Keywords
traumatic
life-threatening
medical emergency
CPR
management
How to Cite
Abstract
Introduction: Patients with life-threatening injuries are a significant concern in the emergency department (ED). These injured people require timely care, as their lives depend on it, and a longer wait can result in organ failure, irreversible damage, and poor survival outcomes.
The purpose of this research is the evaluation, epidemiology, management, diagnosis, treatment, systematization, and the results obtained for the injured in life-threatening cases with trauma, reducing morbidity, disability, and mortality while increasing survival.
Material and Methods. In this retrospective study, we researched and analyzed the data of patients with critical traumatic injuries in DE treated from January-December 2021
Results. During the study period, we analyzed 75,899 ED patients. Of these, 627 cases, or 0.83%, were severely injured and traumatically admitted as a life-threatening traumatic medical emergency in the resuscitation room. Attacked age were males 507 cases or 80.87% and females 120 cases 19.13% and over 16 were 46 cases or 6.67%. The main problem in the admission of the sick was the injured with disorders of consciousness, shock, cardiac, and respiratory failure, as well as issues at the systemic level.
Conclusion. During the study period, we analyzed 75,899 ED patients. Of these, 627 cases, or 0.83%, were severely injured and traumatically admitted as a life-threatening traumatic medical emergency in the resuscitation room. Attacked age were males 507 cases or 80.87% and females 120 cases 19.13% and over 16 were 46 cases or 6.67%. The main problem in the admission of the sick was the injured with disorders of consciousness, shock, cardiac, and respiratory failure, as well as issues at the systemic level.
Also, these critically injured require structured and well-organized care in the DE in the resuscitation room, with educated medical staff, nurses, and support staff trained with the mandatory BLS, BTLS, PHTLS, and ATLS courses, implementing and developing the algorithms standardized for structured care of the critically injured.
Keywords: DE, traumatic, life-threatening medical emergency, CPR. monitoring, management,
References
Chico Fernández, M., García Fuentes, C., & Guerrero López, F. (2013). Registros de trauma: una prioridad sanitaria, un proyecto estratégico para la SEMICYUC [Trauma registries: a health priority, a strategic project for the SEMICYUC]. Medicina intensiva, 37(4), 284–289. https://doi.org/10.1016/j.medin.2013.01.010
Chesser, T. J., Moran, C., Willett, K., Bouillon, B., Sturm, J., Flohé, S., Ruchholtz, S., Dijkink, S., Schipper, I. B., Rubio-Suarez, J. C., Chana, F., de Caso, J., & Guerado, E. (2023). Development of trauma systems in Europe-reports from England, Germany, the Netherlands, and Spain. OTA International: The open access Journal of Orthopedic Trauma, 2(Suppl 1), e019. https://doi.org/10.1097/OI9.0000000000000019
Clark LJ, Field MJ, Koontz TL, Koontz VL. The impact of Hill-Burton: an analysis of hospital bed and physician distribution in the United States, 1950–1970. Med Care. 1980;18:532–550. [PubMed] [Google Scholar] [Ref list]
Derlet, R. W., & Richards, J. R. (2008). Ten solutions for emergency department crowding. The western journal of emergency medicine, 9(1), 24–27. PMID: 19561699 PMCID: PMC2672221
van Breugel, J. M. M., Niemeyer, M. J. S., Houwert, R. M., Groenwold, R. H. H., Leenen, L. P. H., & van Wessem, K. J. P. (2020). Global changes in mortality rates in polytrauma patients admitted to the ICU-a systematic review. World journal of emergency surgery: WJES, 15(1), 55. https://doi.org/10.1186/s13017-020-00330-3
Rossaint, R., Bouillon, B., Cerny, V., Coats, T. J., Duranteau, J., Fernández-Mondéjar, E., Hunt, B. J., Komadina, R., Nardi, G., Neugebauer, E., Ozier, Y., Riddez, L., Schultz, A., Stahel, P. F., Vincent, J. L., Spahn, D. R., & Task Force for Advanced Bleeding Care in Trauma (2010). Management of bleeding following major trauma: an updated European guideline. Critical care (London, England), 14(2), R52. https://doi.org/10.1186/cc8943
Percival, V., Sondorp, E. A case study of health sector reform in Kosovo. Confl Health 4, 7 (2010). https://doi.org/10.1186/1752-1505-4-7
Basri Lenjani, Nuhi Arslani, Agron Dogjani, & Esen Uysal. (2021). MJEKËSIA E TRAFIKUT. In MJEKËSIA E TRAFIKUT (p. 291). SHTËPIA BOTUESE LIBRI SHKOLLOR. https://doi.org/10.5281/zenodo.5510559
National Clinical Guideline Centre (UK). Major Trauma: Assessment and Initial Management. London: National Institute for Health and Care Excellence (NICE); 2016 Feb. (NICE Guideline, No. 39.) 5, Available from: https://www.ncbi.nlm.nih.gov/books/NBK368114/
Lenjani, B., Rashiti, P., Bunjaku, I., Demiri, A., Shabani, G., & Lenjani, D. (2019). Polytrauma Management and Links to EMS. Albanian Journal of Trauma and Emergency Surgery, 3(2), 417-423. https://doi.org/10.32391/ajtes.v3i2.51
Iyengar, K. P., Venkatesan, A. S., Jain, V. K., Shashidhara, M. K., Elbana, H., & Botchu, R. (2023). Risks in the Management of Polytrauma Patients: Clinical Insights. Orthopedic research and reviews, 15, 27–38. https://doi.org/10.2147/ORR.S340532
Metelmann, C., Barry, T., & Greif, R. (2022). Editorial - Impact of first responders in resuscitation. Resuscitation plus, 12, 100303. https://doi.org/10.1016/j.resplu.2022.100303
Semeraro, F., Greif, R., Böttiger, B. W., Burkart, R., Cimpoesu, D., Georgiou, M., Yeung, J., Lippert, F., S Lockey, A., Olasveengen, T. M., Ristagno, G., Schlieber, J., Schnaubelt, S., Scapigliati, A., & G Monsieurs, K. (2021). European Resuscitation Council Guidelines (2021). Systems saving lives. Resuscitation, 161, 80–97. https://doi.org/10.1016/j.resuscitation.2021.02.008
Bazyar, J., Farrokhi, M., & Khankeh, H. (2019). Triage Systems in Mass Casualty Incidents and Disasters: A Review Study with A Worldwide Approach. Open access Macedonian Journal of Medical Sciences, 7(3), 482–494. https://doi.org/10.3889/oamjms.2019.119
James D, Pennardt AM. Trauma Care Principles. [Updated 2023 May 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547757/
Dogjani, A., Gjata, A., Haxhirexha, K., & Cobani, D. (2021). Current Concepts about Managing of Trauma Patients. Albanian Journal of Trauma and Emergency Surgery, 5(2.5), 24-25. https://doi.org/10.32391/ajtes.v5i2.5.259
Baker, C. C., Oppenheimer, L., Stephens, B., Lewis, F. R., & Trunkey, D. D. (1980). Epidemiology of trauma deaths. American journal of surgery, 140(1), 144–150. https://doi.org/10.1016/0002-9610(80)90431-6
Ekonomia Online IPK 2019 https://ekonomiaonline.com/lendimet-dhe-vdekjet-ne-vendin-e-punes-gjate-vitit-2018-2019-punetoret-ne-meshiren-e-fatit/
Ali Ali, B., Lefering, R., Fortun Moral, M., & Belzunegui Otano, T. (2017). Epidemiological comparison between the Navarra Major Trauma Registry and the German Trauma Registry (TR-DGU®). Scandinavian journal of trauma, resuscitation and emergency medicine, 25(1), 107. https://doi.org/10.1186/s13049-017-0453-2
Bieler, D., Paffrath, T., Schmidt, A., Völlmecke, M., Lefering, R., Kulla, M., Kollig, E., Franke, A., & Sektion NIS of the German Trauma Society (2020). Why do some trauma patients die while others survive? A matched-pair analysis based on data from Trauma Register DGU®. Chinese journal of traumatology = Zhonghua chuang shang za zhi, 23(4), 224–232. https://doi.org/10.1016/j.cjtee.2020.05.001
Basri Lenjani First Aid CPR-AED in emergency P20:67.80:120, 240:90. 2023.
Agron Dogjani, & Kastriot Haxhirexha. (2021). MBËSHTETJA BAZIKE JETËSORE DHE DEFIBRILIMI. (p. 178). Botimet M & B. https://doi.org/10.5281/zenodo.5484293
Ramadani, N., Zhjeqi, V., Berisha, M., Hoxha, R., Begolli, I., Salihu, D., & Krasniqi, P. (2017). Public Health Profile of Road Traffic Accidents in Kosovo 2010-2015. Open access Macedonian Journal of Medical Sciences, 5(7), 1036–1041. https://doi.org/10.3889/oamjms.2017.214
Reade M. C. (2022). Perspective: the top 11 priorities to improve trauma outcomes, from system to patient level. Critical care (London, England), 26(1), 395. https://doi.org/10.1186/s13054-022-04243-2
Yancey CC, O'Rourke MC. Emergency Department Triage. [Updated 2023 Aug 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557583/
ATLS ® for Doctors Student Manual. 10 ed. Chicago, IL: American College of Surgeons, 2018.
Lenjani, B., Baftiu, N., Krasniqi, B., Makolli, S., Lenjani, D., Mišanović, V., Ljuhar, K., & Dogjani, A. (2023). Access and Emergency Medical Care for Massive or Multiple Injuries. Albanian Journal of Trauma and Emergency Surgery, 7(1), 1181-1188. https://doi.org/10.32391/ajtes.v7i1.298
Coughenour J. (2018). Initial Evaluation and Management of the Injured Patient. Missouri Medicine, 115(5), 429–433. PMID: 30385990 PMCID: PMC6205268
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.