Samad Shams-Vahdati1, Changiz Gholipour2, Mehran Jalilzadeh-Binazar3, Payman Moharamzadeh4, Rana Sorkhabi5, Respina Jalilian6. 1. Road Traffic Injury Research Center, Department of Emergency Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. 2. Road Traffic Injury Research Center, Department of Surgery, Tabriz University of Medical Sciences, Tabriz, Iran. 3. Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address: mehran.jalilzadeh@gmail.com. 4. Imam Reza Hospital, Department of Emergency Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. 5. Nikokari Hospital, Department of Ophthalmology, Tabriz University of Medical Sciences, Tabriz, Iran. 6. Tabriz University of Medical Sciences, Tabriz, Iran.
Abstract
INTRODUCTION: Multiple trauma patients frequently suffer eye injuries, especially those patients with head traumas. We evaluated the accuracy of physical findings to determine the priorities of emergency ophthalmologic intervention in these patients. PATIENTS AND METHODS: This study included all multiple trauma patients with ophthalmic trauma who had a GCS of 15 when they arrived at the emergency department during the period of March, 2008-March, 2009. First, we evaluated the patients according to the criteria of the study. Then, an ophthalmologist evaluated them. RESULT: From March 2008-March 2009, 306 multiple trauma patients with ocular trauma came to our ED. The sensitivity and accuracy of emergency physicians in diagnosing the priority of ophthalmologic treatment were comparable to an ophthalmologist (measure of agreement in kappa=0.967). DISCUSSION: The ability of an emergency physician or general surgeon to determine the actual need of early ophthalmologist intervention can improve decision making and saving both time and money. Our study suggests that it is possible to determine according to clinical findings the need of the patient to have ophthalmologic intervention without referring the patient to ophthalmologist examination. CONCLUSION: Defining specific criteria of ophthalmologic examinations can clarify the necessity of emergency ophthalmologic examination and intervention.
INTRODUCTION:Multiple traumapatients frequently suffer eye injuries, especially those patients with head traumas. We evaluated the accuracy of physical findings to determine the priorities of emergency ophthalmologic intervention in these patients. PATIENTS AND METHODS: This study included all multiple traumapatients with ophthalmic trauma who had a GCS of 15 when they arrived at the emergency department during the period of March, 2008-March, 2009. First, we evaluated the patients according to the criteria of the study. Then, an ophthalmologist evaluated them. RESULT: From March 2008-March 2009, 306 multiple traumapatients with ocular trauma came to our ED. The sensitivity and accuracy of emergency physicians in diagnosing the priority of ophthalmologic treatment were comparable to an ophthalmologist (measure of agreement in kappa=0.967). DISCUSSION: The ability of an emergency physician or general surgeon to determine the actual need of early ophthalmologist intervention can improve decision making and saving both time and money. Our study suggests that it is possible to determine according to clinical findings the need of the patient to have ophthalmologic intervention without referring the patient to ophthalmologist examination. CONCLUSION: Defining specific criteria of ophthalmologic examinations can clarify the necessity of emergency ophthalmologic examination and intervention.
Authors: Philip N Gorleku; Emmanuel K Edzie; Klenam Dzefi-Tettey; Jacob Setorglo; Albert D Piersson; Stephen Ocansey; Enyam K A Morny; Celso D G Armah Journal: Heliyon Date: 2020-06-20