Eur J Trauma Emerg S
-
Eur J Trauma Emerg S · Jun 2009
The 2001 World Trade Center Disaster: Summary and Evaluation of Experiences.
To collect and analyze data from deaths and injuries, and from evaluation of the responses by medical services and by fire, rescue, and police services 1 year after the terror attack on World Trade Center. ⋯ The difficulties encountered were very similar to those commonly seen in major accidents or disasters, although on a great scale. Response plans have to be critically reviewed based on the experiences from this and other events, in order to pre-empt difficulties such as those described here in future responses to major urban accidents and disasters.
-
We report on a three-year-old girl who fell accidentally from the fourth floor. She suffered multiple trauma, including severe head injury, unstable T2-T3 Chance fracture, pneumothorax with lung contusion and serial rib fractures on the left side, liver laceration, splenic injury and fracture of the sacral bone on the right side. The progressive intracranial pressure was released by trepanation and bifrontal craniectomy. ⋯ After stabilization of the intracranial situation, dorsal spondylodesis from T2 to T4 was performed employing the cannulated NEON system (Ulrich(®)) with CT-controlled positioning of guide wires. One year on, the implants have been removed and the patient has good function, with only a small atactic dysfunction as residuum. To our knowledge, this is the first report of a pediatric Chance fracture located in the upper thoracic spine following a fall from great height that describes how this treatment approach led to a very favorable outcome.
-
Eur J Trauma Emerg S · Jun 2009
Role of Selective Management of Penetrating Injuries in Mass Casualty Incidents.
Terrorist violence has emerged as an increasingly common cause of mass casualty incidents (MCI) due to the sequelae of explosive devices and shooting massacres. A proper emergency medical system disaster plan for dealing with an MCI is of paramount importance to salvage lives. Because the number of casualties following a MCI is likely to exceed the medical resources of the receiving health care facilities, patients must be appropriately sorted to establish treatment priorities. ⋯ An appropriate and effective application of experiences learned from the use of selective nonoperative management (SNOM) techniques may prove essential in this triage process. The present appraisal of the available literature strongly supports that the appropriate utilization of these clinical indicators to identify patients appropriate for SNOM is essential, critical, and readily applicable. We also review the initial emergent triage priorities for penetrating injuries to the head, neck, torso, and extremities in a mass casualty setting.
-
Eur J Trauma Emerg S · Jun 2009
US Trauma Center Preparation for a Terrorist Attack in the Community.
Since the 2001 terrorist attacks on the United States, federal and state funding, primarily from the National Bioterrorism Hospital Preparedness Program, has resulted in a surge of hospital activity to prepare for future natural or human-caused catastrophes. Trauma centers were integrally involved in the response to the 2001 attacks as first receivers of patients, communication hubs, and as convergence sites for families, the worried well, volunteers, and donors. After the Madrid train station terrorist attack, Congress identified the need to study trauma center preparedness as an essential part of the nation's emergency management system. ⋯ Trauma centers are a major resource in disaster management. One-hundred and seventy-five centers candidly reported their resources and vulnerabilities. This inventory should be expanded to all trauma centers and recommendations for change as discussed.
-
An 11-year-old boy presented with three days' history of blunt trauma to the left shoulder due to a fall to the ground. The boy was taken to the traditional practitioner, who applied a very tight bandage over a piece of cartoon on the upper left humerus, which resulted in progressive pain and swelling of the whole left upper limb and impairment of movement and sensation. The tight bandage was removed after 48 h and fasciotomy was performed at Aljamhuri Hospital in Taiz, Yemen. ⋯ After three months, the left upper limb healed with fixed flexor contracture of the elbow and wrist joint. Manipulation and release of adhesions and subsequent skin grafting was performed and the elbow joint was kept in extension, the wrist in the neutral position, and the interphalangeal joints in flexion. Although the limb was saved, its aesthetic appearance was retained, and some sensation was achieved, the lost motor function of the forearm (including the hand) was irreversible.