Injury
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To describe measures that assaulted EMS personnel believe will help prevent violence against EMS personnel. ⋯ Of 1778 survey respondents, 633 reported being assaulted in the previous 12 months; 203 of them believed the incident could have been prevented and 193 of them (95%) answered this question. Six themes were identified using Haddon's Matrix as a framework. The themes included: Human factors, including specialized training related to specific populations and de-escalation techniques as well as improved situational awareness; Equipment factors, such as restraint equipment and resources; and, Operational and environment factors, including advanced warning systems. Persons who could have prevented the violence were identified as police, self, other professionals, partners and dispatchers. Restraints and training were suggested as violence-prevention tools and methods CONCLUSIONS: This is the first international study from the perspective of victimized EMS personnel, to report on ways that violence could be prevented. Ambulance agencies should consider these suggestions and work with researchers to evaluate risks at the agency level and to develop, implement and test interventions to reduce the risks of violence against EMS personnel. These teams should work together to both form an evidence-base for prevention and to publish findings so that EMS medical directors, administrators and professionals around the world can learn from each experience.
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Various factors have been shown to affect rehabilitation outcome of hip fractured patients. The degree of extracapsular fracture stability may also affect functional recovery. The aim of our study was to assess the relationship between extracapsular hip fracture stability and rehabilitation outcome in a post-acute setting. ⋯ Patients with unstable extracapsular hip fractures may require a prolonged rehabilitation period in order to achieve the same functional gain as patients with stable fractures.
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Implementation of trauma systems has markedly assisted in improving outcomes of the injured patient. However, differences exist internationally as diverse social factors, economic conditions and national particularities are placing obstacles. The purpose of this paper is to critically evaluate the current Greek trauma system, provide a comprehensive review and suggest key actions. ⋯ Despite recent economic crisis in Greece, actions solving logistics and organising issues may offer a well-defined, integrated trauma system without uncontrollably raising the costs. Political will is needed for reforms that use pre-existing infrastructure and working power in a more efficient way, with a first line priority being the establishment of the first major trauma centre that could function as the cornerstone for the building of the Greek trauma system.
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Randomized Controlled Trial Comparative Study
Single versus double column fixation in transverse fractures of the acetabulum: A randomised controlled trial.
Biomechanical studies have compared fixation methods in transverse acetabular fractures, yet there is not enough clinical data to suggest an optimal fixation method. The aim of this randomized controlled trail was to compare fracture stability in posterior plating alone versus posterior plating and anterior column lag-screw fixation in treatment of transverse and transverse with posterior wall acetabular fractures. ⋯ Single poster column fixation in transverse and transverse posterior wall fractures showed similar result to double column fixation, in terms of fractures stability in the follow up period, quality of reduction and early functional outcome.
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The UK Home Office test method for ballistic protective police body armours considers anterior torso impacts to be the worst-case scenario and tests rear armour panels to the same standards as front panels. The aim of this paper was to examine the injuries from spinal behind armour blunt trauma (BABT) impacts. This study used a cadaveric 65 kg, female pig barrel and 9 mm Luger ammunition (9 × 19 mm, FMJ Nammo Lapur Oy) into HG1/A + KR1 soft armour panels over the spine. ⋯ Shots were also fired at the posterior and anterior rib area of the pig barrel, for comparison to the spine. Similar wounds were seen on the shots to the posterior rib area while shallower, smaller wounds were seen on the anterior and one anterior rib shot resulted in a single, un-displaced rib fracture. The anatomical differences between pigs and humans would most likely mean that injury to a human from these impacts would be more serious.