Ten-year reduction in thoracic injury-related mortality among Israel Defense Forces soldiers

2021 ◽  
pp. e001986
Author(s):  
Jacob Chen ◽  
A M Tsur ◽  
R Nadler ◽  
E BeitNer ◽  
A Sorkin ◽  
...  
Keyword(s):  
Trauma Registry ◽  
Thoracic Injury ◽  
Thoracic Injuries ◽  
National Trauma ◽  
Life Saving ◽  
Before And After ◽  
Israel Defense Forces ◽  
Related Mortality ◽  
Overall Mortality ◽  
Rapid Evacuation

IntroductionThis study aims to describe injury patterns, prehospital interventions and mortality rates of combat-related thoracic injuries during the past decade among Israel Defense Forces (IDF) soldiers before and after implementation of the 2012 IDF-Military Corps ‘My Brother’s Keeper’ plan which included the publication of clinical practice guidelines (CPGs) for thoracic injuries, emphasis on adequate torso protection, introduction of modern life-saving procedures and encouragement of rapid evacuation.MethodsThe IDF prehospital trauma registry was reviewed to identify all patients who sustained thoracic injuries from January 2006 to December 2017. IDF soldiers who were injured, died of wounds or killed in action (KIA) were included. These were cross-referenced with the Israel National Trauma Registry. The periods before and after the plan were compared.Results458 (12.3%) of 3733 IDF soldiers wounded on the battlefield sustained combat-related thoracic injuries. The overall mortality was 44.3% before the CPG and 17.3% after (p<0.001). Most were KIA: 97% (95 of 98) died by 30 June 2012, and 83% (20 of 24) after (p<0.001). Casualties treated with needle thoracostomy before and after CPG were 6.3% and 18.3%, respectively (p=0.002). More tube thoracostomies were performed after June 2012 (16.1% vs 5.4%, p=0.001). Evacuation was faster after June 2012 (119.4 min vs 560.8 min, p<0.001), but the rates of casualties evacuated within 60 min were similar (21.1% vs 25%, p=0.617).ConclusionsAmong military casualties with thoracic injuries, the rate of life-saving interventions increased, evacuation time decreased and mortality dropped following the implementation of My Brother’s Keeper plan.

scholarly journals COVID-19 Changed the Injury Patterns of Hospitalized Patients

2021 ◽  
Vol 36 (3) ◽  
pp. 251-259
Author(s):  
Michael Rozenfeld ◽  
Kobi Peleg ◽  
Adi Givon ◽  
Miklosh Bala ◽  
Gad Shaked ◽  
...  
Keyword(s):  
Trauma Registry ◽  
Road Traffic ◽  
Disease Outbreaks ◽  
Injury Patterns ◽  
Severe Injuries ◽  
Study Objective ◽  
Major Health ◽  
National Trauma ◽  
Number Of Patients ◽  
Injured Patients

AbstractIntroduction:Injury patterns are closely related to changes in behavior. Pandemics and measures undertaken against them may cause changes in behavior; therefore, changes in injury patterns during the coronavirus disease 2019 (COVID-19) outbreak can be expected when compared to the parallel period in previous years.Study Objective:The aim of this study was to compare injury-related hospitalization patterns during the overall national lockdown period with parallel periods of previous years.Methods:A retrospective study was completed of all patients hospitalized from March 15 through April 30, for years 2016-2020. Data were obtained from 21 hospitals included in the national trauma registry during the study years. Clinical, demographic, and circumstantial parameters were compared amongst the years of the study.Results:The overall volume of injured patients significantly decreased during the lockdown period of the COVID-19 outbreak, with the greatest decrease registered for road traffic collisions (RTCs). Patients’ sex and ethnic compositions did not change, but a smaller proportion of children were hospitalized during the outbreak. Many more injuries were sustained at home during the outbreak, with proportions of injuries in all other localities significantly decreased. Injuries sustained during the COVID-19 outbreak were more severe, specifically due to an increase in severe injuries in RTCs and falls. The proportion of intensive care unit (ICU) hospitalizations did not change, however more surgeries were performed; patients stayed less days in hospital.Conclusions:The lockdown period of the COVID-19 outbreak led to a significant decrease in number of patients hospitalized due to trauma as compared to parallel periods of previous years. Nevertheless, trauma remains a major health care concern even during periods of high-impact disease outbreaks, in particular due to increased proportion of severe injuries and surgeries.

scholarly journals 282 NESTED: National Trauma Registry Study of Deprivation

2015 ◽  
Vol 66 (4) ◽  
pp. S101-S102 ◽  
Author(s):  
A. Corfield ◽  
J. Pell ◽  
D. MacKay
Keyword(s):  
Trauma Registry ◽  
Registry Study ◽  
National Trauma

scholarly journals Prescribing of opioid analgesics and related mortality before and after the introduction of long-acting oxycodone

2009 ◽  
Vol 181 (12) ◽  
pp. 891-896 ◽  
Author(s):  
I. A. Dhalla ◽  
M. M. Mamdani ◽  
M. L.A. Sivilotti ◽  
A. Kopp ◽  
O. Qureshi ◽  
...  
Keyword(s):  
Opioid Analgesics ◽  
Before And After ◽  
Long Acting ◽  
Related Mortality

High Success Rate of Prehospital and En Route Cricothyroidotomy Performed in the Israel Defense Forces: 20 Years of Experience

2021 ◽  
pp. 1-6
Author(s):  
Eran Beit Ner ◽  
Avishai M. Tsur ◽  
Roy Nadler ◽  
Elon Glassberg ◽  
Avi Benov ◽  
...  
Keyword(s):  
Success Rate ◽  
Body Part ◽  
Salvage Procedure ◽  
Care Providers ◽  
Success Rates ◽  
Exact Test ◽  
Medical Teams ◽  
Israel Defense Forces ◽  
Different Levels ◽  
Overall Mortality

Abstract Introduction: Securing the airway is a crucial stage of trauma care. Cricothyroidotomy (CRIC) is often addressed as a salvage procedure in complicated cases or following a failed endotracheal intubation (ETI). Nevertheless, it is a very important skill in prehospital settings, such as on the battlefield. Hypothesis/Problem: This study aimed to review the Israel Defense Forces (IDF) experience with CRIC over the past two decades. Methods: The IDF Trauma Registry (IDF-TR) holds data on all trauma casualties (civilian and military) cared for by military medical teams since 1997. Data of all casualties treated by IDF from 1998 through 2018 were extracted and analyzed to identify all patients who underwent CRIC procedures. Variables describing the incident scenario, patient’s characteristics, injury pattern, treatment, and outcome were extracted. The success rate of the procedure was described, and selected variables were further analyzed and compared using the Fisher’s-exact test to identify their effect on the success and failure rates. Odds Ratio (OR) was further calculated for the effect of different body part involvement on success and for the mortality after failed ETI. Results: One hundred fifty-three casualties on which a CRIC attempt was made were identified from the IDF-TR records. The overall success rate of CRIC was reported at 88%. In patients who underwent one or two attempts, the success rate was 86%. No difference was found across providers (physician versus paramedic). The CRIC success rates for casualties with and without head trauma were 80% and 92%, respectively (P = .06). Overall mortality was 33%. Conclusions: This study shows that CRIC is of merit in airway management as it has shown to have consistently high success rates throughout different levels of training, injuries, and previous attempts with ETI. Care providers should be encouraged to retain and develop this skill as part of their tool box.

scholarly journals Endoscopic follow-up of cyanoacrylate obliteration of gastric varices

2009 ◽  
Vol 46 (1) ◽  
pp. 81-84 ◽  
Author(s):  
Fernanda Prata Martins ◽  
Erika Pereira de Macedo ◽  
Gustavo Andrade de Paulo ◽  
Frank Shigueo Nakao ◽  
José Celso Ardengh ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Portal Hypertension ◽  
Gastric Varices ◽  
Study Endpoint ◽  
Mild Abdominal Pain ◽  
Threatening Condition ◽  
Life Threatening ◽  
Related Mortality ◽  
Overall Mortality

Bleeding from gastric varices is a life-threatening condition. We report our experience with cyanoacrylate injection. Twenty three patients with portal hypertension and gastric varices underwent intra-variceal injection of a cyanoacrylate/lipiodol solution (1:1). Study endpoint was variceal obliteration. Mean follow-up was 25.3 months. Variceal obliteration was achieved in 87% of patients. Recurrence occurred in one patient (4.3%) and rebleeding in another case (4.3%). Mild abdominal pain was described in 13% of patients. Overall mortality was 21.7% and rebleeding related mortality rate was 4.3%. Our results confirm that cyanoacrylate injection is effective and safe to eradicate gastric varices.

scholarly journals SoftPSN: Software-Defined Resource Slicing for Low-Latency Reliable Public Safety Networks

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Anteneh A. Gebremariam ◽  
Muhammad Usman ◽  
Riccardo Bassoli ◽  
Fabrizio Granelli
Keyword(s):  
Public Safety ◽  
First Responders ◽  
Base Station ◽  
Low Latency ◽  
Radio Resource ◽  
Life Saving ◽  
Before And After ◽  
Simulation Results ◽  
Emergency Scenarios ◽  
Safety Applications

Achieving the low-latency constraints of public safety applications during disaster could be life-saving. In the context of public safety scenarios, in this paper, we propose an efficient radio resource slicing algorithm that enables first responders to deliver their life-saving activities effectively. We used the tool of stochastic geometry to model the base station distribution before and after a disaster. In addition, under this umbrella, we also proposed an example of public safety scenario, ultrareliable low-latency file sharing, via in-band device-to-device (D2D) communication. The example scenario is implemented in NS-3. The simulation results show that radio resource slicing and prioritization of first responders resources can ensure ultrareliable low-latency communication (URLLC) in emergency scenarios.

Brief Report: A Case of Tramadol Overdose: Extracorporeal Life Support and Hemoperfusion as Life-Saving Treatment

2020 ◽  
Vol 49 (4) ◽  
pp. 509-512 ◽  
Author(s):  
Fiorenza Ferrari ◽  
Alessandro Carletti ◽  
Nicola Peroni ◽  
Silvia Mongodi ◽  
Pasquale Esposito ◽  
...  
Keyword(s):  
Medical Service ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Multiorgan Failure ◽  
Rebound Effect ◽  
Metabolic Encephalopathy ◽  
Life Saving ◽  
Before And After ◽  
Organ Failures ◽  
Severe Shock

We describe the case of a 49-year-old woman with a Tramadol intoxication associated with multiorgan failure. Veno-arterial femoro-femoral extracorporeal life support (VA-ECLS) and hemoperfusion (HP) were used as rescue treatments. The emergency medical service found a woman at home unconscious. Once in the hospital, she was intubated and catecholamines support was immediately started for a severe shock. Brain CT was normal, whereas EEG revealed a metabolic encephalopathy pattern. Toxic levels of Tramadol and Quetiapine were detected. VA-ECLS was implanted due to persistent multiorgan failure, and HP with a charcoal cartridge was set to increase the Tramadol clearance. To quantify the charcoal cartridge’s removal efficiency of Tramadol, Tramadol concentration was measured before and after the cartridge and before and after the treatment in the patient’s blood. The charcoal cartridge showed good extraction ratio during the treatment and no significant rebound effect. VA-ECLS and HP allowed the patient to be weaned from vasoconstrictors and the resolution of the organ failures. These treatments might be lifesaving in the Tramadol intoxication.

External Ventricular Drainage in the Management of Posterior Fossa Tumors in Children and Adolescents

Neurosurgery ◽  
1982 ◽  
Vol 10 (1) ◽  
pp. 13-15 ◽  
Author(s):  
I. Papo ◽  
G. Caruselli ◽  
A. Luongo
Keyword(s):  
Children And Adolescents ◽  
Posterior Fossa ◽  
External Ventricular Drainage ◽  
Ventricular Drainage ◽  
Total Removal ◽  
Posterior Fossa Tumors ◽  
Postoperative Course ◽  
Csf Shunting ◽  
Before And After ◽  
Overall Mortality

Abstract External ventricular drainage (EVD) was used before and after posterior fossa operations in 62 children and adolescents. In all cases, the removal of the tumor (midline in 47 and lateral in 15) was attempted: total removal was achieved in 41. The overall mortality was 6.5% (4 patients). Only 25% of the survivors needed permanent cerebrospinal fluid (CSF) shunting. EVD seems, therefore, to be effective in controlling preoperative intracranial hypertension and in securing a smooth postoperative course. Preoperative CSF shunting seems to be necessary or advisable only in particular circum- stances.

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