Background: Chest trauma is responsible for more than 20 to 25% of all traumatic death. Chest trauma is the second leading cause of traumatic death in each year. In order to keep the prognosis of patients with chest trauma relatively good, the patient should be diagnosed rapidly & managed adequately. Chest ultrasound is a safe, rapid and accurate method in diagnosing chest trauma.Methods: A total of 50 patients were enrolled in this study. Objectives were to assess the accuracy of bedside chest US in detection of either haemothorax, pneumothorax or lung contusion in chest trauma patients. All the patients underwent chest US, CXR, and chest CT. The data from ultrasound and CXR were compared with the gold standard CT. Then the accuracy of which were calculated.Results: Showed that Motorcar accidents are the most common cause for chest trauma and most patients were presented by chest pain and dyspnea. Chest ultrasound specificity in diagnosing pneumothorax was higher than sensitivity, 100% and 81% respectively, with over all accuracy 88%. Supine CXR showed sensitivity (75%), specificity (88.9%) and accuracy (80%) which are good numbers but still lower than chest US. Chest US Detection of haemothorax by chest had showed 100% sensitivity, 90% specificity and 96% accuracy.Conclusions: Chest ultrasound is highly accurate tool for detection of pneumothorax, haemothorax and less lung contusion in chest trauma. Chest ultrasound is a useful tool for the emergency physician for bedside rapid and accurate diagnosis without interruption of the resuscitation and without transferring the patient for the radiology unit.
Background: Ectopic pregnancy is a major cause of morbidity and mortality in reproductive-aged women, accounting for 9% of pregnancy-related deaths in the first trimester. Clinical prediction tools have been developed to aid management decision making. Fernandez et al “1991” developed a score based on gestational age, β-hCG level, progesterone level, abdominal pain, hemo-peritoneum volume, and hematosalpinx diameter. A score of less than 12 predicts more than 80% success with expectant or nonsurgical management. Aim of the study was to improve the outcome of patients with ectopic pregnancy attending the emergency room at Suez Canal University hospitals, Egypt.Methods: This is a descriptive (cross-sectional) study conducted on 62 patients diagnosed to have ectopic pregnancy in the emergency department in Suez Canal University Hospital. The patients were subjected to full assessment including full history, examination, investigation and Fernandez score. These data were collected in a questionnaire, interpretted using SPSS program and the score was calculated.Results: The study revealed that 48.8% of the patients were in the age group between 31-40 years. It was found that in 61 patients (98%) the decision matched using Fernandez score and experts’s opinion while only one patient was given a different decision. Using Fernandez score, 40 patients had results less than 12 which guided to conservative management and 22 patients had a score more than 12 which guided to operative management.Conclusions: It was found that Fernandez score has 100% sensitivity and 95.2% specificity.
INTRODUCTIONTrauma is the leading cause of death and disability in children ≥ 1 year of age. More than 80% of injuries are caused by blunt trauma. Most seriously injured children have multiple injuries.1 Injury scoring systems are designed to accurately assess injury severity, appropriately triage the injured, and develop and refine ABSTRACT Background: Trauma is the leading cause of death and disability in children ≥ 1 year of age. More than 80% of injuries are caused by blunt trauma. Most seriously injured children have multiple injuries. Injury scoring systems are designed to accurately assess injury severity, appropriately triage the injured, and develop and refine trauma patient care. The pediatric trauma scoring (PTS) was devised specifically for the triage of pediatric trauma patients. The pediatric trauma scoring (PTS) was devised specifically for the triage of pediatric trauma patients. The PTS is calculated as the sum of individual scores from six clinical variables. The variables include weight, airway, systolic blood pressure (SBP), central nervous system (CNS) status (level of consciousness), presence of an open wound, and skeletal injuries. Other predicting factors for morbidity and mortality in polytraumatised children include age and gender of the patients, trauma type, arrival interval time, Glasgow Coma Scale (GCS), respiratory rate, heart rate, hematocrit value at admission. These factors can further help to prevent mortality. The objectives of this study were to assess the prognosis of polytraumatised pediatric patients by evaluation of pediatric trauma scoring system and clinical predictors of morbidity and mortality as prognostic predictors of trauma in pediatric patients. Methods: This was adescriptive study, included 60 polytraumatised pediatric patients who were attended emergency department in Suez Canal University Hospital, Ismailia, Egypt. Results: This study showed that the mean of the pediatric trauma scoring system was 10±2. According to the nature of the most severe injury, this study showed that 43 % of injuries among patients were of extremities and pelvis nature. According to length of resuscitation time among patients, this study showed that the mean time of resuscitation was 35.5±8.23 minutes. According to the type of treatment done for the patients, this study showed that 72% of the patients didn't need surgical intervention. This study showed that regarding the final outcome of the patients, 68% of the patients were admitted to inpatient. Conclusions: This study showed that both heart rate and respiratory rate had good sensitivity while both of them had lower specificity. This study showed that GCS good specificity and fair sensitivity. Regarding the PTS, this study showed that PTS had the highest specificity and the highest sensitivity among all the predictors.
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