency virus(HIV) testing and emphasis on the attendant components of HIV testing.Methods: The study was conducted at the theatres of the University of Port Harcourt Teaching Hospital among 123 nursing,anaesthetic,and operating staff.A descriptive cross sectional design was adopted with stratified sampling.The study instrument was a structured,self administered pro forma.Results:All respondents were all aware of HIV infection and all had transmission through infected blood and tissues(100.0%).88.6%had infection through needle stick injuries, 62.6%through vertical transmission,and 98.4%through blood transfusion.Sixty three percent of respondents correctly knew what preoperative testing was,while 58.5%were aware of the preoperative testing policy of the hospital.All respondents favoured the policy of preoperative testing.Attitudinal values to seropositive patients were not very different as 72.4%of respondents claimed they treated every patient as high risk,and all respondents used personal protective equipment.Conclusions:Routine HIV testing now represents a conventional means providing patients with knowledge of their HIV status.Such testing should be accompanied by informed consent,counselling,confidentiality,protection,and access to treatment.
文摘<strong>Objective:</strong> The purpose of this work was to determine the epidemiological, clinical and evolutionary aspects of the pulmonary embolism of the young person in the cardiology department of the University Hospital Center (CHU) Point G in Bamako-Mali. <strong>Methodology:</strong> This was an analytical study from January 01, 2018 to December 31, 2018 in the CHU Point G cardiology department, including all patients hospitalized during this period. <strong>Results:</strong> Of 1379 hospitalized patients, 19 patients were concerned by pulmonary embolism of the young person. The prevalence of pulmonary embolism of the young person was 1.37%. The most affected age group was 21 - 30 (47.4%) of patients. The predominance was female (89.47%) with a gender ratio of 0.11 in favour of women. The average age in the series was 29.79 years with extremes of 16 years and 40 years. Factors predisposing to pulmonary embolism were dominated by peri partum, cardiomyopathy and obesity with 47.3%, 31.57% and 21.1%, respectively. The dominant signs were chest pain and dyspnea in 94.7% and 89.5% of cases respectively. Pulmonary embolism was unlikely in 60.52% according to the Geneva and Wells score simplified. At the thoracic angioscanner, the embolism was bilateral in 52.6% of cases and distal in 36.8% of patients;in 10 patients who performed cardiac ultrasound, pulmonary arterial hypertension (70%), dilation of the right ventricle (20%) and left ventricular dilation (40%). Hyper leucocytosis (47.4%), anemia and low prothrombin rate (TP) (22.2%) were the most found biological abnormalities. More than 2/3 (68.5%) our patients had an intermediate mortality risk according to the PESI (Pulmonary Embolism Severity Index) score. The average hospital stay was 10 days. Hospital mortality was 10.5%. <strong>Conclusion:</strong> The pulmonary embolism of the young person is a frequent, serious and multifactorial pathology and the female sex is most affected especially during peri partum periods, hence the need for preventive measures. Clinical signs are not specific and based on the assessment of clinical probability. Pulmonary angioscanner remains the confirmation review in our context.
文摘目的探讨凝视-面-臂-言语-时间(gaze-face-arm-speech-time,G-FAST)评分对院前急救卒中前循环大血管闭塞(large vessel occlusion in the anterior circulation,aLVO)的诊断价值。方法选取2019年7月至2020年12月北京急救中心直属5个分中心送至宣武医院,且有完整院前G-FAST评分和入院诊断信息的卒中患者,根据缺血性卒中患者是否发生LVO分为LVO和非LVO组,采用ROC曲线分析G-FAST评分对院前卒中急救aLVO的诊断价值。结果纳入患者352例,其中急性缺血性卒中占比69.0%(243/352)。进行大血管评估的急性缺血性卒中患者149例,占急性缺血性卒中的61.3%(149/243);发生aLVO患者61例,占大血管病变评估的40.9%(61/149)、占急性缺血性卒中的25.1%(61/243)。149例大血管评估的急性缺血性卒中患者中,男100例,女49例;年龄18~93岁,平均70.5岁。与非aLVO组相比,aLVO组女性较多,G-FAST评分较高,差异均有统计学意义(P<0.05)。G-FAST≥3分患者的aLVO发生率显著高于G-FAST≤2分者(68.9%比31.1%),差异有统计学意义(P<0.05)。G-FAST评分诊断院前急救卒中aLVO的ROC曲线的AUC为0.675(95%CI:0.589~0.761,P=0.000),G-FAST的cut-off值为2.5分时,灵敏度为72.10%,特异度为58.00%。结论G-FAST评分在院前急救卒中可准确识别急性缺血性患者aLVO,早诊断aLVO将利于急性缺血性患者尽早送至高级别卒中中心。
文摘动脉粥样硬化是心血管疾病重要的病理生理基础,延缓和防治动脉粥样硬化对于减少和降低心血管疾病的发病率及病死率具有重要意义。高密度脂蛋白(high density lipoprotein,HDL)通过参与介导胆固醇逆向转运(reverse cholesterol transport,RCT)在抗动脉粥样硬化的形成和进展中发挥了重要作用。Preβ-1高密度脂蛋白(prebeta-1 high density lipoprotein,Preβ-1HDL)作为HDL的一种亚类,是外周细胞移出胆固醇的最初接受体,直接参与了RCT的起始步骤,并在随后的胆固醇酯化及转运中起着重要作用。本文就Preβ-1HDL的结构、代谢及其与心血管疾病的关系作一简要综述。
文摘目的了解我国军、地医院创伤院前救护能力现状及延时现场救护(prolonged field care,PFC)认知及能力准备情况,为相关培训提供参考。方法2021年2月—6月,采用分层抽样和便利抽样相结合的方法,选取东北、西南、中部、东南以及珠三角地区242名军队及地方医护人员,采用自行设计的《中国创伤院前急救及延时现场救护(PFC)认知情况调查问卷》,借助于问卷星平台进行多中心横断面调查。结果(1)部队三甲医院年均院前救护任务显著多于地方二甲医院(P<0.05),道路交通伤在所有伤型中占比最高;(2)“途中持续监护和复苏预案”是制定最多的院前救护预案,“转运时间过长”是反映最多的问题;(3)PFC知晓率仅为35.1%;(4)“现场处理能力”和“复杂伤情评估”被分别认为是军、地医院创伤院前急救培训中最急需和最缺少的能力。结论当前我国军、地医院救护人员对创伤院前急救措施的掌握情况不容乐观,对各类预案了解不足,PFC概念知晓度普遍较低,缺乏复杂伤情评估和决策能力,亟待完善培训策略,提升整体创伤院前救护能力。
文摘Background: Minimally invasive surgery in the field of traumatic vascular injury diagnosis and treatment has achieved good results. This study was designed to determine whether pre-hospital emergency intervention is feasible for vascular injury in a field intervention cabin under the condition of war or a disaster site.Methods: Different types of animal experiments of vascular injury intervention were performed in a field intervention cabin. Treatment capacity was evaluated by data collection, including duration of surgery, clinical evaluation, image clarity, and equipment handling. Environmental adaptability and mobility were evaluated by maneuverability and long-distance mobility.Results: A total of 56 surgeries(7 types) were performed in the field intervention cabin. Digital subtraction angiography(DSA) had good imaging performance. A total of 4800 km of long-distance mobility was performed, and all the equipment operated normally without any equipment failure. We participated in the medical service maneuver twice. The cabin unfolded and worked properly. There was no equipment damage during the medical service maneuver.Conclusion: Use of a field intervention cabin under the conditions of war or disaster is feasible for pre-hospital emergency intervention of vascular injury.