scholarly journals Increasing Onshore Oil Production

2019 ◽  
Vol 11 (2) ◽  
pp. 34-37
Author(s):  
Dakota M. Urban ◽  
Jeanette G. Ward ◽  
Stephen D. Helmer ◽  
Alan D. Cook ◽  
James M. Haan
Keyword(s):  
Injury Severity ◽  
Training Programs ◽  
Oil Production ◽  
Oil Field ◽  
Injury Incidence ◽  
Inclusion Criteria ◽  
Injury Patterns ◽  
American College Of Surgeons ◽  
Level 1 ◽  
Few Data

Introduction. Few data currently exist which are focused on typeand severity of onshore oil extraction-related injuries. The purposeof this study was to evaluate injury patterns among onshore oil fieldoperations. Methods. A retrospective review was conducted of all traumapatients aged 18 and older with an onshore oil field-related injuryadmitted to an American College of Surgeons-verified level 1 traumacenter between January 1, 2003 and June 30, 2012. Data collectedincluded demographics, injury severity and details, hospital outcomes,and disposition. Results. A total of 66 patients met inclusion criteria. All patientswere male, of which the majority were Caucasian (81.8%, n = 54)with an average age of 36.5 ± 11.8 years, injury severity score of 9.4 ±8.9, and Glasgow Coma Scale score of 13.8 ± 3.4. Extremity injurieswere the most common (43.9%, n = 29), and most were the resultof being struck by an object (40.9%, n = 27). Approximately onethirdof patients (34.8%, n = 23) were admitted to the intensive careunit. Nine patients (13.6%) required mechanical ventilation while27 (40.9%) underwent operative treatment. The average hospitallength of stay was 5.8 ± 16.6 days, and most patients (78.8%, n = 52)were discharged home. Four patients suffered permanent disabilities,and there were two deaths. Conclusions. Increased domestic onshore oil production inevitablywill result in higher numbers of oil field-related traumas. By focusingon employees who are at the greatest risk for injuries and by targetingthe main causes of injuries, training programs can lead to a decreasein injury incidence. Kans J Med 2018;11(2):34-37.

Efforts to Improve Appropriate Trauma Activation for Patients Transferred to a Level 1 Trauma Center From Outside Hospitals

2020 ◽  
Vol 86 (5) ◽  
pp. 467-475
Author(s):  
Sara Seegert ◽  
Roberta E. Redfern ◽  
Bethany Chapman ◽  
Daniel Benson
Keyword(s):  
Injury Severity ◽  
Trauma Centers ◽  
Activation Level ◽  
American College Of Surgeons ◽  
Before And After ◽  
Trauma Response ◽  
Level 1 ◽  
Transferred Patients ◽  
Trauma Activation ◽  
Level 1 Trauma Center

Trauma centers monitor under- and overtriage rates to comply with American College of Surgeons Committee on Trauma verification requirements. Efforts to maintain acceptable rates are often undertaken as part of quality assurance. The purpose of this project was to improve the institutional undertriage rate by focusing on appropriately triaging patients transferred from outside hospitals (OSHs). Trauma physicians received education and pocket cards outlining injury severity score (ISS) calculation to aid in prospectively estimating ISS for patients transferred from OSHs, and activate the trauma response expected for that score. Under- and overtriage rates before and after the intervention were compared. The postintervention period saw a significant decrease in overall overtriage rate, with simultaneous trend toward lower overall undertriage rate, attributable to the significant reduction in undertriage rate of patients transferred from OSHs. Prospectively estimating ISS to assist in determining trauma activation level shows promise in managing appropriate patient triage. However, questions arose regarding the necessity for full trauma activation for transferred patients, regardless of ISS. It may be necessary to reconsider how patients transferred from OSHs are evaluated. Full trauma activation can be a financial and resource burden, and should not be taken lightly.

scholarly journals MP13: Injuries presenting to the ED following jumps from bridges into water: a multi-agency retrospective case series

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S47-S47
Author(s):  
D. Stephanian ◽  
D. Shearer ◽  
N. Bandara ◽  
J. Brubacher
Keyword(s):  
Injury Severity ◽  
Cold Water ◽  
Mild Hypothermia ◽  
Water Immersion ◽  
Case Series ◽  
Incidence Rates ◽  
Coast Guard ◽  
Injury Incidence ◽  
Injury Patterns ◽  
Retrospective Case

Introduction: Suicidal jumps from bridges into water are a unique blunt trauma mechanism. Impact into water produces substantial variation in injuries as compared to falls onto hard surfaces. Outcomes can be further complicated by submersion injuries. We identified cases through a multi-agency review in order to analyze injury patterns seen in EDs. Methods: Cases in British Columbia's Lower Mainland of jumps from bridges >12m into water between 2006 and 2017 were identified by retrospective review of Coast Guard and Police records. Records pertaining to identified incidents were located in ambulance and then hospital records. This multi-agency approach was necessary to generate a comprehensive case series, as case identification was not possible at the hospital level. Patient hospital charts were abstracted and injury incidence rates were analyzed. Results: Records were available for 41 of 52 patients. The population was 63% (26/41) male, median age 37 (IQR 29-48). Thirty-two cases were admitted to hospital, seven were deceased in the ED, one was discharged, and disposition is unknown for one. Most patients (85%) presented to Level One trauma centers. Bridge heights ranged from 15m to 70m; the mean fall height was 40.1m. Pulmonary injuries were nearly universal, including pneumothorax (51%), haemothorax (22%), and pulmonary infiltrate (34%). The primary cardiovascular concern was cardiac arrhythmia (51%). A quarter of cases had intraabdominal lacerations or ruptures (27%). Vertebral fractures at all levels were frequent (59%), although there was only one case each of cord transection and contusion. Neurological injuries were rare; 59% of patients presented to the ED with GCS ≥14 and the incidence of intracranial bleeding was low (7%). Rib fractures were commonly reported (37%) along with other fractures (32%). Body temperature was reported in 24 cases with 3 reports of moderate and 6 reports of mild hypothermia. Conclusion: This case series is the first to characterize injury patterns of jumps from bridges into water in Canada. Patterns are similar to reports in the literature from other countries. However, we found lower injury severity, and higher incidences of spinal fractures and cardiac arrhythmias. The low injury severity reflects the survivorship bias inherent to the sample: data was only obtained from patients who survived to be assessed the ED. These results suggest that patients with this mechanism of injury should be treated for both suspected trauma and cold-water immersion injuries.

Injury patterns differ with age in male youth football: a four-season prospective study of 1111 time-loss injuries in an elite national academy

2020 ◽  
pp. bjsports-2020-103430
Author(s):  
Eirik Halvorsen Wik ◽  
Lorenzo Lolli ◽  
Karim Chamari ◽  
Olivier Materne ◽  
Valter Di Salvo ◽  
...  
Keyword(s):  
Injury Severity ◽  
Age Groups ◽  
Older Age ◽  
Injury Incidence ◽  
Age Group ◽  
Muscle Injuries ◽  
Injury Patterns ◽  
Time Loss ◽  
Male Youth ◽  
Youth Football

ObjectivesTo describe age group patterns for injury incidence, severity and burden in elite male youth football.MethodsProspective cohort study capturing data on individual exposure and time-loss injuries from training and matches over four seasons (2016/2017 through 2019/2020) at a national football academy (U13–U18; age range: 11–18 years). Injury incidence was calculated as the number of injuries per 1000 hours, injury severity as the median number of days lost and injury burden as the number of days lost per 1000 hours.ResultsWe included 301 players (591 player-seasons) and recorded 1111 time-loss injuries. Overall incidence was 12.0 per 1000 hours (95% CI 11.3 to 12.7) and burden was 255 days lost per 1000 hours (252 to 259). The mean incidence for overall injuries was higher in the older age groups (7.8 to 18.6 injuries per 1000 hours), while the greatest burden was observed in the U16 age group (425 days; 415 to 435). In older age groups, incidence and burden were higher for muscle injuries and lower for physis injuries. Incidence of joint sprains and bone stress injuries was greatest for players in the U16, U17 and U18 age groups, with the largest burden observed for U16 players. No clear age group trend was observed for fractures.ConclusionInjury patterns differed with age; tailoring prevention programmes may be possible.

Early Chemoprophylaxis in Severely Injured Trauma Patients Reduces Risk of Venous Thromboembolism

2020 ◽  
Vol 86 (9) ◽  
pp. 1185-1193
Author(s):  
Jason P. Hecht ◽  
Emily J. Han ◽  
Mary-Margaret Brandt ◽  
Wendy L. Wahl
Keyword(s):  
Venous Thromboembolism ◽  
Injury Severity ◽  
Unit Length ◽  
Trauma Patients ◽  
Severely Injured ◽  
Trauma Centers ◽  
Vte Prophylaxis ◽  
American College Of Surgeons ◽  
Level 1 ◽  
Injured Patients

Background Venous thromboembolism (VTE) remains a serious complication for trauma patients. While early VTE prophylaxis has gained traction, the timing of prophylaxis remains uncertain. We hypothesized that VTE prophylaxis within 24 hours of admission would have lower VTE rates and similar rates of adverse events in seriously injured patients. Methods Trauma patients were included from 32 American College of Surgeons verified Level 1 and 2 trauma centers over a 10-year period. Patients with injury severity score (ISS) <15, death or discharge within 48 hours of arrival, or who received no prophylaxis were excluded. Results 14 096 patients received VTE prophylaxis with an ISS of ≥15. Patients given prophylaxis at <24 hours had fewer VTE events and trended toward fewer serious in-hospital complications. Mortality and return to the operating room were similar across groups. Hospital and intensive care unit length of stay in the <24 hours prophylaxis group was significantly shorter when VTE prophylaxis was initiated earlier. Conclusions In severely injured trauma patients with ISS >15, early VTE prophylaxis within 24 hours significantly reduced the risk of VTE as compared with delayed prophylaxis. Early chemoprophylaxis was found to be efficacious in reducing the incidence of VTE; however, the safety of this practice should be evaluated by future prospective studies.

Thermomechanical Combination Injuries: A Rare But Life-Threatening Entity

2021 ◽  
Author(s):  
Matthias Muenzberg ◽  
Kathrin Kaeppler ◽  
Gabriel Hundeshagen ◽  
Theresa Kenngott ◽  
Benjamin Ziegler ◽  
...  
Keyword(s):  
Injury Severity Score ◽  
Multiple Trauma ◽  
Severity Score ◽  
Injury Severity ◽  
Highly Qualified ◽  
Inclusion Criteria ◽  
Burn Care ◽  
Life Threatening ◽  
The Mean ◽  
Level 1

Abstract Thermomechanical combination injuries (TMCIs) are feared for their demanding preclinical and clinical management and bear the risk of high mortality compared to the single injury of a severe burn or multiple trauma. There remains a significant lack of standardized algorithms for diagnostics and therapy of this rare entity. The objective of the present study was to profile TMCI aiming at standardized procedures. In this study, TMCIs were extracted from our burn database of a level 1 burn and trauma center. From 2004 to 2017, all patients with TMCI were retrospectively analyzed. Further inclusion criteria were multiple trauma accompanied by burn with ≥10% TBSA. Patient and injury characteristics including injury severity score and outcome parameter were analyzed. A total of 45 patients matched the selective inclusion criteria of TMCI, comprising 4% of all burn injuries during the period. The average age was 38 years (range: 14–86), with a mean TBSA of 43% (range: 10–97%). The mean recorded temperature at admission was 34.8°C (range: 29.6–37.1) with 2215 ml volume of resuscitation fluids (range: 500–8000) administered preclinically in total. The mean injury severity score was 16. The overall mortality rate was 22%. TMCIs are rare and life-threatening events that require highly qualified management in combined level 1 trauma and burn centers to address both burn and trauma treatment. The multiple injury pattern is diverse, complicating standardized management in view of burn care-specific measures, as normothermia and restrictive volume management. The present study reveals further profiles and underlines the need for addressing TMCIs in ABLS®, ATLS®, and PHTLS® programs.

Ultrastructural study on the development of rat amygdaloid body

1990 ◽  
Vol 48 (3) ◽  
pp. 432-433
Author(s):  
A. Manolova ◽  
S. Manolov
Keyword(s):  
Nerve Cells ◽  
Amygdaloid Complex ◽  
Amygdaloid Body ◽  
Thin Ring ◽  
Morphological Criteria ◽  
Neural Processes ◽  
Abundant Cytoplasm ◽  
Level 1 ◽  
Few Data ◽  
Oval Shape

Relatively few data on the development of the amygdaloid complex are available only at the light microscopic level (1-3). The existence of just general morphological criteria requires the performance of other investigations in particular ultrastructural in order to obtain new and more detailed information about the changes in the amygdaloid complex during development.The prenatal and postnatal development of rat amygdaloid complex beginning from the 12th embrionic day (ED) till the 33rd postnatal day (PD) has been studied. During the early stages of neurogenesis (12ED), the nerve cells were observed to be closely packed, small-sized, with oval shape. A thin ring of cytoplasm surrounded their large nuclei, their nucleoli being very active with various size and form (Fig.1). Some cells possessed more abundant cytoplasm. The perikarya were extremely rich in free ribosomes. Single sacs of the rough endoplasmic reticulum and mitochondria were observed among them. The mitochondria were with light matrix and possessed few cristae. Neural processes were viewed to sprout from some nerve cells (Fig.2). Later the nuclei were still comparatively large and with various shape.

Selection of effective wax (deposition) inhibitors to oil production and transportation at the Kondinskoye oil field

2020 ◽  
pp. 120-127
Author(s):  
E. N. Skvortsova ◽  
O. P. Deryugina
Keyword(s):  
Laboratory Tests ◽  
Initial Dosage ◽  
Oil Production ◽  
Oil Field ◽  
Transport Systems ◽  
Asphaltene Precipitation ◽  
Wax Deposition ◽  
Selection Of ◽  
Pilot Tests

The article discusses the results of a study on the selection of wax inhibitors that can be used at the Kondinskoye oil field during transportation and dehydration of the emulsion.Asphaltene precipitation is one of the most serious issues in oil production. The experiment was conducted in order to select the most effective wax inhibitors. We have carried out laboratory tests to choose the most effective wax inhibitor in the conditions of oil production, collection, preparation and external transport systems at the Kondinskoye oil field. Based on the data obtained, wax inhibitor-2, wax inhibitor-4, and wax inhibitor-6 have shown the best results in ensuring the efficiency of inhibition, which should be at least 70 %, and, therefore, they can be allowed to pilot tests. The recommended initial dosage of inhibitors according to the results obtained during pilot tests should be at least 500 g/t of oil.

Pathologic Fibrinolysis is More Common in a Rural Trauma Setting

2020 ◽  
pp. 000313482097372
Author(s):  
James M. Bardes ◽  
Daniel J. Grabo ◽  
Sijin Wen ◽  
Alison Wilson
Keyword(s):  
Trauma Team ◽  
Rural Environment ◽  
Trauma Patients ◽  
Future Studies ◽  
Factors Influencing ◽  
American College Of Surgeons ◽  
Level 1 ◽  
Transferred Patients ◽  
Prehospital Time ◽  
Level 1 Trauma Center

Introduction Fibrinolysis (lysis) has been extensively studied in trauma patients. Many studies on the distribution of lysis phenotype have been conducted in setting with short prehospital time. This study aimed to evaluate the distribution of lysis phenotypes in a population with prolonged prehospital times in a rural environment. Methods A retrospective study was performed at an American College of Surgeons-verified level 1 trauma center, serving a large rural population. Full trauma team activations from January 1, 2017 to August 31, 2018 were evaluated, and all patients with an ISS>15 analyzed. Thromboelastography was routinely performed on all participants on arrival. Lysis phenotypes were classified based on LY30 results: shutdown (≤.8%), physiologic (.9-2.9%), and hyper (>2.9%). Results 259 patients were evaluated, 134 (52%) presented direct from the scene. For scene patients, lysis distribution was 24% physiologic, 49% shutdown, and 27% hyper. Transferred patients demonstrated a reduction in physiologic lysis to 14% ( P = .03), shutdown present in 66%, and hyper in 20%. Empiric prehospital tranexamic acid was given to 18 patients, physiologic lysis was present in 6%, shutdown 72%, and hyper 22%; this increase was not statistically significant ( P = .5). Conclusion Fibrinolysis phenotypes are not consistent across all trauma populations. This study showed rural trauma patients had a significantly increased rate of pathologic lysis. This was consistent for scene and transfer patients who received care at another facility prior to arrival for definitive care. Future studies to evaluate the factors influencing these differences are warranted.

scholarly journals Characteristics of Pediatric Emergency and Risk Factors for Life-saving Interventions

2021 ◽  
Vol 8 ◽  
pp. 2333794X2199034
Author(s):  
Phatthranit Phattharapornjaroen ◽  
Yuwares Sittichanbuncha ◽  
Pongsakorn Atiksawedparit ◽  
Kittisak Sawanyawisuth
Keyword(s):  
Risk Factors ◽  
Analytical Study ◽  
Pediatric Patients ◽  
Pediatric Emergency ◽  
Limited Data ◽  
Inclusion Criteria ◽  
Resuscitation Room ◽  
Life Saving ◽  
Level 1 ◽  
Triage Level

Pediatric emergency patients are vulnerable population and require special care or interventions. Nevertheless, there is limited data on the prevalence and risk factors for life-saving interventions. This study is a retrospective analytical study. The inclusion criteria were children aged 15 years or under who were triaged as level 1 or 2 and treated at the resuscitation room. Factors associated with LSI were executed by logistic regression analysis. During the study period, there were 22 759 ER visits by 14 066 pediatric patients. Of those, 346 patients (2.46%) met the study criteria. Triage level 1 accounted for 16.18% (56 patients) with 29 patients (8.38%) with LSI. Trauma was an independent factor for LSI with adjusted odds ratio (95% CI) of 4.37 (1.49, 12.76). In conclusion, approximately 8.38% of these patients required LSI. Trauma cause was an independent predictor for LSI.

scholarly journals Effect of the COVID-19 pandemic on the ability of level 1 trauma centers to meet American College of Surgeons research requirements

2021 ◽  
Vol 6 (1) ◽  
pp. e000692
Author(s):  
Robert M Madayag ◽  
Erica Sercy ◽  
Gina M Berg ◽  
Kaysie L Banton ◽  
Matthew Carrick ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Trauma Centers ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
American College Of Surgeons ◽  
The Usa ◽  
Virus Exposure ◽  
Level 1 ◽  
Verification Process ◽  
Question Survey

IntroductionThe COVID-19 pandemic has had major effects on hospitals’ ability to perform scientific research while providing patient care and minimizing virus exposure and spread. Many non-COVID-19 research has been halted, and funding has been diverted to COVID-19 research and away from other areas.MethodsA 28-question survey was administered to all level 1 trauma centers in the USA that included questions about how the pandemic affected the trauma centers’ ability to fulfill the volume and research requirements of level 1 verification by the American College of Surgeons (ACS).ResultsThe survey had a 29% response rate (40/137 successful invitations). Over half of respondents (52%) reported reduced trauma admissions during the pandemic, and 7% reported that their admissions dropped below the volume required for level 1 verification. Many centers diverted resources from research during the pandemic (44%), halted ongoing consenting studies (33%), and had difficulty fulfilling research requirements because of competing clinical priorities (40%).DiscussionResults of this study show a need for flexibility in the ACS verification process during the COVID-19 pandemic, potentially including reduction of the required admissions and/or research publication volumes.Level of evidenceLevel IV, cross-sectional study.

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