Archives of trauma research
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Estimating pain in patients of intensive care unit (ICU) is essential, but because of their special situation, verbal scales cannot be used. Therefore, to estimate the level of pain, behavioral pain scale was developed by Payen in 2001. ⋯ BPS in patients with low level of consciousness due to head trauma has strong reliability and validity. Therefore, this scale can be used for patients hospitalized in ICU to assess the level of pain.
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Tibial fractures are the third most common pediatric long-bone fracture after forearm and femoral fractures. Approximately 50% of pediatric tibial fractures occur in the distal third of the tibia. This is followed by midshaft tibial fractures (39%), and least commonly, the proximal third of the tibia is involved. Tibial fractures in the skeletally immature patient can usually be treated without surgery but tibial fractures resulting from high energy traumas are of special importance considering type of the selected treatment method affecting the children future. Manipulation and casting are regarded as definite treatments for children tibial fractures. They are used following compartment syndrome in poly-trauma, neurovascular damages, open fractures, and fasciotomy cases. ⋯ Although external fixation in open pediatric fractures and severe injuries is recommended, intramedullary nailing is also an effective method with low complications. Combining pins and flexible intramedullary nails is effective in developing more stability and is not associated with more complications.
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On the last Wednesday of every year Iranians celebrate the sanctity of fire in the annual festival of Chaharshanbeh Soori. Each year many cases of firecracker-related injuries (FRI) are reported during this festival. The aim of this study was to assess the pattern of injuries and the frequency of disabilities during this period. ⋯ Twenty-one patients were hospitalized, 12 patients (34%) received outpatient treatment and two patients were referred to other hospitals. There are still many victims during Chaharshanbeh Soori festival despite efforts and legislations by the government. Education and raise of awareness among people especially for youth are the most important ways to prevent and reduce Red Wednesday injuries.
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Extensive hemorrhage is the leading cause of death in the first few hours following multiple traumas. Therefore, early and aggressive treatment of clotting disorders could reduce mortality. Unfortunately, the availability of results from commonly performed blood coagulation studies are often delayed whereas hemoglobin (Hb) levels are quickly available. ⋯ An Hb-driven algorithm, in combination with the "coagulation box" and the early use of clotting factors, could be a simple and effective tool for improving coagulopathy in multiple trauma patients.
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Trauma, especially chest and abdominal trauma are increasing due to the growing number of vehicles on the roads, which leads to an increased incidence of road accidents. Urbanization, industrialization and additional problems are the other associated factors which accelerate this phenomenon. A better understanding of the etiology and pattern of such injuries can help to improve the management and ultimate the outcomes of these patients. ⋯ Considering the fact that road-related accidents are quite predictable and controllable; therefore, the quality promotion of traumatic patients' care, and the road safety should be noted as problems associated with public health.