3rd Annual Congress and Medicare Expo on Trauma & Critical Care March 13-14, 2017 London, UK

Marta Rogowska is a student of Nursing from Poland. She is studying on the second year at State University of Applied Sciences in Plock. She belongs to the scientific circle of health promotion. She participates regularly in scientific conferences and is actively involved in promoting the university.

The main cause of injury in geriatric age is falls - a sudden unintended position changes due to various barriers - both physical and mental. Among people over the age of 75 falls could have serious health consequences and in the worst case can even lead to death. Other serious consequences of falls are among other fractures of the forearm, femur and spine. They can also leave stigma on the psyche of the patient which will make him to fear while doing activities and going out of the house. The role of the nurse is to improve the patient's physical and adjustment of preventive tasks to factors that may cause the fall. To evaluate the risk of falls, we can use the following tests: The Timed Get-Up and Go Test, The Dynamic Gait Index, The Step Test, Stops Walking When Talking, The Performance-Oriented Mobility Assessment, The Four Square Step Test, The One Leg Standing Test, Functional Reach Test and Test Berg. The majority of surveyed nurses working in the profession are of 21-30 years of age. Health care services to patients in the geriatric are among the most frequently performed. Falls among the elderly are common and therefore, nurses assess the risk of falls by means of special scales, among which the most common is the scale of Tinetti and not the scale of Berg. The main risk factors for falls in geriatric patients are imbalance. According to the respondents, the main environmental factor increasing the risk of falls is incorrect bed height. Respondents believe that for assessing the risk of falls, neurological examination should be performed.

Awaneesh Katiyar is a Post-graduate student in Master of Surgery. He is working as Junior Resident at Sir Sunder Lal Hospital and Trauma Centre and Super Specialty Hospital. He has special interest in Trauma Surgery and Evaluation of Trauma Patients. During his Post-graduation, he developed a trauma score for proper assessment and prognosis of trauma patients in terms of mortality and morbidity.

Majority of thoracic injuries encountered in India are secondary to blunt trauma following motor vehicle accidents. Rib fractures are the cause of major morbidity in trauma patients, leading to pain and difficult respiration with hypoventilation, cyanosis, tachypnoea and chest retractions. A prospective study was conducted at Trauma Centre and Super Specialty, BHU, Varanasi from June 2015 to June 2016. 412 cases enrolled age, sex, socioeconomic status, number of fractured ribs and associated injuries were noted. Out of 412, 331 were males and 81 were females. RTA was the most common cause of chest trauma and fall from height was the second most common cause. Common complaints following trauma were painful respiration (95%) and dyspnoea (60%). Most common complication was hemopneumothorax (34%), followed by pneumothorax (20%). The complications were common in elderly population because of non-plaint nature of ribs over children. In Northeast India, RTA is the most common cause of chest trauma. Isolated ribs fracture (<3) with any associated complications can be managed conservatively and injury associated hemothorax or pneumothorax or hemopneumothorax require chest tube drainage.

Mohamed E Abbasy is currently working as an Emergency Medicine Clinical Fellow at Hamad Medical Corporation, Qatar. He successfully completed his Injury Prevention Research and Training Program at University of Maryland, School of Medicine, Maryland, USA. He has attended R Adams Shock Trauma Center, University of Maryland, School of Medicine, Maryland in 2008. He completed his training in Emergency Medicine and successfully awarded the fellowship of Egyptian Board of Emergency Medicine in 2009. He has a good experience of working in Gulf region and worked as an Assistant Program Director of Saudi Board of Emergency Medicine in Eastern region, KSA in 2013. He successfully passed his membership examination of Royal College of Emergency Medicine UK in 2014 and European Board of Emergency Medicine in 2016. His research interest includes Critical Care, Trauma and Emergency Ultrasound.

Post traumatic seizure (PTS) activity is considered to be around 10% following acute TBI. Immediate post traumatic status epilepticus incidence however is not clear in the current literature, though it is thought to be from 1.9 to 8%. PTS is often missed and not fully recognized specially without eEEG monitoring, almost 50%, nevertheless status epilepticus is associated with a significant mortality up to 100%. Age of the patient and type of seizure among other factors are some major contributors of poor outcome. A case of 33 years previously healthy female brought to emergency department as a pedestrian hit by a speeding car while passing the street. Patient was brought vitally stable with GCS 12, the patient prior to be shifted to CT scan had a generalized tonic clonic seizure activity not responding to single dose of benzodiazepines. Subsequently, she had been intubated but the seizure activity didn’t stop despite administration of further doses of benzodiazepines and second line of treatment as loading dose of phenytoin, surprisingly seizures persisted around 90 minutes despite all intervention up to propofol induction and continuous infusion. Initial CT head scan showed no intracranial injury or fracture noted. Her laboratory investigations were within normal limits. Later patient had been extubated with GCS 14 and regained her full consciousness after few days with excellent neurological recovery. She had EEG reported as diffuse slowing with no epileptiform discharges. MRI scans routinely done, small hyper intensities noted in the right centrum semiovale suggestive of non-hemorrhagic DAI. This is a case report of post traumatic status epilepticus with 100% neurological recovery.

Farahnaz Behrozishad completed her Master’s Degree as PHC Nurse at Tehran University. She has worked for 16 years at Mirza Kuchak Khan Hospital in different units as a Staff Nurse, Nurse Educator and Supervisor. She has worked in Palliative Care Unit at Toronto East General Hospital as a part time Nurse for two years and worked for five years in dialysis unit after completing her special training and certification in Critical Care. She has completed her Post Master’s Degree as a Nurse Educator at Walden University in 2011; ICU Certification at Humber Collage, Canada in April 2014; Post Master certification in Nursing– Education at Walden University, USA in Feb, 2011; Master’s Degree in Nursing at Tehran University of Medical Science, Iran in Jan, 1996; Bachelor Degree in Nursing at Tehran University of Medical Sciences, Iran in July, 1992 and; Associate’s Degree in Nursing at Iran University of Medical Science, Iran in April, 1988.

Trauma is often the result of an overwhelming amount of stress that exceeds one's ability to cope, or integrate the emotions involved with that experience. A trauma is an intense event. This can include medical events, such as a heart attack, surgery or treatment in a hospital's intensive care unit (ICU). PTSD can happen in any age. PTSD can cause nightmares, upsetting memories, flashback, feeling numb, fear, worry, anxiety, and other symptoms. Patient and family education is an important part of nursing care. Different techniques are used for coping after trauma. These techniques are: Role playing; assertiveness training; stress management; meditation; exercise; biofeedback and yoga. The poster will present different ways of treatment for coping after trauma without any medication.

Ramak Attarinezhad is a Nurse, pursuing her MSc in Nursing. She is interested in “Search and evaluation of her knowledge in different related emphasis in nursing education”. With review of many responsive constructivists’ articles, she creates new pathways for improving healthcare quality as well as evaluation in emergency medicine practices.

Statement of the Problem: The properness of function of different parts of emergency medical services will be resulted in a quick and timely dispatch of ambulances to patients and preventing deaths as well as lack of disability in damage. The success of this set depends on various factors such as the ability of those responsible, trained personnel, equipment, co-ordination and communications systems. Today, in the city's health care system, generally the first treatment for critical patients is carried by pre-hospital emergency and the more accurate and faster care for patients by EMS, the less deaths and disabilities caused by diseases and public confidence in the system increases. Since the trauma and damages resulting from accidents are the most common cause of death among people ages fourth decade as well as known as the third leading cause of death in all ages, emergency medical services on trauma has given special emphasis. Given the major role of emergency medical services in ensuring the health of people during accidents and the need for improved basic services prompted us to study the complexities and factors involved in improving the look of a medical emergency. Methodology & Theoretical Orientation: The study was a systematic review. At first, we needed to gather studies related to our upcoming study. Therefore, a set of keywords related to research, such as medical services, hospital emergency rooms, trauma was obtained. Finally the collected essays in the period from 1990 to 2015 were studied and compared, and ultimately the final results in classified parts were shown as following. Conclusion & Significance: Since the emergency medical centers and emergency medical centers of hospitals considering their sensitive role in providing immediate medical care to patients needed therapeutic interventions at all times of the day and all days of the year are one of the necessary and inevitable pillars of public hospitals. However, according to the results of recent decades, it has recognized that in the most countries pre-hospital care as the first group encountered with critically ill patients transferred to hospital, equal to international standards. One of the most important as a catalyst for overcoming the problems caused by personnel skills and need for retraining employees has been mentioned that this in addition to affects the ability of new personnel, is also an important factor for employees with experience that can increase both their motivation and performance. However, these educations (trainings) should be oriented and based on personnel requirements and in addition to their functional skills, consider interactive manner with patients.

Emad Geddoa is a Consultant General Surgeon, completed his Graduation from Iraq in 1993 and settled in London where he trained for General Surgery. He is a Senior Lecturer at Kerbala Medical School and General and Colorectal Surgeon at Imam Hussain Medical City, Kerbala.

Statement of the Problem: Kerbala is regarded as one of the holiest cities for the Muslim nations due to the fact that the grandson of prophet Muhammed, Imam Hussain is buried there. The total area of Kerbala is about 5034 square km. It is almost in the centre of Iraq, with a total population of 1.267 million. The estimated number of annual visitors/pilgrims to Kerbala is between 58 to 62 million, and the number is rising. Arbaeen event is the greatest human gathering where 20 to 24 million pilgrims attend Kerbala over a confined peak period of 10 to 12 days, to commemorate the martyrdom of Imam Hussain which took place 1337 years ago. Offering standard casual healthcare services face a huge challenge to all those involved over a short period of time. Methodology & Theoretical Orientation: On an ordinary day Safeer Al-Hussain Hospital is staffed with 238 employees. During the Arbaeen period, this number is supported by other partners: Imamia Medics International (IMI) (95), Karbala University (medicine & nursing) (75), Iraqi delegates from other hospitals (146), international volunteers (253). The number of patients seen in 2015 during the Arbaeen period (10-12 days) at Safeer AL-Hussain were 919,682 patients. Finding: The total number of hospital staff at Safeer ALHussain during Arbaeen Gathering at Kerbala were 806 serving 919682 patients in 12 days period of time. These patients are divided as follows: Iraqi patients 477886, Arabic patients 245732, and other 532762. Number of emergency operations done at the hospital (12 days). super major 45, major 13, minor 9. Conclusion: Offering standard health care faces huge challenge to all the healthcare professionals involved; proper planning is required to perform even better.

Mohamed E Abbasy is currently working as an Emergency Medicine Clinical Fellow at Hamad Medical Corporation, Qatar. He successfully completed his Injury Prevention Research and Training Program at University of Maryland, School of Medicine, Maryland, USA. He has attended R Adams Shock Trauma Center, University of Maryland, School of Medicine, Maryland in 2008. He completed his training in Emergency Medicine and successfully awarded the fellowship of Egyptian Board of Emergency Medicine in 2009. He has a good experience of working in Gulf region and worked as an Assistant Program Director of Saudi Board of Emergency Medicine in Eastern region, KSA in 2013. He successfully passed his membership examination of Royal College of Emergency Medicine UK in 2014 and European Board of Emergency Medicine in 2016. His research interest includes Critical Care, Trauma and Emergency Ultrasound.

Background: Although emergency medicine has existed as a recognized specialty in Alexandria University in late seventies, a recent shining as a highly competitive specialty since 2003 through Egyptian Fellowship training program is granting a professional and not an academic degree. Emergency medicine is still in its development phase as a practice. Five public universities are offering postgraduate degrees in emergency medicine. These degrees when obtained by trainees, in addition to a varying number of years of experience, enable doctors to climb up the medical hierarchical ladder, which begins with a resident post till senior consultant one. Methods: We describe the development of emergency medicine as a separate specialty in Egypt highlighting the history, challenges we faced, collaborations and recommendations for future improvement of emergency medicine training in Egypt. Results: As up to date references, there are five emergency medicine educational programs in Egypt, which are primarily based upon the British model of obtaining a masters or higher degree. The largest of these, the Egyptian fellowship program, is supported by the Ministry of Health and Population (MOHP) and is the country’s most formalized and acknowledged training program. Currently, there are more than 350 specialists graduated with around 50 registered consultants. However, the majority of the qualified graduated physicians capable of leading the field of emergency medicine had left Egypt due to financial, social and economic stresses. Conclusion: Although, the fast developing field of emergency medicine, Egypt still need an urgent well-structured system supported by Ministry of Health and Population. There needs to be creation of an emergency medicine committee by Egyptian board certified emergency physicians to monitor and improve the training and exams done by universities, and holding of regional conferences to enhance emergency medicine in Egypt and the Middle East region.