ORIGINAL_ARTICLE
Prevalence of Needlestick Injuries among Health‑Care Workers in Iranian Hospitals: An Updated Systematic Review and Meta‑Analysis
Background: Needlestick and sharp injuries have been identified as the most dangerous factor among health‑care workers. The Centers for Disease Control and Prevention estimates that 385,000 health‑care workers experience needlestick each year. Methods: The aim of this study was to determine the prevalence of needlestick injuries (NSIs) in Iranian health‑care workers. In this review and meta‑analysis, the local and international databases such as Scopus, Medline, PubMed, ScienceDirect, Web of Science, Google Scholar, Scientific Information Database (SID), and Magiran were searched using keywords including “prevalence” OR “needle” OR “needle stick” OR “Sharp injury” OR “Iranian personnel’s” OR “Iranian health care workers” OR “Iranian hospitals” OR “Iran.” The original researches that determined the prevalence of NSIs among Iranian health‑care workers and published from January 2005 to June 2019 were included in the current study. The pooled prevalence of NSIs was determined using a random‑effects model with a 95% confidence interval. All analyses were performed using STATA version 11 (Stata Corporation, College Station, TX, USA). P < 0.05 was considered as a significant level. Results: The overall prevalence of NSIs among Iranian health‑care personnel was about 50.8 (46.3–55.2). Furthermore, this prevalence in educational, noneducational, both noneducational and educational, and military centers was about 51.1 (46.5–57.7), 40.4.1 (34.2–46.6), 61.0 (32.1–89.9), and 41.5 (23.0–60.0), respectively. The prevalence of NSIs among the nurses was 51.1 (45.4–56.8), which was more than other groups. Conclusions: The prevalence of NSIs in Iranian hospitals was high. Since most of the injuries are caused by nurses, more intervention programs should be designed for nurses in these wards.
https://archtrauma.kaums.ac.ir/article_118975_f372287aecf521665d35afae92a18f2a.pdf
2020-04-01
47
55
Iranian hospitals
Needlestick Injury
Prevalence
Yousef
Alimohamadi
1
Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran
AUTHOR
Maryam
Taghdir
2
Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
AUTHOR
Mojtaba
Sepandi
3
Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
AUTHOR
Leila
Kalhor
4
Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
AUTHOR
Fahimeh
Abedini
5
Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
AUTHOR
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72
ORIGINAL_ARTICLE
Thromboelastography in Different Mechanisms of Injuries/ Organ Injuries in Traumatized Patients in Southern Thailand
Background: Trauma is the second most common cause of death in Thailand, relatively with massive blood loss. Coagulopathy plays a role in blood loss. Differences in mechanisms and organs injured can affect coagulopathy stage and blood loss. Thromboelastometry is a measuring instrument for accurate and rapid detection of coagulopathy. We hypothesized that thromboelastometry in traumatized patients who require surgery in Songklanagarind Hospital will help with early detection of coagulopathy and assess anticipated blood loss. Methods: After approval from the Institutional Ethics Committee, patients aged above 18 years who had American Society of Anesthesiologists Physical Status (ASA) IE–VE, activated by trauma team and sent for emergency surgery. Anesthesia was induced and maintained, and invasive procedures were done as anesthesiologist’s consideration. Thromboelastometry, prothrombin time (PT), partial thromboplastin time (PTT), complete blood count, platelets, arterial blood gas, lactate, and base deficit were assessed and recorded at the emergency room and after Massive Transfusion Protocol (MTP) was activated at 1 and 2 MTP, respectively. Results: Most traumatized patients who were operated on in Songklanagarind Hospital during the study period were male, the most common cause of their injuries was a motorcycle accident, and the most common organ associated with massive blood loss and blood transfusion was the head. After the patients received PRCs of 5 and 11 units, the hematocrit level and platelet count decreased from baseline, while PT and PTT were prolonged. pH, base deficit, and lactate were worse. Clot formation time (CFT), A10, and maximum clot firmness (MCF) of EXTEM were statistically significantly different among the three time periods. Clotting times, CFT, A10, and MCF of INTEM were statistically significantly different among three time periods. A10 and MCF of FIBTEM wer statistically significantly different among three time periods. Conclusion: Most baseline laboratory tests in the traumatized patients who received massive blood transfusion and underwent surgery were worse after they received 1 and 2 MTP. These parameters including thromboelastometry could be guided for preparing proper blood components for patients requiring massive transfusion.
https://archtrauma.kaums.ac.ir/article_118976_703eed178068563e2c831b60040053e1.pdf
2020-04-01
56
61
Mechanism of injuries
organ injuries
THROMBOELASTOGRAPHY
traumatized patients
Sumidtra
Prathep
1
Departments of Anesthesiology and Surgery, Prince of Songkla University, Songkhla, Thailand
AUTHOR
P.
Sengsai
2
Departments of Anesthesiology and Surgery, Prince of Songkla University, Songkhla, Thailand
AUTHOR
T.
Chanchayanon
3
Departments of Anesthesiology and Surgery, Prince of Songkla University, Songkhla, Thailand
AUTHOR
O.
Karnjanavanichkul
4
Departments of Anesthesiology and Surgery, Prince of Songkla University, Songkhla, Thailand
AUTHOR
O.
Akaraboworn
5
Surgery, Prince of Songkla University, Songkhla, Thailand
AUTHOR
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13. Schöchl H, Nienaber U, Hofer G, Voelckel W, Jambor C, Scharbert G, et al. Goal‑directed coagulation management of major trauma patients using thromboelastometry (ROTEM)‑guided administration of fibrinogen concentrate and prothrombin complex concentrate. Crit Care 2010;14:R55.
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16
ORIGINAL_ARTICLE
A comparative study on the ability of trauma severity-assessing methods in determining the prognosis of patients having accident and referred to Imam Khomeini Hospital of Urmia in 2016
Introduction: Trauma is the leading cause of death and disability in developing countries. According to the World Health Organization projections by 2020, accidents alone are the second leading cause of missing year around the world. Therefore, the aim of this study was to compare the ability of trauma severity-assessing methods in determining the prognosis of accident patients referred to Imam Khomeini Hospital of Urmia in 2016. Methodology: In this study, the severity of trauma in traffic accident patients referring to Imam Khomeini Hospital of Urmia was determined using the Injury Severity Score (ISS), Revised Trauma Score (RTS), Trauma and Injury Severity Score (TRISS), and A Severity Characterization of Trauma (ASCOT), in a 1-year period, via the census method on 2015 hospitalized accident victims, and the ability of these methods to predict mortality and morbidity, length of stay in hospital, and hospital length charges were investigated by the receiver operating characteristic curve of regression methods. To this end, the hospital records of accident victims who were hospitalized for at least 1 day or whose deaths were examined along with their autopsy reports were the main components of this study. Results: The mean age of the patients was 33.63 ± 18.53 years, and their age range was 1–96 years. The ratio of males to females was 2.73. In addition, in terms of job status (46.8%), they were free. The majority of women were homemakers (70.8%). In the two gender groups, most accidents occurred within the city, The mean severity of lesions based on ISS system was 16.44 ± 16.28 and 16.8% of ISS injuries were above 25. The mean RTS of the patients was 7.69 ± 0.54, which ranged from 0 to 7.84, and the mean TRISS of the patients was 92.24 ± 15.87. The trauma means via the ASCOT method was 5.35 ± 1.85. The difference in the severity of trauma (calculated by each of the methods of ISS, RTS, TRISS, and ASCOT) was significant between those who survived and those who died. Conclusion: In this study, most of the accidents happened in males, married, undergraduate, and homemaker, and those on the street as well, and the RTS and TRISS methods showed the highest ability in predicting mortality. Given the usefulness and special applications of these methods, their use in designing a national care system in the trauma area is recommended.
https://archtrauma.kaums.ac.ir/article_119040_09fca832836f51eb5bbd1cff4b161bd6.pdf
2020-04-01
62
68
Patients having an accident
Trauma
Urmia
Omid
Garkaz
1
Department of Epidemiology, Shahroud University of Medical Sciences, Shahroud, Iran
AUTHOR
Hamid Reza
Mehryar
2
Department of Emergency Medicine, Urmia University of Medical Sciences, Urmia, Iran
AUTHOR
Hamid Reza
Khalkhali
3
Department of Biomedical Sciences, Urmia University of Medical Sciences, Urmia, Iran
AUTHOR
Shaker Salari
Lak
4
Department of Public Health, Islamic Azad University, Tabriz Branch, Tabriz, Iran
AUTHOR
1. Peden M, Scurfield R, Sleet D, Mohan D, Hyder AA, Jarawan E, et al., editors. World Report on Road Traffic Injury Prevention. World Health Organization; 2004.
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51
ORIGINAL_ARTICLE
The Effectiveness of Acceptance and Commitment Therapy on Posttraumatic Cognitions and Psychological Inflexibility among Students with Trauma Exposure
Background: Posttraumatic stress disorder has a negative impact on the individual, family, and community due to disturbance in social functioning, increased stress, and life‑threatening health status. Therefore, effective and useful therapeutic interventions in this area are very important. This study aimed at examining the effectiveness of acceptance and commitment therapy (ACT) on the posttraumatic cognitions of students with trauma exposure. Methods: In this quasi‑experimental study, population included all students of Islamic Azad University in Roudehen, Tehran, Iran, during the academic year of 2018–2019. After administering trauma questionnaire, the second version of acceptance and action questionnaire (AAQ‑II), and posttraumatic cognitions inventory (PTCI) to 500 people, 113 people who experienced trauma and had high scores in PTCI and low scores in AAQ‑II were identified. Of whom 40 people were selected randomly. After the clinical interview, the subjects were randomly placed in the experimental group (who received ACT, n = 20) and placebo group (n = 20). Both groups were pre‑ and posttested using the PTCI and AAQ‑II. Then, the obtained data were analyzed using covariance analysis. Results: The results showed that there was a significan difference in posttraumatic cognitions (negative cognitions about self, negative cognitions about the world, and self‑blame) between the two groups. In addition, the results of posttest related to ACT had a significant impact on psychological inflexibility. In other words, ACT reduced posttraumatic cognitions and increased psychological flexibility of these students. Conclusion: The findings of the present study reveal that despite posttraumatic cognitions of students with trauma exposure, ACT increases value‑based behaviors through increasing psychological flexibility and decreasing experiential avoidance.
https://archtrauma.kaums.ac.ir/article_118977_f277db87ef69ab78df2e312cd92e5b68.pdf
2020-04-01
69
74
Acceptance and Commitment Therapy
experiential avoidance
posttraumatic cognitions
post‑traumatic stress
psychological inflexibility
Trauma
Parviz
Molavi
1
Department and Psychiatry, Fatemi Hospital, Ardabil University of Medical Science, Ardabil, Iran
AUTHOR
Saeed
Pourabdol
2
Department of Clinical Psychology, Faculty of Human Sciences, Shahed University of Tehran, Tehran, Iran
AUTHOR
Anita
Azarkolah
3
Department and Psychiatry, Fatemi Hospital, Ardabil University of Medical Science, Ardabil, Iran
AUTHOR
1. Read JP, Griffin MJ, Wardell JD, Ouimette P. Coping, PTSD symptoms, and alcohol involvement in trauma‑exposed college students in the first three years of college. Psychol Addict Behav 2014;28:1052‑64.
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5. McDevitt‑Murphy ME, Weathers FW, FloodAM, Eakin DE, Benson TA. The utility of the PAI and the MMPI‑2 for discriminating PTSD, depression, and social phobia in trauma‑exposed college students. Assessment 2007;14:181‑95.
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7. Smyth JM, HockemeyerJR, Heron KE, Wonderlich SA, PennebakerJW. Prevalence, type, disclosure, and severity of adverse life events in college students. J Am Coll Health 2008;57:69‑76.
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23. Kolts RL, Robinson AM, Tracy JJ. The relationship of sociotropy and autonomy to posttraumatic cognitions and PTSD symptomatology in trauma survivors. J. Clin. Psychol 2004;60:53-63.
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24. Wenninger K, Ehlers A. Dysfunctional cognitions and adult psychological functioning in child sexual abuse survivors. J Trauma Stress 1998;11:281‑300. 25. Moser JS, Hajcak G, Simons RF, Foa EB. Posttraumatic stress disorder symptoms in trauma‑exposed college students: The role of trauma‑related cognitions, gender, and negative affect. J Anxiety Disord 2007;21:1039‑49. 26. Tyler KA. Social and emotional outcomes of childhood sexual abuse: A review of recent research. Aggress Violent Behav 2002;7:567‑89.
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27. Palosaari E, Punamäki RL, Diab M, Qouta S. Posttraumatic cognitions and posttraumatic stress symptoms among war‑affected children: A cross‑lagged analysis. J Abnorm Psychol 2013;122:656‑61.
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29. Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J. Acceptance and commitment therapy: Model, processes and outcomes. Behav Res Ther 2006;44:1‑25.
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30. Meyer EC, Walser R, Hermann B, La Bash H, DeBeer BB, Morissette SB, et al. Acceptance and commitment therapy for co‑occurring posttraumatic stress disorder and alcohol use disorders in veterans: Pilot treatment outcomes. J Trauma Stress 2018;31:781‑9.
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35. You S, Son C. Effects of acceptance and commitment therapy (ACT) on complex PTSD symptoms, acceptance, and post‑traumatic Growth of college students with childhood emotional abuse. J Digit Convergence 2018;16:561-72.
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48
ORIGINAL_ARTICLE
The association between time intervals in emergency medical services and In-hospital mortality of trauma patients
Context: While the clinical practice recommends field stabilization in trauma patients, in some situations, the speed of transport is crucial. Aims: This study aimed to evaluate the association between emergency medical services (EMS) time intervals (response time [RT], scene time [ST], and transport time [TT]) and in-hospital mortality in trauma patients in Tehran, the largest metropolis of Iran. Settings and Design: A prospective cohort study was conducted between May 2017 and April 2018. Methods: All EMS operations related to trauma events in the Tehran city that were transferred to three targeted major trauma centers were included. Statistical Analysis: Logistic regression analysis was used to assess the relationship between EMS time intervals and other risk factors of trauma death. Results: A total of 14,372 trauma patients were included in the final analysis. In-hospital mortality occurred in 225 (1.6%) patients. After adjustment for confounding variables, older age (odds ratio [OR] = 1.04/year), female gender (OR = 2.16), low Mechanism, Glasgow Coma Scale (GCS), age, and arterial pressure score (OR = 0.84 for each unit), low GCS (OR = 0.56 for each unit), longer ST (OR = 1.17/10 min), and longer TT (OR = 1.21/10 min) were found to be risk factors for death in trauma. Conclusions: Our study showed that in-hospital mortality of trauma patients correlated with longer EMS ST and TT, but the RT was not associated with mortality. Our results recommend that the EMS system should consider ST and TT rather than RT, as indexes of quality control in prehospital care of trauma patients.
https://archtrauma.kaums.ac.ir/article_119041_ed9bb1c0035afc51ff56d0f1e8fbf5c3.pdf
2020-04-01
75
80
Emergency Medical Services
mortality
Prehospital
time
Trauma
Peyman
Saberian
1
Prehospital and Hospital Emergency Research Center; Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
AUTHOR
Pir-Hossein
Kolivand
2
Emergency Medical Services, Iran Ministry of Health and Medical Education, Tehran, Iran
AUTHOR
Parisa
Hassani-Sharamin
3
Tehran Emergency Medical Service Center, Tehran, Iran
AUTHOR
Maryam
Modaber
4
Tehran Emergency Medical Service Center, Tehran, Iran
AUTHOR
Amirreza
Farhoud
5
Prehospital and Hospital Emergency Research Center; Department of Orthopedic Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
AUTHOR
Ehsan
Karimialavijeh
6
Prehospital and Hospital Emergency Research Center; Department of Emergency Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
AUTHOR
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1
2. Safari S, Radfar F, Baratloo A. Thoracic injury rule out criteria and NEXUS chest in predicting the risk of traumatic intra‑thoracic injuries: A diagnostic accuracy study. Injury 2018;49:959‑62.
2
3. Haghparast‑BidgoliH, HasselbergM, KhankehH, Khorasani‑ZavarehD, Johansson E. Barriers and facilitators to provide effective pre‑hospital trauma care for road traffic injury victims in Iran: A grounded theory approach. BMC Emerg Med 2010;10:20.
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4. Rogers FB, Rittenhouse KJ, Gross BW. The golden hour in trauma: Dogma or medical folklore? Injury 2015;46:525‑7.
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5. Murray B, Kue R. The use of emergency lights and sirens by ambulances and their effect on patient outcomes and public safety: A comprehensive review of the literature – ADDENDUM. Prehosp Disaster Med 2019;34:345.
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8. Kahn CA, Pirrallo RG, Kuhn EM. Characteristics of fatal ambulance crashes in the United States: An 11‑year retrospective analysis. Prehosp Emerg Care 2001;5:261‑9.
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11. Newgard CD, Meier EN, Bulger EM, Buick J, Sheehan K, Lin S, et al. Revisiting the “Golden Hour”: An evaluation of out‑of‑hospital time in shock and traumatic brain injury. Ann Emerg Med 2015;66:30‑41, 41.e1‑3.
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15. Sartorius D, Le Manach Y, David JS, Rancurel E, Smail N, Thicoïpé M, et al. Mechanism, Glasgow Coma Scale, age, and arterial pressure (MGAP): A new simple prehospital triage score to predict mortality in trauma patients. Crit Care Med 2010;38:831‑7.
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19. Möller A, Hunter L, Kurland L, Lahri S, van Hoving DJ. The association between hospital arrival time, transport method, prehospital time intervals, and in‑hospital mortality in trauma patients presenting to Khayelitsha Hospital, Cape Town. Afr J Emerg Med 2018;8:89‑94.
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20. Bulger EM, May S, Brasel KJ, Schreiber M, Kerby JD, Tisherman SA, et al. Out‑of‑hospital hypertonic resuscitation following severe traumatic brain injury: A randomized controlled trial. JAMA 2010;304:1455‑64.
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21. Brasel KJ, BulgerE, CookAJ, MorrisonLJ, NewgardCD, Tisherman SA, et al. Hypertonic resuscitation: Design and implementation of a prehospital intervention trial. J Am Coll Surg 2008;206:220‑32.
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23. Swaroop M, Straus DC, Agubuzu O, Esposito TJ, Schermer CR, Crandall ML. Pre‑hospital transport times and survival for Hypotensive patients with penetrating thoracic trauma. J Emerg Trauma Shock 2013;6:16‑20.
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25. McConnell KJ, Newgard CD, Mullins RJ, Arthur M, Hedges JR. Mortality benefit of transfer to level I versus level II trauma centers for head‑injured patients. Health Serv Res 2005;40:435‑57.
25
ORIGINAL_ARTICLE
Promotion of knowledge, skill, and performance of emergency medical technicians in prehospital care of traumatic patients: An action-research study
Background: Annually, there is a high rate of mortality due to trauma. Prehospital emergency personnel are the first caregivers present beside trauma patients, and their dexterity to take care of trauma patients is of great significance in the vast majority of patients' survival. Materials and Methods: This study was action research with the participation of 125 prehospital emergency personnel from May 2016 to December 2018 in five stages (observation, reflection, planning, action, and evaluation) in Iran. Knowledge, skills, and performance of personnel were assessed before and after the action. Data collection tools included knowledge questionnaire and PERFECT skill assessment checklist by Objective Structured Clinical Examination method and researcher-made checklist for performance. Data were analyzed using SPSS-21 software. Results: The findings indicated that 67.82% and 84.4% of prehospital emergency staff have median to low knowledge and expertise in respect to trauma care, respectively. Their performance of necessary measurements for trauma patients was poor prior to training. There was a significant difference between the mean knowledge, skills, and performance of medical emergency technicians before and after the training course (p = 0.00). Conclusions: Participation of beneficiaries in planning for trauma patient's care is helpful. Establishment of prehospital trauma life support training in the medical emergency, training curriculum, and its instruction to prehospital emergency personnel while serving in trauma care will be of great benefit.
https://archtrauma.kaums.ac.ir/article_119042_9e1264373859d856529437d6d86dc394.pdf
2020-04-01
81
86
Action Research
Emergency
pre‑hospital
Trauma
Javad
Dehghannezhad
1
Road Traffic Injury Research Center, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
AUTHOR
Farzad
Rahmani
2
Department of Emergency Medicine, Sina Medical Research and Training Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
AUTHOR
Rouzbeh
Rajaei Ghafouri
rrajaei88@gmail.com
3
Department of Emergency Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
AUTHOR
Hadi
Hassankhani
4
Center of Qualitative Studies, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
AUTHOR
Abbas
Dadashzadeh
5
Road Traffic Injury Research Center, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
AUTHOR
Zhilla Heydarpoor
Damanabad
6
Department of Pediatric Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, East Azerbaijan Province, Tabriz, Iran
AUTHOR
1. Baru A, Azazh A, Beza L. Injury severity levels and associated factors among road traffic collision victims referred to emergency departments of selected public hospitals in Addis Ababa, Ethiopia: The study based on the Haddon matrix. BMC Emerg Med 2019;19:2.
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2. Pawłowski W, Goniewicz K, Schwebel DC, Shen J, Goniewicz M. Road traffic injuries in Poland: Magnitude and risk factors. Eur J Trauma Emerg Surg 2019;45:815‑20.
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5. Rahmati F, Doosti M, Bahreini M. The cost analysis of patients with traffic traumatic injuries presenting to emergency department; a cross‑sectional study. Adv J Emerg Med 2019;3:e2.
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7. Crandall M. Rapid emergency medical services response saves lives of persons injured in motor vehicle crashes. JAMA Surg 2019;154:293‑4.
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8. Mlcak RP, Buffalo MC, Jimenez CJ. Prehospital management, transportation, and emergency care. Total Burn Care. E- Book: Elsevier; 2018. p. 5865. e1. 9. Bieler D, Franke A, Lefering R, Hentsch S, Willms A, Kulla M, et al. Does the presence of an emergency physician influence pre‑hospital time, pre‑hospital interventions and the mortality of severely injured patients? A matched‑pair analysis based on the trauma registry of the German Trauma Society (TraumaRegister DGU®). Injury 2017;48:32‑40.
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11. Teuben M, Löhr N, Jensen KO, Brüesch M, Müller S, Pfeifer R, et al. Improved pre‑hospital care efficiency due to the implementation of pre‑hospital trauma life support (PHTLS®) algorithms. Eur J Trauma Emerg Surg 2019;45:5-19.
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12. Pinciroli R, Pizzilli G, Vassena E, Checchi S, Ghinaglia M, Bassi G. Prehospital care and inhospital initial trauma management. Oper Techn Recent Adv Acute Care Emerg Surg. E- Book: Elsevier; 2019. P.11127. el. [Doi: 10.1007/9783319951140_8].
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17. Haghani F, Sadeghi N. Training in Prehospital Emergency: Needs and Truths. Iran J Med Educ 2011;10:1273-80.
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18. Ezati P, Vaziri M, Adli F. Educational needs assessment in the medical emergency technicians of Tehran emergency center. Saf Promot Inj Prev 2017;5:109‑19.
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19. Hegney DG, Francis K. Action research: Changing nursing practice. Nurs Stand 2015;29:36‑41.
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21. Crow J, Smith L, Keenan I. Sustainability in an action research project: 5 years of a dignity and respect action group in a hospital setting. J Res Nurs 2010;15:55‑68.
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22. Häske D, Beckers SK, Hofmann M, Lefering R, Grützner PA, Stöckle U, et al. Subjective safety and self‑confidence in prehospital trauma care and learning progress after trauma‑courses: Part of the prospective longitudinal mixed‑methods EPPTC‑trial. Scand J Trauma Resusc Emerg Med 2017;25:79. 23. KreinestM, Goller S, GliwitzkyB, Grützner PA, Küffer M, Häske D, et al. Expertise of German paramedics concerning the prehospital treatment of patients with spinal trauma. Eur J Trauma Emerg Surg 2017;43:371‑6.
21
24. Silanuwat O, Krairojananan N. PW 1473 Association between survival rate and complication in trauma patients after implementation of prehospital trauma life support’s principle of phramongkutklao emergency medical service. Inj Prev 2018;24 Suppl 2:A250.
22
25. Nandasena G, Abeysena C. Knowledge, Attitudes and skills of Doctors, Nurses and emergency medical technicians in prehospital care and emergency medicine who accompany patients in ambulances which arrive at the National Hospital of Sri Lanka. Int J Clin Anesth Res. 2018; 2:038-43.
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27. Frank CB, Wölfl CG, Hogan A, Suda AJ, Gühring T, Gliwitzky B, et al. PHTLS® (prehospital Trauma Life Support) provider courses in Germany – Who takes part and what do participants think about prehospital trauma care training? J Trauma Manag Outcomes 2014;8:7.
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29. Van Dillen CM, Tice MR, Patel AD, Meurer DA, Tyndall JA, Elie MC, et al. Trauma Simulation Training Increases Confidence Levels in Prehospital Personnel Performing LifeSaving Interventions in Trauma Patients. Emerg Med Int 2016:2016:1-5.
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29
ORIGINAL_ARTICLE
Prevalence of Work‑Related Violence among Nurses Working in Kashan Shahid Beheshti Hospital in 2018
Background and Objectives: Aggressive behaviors against medical personnel have been reported as a common problem that occurs in man ways and associated with many complications. The aim of this study was to describe the prevalence and work‑related factors of workplace violent incidents against nurses in hospital environment. Materials and Methods: This descriptive, cross‑sectional study was conducted on 161 nursing professionals working at Shahid Beheshti Hospital in Kashan. Data were collected using the Persian version of the standard questionnaire “Workplace violence in the health sector.” Descriptive analyses were conducted to examine the relationship of individual and work variables with the incidence of aggression. Results: Of the participants, 67% reported having been experienced at least one type of aggression within the past 12 months. The 1‑year prevalence of verbal aggression (87%) was the highest, followed by physical aggression (31.2%). Nurses reported being pushed (13.6%) and beating (12.4%) as common physical aggression. Bullying (34.7%) and vilification (25.4%) were reported the most frequent verbal abuse. Perpetrators were mainly patients’ family (61.2%) and patients (30.2%). Married nurses were more likely exposed to physical and verbal violence compared to single nurses (P = 0.016). The majority of nurses reported uselessness (62.8%) and unimportance (27.3%) of declaring violent events as the main reason for avoiding disclosure. Conclusion: The frequency of aggression, particularly verbal abuse is significantly high in nursing profession. The results suggest the need for the development of appropriate violent reporting and prevention systems in the hospital environment.
https://archtrauma.kaums.ac.ir/article_118978_0fddde13b01071ae12036186d611cfad.pdf
2020-04-01
87
92
Hospital
Nurses
Violence
Hamidreza
Saberi
1
Department of Occupational Health, School of Health and Social Determinants of Health (SDH), Research Center, Kashan University of Medical Sciences, Kashan, Iran
AUTHOR
Alireza
Dehdashti
2
Department of Occupational Health, Faculty of Health, Semnan University of Medical Sciences, Semnan, Iran
AUTHOR
Hakime
Zamani-Badi
3
Department of Health, Safety and Environment Management, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran
AUTHOR
1. Gill M, Fisher BS, Bowie V, editors. Violence at work. Routledge; 2013 Jan 11. [BOOK].
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20. Zamanzadeh V, Soleimamnejad N, Abdollahzadeh F. The workplace violence against nurses working in East Azarbaijan Province hospitals. Iran J Res Nurs 2009;29:61‑6.
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32
ORIGINAL_ARTICLE
Minimally Invasive Management of a Dental Trauma: Two Years of Follow‑up in Biodentine‑Induced Maturogenesis
Dental trauma is an ordinary complication in childhood period. Most of the traumas are crown fractures in the permanent dentition. Complicated crown fracture, introduced as a crown fracture accompanied by pulp exposure. Treatment plan and long‑term prognosis could be modified by different factors, such as fracture line position, root development, alveolar bone fracture, and occlusion. In traumatized open apices teeth, apexogenesis can be occurred after traumatic exposure by vital pulp therapy procedures such as pulp capping, partial or complete pulpotomy in pertinent to the size of the exposure. In this complicated crown fracture case, cervical pulpotomy was performed with a silicate‑based biomaterial. Patients smile and esthetic demands play an important role in the perception and judgment that people have of others appearance and character. To reconstruct the patient’s smile line, the adhesive reattachment of the coronal fractured fragment to the remaining tooth structure was planned. Reattachment could be suggested as an ideal treatment procedure for crown fracture cases. This technique could be applied to achieve excellent esthetic outcomes and normal function. At 1‑year follow‑up visit, the patient had no complaints of pain. The clinical and radiographic examination showed a stable reattachment and good periodontal health. Apex diameter was decreased significantly. Physiological root‑end closure was obvious. Secondary dentin and calcific barrier were also observed on the radiograph below the Biodentine layer.
https://archtrauma.kaums.ac.ir/article_118979_8a64667be23bb2aa624961b15defc8b4.pdf
2020-04-01
93
98
Biodentine
dental trauma
Mineral trioxide aggregate
pulpotomy
reattachment
Khashayar
Sanjari
1
Department of Pediatric Dentistry, School of Dentistry, Arak University of Medical Sciences, Arak, Iran
AUTHOR
Hosna
Ebrahimi Zadeh
2
Department of Restorative, Dental Research Center, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
AUTHOR
1. Ghadimi S, Seraj B, Keshavarz H, Shamshiri AR, Abiri R. The effect of using an educational poster on elementary school health teachers’ knowledge of emergency management of traumatic dental injuries. J Dent (Tehran) 2014;11:620‑8.
1
2. Singh TK, Passi D, Aggarwal S, Mohan S, Sharma A, Gupta U. Esthetic management of complicated crown fracture of three permanent maxillary teeth by grout technique -A case report. J Family Med Prim Care 2019;8:2538–41.
2
3. Goenka P, Marwah N, Dutta S. Biological approach for management of anterior tooth trauma: Triple case report. J Indian Soc Pedod Prev Dent 2010;28:223‑9.
3
4. Zerman N, Cavalleri G. Traumatic injuries to permanent incisors. Endod Dent Traumatol 1993;9:61‑4.
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5. Ghorbanzadeh A, Ghorbanzadeh A. Maturogenesis of two maxillary central incisors: ACase report with 10 years of follow up. J Dent (Tehran) 2015;12:306‑15.
5
6. Scholtes E, Suttorp CM, Loomans BA, Van Elsas P, Schols JG. Combined orthodontic, surgical, and restorative approach to treat a complicated crown‑root fracture in a maxillary central incisor. Am J Orthod Dentofacial Orthop 2018;154:570‑82.
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8. Martens L, Rajasekharan S, Cauwels R. Pulp management after traumatic injuries with a tricalcium silicate-based cement (Biodentine™): a report of two cases, up to 48 months follow-up. Eur Arch Paediatr Dent 2015;16:491-1.
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36