Showing papers in "Journal of Trauma-injury Infection and Critical Care in 1973"

Energy damage and the ten countermeasure strategies.

Abstract: A major class of ecologic phenomena involves the transfer of energy in such ways and amounts, and at such rapid rates, that inanimate or animate structures are damaged. The harmful interactions with people and property of hurricanes, earthquakes, projectiles, moving vehicles, ionizing radiation, lightning, conflagrations, and the cuts and bruises of daily life illustrate this class.There are ten strategies for reducing the human and other losses that make this class of social concern. These are identified in logical sequence and copiously illustrated by tactics widely employed. The reduction of animate and inanimate damage due to interaction with most environmental hazards, including pollutants, drugs, and microorganisms can be approached in the same manner, as can strategies for population control. Appendices provide additional examples and four illustrative case studies concerned, respectively, with reducing: losses associated with femoral fractures among the elderly; thermal energy damage to children a...

An economical and proved helicopter program for transporting the emergency critically ill and injured patient in Maryland.

Abstract: There is a rapidly growing awareness that military experience with helicopter transport can be translated to civilian medical practice in those regions which have a suitable topography. The main obstacles to a widespread introduction of this mode of transportation for the critically ill have been related to cost of implementation, a lack of knowledge of the problems involved, and the absence of specialized reception centers. A unique and successful Air Med-Evac Program has been functional in the State of Maryland for over 3 years, and feeds into the University of Maryland Center for the Study of Trauma. The evolution of the Program has been described, and the utilization of state agencies such as the State Police Aviation Section, local and state fire department ambulance and rescue programs, and local and state law enforcement agencies renders the entire operation strikingly economical. The role of the ambulance and rescue squads and state police helicopter crews has been mentioned, and how original political and jurisdictional difference between them and the helicopter crews were solved. These and other practical problems of development and implementation have been presented in detail.

Traumatic subdural hygroma.

Abstract: Etiology It is almost always associated with head trauma, especially alcohol-related falls or assaults . Skull fractures were found in 39% of cases. Distinct from a chronic subdural hematoma, which is usually associated with an underlying cerebral contusion, and usually contains darker clots or brownish fluid (“motor oil” fluid), and may show membrane formation adjacent to the inner surface of the dura (hygromas lack membranes). Secondary to tear in the arachnoid mater post surgical, e.g. haematoma evacuation, ventricular drainage see Traumatic subdural hygroma after endoscopy. see Postoperative contralateral subdural effusion. It has been described as a complication of cerebellopontine angle tumor requiring surgical evacuation . see Subdural hygroma after cerebellopontine angle tumor surgery.

The effects of a modern emergency medical care system in reducing automobile crash deaths

Abstract: Implementation of a modern emergency medical care system with presently available knowledge may reduce traffic mortality among those injured by 24%. Injury rates per 1,000 crashes are declining, due partially to new automobile safety features and traffic environmental changes; but the total number of traffic accidents is rising steeply, with total injuries rising at a slower rate. A study of traffic mortality in Jacksonville in 1971 offers little hope that improvements in the already highly effective Jacksonville Emergency Medical Care system can reduce traffic mortality significantly below the prevailing 1.18% of those injured, unless seat belt restraints are more widely used. Upgrading of the rural EMC systems, combined with a mandatory seat belt law, appears to offer the greatest payoff in reducing the high prevailing rural traffic death rate.

The treatment of fractures of the femur in patients with head injuries.

Abstract: Among patients with multiple injuries, the incidence of head injuries is high. In a group of 165 such patients reviewed by Kulowski, approximately two-thirds had head injuries. Of 114 patients with serious injuries admitted to the orthopedic service of Ichilov Hospital, Tel-Aviv, there were 47 with head injuries. On our own service, head injuries were found to be the most frequent injury associated with a fracture of the-femur in children under 16 years of age (James H. Garner, Jr., unpublished data, 1967). Among 132 patients there were 16 with head injuries. How does the presence of a head injury affect the treatment of a fracture of the shaft of the femur? Can the usual methods of treatment be used successfully? Are there special difficulties to be anticipated in such cases? It is the purpose of this paper to search for answers to such questions.