scholarly journals MP13: Injuries presenting to the ED following jumps from bridges into water: a multi-agency retrospective case series

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S47-S47
Author(s):  
D. Stephanian ◽  
D. Shearer ◽  
N. Bandara ◽  
J. Brubacher
Keyword(s):  
Injury Severity ◽  
Cold Water ◽  
Mild Hypothermia ◽  
Water Immersion ◽  
Case Series ◽  
Incidence Rates ◽  
Coast Guard ◽  
Injury Incidence ◽  
Injury Patterns ◽  
Retrospective Case

Introduction: Suicidal jumps from bridges into water are a unique blunt trauma mechanism. Impact into water produces substantial variation in injuries as compared to falls onto hard surfaces. Outcomes can be further complicated by submersion injuries. We identified cases through a multi-agency review in order to analyze injury patterns seen in EDs. Methods: Cases in British Columbia's Lower Mainland of jumps from bridges >12m into water between 2006 and 2017 were identified by retrospective review of Coast Guard and Police records. Records pertaining to identified incidents were located in ambulance and then hospital records. This multi-agency approach was necessary to generate a comprehensive case series, as case identification was not possible at the hospital level. Patient hospital charts were abstracted and injury incidence rates were analyzed. Results: Records were available for 41 of 52 patients. The population was 63% (26/41) male, median age 37 (IQR 29-48). Thirty-two cases were admitted to hospital, seven were deceased in the ED, one was discharged, and disposition is unknown for one. Most patients (85%) presented to Level One trauma centers. Bridge heights ranged from 15m to 70m; the mean fall height was 40.1m. Pulmonary injuries were nearly universal, including pneumothorax (51%), haemothorax (22%), and pulmonary infiltrate (34%). The primary cardiovascular concern was cardiac arrhythmia (51%). A quarter of cases had intraabdominal lacerations or ruptures (27%). Vertebral fractures at all levels were frequent (59%), although there was only one case each of cord transection and contusion. Neurological injuries were rare; 59% of patients presented to the ED with GCS ≥14 and the incidence of intracranial bleeding was low (7%). Rib fractures were commonly reported (37%) along with other fractures (32%). Body temperature was reported in 24 cases with 3 reports of moderate and 6 reports of mild hypothermia. Conclusion: This case series is the first to characterize injury patterns of jumps from bridges into water in Canada. Patterns are similar to reports in the literature from other countries. However, we found lower injury severity, and higher incidences of spinal fractures and cardiac arrhythmias. The low injury severity reflects the survivorship bias inherent to the sample: data was only obtained from patients who survived to be assessed the ED. These results suggest that patients with this mechanism of injury should be treated for both suspected trauma and cold-water immersion injuries.

scholarly journals Injury patterns and circumstances associated with electric scooter collisions: a scoping review

2021 ◽  
pp. injuryprev-2020-044085
Author(s):  
Manish Toofany ◽  
Sasha Mohsenian ◽  
Leona K Shum ◽  
Herbert Chan ◽  
Jeffrey R Brubacher
Keyword(s):  
Current Literature ◽  
Scoping Review ◽  
Injury Severity ◽  
Grey Literature ◽  
Case Series ◽  
Associated Injuries ◽  
Injury Patterns ◽  
Retrospective Case ◽  
Clinical Variables ◽  
Electric Scooter

BackgroundElectric scooters are personal mobility devices that have risen in popularity worldwide since 2017. Emerging reports suggest that both riders and other road users, such as pedestrians and cyclists, have been injured in electric scooter-associated incidents. We undertook a scoping review of the current literature to evaluate the injury patterns and circumstances of electric scooter-associated injuries.MethodsA scoping review of literature published from 2010 to 2020 was undertaken following accepted guidelines. Relevant articles were identified in Medline, Embase, SafetyLit and Transport Research International Documentation using terms related to electric scooters, injuries and incident circumstances. Supplemental searches were conducted to identify relevant grey literature (non-peer-reviewed reports).ResultsTwenty-eight peer-reviewed studies and nine grey literature records were included in the review. The current literature surrounding electric scooter-associated injuries mainly comprises retrospective case series reporting clinical variables. Factors relating to injury circumstances are inconsistently reported. Findings suggest that the head, upper extremities and lower extremities are particularly vulnerable in electric scooter falls or collisions, while injuries to the chest and abdomen are less common. Injury severity was inconsistently reported, but most reported injuries were minor. Low rates of helmet use among electric scooter users were noted in several studies.ConclusionElectric scooters leave riders vulnerable to traumatic injuries of varying severity. Future work should prospectively collect standardised data that include information on the context of the injury event and key clinical variables. Research on interventions to prevent electric scooter injuries is also needed to address this growing area of concern.

scholarly journals Safety and efficacy of cold‐water immersion in the treatment of older patients with heat stroke: a case series

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Chikao Ito ◽  
Isao Takahashi ◽  
Miyuki Kasuya ◽  
Kyoji Oe ◽  
Masahito Uchino ◽  
...  
Keyword(s):  
Older Patients ◽  
Cold Water ◽  
Water Immersion ◽  
Heat Stroke ◽  
Case Series ◽  
Cold Water Immersion ◽  
Safety And Efficacy

Mild hypothermia affects the morphology and impairs glutamine-induced anabolic response in human primary myotubes

2019 ◽  
Vol 317 (1) ◽  
pp. C101-C110 ◽  
Author(s):  
Robert Rantala ◽  
Thomas Chaillou
Keyword(s):  
Skeletal Muscle ◽  
Protein Synthesis ◽  
Ribosome Biogenesis ◽  
Cold Water ◽  
Mild Hypothermia ◽  
Water Immersion ◽  
Strenuous Exercise ◽  
Muscle Adaptation ◽  
Hypertrophic Response ◽  
Human Myotubes

The specific impact of reduced temperature on skeletal muscle adaptation has been poorly investigated. Cold water immersion, one situation leading to decreased skeletal muscle temperature, is commonly proposed to reduce the perception of fatigue and muscle soreness after strenuous exercise. In contrast, it may impair long-term benefits of resistance exercise training on muscle strength and hypertrophy. To date, the physiological factors responsible for this blunted muscle adaptation remain unclear. Here, we used a cell culture model of human primary myotubes to specifically investigate the intrinsic behavior of muscle cells during mild hypothermia (MH). Newly formed myotubes were exposed to either 37°C or 32°C to evaluate the effect of MH on myotube size and morphology, protein synthesis, and anabolic signaling. We also compared the glutamine (GLUT)-induced hypertrophic response between myotubes incubated at 32°C or 37°C. We showed that 48 h exposure to MH altered the cellular morphology (greater myotube area, shorter myosegments, myotubes with irregular shape) and impaired GLUT-induced myotube hypertrophy. Moreover, MH specifically reduced protein synthesis at 8 h. This result may be explained by an altered regulation of ribosome biogenesis, as evidenced by a lower expression of 45S pre-ribosomal RNA and MYC protein, and a lower total RNA concentration. Furthermore, MH blunted GLUT-induced increase in protein synthesis at 8 h, a finding consistent with an impaired activation of the mechanistic target of rapamycin pathway. In conclusion, this study demonstrates that MH impairs the morphology of human myotubes and alters the hypertrophic response to GLUT.

Influence of skeletal muscle glycogen on passive rewarming after hypothermia

1988 ◽  
Vol 65 (2) ◽  
pp. 805-810 ◽  
Author(s):  
P. D. Neufer ◽  
A. J. Young ◽  
M. N. Sawka ◽  
S. R. Muza
Keyword(s):  
Body Fat ◽  
Muscle Glycogen ◽  
Cold Water ◽  
Mild Hypothermia ◽  
Water Immersion ◽  
Cold Water Immersion ◽  
Moderate Hypothermia ◽  
Group A ◽  
Passive Rewarming ◽  
Group B

To examine the influence of muscle glycogen on the thermal responses to passive rewarming subsequent to mild hypothermia, eight subjects completed two cold-water immersions (18 degrees C), followed by 75 min of passive rewarming (24 degrees C air, resting in blanket). The experiments followed several days of different exercise-diet regimens eliciting either low (LMG; 141.0 +/- 10.5 mmol.kg.dry wt-1) or normal (NMG; 526.2 +/- 44.2 mmol.kg.dry wt-1) prewarming muscle glycogen levels. Cold-water immersion was performed for 180 min or to a rectal temperature (Tre) of 35.5 degrees C. In four subjects (group A, body fat = 20 +/- 1%), postimmersion Tre was similar to preimmersion Tre for both trials (36.73 +/- 0.18 vs. 37.26 +/- 0.18 degrees C, respectively). Passive rewarming in group A resulted in an increase in Tre of only 0.13 +/- 0.08 degrees C. Conversely, initial rewarming Tre for the other four subjects (group B, body fat = 12 +/- 1%) averaged 35.50 +/- 0.05 degrees C for both trials. Rewarming increased Tre similarly in group B during both LMG (0.76 +/- 0.25 degrees C) and NMG (0.89 +/- 0.13 degrees C). Afterdrop responses, evident only in those individuals whose body core cooled during immersion (group B), were not different between LMG and NMG. These data support the contention that Tre responses during passive rewarming are related to body insulation. Furthermore these results indicate that low muscle glycogen levels do not impair rewarming time nor alter after-drop responses during passive rewarming after mild-to-moderate hypothermia.

Injury patterns differ with age in male youth football: a four-season prospective study of 1111 time-loss injuries in an elite national academy

2020 ◽  
pp. bjsports-2020-103430
Author(s):  
Eirik Halvorsen Wik ◽  
Lorenzo Lolli ◽  
Karim Chamari ◽  
Olivier Materne ◽  
Valter Di Salvo ◽  
...  
Keyword(s):  
Injury Severity ◽  
Age Groups ◽  
Older Age ◽  
Injury Incidence ◽  
Age Group ◽  
Muscle Injuries ◽  
Injury Patterns ◽  
Time Loss ◽  
Male Youth ◽  
Youth Football

ObjectivesTo describe age group patterns for injury incidence, severity and burden in elite male youth football.MethodsProspective cohort study capturing data on individual exposure and time-loss injuries from training and matches over four seasons (2016/2017 through 2019/2020) at a national football academy (U13–U18; age range: 11–18 years). Injury incidence was calculated as the number of injuries per 1000 hours, injury severity as the median number of days lost and injury burden as the number of days lost per 1000 hours.ResultsWe included 301 players (591 player-seasons) and recorded 1111 time-loss injuries. Overall incidence was 12.0 per 1000 hours (95% CI 11.3 to 12.7) and burden was 255 days lost per 1000 hours (252 to 259). The mean incidence for overall injuries was higher in the older age groups (7.8 to 18.6 injuries per 1000 hours), while the greatest burden was observed in the U16 age group (425 days; 415 to 435). In older age groups, incidence and burden were higher for muscle injuries and lower for physis injuries. Incidence of joint sprains and bone stress injuries was greatest for players in the U16, U17 and U18 age groups, with the largest burden observed for U16 players. No clear age group trend was observed for fractures.ConclusionInjury patterns differed with age; tailoring prevention programmes may be possible.

scholarly journals Epidemiology of injuries in Olympic-style karate competitions: systematic review and meta-analysis

2020 ◽  
Vol 54 (16) ◽  
pp. 976-983
Author(s):  
Reidar P Lystad ◽  
Dusana Augustovičová ◽  
Gail Harris ◽  
Kirran Beskin ◽  
Rafael Arriaza
Keyword(s):  
Systematic Review ◽  
Injury Severity ◽  
Meta Analysis ◽  
Incidence Rates ◽  
Body Region ◽  
Injury Incidence ◽  
Eligibility Criteria ◽  
Random Effects Models ◽  
Significant Difference ◽  
Karate Athletes

ObjectiveTo report the epidemiology of injuries in Olympic-style karate competitions.DesignSystematic review and meta-analysis. Pooled estimates of injury incidence rates per 1000 athlete-exposures (IIRAE) and per 1000 min of exposure (IIRME) were obtained by fitting random-effects models.Data sourcesMEDLINE, Embase, AMED, SPORTDiscus and AusportMed databases were searched from inception to 21 August 2019.Eligibility criteriaProspective cohort studies published in peer-reviewed journals and reporting injury data (ie, incidence, severity, location, type, mechanism or risk factors) among athletes participating in Olympic-style karate competition.ResultsTwenty-eight studies were included. The estimated IIRAE and IIRME were 88.3 (95%CI 66.6 to 117.2) and 39.2 (95%CI 30.6 to 50.2), respectively. The most commonly injured body region was the head and neck (median: 57.9%; range: 33.3% to 96.8%), while contusion (median: 68.3%; range: 54.9% to 95.1%) and laceration (median: 18.6%; range: 0.0% to 29.3%) were the most frequently reported types of injury. Despite inconsistency in classifying injury severity, included studies reported that most injuries were in the least severe category. There was no significant difference in IIRME between male and female karate athletes (rate ratio 1.09; 95%CI 0.88 to 1.36).ConclusionKarate athletes sustain, on average, 1 injury every 11 exposures (bouts) or approximately 25 min of competition. The large majority of these injuries were minor or mild in severity.

scholarly journals Increasing Onshore Oil Production

2019 ◽  
Vol 11 (2) ◽  
pp. 34-37
Author(s):  
Dakota M. Urban ◽  
Jeanette G. Ward ◽  
Stephen D. Helmer ◽  
Alan D. Cook ◽  
James M. Haan
Keyword(s):  
Injury Severity ◽  
Training Programs ◽  
Oil Production ◽  
Oil Field ◽  
Injury Incidence ◽  
Inclusion Criteria ◽  
Injury Patterns ◽  
American College Of Surgeons ◽  
Level 1 ◽  
Few Data

Introduction. Few data currently exist which are focused on typeand severity of onshore oil extraction-related injuries. The purposeof this study was to evaluate injury patterns among onshore oil fieldoperations. Methods. A retrospective review was conducted of all traumapatients aged 18 and older with an onshore oil field-related injuryadmitted to an American College of Surgeons-verified level 1 traumacenter between January 1, 2003 and June 30, 2012. Data collectedincluded demographics, injury severity and details, hospital outcomes,and disposition. Results. A total of 66 patients met inclusion criteria. All patientswere male, of which the majority were Caucasian (81.8%, n = 54)with an average age of 36.5 ± 11.8 years, injury severity score of 9.4 ±8.9, and Glasgow Coma Scale score of 13.8 ± 3.4. Extremity injurieswere the most common (43.9%, n = 29), and most were the resultof being struck by an object (40.9%, n = 27). Approximately onethirdof patients (34.8%, n = 23) were admitted to the intensive careunit. Nine patients (13.6%) required mechanical ventilation while27 (40.9%) underwent operative treatment. The average hospitallength of stay was 5.8 ± 16.6 days, and most patients (78.8%, n = 52)were discharged home. Four patients suffered permanent disabilities,and there were two deaths. Conclusions. Increased domestic onshore oil production inevitablywill result in higher numbers of oil field-related traumas. By focusingon employees who are at the greatest risk for injuries and by targetingthe main causes of injuries, training programs can lead to a decreasein injury incidence. Kans J Med 2018;11(2):34-37.

Shiftwork and Industrial Injuries at a Chemical Plant in South-East Texas

1988 ◽  
Vol 32 (10) ◽  
pp. 603-607
Author(s):  
R.D. Novak ◽  
M.H. Smolensky
Keyword(s):  
Injury Severity ◽  
Night Shift ◽  
Incidence Rates ◽  
Similar Distribution ◽  
Injury Incidence ◽  
Chi Square ◽  
Rotation Direction ◽  
Chemical Manufacturing ◽  
Southeast Texas ◽  
Industrial Injuries

A historical retrospective study of 242 shiftworker (SW) and 224 non-shiftworker (NSW) injuries at a chemical manufacturing plant in southeast Texas was performed. The shiftworker schedule comprised an 8-hour, 7-day backward rotation program, while the NSW schedule consisted of a normal 40-hour work week. Injury records were matched against payroll/attendance records to enhance the probability of isolating possible effects of the shiftwork rotation schedule on the rates, distribution and severity of injuries. For SW injuries, analysis by chi-square comparing day worked into shift with shift rota indicated that the occurrence of an injury, the day worked into each shift and the rota were associated. For the period studied, SW's had more confirmed injuries during the first 4 days of day and night shift than during the evening shift. Female SWs had a significantly higher reported injury incidence rate than did male SWs while maintaining a similar distribution of injury severity ratings. Among NSWs, injury incidence rates were not significantly different between males and females. The number of injuries were not found to vary significantly by clock hour during each shift but did decrease on the average as the shift worked occurred later in the day. It was believed that the rotation direction and reduced number of hours off during evening-day and day-night shift changes may have contributed to the differences in the distribution of injuries for shiftworkers.

scholarly journals Head Impact Situations in Professional Football (Soccer)

2021 ◽  
Vol 5 (02) ◽  
pp. E37-E44
Author(s):  
Florian Beaudouin ◽  
Daniel Demmerle ◽  
Christoph Fuhr ◽  
Tobias Tröß ◽  
Tim Meyer
Keyword(s):  
Head Injury ◽  
Brain Injuries ◽  
Injury Severity ◽  
Head Injuries ◽  
Severe Trauma ◽  
Incidence Rates ◽  
Head Impact ◽  
Video Observation ◽  
Injury Incidence ◽  
Video Recordings

AbstractTo assess head impact incidents (HIIs) and to distinguish diagnosed head injuries from other incidents, a video observation analysis of match HIIs was conducted in the German Bundesliga (2017/18 season). Video recordings of each match were screened to identify the respective events. Head injury data were identified by a prospective injury registry. HII and head injury incidence rates (IR) were calculated with 95% CIs. The total number of HIIs was 1,362 corresponding to an IR of 134.9/1000 match hours (95% CI 127.9–142.2). In 123 HII (IR 12.2, 95% CI 10.2–14.5) the contact was classified as severe. Head contact with the opponent was the most frequent cause (85%). The most frequent mechanism was in 44% (combined) the arm and elbow-to-head, followed by head-to-head and hand-to-head contacts (each 13%). In 58%, the HIIs occurred during header duels. Twenty-nine head injuries were recorded (IR 2.9, 95% CI 2.0–4.1). Concussions/traumatic brain injuries accounted for 48%, head/facial fractures 24%, head/facial contusions 21%, and lacerations/abrasions 7%. The number of HIIs not classified as concussions/more severe trauma was high. Identification of HIIs and head injury severity should be improved during on-field assessment as many head injuries might go unrecognised based on the large number of HIIs.

Patient Involvement in Treatment Decision Making Can Help or Hinder Placebo Analgesia

2014 ◽  
Vol 222 (3) ◽  
pp. 165-170 ◽  
Author(s):  
Andrew L. Geers ◽  
Jason P. Rose ◽  
Stephanie L. Fowler ◽  
Jill A. Brown
Keyword(s):  
Patient Involvement ◽  
Cold Water ◽  
Prior Experience ◽  
Water Immersion ◽  
Treatment Decision ◽  
Cold Water Immersion ◽  
Not Given ◽  
Placebo Analgesia ◽  
Treatment Decision Making ◽  
Immersion Experience

Experiments have found that choosing between placebo analgesics can reduce pain more than being assigned a placebo analgesic. Because earlier research has shown prior experience moderates choice effects in other contexts, we tested whether prior experience with a pain stimulus moderates this placebo-choice association. Before a cold water pain task, participants were either told that an inert cream would reduce their pain or they were not told this information. Additionally, participants chose between one of two inert creams for the task or they were not given choice. Importantly, we also measured prior experience with cold water immersion. Individuals with prior cold water immersion experience tended to display greater placebo analgesia when given choice, whereas participants without this experience tended to display greater placebo analgesia without choice. Prior stimulus experience appears to moderate the effect of choice on placebo analgesia.

Sign in / Sign up

Export Citation Format

Share Document