Self-inflicted serious injuries among adolescents in Zambia

Introduction: Disk Battery Ingestion (DBI) is a cause of access to the emergency department (ED), especially in pediatric age. This problem, if not well managed, may lead to serious injuries, with several complications involving the gastrointestinal and respiratory tract. Objective: Aim of this review is to analyze the literature of the last 25 years to make a decisional flow-chart that may help the emergency physician. Methods: For this review 36 articles have been analyzed (8 articles and 28 case reports), from 1995 to 2019. Data considered from each study were: year of publication, type of study, population studied, type of battery, timing of ingestion, treatment, outcomes, complications. Results: A decisional flow-chart has been configured. X-ray should be performed as a first step in every stable patient, meanwhile CT scan should be performed in unstable patients. When the battery is still localized in the esophagus, endoscopy should be performed as soon as possible, meanwhile, when the battery is beyond the esophagus, it should be noted its diameter before taking a decision. Conclusion: The use of the flow-chart proposed may reduce the risk of consequences and severe injuries for the patients, helping the emergency physician in his decisional process.

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Diverticulization Duodenal Distal Technique for Injury Angle Duodenojejunal

Open Medicine Journal ◽

10.2174/1874220301603010265 ◽

2016 ◽

Vol 3 (1) ◽

pp. 265-268

Author(s):

Luis R. Martinez ◽

Pablo Valsangiacomo ◽

Gabriela Espinosa ◽

Gabriela Wagner ◽

Roberto Taruselli

Keyword(s):

Case Series ◽

Average Hospital ◽

Single Anastomosis ◽

Observational Technique ◽

Mortality Case ◽

Management Techniques ◽

The Right ◽

Serious Injuries ◽

Suture Failure ◽

Initial Results

Duodenojejunal injuries region at the angle of Treitz are rare, variable etiology and often associated with other serious injuries. In trauma situations with perforations and bleeding, his approach is often difficult. The primary suture, resection / anastomosis and duodenal exclusion are the usual for trauma management techniques in this region. The aim of this paper is to show the initial results of an alternative for injuries duodenojejunal angle (IDJA) by filling a retrospective, descriptive and observational technique, 12 patients operated were analyzed over a period of 15 years, carriers IDJA, age: 34, 11 gunshot wound. 92% of the cases had other associated visceral injuries. The average for the ISS was 29. In all cases located in duodenum duodenojejunoanastomosis II, via the right lateromesenterica upon closing section and duodenum level III was performed. 58% of cases were complicated. Mortality case series were 1 (8%) digestive suture failure colon. Average Hospital stay 26 days. Conclusion: A simple, safe and maintaining gut physiology is proposed technique; with a single anastomosis, located in well-vascularized area and away from bruising and contaminated areas. The complications were pancreatic fistula and digestive suture failure.

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Duodenoscope Medical Device Reports Associated with Patient Infection, Patient Exposure, or Device Contamination

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.737 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s196-s197

Author(s):

Jian Connell ◽

Shanil Haugen ◽

Ann Ferriter

Keyword(s):

Medical Device ◽

The United States ◽

Risk Of Infection ◽

Patient Exposure ◽

Safety Issues ◽

Device User ◽

Infection Patient ◽

Device Use ◽

Serious Injuries ◽

Patient Infection

Background: Each year, the FDA receives more than a million reports of suspected device-associated deaths, serious injuries, and malfunctions. Medical device reports (MDRs) are submitted to the FDA by mandatory reporters (manufacturers, importers, and device user facilities) and voluntary reporters such as healthcare professionals, patients, and consumers. The FDA uses MDRs to monitor device performance, including monitoring reports of infection or device contamination to detect potential device-related safety issues and to share this information in public communications. In this analysis, the FDA presents MDRs for duodenoscopes, which are a type of flexible endoscope that have been associated with infections in patients. Methods: For this analysis, we searched the MDR database for duodenoscope reports submitted between January 2015 and July 1, 2019. MDRs were classified into clinical risk categories based on the MDR’s text narratives as patient infection (indicated the presence of infection in patients potentially transmitted by the device), patient exposure (indicated a contaminated device has been used in a patient, but the MDR lacks clear mention of patient infection), or device contamination (indicated that the device was contaminated, but no mention of device use in patients or patient infection). Results: Overall, 1,115 duodenoscope reports related to a patient infection, patient exposure, or device contamination for devices marketed inside and outside the United States were received from January 2015 to mid-2019. Among them, 79 MDRs were received for deaths in patient infection, patient exposure, or device contamination reports. The number of reported infections decreased from 247 MDRs in 2015 to 55 MDRs in the first half of 2019. Furthermore, the number of reported deaths decreased from 25 MDRs in 2015 to 2 MDRs reported in the first half of 2019. Conclusions: The MDR data indicate a decrease in the number of reported infections. The decrease in infections suggests that efforts to reduce the risk of infection from duodenoscopes have yielded improvements; however, additional improvements are necessary to further decrease the risk of infection.Funding: NoneDisclosures: None

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Risk Factors for Fall-Related Serious Injury among Korean Adults: A Cross-Sectional Retrospective Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18031239 ◽

2021 ◽

Vol 18 (3) ◽

pp. 1239

Author(s):

Moon-Sook Kim ◽

Hyun-Myung Jung ◽

Hyo-Yeon Lee ◽

Jinhyun Kim

Keyword(s):

Risk Factors ◽

Fall Prevention ◽

Medical Records ◽

Brain Injuries ◽

Tertiary Hospital ◽

Antiplatelet Drugs ◽

Cross Sectional ◽

Complete Survey ◽

Serious Injury ◽

Serious Injuries

The purpose of this study was to identify the risk factors of serious fall-related injuries by analyzing the differences between two fall groups: one with serious fall-related injuries and one without such injuries. Applying a retrospective, descriptive investigation study design, we analyzed the degree of fall-related injury and the risk factors related to serious falls by conducting a complete survey of the medical records of fall patients reported throughout one full year, 2017, at a tertiary hospital in Seoul, Korea. Among the patients with reported falls, 188 sustained no injury (63.1%), 72 sustained minor injury (24.2%), and 38 patients sustained serious injury (12.8%). The serious fall-related injuries included eight lacerations requiring suture (2.7%), 23 fractures (7.7%), five brain injuries (1.7%), and two deaths (0.7%). Analysis results indicated that taking anticoagulants/antiplatelet drugs (p = 0.016) and having a fall history (p = 0.038) were statistically significant in the differences between the group with serious injury related to falls and the group without serious injury. Logistic regression revealed that taking anticoagulant/antiplatelet drugs was the factor most significantly correlated with serious injuries related to falls (OR = 2.299, p = 0.022). Results show that it is necessary to develop a patient-tailored fall prevention activity program.

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Addressing the Data Acquisition Paradigm in the Early Detection of Pediatric Foot Deformities

Sensors ◽

10.3390/s21134422 ◽

2021 ◽

Vol 21 (13) ◽

pp. 4422

Author(s):

Paul D. Rosero-Montalvo ◽

Edison A. Fuentes-Hernández ◽

Manuel E. Morocho-Cayamcela ◽

Luz M. Sierra-Martínez ◽

Diego H. Peluffo-Ordóñez

Keyword(s):

Early Detection ◽

Embedded System ◽

Data Acquisition ◽

School Children ◽

Pressure Sensors ◽

Foot Deformities ◽

Flat Feet ◽

Child Patients ◽

Pediatric Foot ◽

Serious Injuries

The analysis of plantar pressure through podometry has allowed analyzing and detecting different types of disorders and treatments in child patients. Early detection of an inadequate distribution of the patient’s weight can prevent serious injuries to the knees and lower spine. In this paper, an embedded system capable of detecting the presence of normal, flat, or arched footprints using resistive pressure sensors was proposed. For this purpose, both hardware- and software-related criteria were studied for an improved data acquisition through signal coupling and filtering processes. Subsequently, learning algorithms allowed us to estimate the type of footprint biomechanics in preschool and school children volunteers. As a result, the proposed algorithm achieved an overall classification accuracy of 97.2%. A flat feet share of 60% was encountered in a sample of 1000 preschool children. Similarly, flat feet were observed in 52% of a sample of 600 school children.

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Increased Risk of Traffic Injury After a Cerebrovascular Event

Stroke ◽

10.1161/strokeaha.118.022657 ◽

2018 ◽

Vol 49 (12) ◽

pp. 3006-3011

Author(s):

Amy Y.X. Yu ◽

Moira K. Kapral ◽

Jiming Fang ◽

Donald A. Redelmeier

Keyword(s):

Transient Ischemic Attack ◽

Motor Vehicle ◽

Population Based ◽

Hazard Ratio ◽

Adjusted Hazard Ratio ◽

Cerebrovascular Event ◽

Traffic Injury ◽

Increased Risk ◽

Ischemic Attack ◽

Serious Injuries

Background and Purpose— We aimed to determine the long-term risks of a motor vehicle collision after a cerebrovascular event and whether the risks were similar after left- or right-hemispheric events. Methods— We used a population-based registry to identify patients diagnosed with a transient ischemic attack or stroke (hemorrhagic or ischemic) between 2003 and 2013 in Ontario, Canada. Hemispheric laterality was determined using radiological and clinical findings. We identified subsequent serious injuries involving the patient as a driver using linked administrative data. Secondary outcomes included serious injuries involving the patient as a pedestrian, as a passenger, or other traumatic events (fall, fracture, ankle sprain). We used proportional hazard models accounting for death as a competing risk to test the association of hemispheric laterality and outcomes with and without adjustment for age, sex, discharge modified Rankin Scale score, home location, and prior driving record. Patients were followed through to 2017. Results— Among 26 144 patients with hemispheric cerebrovascular events, 377 subsequent serious traffic injuries as a driver (2.2 per 1000 person-year) were identified over a median follow-up of 6.4 person-years. The rate did not differ by laterality (adjusted hazard ratio, 1.00; 95% CI, 0.82–1.23). The risk of a serious traffic injury as a pedestrian was significantly higher after a right-sided than left-sided event (adjusted hazard ratio, 1.27; 95% CI, 1.02–1.58). Subsequent risks for other traumatic injuries did not differ by laterality of cerebrovascular event. Conclusions— The risk of a serious traffic injury as a pedestrian is substantially higher after a right-hemispheric cerebrovascular event compared with a left-sided event. Walking should be promoted for exercise in survivors of a stroke or transient ischemic attack, but these vulnerable road users may benefit from additional poststroke rehabilitation to optimize safety.

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Effects of body protection vests and experience levels in prevention of equestrian injuries

BMJ Open Sport & Exercise Medicine ◽

10.1136/bmjsem-2018-000426 ◽

2018 ◽

Vol 4 (1) ◽

pp. e000426 ◽

Cited By ~ 2

Author(s):

Sarah A Andres ◽

Adrienne M Bushau-Sprinkle ◽

Michael E Brier ◽

Yvette R Seger

Keyword(s):

The United States ◽

Safety Equipment ◽

Contributing Factors ◽

Experience Levels ◽

Equestrian Sports ◽

Risk Of Injury ◽

Report Data ◽

Cross Country ◽

Serious Injuries ◽

Show Jumping

ObjectivesTo investigate the risk reduction and benefit of wearing body protection/safety vests in equestrian sports.MethodsA comparison of equestrians wearing body protective vests and those not wearing vests was performed using incident report data of 718 participants in the United States Pony Clubs during 2011–2017. Data obtained included age, gender, certification level of member, type of activity, description of incident, description of injuries, what protective equipment was worn and other possible contributing factors.ResultsWhile wearing body protective vests when riding on the flat or for show jumping was not correlated with a decrease in injuries, wearing vests for cross country was correlated with decrease in reported injuries (p=0.036) and showed a trend towards a lower incident severity level (p=0.062). Wearing body protection during cross country reduced the relative risk of injury by 56%. While the volume of incidents varied with a rider’s experience level, the number of serious injuries did not appear to correlate with lesser equestrian experience.ConclusionsWhile equestrian sports are considered to have a certain degree of risk associated with them, there are ways to make them safer. Wearing safety equipment, such as helmets and body protection, and obtaining education and experience can lessen the chance of incurring serious injuries.

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Biomechanical Analysis of Soft Tissue Neck Injury During Pedestrian Fall

Advances in Bioengineering ◽

10.1115/imece2002-32638 ◽

2002 ◽

Author(s):

Anthony Sances ◽

Srirangam Kumaresan

Keyword(s):

Cervical Spine ◽

Soft Tissue ◽

Direct Contact ◽

Neck Injury ◽

Biomechanical Analysis ◽

Test Device ◽

Soft Tissue Neck ◽

Direct Loading ◽

Inertial Loading ◽

Serious Injuries

Pedestrians sustain serious injuries when impacted by vehicles [1]. Various biomechanical studies have focused on pedestrian injuries due to direct contact with the vehicle and environment [1–5]. Similar studies on the injuries to the pedestrian due to indirect force such as inertial load are limited [6]. One of the most susceptible regions of the human body to inertial loading is the neck component (cervical spine). The cervical spine connects the head and upper torso, and provides mobility to the head. Direct loading to the head and/or upper torso subjects the cervical spine to indirect loading. For example, in a pedestrian lateral fall on the shoulder, the cervical spine flexes laterally due to inertial loading from the head and upper torso, and may injure its soft tissue components. The purpose of this study is to delineate the biomechanics of the soft tissue neck injury during the pedestrian lateral fall due to vehicular impact using the anthropometric test device.

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Lessons identified from the 2017 Manchester and London terrorism incidents. Part two: the reception and definitive care (hospital) phases

BMJ Military Health ◽

10.1136/jramc-2018-000935 ◽

2018 ◽

Vol 166 (2) ◽

pp. 115-119 ◽

Cited By ~ 4

Author(s):

Paul Hunt

Keyword(s):

Multidisciplinary Approach ◽

Large City ◽

Care Hospital ◽

Effective Response ◽

Severe Burns ◽

Clinical Support ◽

Specialist Services ◽

Serious Injuries ◽

To Receive ◽

Network Organisation

The provision of medical care during the reception and definitive care phases of a terrorist incident will likely take place in designated receiving hospitals such as Major Trauma Centres. There is a need for an enhanced capability in such units to receive, initially manage and hold casualties with more serious injuries. Also, even less severely injured casualties may require significant time and clinical input such as risk management in potential bloodborne viruses.The distribution of casualties from the incident scene requires advance consideration of the injury pattern and regional network organisation of specialist services, such as maxillofacial, neurosurgery or severe burns care. Paediatric centres are also more sparsely distributed and often only in large city networks which represents a significant challenge for planners and responders in other regions. An effective response relies on a coordinated multidisciplinary approach including emergency and front-of-house teams, surgical, medical and clinical support services.

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