1/73. Injuries among railroad trespassers--georgia, 1990-1996.Railroad trespassers are persons on railroad property whose presence is prohibited or unlawful. Most trespassers are walking along or across railroad tracks. In 1997, fatalities to railroad trespassers became the leading cause of railroad-related deaths in the united states. In 1998, 513 persons were injured and 536 persons were killed while trespassing (Federal Railroad Administration, unpublished data, 1999). This report presents three incidents in which trespassers were injured or killed and summarizes a study of fatal and nonfatal injuries to railroad trespassers in georgia from 1990 through 1996.- - - - - - - - - - ranking = 1keywords = bite (Clic here for more details about this article) |
2/73. Possible sequelae of trauma and somatic disorder in early life.All children experience trauma. The age, state of development and constitutional factors will determine whether some children will have a traumatic effect. Trauma occurring before the age of three, at a time when the ego has not developed its synthetic and integrative functions, may be reproduced in later life as an isolated symptom, by selected sensations involved in a sensory imprint or screen sensation of the trauma as a simple recording. After the age of three, under the influence of a more mature ego, excessive traumatic stimuli will be integrated and elaborated in symptom formations as phobias or other conditions and extended as part of the total personality. recurrence in later life is triggered by events related not only to the original experience, but also to the content of its elaboration. The earlier in life the trauma occurs, the more likely that somatic imprints of primitive physiological symptoms would result as an archaic, biological defense or screen sensations. Recurrent sensory imprints or screens may appear as organic illness or functional somatic symptoms. Diagnostically, a detailed early life history is necessary to uncover the presence of a sensory screen memory of a trauma and so avoid diagnostic medical search for organic causation. Case material illustrating the two groups are presented. Indications for psychoanalysis and for supportive psychotherapy are discussed from our theoretical framework as well as from the literature.- - - - - - - - - - ranking = 1.8013502644681keywords = record (Clic here for more details about this article) |
3/73. Operating theatre photography for personal injury cases.photography, including records taken in theatre, has an important role to play in the legal settlement of personal injury claims. photographs taken immediately prior to an operation in the anaesthetic room or during the operation provide valuable evidence for civil litigation. The type of operations at which personal injury photographs should be taken range from emergency surgery and minor operations to exploratory or reparative surgery. The value of pre-operative photography is demonstrated in two examples of orthopaedic surgery for personal injury claims.- - - - - - - - - - ranking = 1.8013502644681keywords = record (Clic here for more details about this article) |
4/73. Deep venous thrombosis in the pediatric trauma population: an unusual event: report of three cases.The incidence of deep venous thrombosis (DVT) in the pediatric population has been reported to be lower than in adults. Pediatric trauma patients have predisposing risk factors for DVT similar to those in the general trauma population. We reviewed the records of 2746 children under 16 years of age admitted to our Level I pediatric trauma service from 1989 to 1997. Only three cases of DVT were documented, all adolescents. DVT was located in the upper (n = 1) and lower (n = 1) extremity venous system. One patient presented with pulmonary embolism alone without identifiable DVT. risk factors found were venous system manipulations, including atriocaval shunt, subclavian central line, and hyperinflated medical antishock trousers garment. Therapy consisted of heparin followed by warfarin anticoagulation. A vena cava filter was inserted in one patient for whom systemic anticoagulation was contraindicated. No DVT was seen in 1123 closed head injury patients or 29 spinal cord injury patients without associated risk factors. The thrombotic risk in pediatric trauma patients is low. Routine screening or prophylaxis is not indicated except for patients who are likely to remain immobile for an extended period of time and require prolonged rehabilitation, have venous manipulations, or present with clinical symptoms. Hematologic evaluation in patients with diagnosed DVT is necessary to identify individual risk factors.- - - - - - - - - - ranking = 1.8013502644681keywords = record (Clic here for more details about this article) |
5/73. myocardial infarction as a complication of injury.BACKGROUND: MI is a rare complication of trauma. We anticipate that the aging of the population and the concomitant rise in geriatric trauma will result in an increase in acute illnesses of the elderly (such as MI) complicating recovery from injury. The purpose of this article is to define the presentation of MI in the immediate postinjury period. STUDY DESIGN: medical records of all trauma patients in whom MI developed during their hospitalizations at a single Level I trauma center, the Barnes Hospital/washington University Medical Center, between 1990 and 1999 were screened through the trauma registry. Nineteen patients with possible postinjury MI were identified. Of these, five had bona fide cases of postinjury MI, five had ambiguity about whether MI preceded or followed trauma, one had an MI resulting in trauma, and eight were excluded because they did not meet strict diagnostic criteria for MI. RESULTS: The five patients with posttraumatic MI were older than the general trauma population with ages ranging from 51 to 81 years (mean /- SD = 72 /- 14 years). Each had preexisting medical illnesses, some of which are recognized to predispose to coronary artery disease. There were no identifiable precipitants other than the recent injury. Importantly, only one of the five patients had chest pain as a presenting symptom and each of the five cases was complicated by acute congestive heart failure. CONCLUSIONS: MI remains a rare but important complication of injury and may increase owing to the changing demographics of trauma victims. methods for thorough history-gathering to identify preexisting conditions, for early hemodynamic monitoring and anticoagulation for MI in the setting of trauma, and for identifying preexisting conditions should be defined. The presentation of MI in the setting of injury is atypical and complications are frequent.- - - - - - - - - - ranking = 1.8013502644681keywords = record (Clic here for more details about this article) |
6/73. Cutaneous leishmaniasis following local trauma: a clinical pearl.Cutaneous leishmaniasis is acquired from the bite of an infected sand fly and can result in chronic skin lesions that develop within weeks to months after a bite. Local trauma has been implicated as a precipitating event in the development of skin lesions in patients who have been infected with Leishmania species. Here we report a case series and review the literature on patients who developed cutaneous leishmaniasis after local trauma, which may familiarize clinicians with this presentation.- - - - - - - - - - ranking = 2keywords = bite (Clic here for more details about this article) |
7/73. Disability, injury and ergonomics intervention.PURPOSE: Disability due to work injury, trauma or disease is prevalent in our society. Also, due to slower growth of population and rapid increase in ageing population there may be an increasing pressure on shrinking labour pool. The purpose of this study is to review disability profile with common disabilities, socioeconomic impact of these disabilities, make a case for ergonomics as an enabler, and provide a couple of case studies to illustrate the point. METHOD: Major disability statistical records were reviewed to reveal rates of disability in some countries of the world. Among them the age and gender association of disability has been described. Furthermore the major categories of disabilities associated with systemic disorders and their gradations have been described, e.g. cardiovascular conditions, pulmonary conditions and joint diseases. Finally, using a feed forward mechanism a specific and customized ergonomic intervention was designed for two workers with knee injury. RESULTS: The prevalence of disability has been reported to range between 0.2% -20.9%. A significant association of disability with ageing was reconfirmed. A significant socio-economic impact of disability including differential employment rate for normal and disabled was discovered. A strategy and a means to achieve increased functionality in people with disability using ergonomic intervention has been described. Using a custom designed shin pad for rehabilitation of two workers with injured knee who were also on compensation were successfully returned to work many weeks before they may have been able to resume their work. CONCLUSION: Using a functional classification and developing functional profiles of people with disability may allow ergonomists to develop generic as well as specific solutions to successfully intervene in many cases and improve their functional capacity.- - - - - - - - - - ranking = 1.8013502644681keywords = record (Clic here for more details about this article) |
8/73. Promoting patient partnership in wound care.Involving patients in their care is a key component of the NHS plan and clinical governance (Department of Health, 1999a). Involvement is enhanced through nurse-patient relationships which are based on partnership in which the patient's viewpoint is given equal weight to that of the practitioner. In the management of wounds, this may be complex due to conflict between clinically effective treatment and a patient's wish. High quality care relies on a holistic assessment of the patient and a negotiated care plan which is implemented and evaluated in order to judge the effectiveness of care.- - - - - - - - - - ranking = 0.20278644483785keywords = relation (Clic here for more details about this article) |
9/73. Critical incident stress debriefing following traumatic life experiences.This study was designed to explore the use of critical incident stress debriefing as a therapeutic intervention following traumatic life events. A case study approach was used to allow the researchers to adopt a more flexible and overtly involved stance. Initial contact took place 24 h following the traumatic life experiences of three women. Critical incident stress debriefing was provided and data were collected and recorded within an ethical framework. Six months following the traumatic life experiences the women were interviewed again to explore their perceptions of the intervention that was provided. The results demonstrated positive outcomes. The women concluded that the debriefing intervention provided a safe forum for them to explore their needs, process their experiences and create constructive narratives. A carefully constructed critical incident stress debriefing intervention was used within the context of its objectives and acknowledged limitations. The study was small and generalizations cannot be made to other individuals who experience similar tragedies. Nevertheless, evidence from previous research coupled with the findings from this study suggests that mental health nurses might benefit from being educated and trained in critical incident stress debriefing. Further research needs to be carried out to explore the use of different models of stress debriefing applied to special circumstances. The goal of such interventions should be to alleviate symptoms and to prevent the development of a full-blown post-traumatic stress disorder.- - - - - - - - - - ranking = 1.8013502644681keywords = record (Clic here for more details about this article) |
10/73. Mixing and matching dressing products.The reality of wound management in clinical practice leaves a lot to be desired in relation to dressing selection and use. Maureen Benbow highlights some of the problems currently being encountered in relation to good wound management practice and illustrates good practice with a particularly difficult case study. A basic understanding of patient assessment, wound assessment, dressing properties and their appropriateness at different stages of healing and for differing clinical appearances is essential to achieving success in wound and patient management. The author uses an unusual case study to illustrate the thinking and informed decision-making behind the choice of dressings used in combination. The issues to be addressed in relation to the management of wounds generally reflect the professional accountability of nurses and how they try to avoid harming the patient, the cost implications of dressings, their efficacy and clinical effectiveness and how practice can be improved.- - - - - - - - - - ranking = 0.60835933451354keywords = relation (Clic here for more details about this article) |
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