Journal of Trauma and Injury

Case Report

Penetrating right ventricular injury following a single gunshot to the left flank in Iraq: a case report: Zryan Salar Majeed, Yad N. Othman, Razhan K. Ali; J Trauma Inj. 2023;36(3):253-257. Published online April 19, 2023; DOI: https://doi.org/10.20408/jti.2022.0073

1,103 View
35 Download

Abstract PDF: A century ago, cardiac injuries usually resulted in death. However, despite all the advances in medicine, these injuries still have high mortality and morbidity rates. In the present case, we describe a patient with a bullet injury to the right ventricle who survived at our hospital despite the limitations of our center with regard to modalities and equipment. A 30-year-old man was brought to our emergency department with a bullet wound to his left flank. He was hemodynamically unstable. After only 8 minutes in the hospital and without further investigations he was rushed to the operating room. During laparotomy, a clot was visible in the left diaphragm, which dislodged and caused extensive bleeding. The decision was made to perform a sternotomy in the absence of a sternal saw. An oblique 8-cm injury to the right ventricle was discovered following rapid exploration. It was repaired without the need for cardiopulmonary bypass surgery. After a few days in the hospital, the patient was discharged home. In the event of a penetrating cardiac injury, rapid decision-making is crucial for survival. Whenever possible, the patient should be transferred to the operating room, as emergency department thoracotomies are associated with a high mortality rate.; Summary

Original Articles

Analysis of Errors on Death Certificate for Trauma Related Death: Jun Hyuk Chang, Sun Hyu Kim, Hyeji Lee, Byungho Choi; J Trauma Inj. 2019;32(3):127-135. Published online September 30, 2019; DOI: https://doi.org/10.20408/jti.2019.012

4,079 View
41 Download
6 Citations

Abstract PDF

Purpose

This study was to investigate errors of death certificate (DC) issued for patients with trauma.

Methods

A retrospective review for DC issued after death related to trauma at a training hospital trauma center was conducted. Errors on DC were classified into major and minor errors depending on their influence on the process of selecting the cause of death (COD). All errors were compared depending on the place of issue of DC, medical doctors who wrote the DC, and the number of lines filled up for COD of DC.

Results

Of a total 140 DCs, average numbers of major and minor errors per DC were 0.8 and 3.7, respectively. There were a total of 2.8 errors for DCs issued at the emergency department (ED) and 5.4 errors for DCs issued beyond ED. The most common major error was more than one COD on a single line for DCs issued at the ED and incompatible casual relation between CODs for DCs issued beyond ED. The number of major errors was 0.5 for emergency physician and 0.8 for trauma surgeon and neurosurgeon. Total errors by the number of lines filled up for COD were the smallest (3.1) for two lines and the largest (6.0) for four lines.

Conclusions

Numbers of total errors and major errors on DCs related to trauma only were 4 and 0.8, respectively. As more CODs were written, more errors were found.

Summary

Citations

Citations to this article as recorded by

Do Death Certificate Errors Decrease as Clinical Experience in an Emergency Department Increases?
Jung Jun Kim, Sun Hyu Kim, Sangyup Chung, Byeong Ju Park, Soobeom Park, Song Yi Park
Journal of Korean Medical Science.2024;[Epub] CrossRef
Does the Application of International Classification of Disease Codes for the Cause of Death on Death Certificates Reduce Garbage Codes?
Soobeom Park, Sun Hyu Kim
INQUIRY: The Journal of Health Care Organization, .2022; 59: 004695802210814. CrossRef
Factors Associated with Major Errors on Death Certificates
Sangyup Chung, Sun-Hyu Kim, Byeong-Ju Park, Soobeom Park
Healthcare.2022; 10(4): 726. CrossRef
Errors in pediatric death certificates issued in an emergency department
Byeong Ju Park, Sun Hyu Kim
Pediatric Emergency Medicine Journal.2022; 9(1): 17. CrossRef
Quality of death certificates completion for COVID‐19 cases in the southeast of Iran: A cross‐sectional study
Jahanpour Alipour, Afsaneh Karimi, Ghasem Miri‐Aliabad, Farzaneh Baloochzahei‐Shahbakhsh, Abolfazl Payandeh, Roxana Sharifian
Health Science Reports.2022;[Epub] CrossRef
Common errors in reporting cause-of-death statement on death certificates: A systematic review and meta-analysis
Jahanpour Alipour, Abolfazl Payandeh
Journal of Forensic and Legal Medicine.2021; 82: 102220. CrossRef

Analysis of Factors Related to Length of Stay Time in Patients with Back Pain at Emergency Department: Kwang Yong Choi, Byung Hak So, Hyung Min Kim, Kyung Man Cha, Won Jung Jeong; J Trauma Inj. 2017;30(4):173-178. Published online December 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.4.173

2,686 View
21 Download

Abstract PDF: Purpose
Most patients with acute low back pain visit emergency room (ER). They mostly need beds, and if their length of stay is longer, it can become difficult to accommodate new patients at the ER. We analyzed the treatment process of patients with back pain and tried to find method for shortening of the length of stay at the ER.
Methods
We retrospectively analyzed the medical records of patients with back pain who visited at our ER for one year. Patients were divided into two groups according to their length of stay at ER and were compared the charateristcs of between two groups.
Results
A total of 274 patients were included in the study. Eigthy-nine patients (32.5%) were in the group with less than 3 hours and 185 patients (67.5%) were in the other group. In the comparison of the two groups according to the medical departments, the number of patients who were in group with more than 3 hours were 25 (14.0%) in the emergency department, 94 (50.5%) in neurosurgery, 66 (35.5%) in orthopedic surgery. Length of stay was significantly increased in orthopedic surgery and neurosurgery (p=0.014). In addition, the length of stay was longer when computed tomography and magnetic resonance imaging examinations were performed (p=0.000). Regardless of the type of analgesic agent, the median time to the analgesic treatment was shorter in the group with less than 3 hours (p=0.034).
Conclusions
In patients with back pain who visit the ER, the emergency medicine doctor will early control the pain and do not unnecessary image examination to reduce a length of stay at the ER.; Summary

The Effect of Application of Injury Area to Overcrowding Indices in Local Emergency Department: Jin Wook Kang, Sang Do Shin, Gil Joon Suh, Eun Young You, Kyoung Jun Song; J Korean Soc Traumatol. 2007;20(2):77-82.

1,206 View
3 Download

Abstract PDF: PURPOSE
S: There have been many efforts to improve the service of emergency centers. In spite of these, no evidence is showing any landmark advancement of emergency services, especially in the hospital stage, exists. We need some efficient standard criteria to evaluate emergency service in the hospital stage, and a useful method might utilize the overcrowding index. We want to know the change in the overcrowding index at a regional emergency center after injury area administration. Injury area means an area in which only an assigned duty physician manages patients with injuries such as those from traffic accidents, falls, assualts, collisions, lacerations, amputations, burns, intoxication, asphyxia, drowning, animal bites, sexual assualts, etc.
METHODS
We started to operate an injury area in our emergency department from late 2004, and from January to June in 2004 and in 2005, we collected patients' data, age, sex, assigned department, and result from hospital order communication system to figure out overcrowding indices and result indices. We found the daily number of patients, the turnover rate, the admission rate, the ICU admission rate, the emergency operation rate, the ED stay duration, and the ED patient volume to be overcrowding indices. Also we found the withdrawal rate, the transfer rate, and mortality to be result indices. We compared these indices between 2004 to 2005 by using a t-test.
RESULTS
There was a significant increase in the daily number of visiting patients in 2005, overcrowding indices, such as the turnover rate, the admission rate, the ICU admission rate, and the emergency operation rate, also showed statistically significant increases in 2005 (P<0.001). As for the result indices, there was a noticeable decrease in the number of withdrawals (11.77/day in 2004 to 4.53/day in 2005).
CONCLUSION
Operating an injury area in a mildly overcrowded local emergency center is beneficial. Evaluating the effect of operating an injury area and it's impact on hospital finances by conducting a similar study analyziing patients for a longer duration would be valuable.; Summary

Original article

The Effect of Six Sigma Activity in Major Trauma Patients on the Time Spent in the Emergency Department: Hyun Soo Kim, Ok Jun Kim, Sung Wook Choi, Eui Chung Kim, Young Tae Park, Tae I Ko, Yun Kyung Cho; J Korean Soc Traumatol. 2010;23(2):119-127.

1,215 View
7 Download

Abstract PDF: PURPOSE
This study was conducted to shorten the time spent at each stage of treatment and to reduce the total amount of time patients spend in the emergency department (ED) by applying Six Sigma in the treatment of major trauma patients.
METHODS
This is a comparative study encompassing 60 patients presenting to the ED of Bundang CHA Hospital from January 2008 to December 2008 and from July 2009 to March 2010. The stages of treatment for major trauma patients were divided into six categories (T1: total emergency department staying time, T2: duration of visit-radiologic evaluation time, T3: duration of visit-consult to department of admission, T4: duration of consultation-issue of hospital admissions time, T5: duration of visit-issue of hospital admissions time, T6: duration of issue of hospital admission-emergency department discharge time) and the total time patients spent in the ED was compared and analyzed for periods; before and after the application of Six Sigma.
RESULTS
After the application of Six Sigma, the numerical values in four of the six categories were significantly reduced; T2, T3, T4, and T5. However, the average of the total time patients spent in the ED did not show any remarkable change because the T6 increased highly. The level of Six Sigma increased 0.17sigma.
CONCLUSION
The application of Six Sigma for major trauma patients in the ED resulted in a significant improvement in the error rate for the total time patients spent in the ED. The Six Sigma activity has shown great potential. Therefore, the project is expected to bring better results in every stage of treatment if the levels of the hospital facilities are improved.; Summary

First
Prev
Page of 1
Next
Last

Search