Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention
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To determine the prevalence of lifetime history of traumatic brain injury (TBI) with loss of consciousness (LOC) among adult, non-institutionalised residents of Ohio. ⋯ One in five adults experienced TBIs of sufficient severity to cause LOC; 3% experienced at least one moderate or severe TBI and almost 10% experienced a first TBI with LOC before the age of 15 years. The prevalence of lifetime TBI in the present study suggests that there may be a substantially greater burden of injury than concluded from previous prevalence estimates.
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Traumatic injury is a leading cause of premature death and health loss in New Zealand. Outcomes following injury are very time sensitive, and timely access of critically injured patients to advanced hospital trauma care services can improve injury survival. ⋯ The findings of this research will identify opportunities to optimise access to advanced-level hospital care in New Zealand to increase the chances of survival from serious injury. The resulting epidemiological and geospatial analyses will represent an advancement of knowledge for injury prevention and health service quality improvement towards better patient outcomes following serious injury in New Zealand and similar countries.
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Emergency departments (EDs) are usually the first point of contact, and often the only medical service available, for patients with mild traumatic brain injury (mTBI) in rural and regional areas. Clinical practice guidelines (CPGs) have been created to ensure best practice management of mTBI in EDs. Adherence to mTBI CPGs has rarely been evaluated in rural and regional areas. ⋯ Several key elements for the management of mTBI were under-recorded, particularly 4-hour observations, safe discharge and education. Acquired brain injury clinic referrals were received in overwhelmingly fewer cases than had a CT scan (n=19, 6.3%). Overall, this study suggests that the regional health service does not currently fully adhere to the CPG and that the referral services are potentially underutilised.
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Randomized Controlled Trial Comparative Study
Comparison of the effectiveness of hands-on versus online education in child passenger safety.
Community paediatricians' knowledge of appropriate child safety seat (CSS) use in vehicles may be inadequate. We compared the effectiveness of hands-on and online education in improving and retaining child passenger safety (CPS) knowledge and skills among paediatric trainees. ⋯ Among paediatric trainees, hands-on and online CPS education are both effective in improving long-term CPS knowledge. Long-term installation skills for forward-facing and rear-facing CSS persist for hands-on education but are inconclusive for online education.
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Drowning is a global health problem that can be addressed with multiple strategies including utilisation of lifeguards in recreational swim areas. However, few studies have described lifeguard prevention activities. We conducted a retrospective analysis using lifeguard activity data collected in real time with a Computer-Aided-Dispatch (CAD) system to characterise the nature of lifeguard primary and secondary drowning prevention at a popular ocean beach in California. ⋯ Most preventative actions and rescues occurred during summer months, weekends and afternoons. Statistically significant geographical clusters of preventative actions were identified all over the beach, while rescue clusters were primarily restricted to two sites. Using the most reliable and valid collection system to date, these data show spatial and temporal patterns for ocean lifeguard provision of primary prevention as well as secondary drowning prevention (rescue).