Introduction. We focus on trauma care conducted in the context of a simulated traumatic event. This is in this study defined as a four-meter fall onto a hard surface, resulting in severe injuries to extremities in the form of bilateral open femur fractures, an open tibia fracture, and a closed pelvic fracture, all fractures bleeding extensively. Methods. The simulated trauma care competence of 63 ambulance nurses in prehospital emergency care was quantitatively evaluated along with their perception of their sufficiency. Data was collected by means of simulated trauma care and a questionnaire. Results. Life-saving interventions were not consistently performed. Time to perform interventions could be considered long due to the life-threatening situation. In comparison, the ambulance nurses&#x2019; perception of the sufficiency of their theoretical and practical knowledge and skills for trauma care scored high. In contrast, the perception of having sufficient ethical training for trauma care scored low. Discussion. This study suggests there is no guarantee that the ambulance nurses&#x2019; perception of theoretical and practical knowledge and skill level corresponds with their performed knowledge and skill. The ambulance nurses rated themselves having sufficient theoretical and practical knowledge and skills while the score of trauma care can be considered quite low.

Anna Abelsson

Lillemor Lindwall

Bj&#xf6;rn-Ove Suserud

Ingrid Rystedt

Ambulance Nurses&#x2019; Competence and Perception of Competence in Prehospital Trauma Care

Background and Purpose. Workplace violence is a global phenomenon and violation of human rights affects the people&#x2019;s self-esteem and quality of work and causes inequality, discrimination, disorder, and conflict at work. The present study was carried out aiming at determining the workplace violence against the prehospital emergency medical technicians (PEMTs) in three provinces of Fars, Kohgiluyeh and Boyer-Ahmad, and Bushehr, Iran. Materials and Methods. This was a cross-sectional multicenter study in which 206 PEMTs from Fars, Bushehr, and Kohgiluyeh and Boyer-Ahmad provinces participated. Simple random sampling was used in this study. In order to collect data, a researcher-made tool was used. Descriptive statistics and SPSS&#xae; software version 22 were used to analyze the data. Results. Among various types of workplace violence, the most frequent ones were verbal violence (78.1&#x25;), physical violence (60.3&#x25;), and cultural violence (31.7&#x25;), respectively. The most important factor in the occurrence of workplace violence was the lack of the awareness of people about the duties of the PEMTs. With regard to the handling of the violent situations, the results indicated that 61.6&#x25; of the personnel asked the attacker to calm down. 48.5&#x25; of PEMTs believed that violence was normal in their work. Conclusion. Due to the high rate of workplace violence against PEMTs, it is suggested that methods such as formal training and retraining programs for the employees, general education with regard to the duties of the PEMTs, and socially supporting them should be used to reduce and control violence.

Seyed Hamid Hosseinikia

Shekufeh Zarei

Majid Najafi Kalyani

Sepideh Tahamtan

A Cross-Sectional Multicenter Study of Workplace Violence against Prehospital Emergency Medical Technicians

Radiological imaging plays an essential role in the evaluation of a patient with suspected small bowel obstruction (SBO). In a few studies, point-of-care ultrasound (POCUS) has been utilized as a primary imaging modality in patients with suspected SBO. POCUS has been shown to be an accurate tool in the diagnosis of SBO with multiple research studies noting a consistent high sensitivity with a range of 94&#x2013;100&#x25; and specificity of 81&#x2013;100&#x25;. Specific sonographic findings that increase the likelihood of SBO include dilatation of small bowel loops &#x3e; 25&#x2009;mm, altered intestinal peristalsis, increased thickness of the bowel wall, and intraperitoneal fluid accumulation. Studies also reported that emergency physicians could apply this technique with limited and short-term ultrasound training. In this article, we aim to review the sensitivity and specificity of ultrasound examinations performed by emergency physicians in patients with suspected SBO.

A. Pourmand

U. Dimbil

A. Drake

H. Shokoohi

The Accuracy of Point-of-Care Ultrasound in Detecting Small Bowel Obstruction in Emergency Department

Background. Traumatic Pneumothorax (PTX) is a potentially life-threatening injury. It requires a fast and accurate diagnosis and treatment, but diagnostic tools are limited. A new point-of-care device (PneumoScan) based on micropower impulse radar (MIR) promises to diagnose a PTX within seconds. In this study, we compare standard diagnostics with PneumoScan during shock-trauma-room management. Patients and Methods. Patients with blunt or penetrating chest trauma were consecutively included in the study. All patients were examined including clinical examination with auscultation (CE) and supine chest radiography (CXR). In addition, PneumoScan-readings and thoracic ultrasound scan (US) were performed. Computed tomography (CT) served as gold standard. Results. CT scan revealed PTX in 11 patients. PneumoScan detected two PTX correctly but missed nine. 15 false-positive results were found by PneumoScan, leading to a sensitivity of 20&#x25; and specificity of 80&#x25;. Six PTX were detected through CE (sensitivity: 54,5&#x25;). CXR detected four (sensitivity: 27,3&#x25;) and thoracic US two PTX correctly (sensitivity: 25&#x25;). Conclusion. The unblinded PneumoScan prototype did not confirm the promising results of previous studies. The examined standard diagnostics and thoracic US showed rather weak sensitivity as well. Until now, there is no appropriate point-of-care tool to rule out PTX.

M. Rehfeldt

A. Slagman

B. A. Leidel

M. M&#xf6;ckel

T. Lindner

Point-of-Care Diagnostic Device for Traumatic Pneumothorax: Low Sensitivity of the Unblinded PneumoScan&#x2122;

Background and Purpose. In this study, we aimed to evaluate the relationship between pneumonia and meteorological parameters (temperature, humidity, precipitation, airborne particles, sulfur dioxide (SO2), carbon monoxide (CO), nitrogen dioxide (NO2), nitrite oxide (NO), and nitric oxide (NOX)) in patients with the diagnosis of pneumonia in the emergency department. Methods. Our study was performed retrospectively with patients over 65 years of age who were diagnosed with pneumonia. The meteorological variables in the days of diagnosing pneumonia were compared with the meteorological variables in the days without diagnosis of pneumonia. The sociodemographic characteristics, complete blood count of the patients, and meteorological parameters (temperature, humidity, precipitation, airborne particles, SO2, CO, NO2, NO, and NOX) were investigated. Results. When the temperature was high and low, the number of days consulted due to pneumonia was related to low air temperature (<svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="18.973pt" style="vertical-align:-3.42938pt" id="M1" height="11.7782pt" version="1.1" viewBox="-0.0498162 -8.34882 18.973 11.7782"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-113" d="M570 304C570 398 525 448 414 448C385 448 343 445 312 434L329 511L321 518C297 504 262 482 244 460L233 411C195 397 159 381 128 358L135 332C160 347 189 360 224 373L111 -147C97 -210 84 -218 17 -231L13 -257L254 -247L259 -218L233 -216C183 -212 177 -202 189 -142L218 -1C238 -10 266 -12 283 -12C351 3 429 48 483 105C543 168 570 242 570 304ZM482 289C482 161 380 33 304 33C278 33 248 51 233 69L303 396C326 400 352 403 369 403C428 403 482 380 482 289Z"/></g><g transform="matrix(.013,0,0,-0.013,11.342,0)"><path id="g117-91" d="M512 -3V55L134 254V256L512 456V514L75 281V230L512 -3Z"/></g></svg><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="21.921pt" style="vertical-align:-3.42938pt" height="11.7782pt" version="1.1" viewBox="22.555183800000002 -8.34882 21.921 11.7782"><g transform="matrix(.013,0,0,-0.013,22.605,0)"><path id="g113-49" d="M241 635C89 635 35 457 35 312C35 153 89 -12 240 -12C390 -12 443 166 443 312C443 466 390 635 241 635ZM238 602C329 602 354 454 354 312C354 172 330 22 240 22C152 22 124 173 124 313S148 602 238 602Z"/></g><g transform="matrix(.013,0,0,-0.013,28.845,0)"><path id="g113-47" d="M113 -12C146 -12 170 11 170 46C170 78 146 103 114 103S58 78 58 46C58 11 82 -12 113 -12Z"/></g><g transform="matrix(.013,0,0,-0.013,31.809,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.013,0,0,-0.013,38.049,0)"><path id="g113-54" d="M153 550H386L412 615L406 623H120L82 318C104 327 142 338 184 338C294 338 347 275 347 187C347 112 305 39 221 39C160 39 119 71 97 89C88 97 80 96 71 90C59 80 50 67 49 57C48 45 52 36 66 23C80 9 123 -12 169 -12C221 -11 288 15 342 59C403 109 431 165 431 225C431 308 366 395 238 395C212 395 165 379 127 364L153 550Z"/></g></svg>). During the periods when PM 10, NO, NO2, NOX, and CO levels were high, the number of days referred for pneumonia was increased (<svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="18.973pt" style="vertical-align:-3.42938pt" id="M2" height="11.7782pt" version="1.1" viewBox="-0.0498162 -8.34882 18.973 11.7782"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g113-113"/></g><g transform="matrix(.013,0,0,-0.013,11.342,0)"><use xlink:href="#g117-91"/></g></svg><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="21.921pt" style="vertical-align:-3.42938pt" height="11.7782pt" version="1.1" viewBox="22.555183800000002 -8.34882 21.921 11.7782"><g transform="matrix(.013,0,0,-0.013,22.605,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.013,0,0,-0.013,28.845,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,31.809,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.013,0,0,-0.013,38.049,0)"><use xlink:href="#g113-54"/></g></svg>). Conclusion. As a result, climatic (temperature, humidity, pressure levels, rain, etc.) and environmental factors (airborne particles, CO, NO, and NOX) were found to be effective in the number of patients admitted to the hospital due to pneumonia.

Suleyman Serdar Tasci

Cemil Kavalci

Afsin Emre Kayipmaz

Relationship of Meteorological and Air Pollution Parameters with Pneumonia in Elderly Patients

Objective. Sleep deprivation decreases work performance and predisposes workers to deleterious health outcomes. We sought to evaluate sleep hygiene and fatigue among emergency physicians. Methods. In March&#x2013;June 2016, physicians and residents at an academic emergency medicine program were invited to complete a survey evaluating sleep and alertness. Results. Six attending physicians and 26 residents completed the survey. Among six personal priorities, sleep ranked fourth behind family, work, and leisure. 75&#x25; stated poor sleep impedes effectiveness as a physician while 53&#x25; noted difficulty falling asleep before a night shift. In the last three months, 39&#x25; of subjects forgot driving home from a shift, and 34&#x25; had fallen asleep while driving. 34&#x25; used medications to assist with sleep (including melatonin (36&#x25;), alcohol (27&#x25;), and prescription drugs (9&#x25;)). Most providers attested to phone (88&#x25;) and television exposure (69&#x25;) immediately prior to goal sleep onset. Conclusion. Despite sleep being identified as a priority among EM physicians, deleterious habits remain. Poor sleep affects perceived effectiveness and personal safety, as evidenced by a significant portion of providers falling asleep on the commute home. Night shift is the chief obstacle to optimal sleep hygiene.

Brian A. Ferguson

Hugh W. Shoff

Jennifer E. McGowan

Martin R. Huecker

Remember the Drive Home? An Assessment of Emergency Providers&#x2019; Sleep Deficit

Trauma is a leading cause of morbidity and mortality in infants and children worldwide. Trauma education is one of the most commonly reported deficiencies in pediatric emergency medicine (PEM) training. In this study, we describe the creation of a pediatric trauma boot camp in which trainees&#x2019; basic knowledge, level of confidence, teamwork, and communication skills are assessed. The primary goal of this pilot study was to create a simulation-based pediatric trauma curriculum for PEM fellows and emergency medicine residents utilizing Kern&#x2019;s curricular conceptual framework. This was a pilot, prospective, single cohort, exploratory, observational study utilizing survey methodology and a convenience sample. The curriculum consisted of a two-day experience that included confidence surveys, a cognitive multiple-choice questionnaire, and formative and summative simulation scenarios. At the conclusion of this intensive simulation-based trauma boot camp participants reported increased confidence and demonstrated significant improvement in the basic knowledge and performance of the management of pediatric trauma cases in a simulated environment.

Ahmad Khobrani

Nirali H. Patel

Richard L. George

Neil L. McNinch

Rami A. Ahmed

Pediatric Trauma Boot Camp: A Simulation Curriculum and Pilot Study

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Emergency Medicine International publishes original research articles and&nbsp;review articles&nbsp;related to prehospital care, disaster preparedness and response, acute medical and paediatric emergencies, critical care and wound care

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Emergency Medicine International - Table of contents 2018

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Emergency Medicine International publishes original research articles and review articles related to prehospital care, disaster preparedness and response, acute medical and paediatric emergencies, critical care and wound care

Emergency Medicine International