Pediatric Electrical Bicycle Road Accidents

2022 ◽  
Author(s):  
Ethel Avrahamov-Kraft ◽  
Alon Yulevich ◽  
Yechiel Sweed
Keyword(s):  
Injury Severity ◽  
Medical Center ◽  
Head Injuries ◽  
Pediatric Intensive Care ◽  
Loss Of Consciousness ◽  
Road Accidents ◽  
Surgical Interventions ◽  
Lower Extremity Injuries ◽  
Accident Data ◽  
Motorized Vehicles

Abstract Introduction The use of electric bicycles (EBs) among children younger than 18 years of age is rapidly increasing worldwide and becoming a substantial contributor to road accidents. We analyzed patterns and severity of pediatric bicycle-related injuries, comparing children riding EBs and classic bicycles (CBs). Materials and Methods This was a retrospective study (January 2016–December 2018) of patients arriving at our medical center due to a bicycle accident. Data were collected from medical records and included demographics, injury characteristics, treatment, and outcomes. Results Of 561 children, 197 (35%) were EB riders and 364 (65%) were CB riders. Injury severity score (ISS) of EB cyclists was significantly higher than CB cyclists (mean 4.08 ± 4.67 and 3.16 ± 2.84, respectively, p = 0.012). The rate of accidents involving motorized vehicles was higher in the EB versus CB group (25.9 vs. 11.3%, p < 0.001). Head injuries were the most common type of injury in both groups; incidence was higher in CB than in EB cyclists. However, loss of consciousness was more common in the EB group (18.3 and 12.1%, respectively, p = 0.057). Lower extremity injuries were more common in EBs versus CBs (55.8 and 37.6%, respectively, p < 0.001). Orthopaedic surgical interventions were significantly higher in the EB group (49.2 vs. 33.2%, p < 0.001), and length of stay in hospital and admission to pediatric intensive care unit were more common in EB compared with CB, although not significantly. Conclusion Injury severity of EB patients was significantly higher than that of CB patients. Accidents involving motorized vehicles were more common in the EB group. Head injury associated with loss of consciousness was significantly higher in EB patients.

scholarly journals Management of Traumatic Brain Injury: A review Update

2017 ◽  
Vol 6 (2) ◽  
pp. 87-89
Author(s):  
ATM Ashadullah ◽  
Monirul Islam ◽  
Fazley Elahi Milad ◽  
Abdullah Alamgir ◽  
Md Shafiul Alam
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injuries ◽  
Skull Fracture ◽  
Traumatic Injury ◽  
Loss Of Consciousness ◽  
Extradural Haematoma ◽  
Inner Surface ◽  
Injury Patient ◽  
Extradural Haematomas

Traumatic Brain Injury leads to serious consequences. Approximately half of all deaths is related to traumatic injury and the main cause of head trauma. Extradural haematomas (EDH) develops in all major head injuries. A head injury patient who is only temporary loss of consciousness and is left asleep may sometimes be found dead in the bed next morning due to extradural haematoma. Extradural haematoma which lies in between the inner surface of skull and stripes of dural membrane, are nearly always caused by, and located near a skull fracture. The collection takes several forms in terms of size, location, speed of development and effects they exert on patient. Immediate management is necessary to decrease the bad consequences. In this review the management of traumatic brain injury is highlighted.J Shaheed Suhrawardy Med Coll, 2014; 6(2):87-89

Musculoskeletal Injuries Among Victims of the Battagram, Pakistan Earthquake in October 2005

2012 ◽  
Vol 27 (5) ◽  
pp. 489-491 ◽  
Author(s):  
Ghulam Mustafa Kaim Khani ◽  
Akhtar Baig ◽  
Mujahid Humail ◽  
Manzoor Memon ◽  
M.A. Quarashi
Keyword(s):  
Soft Tissues ◽  
Head Injuries ◽  
Cross Sectional Study ◽  
Musculoskeletal Injuries ◽  
Publication Type ◽  
Disaster Plan ◽  
Cross Sectional ◽  
Surgical Interventions ◽  
North West ◽  
Wound Debridement

AbstractObjectiveThis study was conducted to assess the type, pattern, and severity of musculoskeletal injuries, as well as the type of simple orthopedic surgical procedures, that can be performed at the site of a disaster.MethodsThis was a cross-sectional study conducted in Battagram, located in the North West Frontier Province of Pakistan after the October 2005 earthquake. Researchers arrived in the affected area during the second week after the earthquake, and remained there for one week. During this period, patients were received from distant areas of the district. These patients were admitted to a tent hospital because the district headquarters hospital was completely damaged. Those requiring orthopedic surgical intervention or closed manipulation and plaster of paris casts were included in the study.ResultsOf 110 patients, 61 were female and 49 were male, and 140 bones were involved. In this series, 92 fractures were closed, while 48 were open. A total of 67.3% of the patients were <40 years of age. The tibia was involved in 32.1% of cases and the femur 16.4%. No cases of compartment syndrome were found. Wound debridement was performed in 35 cases. An external fixator was applied to 10 cases of open tibia fractures. Four humerus fractures and a fracture to the radius and ulna were fixed with the Rashnail method. One open femur fracture was repaired with external fixation. Pre- and post-operative antibiotics were administered in all cases. Thirty patients sustained injuries in addition to orthopedic trauma: 13 vertebral injuries, eight head injuries, six fractured ribs, three blunt injuries to the abdomen, and 10 significant soft tissues injuries without bony involvement.ConclusionsAfter the earthquake in Battagram, young persons, especially females, were prone to orthopedic injuries, mainly involving the extremities. A comprehensive disaster plan would have helped to manage these emergencies, and further experience is needed for on-site surgical interventions.Kaim KhaniGM, BaigA, HumailM, MemonM, QuarashiMA. Musculoskeletal injuries among victims of the Battagram, Pakistan earthquake in October 2005. Prehosp Disaster Med.2012;27(5):1-3.

Inappropriate Discharge Instructions for Youth Athletes Hospitalized for Concussion

PEDIATRICS ◽  
1995 ◽  
Vol 95 (2) ◽  
pp. 216-218
Author(s):  
Frank J. Genuardi ◽  
William D. King
Keyword(s):  
Head Injury ◽  
Injury Severity ◽  
Head Injuries ◽  
Closed Head Injury ◽  
Medical Society ◽  
Discharge Instructions ◽  
Youth Athletes ◽  
Closed Head Injuries ◽  
Closed Head ◽  
Grade 3

Objective. To evaluate the medical care, especially the discharge instructions regarding return to participation, received by youth athletes hospitalized for a closed head injury. Methods. We examined the records of all patients admitted over a 5-year period (1987 through 1991) to The Children's Hospital of Alabama for a sports-related closed head injury. Descriptive information was recorded and discharge instructions reviewed. Injury severity was graded according to guidelines current during the study period, as well as those outlined most recently by the Colorado Medical Society, which have been endorsed by a number of organizations including the American Academy of Pediatrics. Discharge instructions recorded for each patient were then compared with those recommended in the guidelines. Results. We identified 33 patients with sports-related closed head injuries. Grade 1 concussions (least severe) occurred in 8 patients (24.2%), grade 2 in 10 (30.3%), and grade 3 (most severe) in 15 (45.4%). Overall, discharge instructions were appropriate for only 10 patients (30.3%), including all with grade 1 concussions, but only 2 with a grade 2 (20.0%) and none with a grade 3 concussion. Conclusion. All who care for youth athletes must become familiar with the guidelines for management of concussion to provide appropriate care and counseling and to avoid a tragic outcome.

Comparison of Scoring Systems for Mortality Prediction in Pediatric Multitrauma Patients

2021 ◽  
Author(s):  
Mehmet Çelegen ◽  
Kübra Çelegen
Keyword(s):  
Injury Severity ◽  
Pediatric Trauma ◽  
Pediatric Intensive Care ◽  
Scoring Systems ◽  
International Normalized Ratio ◽  
Mortality Prediction ◽  
Risk Scores ◽  
Mortality Ratio ◽  
Risk Predictors ◽  
Trauma Score

AbstractThe aim of this study was to compare scoring systems for mortality prediction and determine the threshold values of this scoring systems in pediatric multitrauma patients. A total of 57 multitrauma patients referred to the pediatric intensive care unit from January 2020 to August 2021 were included. The pediatric trauma score (PTS), injury severity score (ISS), base deficit (B), international normalized ratio (I), Glasgow coma scale (G) (BIG) score, and pediatric risk of mortality 3 (PRISM 3) score were analyzed for all patients. Of the study group, 35% were females and 65% were males with a mean age of 72 months (interquartile range: 140). All groups' mortality ratio was 12.2%. All risk scores based on mortality prediction were statistically significant. Cutoff value for PTS was 3.5 with 96% sensitivity and 62% specificity; for the ISS, it was 20.5 with 92% sensitivity and 43% specificity; threshold of the BIG score was 17.75 with 85.7% sensitivity and 34% specificity; and 12.5 for PRISM 3 score with 87.6% sensitivity and 28% specificity. PTS, ISS, BIG score, and PRISM 3 score were accurate risk predictors for mortality in pediatric multitrauma patients. ISS was superior to PTS, PRISM 3 score, and BIG score for discrimination between survivors and nonsurvivors.

scholarly journals Risk Factors Associated with Mechanical Ventilation in Critical Bronchiolitis

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1035
Author(s):  
Rachel K. Marlow ◽  
Sydney Brouillette ◽  
Vannessa Williams ◽  
Ariann Lenihan ◽  
Nichole Nemec ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Medical Center ◽  
Invasive Mechanical Ventilation ◽  
Severity Of Illness ◽  
Pediatric Intensive Care ◽  
Respiratory Support ◽  
Non Invasive ◽  
Lengths Of Stay

The American Academy of Pediatrics (AAP) recommends supportive care for the management of bronchiolitis. However, patients admitted to the intensive care unit with severe (critical) bronchiolitis define a unique group with varying needs for both non-invasive and invasive respiratory support. Currently, no guidance exists to help clinicians discern who will progress to invasive mechanical support. Here, we sought to identify key clinical features that distinguish pediatric patients with critical bronchiolitis requiring invasive mechanical ventilation from those that did not. We conducted a retrospective cohort study at a tertiary pediatric medical center. Children ≤2 years old admitted to the pediatric intensive care unit (PICU) from January 2015 to December 2019 with acute bronchiolitis were studied. Patients were divided into non-invasive respiratory support (NRS) and invasive mechanical ventilation (IMV) groups; the IMV group was further subdivided depending on timing of intubation relative to PICU admission. Of the 573 qualifying patients, 133 (23%) required invasive mechanical ventilation. Median age and weight were lower in the IMV group, while incidence of prematurity and pre-existing neurologic or genetic conditions were higher compared to the NRS group. Multi-microbial pneumonias were diagnosed more commonly in the IMV group, in turn associated with higher severity of illness scores, longer PICU lengths of stay, and more antibiotic usage. Within the IMV group, those intubated earlier had a shorter duration of mechanical ventilation and PICU length of stay, associated with lower pathogen load and, in turn, shorter antibiotic duration. Taken together, our data reveal that critically ill patients with bronchiolitis who require mechanical ventilation possess high risk features, including younger age, history of prematurity, neurologic or genetic co-morbidities, and a propensity for multi-microbial infections.

scholarly journals Machine Learning Approaches to Traffic Accident Analysis and Hotspot Prediction

Computers ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 157
Author(s):  
Daniel Santos ◽  
José Saias ◽  
Paulo Quaresma ◽  
Vítor Beires Nogueira
Keyword(s):  
Machine Learning ◽  
Predictive Model ◽  
Road Accident ◽  
Influential Factors ◽  
Supervised Machine Learning ◽  
Machine Learning Techniques ◽  
Economic Losses ◽  
Learning Approaches ◽  
Road Accidents ◽  
Accident Data

Traffic accidents are one of the most important concerns of the world, since they result in numerous casualties, injuries, and fatalities each year, as well as significant economic losses. There are many factors that are responsible for causing road accidents. If these factors can be better understood and predicted, it might be possible to take measures to mitigate the damages and its severity. The purpose of this work is to identify these factors using accident data from 2016 to 2019 from the district of Setúbal, Portugal. This work aims at developing models that can select a set of influential factors that may be used to classify the severity of an accident, supporting an analysis on the accident data. In addition, this study also proposes a predictive model for future road accidents based on past data. Various machine learning approaches are used to create these models. Supervised machine learning methods such as decision trees (DT), random forests (RF), logistic regression (LR), and naive Bayes (NB) are used, as well as unsupervised machine learning techniques including DBSCAN and hierarchical clustering. Results show that a rule-based model using the C5.0 algorithm is capable of accurately detecting the most relevant factors describing a road accident severity. Further, the results of the predictive model suggests the RF model could be a useful tool for forecasting accident hotspots.

scholarly journals Head injuries in professional football (soccer): Results of video analysis verified by an accident insurance registry

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255695
Author(s):  
Volker Krutsch ◽  
Werner Krutsch ◽  
Jonas Härtl ◽  
Hendrik Bloch ◽  
Volker Alt ◽  
...  
Keyword(s):  
Video Analysis ◽  
Injury Severity ◽  
Bone Fractures ◽  
Methodological Issue ◽  
Head Injuries ◽  
Training Session ◽  
Accident Insurance ◽  
Professional Football ◽  
German Statutory Accident Insurance ◽  
Clinical Consequences

Background Video analysis is one of the most commonly applied methods for analysing football injuries. Purpose The objective of this study was to assess the accuracy of video analysis for recording head injuries in professional football from official matches in the four highest men’s professional football leagues in Germany. Methods In this cohort study, head injuries detected by means of video analysis of all official matches over one season (2017–18) were compared to head injuries registered with the German statutory accident insurance. Results Our video analysis yielded 359 head injuries of 287 players. The comparison of head injuries found in our video analysis to those registered with the accident insurance only yielded a match in 23.1% (n = 83), which presents a rather low verification rate. The verification rates varied between the leagues (7.0–30.8%). All injuries documented in the accident insurance registry were found in the video analysis (100%). The types of head injury most often verified by the accident insurance registry (n = 83) were contusion (43.4%), bone fractures (19.3%) and skin lacerations (18.1%). Only 66 of the 359 head injuries (18.4%) resulted in absence from at least one training session and involved a mean time loss of 18.5 days (1–87 days). Conclusion The mismatch between the number of head injuries found in the video analysis and head injuries registered with the accident insurance is an important methodological issue in scientific research. The low verification rate seems to be due to the unclear correlation between injury severity and clinical consequences of head injuries detected by means of video analysis and the failure of football clubs to register minor head injuries with the accident insurance.

scholarly journals Boarding Injuries: The Long and the Short of It

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Leslie A. Fabian ◽  
Steven M. Thygerson ◽  
Ray M. Merrill
Keyword(s):  
Brain Injuries ◽  
Injury Severity ◽  
Treatment Options ◽  
Head Injuries ◽  
Patient Treatment ◽  
Injury Patterns ◽  
Population Demographics ◽  
Icu Length Of Stay ◽  
Level Ii ◽  
Prospective Investigation

As the popularity of longboarding increases, trauma centers are treating an increased number of high severity injuries. Current literature lacks descriptions of the types of injuries experienced by longboarders, a distinct subset of the skateboarding culture. A retrospective review of longboarding and skateboarding injury cases was conducted at a level II trauma center from January 1, 2006, through December 31, 2011. Specific injuries in addition to high injury severity factors (hospital and intensive care unit (ICU) length of stay (LOS), Injury Severity Score (ISS), patient treatment options, disposition, and outcome) were calculated to compare longboarder to skateboarder injuries. A total of 824 patients met the inclusion criteria. Skull fractures, traumatic brain injuries (TBI), and intracranial hemorrhage (ICH) were significantly more common among longboard patients than skateboarders (P<0.0001). All patients with an ISS above 15 were longboarders. Hospital and ICU LOS in days was also significantly greater for longboarders compared with skateboarders (P<0.0001). Of the three patients that died, each was a longboarder and each experienced a head injury. Longboard injuries account for a higher incidence rate of severe head injuries compared to skateboard injuries. Our data show that further, prospective investigation into the longboarding population demographics and injury patterns is necessary to contribute to effective injury prevention in this population.

Long-Term Anesthetic-Dependent Hypoactivity after Repetitive Mild Traumatic Brain Injuries in Adolescent Mice

2016 ◽  
Vol 38 (3) ◽  
pp. 220-238 ◽  
Author(s):  
Bridgette D. Semple ◽  
Raha Sadjadi ◽  
Jaclyn Carlson ◽  
Yiran Chen ◽  
Duan Xu ◽  
...  
Keyword(s):  
Brain Injuries ◽  
Injury Severity ◽  
Vasogenic Edema ◽  
Head Injuries ◽  
Traumatic Brain Injuries ◽  
Return To Play ◽  
Brain Maturation ◽  
Long Term Outcomes ◽  
Mild Traumatic Brain Injuries

Recent evidence supports the hypothesis that repetitive mild traumatic brain injuries (rmTBIs) culminate in neurological impairments and chronic neurodegeneration, which have wide-ranging implications for patient management and return-to-play decisions for athletes. Adolescents show a high prevalence of sports-related head injuries and may be particularly vulnerable to rmTBIs due to ongoing brain maturation. However, it remains unclear whether rmTBIs, below the threshold for acute neuronal injury or symptomology, influence long-term outcomes. To address this issue, we first defined a very mild injury in adolescent mice (postnatal day 35) as evidenced by an increase in Iba-1- labeled microglia in white matter in the acutely injured brain, in the absence of indices of cell death, axonal injury, and vasogenic edema. Using this level of injury severity and Avertin (2,2,2-tribromoethanol) as the anesthetic, we compared mice subjected to either a single mTBI or 2 rmTBIs, each separated by 48 h. Neurobehavioral assessments were conducted at 1 week and at 1 and 3 months postimpact. Mice subjected to rmTBIs showed transient anxiety and persistent and pronounced hypoactivity compared to sham control mice, alongside normal sensorimotor, cognitive, social, and emotional function. As isoflurane is more commonly used than Avertin in animal models of TBI, we next examined long-term outcomes after rmTBIs in mice that were anesthetized with this agent. However, there was no evidence of abnormal behaviors even with the addition of a third rmTBI. To determine whether isoflurane may be neuroprotective, we compared the acute pathology after a single mTBI in mice anesthetized with either Avertin or isoflurane. Pathological findings were more pronounced in the group exposed to Avertin compared to the isoflurane group. These collective findings reveal distinct behavioral phenotypes (transient anxiety and prolonged hypoactivity) that emerge in response to rmTBIs. Our findings further suggest that selected anesthetics may confer early neuroprotection after rmTBIs, and as such mask long-term abnormal phenotypes that may otherwise emerge as a consequence of acute pathogenesis.

Abstract WP242: A Prehospital Acute Stroke Trial has Only Modest Impact on Enrollment in Concurrent, Post-arrival-recruiting Stroke Trials

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Phoebe Johnson-Black ◽  
Greg Wong ◽  
Sidney Starkman ◽  
Nerses Sanossian ◽  
Latisha Ali ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Medical Center ◽  
Academic Medical Center ◽  
Prehospital Treatment ◽  
Surgical Interventions ◽  
Therapeutic Trials ◽  
Standard Management ◽  
Academic Medical ◽  
Regulatory Practice ◽  
Stroke Trial

Introduction: Because “time is brain,” acute stroke trials are increasingly migrating to the prehospital setting. However, some study therapies are ill-suited for paramedic, prehospital delivery, including fibrinolytics, endovascular therapies, and surgical interventions. Best scientific and regulatory practice does not permit one patient to participate in two different therapeutic trials simultaneously. The potential reduction in enrollment in post-arrival trials due to earlier recruitment in a prehospital trial has not been well delineated. Methods: We analyzed all patients recruited into acute stroke trials at an academic medical center (AMC) from Jan 2005 - Dec 2012. Throughout this period, the AMC was participating in a prehospital treatment trial (NIH FAST-MAG trial), as well as diverse concurrent post-arrival acute trials. Results: During the 96 month study period, in addition to the prehospital trial, the AMC participated in 26 other acute, post-arrival stroke trials, 25 for ischemic stroke and 1 for intracerebral hemorrhage. Length of participation in each post-arrival trial varied, but at all times throughout the study period, the AMC was recruiting for at least 3 concurrent post-arrival acute trials. During this time, a total of 200 patients were enrolled in acute stroke trials, including 98 (49%) in FAST-MAG and 102 (51%) in concurrent, post-arrival acute trials. Among the patients enrolled in FAST-MAG, 67% were not eligible for any concurrent trial. Among the 33% eligible for a concurrent trial, 15% were eligible for 1, 7% for 2, 7% for 3, and 3% for 4. Of the 134 patients eligible for post-arrival trials, 102 (76%) were enrolled in post-arrival trials and 32 (24%) in FAST-MAG. Leading reasons that FAST-MAG patients were ineligible for post-arrival trials included: NIHSS too low (23.4%), intracranial hemorrhage (17.9%), deficit resolved to TIA (9.2%), IV tPA used in standard management (9.0%), NIHSS too high (7.1%), and age too high (5.2%). Conclusions: A prehospital hyperacute stroke trial with wide entry criteria reduced only modestly, by one-fourth, enrollment into concurrently active, post-arrival stroke trials. Simultaneous performance of prehospital and ED-based acute stroke trials in research networks is highly feasible.

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