scholarly journals CHALLENGING ISSUES RELATING TO COMPREHENSIVE EXAMINATION IN MOTOR VEHICLE INJURIES: FORENSIC MEDICAL ASPECTS

Author(s):  
H. Zaritskyi

Motor vehicle traumas are among the most common causes of injury both in Ukraine and around the world. Comprehensive examinations enable investigating and judicial authorities to investigate and detect crimes in cases of motor accident. The purpose of the study was to identify the most common challenging issues arising during the complex expert examinations traumas caused by motor vehicle accidents (MVA) and the ways to solve them by analyzing data obtained from forensic examinations of non-survivors in motor vehicle accidents in Ukraine. Results and discussion. According to 45 complex examination reports from the State Institution «Main Bureau of Forensic Medical Examination of the Ministry of Health of Ukraine» it was impossible to identify the position of the victims at the moment of trauma (and to identify the places the victims set in the car salon) due to the lack of primary data in 20% of the cases studied; and in only 5 cases it was possibility to establish the position of the victims at the moment of injury. Determining the location of the victim in the car, pedestrian, etc. can be only identified by characteristic and specific injuries, which are not always paid attention during the initial examination of cadavers. A lot of medical records can omit the description of some injuries (size, localization, shape, morphological features, etc.) or do not provide complete information that impedes the investigative of motor vehicle accidents. Another cause to identify the position of MVA non-survivor is inability to indicate the mechanism and sequence of damage to the car during the auto-technical expert examination. Conclusion. The study has shown that the main factors impeding the MVA investigation and clarifying the picture of event are: violation of the «Rules for conducting forensic expert examination of corpses in the forensic examination bureau» during the initial examination; the absence or poor quality description in the protocols and guidelines for the inspection of the accident scene, including physical evidence and the condition of the vehicle; the inability to establish the nature of injuries on the body of victims or non-survivors and damage to vehicles due to delays in the investigation of crimes; drawbacks in filling in and keeping medical documentation: absence or incomplete description of damage (size, shape, location, morphological features, etc.).

2008 ◽  
Author(s):  
Yoshiharu Kim ◽  
Yutaka Matsuoka ◽  
Ulrich Schnyder ◽  
Sara Freedman ◽  
Robert Ursano

Author(s):  
Kelvin Allenson ◽  
Laura Moore

Trauma related injury is the leading cause of non-obstetric maternal death.  The gravid uterus is at risk for injury, particularly during motor vehicle accidents.  Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a means of controlling pelvic hemorrhage in the setting of trauma.  We report the use of REBOA in a hemodynamically unstable, multiply-injured young woman with viable intrauterine pregnancy.


2021 ◽  
Vol 121 ◽  
pp. 108046
Author(s):  
Mintao Lin ◽  
Jiani Chen ◽  
Sisi Li ◽  
Yingjie Qin ◽  
Xuruan Wang ◽  
...  

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Imthiaz Manoly ◽  
Mohamed El Tahan ◽  
Maymoona Al Shuaibi ◽  
Fatimah Adel ◽  
Mohammed Al Harbi ◽  
...  

Abstract Background Thoracic endovascular aortic repair (TEVAR) is the standard-of-care for treating traumatic aortic injury (TAI). Few retrospective studies compared TEVAR to open repair in blunt traumatic aortic injury (BTAI). Our objectives were to compare the early outcomes of TEVAR for blunt traumatic descending aortic injury to open repair (OR) in polytraumatic patients involved in motor vehicle accidents (MVA). Results Between February 2005 and April 2017, 71 patients with TAI due to MVA presented to our institution. All patients with descending aortic injuries were considered for open repair (n = 41) or TEVAR (n = 30) if there was no contraindication. The primary outcome was mortality, and secondary outcomes were stroke, paraplegia, intensive care unit (ICU), and hospital stay. The mean age was 28.4 ± 10.1 years in the OR group and 33.3 ± 16.6 years in TEVAR-group (P = 0.13). The injury severity scores were 41 ± 10 in the OR group and 33 ± 17 in the TEVAR group (P = 0.03). Patients in the OR group underwent emergency repair with a mean time of 0.56 ± 0.18 days from arrival. The TEVAR group had a longer time interval between arrival and procedure (2.1 ± 1.7 days, P = 0.001). The OR group had more blood transfusion (24 (58.5%) vs. 8 (27.5%), P = 0.002), renal impairment (6 (14.6%) vs. 1 (5.50%), P = 0.23), and wound infection (21 (51.2%) vs. 3 (10%), P < 0.001). Three TEVAR patients had a perioperative stroke compared to two patients in the OR group (P = 0.64). There was no difference in the mean ICU (6 ± 8.9 vs. 5.3 ± 2.9 days; P = 0.1) or hospital stay (20.1 ± 12.3 vs. 20.1 ± 18.3, P = 0.62) between the two groups. There were four deaths in the OR group and none in the TEVAR group (P = 0.13). Conclusion The results of TEVAR were comparable with the open repair for traumatic aortic injury with good early postoperative outcomes. TEVAR repair could be associated with lower mortality, blood transfusion, and infective complications. However, the complexity of the injury and technical challenges were higher in the open group.


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