Diana Cimpoesu

Digital templating in surgical treatment of trochanteric fractures

Surgical interventions in orthopaedic and trauma need careful preoperative planning. The classical method is based on transparent sheets on which the implant is drawn. In the last years, digital radiography has become the standard method of imaging in most modern medical centers, thus leading to the necessity of digital planning. We performed a retrospective analysis on 154 patients with trochanteric fractures treated by internal fixation with DHS (Dynamic Hip Screw). On 91 cases that were investigated by classic radiography, we performed preoperative planning with transparent templates and on 63 cases, digital X-rays were used and planning was performed with TraumaCad™. Estimated results were compared with postoperative results regarding dimension and placement of the implant. Results show a better accuracy of TraumaCad™ to predict the length of the hip screw and the entry point of the implant; this program is an attractive option useful in preoperative planning in fractures.

HEMS BENEFITS IN TRANSFERING SEPSIS PATIENTS – NORTH-EAST ROMANIAN EXPERIENCE.

Tudor Ovidiu Popa 1,2 , Diana Cimpoesu 1,2 , Mihaela Corlade 1,2 and Paul Nedelea 1,2 . 1. University of Medicine and Pharmacy “Gr. T.Popa” Iasi, Emergency Medicine Department. 2. County Emergency Hospital “Sf.Spiridon” Iasi – Emergency Department. ...................................................................................................................... Manuscript Info Abstract ......................... ........................................................................ Manuscript History

Effectiveness of Paracetamol, Tramadol and Fentanyl on the patients from the Emergency Department of the “Sf Spiridon” Emergency Hospital, Iasi

Pain management has become a serious concern for Romanian doctors. Pain is the most frequent reason why patients come in ED. The objective of this study was to assess pain after treating it with Paracetamol, Tramadol, Fentanyl and combinations of these drugs. Their beneficial effects and minor side effects that appear in the patients treated with opioids should confirm our trust in using them as analgesics. 22% of the patients that took part in the study received other treatments as well for their associated pathological conditions (HA, IMA, AOMI), but these did not influence the main effects of the analgesics.

Helicopter interventions for the patients with STEMI in the North-East Romania

From 2010, Romanian patients diagnosed with STEMI can benefit from the primary PCI through a national program, according to the Stent for Life ESC program. Purpose: Evaluate the importance of helicopter transport of patients with STEMI in a region with a deficit of emergency specialists and only one Interventional Cardiology Centre. Methods: Retrospective study of the interventions by helicopter for patients with STEMI in the North-East Region of Romania between March 15, 2011 and March 15, 2013. MY 8 helicopter/Eurocopter 135 was used, with intensive care medical equipment, 2 pilots, 1 doctor and 1 nurse. Results: The study includes 71 patients that needed medical intervention and transportation tohospital via helicopter. Thedecisions to send the helicopter were taken onmedical criteria – STEMI diagnostic, the transfer time to PCI and the availability of the terrestrial emergency crew. The average distance to the site, measured by land, was 162km, (34–250km). The average time of transport by air was 39.3±14.6min compared to 108.7±47.3min estimated by land (p>0.01) with an average time since the chest pain onset 6.32±4.7h. 66.2% were males, aged between 25 and 85 years old. Three patients suffered cardiopulmonary arrest during transportation, 2 were pronounced dead after receiving CPR. During transfer Aspirin and Clopidogrel was administrated in 69.01% cases, Heparin 28.16% cases, thrombolytics in 7.04% (5 patients). 4.22% of the patients needed oro-tracheal intubation and mechanical ventilation due to cardiogenic shock. In this period, the mortality rate in patients with STEMI decreased from 13.4% to 8.19% all over Romania and to 7.9% in our region. Conclusion: The helicopter is a very important means of transportation for patients living in either far or inaccessible by land areas, reducing the door-to-balloon times in patients with STEMI.