Hand injuries from tools in domestic and leisure settings: relative incidence and patterns of initial management

2011 ◽  
Vol 36 (5) ◽  
pp. 408-412 ◽  
Author(s):  
S. T. B. Williams ◽  
D. Power
Keyword(s):  
Hand Injury ◽  
Hand Injuries ◽  
Initial Management ◽  
Emergency Hospital ◽  
Hospital Specialist ◽  
Specialist Referral ◽  
Power Tools ◽  
The Uk ◽  
Circular Saws ◽  
Missed Diagnoses

A search of the UK Department of Trade and Industry’s Home and Leisure Accident database found 16,003 emergency hospital attendances in 2000–2002 following accidents with tools. The hand was the site of injury in 9535 cases (60%). The tool most commonly involved was a Stanley knife, causing as many hand injuries (21%) as all power tools combined. The power tools most frequently causing hand injury were circular saws (28% of power tool injuries), hedge trimmers (21%) and electric drills (17%). Compared to injuries from manual tools, power tool hand injuries were more than twice as likely to be referred to specialists and three times more likely to be admitted to hospital. Specialist referral/admission most commonly occurred following hand injury from mowers (51% admitted/referred), routers (50%) and circular saws (48%). The rate for manual blade injuries was 14%. Missed diagnoses following manual blade injuries may stem from comparatively low rates of specialist assessment.

scholarly journals Acute hand injury splinting – the good, the bad and the ugly

2018 ◽  
Vol 100 (2) ◽  
pp. 92-96
Author(s):  
T Richards ◽  
R Clement ◽  
I Russell ◽  
D Newington
Keyword(s):  
Hand Surgery ◽  
Hand Injury ◽  
Initial Assessment ◽  
Frontline Staff ◽  
Initial Management ◽  
Junior Staff ◽  
Hand Fractures ◽  
Hand Fracture ◽  
The Uk ◽  
Annual Treatment Cost

Injuries to the hand comprise 20% of all emergency department attendances, with an estimated annual treatment cost of over £100 million in the UK. The initial assessment and management of hand injuries is usually undertaken by junior staff, many of whom have little or no training or experience in splinting hand fractures. In the Department of Orthopaedic Hand Surgery, Morriston Hospital, we regularly observe patients presenting to the specialist hand fracture clinics having had initial management that shows no appreciation for the treatment objectives or the safe positions for splinting. This article aims to provide guidance for frontline staff on the management of hand fractures, with particular emphasis on the appropriate nonoperative care to avoid any unnecessary morbidity.

scholarly journals Real-world presentation with heart failure in primary care: do patients selected to follow diagnostic and management guidelines have better outcomes?

Open Heart ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. e000935
Author(s):  
Alex Bottle ◽  
Dani Kim ◽  
Paul P Aylin ◽  
F Azeem Majeed ◽  
Martin R Cowie ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Initial Management ◽  
Risk Of Death ◽  
Specialist Referral ◽  
Partial Completion ◽  
General Practices ◽  
Using Data

ObjectiveTo describe associations between initial management of people presenting with heart failure (HF) symptoms in primary care, including compliance with the recommendations of the National Institute for Health and Care Excellence (NICE), and subsequent unplanned hospitalisation for HF and death.MethodsThis is a retrospective cohort study using data from general practices submitting records to the Clinical Practice Research Datalink. The cohort comprised patients diagnosed with HF during 2010–2013 and presenting to their general practitioners with breathlessness, fatigue or ankle swelling.Results13 897 patients were included in the study. Within the first 6 months, only 7% had completed the NICE-recommended pathway; another 18.6% had followed part of it (B-type natriuretic peptide testing and/or echocardiography, or specialist referral). Significant differences in hazards were seen in unadjusted analysis in favour of full or partial completion of the NICE-recommended pathway. Covariate adjustment attenuated the relations with death much more than those for HF admission. Compared with patients placed on the NICE pathway, treatment with HF medications had an HR of 1.16 (95% CI 1.05 to 1.28, p=0.003) for HF admission and 1.03 (95% CI 0.90 to 1.17, p= 0.674) for death. Patients who partially followed the NICE pathway had similar hazards to those who completed it. Patients on no pathway had the highest hazard for HF admission at 1.30 (95% 1.18 to 1.43, p<0.001) but similar hazard for death.ConclusionsPatients not put on at least some elements of the NICE-recommended pathway had significantly higher risk of HF admission but non-significant higher risk of death than other patients had.

scholarly journals The UK Paediatric Ocular Trauma Study 3 (POTS3): clinical features and initial management of injuries

2019 ◽  
Vol Volume 13 ◽  
pp. 1165-1172 ◽  
Author(s):  
Robert J Barry ◽  
Freda Sii ◽  
Alice Bruynseels ◽  
Joseph Abbott ◽  
Richard J Blanch ◽  
...  
Keyword(s):  
Clinical Features ◽  
Ocular Trauma ◽  
Initial Management ◽  
The Uk

Cut-Off Value for Self-Reported Abnormal Cold Sensitivity and Predictors for Abnormality and Severity in Hand Injuries

2010 ◽  
Vol 35 (5) ◽  
pp. 409-416 ◽  
Author(s):  
I.K. Carlsson ◽  
J.Å. Nilsson ◽  
L.B. Dahlin
Keyword(s):  
Symptom Severity ◽  
Injury Severity ◽  
Hand Injury ◽  
Hand Injuries ◽  
Cold Sensitivity ◽  
Cold Intolerance ◽  
Normal People ◽  
Bone Injury ◽  
Multiple Injured ◽  
Vas Scores

Our aim was to identify a cut-off value for self-reported, abnormal cold sensitivity and to identify cold sensitivity predictors after hand injuries. The Cold Intolerance Symptom Severity (CISS) questionnaire and a VAS question concerning discomfort on exposure to cold were investigated in 94 normal people and 88 patients. A CISS score>50 was defined as abnormal cold sensitivity. Multiple injured digits, an increased number of injured vessels, complete nerve injury and replantation were variables associated with high VAS scores. Factors linked to both abnormality and worse CISS or VAS scores were: the presence of bone injury; a larger number of repaired vessels; the use of vascular grafts and a high Hand Injury Severity Score (HISS). The causes of abnormality and severity suggest a multifactorial aetiology with bony, vascular and neural components. A cut-off for abnormality is useful for descriptive, comparative and assessment purposes.

Sound Quality Evaluation of Hand-Held Power Tools

2012 ◽  
Vol 98 (3) ◽  
pp. 487-504 ◽  
Author(s):  
M. Horvat ◽  
H. Domitrovi ◽  
K. Jambrošić
Keyword(s):  
Linear Regression ◽  
Regression Models ◽  
Quality Evaluation ◽  
Sound Quality ◽  
Linear Regression Models ◽  
Proper Functioning ◽  
Listening Tests ◽  
Power Tools ◽  
Single Number ◽  
Circular Saws

Sound quality evaluation in the context of product sound quality has been addressed and investigated on hand-held power tools. Out of those, power drills, hand-held circular saws and jigsaws have been chosen as the products of interest. A series of listening tests has been conducted in order to ascertain how people perceive not only the sound emitted by these devices in operation, but also certain properties of the devices themselves, such as their quality, safety of handling, robustness, proper functioning and others. The values of objective parameters describing the sounds of these devices were obtained. Well known parameters such as loudness, sharpness and roughness were used, and certain new parameters were defined. Linear regression models were made for subjective parameters describing the perception of the devices using relevant objective parameters as an attempt to model the subjective grades obtained through listening tests and to predict such grades for future products to be included in the investigation. Based on individual parameters, a single-number overall grade was defined.

The Psychological Impact of Severe Hand Injury

2008 ◽  
Vol 33 (3) ◽  
pp. 358-362 ◽  
Author(s):  
M. GROB ◽  
N. A. PAPADOPULOS ◽  
A. ZIMMERMANN ◽  
E. BIEMER ◽  
L. KOVACS
Keyword(s):  
Psychological Impact ◽  
Surgical Techniques ◽  
Treatment Strategies ◽  
Psychological Trauma ◽  
Positive Outcome ◽  
Hand Injury ◽  
Hand Injuries ◽  
Residual Functional ◽  
Constant State ◽  
Adaptation Processes

The final outcome of severe hand injuries is not solely determined by the residual functional impairment, but is also a function of non-functional criteria, including the sequelae of the accompanying psychological trauma. This paper reviews the literature with respect to the psychological impact of severe hand injuries, including the special impact of amputations, adaptation processes, adaptation stages, prognostic criteria and aesthetic issues influencing the final individual outcome, including present recommendations for promoting a positive outcome. Motivated and psychologically stable people are reported to do well irrespective of the severity of a hand injury. In patients who find it difficult to cope mentally, successful treatment strategies have been proposed. Their implementation is in a constant state of evolution and includes not only improved surgical techniques and advanced pharmacological pain management but also early psychotherapeutic input and involvement of patients in decision making for treatment.

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