Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Feb 2011
Diagnostic and therapeutic aspects in the treatment of gunshot wounds of the viscerocranium.
Gunshot wounds of the viscerocranium are a rare occurrence during times of peace in Europe. The removal of projectiles is recommended; in some cases, however, this is controversial. The material properties of projectiles and destruction of anatomical landmarks make it difficult to determine their precise location. ⋯ In conclusion, there is a significant correlation between reduced intra- and postoperative complications including wound infections, nerve damage and major bleeding and the appropriate use of a navigation system. In all these cases we were able to present reduced operating time. Cone-beam CT plays a key role as a useful diagnostic tool in detecting projectiles or metallic foreign bodies intraoperatively.
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Eur J Trauma Emerg S · Feb 2011
Anesthetic management of injuries following the 2008 Wenchuan, China earthquake.
The authors report anesthetic considerations and management of injuries after the 2008 Wenchuan earthquake, Sichuan, China. ⋯ Epidural anesthesia and peripheral nerve block are the anesthetic techniques of choice for post-earthquake injuries due to limited conditions and appliances. More attention should be paid to preoperative evaluation, anesthetic techniques, anesthetic management, anesthetic application and postoperative recovery according to patient conditions and the limited environment.
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Eur J Trauma Emerg S · Feb 2011
Functional outcome and quality of life in victims of terrorist explosions as compared to conventional trauma.
Following trauma, the number of preventable deaths is low. Outcome should also be measured in terms of quality of life (QoL). Studies analyzing QoL in trauma patients have been published, but little is known about the long term QoL of victims of terrorist attacks. ⋯ Subjects present more emotional distortions, residual pain in the head region and a tendency towards a worsened perception of their own health and wellness. They also present symptoms associated to PTSD more frequently. The presence of symptoms associated to PTSD, depression or anxiety was an independent variable related to lower QoL in both groups.
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Eur J Trauma Emerg S · Feb 2011
Gunshot injury without direct injury to the cord may lead to complete paraplegia.
Paraplegia following gunshot injury without direct injury to the cord is extremely rare. We describe the case of a 31-year-old woman who was admitted to our trauma resuscitation unit for a penetrating gunshot wound to the abdomen with hemorrhagic shock and paraplegia. Computed tomography (CT) scan of the abdomen showed severe hepatic and pulmonary injuries, with the trajectory of the missile away from the spinal canal. ⋯ After 24 months, no significant neurologic improvement occurred. Physicians managing severe trauma should be aware of the possibility to observe severe neurologic deficit following gunshot wounds even without violation of the spinal canal. These injuries might be in relation to the kinetic energy emission to the surrounding tissue by the missile.
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Eur J Trauma Emerg S · Feb 2011
Toward a new definition of 'refugee': is the 1951 convention out of date?
Definitions, by necessity, may change or need to be changed to accommodate situations that arise. The United Nations recognized that the emergence of new refugee situations required changes in the Convention. These changes were codified in the 1967 Protocol Relating to the Status of Refugees. ⋯ As new classifications of refugees develop, there needs to be changes in the definition of what is a refugee. There has been a growing consensus in the international arena to recognize those displaced by environmental causes. We need to take steps to develop an inclusive definition of refugee that includes those displaced by environmental causes.