Injury
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The use of airguns in attempted suicide is uncommon. In such instances, the surface wounds caused by discharged pellets may be inconspicuous or appear deceptively trivial to the medical examiner. Airgun pellets however are easily capable of penetrating the skull or abdominal cavity when fired at the close ranges involved in suicide attempts. ⋯ Most of the victims were male. The majority of wounds were right sided. Four of the attempts were extremely determined, involving repeated discharge of the airgun or the use of other means to effect suicide.
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To determine the existence and composition of Trauma Teams in UK hospitals postal and telephone enquiries were made to 185 Accident & Emergency (A&E) departments comprising all those in the UK with an annual attendance of over 30,000 patients per year. The existence of Trauma Teams was not influenced by the number of A&E attendances or the medical staffing composition in the A&E department. ⋯ In 58 out of the 69 hospitals the difficulties in getting the appropriate doctors to respond quickly to multiply injured patients was the main reason for not making any arrangements for rapid multidisciplinary evaluation of them. Changing the medical profession's attitude to injury management is a hurdle that will need to be overcome.
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Distal pancreatectomy to manage disruption of the body and tail of the pancreas is a well-established surgical procedure. Fistula formation after distal pancreatectomy for injury may be as high as 24 per cent, and its treatment, although non-operative, prolongs hospitalization and increases the patient's discomfort. ⋯ Although this procedure has been previously described, it did not receive appropriate acclaim. Our experience suggests that this technique may eliminate fistula formation and other complications, thereby reducing patient discomfort, morbidity and hospital stay.
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Comparative Study Clinical Trial Controlled Clinical Trial
Comparison of intra-articular lignocaine and a suprascapular nerve block for acute anterior shoulder dislocation.
We compared the analgesic effects of a suprascapular nerve block with intra-articular local anaesthetic in 20 patients presenting with acute anterior glenohumeral dislocations. The intra-articular local anaesthetic technique was a simpler procedure which provided significantly more analgesia for patients.