Injury
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Timely and appropriate pain management in the pre-hospital environment is paramount to effective patient care. Experts agree that there are many factors that hinder the delivery of adequate pain management to patients with pain. The purpose of this study was to use the Theory of Planned Behaviour (TPB) model to identify the factors influencing Ambulance Paramedics' intention to administer morphine to patients with pain. ⋯ Whilst participants reported strong intentions to administer morphine they also reported negative attitudes towards the behaviour. The constructs of the TPB explained 26% of the variance in intention to administer morphine with subjective norm being the strongest significant predictor. The findings related to specific attitudes and normative pressures provide an understanding into Paramedic's pain management behaviour.
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To study the anatomical distribution, severity, and outcome of bicycle-related injuries requiring hospitalization in Al-Ain city, United Arab Emirates in order to improve preventive measures. ⋯ The majority of hospitalized injured cyclists in our study were low income adults using cycling as a cheap transportation method. Compulsory helmet use by bicycle riders and subsidising helmet cost should be adopted so as to reduce morbidity and mortality of bicycle-related injuries.
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Lower extremity (LE) arterial trauma and its treatment may lead to extremity compartment syndrome (ECS). In that setting, the decision to perform fasciotomies is multifactoral and is not well delineated. We evaluated the outcomes of patients with surgically treated LE arterial injury who underwent early or delayed fasciotomies. ⋯ Early fasciotomy is associated with improved outcomes in patients with lower extremity vascular trauma treated with surgical intervention. Our findings suggest that appropriate implementation of early fasciotomy may reduce amputation rates in extremity arterial injury.
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Randomized Controlled Trial
Informed consent in trauma: does written information improve patient recall of risks? A prospective randomised study.
Informed consent is vital to good surgical practice. Pain, sedative medication and psychological distress resulting from trauma are likely to adversely affect a patient's ability to understand and retain information thus impairing the quality of the consent process. This study aims to assess whether provision of written information improves trauma patient's recall of the risks associated with their surgery. 121 consecutive trauma patients were randomised to receive structured verbal information or structured verbal information with the addition of supplementary written information at the time of obtaining consent for their surgery. ⋯ Patient satisfaction with the consent process was improved in the group receiving written and verbal information and 90% of patients in both groups expressed a preference for both written and verbal information compared to verbal information alone. Patients awaiting surgery following trauma can pose a challenge to adequately inform about benefits conferred, the likely post operative course and potential risks. Written information is a simple and cost-effective means to improve the consent process and was popular with patients.
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To study the clinical application of MRI (magnetic resonance imaging) and MRA (MR angiography) technologies for examining the imaging characteristics of muscular and vascular injuries following high-voltage electrical burns. ⋯ Specific MRI and MRA imaging characteristics can be observed in muscular and vascular injures following high-voltage electrical burns. MRI and MRA were very useful for assessing the scope and degree of injury following high-voltage electrical burns, which was helpful to guide the explorative surgery.