Injury
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High tension electrical injuries have a high morbidity and mortality. Carbon fibre and graphite used in the manufacture of fishing rods gives them superconductor qualities. We report a case which teaches an important lesson not only in the management of such severe injuries, but also in their prevention.
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The results of resuscitation of the multiply-injured patient have been subjected to audit at this district teaching hospital (Lewisham) over a 6-month period in 1988. During this period the trauma team was called to 30 patients in the accident department and one death was identified as being potentially preventable. ⋯ There is now little doubt that the creation of a network of trauma centres in the United Kingdom will decrease the occurrence of preventable deaths in multiply-injured patients. However, until this network is introduced, each hospital must consider in the interim how best it can respond to the immediate needs of the multiply-injured patient.
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On the 7 December 1988 an earthquake struck a densely populated region in northern Armenia. Up to 50,000 people were killed and many thousands were seriously injured. At least 385 of these casualties developed acute renal failure secondary to crush syndrome and required dialysis. ⋯ We assisted by taking a team of dialysis personnel, equipped with portable haemodialysis machines, to Yerevan. We performed 57 haemodialysis sessions and treated 15 patients, 13 of whom ultimately survived. Valuable lessons were learnt about the medical management of disasters abroad.
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This paper discusses the problems of handling major burns in disasters with particular reference to the disaster that occurred in Bradford. Several major features of the Bradford fire, in which 56 people died, made its management much simpler than might be expected in subsequent burns disasters; these are discussed. Lessons that have been learned from handling this disaster are indicated.