J Trauma
-
Despite harsh legislation, driving under the influence of alcohol (DUI) is exceedingly common, and alcohol-related motor vehicle crashes (MVCs) account for significant morbidity, mortality, and economic loss. Legal sanctions can keep offenders off the road (protecting other drivers and pedestrians) and ensure compliance with treatment programs (reducing recidivism). However, even with clear evidence of a transgression, the law seems to be inconsistently enforced among trauma patients. The purpose of this study was to measure the rate of legal prosecution among impaired drivers admitted to a trauma center after MVCs, and to determine the recidivism rate among these individuals. ⋯ Alcohol is involved in a large percentage of MVCs in our region. The infrequency of prosecution for DUI despite property damage and/or personal injury, and the high recidivism rate, are significant social concerns. These data suggest the need for processes to facilitate legal prosecution--possibly including revision of legislation involving reporting of BACs.
-
Pelvic fractures occur uncommonly in children. Despite serious sequelae, they have been infrequently reviewed. ⋯ The majority of pelvic fractures in children may be satisfactorily treated nonoperatively. Operative interventions were more frequently required for associated injuries. Long-term review is indicated because of delayed complications in children that are continuing to grow and develop.
-
Blunt cerebrovascular artery injury (BCI) remains difficult to diagnose but is recognized with increasing frequency after motor vehicle collisions (MVCs). Failure to detect this injury in a timely fashion can be devastating. Criteria that can be used to heighten the suspicion of this injury have been suggested; however, more encompassing screening has been recommended. To address this need, we sought to describe occupant, vehicle, and collision characteristics among MVC occupants who sustained a BCI. ⋯ This study indicates that BCI is both a rare and lethal injury typified by specific occupant and collision characteristics. These characteristics provide insight as to the cause of this injury that may aid in the evaluation and management of the blunt trauma patient at risk for BCI.
-
The New Injury Severity Score (NISS) was proposed in 1997 to replace the Injury Severity Score (ISS) because it is more sensitive for mortality. We aim to test whether this is true in our patients. ⋯ The NISS should not replace the ISS, as they share similar accuracy and calibration.