Survival Fight of a Teen With Polytrauma, Severe Head Injury, Gr-V Liver Injury Followed By ARDS, Managed in a Rural Hospital of Andaman, India

2017 ◽  
Vol 7 (2) ◽  
pp. 42-45
Author(s):  
Sidharth Bhasin ◽  
Anil Kumar Narayan ◽  
Janardhan AL

This article describes how the liver is one of the most commonly injured organs in the abdomen, especially in road traffic accidents. Patients do present with polytrauma and those who are hemodynamically unstable have a high morbidity and mortality, even in advanced hospital settings. Following is the case report of a 17-yr. old boy, who was involved in a road traffic accident with polytrauma, presented to a tertiary care hospital in a remote island, with Grade IV-V liver injury and developed ARDS in post-operative period. The patient was managed successfully and discharged.

2018 ◽  
Vol 20 (4) ◽  
Author(s):  
Abdul Issa ◽  
Nkinda Mbelenge ◽  
Phillipo L. Chalya ◽  
Japhet M. Gilyoma

Background: Multiple injuries constitute a public health problem and contribute significantly to high morbidity, mortality and long-term disabilities worldwide. This study describes the etiological spectrum, injury characteristics and treatment outcome of multiple injuries at a tertiary care hospital in Tanzania.Methods: This was a descriptive prospective study involving multiple injury patients admitted to Bugando Medical Centre (BMC) from March 2013 to June 2013 inclusive.Results: Out of 712 trauma patients who were admitted to BMC during the study period, 150 (21.1%) had multiple injuries. Their male to female ratio was of 2.3:1. The majority of patients were in the second decade of life. Road traffic accidents (RTAs) were the most common (93.3%) cause of injury. The majority of patients, 142 (94.7%) sustained blunt injuries. Twelve (8.0%) patients had pre-hospital care. The limbs (89.2%) and the head (78.7%) were the most common body regions injured. The majority of patients (85.3%) sustained severe injuries (ISS ≥ 16). Out of 150 patients, 46 (30.7%) had 65 missed injuries. A total of 142 (94.7%) patients were treated surgically. Wound debridement (87.3%) was the most common surgical procedure performed. The complication and mortality rates were 54.7% and 38.7%, respectively. The overall median length of hospital stay (LOS) was 23 days. Co-morbid illness, HIV positivity, CD4 count (≤ 200 cells/μl), severe trauma (ISS ≥ 16), admission Systolic Blood Pressure < 90 mmHg, missed injuries and surgical site infection significantly influenced mortality (P < 0.001). Patients who developed complications and those who had long bone fractures stayed longer in the hospital (p < 0.001).Conclusion: Road traffic accidents remain a major cause of multiple injuries at BMC and contribute significantly to unacceptably high morbidity and mortality. Urgent preventive measures targeting at reducing the occurrence of road traffic accidents is necessary to reduce the incidence of multiple injuries in our centre.


Author(s):  
Sachin Chourasia ◽  
K. V. Radhakrishna ◽  
Ravi Rautji ◽  
Shivakumar D. K.

Background: Road Traffic Accident (RTA) is any vehicular accident occurring on the roadway i.e. originating on, terminating on, or involving a vehicle partially on the roadway. Road traffic accidents are a human tragedy which has an immeasurable impact on the families affected. The WHO estimates that over 1.2 million people pass away every year on the world’s roads, and between 20 and 50 million fall victims to non-fatal injuries.  The incidence of RTA remains poorly measured in India.Methods: The present study is conducted at casualty department of a tertiary care hospital in South Western India among victims of road traffic accident. This cross sectional study was conducted to elucidate the role of various factors involved in road traffic accidents and to study demographic profile and injury pattern among RTA victims. All the reported RTA cases from 1st January 2016 to 31st December 2018 were included in the study.Results: A total of 875 cases of RTA were studied. There were 83.77%(n=733) male and 16.23%(n=142) female accident victims. Most of the patients were aged between 21 and 30 years. Monsoons witnessed 46.63%(n=408) cases. Most cases occurred between 6 and 12pm (54.4%, n=476). Commonest injury was a simple injury (72.91%, n=638), dangerous injuries (27.09% percent, n=237) and dead was (7.43%, n=65). The highest number of accidents took place in the month of June (19.09%, n=167) and on Sundays (22.17%). Among the motorized vehicles, two-wheeler drivers were more (76.91%, n=673) involved in accidents. In this study 17.60% (n=154) were under influence of alcohol while driving.Conclusions: This study shows there are multiple factors associated with road traffic accidents. Most of the factors responsible for RTA and its fatal consequences are preventable. India, as a signatory to the Brasilia declaration, intends to reduce road accidents and traffic fatalities by 50% by 2022. A comprehensive multipronged approach can mitigate most of them.


2020 ◽  
Vol 58 (229) ◽  
Author(s):  
Sameer Thapa ◽  
Anup Raj Upreti ◽  
Bishow Raj Dawadi

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.


Author(s):  
Muthukumar T. ◽  
Zile Singh ◽  
Vishnu Prasad R. ◽  
Abel K. Samuel ◽  
Raja T. K.

Background: Road traffic accidents (RTA) are the only public health problem for which society and decision makers still accept death and disability among young people on a large scale. This study was undertaken to determine the various epidemiological factors influencing RTA with a view to suggest appropriate remedial measures for prevention of accidents.Methods: A hospital based prospective observational study was conducted at a tertiary care hospital in Puducherry. All the patients admitted in the hospital due to RTA from Jan to Dec 2014 were interviewed by using a pre-tested and pre-designed questionnaire. Data was entered in MS Excel and analysed using SPSS version 21.0. Institute ethics committee clearance was obtained.Results: Among 541 participants, 50% of the victims were in the productive age group of 20-40 yrs. The approximate speed of majority of the vehicles (55.6%) at the time of accident was 40-80 km/hr. Among the accident victims, 85.8% of the two wheeler riders did not use helmet and 70.9% of the car drivers did not wear seat belt at the time of accident. Around 39% of the drivers were under the influence of alcohol at the time of accident. Mobile phone is the major cause of distraction (51.9%) at the time of accident.Conclusions: Based on this study it is evident that prevention and control of most of the modifiable factors can bring about a change in the statistics that would ensure our future to be safer.


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