Injury
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Majority of human animal-related injuries in the United Arab Emirates are caused by camels. These may involve major vessels and can be life-threatening. We aimed to study the biomechanism, injured regions, management, and outcome of major camel-related human vascular injuries. ⋯ Major camel-related vascular injuries have a poor clinical outcome. This is related to the biomechanism of injury which combines penetrating, crushing and blunt trauma. Neck wounds of camel bites can be closed primarily after debridement.
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Penetrating injury (PI) is a relatively rare mechanism of trauma in the Netherlands. Nevertheless, injuries can be severe with high morbidity and mortality rates. The aim of this study is to assess fatalities due to PI and evaluate the demographic parameters, mechanism of injury and the resulting injury patterns of this group of patients in three Dutch regions. ⋯ Fatal PI most often involves the relatively young, male, and psychiatric patient. Self-inflicted fatal PI accounted for 35%, addressing the importance of suicide prevention programs. Identification of preventable deaths needs more awareness to reduce the number of fatal PI.
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Both inhalation injury and acute respiratory distress syndrome (ARDS) are risk factors that predict mortality in severely burned patients. Extracorporeal life support (ECLS) is widely used to rescue these patients; however, its efficacy and safety in this critical population have not been well defined. We report our experience of using ECLS for the treatment of severely burned patients with concurrent inhalation injury and ARDS. ⋯ For severely burned patients with concurrent inhalation injury and ARDS, ECLS could be a salvage treatment to improve sustained hypoxemia. However, the efficacy of hemodynamic support was limited. Identifying definite ECLS indications and rigorous patient selection would contribute to better clinical outcomes.
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Randomized Controlled Trial
Evaluating feasibility of a novel mobile emergency medical dispatch tool for lay first responder prehospital response coordination in Sierra Leone: A simulation-based study.
The global injury burden, driven by road traffic injuries, disproportionately affects low- and middle-income countries, which lack robust emergency medical services (EMS) to address injury. The WHO recommends training lay first responders (LFRs) as the first step toward formal EMS development. Emergency medical dispatch (EMD) systems are the recognized next step but whether small groups of LFRs equipped with mobile dispatch infrastructure can efficiently respond to geographically-dispersed emergencies in a timely fashion and the quality of prehospital care provided is unknown. ⋯ LFRs equipped with mobile dispatch demonstrate appropriate response times and effective basic initial management of simulated emergencies. Training smaller cohorts of highly-active LFRs equipped with mobile dispatch appears highly cost-effective and may be a feasible model to facilitate efficient dispatch to expand emergency coverage while conserving valuable training resources in resource-limited settings.