International journal of emergency medicine
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Injury remains a major cause of death and disability worldwide. ⋯ Childhood injury accounts for a substantial burden of disease in Maputo, Mozambique. This study highlights the fact that many of these injuries are consistent with the injury patterns seen in children in other low and middle income countries, and are amenable to prevention, access, and emergency care programs targeted at children and their families, schools, and the local and national community.
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Bronchial rupture is a rare and serious complication of blunt chest trauma, which can be easily overlooked on initial evaluation in the emergency room (ER) as the focus of the attending physician is diverted to more obvious external injuries which may not be of much significance. We present one such patient referred to us as a case of unresolved right-sided pneumothorax 2 days after intercostal drainage (ICD) tube placement.
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Trauma care in developing countries suffers from many limitations related to equipment shortages, disrepair, quality assurance, and lack of training. Health care providers in the three principal hospitals in Cusco, Peru have ultrasound machines, but they do not utilize this for the focused assessment of sonography in trauma (FAST) scan (only one of the three hospitals has a computed tomography scanner). ⋯ After a training session in the use of ultrasound in trauma, health care workers in Cusco, Peru reported increased confidence in their FAST scan ability and in their comfort in using this exam for clinical decision-making. Future research should include objective testing of participants' skill as well as longitudinal follow-up to determine the extent to which the FAST scan has been incorporated into participants' evaluations of trauma patients.
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Trauma is major cause of morbidity and mortality in India. The Advanced Trauma Life Support (ATLS) programme teaches a standardised method for the initial assessment and management of trauma patients, and has been adopted by more than 50 countries worldwide. ⋯ Our study demonstrated the positive influence of completion of an ATLS-type programme on the score obtained on the trauma management quiz. Although previous work has demonstrated mixed results concerning improvement in the care of trauma patients following completion of an ATLS programme, we recommend that such programmes be integrated into the training of Indian ED MOs and suggest that ATLS should be viewed as an integral part of medical training.
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Life-threatening acute lung injury due to combat and/or terror attacks is associated with high mortality. The successful management includes the use of "rescue" extracorporeal lung assist and early transport by aeromedical evacuation teams. ⋯ Novel techniques in extracorporeal lung assist and in ventilatory support may help save lives even in disaster medicine.