Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Feb 2011
Toward a new definition of 'refugee': is the 1951 convention out of date?
Definitions, by necessity, may change or need to be changed to accommodate situations that arise. The United Nations recognized that the emergence of new refugee situations required changes in the Convention. These changes were codified in the 1967 Protocol Relating to the Status of Refugees. ⋯ As new classifications of refugees develop, there needs to be changes in the definition of what is a refugee. There has been a growing consensus in the international arena to recognize those displaced by environmental causes. We need to take steps to develop an inclusive definition of refugee that includes those displaced by environmental causes.
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Eur J Trauma Emerg S · Feb 2011
Diagnostic and therapeutic aspects in the treatment of gunshot wounds of the viscerocranium.
Gunshot wounds of the viscerocranium are a rare occurrence during times of peace in Europe. The removal of projectiles is recommended; in some cases, however, this is controversial. The material properties of projectiles and destruction of anatomical landmarks make it difficult to determine their precise location. ⋯ In conclusion, there is a significant correlation between reduced intra- and postoperative complications including wound infections, nerve damage and major bleeding and the appropriate use of a navigation system. In all these cases we were able to present reduced operating time. Cone-beam CT plays a key role as a useful diagnostic tool in detecting projectiles or metallic foreign bodies intraoperatively.
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Eur J Trauma Emerg S · Feb 2011
Prehospital triage, discrepancy in priority-setting between emergency medical dispatch centre and ambulance crews.
The timely provision of emergency medical services might be influenced by discrepancies in triage-setting between emergency medical dispatch centre and ambulance crews (ACR) on the scene resulting in overloaded emergency departments (ED) and ambulance activities. The aim of this study was to identify such discrepancies by reviewing ambulance transports within a metropolitan city in the western region of Sweden. ⋯ Appropriate ambulance use is one important part of emergency preparedness. Overuse results in decreased emergency medical services (EMS) availability and ED-overcrowding. Several factors, such as an imprecise triage system and increased public demands, may influence such overutilization. Improving the triage system and comprehensive public education on appropriate use of ambulances are two important steps toward a better use of national EMS resources.
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Eur J Trauma Emerg S · Feb 2011
Functional outcome and quality of life in victims of terrorist explosions as compared to conventional trauma.
Following trauma, the number of preventable deaths is low. Outcome should also be measured in terms of quality of life (QoL). Studies analyzing QoL in trauma patients have been published, but little is known about the long term QoL of victims of terrorist attacks. ⋯ Subjects present more emotional distortions, residual pain in the head region and a tendency towards a worsened perception of their own health and wellness. They also present symptoms associated to PTSD more frequently. The presence of symptoms associated to PTSD, depression or anxiety was an independent variable related to lower QoL in both groups.
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Eur J Trauma Emerg S · Feb 2011
Acute ischemia of the lower limb after injury by gunshot: case report and review of literature.
Civilian and military vascular trauma has evolved dramatically. It is estimated that 80% of all cases of vascular injuries are due to peripheral vascular trauma, most involving the lower extremities. Arterial below-knee injuries by gunshot still remain a challenge, with an associated rate of amputation of 20-54%. ⋯ This case report shows the importance of an adequate team approach for treatment of a gunshot extremity injury with vascular lesion. The authors want to highlight the scientific background evidence and the value of comparing worldwide civilian trauma center outcomes, mostly reported previously from the military field.