scholarly journals Proposal for Preventing Motor Vehicle Accident Related to Drowsy Driving in Patients With Narcolepsy

2021 ◽  
Vol 18 (3) ◽  
pp. 137-144
Author(s):  
Jae Wook Cho ◽  
Jun-Sang Sunwoo ◽  
Soo Hwan Yim ◽  
Daeyoung Kim ◽  
Dae Lim Koo ◽  
...  
Keyword(s):  
Traffic Accidents ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Road Traffic ◽  
Muscle Tone ◽  
Research Society ◽  
Driving Safety ◽  
Drowsy Driving ◽  
Near Misses ◽  
Vehicle Accidents

Narcolepsy is a chronic sleep disorder characterized by irresistible sleep attacks, hypersomnolence, cataplexy (sudden loss of muscle tone provoked by emotion), and sleep paralysis. Individuals with narcolepsy are at a high risk of experiencing sleepiness while driving leading to road traffic accidents. To prevent such accidents, some countries have regulations for commercial and noncommercial drivers with narcolepsy. Evaluating sleepiness is essential. Therefore, several subjective reports and objective tests were used to predict the possibility of car crashes or near-misses. Brain stimulants are effective in treating narcolepsy and can reduce daytime sleepiness in these patients. However, no guideline has been established for the driving safety of patients with narcolepsy in Korea. The Korean Sleep Research Society has prepared this proposal for preventing motor vehicle accidents caused by drowsy driving in patients with narcolepsy.

scholarly journals Sleep Disorders and Risk of Motor Vehicle Accident

2021 ◽  
Vol 18 (2) ◽  
pp. 72-77
Author(s):  
Soo Hwan Yim ◽  
Jae Wook Cho ◽  
Jun-Sang Sunwoo ◽  
Daeyoung Kim ◽  
Dae Lim Koo ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Traffic Accidents ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Drowsy Driving ◽  
Vehicle Accidents ◽  
Neurocognitive Functions ◽  
Sleeping Pills ◽  
Obstructive Sleep ◽  
Sedative Drugs

Driving is a complicated process that demands coordination between a range of neurocognitive functions, including attention, visuo-perception, and appropriate judgment, as well as sensory and motor responses. Therefore, several factors may reduce the driving performance of an individual, such as sleepiness, distraction, overspeeding, alcohol consumption, and sedative drugs, all of which increase the hazard of motor vehicle accidents. Among them, drowsy driving is a major cause of traffic accidents, leading to more serious injuries as compared to other causes of major traffic accidents. Although sleep disorders have been highly associated among drowsy drivers, they are often untreated and unrecognized as a disease. In particular, obstructive sleep apnea and narcolepsy are some sleep disorders that are highly related to traffic accidents. Insomnia, which can cause inadequate sleep duration and promote sedative effects from sleeping pills, may also cause traffic accidents. These conditions are especially applicable to commercial bus or truck drivers, nocturnal workers, and shift workers, who are highly vulnerable to drowsy driving. Therefore, assertive screening and management of sleep disorders are necessary in general private drivers and relevant occupational drivers.

scholarly journals Peno-scrotal degloving injury following motor vehicle accident—a case report

2020 ◽  
Vol 2020 (10) ◽  
Author(s):  
Aabishkar Bhattarai ◽  
Niraj Thapa ◽  
Bijaya Karki ◽  
Alok Atreya
Keyword(s):  
Traffic Accidents ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Road Traffic ◽  
Sexual Assaults ◽  
Scrotal Skin ◽  
Voiding Function ◽  
Vehicle Accident ◽  
Degloving Injury ◽  
Male Genital

Abstract Male genital injuries in the form of avulsed laceration of penis and scrotum are less frequent injuries in urological practice. The cases that occur are mostly caused by road traffic accidents, animal attacks, machinery-related accidents and physical/sexual assaults. Here, we report a case of a 28-year-old male with avulsion and traumatic degloving of the penile and scrotal skin with the exposure of the cavernous and spongy penile body, bilateral testes and total amputation of scrotal skin secondary to motor vehicle accident from Nepal. The patient was managed by emergency surgical debridement and reconstruction of the avulsed penile skin and burial of testis in the medial thigh pockets with primary suturing and hemostasis of the amputated scrotal region, which healed with satisfactory esthetic results with normal voiding function and erection of penis.

The Role of Placental Locations on Fetus Mortality in Road Traffic Accidents

2012 ◽  
Author(s):  
Moustafa Moustafa ◽  
B. Serpil Acar ◽  
Memis Acar
Keyword(s):  
Traffic Accidents ◽  
Placental Abruption ◽  
Motor Vehicle ◽  
Road Traffic ◽  
Fetal Loss ◽  
Road Traffic Accidents ◽  
Vehicle Accidents ◽  
Frontal Impacts ◽  
Multi Body

The aim of this study is to investigate the possible role of placental location on the risk of placental abruption in road traffic accidents involving a pregnant driver. Placental abruption accounts for around 50–70% of fetal deaths in motor vehicle accidents. The computational pregnant occupant model, ‘Expecting’, which has a multi-body fetus and a finite element uterus model was developed at Loughborough University and is used in this investigation. The placenta is located in the upper region of the uterus near the fundus in ‘Expecting’. Four locations for the placenta; anterior, posterior, lateral left, lateral right cases are modelled and used in simulations in this study. These models are used to simulate a range of frontal impacts of severity 15 kph and 30 kph. Three cases of occupant restraint: three-point seatbelt with an airbag, three-point seatbelt only and airbag only conditions are investigated. The maximum strains developed in the uterus and utero-placental interface (UPI) have been estimated and compared for these scenarios in order to investigate placental abruption that leads to fetal loss. Placenta located at anterior position is found to be at higher risk than other positions considered.

Epidemiological profile and pattern of injuries in road traffic accidents in Moradabad: A prospective study

2017 ◽  
Vol 3 (02) ◽  
Author(s):  
MohdAmjad Bhat ◽  
Sarvjit Singh Sandhu ◽  
Pardeep Singh
Keyword(s):  
Traffic Accidents ◽  
Motor Vehicle ◽  
Road Traffic ◽  
Pattern Of Injury ◽  
Vehicle Accidents ◽  
Road Users ◽  
Lacerated Wound ◽  
Epidemiological Profile ◽  
Integrated Facility ◽  
A Prospective Study

Background: In many countries, motor vehicle accidents rank first among all fatal accidents. RTAs have got multi-factorial causation. It is a part of the price we pay for our technological progress. Regional differences exist in the pattern of injury sustained by different types of road users that can have significant implications in the development of prevention policies. The objective of the Study: To understand the profile and pattern of injuries sustained and circumstances leading to RTAs in and around Moradabad, U.P. Materials and Methods: After ethical clearance for the study, all RTA victims presenting to the Casualty of TMU Moradabad, U.P. were taken for this study. All relevant details of RTIs were recorded and data collected, entered on a predesigned proforma and then tabulated, analyzed and interpreted statistically. Results: Out of 730 patients included in this study, most common victims were pedestrians (33.01%), most common site of injury was head (86.71%), most common external injury was lacerated wound (46.75%), and intoxication was seen in 24.11%, protective/safety measures used by 10.23%. Conclusion: RTAs continue to be a speedily rising problem, causing heavy loss of manpower and resources. Road users should be properly trained by authorized centers; driving licenses should be issued after strict testing of driving skills. Trauma centers with integrated facility of surgical, orthopedic, neurosurgical, anesthetic experts with modern investigative procedures like USG, CT-Scan and facility of blood-bank is the best solution for RTA victims who are severely injured.

scholarly journals Traumatic Aortic Injury in a 3-Year-Old Child - A Case Report and Literature Review

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Aljohani M ◽  
◽  
Alanazi S ◽  
Keyword(s):  
Case Report ◽  
Significant Contribution ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Aortic Injury ◽  
Vehicle Accidents ◽  
Vehicle Accident ◽  
Pseudo Aneurysm ◽  
High Index Of Suspicion ◽  
Tomography Scan

This case report describes a case of aortic injury with pseudo-aneurysm in a 3-year-old Saudi boy following a motor vehicle accident. The diagnosis was suspected on computed tomography scan, and emergency surgery was performed. A Dacron graft was inserted to repair the injured aorta. Postoperatively, absent femoral, and distal pulses were noted, and thromboembolectomy was performed with good outcome. We believe that our study makes a significant contribution to the literature because it raises awareness of aortic injury and rupture in pediatric patients with multi-organ trauma following motor vehicle accidents. A high index of suspicion and early intervention are essential in improving outcomes.

scholarly journals Toward a New Paradigm in Graduate Medical Education in the United States: Elimination of the 24-Hour Call

2009 ◽  
Vol 1 (2) ◽  
pp. 188-194 ◽  
Author(s):  
Susan G. Mautone
Keyword(s):  
Medical Education ◽  
Patient Care ◽  
Graduate Medical Education ◽  
Motor Vehicle ◽  
Motor Vehicle Accidents ◽  
Near Misses ◽  
Scheduling System ◽  
Duty Hours ◽  
Graduate Medical ◽  
Vehicle Accidents

Abstract Background Sleep deprivation negatively affects resident performance, education, and safety. Concerns over these effects have prompted efforts to reduce resident hours. This article describes the design and implementation of a scheduling system with no continuous 24-hour calls. Aims included meeting Accreditation Council for Graduate Medical Education work hour requirements without increasing resident complement, maximizing continuity of learning and patient care, maintaining patient care quality, and acceptance by residents, faculty, and administration. Methods Various coverage options were formulated and discussed. The final schedule was the product of consensus. After re-engineering the master rotation schedule, service-specific conversion of on-call schedules was initiated in July 2003 and completed in July 2004. Annual in-training and certifying examination performance, length of stay, patient mortalities, resident motor vehicle accidents/near misses, and resident satisfaction with the new scheduling system were tracked. Results Continuous 24-hour call has been eliminated from the program since July 2004, with the longest assigned shift being 14 hours. Residents have at least 1 free weekend per month, a 10-hour break between consecutive assigned duty hours, and a mandatory 4-hour “nap” break if assigned a night shift immediately following a day shift. Program-wide, duty hours average 66 hours per week for first-year residents, 63 hours per week for second-year residents, and 60 hours per week for third-year residents. Self-reported motor vehicle accidents and/or near misses of accidents significantly decreased (P < .001) and resident satisfaction increased (P  =  .42). The change was accomplished at no additional cost to the institution and with no adverse patient care or educational outcomes. Conclusions Pediatric residency training with restriction to 14 consecutive duty hours is effective and well accepted by stakeholders. Five years later, the re-engineered schedule has become the new “normal” for our program.

scholarly journals 0404 Jewish-Arab Disparities in Sleep Behaviors and Differential Ethnic Impact on Daytime Functioning, Driving Safety, and Health in Israel

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A154-A155
Author(s):  
E Rosenberg ◽  
M L Perlis ◽  
S Parthasarathy ◽  
G Jean-Louis ◽  
S Chakravorty ◽  
...  
Keyword(s):  
Sleep Disturbance ◽  
Sleep Duration ◽  
Functional Impairment ◽  
Motor Vehicle ◽  
Health And Safety ◽  
Population Based ◽  
Driving Safety ◽  
Drowsy Driving ◽  
The Impact ◽  
Sleep Difficulties

Abstract Introduction In Israel, those with Arabic as compared to Jewish ethnicity, exhibit poorer health and motor vehicle safety behaviors. Their ethnic differences in sleep duration and quality may modulate their vulnerabilities to these behaviors. Methods 7,230 Israeli individuals (N=5,880 Jewish and N=1350 Arabic) responded to the 2017 Israeli Bureau of Statistics population-based survey of households. Variables were self-reported. Outcomes included sleepiness, sleep medications, functional impairment, drowsy driving, overall health, 1-year health change, and obesity. Predictors included categorical sleep duration (<=5, 6, 7, 8 [reference], or >=9 hours) and sleep disturbance in the past month (none [reference], mild [1/week], moderate [2-3/week], or severe [>3/week]). Covariates included age, sex, and financial status. Ethnicity (Jewish/Arabic) was treated as a predictor of sleep and behavioral outcomes. Results When compared to normal (8-hour) sleepers, Jewish as compared to Arabic individuals were more likely to to sleep <=5h (RRR=3.99, p<0.0005), 6h (RRR=4.65, p<0.0005), and 7h (RRR=3.34, p<0.0005), and were more likely to report severe sleep difficulties (RRR=1.49, p<0.0005) and sleepiness (oOR=1.52, p< 0.0005). Yet, they were less likely to report functional impairment (oOR=0.65, p<0.0005), drowsy driving (OR=0.58, p<0.0005), worse health (oOR=0.51, p<0005), worsening health (oOR=0.70, p<0.0005), or obesity (OR=0.64, p<0.0005). Significant ethnicity by sleep duration interactions (p<0.05) characterized sleepiness, sleep medications, functional impairment, health, and health change. Moreover, significant ethnicity by sleep disturbance interactions (p<0.05) characterized the same outcomes, in addition to drowsy driving. Overall, the impact of sleep duration and sleep difficulties was generally greater among Arabs for all variables. Conclusion Despite Jewish individuals endorsing relatively shorter sleep and more severe sleep difficulties, Arabs seem to be more vulnerable to the health and functional outcomes. This finding may explain some of the discrepancies in the health and safety outcomes between these ethnic groups. Support Dr. Grandner is supported by R01MD011600

scholarly journals Relationship Between Traffic Volume and Accident Frequency at Intersections

2020 ◽  
Vol 17 (4) ◽  
pp. 1393
Author(s):  
Angus Eugene Retallack ◽  
Bertram Ostendorf
Keyword(s):  
Traffic Accidents ◽  
Negative Binomial ◽  
Motor Vehicle ◽  
Traffic Volume ◽  
Accident Risk ◽  
Vehicle Accidents ◽  
Accident Frequency ◽  
Traffic Volumes ◽  
Congestion Index ◽  
Binomial Models

Driven by the high social costs and emotional trauma that result from traffic accidents around the world, research into understanding the factors that influence accident occurrence is critical. There is a lack of consensus about how the management of congestion may affect traffic accidents. This paper aims to improve our understanding of this relationship by analysing accidents at 120 intersections in Adelaide, Australia. Data comprised of 1629 motor vehicle accidents with traffic volumes from a dataset of more than five million hourly measurements. The effect of rainfall was also examined. Results showed an approximately linear relationship between traffic volume and accident frequency at lower traffic volumes. In the highest traffic volumes, poisson and negative binomial models showed a significant quadratic explanatory term as accident frequency increases at a higher rate. This implies that focusing management efforts on avoiding these conditions would be most effective in reducing accident frequency. The relative risk of rainfall on accident frequency decreases with increasing congestion index. Accident risk is five times greater during rain at low congestion levels, successively decreasing to no elevated risk at the highest congestion level. No significant effect of congestion index on accident severity was detected.

scholarly journals Traumatic Brain Injury Related Hospitalization and Mortality in California

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Clint Lagbas ◽  
Shahrzad Bazargan-Hejazi ◽  
Magda Shaheen ◽  
Dulcie Kermah ◽  
Deyu Pan
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Age Groups ◽  
Motor Vehicle Accidents ◽  
Elderly Male ◽  
Cross Sectional ◽  
Discharge Data ◽  
Vehicle Accidents

Objective. The aim of this study is to describe the traumatic brain injury (TBI) population and causes and identify factors associated with TBI hospitalizations and mortality in California.Methods. This is a cross-sectional study of 61,188 patients with TBI from the California Hospital Discharge Data 2001 to 2009. We used descriptive, bivariate, and multivariate analyses in SAS version 9.3.Results. TBI-related hospitalizations decreased by 14% and mortality increased by 19% from 2001 to 2009. The highest percentages of TBI hospitalizations were due to other causes (38.4%), falls (31.2%), being of age≥75years old (37.2%), being a males (58.9%), and being of Medicare patients (44%). TBIs due to falls were found in those age≤4years old (53.5%),≥75years old (44.0%), and females (37.2%). TBIs due to assaults were more frequent in Blacks (29.0%). TBIs due to motor vehicle accidents were more frequent in 15–19 and 20–24 age groups (48.7% and 48.6%, resp.) and among Hispanics (27.8%). Higher odds of mortality were found among motor vehicle accident category (adjusted odds ratio (AOR): 1.27, 95% CI: 1.14–1.41); males (AOR: 1.36, 95% CI: 1.27–1.46); and the≥75-year-old group (AOR: 6.4, 95% CI: 4.9–8.4).Conclusions. Our findings suggest a decrease in TBI-related hospitalizations but an increase in TBI-related mortality during the study period. The majority of TBI-related hospitalizations was due to other causes and falls and was more frequent in the older, male, and Medicare populations. The higher likelihood of TBI-related mortalities was found among elderly male≥75years old who had motor vehicle accidents. Our data can inform practitioners, prevention planners, educators, service sectors, and policy makers who aim to reduce the burden of TBI in the community. Implications for interventions are discussed.

scholarly journals Organization of First Aid in the Arkhangelsk Region

2020 ◽  
Vol 9 (2) ◽  
pp. 259-263
Author(s):  
A. V. Baranov
Keyword(s):  
Traffic Accidents ◽  
Motor Vehicle ◽  
Road Traffic ◽  
Statistical Significance ◽  
Fold Increase ◽  
First Aid ◽  
Disaster Medicine ◽  
Emergency Situations ◽  
Arkhangelsk Region ◽  
Federal Highway

Background The development and implementation of widespread training for rules, techniques and methods of providing first aid to the widest possible range of people will significantly reduce the level of disability and mortality among victims of road traffic accidents (RTAs).Aim of study To study the organization of first aid for the victims in the Arkhangelsk region.Material and methods Part 1. The journals of registration of attendance at classes with a trained contingent in the educational-methodical department of the School of Disaster Medicine of the Territorial Center for Disaster Medicine of the Arkhangelsk Region for the period from 01.01.2012 to 12.31.2018 are analyzed. Part 2. We selected 906 medical records of patients (003/u) affected by an accident on the federal highway M-8 “Kholmogory” and treated in hospitals of Arkhangelsk region, admitted acutely in period from 01.01.2012 till 31.12.2018. The study was conducted according to the criteria of retrospective continuous documentary observation. As a criterion of statistical significance, the probability of a random error of less than 5% (p<0.05) was applied using the correction for multiple comparisons (Bonferroni correction).Conclusion 1. The educational activities of the TCDH of the Arkhangelsk Region over a seven-year period are characterized by a significant increase in the total number of trained cadets (p<0.001); 2-fold increase in the number of trained motor vehicle drivers (p<0.001) and employees of Ministry of Emergency Situations and Russian Interior Ministry (p<0.001). 2. The first aid to injured in an accident on the federal highway M-8 Kholmogory in the Arkhangelsk Region was provided in 65 cases (7.2%); in almost 90% of cases, first aid was recorded in the Arkhangelsk and Severodvinsk medical districts of the Arkhangelsk region (p<0.001).

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