Reducing mortality in near-hanging patients with a novel early management protocol
| Autor: | Mimi Vallabhai, Andrew C. Meltzer, Hamza Ijaz, Jeffrey Smith, Narendra Nath Jena, Yan Ma, Katherine Douglass, Muralitharan Tharmarajah, Chen Chen, Maxine LeSaux |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Mean arterial pressure Adolescent medicine.medical_treatment Suicide Attempted Targeted temperature management Body Temperature 03 medical and health sciences Asphyxia Young Adult 0302 clinical medicine Clinical Protocols Heart rate Intubation Intratracheal Medicine Intubation Humans Arterial Pressure 030212 general & internal medicine Hospital Mortality Prospective Studies Prospective cohort study Emergency Treatment Oxygen saturation (medicine) business.industry Glasgow Coma Scale 030208 emergency & critical care medicine General Medicine Emergency department Emergency medicine Emergency Medicine Female Nervous System Diseases business |
| Zdroj: | The American journal of emergency medicine. 36(11) |
| ISSN: | 1532-8171 |
| Popis: | Hanging is one of the most common causes of suicide world-wide, more prevalent in developing countries. There are no established protocols for early management of near-hanging patients who present to the emergency department (ED). The use of early intubation, strict blood pressure control and targeted temperature management has shown promise in small studies.To detect changes in mortality and neurological deficits in near-hanging patients before and after implementation of a novel early management protocol in a tertiary care hospital in India.Prospective cohort study conducted at a tertiary-care hospital in Tamil Nadu, India from August 2014-July 2016. For first year of study (pre-implementation), near-hanging patients were treated without a structured protocol. For second year of study (post-implementation), near-hanging patients were treated per a protocol including early intubation, strict blood pressure control and targeted temperature management. Primary outcomes included: (1) in-hospital mortality and (2) hospital discharge without neurological deficit.65 patients were included (27 in the pre-implementation phase and 38 in the post-implementation phase.) At presentation, there was no difference between the two groups in mean heart rate, mean arterial pressure, mean oxygen saturation, Glasgow coma score, or mean respiratory rate. Protocol implementation decreased mortality (10/27 (37%) versus 2/38 (5%), P 0.05) and increased the number of patients discharged without neurological deficit (10/27 (37%) versus 35/38 (92%), P 0.05).This novel early management protocol reduced mortality and increased the number discharged without neurological deficit in near-hanging patients in a single tertiary care center in India. |
| Databáze: | OpenAIRE |
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