J Trauma
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Comparative Study
Bicyclists injured by automobiles: relationship of age to injury type and severity--a national trauma databank analysis.
Bicycle riding is a popular recreational activity and a common mode of transportation. Impact with a motor vehicle, however, has the potential to result in significant injury to the rider. The magnitude of this problem, the incidence and types of injuries, and the effect of age on these variables are poorly defined in the literature. ⋯ Bicycle-related injuries involving motor vehicles are associated with a high incidence of head injuries and extremity fractures. Age plays a critical role in the severity and anatomic distribution of injuries sustained, with a stepwise increase in mortality with increasing age. Further evaluation of specific preventative measures, especially for elderly bicyclists is warranted.
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Comparative Study
Triage and trauma workload in mass casualty: a computer model.
The aim of this study was to quantitatively analyze the impact of hospital triage on the workload of trauma teams in the Emergency Department during a mass casualty incident, using a computer model. ⋯ This study introduces innovative tools for quantitative analysis of hospital triage in mass casualty incidents and shows how triage accuracy and mode affect the ability of trauma teams to cope with heavy casualty loads. These tools can be used to optimize the hospital response to future threats.
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Comparative Study
Use of force by law enforcement: an evaluation of safetyand injury.
Little is known about the frequency and types of injuries sustained from law enforcement use of force (UOF). The purpose of this study was to examine injury patterns and subject conditions after law enforcement UOF under real-life conditions. ⋯ Significant injuries related to law enforcement UOF in one city were rare and the only deaths were related to firearm use. A large percentage of those subjected to UOF had diagnoses of substance abuse and/or psychiatric conditions, and most hospital admissions were for problems unrelated to the UOF.
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Comparative Study
Clot-inducing minerals versus plasma protein dressing for topical treatment of external bleeding in the presence of coagulopathy.
Previous studies identified WoundStat (WS, smectite) and Combat Gauze (CG, kaolin-coated gauze) as the most effective available agents for controlling arterial bleeding with potential utility in casualty care. Tissue sealant properties of WS suggested its potential advantage over clot-promoting CG for treating coagulopathic bleeding. This study compared the efficacy of CG and WS with a fibrinogen-based (FAST) dressing to control bleeding in coagulopathic animals. ⋯ The tissue sealant property of WS is apparently mediated by clot formation in the wound; therefore, it was ineffective under coagulopathic conditions. CG was partially effective in maintaining blood pressure up to 1 hour after application. FAST dressing showed the highest efficacy because of the exogenous delivery of concentrated fibrinogen and thrombin to the wound, which bypasses coagulopathy and secures hemostasis.