ABSTRACT
One of the most common and important therapeutic tools used by physicians is prescription. The use of digital systems in the health field has many benefits and significant impacts on the health system. One of these systems is digital prescription. In this article, First, we will review the existing infrastructure and work done in this area, and then with a new perspective on health issues, we will provide a new infrastructure.Instead of introduction and use of a product or a system or statistical work, we aim to reviewe fundamental issues in the field of health system and present a strategic plan in the field of medicine from the perspective of experts of medical informatics and IT specialists. In fact, we will present a strategic plan and will provide infrastructure in the health field. The infrastructure needed to create a digital system will be provided in order to increase productivity in various aspects of the health system; also, the interactions between different parts of this infrastructure will be discussed. The advantages of this project will be reviewed from the perspective of various elements involved in the health system; these include patients, doctors, health system managers, pharmacies, pharmaceutical distribution companies, insurance office and other organizations, such as the environmental organizations, tax office, etc. and benefits of each one will be reviewed
ABSTRACT
Objective: To explore the pros and cons of early versus delayed intervention when dealing with severe blunt liver injury with significant hemoperitoneum and hemodynamic instability
Methods: This retrospective cross-sectional study was performed at the Nemazi hospital, Shiraz, Southern Iran, level I trauma Center affiliated with Shiraz University of Medical Sciences. The study population comprised of all patients who were operated with the impression of blunt abdominal trauma and confirmed diagnosis of liver trauma during an 8-year period. All data were extracted from patients' hospital medical records during the study period. The patients' outcome was compared between those who underwent perihepatic packing or primary surgical repair
Results: Medical records of 76 patients with blunt abdominal liver trauma who underwent surgical intervention were evaluated. Perihepatic packing was performed more in patients who have been transferred to operation room due to unstable hemodynamics [p<0.001] as well as in patients with more than 1000 milliliters of hemoperitoneum based on pre-operative imaging studies [e.g. CT/US] [p=0.002]
Conclusion: We recommend that trauma surgeons should approach perihepatic packing earlier in patients who have been developed at least two of these three criteria; unstable hemodynamics, more than 1000 milliliters hemoperitoneum and more than 1600 milliliters of intra-operative estimated blood loss. We believe that considering these criteria will help trauma surgeons to diagnose and treat high risk patients in time so significant hemorrhage [e.g. caused by dilatational coagulopathy, hypothermia and acidosis, etc.] can ultimately be prevented and more lives can be saved