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Publisher: Medknow Publishers   (Total: 429 journals)

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Showing 1 - 200 of 429 Journals sorted alphabetically
Acta Medica Intl.     Open Access   (SJR: 0.101, CiteScore: 0)
Advanced Arab Academy of Audio-Vestibulogy J.     Open Access  
Advanced Biomedical Research     Open Access  
Advances in Human Biology     Open Access   (Followers: 3)
Advances in Skeletal Muscle Function Assessment     Open Access  
African J. for Infertility and Assisted Conception     Open Access  
African J. of Medical and Health Sciences     Open Access   (Followers: 2)
African J. of Paediatric Surgery     Open Access   (Followers: 7, SJR: 0.25, CiteScore: 1)
African J. of Trauma     Open Access   (Followers: 1)
Ain-Shams J. of Anaesthesiology     Open Access   (Followers: 3)
Al-Azhar Assiut Medical J.     Open Access  
Al-Basar Intl. J. of Ophthalmology     Open Access   (Followers: 1)
Alexandria J. of Pediatrics     Open Access  
Ancient Science of Life     Open Access   (Followers: 5)
Anesthesia : Essays and Researches     Open Access   (Followers: 10)
Annals of African Medicine     Open Access   (Followers: 1, SJR: 0.258, CiteScore: 1)
Annals of Bioanthropology     Open Access   (Followers: 4)
Annals of Cardiac Anaesthesia     Open Access   (Followers: 14, SJR: 0.308, CiteScore: 1)
Annals of Indian Academy of Neurology     Open Access   (Followers: 3, SJR: 0.434, CiteScore: 1)
Annals of Indian Academy of Otorhinolaryngology Head and Neck Surgery     Open Access  
Annals of Indian Psychiatry     Open Access  
Annals of Maxillofacial Surgery     Open Access   (Followers: 6)
Annals of Medical and Health Sciences Research     Open Access   (Followers: 7)
Annals of Nigerian Medicine     Open Access   (Followers: 1)
Annals of Pediatric Cardiology     Open Access   (Followers: 7, SJR: 0.352, CiteScore: 1)
Annals of Saudi Medicine     Open Access   (SJR: 0.238, CiteScore: 1)
Annals of Thoracic Medicine     Open Access   (Followers: 5, SJR: 0.524, CiteScore: 1)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 12, SJR: 0.152, CiteScore: 0)
Annals of Tropical Pathology     Open Access  
Apollo Medicine     Open Access  
APOS Trends in Orthodontics     Open Access  
Arab J. of Interventional Radiology     Open Access  
Archives of Cardiovascular Imaging     Open Access   (Followers: 1, SJR: 0.187, CiteScore: 0)
Archives of Intl. Surgery     Open Access   (Followers: 10, SJR: 0.302, CiteScore: 1)
Archives of Medicine and Health Sciences     Open Access   (Followers: 3)
Archives of Medicine and Surgery     Open Access  
Archives of Pharmacy Practice     Open Access   (Followers: 6, SJR: 0.102, CiteScore: 0)
Archives of Trauma Research     Open Access   (Followers: 3, SJR: 0.37, CiteScore: 2)
Asia Pacific J. of Clinical Trials : Nervous System Diseases     Open Access  
Asia-Pacific J. of Oncology Nursing     Open Access   (Followers: 4)
Asian J. of Andrology     Open Access   (Followers: 1, SJR: 0.856, CiteScore: 2)
Asian J. of Neurosurgery     Open Access   (Followers: 2)
Asian J. of Oncology     Open Access   (Followers: 1)
Asian J. of Transfusion Science     Open Access   (Followers: 1, SJR: 0.35, CiteScore: 1)
Asian Pacific J. of Reproduction     Open Access   (SJR: 0.227, CiteScore: 1)
Asian Pacific J. of Tropical Biomedicine     Open Access   (Followers: 2, SJR: 0.491, CiteScore: 2)
Asian Pacific J. of Tropical Medicine     Open Access   (Followers: 1, SJR: 0.561, CiteScore: 2)
Astrocyte     Open Access  
Avicenna J. of Medicine     Open Access   (Followers: 1)
AYU : An international quarterly journal of research in Ayurveda     Open Access   (Followers: 6)
Benha Medical J.     Open Access  
Biomedical and Biotechnology Research J.     Open Access  
BLDE University J. of Health Sciences     Open Access  
Brain Circulation     Open Access  
Bulletin of Faculty of Physical Therapy     Open Access   (Followers: 1)
Canadian J. of Rural Medicine     Full-text available via subscription   (SJR: 0.202, CiteScore: 0)
Cancer Translational Medicine     Open Access   (Followers: 2)
Cardiology Plus     Open Access  
Chinese Medical J.     Open Access   (Followers: 10, SJR: 0.52, CiteScore: 1)
CHRISMED J. of Health and Research     Open Access  
Clinical Cancer Investigation J.     Open Access  
Clinical Dermatology Review     Open Access   (Followers: 2)
Clinical Trials in Degenerative Diseases     Open Access  
Clinical Trials in Orthopedic Disorders     Open Access  
Community Acquired Infection     Open Access  
Conservation and Society     Open Access   (Followers: 10, SJR: 0.811, CiteScore: 2)
Contemporary Clinical Dentistry     Open Access   (Followers: 4, SJR: 0.353, CiteScore: 1)
Current Medical Issues     Open Access   (Followers: 1)
CytoJ.     Open Access   (Followers: 2, SJR: 0.543, CiteScore: 1)
Delta J. of Ophthalmology     Open Access  
Dental Hypotheses     Open Access   (Followers: 3, SJR: 0.152, CiteScore: 0)
Dental Research J.     Open Access   (Followers: 11, SJR: 0.416, CiteScore: 1)
Dentistry and Medical Research     Open Access  
Digital Medicine     Open Access  
Drug Development and Therapeutics     Open Access  
Education for Health     Open Access   (Followers: 6, SJR: 0.242, CiteScore: 0)
Egyptian J. of Bronchology     Open Access  
Egyptian J. of Cardiothoracic Anesthesia     Open Access  
Egyptian J. of Cataract and Refractive Surgery     Open Access   (Followers: 1, SJR: 1.799, CiteScore: 2)
Egyptian J. of Chest Diseases and Tuberculosis     Open Access   (Followers: 3, SJR: 0.155, CiteScore: 0)
Egyptian J. of Dermatology and Venerology     Open Access   (Followers: 1)
Egyptian J. of Haematology     Open Access   (Followers: 1)
Egyptian J. of Internal Medicine     Open Access   (Followers: 1)
Egyptian J. of Neurology, Psychiatry and Neurosurgery     Open Access   (Followers: 1, SJR: 0.127, CiteScore: 0)
Egyptian J. of Obesity, Diabetes and Endocrinology     Open Access  
Egyptian J. of Otolaryngology     Open Access   (Followers: 2)
Egyptian J. of Psychiatry     Open Access   (Followers: 2)
Egyptian J. of Surgery     Open Access   (Followers: 1)
Egyptian Nursing J.     Open Access  
Egyptian Orthopaedic J.     Open Access   (Followers: 2)
Egyptian Pharmaceutical J.     Open Access  
Egyptian Retina J.     Open Access  
Egyptian Rheumatology and Rehabilitation     Open Access  
Endodontology     Open Access  
Endoscopic Ultrasound     Open Access   (SJR: 0.822, CiteScore: 2)
Environmental Disease     Open Access   (Followers: 2)
Eurasian J. of Pulmonology     Open Access  
European J. of Dentistry     Open Access   (Followers: 2, SJR: 0.749, CiteScore: 2)
European J. of General Dentistry     Open Access   (Followers: 1, SJR: 0.12, CiteScore: 0)
European J. of Prosthodontics     Open Access   (Followers: 3)
European J. of Psychology and Educational Studies     Open Access   (Followers: 11, SJR: 0.113, CiteScore: 0)
Fertility Science and Research     Open Access  
Formosan J. of Surgery     Open Access   (SJR: 0.112, CiteScore: 0)
Genome Integrity     Open Access   (Followers: 3, SJR: 0.153, CiteScore: 0)
Glioma     Open Access  
Global J. of Transfusion Medicine     Open Access   (Followers: 1)
Gynecology and Minimally Invasive Therapy     Open Access   (SJR: 0.311, CiteScore: 1)
Hamdan Medical J.     Open Access  
Heart and Mind     Open Access  
Heart India     Open Access   (Followers: 1)
Heart Views     Open Access   (Followers: 2)
Hepatitis B Annual     Open Access   (Followers: 3)
Ibnosina J. of Medicine and Biomedical Sciences     Open Access  
IJS Short Reports     Open Access  
Imam J. of Applied Sciences     Open Access  
Indian Anaesthetists Forum     Open Access  
Indian Dermatology Online J.     Open Access   (Followers: 3)
Indian J. of Allergy, Asthma and Immunology     Open Access   (Followers: 1)
Indian J. of Anaesthesia     Open Access   (Followers: 7, SJR: 0.478, CiteScore: 1)
Indian J. of Burns     Open Access   (Followers: 1)
Indian J. of Cancer     Open Access   (Followers: 1, SJR: 0.361, CiteScore: 1)
Indian J. of Cerebral Palsy     Open Access   (Followers: 1)
Indian J. of Community Medicine     Open Access   (Followers: 2, SJR: 0.37, CiteScore: 1)
Indian J. of Critical Care Medicine     Open Access   (Followers: 2, SJR: 0.604, CiteScore: 1)
Indian J. of Dental Research     Open Access   (Followers: 4, SJR: 0.266, CiteScore: 1)
Indian J. of Dental Sciences     Open Access  
Indian J. of Dentistry     Open Access   (Followers: 1)
Indian J. of Dermatology     Open Access   (Followers: 2, SJR: 0.468, CiteScore: 1)
Indian J. of Dermatology, Venereology and Leprology     Open Access   (Followers: 5, SJR: 0.445, CiteScore: 1)
Indian J. of Dermatopathology and Diagnostic Dermatology     Open Access  
Indian J. of Drugs in Dermatology     Open Access   (Followers: 1, SJR: 0.791, CiteScore: 1)
Indian J. of Endocrinology and Metabolism     Open Access   (Followers: 4, SJR: 0.568, CiteScore: 1)
Indian J. of Health Sciences     Open Access   (Followers: 3)
Indian J. of Medical and Paediatric Oncology     Open Access   (SJR: 0.425, CiteScore: 1)
Indian J. of Medical Microbiology     Open Access   (Followers: 1, SJR: 0.503, CiteScore: 1)
Indian J. of Medical Research     Open Access   (Followers: 4, SJR: 0.656, CiteScore: 1)
Indian J. of Medical Sciences     Open Access   (Followers: 2, SJR: 0.102, CiteScore: 0)
Indian J. of Multidisciplinary Dentistry     Open Access   (Followers: 1)
Indian J. of Nephrology     Open Access   (Followers: 2, SJR: 0.347, CiteScore: 1)
Indian J. of Nuclear Medicine     Open Access   (Followers: 2, SJR: 0.23, CiteScore: 0)
Indian J. of Occupational and Environmental Medicine     Open Access   (Followers: 3, SJR: 0.225, CiteScore: 1)
Indian J. of Ophthalmology     Open Access   (Followers: 4, SJR: 0.498, CiteScore: 1)
Indian J. of Oral Health and Research     Open Access  
Indian J. of Oral Sciences     Open Access   (Followers: 1)
Indian J. of Orthopaedics     Open Access   (Followers: 8, SJR: 0.392, CiteScore: 1)
Indian J. of Otology     Open Access   (Followers: 1, SJR: 0.199, CiteScore: 0)
Indian J. of Paediatric Dermatology     Open Access   (Followers: 2)
Indian J. of Pain     Open Access   (Followers: 1)
Indian J. of Palliative Care     Open Access   (Followers: 5, SJR: 0.454, CiteScore: 1)
Indian J. of Pathology and Microbiology     Open Access   (Followers: 2, SJR: 0.276, CiteScore: 1)
Indian J. of Pharmacology     Open Access   (SJR: 0.412, CiteScore: 1)
Indian J. of Plastic Surgery     Open Access   (Followers: 12, SJR: 0.311, CiteScore: 0)
Indian J. of Psychiatry     Open Access   (Followers: 3, SJR: 0.408, CiteScore: 1)
Indian J. of Psychological Medicine     Open Access   (SJR: 0.368, CiteScore: 1)
Indian J. of Public Health     Open Access   (Followers: 1)
Indian J. of Radiology and Imaging     Open Access   (Followers: 4)
Indian J. of Research in Homoeopathy     Open Access  
Indian J. of Respiratory Care     Open Access  
Indian J. of Rheumatology     Open Access   (SJR: 0.119, CiteScore: 0)
Indian J. of Sexually Transmitted Diseases and AIDS     Open Access   (Followers: 2, SJR: 0.34, CiteScore: 0)
Indian J. of Social Psychiatry     Open Access   (Followers: 2)
Indian J. of Transplantation     Open Access  
Indian J. of Urology     Open Access   (Followers: 3, SJR: 0.434, CiteScore: 1)
Indian J. of Vascular and Endovascular Surgery     Open Access   (Followers: 2)
Indian Spine J.     Open Access  
Industrial Psychiatry J.     Open Access   (Followers: 2)
Intervention     Open Access   (Followers: 1)
Intl. Archives of Health Sciences     Open Access  
Intl. J. of Abdominal Wall and Hernia Surgery     Open Access  
Intl. J. of Academic Medicine     Open Access  
Intl. J. of Advanced Medical and Health Research     Open Access  
Intl. J. of Applied and Basic Medical Research     Open Access  
Intl. J. of Clinical and Experimental Physiology     Open Access   (Followers: 1)
Intl. J. of Clinicopathological Correlation     Open Access  
Intl. J. of Community Dentistry     Open Access  
Intl. J. of Critical Illness and Injury Science     Open Access   (Followers: 1, SJR: 0.192, CiteScore: 0)
Intl. J. of Educational and Psychological Researches     Open Access   (Followers: 4)
Intl. J. of Environmental Health Engineering     Open Access   (Followers: 1)
Intl. J. of Forensic Odontology     Open Access   (Followers: 1)
Intl. J. of Green Pharmacy     Open Access   (Followers: 3, SJR: 0.142, CiteScore: 0)
Intl. J. of Growth Factors and Stem Cells in Dentistry     Open Access  
Intl. J. of Health & Allied Sciences     Open Access   (Followers: 3)
Intl. J. of Health System and Disaster Management     Open Access   (Followers: 3)
Intl. J. of Heart Rhythm     Open Access  
Intl. J. of Medicine and Public Health     Open Access   (Followers: 6)
Intl. J. of Mycobacteriology     Open Access   (SJR: 0.535, CiteScore: 1)
Intl. J. of Noncommunicable Diseases     Open Access  
Intl. J. of Nutrition, Pharmacology, Neurological Diseases     Open Access   (Followers: 4, SJR: 0.17, CiteScore: 0)
Intl. J. of Oral Health Sciences     Open Access   (Followers: 2)
Intl. J. of Orofacial Biology     Open Access  
Intl. J. of Orofacial Research     Open Access  
Intl. J. of Orthodontic Rehabilitation     Open Access  
Intl. J. of Pedodontic Rehabilitation     Open Access  
Intl. J. of Pharmaceutical Investigation     Open Access   (Followers: 1)
Intl. J. of Preventive Medicine     Open Access   (Followers: 1, SJR: 0.623, CiteScore: 1)
Intl. J. of Shoulder Surgery     Open Access   (Followers: 5, SJR: 0.653, CiteScore: 1)
Intl. J. of the Cardiovascular Academy     Open Access   (SJR: 0.105, CiteScore: 0)
Intl. J. of Trichology     Open Access   (SJR: 0.4, CiteScore: 1)
Intl. J. of Yoga     Open Access   (Followers: 13)
Intl. J. of Yoga : Philosophy, Psychology and Parapsychology     Open Access   (Followers: 5)

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Journal Cover
Journal of Emergencies, Trauma and Shock
Journal Prestige (SJR): 0.455
Citation Impact (citeScore): 1
Number of Followers: 9  

  This is an Open Access Journal Open Access journal
ISSN (Print) 0974-2700 - ISSN (Online) 0974-519X
Published by Medknow Publishers Homepage  [429 journals]
  • What's new in emergencies, trauma, and shock? Using abdominal computed
           tomography in geriatric patients on warfarin

    • Authors: Dorian A Bogdanovski, Daniel Hakakian, Louis T DiFazio, Luca Antonioli, Zoltan H Nemeth
      Pages: 71 - 72
      Abstract: Dorian A Bogdanovski, Daniel Hakakian, Louis T DiFazio, Luca Antonioli, Zoltan H Nemeth
      Journal of Emergencies, Trauma, and Shock 2018 11(2):71-72

      Citation: Journal of Emergencies, Trauma, and Shock 2018 11(2):71-72
      PubDate: Tue,29 May 2018
      DOI: 10.4103/JETS.JETS_85_17
      Issue No: Vol. 11, No. 2 (2018)
       
  • Grace under pressure: Leadership in emergency medicine

    • Authors: Fatimah Lateef
      Pages: 73 - 79
      Abstract: Fatimah Lateef
      Journal of Emergencies, Trauma, and Shock 2018 11(2):73-79
      Physicians in general, including emergency physicians (EPs), are trained in the diagnostic, therapeutic, and administrative aspects of patient care but not so much in the theoretical and practical aspects of assuming and delivery of leadership. EPs are always taught to focus on their performance, to excel and achieve, to be accountable for their own clinical decisions, and to appreciate feedback and peer-to-peer review. Currently, if there are some semblances of formal or semi-formal leadership instruction, the organized theoretical curriculum often does not formally include very structured and planned departmental leadership and management elements. Leadership is a process for a person (≥the leader≥) to lead, influence, and engage a group or organization to accomplish their objectives and mission. To do this, the leader must understand a variety of issues of working, interacting, and integrating with people, the environment and both, the intrinsic and extrinsic factors, and elements that have an impact on the industry or area he/she is leading in. Leadership in emergency medicine (EM) is even more challenging, with its unique focus, issues, and trajectory, moving into the new century, with new considerations. No single strategy is sufficient to ace EM leadership and no single specific leadership model is complete. This paper shares some current views on medical/EM leadership. The author shares her views and some suggested proposals for more formal and structured leadership, implementation, and succession to help nurture and groom Eps who will become leaders in EM in the near future.
      Citation: Journal of Emergencies, Trauma, and Shock 2018 11(2):73-79
      PubDate: Tue,29 May 2018
      DOI: 10.4103/JETS.JETS_18_18
      Issue No: Vol. 11, No. 2 (2018)
       
  • Guiding management in severe trauma: Reviewing factors predicting outcome
           in vastly injured patients

    • Authors: Emmanuel Lilitsis, Sofia Xenaki, Elias Athanasakis, Eleftherios Papadakis, Pavlina Syrogianni, George Chalkiadakis, Emmanuel Chrysos
      Pages: 80 - 87
      Abstract: Emmanuel Lilitsis, Sofia Xenaki, Elias Athanasakis, Eleftherios Papadakis, Pavlina Syrogianni, George Chalkiadakis, Emmanuel Chrysos
      Journal of Emergencies, Trauma, and Shock 2018 11(2):80-87
      Trauma is one of the leading causes of death worldwide, with road traffic collisions, suicides, and homicides accounting for the majority of injury-related deaths. Since trauma mainly affects young age groups, it is recognized as a serious social and economic threat, as annually, almost 16,000 posttrauma individuals are expected to lose their lives and many more to end up disabled. The purpose of this research is to summarize current knowledge on factors predicting outcome – specifically mortality risk – in severely injured patients. Development of this review was mainly based on the systematic search of PubMed medical library, Cochrane database, and advanced trauma life support Guiding Manuals. The research was based on publications between 1994 and 2016. Although hypovolemic, obstructive, cardiogenic, and septic shock can all be seen in multi-trauma patients, hemorrhage-induced shock is by far the most common cause of shock. In this review, we summarize current knowledge on factors predicting outcome – more specifically mortality risk – in severely injured patients. The main mortality-predicting factors in trauma patients are those associated with basic human physiology and tissue perfusion status, coagulation adequacy, and resuscitation requirements. On the contrary, advanced age and the presence of comorbidities predispose patients to a poor outcome because of the loss of physiological reserves. Trauma resuscitation teams considering mortality prediction factors can not only guide resuscitation but also identify patients with high mortality risk who were previously considered less severely injured.
      Citation: Journal of Emergencies, Trauma, and Shock 2018 11(2):80-87
      PubDate: Tue,29 May 2018
      DOI: 10.4103/JETS.JETS_74_17
      Issue No: Vol. 11, No. 2 (2018)
       
  • Utility of abdominal computed tomography in geriatric patients on warfarin
           with a fall from standing

    • Authors: Amit Bahl, Steven Schafer
      Pages: 88 - 91
      Abstract: Amit Bahl, Steven Schafer
      Journal of Emergencies, Trauma, and Shock 2018 11(2):88-91
      Context: Geriatric head trauma resulting from falls has been extensively studied both in the presence and absence of blood thinners. In this population, however, the prevalence and extent of abdominal injury resulting from falls are much less defined. Aim: We aim to evaluate the utility of abdominal computed tomography (CT) imaging in geriatric patients on Warfarin with a recent history of fall. Setting and Design: A retrospective analysis was completed of consecutive geriatric patients who presented to a Level 1 Trauma Center emergency department after fall from standing while taking Warfarin. Methods: Inclusion criteria included age 65 years or older and fall while taking Warfarin. Incomplete medical records were excluded from the study. Data collection included the type of anticoagulant medications, demographics, physical examination, laboratories, CT/X-ray findings if ordered, and final diagnosis on admission. Categorical variables were examined using Pearson's Chi-square where appropriate (expected frequency >5), or Fisher's Exact test. Continuous variables were examined using nonparametric Wilcoxon rank tests. Results: Eight hundred and sixty-three charts were reviewed. One hundred and thirty-one subjects met inclusion criteria. Mean age was 83 years. Nearly 39.6% of patients were male. A total of 48 patients had abdominal CT imaging. Seven of the 131 patients (5.3%) had an abdominal injury. Abdominal tenderness was predictive of injury, with 4 of 7 cases with abdominal injury demonstrating abdominal tenderness versus only 10 of 124 cases without abdominal injury demonstrating tenderness (P = 0.003). Abdominal CTs were ordered in 11 of 19 cases of patients that exhibited head trauma yet none of these patients were shown to have sustained abdominal trauma (P = 0.08). There was no association between international normalized ratio level and presence of abdominal injury (P = 0.99). Conclusions: A small percentage of elderly fall patients on Warfarin have a significant abdominal injury. Anticoagulated geriatric patients are sometimes subjected to abdominal scans liberally without supporting physical examination findings such as abdominal tenderness or presence of a distracting injury. Specifically, the utility of abdominal CT is questionable in isolated head injury patients. Further, taking Warfarin or other anticoagulant medications do not seem to increase the risk of intraabdominal injury.
      Citation: Journal of Emergencies, Trauma, and Shock 2018 11(2):88-91
      PubDate: Tue,29 May 2018
      DOI: 10.4103/JETS.JETS_52_17
      Issue No: Vol. 11, No. 2 (2018)
       
  • Integration of point-of-care ultrasound during rapid sequence intubation
           in trauma resuscitation

    • Authors: Prakash Ranjan Mishra, Sanjeev Bhoi, Tej Prakash Sinha
      Pages: 92 - 97
      Abstract: Prakash Ranjan Mishra, Sanjeev Bhoi, Tej Prakash Sinha
      Journal of Emergencies, Trauma, and Shock 2018 11(2):92-97
      Introduction: Airway and breathing management play critical role in trauma resuscitation. Early identification of esophageal intubation and detection of fatal events is critical.
      Authors studied the utility of integration of point-of-care ultrasound (POCUS) during different phases of rapid sequence intubation (RSI) in trauma resuscitation. Methods: It was prospective, randomized single-centered study conducted at the Emergency Department of a level one trauma center. Patients were divided into ultrasonography (USG) and clinical examination (CE) arm. The objectives were to study the utility of POCUS in endotracheal tube placement and confirmations and identification of potentially fatal conditions as tracheal injury, midline vessels, paratracheal hematoma, vocal cord pathology, pneumothorax, and others during RSI. Patient >1 year of age were included. Time taken for procedure, number of incorrect intubations, and pathologies detected were noted. The data were collected in Microsoft Excel spread sheets and analyzed using Stata (version 11.2, Stata Corp, Texas, U. S. A) software. Results: One hundred and six patients were recruited. The mean time for primary survey USG versus CE arm was (20 ± 10.01 vs. 18 ± 11.03) seconds. USG detected four pneumothorax, one tracheal injury, and one paratracheal hematoma. The mean procedure time USG versus CE arm was (37.3 ± 21.92 vs. 58 ± 32.04) seconds. Eight esophageal intubations were identified in USG arm by POCUS and two in CE arm by EtCO2 values. Conclusion: Integration of POCUS was useful in all three phases of RSI. It identified paratracheal hematoma, tracheal injury, and pneumothorax. It also identified esophageal intubation and confirmed main stem tracheal intubation in less time compared to five-point auscultation and capnography.
      Citation: Journal of Emergencies, Trauma, and Shock 2018 11(2):92-97
      PubDate: Tue,29 May 2018
      DOI: 10.4103/JETS.JETS_56_17
      Issue No: Vol. 11, No. 2 (2018)
       
  • A pilot study of viscoelastic monitoring in pediatric trauma: Outcomes and
           lessons learned

    • Authors: Bola Aladegbami, Pamela M Choi, Martin S Keller, Adam M Vogel
      Pages: 98 - 103
      Abstract: Bola Aladegbami, Pamela M Choi, Martin S Keller, Adam M Vogel
      Journal of Emergencies, Trauma, and Shock 2018 11(2):98-103
      Background: Examine the characteristics and outcomes of pediatric trauma patients at risk for coagulopathy following implementation of viscoelastic monitoring. Materials and Methods: Injured children, aged <18 years, from September 7, 2014, to December 21, 2015, at risk for trauma-induced coagulopathy were identified from a single, level-1 American College of Surgeons verified pediatric trauma center. Patients were grouped by coagulation assessment: no assessment (NA), conventional coagulation testing alone (CCT), and conventional coagulation testing with rapid thromboelastography (rTEG). Coagulation assessment was provider preference with all monitoring options continuously available. Groups were compared and outcomes were evaluated including blood product utilization, Intensive Care Unit (ICU) utilization, duration of mechanical ventilation, and mortality. Results: A total of 155 patients were identified (NA = 78, CCT = 54, and rTEG = 23). There was no difference in age, gender, race, or mechanism. In practice, rTEG patients were more severely injured, more anemic, and received more blood products and crystalloid (P < 0.001). rTEG patients also had increased mortality with fewer ventilator and ICU-free days. Multivariate logistic regression and covariance analysis indicated that while rTEG use was not associated with mortality, it was associated with increased use of blood products, duration of mechanical ventilation, and ICU length of stay. Conclusions: Viscoelastic monitoring was infrequently performed, but utilized in more severely injured patients. Well-designed prospective studies in patients at high risk of coagulopathy are needed to evaluate goal-directed hemostatic resuscitation strategies in children.
      Citation: Journal of Emergencies, Trauma, and Shock 2018 11(2):98-103
      PubDate: Tue,29 May 2018
      DOI: 10.4103/JETS.JETS_150_16
      Issue No: Vol. 11, No. 2 (2018)
       
  • Validation of predicting hyperglycemic crisis death score: A risk
           stratification tool for appropriate disposition of hyperglycemic crisis
           patients from the emergency department

    • Authors: Akilan Elangovan, Srihari Cattamanchi, Abdul Razack Farook, Ramakrishnan Venkatakrishnan Trichur
      Pages: 104 - 110
      Abstract: Akilan Elangovan, Srihari Cattamanchi, Abdul Razack Farook, Ramakrishnan Venkatakrishnan Trichur
      Journal of Emergencies, Trauma, and Shock 2018 11(2):104-110
      Context: Predicting hyperglycemic crisis death (PHD) score is a simple, rapid tool with six independent mortality predictors to calculate 30-day mortality and appropriately dispose patients to Intensive Care Unit (ICU) or ward. Aims: This study aimed at validating the efficiency of PHD score as a decision rule for prognosticating 30-day mortality and classifying hyperglycemic crisis patients for appropriate disposition from the emergency department (ED). Materials and Methods: This is a prospective, observational study done in the ED of a teaching hospital over 14 months. All patients aged >18 years and who met the criteria of hyperglycemic crisis were enrolled. Thirty-day mortality of six independent predictors was the primary end point. Using PHD, risk scores were calculated and patients were disposed as per physician's clinical judgment. Finally, the treating physician's decision and PHD score disposition were compared and the efficiency of PHD in predicting 30-day mortality was analyzed. Multiple logistic regression models were used for analysis. Receiver operating characteristic curve was drawn, and area under the curve along with sensitivity, specificity, positive predictive value, and negative predictive value was analyzed. P < 0.05 was considered statistically significant. Results: A total of 133 patients were included. On applying PHD score, 69, 39, and 25 patients were in the low-, intermediate-, and high-risk groups, respectively, with a mortality rate of 5.8%, 20.5%, and 56%, respectively. On comparing physician disposition with PHD score, an increasing mortality was noticed in ICU, and PHD showed equal weight in risk stratification and appropriate disposition of patients. Conclusion: In adult patients with hyperglycemic crisis, PHD score is validated as a straightforward, prompt tool for predicting 30-day mortality and aids in disposition. The mortality rate in the PHD score Model II was similar to the physician's clinical decision.
      Citation: Journal of Emergencies, Trauma, and Shock 2018 11(2):104-110
      PubDate: Tue,29 May 2018
      DOI: 10.4103/JETS.JETS_2_17
      Issue No: Vol. 11, No. 2 (2018)
       
  • Validation of the cincinnati prehospital stroke scale

    • Authors: Aditya Maddali, Farook Abdul Razack, Srihari Cattamanchi, Trichur V Ramakrishnan
      Pages: 111 - 114
      Abstract: Aditya Maddali, Farook Abdul Razack, Srihari Cattamanchi, Trichur V Ramakrishnan
      Journal of Emergencies, Trauma, and Shock 2018 11(2):111-114
      Background: Early recognition of Stroke is one of the key concepts in the ≤Chain of Survival≥ as described by the American Heart Association/American Stroke Association Stroke guidelines. The most commonly used tools for prehospital assessment of stroke are ≤The Cincinnati Prehospital Stroke Scale,≥ (CPSS) the ≤Face, Arm, Speech Test,≥ and ≤The Los Angeles Prehospital Stroke Screen.≥ The former two are used to identify stroke using physical findings while the latter is used to rule out other causes of altered consciousness. Aim: The aim of this study is to validate the CPSS in the prehospital setting by correlating with computed tomography scan findings. (1) To determine if these scores can be implemented in the Indian prehospital setting. (2) To determine if it is feasible for new emergency departments (EDs) to use these protocols for early detection of stroke. Methodology: A prospective, observational study from December, 2015 to March, 2016. Patients with suspected stroke were enrolled. Data were collected prehospital in patients that arrived to the ED in an ambulance. Sensitivity, specificity, positive predictive value, and negative predictive value of the score were calculated using standard formulae. Results: CPSS showed good sensitivity of 81% (confidence interval [CI] – 68.5%–97%) when combined and a positive predictive value (PPV) of 100% (CI: 91.9%–100%). Individually, they showed a sensitivity of 75.8%, 79%, and 74.1%, respectively, with a PPV of 100% and specificity of 95%–100%. Conclusion: As a prehospital screening tool, CPSS can be extremely useful as any diagnosis is only provisional until confirmed by an appropriate investigation in a hospital.
      Citation: Journal of Emergencies, Trauma, and Shock 2018 11(2):111-114
      PubDate: Tue,29 May 2018
      DOI: 10.4103/JETS.JETS_8_17
      Issue No: Vol. 11, No. 2 (2018)
       
  • Comparison of ultrasound and plain radiography for the detection of
           long-bone fractures

    • Authors: Amit Bahl, Michael Bagan, Steven Joseph, Abigail Brackney
      Pages: 115 - 118
      Abstract: Amit Bahl, Michael Bagan, Steven Joseph, Abigail Brackney
      Journal of Emergencies, Trauma, and Shock 2018 11(2):115-118
      Objective: To compare emergency medicine (EM) resident physicians' ability to identify long-bone fractures using ultrasound (US) versus plain radiography (X-ray). Methods: This was an IRB-approved, randomized prospective study. Study participants included 40 EM residents at a single site. Fractures were mechanically induced in five chicken legs, and five legs were left unfractured. Chicken legs were imaged by both modalities. Participants were given 2 min to view each of the images. Participants were randomized to either US or X-ray interpretation first and randomized to viewing order within each arm. Participants documented the presence or absence of fracture and location and type of fracture when pertinent. Mean proportions and standard deviations (SDs) were analyzed using paired t-test and linear models. Results: Forty residents (15 postgraduate years (PGY)-1, 12 PGY-2, 13 PGY-3) participated in the study. Thirty-one participants were male, and 19 were randomized to US first. Residents completed a mean of 185 (SD 95.8) US scans before the study in a variety of applications. Accurate fracture identification had a higher mean proportion in the US arm than the X-ray arm, 0.89 (SD 0.11) versus 0.75 (SD 0.11), respectively (P < 0.001). There was no statistically significant difference in US arm and X-ray arm for endpoints of fracture location and type. Conclusion: EM residents were better able to identify fractures using US compared to X-ray, especially as level of US and ED experience increased. These results encourage the use of US for the assessment of isolated extremity injury, particularly when the injury is diaphyseal.
      Citation: Journal of Emergencies, Trauma, and Shock 2018 11(2):115-118
      PubDate: Tue,29 May 2018
      DOI: 10.4103/JETS.JETS_82_17
      Issue No: Vol. 11, No. 2 (2018)
       
  • Snakebites in lebanon: a descriptive study of snakebite victims treated at
           a tertiary care center in Beirut, Lebanon

    • Authors: Tharwat El Zahran, Ziad Kazzi, Ahel Al-Hajj Chehadeh, Riyad Sadek, Mazen J El Sayed
      Pages: 119 - 124
      Abstract: Tharwat El Zahran, Ziad Kazzi, Ahel Al-Hajj Chehadeh, Riyad Sadek, Mazen J El Sayed
      Journal of Emergencies, Trauma, and Shock 2018 11(2):119-124
      Background: Snakebites lead to at least 421,000 envenomations and result in more than 20,000 deaths per year worldwide. Few reports exist in the Mediterranean region. This study describes demographic and clinical characteristics, treatment modalities, and outcomes of snakebites in Lebanon. Materials and Methods: This was a retrospective chart review of patients who presented with snakebite complaint to the emergency department between January 2000 and September 2014. Results: A total of 24 patients were included in this study. The mean age was 34.6 (±16.4) years and 58.3% were males. Local manifestations were documented in 15 (62.5%) patients, systemic effects in 10 (41.7%), hematologic abnormalities in 10 (41.7%), and neurologic effects in 4 (16.7%) patients. Nine patients (37.5%) received antivenom. The median amount of antivenom administered was 40 ml or 4 vials (range: 1–8 vials). About 50% of patients were admitted to the hospital with 75% to an Intensive Care Unit and 25% to a regular bed. All were discharged home with a median hospital length of stay of 4 (interquartile range 11) days. Among those admitted, seven patients (58.3%) had at least one documented complication (compartment syndrome, fasciotomy, intubation, deep vein thrombosis, coagulopathy, acute respiratory distress syndrome, sepsis, congestive heart failure, cellulitis, upper gastrointestinal bleeding, and vaginal bleeding). Conclusion: Victims of snakebites in Lebanon developed local, systemic, hematologic, or neurologic manifestations. Complications from snakebites were frequent despite antivenom administration. Larger studies are needed to assess the efficacy of available antivenom and to possibly create a local antivenom for the treatment of snakebites in Lebanon.
      Citation: Journal of Emergencies, Trauma, and Shock 2018 11(2):119-124
      PubDate: Tue,29 May 2018
      DOI: 10.4103/JETS.JETS_141_16
      Issue No: Vol. 11, No. 2 (2018)
       
  • Bedside lung ultrasound in emergency protocol as a diagnostic tool in
           

    • Authors: Chirag J Patel, Hardik B Bhatt, Samira N Parikh, Binit N Jhaveri, Jyothi H Puranik
      Pages: 125 - 129
      Abstract: Chirag J Patel, Hardik B Bhatt, Samira N Parikh, Binit N Jhaveri, Jyothi H Puranik
      Journal of Emergencies, Trauma, and Shock 2018 11(2):125-129
      Objective: The objective of this study is to determine the accuracy of the bedside lung ultrasound in emergency (BLUE) protocol in giving a correct diagnosis in patients presenting with acute respiratory distress in emergency department. Materials and Methods: Patients with acute respiratory distress were evaluated. Ultrasound findings such as artifacts (A line, B line), lung sliding, alveolar consolidation or pleural effusion, and venous analysis were recorded. Ultrasonography findings were correlated with final diagnosis made by the treating unit. Sensitivity and specificity were calculated. Results: A total 50 patients were evaluated. The A profile (predominant A line with lung sliding) indicated chronic obstructive pulmonary disease/asthma (n = 14) with 85.17% sensitivity and 88.88% specificity. B profile (predominant B + lines with lung sliding) indicated pulmonary edema (n = 13) with 92.30% sensitivity and 100% specificity. The A/B profile (A line on one side and B + line on other side) and the C profile (anterior consolidation) and the A profile plus posterolateral alveolar and/or pleural syndrome indicated pneumonia (n = 17) with 94.11 sensitivity and 93.93% specificity. The A profile plus venous thrombosis indicated pulmonary embolism (n = 1) with 100% sensitivity and specificity. A' profile (predominant A line without lung sliding) with lung point indicated pneumothorax (n = 5) with 80% sensitivity and 100% specificity. Conclusion: BLUE protocol was successful in average 90.316% cases. BLUE performed in emergency department is equivalent to computed tomography scan. BLUE protocol aids in making diagnosis and saves time and cost; avoids the side effects related to radiation.
      Citation: Journal of Emergencies, Trauma, and Shock 2018 11(2):125-129
      PubDate: Tue,29 May 2018
      DOI: 10.4103/JETS.JETS_21_17
      Issue No: Vol. 11, No. 2 (2018)
       
  • True costs of medical clearance: Accuracy and disagreement between
           psychiatry and emergency medicine providers

    • Authors: Laura N Medford-Davis, Nidal Moukaddam, Anu Matorin, Asim Shah, Veronica Tucci
      Pages: 130 - 134
      Abstract: Laura N Medford-Davis, Nidal Moukaddam, Anu Matorin, Asim Shah, Veronica Tucci
      Journal of Emergencies, Trauma, and Shock 2018 11(2):130-134
      Introduction: Medical clearance is required to label patients with mental illness as free of acute medical concerns. However, tests may extend emergency department lengths of stay and increase costs to patients and hospitals. The objective of this study was to determine how knowledgeable emergency and psychiatric providers are about the costs of tests used for medical clearance. Materials and Methods: We surveyed the department of psychiatry (Psych) and department of emergency medicine (EM) faculty and residents to obtain their estimates of the costs of 18 laboratory/imaging studies commonly used for medical clearance. Survey responses were analyzed using the Wilcoxon signed-rank test to compare the median cost estimates between residents and faculty in EM and Psych. Results: A total of 99 physicians (response rate, 47.8%) completed the survey, including 47 faculty (EM = 28; Psych = 20) and 52 residents (EM = 29; Psych = 23). Across all the groups, cost estimates for tests were inaccurate, off by several hundred dollars for three tests, and by $13–$80 for 15. Significant differences between EM and Psych providers for estimated median costs of specific tests included between residents for urine drug screens (EM: $800; Psych: $50; P < 0.0001) and ECG (EM: $25; Psych: $75; P = 0.004); between faculty for urinalysis (EM: $40; Psych: $18; P = 0.020) and urine drug screen (EM: $100; Psych: $10; P < 0.0001); and between all physicians for urine drug screen (EM: $500; Psych: $50; P < 0.0001). Conclusion: Further education on the financial costs of medical clearance is needed to inform workup decisions and consensus between emergency and psychiatric providers.
      Citation: Journal of Emergencies, Trauma, and Shock 2018 11(2):130-134
      PubDate: Tue,29 May 2018
      DOI: 10.4103/JETS.JETS_125_16
      Issue No: Vol. 11, No. 2 (2018)
       
  • Measurement of a novel biomarker, secretory phospholipase A2 group IIA as
           a marker of sepsis: A pilot study

    • Authors: Elena Berg, Janel Paukovits, Jennifer Axelband, Jonathan Trager, Dina Ryan, Kathleen Cichonski, Mark Kopnitsky, Daniel Zweitzig, Rebecca Jeanmonod
      Pages: 135 - 139
      Abstract: Elena Berg, Janel Paukovits, Jennifer Axelband, Jonathan Trager, Dina Ryan, Kathleen Cichonski, Mark Kopnitsky, Daniel Zweitzig, Rebecca Jeanmonod
      Journal of Emergencies, Trauma, and Shock 2018 11(2):135-139
      Introduction: Early identification of sepsis is critical as early treatment improves outcomes. We sought to identify threshold values of secretory phospholipase A2 (sPLA2)-IIA that predict sepsis and bacterial infection compared to nonseptic controls in an emergency department (ED) population. Materials and Methods: This is a prospective cohort of consenting adult patients who met two or more systemic inflammatory response syndrome (SIRS) criteria with clinical diagnosis of infectious source likely (septic patients). Controls were nonseptic consenting adults undergoing blood draw for other ED indications. Both groups had blood drawn, blind-coded, and sent to an outside laboratory for quantitative analysis of sPLA2-IIA levels. The study investigators reviewed patients' inpatient medical record for laboratory, imaging, and microbiology results, as well as clinical course. Results: sPLA2-IIA levels were significantly lower in control patients as compared to septic patients (median = 0 ng/ml [interquartile range (IQR): 0–6.5] versus median = 123 ng/ml [IQR 44–507.75]; P < 0.0001). SPLA2-IIA levels were higher in patients with confirmed source (n = 28 patients, median = 186 ng/ml, 95% confidence interval = 115.1–516.8) as compared to those with no source identified or a viral source (n = 17, median = 68 ng/ml, 95% confidence interval = 38.1–122.7; P = 0.04). Using a cutoff value of 25 ng/ml, sPLA2-IIA had a sensitivity of 86.7% (confidence interval 72.5–94.5) and a specificity of 91.1% (confidence interval 77.9–97.1) in detecting sepsis. Conclusions: sPLA2-IIA shows potential as a biomarker distinguishing sepsis from other disease entities. Further study is warranted to identify predictive value of trends in sPLA-IIA during disease course in septic patients.
      Citation: Journal of Emergencies, Trauma, and Shock 2018 11(2):135-139
      PubDate: Tue,29 May 2018
      DOI: 10.4103/JETS.JETS_29_17
      Issue No: Vol. 11, No. 2 (2018)
       
  • Amitraz poisoning: The (Un) common poisoning

    • Authors: William Wilson, Shakuntala Murty
      Pages: 140 - 142
      Abstract: William Wilson, Shakuntala Murty
      Journal of Emergencies, Trauma, and Shock 2018 11(2):140-142
      Pesticide poisoning is always a clinical conundrum for the emergency physician (EP), the complexity of which increases when the pesticide has no antidote! Over the past decade, there has been a sharp increase in cases of Amitraz poisoning, a pesticide routinely used in veterinary medicine, available without a prescription. The usual presentation includes bradycardia, hypotension, poor sensorium, and miosis. In the absence of accurate history, these clinical features can be confused with the cholinergic toxidrome of organophosphorus poisoning. There is a dearth of literature regarding the presentation and protocols for the management of Amitraz poisoning with data mostly based on animal studies and pediatric case reports. Currently, the available medical literature in the form of case reports and case series form an invaluable source of information to the EP to formulate a working diagnosis and methodical approach to this pesticide. Here, we present two case reports highlighting the characteristic clinical features and bringing to light how an organized approach to the toxin can give satisfactory results.
      Citation: Journal of Emergencies, Trauma, and Shock 2018 11(2):140-142
      PubDate: Tue,29 May 2018
      DOI: 10.4103/JETS.JETS_33_17
      Issue No: Vol. 11, No. 2 (2018)
       
  • Acute appendicitis as an unexpected cause of inverted takotsubo
           cardiomyopathy

    • Authors: Mihaela Mihalcea-Danciu, Michel Zupan, Pierrick Le Borgne, Pascal Bilbault
      Pages: 143 - 145
      Abstract: Mihaela Mihalcea-Danciu, Michel Zupan, Pierrick Le Borgne, Pascal Bilbault
      Journal of Emergencies, Trauma, and Shock 2018 11(2):143-145
      Takotsubo cardiomyopathy (TTC), also known as transient left ventricular ballooning syndrome, is a stress-induced-cardiomyopathy. It is precipitated by emotional or physical stress and is characterized by normal coronary arteries and transient regional wall motion abnormalities. Variants of TTC include apical ballooning syndrome and, less commonly, mid, basal, and local variants. New onset heart failure or acute coronary syndromes are a common presentation of TTC. Arrhythmias such as VT, VF, and torsade de pointes have also been reported. We present here a 42-year-old man with an inverted Takotsubo variant with pulmonary edema and transient accelerated idioventricular rhythm. He was initially admitted in the Emergency Department for acute and non-complicated appendicitis. Coronary angiogram showed normal coronary arteries and left ventriculography revealed a reverse variant of TTC. The patient had completely recovered. Myocarditis was ruled out by cardiac magnetic resonance imaging.
      Citation: Journal of Emergencies, Trauma, and Shock 2018 11(2):143-145
      PubDate: Tue,29 May 2018
      DOI: 10.4103/JETS.JETS_13_17
      Issue No: Vol. 11, No. 2 (2018)
       
  • Inferior vena cava obstruction and shock

    • Authors: Megri Mohammed, Shaheed Elhamdani, Waiel Abusnina, Aldliw Majdi, Shweihat Yousef
      Pages: 146 - 148
      Abstract: Megri Mohammed, Shaheed Elhamdani, Waiel Abusnina, Aldliw Majdi, Shweihat Yousef
      Journal of Emergencies, Trauma, and Shock 2018 11(2):146-148
      Shock is one of the most challenging life-threatening conditions with high mortality and morbidity; the outcomes are highly dependent on the early detection and management of the condition. Septic shock is the most common type of shock in the Intensive Care Unit. While not as common as other subsets of shock, obstructive shock is a significant subtype due to well defined mechanical and pathological causes, including tension pneumothorax, massive pulmonary embolism, and cardiac tamponade. We are presenting a patient with obstructive shock due to inferior vena cava obstruction secondary to extensive deep venous thrombosis. Chance of survival from obstructive shock in our patient was small; however, there was complete and immediate recovery after treatment of the obstruction on recognizing the affected vessels. This case alerts the practicing intensivist and the emergency medicine physician to consider occlusion of the great vessels other than the pulmonary artery or aorta as causes of obstructive shock.
      Citation: Journal of Emergencies, Trauma, and Shock 2018 11(2):146-148
      PubDate: Tue,29 May 2018
      DOI: 10.4103/JETS.JETS_22_17
      Issue No: Vol. 11, No. 2 (2018)
       
  • Concomitance acute cerebral infarction and remote intra-cerebral
           hemorrhaging on arrival

    • Authors: Takashi Iso, Youichi Yanagawa, Ikuto Takeuchi, Satoru Suwa
      Pages: 149 - 150
      Abstract: Takashi Iso, Youichi Yanagawa, Ikuto Takeuchi, Satoru Suwa
      Journal of Emergencies, Trauma, and Shock 2018 11(2):149-150

      Citation: Journal of Emergencies, Trauma, and Shock 2018 11(2):149-150
      PubDate: Tue,29 May 2018
      DOI: 10.4103/JETS.JETS_118_17
      Issue No: Vol. 11, No. 2 (2018)
       
  • Mild traumatic brain injury associated with internal carotid artery
           dissection and pseudoaneurysm

    • Authors: Wellingson Silva Paiva, Barbara Albuquerque Morais, Almir Ferreira de Andrade, Manoel Jacobsen Teixeira
      Pages: 151 - 151
      Abstract: Wellingson Silva Paiva, Barbara Albuquerque Morais, Almir Ferreira de Andrade, Manoel Jacobsen Teixeira
      Journal of Emergencies, Trauma, and Shock 2018 11(2):151-151

      Citation: Journal of Emergencies, Trauma, and Shock 2018 11(2):151-151
      PubDate: Tue,29 May 2018
      DOI: 10.4103/JETS.JETS_31_17
      Issue No: Vol. 11, No. 2 (2018)
       
 
 
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