Comparative study of the need for re-intervention after chest tube remove in two groups with and without chest x-ray in Patients Admitted into Razi and Poursina hospital in Rasht city

Introduction: The most common types of injuries following blunt or sharp trauma of lungs and the pleural space are pneumothorax, hemothorax and hemopneumothorax, which in most cases are resolved through supportive care and thoracostomy (use of chest tubes). Removal of the CT (chest tube) can result in complication such as pneumothorax and accumulation of fluid in the pleural space. Despite the lack of a standard guideline regarding the management of patients post CT removal, it is advised to procure a CXR as a means of a conservative approach. However, most of the findings acquired from the post CT removal CXR are not clinically significant and in the case of patients requiring intervention, there are almost always clinical signs and symptoms present. Considering the prior statements, the lack of a standard guideline even in the general and thoracic surgery references, show cases the importance of this study. This study is set upon proving that, the omission of post CT removal CXR in asymptomatic patients will not have an impact on the clinical outcome of the case and will reduce the costs as well as the patients' exposure to radiation and hospital stay. Methods: This study is designed as cross-sectional study with a sample size of 200 patients who were hospitalized for CT insertion in the Surgery clinic of Razi and Poursina Hospitals in Rasht between 21/4/2019 and 20/4/2020 and matched our entry criteria. The patients were divided into 2 groups of 100, with one group being monitored without CXR and the other with the use of CXR. Some forms were designed as checklists for the task of data collection. The data analysis was done through Fisher's exact test, Chi square test and Mann Whitney U test. In addition, the Significance level was set at 0.05 (p value ≤ 0.05). Result: Out of the 200 patients included in our study, 120 were male (60%) and the rest (40%) were female. The most common underlying disease in both groups (with and without CXR) of our study was Hip fracture. In both groups, The most frequent reason for CT insertion was pleural effusion (36% and 43% in with CXR and without CXR groups respectively), but the difference between the 2 groups was not statistically significant (p = 0.597). In most of the cases, 1 CT was inserted and there was no statistically significant difference between the 2 groups. The difference between the 2 groups regarding the need for intervention (11 cases in the CXR group and 6 cases in the Non CXR group) was also statistically insignificant. The duration of hospital stay did not show a statistically significant difference between the 2 groups (p = 0.644). Conclusion: Our study suggests that whether a post CT removal CXR is obtained or not, will not make a statistically significant difference in the number of interventions, the cause of intervention, and the number of inserted CTs and the duration of hospital stay. Therefore, it can be suggested that the need for reintervention in post CT removal patients can be determined through clinical signs, symptoms and the surgeon's judgment, without the need for a routine CXR.

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Harmonic scalpel versus titanium clips and l-hook in the ligation of cystic duct and artery and gall bladder dissection in laparoscopic cholecystectomy

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20175075 ◽

2017 ◽

Vol 5 (12) ◽

pp. 5145

Author(s):

Anand Vijayvargiya ◽

S. K. Jain ◽

Varsha Soni

Keyword(s):

Laparoscopic Cholecystectomy ◽

Gall Bladder ◽

Hospital Stay ◽

Cystic Duct ◽

Harmonic Scalpel ◽

P Value ◽

Duration Of Hospital Stay ◽

Significant Difference ◽

Conversion To Open Cholecystectomy ◽

Duration Of Surgery

Background: Laparoscopic cholecystectomy is a gold standard for gall bladder stone surgery. The Aim and objective of study was to compare the total duration of surgery, intraoperative complication like bile leak from cystic duct stump, spillage of bile from gallbladder and post op pain and abdomen distension and jaundice.Methods: Study was carried out in dept. of gen Surgery, Govt medical college Kota in yr. 2015-16 in a total of 50 patients with cholelithiasis with cholecystitis. Patient were equally divided randomly into two groups (a) Harmonic scalpel group and (b) Titanium Clip and L hook group. All patients with medical comorbidities, Concomitant CBD calculi, cirrhosis and portal HT were excluded from study. Intraoperatively adhesions, bile spillage from GB and cystic duct stump noted Postoperatively complain like pain abdomen, Jaundice, and fever were noted. Duration of hospital stay was observed. All results were statistically analyzed using Chi square and ANOVA test.Results: Both groups were comparable on the basis of age and sex distribution, as no statistically difference was noted (P value 0.867 and 0.999 respectively). Intraoperative findings were adhesions 5 in clip group and 7 in harmonic group. Spillage from gall bladder was 2 in Clip group and 3 in harmonic group. Mean duration of surgery was 65.20 min in clip group and 63.68 in harmonic group with no statistically significant difference in both the group (P Value 0.727). Average duration of hospital stay was similar in both the groups with a mean of 2.6 days. Postoperative complication was fever, abdomen pain and distension were 3,1,1 were respectively in the clip group and 3,2,2 respectively in harmonic group with the P value of 0.999 which was statistically insignificant. No CBD injury was noted in any case. Conversion to open cholecystectomy was not done in any case. On 1week and 1 month follow up 2 cases in clip group and 1 in HS group had collection in gall bladder fossa and none at I month.Conclusions: Harmonic scalpel offers an effective, alternative and safe method to cystic duct division and Gallbladder dissection from liver bed.

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LAPROSCOPIC CHOLECYSTECTOMY;

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.04.3364 ◽

2019 ◽

Vol 26 (04) ◽

Author(s):

Muhammad Usman ◽

Kaiser Saleem ◽

Saddaqat Hayat

Keyword(s):

Hospital Stay ◽

Pain Score ◽

Tertiary Care ◽

P Value ◽

Duration Of Hospital Stay ◽

Significant Difference ◽

Group A ◽

Group B ◽

Surgical Unit ◽

Trial Setting

Objectives: Compare the efficacy in terms of mean pain score and mean duration of hospital stay in patients of symptomatic cholilithiasis undergoing laproscopic cholecystectomy with and without subhepatic drain insertion. Study Design: Randomized control trial. Setting: Surgical unit –iii of Allied Hospital Faisalabad which is tertiary care unit. Duration of Study: 20-02-2013 to 20-08-2013. Results: Out of 150 cases (75 cases in two groups), mean+sd was calculated as 44.74+ 6.57 years, 80%(n=60) in Group-A and 82.66%(n=62) in Group-B were female, post- operative hospital stay was recorded which shows 3.16+0.463 in group-a and 2.32+0.569 days in group-b and it shows statistically significant difference between the two groups, similarly, on comparison of post-operative abdominal pain score at 24 hours in both groups 2.266+1.062 in Group-A and 1.8+0.90 in Group-B pain on vas was recorded at 24 hours which shows significantly lower in Group-B patients by calculating p value as 0.002348. Conclusion: No subhepatic drain insertion after laproscopic cholecystectomy is better when compared to those with subhepatic drain insertion in terms of mean pain score and mean duration of hospital stay in days post operatively.

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A Comparative Study of Laparoscopically Assisted Vaginal Hysterectomy and Non-descended Vaginal Hysterectomy

Journal of SAFOG with DVD ◽

10.5005/jp-journals-10006-1281 ◽

2014 ◽

Vol 6 (2) ◽

pp. 101-103

Author(s):

De Reena ◽

Sebanti Goswami

Keyword(s):

Comparative Study ◽

Hospital Stay ◽

Vaginal Hysterectomy ◽

P Value ◽

Medical College ◽

Laparoscopically Assisted Vaginal Hysterectomy ◽

Significant Difference ◽

The Mean ◽

The Difference ◽

Prospective Longitudinal

ABSTRACT Introduction The present study was done to compare nondescended vaginal hysterectomy (NDVH) and laparoscopically assisted vaginal hysterectomy (LAVH) with reference to indications, operative complications and outcome. Materials and methods This prospective longitudinal comparative study was conducted in the Department of Obstetrics and Gynecology, Medical College and Hospital, Kolkata, from November 2010 to October 2011. Judging the inclusion and exclusion criteria a sample size of 36 patients for NDVH and 31 patients for LAVH were selected randomly. The outcome of each surgical procedure was analyzed by standard statistical methods. Appropriate test of significance was applied (t-test) with p < 0.05 as level of significance. Results The mean duration of NDVH was 65 minutes and that of LAVH was 93.87 minutes. The difference was highly significant as p value was 0.000. The mean pain score analyzed by visual analog scale (VAS) in NDVH was 2.334 and 2.581. This was not statistically significant (p = 0.636). There was no significant difference in hospital stay in either group. Conclusion Laparoscopically assisted vaginal hysterectomy has the advantage of visualization of the pelvic structure from above and occasional dissection and adhesiolysis. But NDVH supersedes in its approach through the naturally created route, being faster, less expensive and results in a similar hospital stay and convalescence. How to cite this article Reena D, Goswami S. A Comparative Study of Laparoscopically Assisted Vaginal Hysterectomy and Non-descended Vaginal Hysterectomy. J South Asian Feder Obst Gynae 2014;6(2):101-103.

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Comparison of Adrenaline and Salbutamol nebulization in treatment of Children with Bronchiolitis.

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.09.1537 ◽

2019 ◽

Vol 26 (09) ◽

pp. 1434-1439

Author(s):

Shehla Usman ◽

Aneela Zareen ◽

Aimun Gillani ◽

Ammara Kaleem ◽

Mohsin Ali ◽

...

Keyword(s):

Heart Rate ◽

Standard Deviation ◽

Hospital Stay ◽

Respiratory Rate ◽

Normal Saline ◽

Oxygen Therapy ◽

P Value ◽

Duration Of Hospital Stay ◽

Significant Difference ◽

The Mean

Background: Bronchiolitis is an acute inflammation of bronchioles that can be severe enough to require admission in intensive care unit. There are multiple modalities used for treatment of bronchiolitis. The objective of this study was to compare the response of adrenaline and salbutamol nebulization in terms of clinical improvement and duration of hospital stay. Study Design: Randomized controlled trial. Setting: Pediatrics Department of Avicenna Medical College and Hospital, Lahore. Period: March 2018 to October 2018. Methods: Total 66 patients with 33 in each group between ages of 2-months to 3-years admitted with the diagnosis of bronchiolitis, were included in the study. Children in the group 1 were patients treated with salbutamol nebulization 0.15 mg/kg with 3 ml normal saline every six hourly. Children in the group 2 received adrenaline nebulization 0.1 ml/kg of 1:1000 dilutions with 3 ml normal saline every six hourly. Both the groups were given similar supportive management that included oxygen therapy, intravenous fluids, and antipyretics. Data was collected in the form of age, gender, heart rate, respiratory rate, SpO2 and RDAI score at admission, 6hr, 24 hr and 48hr after admission, duration of hospital stay and duration of oxygen therapy. Results: Out of 66 patients, 38(57.6%) were male and 28(42%) were female. The mean with standard deviation of age in months was 20.45 + 12.9 in salbutamol group and 16.7 + 12.3 in adrenaline group (p value = 0.23). Mean with standard deviation of weight of patients was 9.7+ 3.5 in salbutamol group and 8.9+3.3 in adrenaline group (p value =0.34). Regarding the duration of hospital stay the mean and standard deviation of hospital stay was 4.2+ 0.9 in salbutamol group and 3.9 + 1 in adrenaline group with p value 0.016. Mean and standard deviation of duration of oxygen therapy was 1.05+ 0.7 in salbutamol group and 0.9+0.4 in adrenaline group with p value 0.42. There was no significant difference in the values of RDAI, heart rate, respiratory rate, SPO2 at admission and subsequently after 6hrs, 24hrs, and 48hrs. Conclusion: We concluded that there was a significant reduction in duration of hospital stay in patients who received adrenaline nebulization then those nebulized with salbutamol. RDAI scores in the initial 48 hours in both the groups were improved in successive readings, but there was no significant difference in RDAI scores between the two groups recorded at different time intervals.

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Perbedaan Penggunaan Antikoagulan K2EDTA DAN K3EDTA Terhadap Hasil Pemeriksaan Indeks Eritrosit

Jurnal Laboratorium Khatulistiwa ◽

10.30602/jlk.v1i2.147 ◽

2018 ◽

Vol 1 (2) ◽

pp. 114

Author(s):

Wahdaniah Wahdaniah ◽

Sri Tumpuk

Keyword(s):

Screening Test ◽

Venous Blood ◽

The Body ◽

Ethylene Diamine ◽

P Value ◽

Cross Sectional ◽

Significant Difference ◽

Ethylene Diamine Tetra Acetate ◽

The Difference ◽

Index Value

Abstract: Routine blood examination is the earliest blood test or screening test to determine the diagnosis of an abnormality. Blood easily froze if it is outside the body and can be prevented by the addition of anticoagulants, one of which Ethylene Diamine Tetra Acetate (EDTA). Currently available vacuum tubes containing EDTA anticoagulants in the form of K2EDTA and K3EDTA. K3EDTA is usually a salt that has better stability than other EDTA salts because it shows a pH approaching a blood pH of about 6.4. The purpose of this research is to know the difference of erythrocyte index results include MCH, MCV and MCHC using K3EDTA anticoagulant with K2EDTA. This research is a cross sectional design. This study used venous blood samples mixed with K2EDTA anticoagulant and venous blood mixed with K3EDTA anticoagulants, each of 30 samples. Data were collected and analyzed using paired different test. Based on data analysis that has been done on MCH examination, p value <0,05 then there is a significant difference between samples with K3EDTA anticoagulant with K2EDTA to erythrocyte index value. Then on the examination of MCV and MCHC obtained p value <0.05 then there is no significant difference between samples with K3EDTA anticoagulant with K2EDTA to erythrocyte index value.Abstrak: Pemeriksaan darah rutin merupakan pemeriksaan darah yang paling awal atau screening test untuk mengetahui diagnosis suatu kelainan. Darah mudah membeku jika berada diluar tubuh dan bisa dicegah dengan penambahan antikoagulan, salah satunya Ethylene Diamine Tetra Acetate (EDTA). Dewasa ini telah tersedia tabung vakum yang sudah berisi antikoagulan EDTA dalam bentuk K2EDTA dan K3EDTA. K3EDTA biasanya berupa garam yang mempunyai stabilitas yang lebih baik dari garam EDTA yang lain karena menunjukkan pH yang mendekati pH darah yaitu sekitar 6,4. Tujuan dari penelitian ini adalah untuk mengetahui perbedaan hasil indeks eritrosit meliputi MCH, MCV dan MCHC menggunakan antikoagulan K3EDTA dengan K2EDTA. Penelitian ini merupakan penelitian dengan desain cross sectional. Penelitian ini menggunakan sampel darah vena yang dicampur dengan antikoagulan K2EDTA dan darah vena yang dicampur dengan antikoagulan K3EDTA, masing-masing sebanyak 30 sampel. Data dikumpulkan dan dianalisis menggunakan uji beda berpasangan. Berdasarkan analisis data yang telah dilakukan pada pemeriksaan MCH didapatkan nilai p < 0,05 maka ada perbedaan yang signifikan antara sampel dengan antikoagulan K3EDTA dengan K2EDTA terhadap nilai indeks eritrosit. Kemudian pada pemeriksaan MCV dan MCHC didapatkan nilai p < 0,05 maka tidak ada perbedaan yang signifikan antara sampel dengan antikoagulan K3EDTA dengan K2EDTA terhadap nilai indeks eritrosit.

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Management of post-operative discitis following discectomy in a tertiary-level hospital

Journal of Orthopaedic Surgery ◽

10.1177/2309499020988213 ◽

2021 ◽

Vol 29 (1) ◽

pp. 230949902098821

Author(s):

Md Kamrul Ahsan ◽

Md Sariful Hasan ◽

Md Shahidul Islam Khan ◽

Najmus Sakeb

Keyword(s):

Hospital Stay ◽

Antibiotic Treatment ◽

Demographic Data ◽

Japanese Orthopaedic Association ◽

Clinical Signs ◽

Length Of Hospital Stay ◽

Tertiary Level ◽

Disc Space ◽

The Difference ◽

Level Hospital

Purpose: To perform retrospective analysis of 75 post-operative disc space infections after open lumbar discectomy (OLD) and to assess the outcome of their medical and surgical management in a tertiary-level hospital. Methods: Records of 50 men and 25 women aged 26–65 (mean, 42.53) years who underwent treatment for post-operative discitis (POD) after single level OLD at L3–4 (n = 8), L4–5 (n = 42), L5–S1 (n = 25) level. The POD was diagnosed according to specific clinical signs, laboratory and radiographic investigations and all of them received initial intravenous antibiotics (IVA) for at least 4–6 weeks followed by oral ones. Successful responders (n = 55) were considered in Group-C and remainder [Group-S (n = 20)] were operated at least after 4 weeks of failure. Demographic data, clinical variables, hospital stay, duration of antibiotic treatment and post-treatment complications were collected from the hospital record and assessment before and after treatment were done by using visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) score. Comprehensive outcome was evaluated by modified criteria of Kirkaldy-Willis. Results: The mean follows up was 36.38 months. Significant improvement of mean VAS and JOA score was achieved in both conservative (76.36% satisfactory) and operative (90% satisfactory) groups although the difference was statistically insignificant. Conclusion: Although insignificant, early surgical intervention provided better results (e.g. functional outcomes, length of hospital stay and duration of antibiotic treatment therapy) than conventional conservative treatment in post-operative discitis.

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Abstract P124: Repeat Manual Office Blood Pressure By A Physician Is Lower Than Automated Office Blood Pressure

Hypertension ◽

10.1161/hyp.78.suppl_1.p124 ◽

2021 ◽

Vol 78 (Suppl_1) ◽

Author(s):

Bryce Rhodehouse ◽

Courtney Shaver ◽

Jerry Fan ◽

Bright Izekor ◽

Clinton Jones ◽

...

Keyword(s):

Blood Pressure ◽

Vital Signs ◽

Outpatient Setting ◽

Office Blood Pressure ◽

P Value ◽

Signed Rank ◽

Significant Difference ◽

Minute Interval ◽

The Difference ◽

Automated Office Blood Pressure

Introduction: An accurate measurement of blood pressure (BP) is critical to diagnosing and treating hypertension (HTN). Manual office BP (MOBP) often results in higher readings than automated office BP (AOBP). In previous studies, a repeat MOBP by a physician resulted in a lower BP than the initial MOBP by nursing staff. We evaluated our hypothesis that a repeat MOBP by a physician is statistically equivalent to AOBP. Methods: In an ambulatory outpatient setting, patients were roomed and at least a 5-minute interval lapsed before an AOBP was performed using a Welch Allyn Connex Vital Signs Monitor. The physician was blinded to the AOBP. The physician then entered the room and obtained a MOBP with a manual aneroid sphygmomanometer. The difference between the AOBP and the MOBP was calculated. A Wilcoxon signed rank sum test was used to determine if a significant difference between AOBP and MOBP exists. Results: A total of 186 patients (112 females, 74 male) had BP measured with a mean age of 66 years. AOBP resulted in a median systolic BP (SBP) 136 mmHg (IQR 121-150 mmHg) and median diastolic BP (DBP) of 78 mmHg (IQR 72-85 mmHg). MOBP SBP had a median of 132 mmHg (IQR 120-142 mmHg) and DBP had a median of 76 mmHg (IQR 70-81 mmHg). SBP and DBP were significantly lower in the MOBP group with a mean difference between AOBP and MOBP of 4.0 and 2.7 mmHg respectively (p-value of <0.0001). Conclusions: Repeat MOBP performed by the physician resulted in a significantly lower BP compared to AOBP. The lower BP may be due to an overall longer interval between the AOBP measurement and MOBP measurement. MOBP may be a viable option for accurate diagnosis and treatment of HTN clinics without access to a AOBP machine.

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Perbedaan kadar hemoglobin pada remaja gizi baik yang tinggal di pegunungan dengan yang tinggal di tepi pantai

e-CliniC ◽

10.35790/ecl.4.1.2016.11696 ◽

2016 ◽

Vol 4 (1) ◽

Author(s):

Marianne C. Jacobus ◽

Max F.J Mantik ◽

Adrian . Umboh

Keyword(s):

Analytical Study ◽

Nutrition Status ◽

P Value ◽

Cross Sectional ◽

Significant Difference ◽

Good Nutrition ◽

The Difference ◽

Cross Sectional Design ◽

And Gender ◽

Main Component

Abstract: Haemoglobin is the main component of red blood cells that serves as a transporter of oxygen and carbon dioxide in the blood. The normal range of haemoglobin values can be used to determine the degree of anemia according to age and gender. Geographical condition such as altitude influences the haemoglobin value. This study aimed to obtain the difference of haemoglobin levels between teenagers with good nutrition status who live at the highland and those at the seaside. This was an observational analytical study with a cross sectional design. Samples were students with good nutrition status of SMPN 3 Tomohon (living at the highland) and those of SMP Kristen Nazaret Tuminting (living at the seaside). There were 60 students who met the inclusion criteria as follows: adolescent, good nutrition status, healthy, aged 13-15 years, lived at the highland or at the seaside ≥ 6 month, and willing to be performed blood examinations, and had been approved by their parents. The Mann-Whitney test for the difference between haemoglobin levels of the two groups showed a p value < 0,001. Conclusion: There was a very significant difference between haemoglobin levels of good nutrition teenagers who lived at the highland and at the seaside. Keywords: haemoglobin levels, good nutrition, teenagers, highland, seaside Abstrak: Hemoglobin merupakan komponen utama sel darah merah dan berfungsi sebagai transporter oksigen dan karbon dioksida dalam darah. Batas normal nilai hemoglobin dapat digunakan untuk menetapkan derajat anemia, dengan distribusi usia dan jenis kelamin spesifik didasarkan pada sampel referensi sehat. Kondisi geografis, seperti ketinggian tempat dari permukaan laut menjadi faktor pertimbangan dalam distribusi nilai normal hemoglobin. Penelitian ini bertujuan untuk mendapatkan perbedaan kadar hemoglobin antara remaja gizi baik yang tinggal di pegunungan dengan yang tinggal di tepi pantai. Jenis penelitian ini analitik-observasional dengan desain potong lintang. Sampel penelitian yaitu remaja gizi baik yang tinggal di pegunungan yaitu siswa SMPN 3 Tomohon dan yang di tepi pantai yaitu siswa SMP Kristen Nazaret Tuminting. Subjek penelitian berjumlah 60 remaja yang memenuhi kriteria inklusi yaitu gizi baik, sehat, berumur 13-15 tahun, berdomisili di pegunungan atau tepi pantai ≥6 bulan, bersedia dilakukan pemeriksaan darah, dan telah disetujui oleh orang tua. Data yang diperoleh dianalisis menggunakan uji Mann-Whitney dengan bantuan program SPSS. Hasil uji Mann-Whitney mengenai perbedaan kadar hemoglobin antara kedua kelompok menunjukkan nila p <0,001. Simpulan: Terdapat perbedaan yang sangat bermakna kadar hemoglobin remaja gizi baik yang tinggal di pegunungan dengan di tepi pantai.Kata kunci: kadar hemoglobin, remaja gizi baik, pegunungan, tepi pantai

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Migraine in Obesity: Is It Prevalent?

Diyala Journal of Medicine ◽

10.26505/djm.19025121223 ◽

2020 ◽

Vol 19 (2) ◽

pp. 1-5

Author(s):

Aso Sabir Saeed ◽

◽

Osama MohammadAmin Shukr

Keyword(s):

Body Mass Index ◽

Waist Circumference ◽

P Value ◽

Cross Sectional ◽

Waist To Hip Ratio ◽

Migraine Prevalence ◽

Significant Difference ◽

Keywords Migraine ◽

The Difference ◽

The Relationship

Background: Several studies have demonstrated an association between obesity and migraine. It’s still unclear whether migraine is the cause or it's the result of obesity. Objective: We investigated the prevalence of migraine among obese and non-obese individuals and analyzed the relationship between migraine prevalence and obesity. Patients and Methods: This is cross-sectional observational study was carried out at the neurology outpatients’ department of the Rizgary Teaching Hospital in Erbil, Iraq, from July 1st , 2018 to September 30, 2019. We interviewed and examined 300 persons, both obese (n=154) and non-obese (n=146), and of both gender. All of them were adults (>18 years old). Each person's weight, height, body mass index (BMI), and waist circumference were measured.The diagnosis of migraine was made according to the International Headache Society’s criteria. Obesity was present if the individual’s BMI is ≥30 and/or waist-to-hip ratio is >0.9 in females and >1.0 in males. Results: Out of the 300 persons, 14 males (8.5%) got migraines while migraine was found in 37 females (27.4%), irrespective of their weight. Out of the 300 persons, the prevalence of migraine among obese individuals was 21.4% (n=33) and while in non-obese individuals was 12.3% (n=18). There was a statistically significant difference between the groups (p-value=0.045). The overall prevalence of migraine was 16.9% of the persons interviewed. Conclusion: The results showed that migraine is more prevalent among obese persons than non-obese persons and the difference was statistically significant. Keywords: Migraine, obesity, BMI, headache

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Pediatric triage variations among nurses, pediatric and emergency residents using the Canadian triage and acuity scale

BMC Emergency Medicine ◽

10.1186/s12873-021-00541-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Saleh Alshaibi ◽

Tala AlBassri ◽

Suliman AlQeuflie ◽

Winnie Philip ◽

Nesrin Alharthy

Keyword(s):

Clinical Signs ◽

Sampling Technique ◽

Weighted Kappa ◽

P Value ◽

Kappa Statistics ◽

Cross Sectional ◽

Pediatric Residents ◽

Significant Difference ◽

The Right ◽

Triage Level

Abstract Background Emergency care continues to be a challenge, since patients’ arrival is unscheduled and could occur at the same time which may fill the Emergency Department with non-urgent patients. Triaging is an integral part of every busy ED. The Canadian Triage and Acuity Scale (CTAS) is considered an accurate tool to be used outside Canada. This study aims to identify the chosen triage level and compare the variation between registered nurses, pediatric and adult emergency residents by using CTAS cases. Method This study was conducted at King Abdulaziz Medical City,Saudi Arabia. A cross-sectional self-administered questionnaire was used, and which contains 15 case scenarios with different triage levels. All cases were adopted from a Canadian triage course after receiving permission. Each case provides the patient’s symptoms, clinical signs and mode of arrival to the ED. The participants were instructed to assign a triage level using the following scale. A non-random sampling technique was used for this study. The rates of agreement between residents were calculated using kappa statistics (weighted-kappa) (95%CI). Result A total of 151 participants completed the study questionnaire which include 15 case scenarios. 73 were nurses and 78 were residents. The results showed 51.3, 56.6, and 59.9% mis-triaged the cases among the nurses, emergency residents, and pediatric residents respectively. Triage scores were compared using the Kruskal Wallis test and were statistically significant with a p value of 0.006. The mean ranks for nurses, emergency residents and pediatric residents were 86.41, 73.6 and 59.96, respectively. The Kruskal Wallis Post-Hoc test was performed to see which groups were statistically significant, and it was found that there was a significant difference between nurses and pediatrics residents (P value = 0.005). Moreover, there were no significant differences found between nurses and ER residents (P value> 0.05). Conclusion The triaging system was found to be a very important tool to prioritize patients based on their complaints. The results showed that nurses had the greatest experience in implementing patients on the right triage level. On the other hand, ER and pediatric residents need to develop more knowledge about CTAS and become exposed more to the triaging system during their training.

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