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Article ; Online: Triage procedure in early hospital management of patients in emergency centres

Šijački Ana / Ercegovac Marko / Đikić M.

Medicinski Glasnik Specijalne Bolnice za Bolesti Štitaste Žlezde i Bolesti Metabolizma "Zlatibor", Vol 22, Iss 64, Pp 7-

2017 Volume 17

Abstract: ... ...

Abstract	nema
Keywords	Medicine ; R
Language	English
Publishing date	2017-01-01T00:00:00Z
Publisher	Specijalna bolnica za bolesti štitaste žlezde i bolesti metabolizma Zlatibor
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Crisis management in mass casualty incidents in hospital settings

Petrović Nataša / Milenković Marija / Stoimirov Ivan / Milenović Miodrag / Lončar Zlatibor / Šijački Ana

Halo 194, Vol 24, Iss 3, Pp 179-

2018 Volume 188

Abstract: The term 'disaster' denotes a low-probability but high-impact event that causes a large number of individuals to become ill or injured. Hospitals are required to have an Emergency Operations Plan (EOP) which describes how a facility will respond to and ... ...

Abstract	The term 'disaster' denotes a low-probability but high-impact event that causes a large number of individuals to become ill or injured. Hospitals are required to have an Emergency Operations Plan (EOP) which describes how a facility will respond to and recover from all hazards. It is inclusive of the six critical elements: communications, resources and assets, safety and security, staff responsibilities, utilities, clinical support activities. The 'all hazards' approach allows ability to respond to a range of emergencies varying in scale, duration, and cause. The EOP addresses response procedures, capabilities and procedures when the hospital cannot be supported by the community, recovery strategies, initiating and terminating response and recovery phases, activating authority and identifies alternate sites for care, treatment and services. The initial response to an emergency begins with recognition that an incident may, or has occurred. In cases where the incident is likely to impact or disrupt routine operations, and may require coordination of efforts and response involvement among hospitals, health care coalition partners, EMS, public health, and environmental health. Key management issues involving situational status, incident characteristics and resource capabilities must be quickly determined and communicated amongst response partners in order to establish a common operating picture. The hospital plays maybe a small but crucial role in this larger picture. It is the epicenter of medical care delivered to those who are injured. Each type of threat presents different challenges to hospitals, which must able to respond to each in some capacity. Given finite resources, however, hospitals must attempt to focus their resources on the most likely and potentially serious scenarios.
Keywords	disaster ; emergency operation plan ; hospital ; communication ; responsibility ; recovery ; Medicine (General) ; R5-920
Subject code	360
Language	English
Publishing date	2018-01-01T00:00:00Z
Publisher	City Medical emergency department, Belgrade
Document type	Article ; Online
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Article ; Online: Application of ultrasound diagnostics in cardiopulmonary resuscitation

Anđelić Slađana / Pavlović Aleksandar / Trpković Slađana / Šijački Ana / Janićijević Aleksandra / Putniković Biljana

Srpski Arhiv za Celokupno Lekarstvo, Vol 146, Iss 5-6, Pp 323-

2018 Volume 329

Abstract: Ultrasound is becoming increasingly available and incorporated into emergency medicine. Focused echocardiographic evaluation in resuscitation (FEER) is a training program available to emergency doctors in order to ensure adequate application of ... ...

Abstract	Ultrasound is becoming increasingly available and incorporated into emergency medicine. Focused echocardiographic evaluation in resuscitation (FEER) is a training program available to emergency doctors in order to ensure adequate application of echocardiography in the cardiac arrest setting. The FEER protocol provides an algorithm, whereby a “quick view” can be provided in 10 seconds during minimal interruptions in chest compressions. Performing ultrasound in the cardiac arrest setting is challenging for emergency doctors. The International Liaison Committee on Resuscitation recommend the ‘quick look’ echocardiography view can be obtained during the 10-second pulse check, minimizing the disruption to cardiopulmonary resuscitation.
Keywords	cardiopulmonary resuscitation ; critical care ; advanced cardiac life support ; ultrasound ; Medicine ; R
Language	English
Publishing date	2018-01-01T00:00:00Z
Publisher	Serbian Medical Society
Document type	Article ; Online
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Article ; Online: Strengthening Emergency Care Systems to Mitigate Public Health Challenges Arising from Influxes of Individuals with Different Socio-Cultural Backgrounds to a Level One Emergency Center in South East Europe.

Twomey, Michèle / Šijački, Ana / Krummrey, Gert / Welzel, Tyson / Exadaktylos, Aristomenis K / Ercegovac, Marko

International journal of environmental research and public health

2018 Volume 15, Issue 3

Abstract: Emergency center visits are mostly unscheduled, undifferentiated, and unpredictable. A standardized triage process is an opportunity to obtain real-time data that paints a picture of the variation in acuity found in emergency centers. This is ... ...

Abstract	Emergency center visits are mostly unscheduled, undifferentiated, and unpredictable. A standardized triage process is an opportunity to obtain real-time data that paints a picture of the variation in acuity found in emergency centers. This is particularly pertinent as the influx of people seeking asylum or in transit mostly present with emergency care needs or first seek help at an emergency center. Triage not only reduces the risk of missing or losing a patient that may be deteriorating in the waiting room but also enables a time-critical response in the emergency care service provision. As part of a joint emergency care system strengthening and patient safety initiative, the Serbian Ministry of Health in collaboration with the Centre of Excellence in Emergency Medicine (CEEM) introduced a standardized triage process at the Clinical Centre of Serbia (CCS). This paper describes four crucial stages that were considered for the integration of a standardized triage process into acute care pathways.
MeSH term(s)	Culture ; Emergency Service, Hospital/standards ; Humans ; Public Health/standards ; Serbia ; Triage/standards
Language	English
Publishing date	2018-03-12
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph15030501
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Article ; Online: Zinner's score for acute mucous lesion bleeding risk assessment in critically ill surgical patient

Petrović Nataša / Lončar Zlatibor / Milenović Miodrag / Stoimirov Ivan / Milenković Marija / Jovanović Dušan / Šijački Ana / Arsenijević Vladimir

Halo 194, Vol 24, Iss 3, Pp 150-

2018 Volume 157

Abstract: Introduction Critically ill patients are at risk of GI hemorrhage from acute mucosal lesion or primarily gastric or duodenal ulcers. Increased gastric acidity and a decrease in gastric mucosal barrier is believed to be the cause. The longer the gastric ... ...

Abstract	Introduction Critically ill patients are at risk of GI hemorrhage from acute mucosal lesion or primarily gastric or duodenal ulcers. Increased gastric acidity and a decrease in gastric mucosal barrier is believed to be the cause. The longer the gastric pH remains below 4 the greater the risk of hemorrhage. Patients most at risk include critically ill (sepsis, burn, trauma including neuro-trauma) patients requiring >48 hours of mechanical ventilation, patients with a coagulopathy, prior history of GI hemorrhage, organ dysfunction (renal, hepatic, cardiac), or with hypotension/shock. Zinner et al defined an Illness Severity Index Score for patients in the Intensive Care Unit (ICU). This can help identify a patient at risk for upper gastrointestinal hemorrhage and who may benefit from interventions to reduce that risk. Overall, we know that there is a good relationship between severity of illness (as determined by, for example, Apache II scores, SIRS score) and incidence of ulceration. Moreover, the longer a patient is in ICU, the more likely they are to have a GI bleeding. As many as 20% of patients may develop clinical GI hemorrhage and if surgery is required mortality can approach 80%. The aim of our study was to evaluate the relationship between Zinner score and bleeding from SRMD in severe trauma and critically ill patients. Methodology The series included 954 patients with severe trauma and critical illnesses, 124 among them with acute bleeding stress ulcers of the stomach and duodenum seen at the Intesive care unit of Clinic for Emergency Surgery, Emergency center, Clinical center of Belgrade, during a 10-year period. Results The incidence of bleeding is low and bleeding develops usually after 7 days of Intensive care unit stay. All of patients received prophylaxis. Thirteen patients underwent operation for control of massive bleeding that was unresponsive to intensive medical therapy. All ulcers were superficial and occurred during clinically stressful circumstances. Overall operative mortality was 54%, and this rate seemed to be related to multiple factors acting together. All patients with clinical significant bleeding were in the group of high Zinner score. Conclusion Zinner score appears to be a good predictor of bleeding in patients with severe trauma and criticall illnesses in Intensive care units.
Keywords	acute mucosal lesion ; severe trauma ; critical illness ; gastrointestinal haemorrhage ; zinner score ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2018-01-01T00:00:00Z
Publisher	City Medical emergency department, Belgrade
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Altered cytokine expression in Helicobacter pylori infected patients with bleeding duodenal ulcer.

Milic, Ljiljana / Karamarkovic, Aleksandar / Popadic, Dusan / Sijacki, Ana / Grigorov, Ilijana / Milosevic, Emina / Cuk, Vladica / Pesko, Predrag

BMC research notes

2019 Volume 12, Issue 1, Page(s) 278

Abstract: Objective: Peptic ulcer disease is a condition in which an important role has infection with H. pylori. The most common complication of peptic ulcer is bleeding. The presence of H. pylori triggers local and systemic cytokine signaling which may affect ... ...

Abstract	Objective: Peptic ulcer disease is a condition in which an important role has infection with H. pylori. The most common complication of peptic ulcer is bleeding. The presence of H. pylori triggers local and systemic cytokine signaling which may affect processes such as healing, gastric or duodenal rupture, and carcinogenesis. In this study, we examined the concentrations of IL-1β, IL-6, IL-10, TNF, TGF-β and IL-17A in serum by enzyme immunoassay and their mRNA expressions in periulcer biopsies obtained from patients with bleeding peptic ulcer by means of real-time-PCR. Results: We have shown that pro-inflammatory IL-6 and TNF concentrations in serum were significantly higher in patients who were infected with H. pylori, while the concentrations of TGF-β and IL-17A were significantly lower compared to non-infected subjects. IL-17A expression in periulcer mucosa was significantly higher in patients who were infected with H. pylori, while the expression of other cytokines, there was no significant difference compared to non-infected controls. Considering higher serum concentrations in non-infected subjects and higher IL-17A expression in mucosal tissue of infected patients, our data support the studies that found IL-17A has protective role in eradication of H. pylori infection in infected patients.
MeSH term(s)	Cytokines/blood ; Cytokines/genetics ; Cytokines/metabolism ; Duodenal Ulcer/blood ; Duodenal Ulcer/complications ; Duodenal Ulcer/genetics ; Duodenal Ulcer/microbiology ; Female ; Gastric Mucosa/microbiology ; Gastric Mucosa/pathology ; Gastrointestinal Hemorrhage/blood ; Gastrointestinal Hemorrhage/complications ; Gastrointestinal Hemorrhage/genetics ; Gastrointestinal Hemorrhage/microbiology ; Gene Expression Regulation ; Helicobacter Infections/blood ; Helicobacter Infections/complications ; Helicobacter Infections/genetics ; Helicobacter Infections/microbiology ; Helicobacter pylori/physiology ; Humans ; Male ; Middle Aged ; RNA, Messenger/genetics ; RNA, Messenger/metabolism
Chemical Substances	Cytokines ; RNA, Messenger
Language	English
Publishing date	2019-05-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2413336-X
ISSN	1756-0500 ; 1756-0500
ISSN (online)	1756-0500
ISSN	1756-0500
DOI	10.1186/s13104-019-4310-4
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Article: Erythropoietin in the Evaluation of Treatment Outcomes in Patients with Polytrauma.

Arsenijević, Vladimir / Šijački, Ana / Marjanović, Ivan / Micić, Dušan / Nikolić, Vladimir / Veljković, Aleksandar / Popović, Pavle / Stanković, Sanja / Jeremić, Vasilije

Acta clinica Croatica

2018 Volume 56, Issue 4, Page(s) 581–587

Abstract: Polytrauma is a term describing patients with injuries involving multiple body regions that compromises function of the body and/or organ involved. The aim of the study was to evaluate the potential role of erythropoietin in predicting poorer outcome in ... ...

Abstract	Polytrauma is a term describing patients with injuries involving multiple body regions that compromises function of the body and/or organ involved. The aim of the study was to evaluate the potential role of erythropoietin in predicting poorer outcome in trauma patients. This prospective study included 86 patients admitted to the Emergency Center of Serbia due to polytrauma assigned according to Injury Severity Score (ISS). The patients were further evaluated using the Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores and erythropoietin levels. There was a significant difference among erythropoietin levels at admission, after 48 and 72 hours, and on day 7 of hospital stay, with significantly higher levels in patients with ISS values 49-75. Based on the results, ROC curves were used to identify cut-off levels to predict ISS score with critical clinical course. It was concluded that erythropoietin could be a good marker of injury severity. Further research has to be performed to determine the cut-off values of erythropoietin that are significant for injury severity.
MeSH term(s)	Erythropoietin/analysis ; Humans ; Injury Severity Score ; Multiple Trauma ; Prospective Studies ; Serbia ; Treatment Outcome
Chemical Substances	Erythropoietin (11096-26-7)
Language	English
Publishing date	2018-03-28
Publishing country	Croatia
Document type	Journal Article
ZDB-ID	1478635-7
ISSN	0353-9466
ISSN	0353-9466
DOI	10.20471/acc.2017.56.04.01
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Article ; Online: Research of injuries of passengers in city buses as a consequence of non-collision effects.

Zunjic, Aleksandar / Sremcevic, Vladimir / Sijacki, Vera Zeravcic / Sijacki, Ana

Work (Reading, Mass.)

2012 Volume 41 Suppl 1, Page(s) 4943–4950

Abstract: In this study, a research of injuries of passengers in city buses is presented, which are not a consequence of collision of buses with other objects. The number of injured passengers in the territory of Belgrade was registered, during three consecutive ... ...

Abstract	In this study, a research of injuries of passengers in city buses is presented, which are not a consequence of collision of buses with other objects. The number of injured passengers in the territory of Belgrade was registered, during three consecutive years. Most frequently injured body part was the head, while women over the age of 60 are the most vulnerable population of passengers. The most often reason for the appearance of injuries was the effect of acceleration. Also, it is pointed out to the importance of consideration of the problem of multiple injuries. These injuries are more complex than the individual ones, and they may indicate to the existence of greater omissions in the design of the interior of the bus. Proposals for certain system solutions, as well as some recommendations for designing are given, which can improve the safety of passengers who use the city bus as a means of transportation.
MeSH term(s)	Acceleration/adverse effects ; Cities ; Female ; Humans ; Interior Design and Furnishings ; Middle Aged ; Motor Vehicles ; Multiple Trauma/etiology ; Safety ; Serbia ; Wounds and Injuries/etiology
Language	English
Publishing date	2012
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1394194-x
ISSN	1875-9270 ; 1051-9815
ISSN (online)	1875-9270
ISSN	1051-9815
DOI	10.3233/WOR-2012-0790-4943
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Article ; Online: Bernard Organ Failure Score in estimation of most severe forms of acute pancreatitis

Glišić Tijana / Šijački Ana / Vuković Goran / Vukojević Vladimir / Subotić Aleksandar

Srpski Arhiv za Celokupno Lekarstvo, Vol 137, Iss 3-4, Pp 166-

2009 Volume 170

Abstract: Introduction. Despite intensive research, efforts and clinical investigations on pathogenesis of acute pancreatitis (AP) and system morbidity during the illness onset, mortality is still very high in the group of severe forms. A significantly high number ...

Abstract	Introduction. Despite intensive research, efforts and clinical investigations on pathogenesis of acute pancreatitis (AP) and system morbidity during the illness onset, mortality is still very high in the group of severe forms. A significantly high number of patients show moderate, self-limited forms of illness, with a minimal degree of systemic or local complications, with full recovery. However, some of them have a severe form, followed by a high percent of morbidity and mortality, and system organ failure. The distinction between mild and severe forms of AP within 24-48 hours of hospital admission is very important for the treatment of these patients. The usage of multifactorial scoring systems holds a lot of promise, reaching reliability in the disease severity estimation of approximately 70-80%. Objective. The main purpose of this prospective study was to assess the correlation of the Acute Physiology and Chronic Health Evaluation II (APACHE II) and the Bernard Organ Failure Score (BOFS) scoring systems in estimation of disease severity and outcome prediction. Methods. Sixty patients with AP participated in the study, all of them scored with the APACHE II and BOFS scores. The results were used for integration of laboratory and clinical parameters. Results. In our study, we had a highly significant correlation between the APACHE II and BOFS scores from the disease onset until the end of treatment. There was a highly significant correlation between these two scores and the serum C-reactive protein concentration level. Conclusion. The concept of the BOFS score has more advantages than the APACHE II score in the patients with severe forms of AP with organ dysfunction.
Keywords	acute pancreatitis ; Acute Physiology and Chronic Health Evaluation II Score (APACHE II Score) ; Bernard Organ Failure Score (BOFS) ; Medicine ; R
Subject code	610
Language	English
Publishing date	2009-01-01T00:00:00Z
Publisher	Serbian Medical Society
Document type	Article ; Online
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Article: [Bernard Organ Failure Score in estimation of most severe forms of acute pancreatitis].

Glisić, Tijana / Sijacki, Ana / Vuković, Vladimir / Subotić, Aleksandar

Srpski arhiv za celokupno lekarstvo

2009 Volume 137, Issue 3-4, Page(s) 166–170

Abstract: Introduction: Despite intensive research, efforts and clinical investigations on pathogenesis of acute pancreatitis (AP) and system morbidity during the illness onset, mortality is still very high in the group of severe forms. A significantly high ... ...

Abstract	Introduction: Despite intensive research, efforts and clinical investigations on pathogenesis of acute pancreatitis (AP) and system morbidity during the illness onset, mortality is still very high in the group of severe forms. A significantly high number of patients show moderate, self-limited forms of illness, with a minimal degree of systemic or local complications, with full recovery. However, some of them have a severe form, followed by a high percent of morbidity and mortality, and system organ failure. The distinction between mild and severe forms of AP within 24-48 hours of hospital admission is very important for the treatment of these patients. The usage of multifactorial scoring systems holds a lot of promise, reaching reliability in the disease severity estimation of approximately 70-80%. Objective: The main purpose of this prospective study was to assess the correlation of the Acute Physiology and Chronic Health Evaluation II (APACHE II) and the Bernard Organ Failure Score (BOFS) scoring systems in estimation of disease severity and outcome prediction. Methods: Sixty patients with AP participated in the study, all of them scored with the APACHE II and BOFS scores. The results were used for integration of laboratory and clinical parameters. Results: In our study, we had a highly significant correlation between the APACHE II and BOFS scores from the disease onset until the end of treatment.There was a highly significant correlation between these two scores and the serum C-reactive protein concentration level. Conclusion: The concept of the BOFS score has more advantages than the APACHE II score in the patients with severe forms of AP with organ dysfunction.
MeSH term(s)	APACHE ; Acute Disease ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biomarkers/blood ; C-Reactive Protein/analysis ; Humans ; Middle Aged ; Multiple Organ Failure/etiology ; Pancreatitis/blood ; Pancreatitis/classification ; Pancreatitis/complications ; Severity of Illness Index ; Young Adult
Chemical Substances	Biomarkers ; C-Reactive Protein (9007-41-4)
Language	Serbian
Publishing date	2009-04-15
Publishing country	Serbia
Document type	Comparative Study ; English Abstract ; Journal Article
ZDB-ID	128567-1
ISSN	0370-8179 ; 0354-2793 ; 0049-0210
ISSN	0370-8179 ; 0354-2793 ; 0049-0210
DOI	10.2298/sarh0904166g
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