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Volume 32(3); September 2019
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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
  • 4,124 View
  • 42 Download
  • 6 Citations
AbstractAbstract 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
The Utility of Non-Invasive Nasal Positive Pressure Ventilation for Acute Respiratory Distress Syndrome in Near Drowning Patients
June Hyeong Kim, Kyung Hoon Sun, Yong Jin Park
J Trauma Inj. 2019;32(3):136-142.   Published online September 30, 2019
DOI: https://doi.org/10.20408/jti.2019.013
  • 7,781 View
  • 92 Download
  • 4 Citations
AbstractAbstract PDF
Purpose

Near drowning refers to immediate survival after asphyxia due to submersion or immersion in water, which is a crucial public safety problem worldwide. Acute lung injury or acute respiratory distress syndrome (ARDS) is a common complication of near drowning. The purpose of this study was to investigate the feasibility and effectiveness of noninvasive nasal positive pressure ventilation (NINPPV).

Methods

This retrospective study was conducted at a tertiary emergency department. NINPPV was administered for moderate ARDS caused by submersion or immersion in patients who were older than 18 years, from January 2015 to December 2018. We collected the demographic (age, sex, length of hospital stay, and outcome), laboratory (arterial blood gas, lactate, oxygen saturation, partial pressure of oxygen divided by the fraction of inspired oxygen, complete blood count, blood urea nitrogen, and creatinine), and clinical data (acute lung injury index and ventilator failure) of the patients. A statistical analysis was performed using Statistical Package for the Social Sciences version 20.0 for Windows.

Results

NINPPV treatment was provided to 57 patients for near drowning, 45 of whom (78.9%) were successfully treated without complications; in 12 (21.1%), treatment was changed to invasive mechanical ventilation within 48 hours due to ARDS or acute kidney injury. NINPPV treatment was successful in 31 (75.6%) out of 41 sea-water near drowning patients. They were more difficult to treat with NINPPV compared with the fresh-water near drowning patients (p<0.05).

Conclusions

NINPPV would be useful and feasible as the initial treatment of moderate ARDS caused by near drowning.

Summary

Citations

Citations to this article as recorded by  
  • Early pronation, protective lung ventilation and use of awake-prone-HFNO therapy after extubation in near-fatal drowning
    G. Misseri, P. Pierucci, D. Bellina, M. Ippolito, G. Ingoglia, C. Gregoretti
    Pulmonology.2024; 30(2): 198.     CrossRef
  • Addressing gaps in our understanding of the drowning patient: a protocol for the retrospective development of an Utstein style database and multicentre collaboration
    Ogilvie Thom, Kym Roberts, Peter A Leggat, Susan Devine, Amy E Peden, Richard Charles Franklin
    BMJ Open.2023; 13(2): e068380.     CrossRef
  • Management for the Drowning Patient
    David Szpilman, Paddy J. Morgan
    Chest.2021; 159(4): 1473.     CrossRef
  • Treatment of the lung injury of drowning: a systematic review
    Ogilvie Thom, Kym Roberts, Susan Devine, Peter A. Leggat, Richard C. Franklin
    Critical Care.2021;[Epub]     CrossRef
Factors and Their Correlation with Injury Severity of Elderly Pedestrian Traffic Accidents
Tae gyu Hyun, Seok-Ran Yeom, Sung-Wook Park, Deasup Lee, Hyung bin Kim, Il Jae Wang, Byung Gwan Bae, Min keun Song, Youngmo Cho
J Trauma Inj. 2019;32(3):143-149.   Published online September 30, 2019
DOI: https://doi.org/10.20408/jti.2019.022
  • 3,295 View
  • 69 Download
AbstractAbstract PDF
Purpose

No previous study has assessed elderly pedestrian traffic accidents based on a nationwide database. This study aimed to help primary physicians who examine patients in emergency departments to determine and make prompt and accurate treatment decisions.

Methods

This study used data from the Emergency Department-based Injury In-depth Surveillance from 2013 to 2017, managed by the Korea Centers for Disease Control and Prevention. Pedestrians aged ≥65 years were included, and using multivariate logistic regression multiple factors were analyzed to determine their relationship with injury severity.

Results

Of 227,695 subjects, 6,498 were included, of whom 2,065 (31.8%) were severely injured. There were more female than male patients in all severity groups. Most accidents occurred in the afternoon and on general roads. In the multivariate analysis, the odds ratio (OR) of injury severity for male pedestrians was 1.165 (95% confidence interval: 1.034?1.313, p=0.012). Older age of patients and the use of ambulances were associated with greater injury severity. The accident time affected the degree of injury severity; i.e., compared to dawn, injury severity increased in the morning (OR: 1.246, p=0.047) and decreased at night (OR: 0.678, p<0.001). A significant difference was noted in the correlation between the type of vehicle causing the accident and the accident severity; i.e., motorcycle accidents had lower severity than bicycle accidents (OR: 0.582, p=0.047).

Conclusions

Injury severity was correlated with sex, age, transportation to the ED, TA onset time, and type of vehicle. The study results suggest that injury severity may be positively reflected in initial assessments and overall integrated treatments by physicians and in the related policies.

Summary
A Peripherally Inserted Central Catheter is a Safe and Reliable Alternative to Short-Term Central Venous Catheter for the Treatment of Trauma Patients
Dong Yeon Ryu, Sang Bong Lee, Gil Whan Kim, Jae Hun Kim
J Trauma Inj. 2019;32(3):150-156.   Published online September 30, 2019
DOI: https://doi.org/10.20408/jti.2019.015
  • 6,576 View
  • 127 Download
  • 3 Citations
AbstractAbstract PDF
Purpose

To determine whether a peripherally inserted central catheter (PICC) meets the goals of a low infection rate and long-term use in trauma patients.

Methods

From January 2016 to June 2018, the medical records of patients who underwent central venous catheterization at a level I trauma center were retrospectively reviewed. Data collected included age, sex, injury severity score, site of catheterization, place of catheterization (intensive care unit [ICU], emergency department, or general ward), type of catheter, length of hospital stay during catheterization, types of cultured bacteria, time to development of central line-associated bloodstream infection (CLABSI), and complications.

Results

During the study period, 333 central vein catheters (CVC) were inserted with a total of 2,626 catheter-days and 97 PICCs were placed with a total of 2,227 catheter-days. The CLABSI rate was significantly lower in the PICC group when the analysis was limited to patients for whom the catheter was changed for the first time in the ICU after CVC insertion in the ER with similar indication and catheter insertion times (18.6 vs. 10.3/1,000 catheter-days, respectively, p<0.05). The median duration of catheter use was significantly longer in the PICC group than in the CVC group (16 vs. 6 days, respectively, p<0.05).

Conclusions

The study results showed that the duration of catheter use was longer and the infection rate were lower in the PICC group than in the CVC group, suggesting that PICC is a safe and reliable alternative to conventional CVC.

Summary

Citations

Citations to this article as recorded by  
  • Anatomical Structures to Be Concerned With During Peripherally Inserted Central Catheter Procedures
    Dasom Kim, Jin Woo Park, Sung Bum Cho, Im Joo Rhyu
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • The incidence and risk of venous thromboembolism associated with peripherally inserted central venous catheters in hospitalized patients: A systematic review and meta-analysis
    Anju Puri, Haiyun Dai, Mohan Giri, Chengfei Wu, Huanhuan Huang, Qinghua Zhao
    Frontiers in Cardiovascular Medicine.2022;[Epub]     CrossRef
  • Peripherally Inserted Central Catheter lines for Intensive Care Unit and onco-hematologic patients: A systematic review and meta-analysis
    Georgios Mavrovounis, Maria Mermiri, Dimitrios G Chatzis, Ioannis Pantazopoulos
    Heart & Lung.2020; 49(6): 922.     CrossRef
Status and Needs of Continuing Education for Trauma Nursing
Yooun-Joong Jung, Suhyun Kim, Sangmi Noh, Eunkyoung Seo, Soyoung Jung, Jiyoung Kim
J Trauma Inj. 2019;32(3):157-167.   Published online September 30, 2019
DOI: https://doi.org/10.20408/jti.2019.016
  • 3,130 View
  • 64 Download
AbstractAbstract PDF
Purpose

This study was conducted to status and needs for continuing education for trauma hospital nurses in Korea.

Methods

Thirty nurses from the seven level I trauma center hospitals or trauma treatment systems were randomly selected and surveyed. The survey was conducted from March 1 to May 31, 2017. Categorical data were analyzed with Pearson chi-square tests and Continuous variables were analyzed with ANOVA.

Results

Only 86 out of 204 nurses had received continuing education (42.1%). The current status of continuing education programs, delivering institution (p<0.001), education method (p<0.001), education period (p=0.003), number of participants (p=0.007), and instructors (p=0.014) were also significantly different from trauma center to trauma center. There were 108 (52.9%) nurses who responded that continuing education programs were “needed” 92 (45.1%) and “very much needed 16 (7.8%). According to each trauma center’s characteristics were significantly differences in the need for continuing education (p=0.089), subject selection method (p<0.001) and the number of continuing education sessions (p=0.043) depending on the hospital.

Conclusions

It is necessary to consider differences between the hospitals to develop continuing education programs that reflect the needs of nurses, in order to improve the efficiency of and satisfaction with the educational programs.

Summary
Case Reports
Case Series: Successful Resuscitation of Severe Facial Injuries Caused by a Chainsaw
Han Joo Choi
J Trauma Inj. 2019;32(3):168-171.   Published online September 30, 2019
DOI: https://doi.org/10.20408/jti.2019.027
  • 8,954 View
  • 142 Download
  • 2 Citations
AbstractAbstract PDF

The treatment outcome remains poor of severe facial injuries because of the high risk of compromised airway or massive bleeding. We experienced two successful treatment cases of severe facial injury by the chainsaw. A 52-year-male had his face injured by the chainsaw during his work. He was transferred to the Level I trauma center using the Doctor-Helicopter. During his flight, bleeding control was tried and the information was given to the trauma surgeons before his arrival. His consciousness was alert and the vital signs were stable. The crushing wound, mandible open fracture, deep laceration of tongue, lip, neck and arterial bleeding were noted around his mandible. Nasotracheal intubation was performed under the bronchoscope-guided. Emergency operation (open reduction & internal fixation, primary repair with neurorrhaphy) was performed. At 30 hospital days, he was discharged with facial palsy on left mandibular area. A 30-year-male had his face injured by the chainsaw. He was transferred to our Level I trauma center from the local hospital. The deep-mutiple lacerations on right upper eyelid and forehead with the bony exposure were noted. The vital signs were stable and emergency operation was performed. He was discharged at 20 hospital days. Bone loss or tissue loss were not devastating than we expected even though the injury was occurred by the chainsaw. Aggressive treatment including airway manipulation or bleeding control and maximal opportunity of therapy are absolutely needed.

Summary

Citations

Citations to this article as recorded by  
  • Thoracoabdominal injury with evisceration from a chainsaw assault: a case report
    Babatunde Abayomi Salami, Babatunde Adeteru Ayoade, El-Zaki Abdullahi Shomoye, Chigbundu Collins Nwokoro
    Journal of Trauma and Injury.2022; 35(2): 118.     CrossRef
  • Unusual Chainsaw Related Penetrating Neck Injury: Initial Management & Surgical Repair, Case Report
    Woohyen Jin, Sang-Wook Park, Seong Jun Won, Jung Je Park
    Journal of Clinical Otolaryngology Head and Neck .2022; 33(4): 259.     CrossRef
Aortoesophageal Fistula after Thoracic Endovascular Aortic Repair for Blunt Thoracic Aortic Injury
Masakazu Nitta, Taro Tamakawa, Natsuo Kamimura, Tadayuki Honda, Hiroshi Endoh
J Trauma Inj. 2019;32(3):172-175.   Published online September 30, 2019
DOI: https://doi.org/10.20408/jti.2019.023
  • 3,428 View
  • 41 Download
AbstractAbstract PDF

Although thoracic endovascular aortic repair (TEVAR) has grown to become the standard of care to treat blunt thoracic aortic injury (BTAI), the long-term effects of TEVAR are still unclear. We here present a 72-year-old man with BTAI due to a traffic accident. He successfully underwent TEVAR and was transferred to another rehabilitation hospital 2 months after the accident. However, 1 month later, he underwent gastroscopy with fever and hematemesis and was diagnosed with aorto-esophageal fistula (AEF). After being re-transferred to Niigata University Medical and Dental Hospital, we tried to convince him to undergo surgical treatment, but he strongly refused. He received palliative care and died due to rupture of the aortic pseudoaneurysm 3 days after the hospital transfer. Fatal complications like AEF may occur after TEVAR, so clinicians need to carefully follow patients who underwent TEVAR.

Summary
Laparoscopy in Blunt Abdominal Trauma: Diaphragmatic and Bladder Lacerations Repair
Ruben Martins, Martins dos Santos, Tatiana Revez
J Trauma Inj. 2019;32(3):176-180.   Published online September 30, 2019
DOI: https://doi.org/10.20408/jti.2019.019
  • 3,138 View
  • 49 Download
AbstractAbstract PDF

The growing use of laparoscopy in elective surgery has led to its increase utilization in emergency surgery. However, the employment of laparoscopy in abdominal trauma is still unusual. Here in we report a case of a patient with blunt abdominal trauma that resulted in a combination of exceptional traumatic lesions, diaphragmatic and bladder lacerations. Both injuries were diagnosed and successfully resolved by laparoscopy. The report of this type of lesions and resolution is extremely rare, being this the second case described in the international literature. This article intends to show that laparoscopy may not only be used as a diagnostic tool, but also as a therapeutic instrument in selected cases of blunt abdominal trauma.

Summary
Bilateral Free 2nd Toe Pulp Flap for Reconstruction of Soft Tissue Defect in Traumatic Finger Injuries
Jeongseok Oh, Seok Chan Eun
J Trauma Inj. 2019;32(3):181-186.   Published online September 30, 2019
DOI: https://doi.org/10.20408/jti.2019.014
  • 3,581 View
  • 62 Download
AbstractAbstract PDF

Finger reconstruction involves paramount significance of both functional and aesthetic aspects, due to its great impact on quality of life. The options range from primary closure, skin grafts, local flaps, pedicled flaps, and free flaps. The optimal method should consider various circumstances of the patient and surgeon. We would like to report a case of a young woman who initially presented with cellulitis and necrosis of the left second finger-tip who underwent reconstruction with bilateral toe pulp free flap. The patient could successfully return to her job that involves keyboard typing and playing the piano, with acceptable donor site morbidity.

Summary
Free Flap Reconstruction in Patients with Traumatic Injury of the Forefoot
Shin Hyuk Kang, Jeongseok Oh, Seok Chan Eun
J Trauma Inj. 2019;32(3):187-193.   Published online September 30, 2019
DOI: https://doi.org/10.20408/jti.2019.018
  • 5,571 View
  • 70 Download
  • 1 Citations
AbstractAbstract PDF

Many techniques have been developed for reconstruction of the hand; however, less attention has been paid to foot reconstruction techniques. In particular, reconstruction of the forefoot and big toe has been considered a minor procedure despite the importance of these body parts for standing and walking. Most of the weight load on the foot is concentrated on the forefoot and big toe, whereas the other toes have a minor role in weight bearing. Moreover, the forefoot and big toe are important for maintaining balance and supporting the body when changing directions. Recently, attention has been focused on the aesthetic appearance and functional aspects of the body, which are important considerations in the field of reconstructive surgery. In patients for whom flap reconstruction in the forefoot and big toe is planned, clinicians should pay close attention to flap survival as well as functional and cosmetic outcomes of surgery. In particular, it is important to assess the ability of the flap to withstand functional weight bearing and maintain sufficient durability under shearing force. Recovery of protective sensation in the forefoot area can reduce the risk of flap loss and promote rapid rehabilitation and functional recovery. Here, we report our experience with two cases of successful reconstruction of the forefoot and big toe with a sensate anterolateral thigh flap, with a review of the relevant literature.

Summary

Citations

Citations to this article as recorded by  
  • Functional Reconstruction of Arches of the Foot With Vascularized Fibula Flap
    Fatih Zor, Yalcin Bayram, Yalcin Kulahci
    Annals of Plastic Surgery.2023; 91(5): 571.     CrossRef

J Trauma Inj : Journal of Trauma and Injury