Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Feb 2011
Gunshot injury without direct injury to the cord may lead to complete paraplegia.
Paraplegia following gunshot injury without direct injury to the cord is extremely rare. We describe the case of a 31-year-old woman who was admitted to our trauma resuscitation unit for a penetrating gunshot wound to the abdomen with hemorrhagic shock and paraplegia. Computed tomography (CT) scan of the abdomen showed severe hepatic and pulmonary injuries, with the trajectory of the missile away from the spinal canal. ⋯ After 24 months, no significant neurologic improvement occurred. Physicians managing severe trauma should be aware of the possibility to observe severe neurologic deficit following gunshot wounds even without violation of the spinal canal. These injuries might be in relation to the kinetic energy emission to the surrounding tissue by the missile.
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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Toward a new definition of 'refugee': is the 1951 convention out of date?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
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
Radial head arthroplasty with an uncemented modular metallic radial head prosthesis: short- and mid-term results.
In comminuted radial head fractures, arthroplasty is an alternative treatment to open reduction and internal fixation or radial head excision. The purpose of this study was to evaluate the short- and mid-term results after the implantation of the EVOLVE™ uncemented modular metallic radial head prosthesis. ⋯ Radial head arthroplasty with the EVOLVE™ prosthesis gave good results in terms of objective physical outcome and outcome scores at short- and mid-term follow-up. Periprosthetic lucency does not affect the outcome negatively. We assume that periprosthetic lucency does not necessarily imply prosthesis loosening in which revision is required. Radiological findings and the severity of the initial injury do not necessarily correlate with results.