A 10-Year Analysis of Head and Neck Injuries Involving Nonpowder Firearms

2017 ◽  
Vol 156 (5) ◽  
pp. 853-856 ◽  
Author(s):  
Kartik V. Dandu ◽  
Eric T. Carniol ◽  
Saurin Sanghvi ◽  
Soly Baredes ◽  
Jean Anderson Eloy
Keyword(s):  
Emergency Room ◽  
Head And Neck ◽  
Medical Center ◽  
Academic Medical Center ◽  
Neck Region ◽  
National Database ◽  
Neck Injuries ◽  
Emergency Room Visits ◽  
Injury Surveillance System ◽  
Cross Sectional

Objectives Firearms have an enduring and visible presence within American culture. However, the public health impact of nonpowder firearms and other “toy” guns has not been fully studied. These guns—including BB guns (ie, ball bearing), paintball guns, and pellet guns—are typically marketed to a younger audience. The objective of this study is to analyze head and neck injuries related to nonpowder firearms. Study Design Cross-sectional analysis of a national database. Setting Academic medical center. Subjects and Methods The National Electronic Injury Surveillance System was queried for head and neck injuries involving nonpowder guns, including air, BB, and pellet guns, and associated ammunition. Analysis of age, sex, incidence, injury location, and diagnosis was performed. Results From 2005 to 2014, there were 1695 cases recorded, or 55,060 estimated emergency room visits, due to injuries related to nonpowder guns and fired ammunition. The majority of patients were male (80.9%). These injuries were most common in children 6 to 12 years of age (37.9%), followed by those 13 to 18 years old (27.1%) and adults (≥19 years old; 17.8%), while preschool children (0-5 years) represented 17.2%. The most common injury diagnosis was penetrating foreign body (34.9%), followed by lacerations (24.3%) and contusions/abrasions (13.7%). Conclusion Nonpowder and other nonlethal firearm-related injuries to the head and neck region are a frequent source of emergency room visits nationally. Safety measures and public education on a mainstream level are required.

Feel the Burn! Fireworks-related Otolaryngologic Trauma

2021 ◽  
pp. 000348942110081
Author(s):  
Alexander J. Straughan ◽  
Luke J. Pasick ◽  
Vrinda Gupta ◽  
Daniel A. Benito ◽  
Joseph F. Goodman ◽  
...  
Keyword(s):  
United States ◽  
Head And Neck ◽  
Emergency Departments ◽  
Closed Head Injury ◽  
Penetrating Trauma ◽  
The United States ◽  
Neck Injuries ◽  
Chi Square ◽  
Injury Surveillance System ◽  
Cross Sectional

Objectives: Fireworks are used commonly for celebrations in the United States, but can lead to severe injury to the head and neck. We aim to assess the incidence, types, and mechanisms of head and neck injuries associated with fireworks use from 2010 to 2019. Methods: A retrospective cross-sectional study, using data from the National Electronic Injury Surveillance System, of individuals presenting to United States Emergency Departments with head and neck injuries caused by fireworks and flares from 2010 to 2019. Incidence, types, and mechanisms of injury related to fireworks use in the US population were assessed. Results: A total of 541 patients (349 [64.5%] male, and 294 [54%] under 18 years of age) presented to emergency departments with fireworks-related head and neck injuries; the estimated national total was 20 584 patients (13 279 male, 9170 white, and 11 186 under 18 years of age). The most common injury diagnoses were burns (44.7% of injuries), laceration/avulsion/penetrating trauma (21.1%), and otologic injury (15.2%), which included hearing loss, otalgia, tinnitus, unspecified acoustic trauma, and tympanic membrane perforation. The remaining 19% of injuries were a mix, including contusion, abrasion, hematoma, fracture, and closed head injury. Associations between fireworks type and injury diagnosis (chi-square P < .001), as well as fireworks type by age group (chi-square P < .001) were found. Similarly, associations were found between age groups and injury diagnoses (chi-square P < .001); these included children 5 years and younger and adults older than 30 years. Conclusions: Fireworks-related head and neck injuries are more likely to occur in young, white, and male individuals. Burns are the most common injury, while otologic injury is a significant contributor. Annual rates of fireworks-related head and neck injuries have not changed or improved significantly in the United States in the past decade, suggesting efforts to identify and prevent these injuries are insufficient.

scholarly journals Penetrating Neck Injuries Treated at a U.S. Role 3 Medical Treatment Facility in Afghanistan During Operation Resolute Support

2020 ◽  
Author(s):  
John Breeze ◽  
William G Gensheimer ◽  
Joseph J DuBose
Keyword(s):  
Medical Treatment ◽  
Emergency Room ◽  
Neck Region ◽  
Neck Injuries ◽  
Treatment Facility ◽  
Medical Treatment Facility ◽  
Trauma Registries ◽  
Neck Wound ◽  
Major Injury ◽  
High Negative Predictive Value

ABSTRACT Introduction Military trauma registries can identify broad epidemiological trends from neck wounds but cannot reliably demonstrate temporal casualty from clinical interventions or differentiate penetrating neck injuries (PNI) from those that do not breach platysma. Materials and Methods All casualties presenting with a neck wound to a Role 3 Medical Treatment Facility in Afghanistan between January 1, 2016 and September 15, 2019 were retrospectively identified using the Emergency Room database. These were matched to records from the Operating Room database, and computed tomography (CT) scans reviewed to determine damage to the neck region. Results During this period, 78 casualties presented to the Emergency Room with a neck wound. Forty-one casualties underwent surgery for a neck wound, all of whom had a CT scan. Of these, 35/41 (85%) were deep to platysma (PNI). Casualties with PNI underwent neck exploration in 71% of casualties (25/35), with 8/25 (32%) having surgical exploration at Role 2 where CT is not present. Exploration was more likely in Zones 1 and 2 (8/10, 80% and 18/22, 82%, respectively) compared to Zone 3 (2/8, 25%). Conclusion Hemodynamically unstable patients in Zones 1 and 2 generally underwent surgery before CT, confirming that the low threshold for exploration in such patients remains. Only 25% (2/8) of Zone 3 PNI were explored, with the high negative predictive value of CT angiography providing confidence that it was capable of excluding major injury in the majority of cases. No deaths from PNI that survived to treatment at Role 3 were identified, lending evidence to the current management protocols being utilized in Afghanistan.

American Academy of Otolaryngology–Head and Neck Surgery/Foundation Reg-ent Registry: Purpose, Properties, and Priorities

2021 ◽  
pp. 019459982098413
Author(s):  
Cecelia E. Schmalbach ◽  
Jean Brereton ◽  
Cathlin Bowman ◽  
James C. Denneny
Keyword(s):  
American Academy ◽  
Head And Neck ◽  
Best Practice ◽  
Medical Center ◽  
Quality Care ◽  
Academic Medical Center ◽  
Neck Surgery ◽  
Performance Measure ◽  
Head And Neck Surgery ◽  
Evidence Based

Objective (1) To describe the patient and membership cohort captured by the otolaryngology-based specialty-specific Reg-ent registry. (2) To outline the capabilities of the Reg-ent registry, including the process by which members can access evidence-based data to address knowledge gaps identified by the American Academy of Otolaryngology–Head and Neck Surgery/Foundation and ultimately define “quality” for our field of otolaryngology–head and neck surgery. Methods Data analytics was performed on Reg-ent (2015-2020) Results A total of 1629 participants from 239 practices were enrolled in Reg-ent, and 42 health care specialties were represented. Reg-ent encompassed 6,496,477 unique patients and 24,296,713 encounters/visits: the 45- to 64-year age group had the highest representation (n = 1,597,618, 28.1%); 3,867,835 (60.3%) patients identified as Caucasian; and “private” was the most common insurance (33%), followed by Blue Cross/Blue Shield (22%). Allergic rhinitis–unspecified and sensorineural hearing loss–bilateral were the top 2 diagnoses (9% each). Overall, 302 research gaps were identified from 17 clinical practice guidelines. Discussion Reg-ent benefits are vast—from monitoring one’s practice to defining otolaryngology–head and neck surgery quality, participating in advocacy, and conducting research. Reg-ent provides mechanisms for benchmarking, quality assessment, and performance measure development, with the objective of defining and guiding best practice in otolaryngology–head and neck surgery. To be successful, patient diversity must be achieved to include ethnicity and socioeconomic status. Increasing academic medical center membership will assist in achieving diversity so that the quality domain of equitable care is achieved. Implications for Practice Reg-ent provides the first ever registry that is specific to otolaryngology–head and neck surgery and compliant with HIPAA (Health Insurance Portability and Accountability Act) to collect patient outcomes and define evidence-based quality care.

The Most Dangerous Game: A Review of Head and Neck Injuries in American Football and Rugby

2022 ◽  
pp. 194338752110734
Author(s):  
Jordan Richardson ◽  
Dani Stanbouly ◽  
Harrison Moynihan ◽  
Renée M. Reynolds ◽  
Matthew J. Recker ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hospital Admission ◽  
Head And Neck ◽  
Predictor Variable ◽  
American Football ◽  
Outcome Variable ◽  
Neck Injuries ◽  
Injury Surveillance System ◽  
Admission Rates ◽  
Increased Risk

Study Design The investigators designed and implemented a 20-year cross-sectional study using the National Electronic Injury Surveillance System database. Objective The purpose of this study is to estimate and compare hospital admission (danger) rates between rugby and football of those who presented to the emergency department with head and neck injuries after playing these sports. Methods The primary predictor variable was sport played. The primary outcome variable was danger, measured by hospital admission rates. Results Over the past 20 years, there has been a trend of decreasing incidence of injuries presenting to the emergency department in both sports. There was no difference in the rate of hospital admission when comparing football and rugby (OR, 1.2; P = .1). Male gender was associated with an increased risk of admission. Other variables associated with hospital admission included white racial group, injury taking place in the fall, being either young (15–24 years old) or senior (65 years of age and over), and being injured at school or at a sport/recreational facility. Conclusions There is no difference in danger as measured by admission rates between American football and rugby. There exists, however, several variables that are associated with admission when sustaining injury to the head and neck, when playing these two sports.

Accessibility and Openness to Diabetes Management Support via Mobile Phones: A Survey of People with Type 1 Diabetes Using Advanced Diabetes Technologies (Preprint)

2022 ◽  
Author(s):  
Yu Kuei Lin ◽  
Caroline Richardson ◽  
Iulia Dobrin ◽  
Rodica Pop-Busui ◽  
Gretchen Piatt ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetes Management ◽  
Interactive Voice Response ◽  
Medical Center ◽  
Academic Medical Center ◽  
Text Messages ◽  
Management Support ◽  
Cross Sectional Survey ◽  
Cross Sectional

BACKGROUND Little is known about the feasibility of mobile health (mHealth) support among people with type 1 diabetes (T1D) using advanced diabetes technologies including continuous glucose monitors (CGMs) and hybrid closed-loop insulin pumps (HCLs). OBJECTIVE To evaluate patient access and openness to receiving mHealth diabetes support in people with T1D using CGMs/HCLs. METHODS We conducted a cross-sectional survey among T1D patients using CGMs or HCLs managed in an academic medical center. Participants reported information regarding their mobile device usage, cellular call/text message/internet connectivity, and openness to various channels of mHealth communication (smartphone applications or “apps”, text messages, and interactive voice response calls or IVR calls). Participants’ demographic characteristics and CGM data were collected from medical records. Analyses focused on differences in openness to mHealth and mHealth communication channels across groups defined by demographic variables and measures of glycemic control. RESULTS Among all participants (n=310; 64% female; mean age: 45 (SD:16)), 98% reported active cellphone use, and 80% were receptive to receiving mHealth support to improve glucose control. Among participants receptive to mHealth support, 98% were willing to share CGM glucose data for mHealth diabetes self-care assistance. Most (71%) were open to receiving messages via apps, 56% were open to text messages, and 12% were open to IVR calls. Older participants were more likely to prefer text messages (P=0.009) and IVR (P=0.03) than younger participants. CONCLUSIONS Most people with T1D who use advanced diabetes technologies have access to cell phones and are receptive to receiving mHealth support to improve diabetes control. CLINICALTRIAL Not applicable

scholarly journals Static Ankle Dorsiflexion and Hip and Pelvis Kinematics During Forward Step-Down in Patients With Hip-Related Groin Pain

2020 ◽  
pp. 1-8
Author(s):  
Stefanie N. Foster ◽  
Michael D. Harris ◽  
Mary K. Hastings ◽  
Michael J. Mueller ◽  
Gretchen B. Salsich ◽  
...  
Keyword(s):  
Pelvic Tilt ◽  
Groin Pain ◽  
Medical Center ◽  
Weight Bearing ◽  
Academic Medical Center ◽  
Ankle Dorsiflexion ◽  
Future Research ◽  
Cross Sectional ◽  
Anterior Pelvic Tilt ◽  
Step Down

Context: The authors hypothesized that in people with hip-related groin pain, less static ankle dorsiflexion could lead to compensatory hip adduction and contralateral pelvic drop during step-down. Ankle dorsiflexion may be a modifiable factor to improve ability in those with hip-related groin pain to decrease hip/pelvic motion during functional tasks and improve function. Objective: To determine whether smaller static ankle dorsiflexion angles were associated with altered ankle, hip, and pelvis kinematics during step-down in people with hip-related groin pain. Design: Cross-sectional Setting: Academic medical center. Patients: A total of 30 people with hip-related groin pain (12 males and 18 females; 28.7 [5.3] y) participated. Intervention: None. Main Outcome Measures: Weight-bearing static ankle dorsiflexion with knee flexed and knee extended were measured via digital inclinometer. Pelvis, hip, and ankle kinematics during forward step-down were measured via 3D motion capture. Static ankle dorsiflexion and kinematics were compared with bivariate correlations. Results: Smaller static ankle dorsiflexion angles were associated with smaller ankle dorsiflexion angles during the step-down for both the knee flexed and knee extended static measures. Among the total sample, smaller static ankle dorsiflexion angle with knee flexed was associated with greater anterior pelvic tilt and greater contralateral pelvic drop during the step-down. Among only those who did not require a lowered step for safety, smaller static ankle dorsiflexion angles with knee flexed and knee extended were associated with greater anterior pelvic tilt, greater contralateral pelvic drop, and greater hip flexion. Conclusions: Among those with hip-related groin pain, smaller static ankle dorsiflexion angles are associated with less ankle dorsiflexion motion and altered pelvis and hip kinematics during a step-down. Future research is needed to assess the effect of treating restricted ankle dorsiflexion on quality of motion and symptoms in patients with hip-related groin pain.

scholarly journals Times to Diagnosis, Staging, and Treatment of Head and Neck Cancer Before and During COVID-19

OTO Open ◽  
2021 ◽  
Vol 5 (4) ◽  
pp. 2473974X2110594
Author(s):  
Peter Yao ◽  
Victoria Cooley ◽  
William Kuhel ◽  
Andrew Tassler ◽  
Victoria Banuchi ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Medical Center ◽  
Academic Medical Center ◽  
Head And Neck Cancers ◽  
Newly Diagnosed ◽  
Time To Treatment ◽  
Time To Diagnosis ◽  
The Times

Objective The coronavirus disease 2019 (COVID-19) pandemic has reduced the demand for, and supply of, head and neck cancer services. This study compares the times to diagnosis, staging, and treatment of head and neck cancers before and during the COVID-19 pandemic. Study Design Retrospective cohort study. Setting Tertiary academic medical center in New York City (NYC). Methods The times to diagnosis, staging, and treatment of head and neck cancer for patients presenting to the clinics of 4 head and neck oncology surgeons with newly diagnosed head and neck cancers were compared between pre–COVID-19 and COVID-19 periods. Results Sixty-eight patients in the pre–COVID-19 period and 26 patients in the COVID-19 period presented with newly diagnosed head and neck cancer. Patients in the COVID-19 group had a significantly longer time to diagnosis than the pre–COVID-19 group after adjustment for age and cancer diagnosis ( P = .02; hazard ratio [HR], 0.54; 95% CI, 0.32-0.92). Patients in the pre–COVID-19 and COVID-19 groups had no statistically significant differences in time to staging ( P > .9; HR, 1.01; 95% CI, 0.58-1.74) or time to treatment ( P = .12; HR, 1.55; 95% CI, 0.89-2.72). Conclusion This study found that time to diagnosis for head and neck cancers was delayed during a COVID-19 period compared to a pre–COVID-19 period. However, there was no evidence of delays in time to staging and time to treatment during the COVID-19 period. Our results prompt further investigations into the factors contributing to diagnostic delays but provide reassurance that despite COVID-19, patients were receiving timely staging and treatment for head and neck cancers.

scholarly journals A Study on Knowledge Towards Brain Death among Residents in Indonesia

2020 ◽  
Vol 56 (2) ◽  
pp. 140
Author(s):  
Asra Al Fauzi ◽  
Christrijogo Sumartono Waloejo ◽  
Abdulloh Machin ◽  
Muhammad Ja'far Shodiq
Keyword(s):  
Brain Death ◽  
Medical Center ◽  
Academic Medical Center ◽  
Cross Sectional Study ◽  
Research Subjects ◽  
Cross Sectional ◽  
Academic Medical ◽  
Center Hospital ◽  
Level 3 ◽  
Level 2

This research was conducted to evaluate the knowledge and diagnosis of brain death among resident in Indonesia. This study used an observational analytic study with a cross-sectional study design using a questionnaire. The research subjects consisted of 132 level 2 (after 2 years of residency) and level 3 (after 4 years of residency) residents, the total sampling for which was taken from the departments of Neurosurgery, Anesthesiology, and Neurology at Dr. Soetomo Academic Medical Center Hospital, Surabaya, Indonesia. Data were taken from November 2018 to January 2019. A total of 132 residents of Neurosurgery, Neurology, and Anesthesiology participated in this study. From the series of studies, residents’ knowledge of the concept of brain death was in the sufficient category (41.7%), residents’ knowledge of the technical diagnosis of brain death was in the good category (40.2%), residents’ knowledge of brain death examination was in the less category (43.2%), and finally, it was found that the resident's knowledge of brain death was in a good category (35.6%). There were also significant differences in knowledge of brain death between Neurosurgery, Neurology, and Anesthesiologist Resident (P <0.001) and knowledge of brain death between level 2 and level 3 residents (P=0.032). In general, the Indonesian resident doctors’ knowledge of brain death is adequate, but knowledge of the clinical examination of brain death is still lacking. Further research must be carried out to promote knowledge of brain death in residents as well as professional doctors/specialists, so that the number of organ transplants, especially in Indonesia, will increase.

scholarly journals Lockdown 1.0 mishaps in Bangalore: an observational study on head and neck injuries

2021 ◽  
Vol 7 (7) ◽  
pp. 1100
Author(s):  
Smitha S. G. ◽  
Suhasini Hanumaiah ◽  
Arunima Sheeja
Keyword(s):  
Observational Study ◽  
Head And Neck ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Neck Region ◽  
Research Centre ◽  
Neck Injuries ◽  
Road Traffic Accidents ◽  
The Face ◽  
The Government

<p class="abstract"><strong>Background:</strong> The government of India imposed a nationwide lockdown from 24 March to 14 April 2020, to contain the highly contagious corona virus. The aim of the study was to reflect upon the psychosocial impact of lockdown 1.0 on the population in terms of assaults, self-inflicted injuries and road traffic accidents during the 21 days of lockdown.</p><p class="abstract"><strong>Methods:</strong> This was a prospective observational study done in KIMS hospital and research centre during nation-wide lockdown 1.0 i.e. from 24 March to 14 April 2020. Patients who visited emergency medicine department with history of assault, self-inflicted injuries, road traffic accidents sustaining injuries to ear, nose, neck and other regions of the face were included in the study.</p><p class="abstract"><strong>Results:</strong> A total of 32 patients who sustained injuries in the head and neck region during the 21-day lockdown period and came to our institution were included. Out of the 32 injuries, 6 injuries were to the ear, 12 to nose,5 to the neck region and 9 to other facial regions. There were 18 assault cases causing head and neck injuries,3 were self-inflicted wounds and rest were injuries due to road traffic accidents.</p><p class="abstract"><strong>Conclusions:</strong> Several problems emerged following the forced quarantine to combat COVID-19. These inexorable circumstances which are beyond normal experience, lead to stress, anxiety and a feeling of helplessness in all. There is a need to ameliorate people’s access to mental health support services geared towards providing measures for developing healthy coping mechanisms during such crisis.</p>

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