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Trauma Victims (trauma + victim)

Distribution by Scientific Domains

Medical Sciences	75%
5 Other Domains	25%

Selected Abstracts

TRANSFER OF FACIALLY INJURED ROAD TRAUMA VICTIMS AND ITS IMPACT ON TREATMENT

ANZ JOURNAL OF SURGERY, Issue 6 2005
Martin Batstone
Background: Road trauma is a common cause of severe facial injuries. The aim of the present study is to define patients involved, and determine the effect of their geographical origin on treatment and follow up. Methods: All patients over 14 years of age suffering facial injuries caused by road trauma presenting to the two study hospitals from 1994 to 1999 were identified and details were collected on demographic details and treatment. Results: Four hundred and nine patients met the inclusion criteria. The majority required hospital transfer. Young men were the most frequently injured group of patients. Patients from peripheral regions had significant delays in transfer and treatment. They were made fewer outpatient appointments but attended at the same frequency as patients from the immediate region of the study hospitals. Conclusions: To minimize delays the process of patient transfer needs to be streamlined and education of staff in peripheral hospitals undertaken regarding facial injuries. [source]

Initial symptoms and reactions to trauma-related stimuli and the development of posttraumatic stress disorder

DEPRESSION AND ANXIETY, Issue 2 2005
Karin Elsesser Ph.D.
Abstract We investigated laboratory and experimental variables as predictors of the development of posttraumatic stress disorder (PTSD). Evoked heart rate response to trauma-related pictures, attentional bias in the dot-probe task, and viewing time were assessed in 35 victims of a traumatic event and again after 3 months. Data was compared to 26 control participants. At first assessment trauma victims showed heart rate (HR) acceleration and controls showed HR deceleration to trauma-related material. The group of trauma victims improved clinically over time. Predictors of the number of PTSD symptoms after 3 months were re-experiencing (33% of the variance) and amplitude of the evoked HR reaction to trauma-related pictures (15%). The two variables were highly correlated. Trauma victims were also more anxious, viewed trauma-related pictures for a longer time, and had a longer reaction time in the dot-probe task (but no distinct attentional bias) than control participants. Results indicate that specific fear responses and re-experiencing contribute to the development of posttraumatic stress disorder. Depression and Anxiety 21:61,70, 2005. © 2005 Wiley-Liss, Inc. [source]

The Influence of Penetrative Trauma on the Rate of Decomposition,

JOURNAL OF FORENSIC SCIENCES, Issue 2 2010
Peter Cross M.Sc.
Abstract:, An understanding of the factors affecting decomposition is important for the accurate estimation of postmortem interval. An experimental study on the influence of penetrating trauma on decomposition rate was carried out using the domestic pig, Sus scrofa. The results of this study were: (i) Diptera were preferentially attracted to and oviposited at natural orifices. Trauma sites were not preferentially selected for oviposition; (ii) no differences between trauma and non-trauma groups were found in time to skeletonization, weight loss (p = 0.906), total body score (p = 0.824), body temperature (p = 0.967), or changes in soil pH (p = 0.684); and (iii) the effect of investigator disturbance was significant when decomposition was measured as weight loss (p = 0.000). This study suggests that penetrating trauma of the type used in this study cannot be considered a major factor in the rate of decomposition and time to skeletonization of a gunshot trauma victim. [source]

Exploring the potential of video technologies for collaboration in emergency medical care: Part II.

JOURNAL OF THE AMERICAN SOCIETY FOR INFORMATION SCIENCE AND TECHNOLOGY, Issue 14 2008
Task performance
We conducted an experiment with a posttest, between-subjects design to evaluate the potential of emerging 3D telepresence technology to support collaboration in emergency health care. 3D telepresence technology has the potential to provide richer visual information than do current 2D video conferencing techniques. This may be of benefit in diagnosing and treating patients in emergency situations where specialized medical expertise is not locally available. The experimental design and results concerning information behavior are presented in the article "Exploring the Potential of Video Technologies for Collaboration in Emergency Medical Care: Part I. Information Sharing" (Sonnenwald et al., this issue). In this article, we explore paramedics' task performance during the experiment as they diagnosed and treated a trauma victim while working alone or in collaboration with a physician via 2D videoconferencing or via a 3D proxy. Analysis of paramedics' task performance shows that paramedics working with a physician via a 3D proxy performed the fewest harmful interventions and showed the least variation in task performance time. Paramedics in the 3D proxy condition also reported the highest levels of self-efficacy. Interview data confirm these statistical results. Overall, the results indicate that 3D telepresence technology has the potential to improve paramedics' performance of complex medical tasks and improve emergency trauma health care if designed and implemented appropriately. [source]

Clearing the cervical spine in unconscious polytrauma victims, balancing risks and effective screening

ANAESTHESIA, Issue 5 2004
C. G. T. Morris
Summary Cervical spine injury occurs in 5,10% of cases of blunt polytrauma. A missed or delayed diagnosis of cervical spine injury may be associated with permanent neurological sequelae. However, there is no consensus about the ideal evaluation and management of the potentially injured cervical spine and, despite the publication of numerous clinical guidelines, this issue remains controversial. In addition, many studies are limited in their application to the obtunded or unconscious trauma victim. This review will provide the clinician managing unconscious trauma victims with an assessment of the actual performance of clinical examination and imaging modalities in detecting cervical spine and isolated ligamentous injury, a review of existing guidelines in light of the available evidence, relative risk estimates and a proposed management scheme. [source]

Initial symptoms and reactions to trauma-related stimuli and the development of posttraumatic stress disorder

Risk factors and outcome in ambulatory assault victims presenting to the acute emergency department setting: Implications for secondary prevention studies in PTSD

DEPRESSION AND ANXIETY, Issue 2 2004
Peter P. Roy-Byrne M.D.
Abstract Prevention of post-traumatic stress disorder (PTSD) in trauma victims is an important public health goal. Planning for the studies required to validate prevention strategies requires identification of subjects at high risk and recruitment of unbiased samples that represent the larger high-risk population (difficult because of the avoidance of many trauma victims). This study recruited high-risk victims of interpersonal violence (sexual or physical assault) presenting to an urban emergency department for prospective 1- and 3-month follow-up. Of 546 victims who were approached about participating, only 56 agreed to be contacted and only 46 participated in either the 1- or 3-month interviews. Of the 46, 43 had been previously victimized with a mean of over six traumas in the group; 21% had prior PTSD, 85% had prior psychiatric illness, and 37% had prior substance abuse. Sixty-seven percent had positive urine for alcohol or drugs on presentation. Fifty-six percent developed PTSD at 1 or 3 months with the rate declining between 1 and 3 months. There was high use of medical and psychiatric services. These findings document both the difficulty of recruiting large samples of high-risk assault victims to participate in research, and the high rate of prior traumatization, PTSD, substance use, and psychiatric morbidity in these subjects which, if still active at the time of victimization, may complicate efforts to document preventive treatment effects. Depression and Anxiety 19:77,84, 2004. © 2004 Wiley-Liss, Inc. [source]

State of play: Clearing the thoracolumbar spine in blunt trauma victims

EMERGENCY MEDICINE AUSTRALASIA, Issue 5-6 2006
Marten C Howes
Abstract Introduction:, The present article reviews the clinical and imaging clearance of the thoracic and lumbar spines of blunt trauma victims and the evolution of these strategies with the use of new imaging technologies. Methods:, A comprehensive literature search was performed, and articles identified were critically appraised Results:, Twenty papers were identified, 12 directly comparing computed tomography screening with plain X-rays. Evidence-based protocols are presented. The evolution of imaging strategies in response to new technology is described. Conclusions:, Thoracolumbar spine screening is best done using reformatted images acquired when scanning the chest and abdomen of high-risk multi-trauma patients. If computed tomography is not clinically indicated for investigation of other injuries then plain films are the first line investigation. [source]

A Comparison of Trauma Intubations Managed by Anesthesiologists and Emergency Physicians

ACADEMIC EMERGENCY MEDICINE, Issue 1 2004
Joseph S. Bushra MD
Although airway management by emergency physicians has become standard for general emergency department (ED) patients, many believe that anesthesiologists should manage the airways of trauma victims. Objectives: To compare the success and failure rates of trauma intubations performed under the supervision of anesthesiologists and emergency physicians. Methods: This was a prospective, observational study of consecutive endotracheal intubations (ETIs) of adult trauma patients in a single ED over a 46-month period. All ETIs before November 26, 2000, were supervised by anesthesiologists (34 months), and all ETIs from November 26, 2000, onward were supervised by emergency physicians (12 months). Data regarding clinical presentation, personnel involved, medications used, number of attempts required, and need for cricothyrotomy were collected. Study outcomes were: 1) successful intubation within two attempts, and 2) failure of intubation. Failure was defined as inability to intubate, resulting in successful intubation by another specialist, or cricothyrotomy. Odds ratios (ORs) with 95% confidence intervals (95% CIs) were used to compare results between groups. Results: There were 673 intubations during the study period. Intubation within two attempts was accomplished in 442 of 467 patients (94.6%) managed by anesthesiologists, and in 196 of 206 of patients (95.2%) managed by emergency physicians (OR = 1.109, 95% CI = 0.498 to 2.522). Failure of intubation occurred in 16 of 467 (3.4%) patients managed by anesthesiologists, and in four of 206 (1.9%) patients managed by emergency physicians (OR = 0.558, 95% CI = 0.156 to 1.806). Conclusions: Emergency physicians can safely manage the airways of trauma patients. Success and failure rates are similar to those of anesthesiologists. [source]

The Focused Abdominal Sonography for Trauma (FAST) Examination: Considerations and Recommendations for Training Physicians in the Use of a New Clinical Tool

ACADEMIC EMERGENCY MEDICINE, Issue 2 2000
Philip N. Salen MD
Abstract. Focused abdominal sonography for trauma (FAST) is being used by growing numbers of emergency physicians and surgeons because it has proven to be an accurate, rapid, and repeatable bedside test for evaluating abdominal trauma victims. Controversy exists about the optimal means of FAST education and the number of examinations necessary to demonstrate competency. Most FAST educators agree that FAST education should consist of three phases: didactic, practical, and experiential. This article summarizes options and preliminary recommendations suitable for developing a FAST curriculum. [source]

Starvation mortality and body condition of Goshawks Accipiter gentilis along a latitudinal gradient in Norway

IBIS, Issue 2 2002
Peter Sunde
Relative starvation risk and body condition were investigated in 599 Goshawks that had died in collision accidents or of starvation. Specimens were collected by the public along a 1300-km north,south (58°N,71°N) gradient in Norway, representing the northernmost geographical range of the species. The probability of a Goshawk's death being caused by starvation as opposed to by a collision accident increased with latitude with juvenile males at a disproportionately higher risk than others. Of birds killed in accidents, females generally were in better condition than males, and adults in better condition than juveniles. A season-by-latitude interaction indicated that males from northern latitudes were in poorer condition during winter and spring than males from southern parts of the country. This could also be modelled as a curvilinear relationship with daylength. There were no significant relationships between weather factors in the weeks prior to the deaths of the birds and the relative starvation probability or the condition of trauma victims. The results suggest that food limitation plays a relatively higher role in northern populations, affecting young males especially. This was also supported by the fact that the sex ratio of accidentally killed birds was increasingly female biased with increasing latitudes. It is suggested that the relatively higher mortality risk of males is due to their smaller average body size, and that selection for starvation resistance during winter is the reason behind the clinal increase of body size in Goshawks towards the northern and eastern parts of Europe. [source]

The intergenerational effects of trauma from terror: A real possibility,

INFANT MENTAL HEALTH JOURNAL, Issue 2 2009
Marsha Kaitz
The goals of this article are to discuss the potential risk of children whose parents were traumatized by terror, to present literature on parenting in the context of terror, and to consider factors that may mediate the transmission of trauma-effects from parents to children. Mediators considered are parents' traumatic distress, disturbed parent,child interactions, trauma-related disturbances in parents' thinking, and effects of stress on children's neural functioning. Also discussed are genetic and environmental factors that may moderate the transmission of intergenerational effects and promote children's risk and resilience. Points raised during the discussion are illustrated with segments from interviews of women who were pregnant or gave birth some time after direct exposure to a terror attack. The authors conclude that empirical studies are needed to learn more about the intergenerational transmission of trauma-effects and processes that underlie it. The authors join others in the call to improve evaluation, treatment, and support of trauma victims and their children to stymie the transmission of problems from one generation to the next. [source]

The Association Between Hypothermia, Prehospital Cooling, and Mortality in Burn Victims

ACADEMIC EMERGENCY MEDICINE, Issue 4 2010
Adam J. Singer MD
Abstract Objectives:, Hypothermia is associated with increased morbidity and mortality in trauma victims. The prognostic value of hypothermia on emergency department (ED) presentation in burn victims is not well known. The objective of this study was to determine the incidence of hypothermia in burn victims and its association with mortality and hospital length of stay (LOS). The study also examined the potential causative role of prehospital cooling in hypothermic burn patients. Methods:, This was a retrospective review of a county trauma registry. The county was both suburban and rural, with a population of 1.5 million and with one burn center. Burn patients between 1994 and 2007 who met trauma registry criteria were included. Demographic and clinical data including prehospital cooling, burn size and depth, and presence of inhalation injury were collected. Hypothermia was defined as a core body temperature of less than or equal to 35°C. Data analysis consisted of univariate associations between patient characteristics and hypothermia. Results:, There were 1,215 burn patients from 1994 to 2007. Mean age (±standard deviation [±SD]) was 29 (±24) years, 67% were male, 248 (26.7%) had full-thickness burns, and 24 (2.6%) had inhalation injury. Only 17 (1.8%) had a burn larger than 70% total body surface area (TBSA). A total of 929 (76%) patients had an initial ED temperature recorded. Only 15/929 (1.6%) burn patients had hypothermia on arrival, and all were mild (lowest temperature was 32.6°C). There was no association between sex, year, and presence of inhalation injury with hypothermia. Hypothermic patients were older (44 years vs. 29 years, p = 0.01), and median Injury Severity Score (ISS) was higher (25 vs. 4, p = 0.002) than for nonhypothermic patients. Hypothermia was present in 6/17 (35%) patients with a TBSA of 70% or greater and in 8/869 (0.9%) patients with a TBSA of <70% (p < 0.001). Mortality was higher in hypothermic patients (60% vs. 3%, p < 0.001). None of the hypothermic patients received prehospital cooling. Conclusions:, Hypothermia on presentation to the ED was noted in 1.6% of all burn victims in this trauma registry. Hypothermia was more common in very large burns and was associated with high mortality. In this series, prehospital cooling did not appear to contribute to hypothermia. ACADEMIC EMERGENCY MEDICINE 2010; 17:456,459 © 2010 by the Society for Academic Emergency Medicine [source]

Children Who Have Been Traumatized: One Court's Response

JUVENILE AND FAMILY COURT JOURNAL, Issue 4 2008
Judge Michael L. Howard
ABSTRACT A court that is trauma-informed can assist with the process of identifying children in need of trauma-focused services and can provide education and direction to families frustrated by prior treatment failures. The unique role of the juvenile court judge as a community convener offers an opportunity to increase community awareness about the impact of trauma, and to promote the adoption of evidence-based treatment for trauma victims. This article outlines the way that increased trauma awareness and trauma screening within a family court system mobilized the development of effective resources for children and families affected by trauma. [source]

Differences in Early Onset Alcohol Use and Heavy Drinking among Persons with Childhood and Adulthood Trauma

THE AMERICAN JOURNAL ON ADDICTIONS, Issue 6 2007
Angela E. Waldrop PhD
We examined predictors for age at onset of first alcohol use and onset of heaviest alcohol use among men (n = 43) and women (n = 46) with alcohol dependence and PTSD, PTSD only, alcohol dependence only, and controls, with a particular focus on individuals with child versus adult trauma. Using analysis of variance procedures, results showed differences in onset of first alcohol use and heaviest drinking between childhood and adulthood trauma victims. These preliminary results indicate that behavioral mechanisms associated with alcohol use patterns between individuals with childhood and adulthood trauma are dissimilar, suggesting greater psychopathological consequences for individuals with childhood trauma. [source]

Clearing the cervical spine in unconscious polytrauma victims, balancing risks and effective screening

Management of spleen injuries: the current profile

ANZ JOURNAL OF SURGERY, Issue 3 2010
Antonina Mikocka-Walus
Abstract Background:, There has been a shift from operative to conservative management of splenic injuries in the last two decades, but the current practice in Australia is not known. This study aims to determine the profile of splenic injury in major trauma victims and the approach to treatment in Victoria for the last 2 years. Methods:, A review of prospectively collected data from the Victorian State Trauma Registry (VSTR) from July 2005 to June 2007 was conducted. Demographic data, details of the event, clinical observations, management and associated outcomes were extracted from the database. The patients were categorized into four groups according to management (conservative, splenectomy, embolization and repair) and were compared accordingly. Multivariate binary logistic regression was performed to identify predictors of treatment (conservative versus splenectomy) on arrival. Results:, Of the 318 major trauma patients with splenic injuries, 186 (59%) were treated conservatively, 103 (32%) with splenectomy, 17 (5%) with arterial embolization and 12 (4%) with repair. Of these, 14 (14%) splenectomy cases and 2 (12%) embolization cases did not receive their respective treatments within 24 h. The severity of the spleen injury (as measured by the Abbreviated Injury Scale (AIS)) and age were identified as significant independent predictors of the form of treatment provided. Conclusion:, In Victoria, conservative management is the preferred approach in patients with minor (AIS = 2) to moderate (AIS = 3) splenic injuries. The low rates of embolization warrant further research into whether splenectomy is overused. [source]