Injury
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Captive bolt guns or 'slaughterer's guns' are weapons used in slaughtering animals. Lesions caused by these weapons are likely to have a more serious character than is to be expected from the size of the entrance wound. The wounds are primarily contaminated and it is imperative to explore the wound thoroughly as foreign bodies are often deeply embedded. Three cases are reported of accidental injuries to personnel working with such weapons.
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To assess the relationship between blood alcohol concentration (BAC) and injury severity in an unselected population of road accident victims, case notes of 820 consecutive road accident victims presenting to hospital in a 12 month period were reviewed retrospectively. Five hundred and thirty-five of these were eligible for BAC analysis and results, obtained from the Victoria Police and the Road Safety and Traffic Bureau were available in 429 cases. These were expressed as mg/100 ml (per cent). ⋯ Second, the median ISS for intoxicated patients (4) was significantly higher than that for sober patients (1) (P < 0.05). Third, when patients were grouped according to ISS, the prevalence of intoxication in each group rose with increasing injury severity (chi 2: P < 0.01). We conclude that there is a significant positive correlation between BAC and injury severity in road accident victims treated at a Melbourne hospital.
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The philosophy of medical audit and methods of data collection and statistical analysis have been extensively reviewed but less has been written about the effect of audit on medical practice. The measurement of performance is only valuable if it identifies areas of concern and stimulates appropriate change. ⋯ Problems remain and there is continuing concern about trauma management in the hospital. This has been reinforced by performance feedback through the Trauma Audit Group which has attracted the interest of senior clinicians in several specialties.