Pediatric Injury Presenting in Emergency Department of Tertiary Care Centre

2020 ◽  
Vol 2 (2) ◽  
pp. 26-30
Author(s):  
Sneha Pradhananga ◽  
Trishna Shrestha ◽  
Kabita Hada Batajoo ◽  
Manjita Bajracharya
Keyword(s):  
Emergency Department ◽  
Road Traffic ◽  
Tissue Injury ◽  
Tertiary Care ◽  
Pediatric Trauma ◽  
Soft Tissue Injury ◽  
Age Group ◽  
Pediatric Injury ◽  
Major Mode ◽  
At Home

Introduction: Pediatric injury is one of the common emergencies encountered in the emergency department. It is emerging as leading cause of death and disabilities in children. This study aims to analyze the patterns of pediatric injury based on age group, gender, mode, type, place of injury and its outcome. Methods: This is a descriptive cross sectional study conducted in Emergency Department of KIST Medical College and Teaching Hospital from 1st May 2019 to 30th July 2019. A total of 110 patients aged 15 years and below and with history of trauma were included in this study. Results: A hundred and ten pediatric patients presented to emergency with injuries. Majority of pediatric trauma cases belonged to age group 1-5 years (38.2%, n=42) and more frequent in male children (66.4%, n=73) .In both gender, male (45.5%, n=50) and female (17.3%, n=19); fall was most common mode of injury followed by accidental cut injury (7.3%,n=8) in male and road traffic accident (6.4%,n=7) in female. Most of the cases sustained soft tissue injury (32.7%, n=36) followed by cut injury (26.4%, n=29) and fracture (16.4%, n=18). Common place of injury was found to be at home (64.5%, n=71). Majority were discharged (n=100; 90.9%), Nine (8.2 %) were admitted and one expired (0.9 %) expired. Conclusion: Fall injuries are the major mode of injury encountered in both male and female children. Injuries tend to occur more at home than school. Children should be adequately supervised at home and school.  

scholarly journals Determination of Antimicrobial Prescribing Practices in an Integrated Health System Emergency Department

2020 ◽  
Vol 13 ◽  
pp. 131-133
Author(s):  
Sarah Sartain ◽  
John Price ◽  
Brooke Bitner ◽  
Elizabeth Wolfe ◽  
Daniel Ortiz
Keyword(s):  
Emergency Department ◽  
Social Services ◽  
Tissue Injury ◽  
Tertiary Care ◽  
Soft Tissue Injury ◽  
Prescribing Practices ◽  
Prescribing Habits ◽  
Antimicrobial Prescribing ◽  
Integrated Health ◽  
Treatment Window

Introduction. Antibiotic stewardship utilizes interprofessional collaborative practices, including professionals from medicine, pharmacy, nursing, social services, and clinical laboratory science, to identify potential problems proactively. A tertiary care integrated health system’s Emergency Department (ED) aimed to identify antimicrobials prescribed to the outpatient community as part of a proactive antimicrobial stewardship project. Methods. A pilot, prospective, snapshot of a tertiary community hospital’s outpatient antimicrobial prescribing habits was conducted. All subjects were identified via a daily report of patients discharged from the ED over 30 days in the summer of 2017 and individually reviewed for prescribed antimicrobial(s). Exclusions were hospital admission, antimicrobial sensitivity, and antimicrobial courses less than five days or more than 14 days. The primary goal was determining the number of antimicrobial oral tablets/capsule prescriptions to adult outpatients within a 5 to 14-day treatment window. Secondary goals were to include the diagnosis, non-capsule/tablet antimicrobial, pediatric patients, and prescriptions outside the treatment window. Results. Total number of antimicrobial prescriptions over the 30-day period was 653 in 5,520 individual visits. Total number of adults prescribed oral antimicrobials was 467 (15.6 daily). Patients were diagnosed with infections including urinary tract, cellulitis, soft tissue injury, abscess, upper respiratory, dental caries, gastrointestinal, sexually transmitted, otitis media/externa, pneumonia, viral, pyelonephritis, tick-borne, fungal, Bell’s Palsy, and sepsis. The number of non-adult, non-oral, and outside window treatment antimicrobial prescriptions were 186 (6.2 daily). With an average 184 patients treated in the ED daily, approximately 11.8% received antimicrobial treatment on discharge. Conclusion. Important aspects of the project were the evaluation of antimicrobial prescribing habits for a midwest ED and identification of potential complications requiring future interventions for follow-up or preventative measures to assist in patient care and community health. Areas of practice improvement were identified inadvertently as a result of this project. Potential future studies included seasonal variability, whether the patient obtained a prescription and complied with treatment, and differences between inpatient and outpatient antimicrobial prescribing practices.

The Hazards of Skateboard-Riding

PEDIATRICS ◽  
1976 ◽  
Vol 57 (5) ◽  
pp. 793-793
Author(s):  
◽  
Fernando Atienza ◽  
Calvin Sia
Keyword(s):  
Emergency Department ◽  
Soft Tissue ◽  
Bone Fractures ◽  
Tissue Injury ◽  
Skull Fracture ◽  
Soft Tissue Injury ◽  
Soft Tissue Injuries ◽  
Major Surgery ◽  
Cerebral Concussion ◽  
Tissue Injuries

Skateboard-riding has become increasingly popular among Hawaii's children. The thrill of the ride and the challenge of keeping one's balance and working intricate maneuvers while speeding down a hill captures the fancy of many of our young. This sport, however, has produced an alarmingly high toll of injury and illness. Pediatricians and emergency departments of our major hospitals have seen and taken care of large numbers of patients (aged between 3 years and 35 years, but with a distribution overwhelmingly pediatric) with significant injuries which include cerebral concussion, fractures, soft tissue injuries of varying degrees of severity and complications, and injury to internal organs. During a three-month period at the Kauikeolani Children's Hospital, July to August 1975, there were 16 patients admitted with the following: seven cerebral concussions, one skull fracture, five assorted bone fractures, one soft tissue injury and infection, one retroperitoneal hemorrhage, and one instance of major surgery for removal of the spleen. During the months of August and September 1975 the Emergency Department of Straub Clinic reported the following skateboard injuries: 14 fractures, 14 soft tissue injuries, 5 lacerations, and 2 cerebral concussions. Of the 35 patients seen, three were admitted—one with an open fracture, one with cerebral concussion, and one with a skull fracture. During a four-week period (two weeks in June and July and two weeks in August and September) at the Emergency Department of Kaiser Medical Center, 66 cases of skateboard injuries were seen with six patients requiring admission for fractures and brain concussion.

scholarly journals Epidemiology of Fatal Injuries reported in the mortuary of a tertiary care hospital

2019 ◽  
Vol 6 (2) ◽  
pp. 633
Author(s):  
Subrat Kumar Pradhan ◽  
Himansu Prasad Acharya ◽  
Rudra Prasanna Mishra ◽  
Jay Kumar Panda ◽  
Durga Madhab Satapathy ◽  
...  
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Adult Population ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Care Hospital ◽  
Age Group ◽  
Microsoft Excel ◽  
Mortality And Morbidity ◽  
Fatal Injuries

Background: Injuries are an increasingly recognized global, preventable public health problem and are an important cause of mortality and morbidity in adult population. The major causes of injury related deaths may be intentional and unintentional. The major unintentional or “accidental” causes are road traffic accidents (RTAs), falls and drowning whereas the leading intentional causes are suicide and homicide. A robust Surveillance System for Injury Mortality is almost non-existent in our country due to which the data for the same is not available and haphazard. Keeping these factors in mind, the following study was under taken to identify the various epidemiological factors related to fatal injury cases.Methods: A record based retrospective study was conducted in the Department of Community Medicine, VSSIMAR, Burla, Odisha. The data were collected from the autopsy reports preserved at the Dept of FM & T, VSSIMSAR. Variables like age, sex, number of injury cause of death, place of death etc. were collected. Data were entered in Microsoft Excel and analysed using proportions and percentages.Results: The age group 25-44 years recorded the maximum number of deaths (37.49%). Males suffered the highest casualty accounting for 61.85% of deaths. Unintentional fatal injuries constituted 63.58% of deaths. The most number of fatal injuries resulting in deaths were RTAs (36.41%).Conclusions: The age group 25-44 years recorded maximum deaths. Males were the major death victims. RTAs constituted maximum of deaths among unintentional fatal injuries. Homicidal injuries constituted maximum of deaths due to intentional fatal injuries.

scholarly journals Emergency Department Referral Profile of Traumatic Brain Injury Records at a Tertiary Care Hospital of Pakistan

2021 ◽  
Author(s):  
Maria Khan ◽  
Uzair Yaqoob ◽  
Zair Hassan ◽  
Muhammad Muizz Uddin
Keyword(s):  
Traumatic Brain Injury ◽  
Emergency Department ◽  
Brain Injury ◽  
Road Traffic ◽  
Tertiary Care ◽  
Initial Assessment ◽  
Care Hospital ◽  
Mild Tbi ◽  
Epidemiological Characteristics ◽  
The Impact

Abstract Background: Traumatic Brain Injury (TBI) is the leading cause of morbidity and mortality all over the world and the impact is much worse in Pakistan. The objective here is to describe the epidemiological characteristics of patients with TBI in our country and to determine the immediate outcomes of patients with TBI after the presentation.Method: This was a cross-sectional study conducted at the Lady Reading Hospital, Peshawar, Pakistan. Data were extracted from the medical records from January 1st to December 31st, 2019. Patient age, sex, type of trauma, and immediate outcome of the referral to the Emergency Department were recorded. The severity of TBI was categorized based on Glasgow Coma Scale (GCS) in mild (GCS 13-15), moderate (GCS 9-12), and severe (GCS <8) classes. The Emergency Department referral profile was classified as admissions, disposed, detained and disposed, referred.Results: Out of 5047 patients, 3689 (73.1%) males and 1358 (26.9%) females. The most commonly affected age group was 0-10 years (25.6%) and 21-30 years (20.1%). Road Traffic accident was the predominant cause of injury (38.8%, n=1960) followed by fall (32.7%, n=1649). Most (93.6%, n=4710) of the TBIs were mild. After the full initial assessment and workup, and completing all first-aid management, the immediate outcome was divided into four, most frequent (67.2%, n=3393) of which was “disposed (discharged)”, and 9.3% (n=470) were admitted for further management.Conclusion: Our study represents a relatively commonplace picture of epidemiological data on the burden of TBI in Pakistan. As a large proportion of patients had a mild TBI, and there is a high risk of mild TBI being under-diagnosed, we warrant further investigation of mild TBI in population-based studies.

scholarly journals The Relationship between Risk Factors of Head Trauma with CT Scan Findings in Children with Minor Head Trauma Admitted to Hospital

2017 ◽  
Vol 5 (3) ◽  
pp. 319-323 ◽  
Author(s):  
Babak Masoumi ◽  
Farhad Heydari ◽  
Hamidreza Hatamabadi ◽  
Reza Azizkhani ◽  
Zahra Yoosefian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Ct Scan ◽  
Head Trauma ◽  
Predictive Value ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Normal Brain ◽  
Brain Ct ◽  
Brain Ct Scan

BACKGROUND: In emergency medicine for determining the intracranial injury (ICI) in children with head trauma, usually brain CT scan is performed. Since brain CT scan, especially in children, has some disadvantages, it is better to find a procedure which could help to choose only the children with real head trauma injury for brain CT scan.AIMS: The aim of this study is to find such procedure. This study was descriptive, analytic and non-interventional.METHODS: We reviewed the archived files of children with head trauma injuries referred to the emergency department of Imam Hossein Hospital within two years. Patient’s CT scan findings and head trauma risk factors were evaluated in this study.RESULTS: Out of 368 patients, 326 patients had normal brain CT scan. 28 of them showed symptoms of ICI consisting intraventricular haemorrhage (IVH), contusion, subarachnoid haemorrhage (SAH), subdural haemorrhage (SDH), epidural hematoma (EDH), and pneumocephalus. Twenty-seven patients showed skull FX, which 14 of them had an Isolated fracture, and 13 of them also showed symptoms of ICI. Since patients with isolated FX usually discharge quickly from Emergency Department; their data did not include in results of the study. The patients have been divided into two groups: 1- ICI, 2- without ICI. RR (relative risk), CI (Confidence interval) and sensitivity, positive predictive value (PPV), negative predictive value (NPV) and association of these risk factors with ICI were assessed with the Chi-2 test. In the end to determine the indications of CT scan, the presence of one of these five risk factors is important including abnormal mental status, clinical symptoms of skull FX, history of vomiting, craniofacial soft tissue injury (including subgaleal hematomas or laceration) and headache.CONCLUSIONS: For all other patients without these risk factors, observation and Follow Up can be used which has more advantages and less cost.

Epidemiology of Blindness From Facial Trauma: A Multi-Centre Nigerian Study

2021 ◽  
pp. 194338752110609
Author(s):  
Bamidele A. Famurewa ◽  
Fadekemi Olufunmilayo Oginni ◽  
Bolajoko A. Adewara ◽  
Benjamin Fomete ◽  
Chukwudi Aniagor ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Road Traffic Accident ◽  
Traffic Accident ◽  
Road Traffic ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Facial Trauma ◽  
Globe Rupture ◽  
Tertiary Hospitals ◽  
Mechanism Of Trauma

Study Design This is a multi-centre retrospective study. Objective To determine the prevalence of blindness and pattern of facial trauma associated with blindness among Nigerians. Methods A multi-centre retrospective study of all patients with facial trauma resulting in blindness, that were co-managed by maxillofacial surgeons and ophthalmologists in 4 Nigerian public tertiary hospitals between January 2010 and December 2019 was undertaken. Data was analysed by IBM SPSS Statistics (version 21.0 for windows, IBM© Inc, Chicago, IL). Results Of 2070 patients who presented with major facial injuries during the study period, 61 eyes of 56 (2.7%) patients were blind. Blindness was bilateral and unilateral in 5 (8.9%) and 51 (92.1%) patients, respectively. The mean age (SD) at presentation was 36.2 (16.6) years, and 47 (83.9%) of these patients were males. Road traffic accident (n = 27; 48%) was the commonest mechanism of facial trauma, the cheek (n = 18; 40.9%) was the commonest site of associated soft tissue injury and zygomatic complex fracture (n = 19; 24.1%) was the commonest related fracture. Globe rupture (n = 34; 55.7%) was the leading cause of blindness. Enucleation (n = 7; 13.2%) and evisceration (n = 22; 41.5%) were performed on 29 eyes of which 12 (41.4%) patients had ocular prosthesis post-operatively. Conclusion Blindness was recorded in 2.7% of Nigerians with facial trauma. The commonest mechanism of trauma and cause of blindness in at least one eye were road traffic accident and globe rupture, respectively. Eye removal surgery was necessary in about half of the blind eyes.

Analysis of Outcomes of Vascularized Flap Reconstruction in Patients with Advanced Mandibular Osteoradionecrosis

2009 ◽  
Vol 141 (2) ◽  
pp. 196-201 ◽  
Author(s):  
Daniel S. Alam ◽  
Michael Nuara ◽  
James Christian
Keyword(s):  
Data Collection ◽  
Tissue Injury ◽  
Tertiary Care ◽  
Soft Tissue Injury ◽  
Case Series ◽  
Fistula Formation ◽  
Wound Complications ◽  
Complication Rates ◽  
Flap Reconstruction ◽  
End Stage

OBJECTIVE: To examine outcomes of vascularized bone flap reconstruction of end-stage osteoradionecrosis of the mandible. STUDY DESIGN: Case series with planned data collection. SETTING: Tertiary care academic hospital. SUBJECTS: Patients with end-stage radiation-induced osteoradionecrosis (ORN) refractory to conservative therapy with wound complications including chronic infections, fistula formation, and pathologic fracture were included. RESULTS: Outcomes of 33 patients were prospectively collected and analyzed, making this the largest series on this subject in the literature and the only one with planned data collection. Data on preoperative variables including radiation dose, sub-site location, treatment date, and prior therapy, along with intraoperative issues and postoperative outcomes, were tracked and are presented. ORN was seen to develop in a bimodal distribution based on the timing of interval surgical intervention. The extent of local soft tissue injury often required the use of contralateral recipient vessels. Local wound complication rates were higher than that seen in primary reconstructions. CONCLUSIONS: Successful reconstruction was achieved in all of the patients in this series. Long-term resolution of infectious complication and disease resolution was seen in 91 percent of the patients in this series.

scholarly journals EVALUATION OF RESULTS OF INTERNAL FIXATION OF CLOSED, DISPLACED, RECENT FRACTURE SHAFT OF HUMERUS BY MIPPO TECHNIQUE

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Alok Sobhan Datta ◽  
S. Velagada ◽  
A. Haque
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Road Traffic ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
High Energy ◽  
Time Interval ◽  
Shaft Fractures ◽  
Recent Fracture ◽  
Humerus Shaft

BACKGROUND: The humerus shaft fracture is the second most common fracture of the upper extremity. The predominant causes of humerus shaft fractures include low energy trauma such as fall from a standing height in older population, while in the younger population it is caused by high energy trauma. Aims and Objectives - To investigate the effectiveness of economical MIPPO technique and to determine the radiological and functional significance of MIPPO technique in the patients undergoing treatment for recent fracture shaft of humerus. MATERIALS AND METHODS: A prospective study had been carried out from December 2012 to August 2014 in the Orthopaedics Department of SSKM Hospital, Kolkata, West Bengal, India. Thirty three patients, who presented with fracture shaft of humerus and underwent fixation of humeral shaft fractures by MIPPO technique were included in this study. Complete history was taken and full clinical examination was carried out. RESULTS: The average age group in our study is 35.3 years. Of them 85% are male and 15% are female. In majority cases, mode of injury was road traffic accident. 85% cases had middle 1/3rd fracture shaft of humerus and the average time interval between the injury and surgery was 8.54 days. CONCLUSION: The results obtained in this study have shown that the MIPPO technique is safe, convenient and effective, since there was minimal soft tissue injury with no major complications. KEYWORDS: Minimally Invasive Percutaneous Plate Osteosynthesis (MIPPO); Road Traffic Accident (RTA).

scholarly journals Study of Trauma Profile and its Outcomes at a Tertiary Care Centre: A Cohort Study of 1000 Cases

2021 ◽  
Author(s):  
Bhupinder Singh Walia ◽  
Pankaj Dugg ◽  
Kanwaldeep Singh Aulakh ◽  
Sanjeev Sharma ◽  
Venita Kapur
Keyword(s):  
Cohort Study ◽  
Mortality Rate ◽  
Emergency Surgery ◽  
Road Traffic ◽  
Tertiary Care ◽  
P Value ◽  
Age Group ◽  
Tertiary Care Centre ◽  
Male Population ◽  
Male Predominance

Introduction: Trauma has been the leading cause of mortality and morbidity. However, there are changes in pattern of trauma and their outcomes with time. Aim: To study the mode and nature of injury and mortality associated with trauma of head, chest and abdomen. Materials and Methods: A prospective cohort study was conducted on 1000 individuals that presented to emergency surgery ward from 2014 to 2019. Patients presented to emergency surgery of Government Medical College, Amritsar, Punjab, India were observed for various characteristics i.e., age group, mode of injury, site of injury, outcomes and management. Results: The mean age of patients was 33.91±16.29 years with significant male predominance (n=794, 79.4%) (p-value 0.00001). Road Traffic Injuries (RTIs) were the most common mode of trauma affecting 490 patients (49%). Head injury was the most common of all injuries (n=834). Overall mortality was 3.6% (n=36). Mortality was higher in males (p-value 0.00933) and mortality rate of 25% was seen in age group of 61-70 years. Conclusion: RTIs followed by assaults are the most common cause of trauma and it significantly affects young male population. However, mortality rate increases with increase in age group with higher rates in older age groups.

scholarly journals Spectrum of Injury Presenting to Emergency Department in A Tertiary Care Hospital in Nepal: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (229) ◽  
Author(s):  
Sameer Thapa ◽  
Anup Raj Upreti ◽  
Bishow Raj Dawadi
Keyword(s):  
Emergency Department ◽  
Road Traffic Accident ◽  
Traffic Accident ◽  
Road Traffic ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional

Introduction: Injury is one of the major global public health problems causing significant number of death and disability. The study aims to study the epidemiological and clinical profile of patients presented in emergency department with injury. Methods: This was a descriptive cross-sectional study conducted in a tertiary care hospital from September 2019 to February 2020 after obtaining ethical approval from Institutional review board (reference number 007-076/077). A convenient sampling method was applied. Epidemiological factors, chronological factors, causes of injury, anatomical distribution, pattern of injury were studied. Statistical analysis was done using statistical package for the social sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 197 patients, 72 (36.5%) patients had fall followed by road traffic accident 57 (28.9%). Of total, 80 (40.6%) had injury at home and 80 (40.6%) had cut injury. Head and neck accounted for 66 (33.5%) of total injury followed by upper Extremities 50 (25.4%) and lower extremities 47 (23.9%). Eighty-seven (44.2%) of the patients visited emergency within 30 minutes of sustained injury. Conclusions: The top three leading causes of injuries visiting emergency department were: fall, Road Traffic Accident and physical assaults respectively. The most common mode was fall being cut as most common pattern. Head and neck was the most commonest site of injury. The common place of injury was home.

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