• Title/Summary/Keyword: impact of trauma

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Are Falls of Less Than 6 Meters Safe? (6미터 이하 저고도 추락 환자의 안전성 여부)

  • Seo, Young Woo;Hong, Jung Seok;Kim, Woo Yun;Ahn, Ryeok;Hong, Eun Seok
    • Journal of Trauma and Injury
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    • v.19 no.1
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    • pp.54-58
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    • 2006
  • Purpose: The committee on trauma of the american college of surgeons, in its manual resources for optimal care of the injured patients involved in falls from less than 20 feet need not be taken to trauma centers. Because triage criteria dictate less urgency for low-level falls, this classification scheme has demerits for early detection and treatment of serious problems in the emergency room. Methods: A prospective analysis was conducted of 182 patients treated for fall-related trauma from June 2003 to March 2004. Falls were classified as group A (<3 m), group B (${\geq}3m$, <6 m), and group C (${\geq}6m$). Collected data included the patient's age, gender, site and height of fall, surface fallen upon, body area of first impact, body regions of injuries, Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), and Injury Severity Score (ISS). Results: The 182 patients were classified as group A (105) 57.7%, group B (61) 33.5%, and group C (16) 8.8%. There was a weak positive correlation between the height of fall and the patients' ISS in the three groups (p<0.001). There were significant differences in GCS (p=0.017), RTS (p=0.034), and ISS (p=0.007) between group A and B. In cases that the head was the initial impact area of the body, the GCS (p<0.001) and the RTS (p=0.002) were lower, but the ISS (p<0.001) was higher than it was for other type of injuries. Hard surfaces as an impact surface type, had an influence on the GCS (p<0.001) and the ISS (p=0.025). Conclusion: To simply categorize patients who fall over 6 meters as severely injured patients doesn't have much meaning, and though patients may have fallen less than 6 meters, they should be categorized by using the dynamics (impact surface type, initial body - impact area) of their fall.

Analysis of procedural performance after a pilot course on endovascular training for resuscitative endovascular balloon occlusion of the aorta

  • Sung Wook Chang;Dong Hun Kim;Dae Sung Ma;Ye Rim Chang
    • Journal of Trauma and Injury
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    • v.36 no.1
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    • pp.3-7
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    • 2023
  • Purpose: As resuscitative endovascular balloon occlusion of the aorta (REBOA) is performed in an extremely emergent situation, achieving competent clinical practice is mandatory. Although there are several educational courses that teach the REBOA procedure, there have been no reports evaluating the impact of training on clinical practice. Therefore, this study is aimed to evaluate the effects of the course on procedural performance during resuscitation and on clinical outcomes. Methods: Patients who were managed at a regional trauma center in Dankook University Hospital from August 2016 to February 2018 were included and were grouped as precourse (August 2016-August 2017, n=9) and postcourse (September 2017- February 2018, n=9). Variables regarding injury, parameters regarding REBOA procedure, morbidity, and mortality were prospectively collected and reviewed for comparison between the groups. Results: Demographics and REBOA variables did not differ between groups. The time required from arterial puncture to balloon inflation was significantly shortened from 9.0 to 5.0 minutes (P=0.003). There were no complications associated with REBOA after the course. Mortality did not show any statistical difference before and after the course. Conclusions: The endovascular training for REBOA pilot course, which uses a modified form of flipped learning, realistic simulation of ultrasound-guided catheter insertion and balloon manipulation, and competence assessment, significantly improved procedural performance during resuscitation of trauma patients.

The Mass Social Trauma and Mental Health of Cambodian (캄보디아인의 집단 외상과 정신건강)

  • Lee, Nabin;Min, Jung-Ah;Chae, Jeong-Ho
    • Anxiety and mood
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    • v.8 no.2
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    • pp.71-78
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    • 2012
  • The mass social trauma, such as organized violence, wars, oppression by dictatorships and massive terrorist attacks, exposes thousands of people to trauma in a short period of time. Therefore, the mass social trauma is distinguished from individualized trauma, such as a violent attack, rape or a traffic accident in that it results in multiple and extended consequences beyond the individual. During the Khmer Rouge regime, one quarter of the Cambodian population was killed as a result of malnutrition, forced labor and mass killings. Until now, its evil continues to affect Cambodian's physical and mental health problems. Although there is ongoing debate, to date, no consensus has been reached supporting a clear set of recommendations for the intervention and longitudinal study regarding the influence of killing field massacre being too little. And comparative cultural studies, such as comparing the East to West or other Asian cultures are also lacking. This article gives an overview of previous study results about the mental health of Cambodians, and suggests a possible research issue and therapeutic interventions to determine the impact of mass trauma to the members of society and post-traumatic recovery factors.

Role and Function of Mouthguard (마우스가드의 역할과 기능)

  • Kwon, Kung-Rock
    • The Journal of the Korean dental association
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    • v.56 no.6
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    • pp.324-332
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    • 2018
  • A mouthguard is a protective device normally worn on the upper jaw, to reduce injures to the teeth, jaws and surrounding soft tissues. It has a definite role in preventing injuries to the teeth and face and for this reason it is strongly recommended for all sporting activities where there is a risk of trauma to the teeth and associated structures. Mouthguards can be effective in reducing impact force to the teeth, and attributed to enhancement of postural control and muscle performance during teeth clenching. Although there is evidence that mouthguards reducing impact force to the teeth, and prevent orofacial trauma occurrence during sport practice, the influence of this device on athletic performance has not been systematically quantified. Nevertheless, wearing a dentally fitted laminated mouthguard of at least 3 mm thickness can be strongly recommended during sport practice.

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Differences in Self- and Other-concept in the Single and Complex Trauma Type Groups (단순 및 복합외상 유형 집단의 자기-와 타인-개념의 차이: 자극 제시시간에 따른 정보처리 편향을 중심으로)

  • Kim, YeSeul;Lee, Jong-Sun
    • Journal of the Korea Convergence Society
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    • v.12 no.2
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    • pp.233-246
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    • 2021
  • The present study aimed to investigate whether there would be differences in the severity of PTSD symptoms, self and others concepts between trauma types. Among 166 university students, 61 (simple trauma's n = 31, complex trauma's n = 30) finally met the criteria and completed the Life Events Checklist, Impact of the Event Scale-Revised, and the emotional Stroop task. The results were as follows: firstly, PTSD symptoms were higher in complex trauma group than single trauma group. Secondly, response time in the complex trauma group was longer in the condition that the negative word related to 'self' was presented for 2 seconds compared to the single trauma group. These results suggest that the complex trauma group has different features at least in the severity of PTSD symptoms and the concept of the self, compared with the single trauma group. Finally, the therapeutic implications and limitations of the study were discussed.

Management of Thoracic Aortic Injury after Blunt Trauma: Nine Cases at a Single Medical Center

  • Lee, Kyungwon;Lee, Jae Gil
    • Journal of Trauma and Injury
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    • v.29 no.4
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    • pp.146-150
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    • 2016
  • Purpose: Traumatic aortic injuries are rare, but life threatening condition. They usually occur after high velocity impact on the chest or abdomen such as traffic accident or fall. We report the experiences of the traumatic aortic injuries at a single center. Methods: We retrospectively reviewed the medical records of nine patients with aortic injury resulting from the blunt trauma from Jan. 2010 to May. 2016. Results: The mean age was $51.1{\pm}20.8$ years old, and ten (90.9%) were men. The mechanisms of injury were traffic accidents in seven patients (motorcycle accidents; 3, car accidents; 4), and four in fall injury. Most common injured sites were thoracic aorta (9, 81.8%). Aortic injuries were repaired by endovascular approach in four patients, and by open graft surgery in four. Two patients were managed conservatively. Nine patients survived without any complications. Conclusion: We had experienced different approaches for management of aortic injuries after blunt trauma according to locations and severity of lesions.

The impact of COVID-19 on trauma patients and orthopedic trauma operations at a single focused training center for trauma in Korea

  • Choi, Wonseok;Kim, Hanju;Son, Whee Sung;Sakong, Seungyeob;Cho, Jun-Min;Choi, Nak-Jun;Noh, Tae-Wook;Kim, Namryeol;Cho, Jae-Woo;Oh, Jong-Keon
    • Journal of Trauma and Injury
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    • v.35 no.3
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    • pp.195-201
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    • 2022
  • Purpose: The objective of this study was to determine the effects of coronavirus disease 2019 (COVID-19) on the volume of trauma patients, the number of orthopedic trauma operations, and the severity of injuries. We also investigated the correlations between social distancing and these variables. Methods: This was a retrospective review of trauma patient cases at a single focused training center for trauma in Korea from January 2017 to April 2021. The COVID-19 group included patients treated from January 1 to April 30 in 2020 and 2021, and the control group included patients treated during the same months from 2017 to 2019. The volume of trauma patients according to the level of social distancing was evaluated among patients treated from August 2, 2020 to November 23, 2020. Results: The study included 3,032 patients who presented to the emergency department with traumatic injuries from January to April 2017 to 2021. The average number of patients was 646.7 and 546.0 in the control and COVID-19 groups, respectively. The percentage of patients injured in traffic accidents (TAs) decreased from 25.0% to 18.2% (P<0.0001). The proportions of in-car TAs and pedestrian TAs also decreased from 6.7% and 10.8% to 3.5% and 6.0%, respectively (P=0.0002 and P<0.0001). The percentage of bicycle TAs increased from 2.4% to 4.0% (P=0.0128). The proportion of patients with an Injury Severity Score above 15 and the mortality rate did not change significantly. As the level of social distancing increased, the number of trauma patients and the number of trauma injuries from TAs decreased. The number of orthopedic trauma operations also depended on the social distancing level. Conclusions: The number of trauma patients presenting to the emergency department decreased during the COVID-19 period. The volume of trauma patients and orthopedic trauma operations decreased as the social distance level increased.

The Effects of M&L Trauma Psychotherapy on Impact of Events, Affection, and Quality of Life among Female Vicims of Family Violence (가정폭력 피해여성들의 사건충격과 정서 그리고 삶의 질에 대한 M&L 트라우마 심리치료 프로그램의 효과에 대한 임상연구)

  • Sue, Joo-Hee;Kim, Jung-suk;Ko, Kyung-sook;Oh, Jung-lan;Ko, In-sung;Kang, Hyung-won
    • Journal of Oriental Neuropsychiatry
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    • v.26 no.2
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    • pp.79-88
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    • 2015
  • Objectives: The purpose of this study is to investigate the effects of the M&L Trauma Psychotherapy Program on: Impact of Event Scale - Revised (IES-R-K); Euro QOL-5 Dimension (EQ5D); Five-facet Mindfulness Questionnaire (FFMQ); and psychological tests. Methods: Eight middle-aged women subjected to domestic violence participated in the two-day M&L Trauma Psychotherapy Program. The Program was executed 5 times 2 days for about 3 hours. We evaluated IES-R-K, EQ5D, FFMQ, Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), State-Trait Anger Expression inventory (STAXI) and SUDS before the Program and for four weeks afterwards, to analyze the effects of the M&L Trauma Psychotherapy Program. Results: The scores of IES-R-K, BDI, STAI-S, STAI-T, Hwa ST and Hwa CT decreased significantly (p<0.05). EQ5D scores increased significantly (p<0.05) and overall physical condition scale (VAS) increased. In the FFMQ scores, all five facet scores increased slightly. Scores of SUDS decreased significantly right after the program, and remained decreased four weeks later, rather than before the Program (p<0.05). Conclusions: The results suggested that the M&L Trauma Psychotherapy Program improved post-traumatic stress, quality of life and mindfulness skills, and had positive responses to psychological problems - depression, anxiety, anger and distress.

A Study on the Effects of Trauma Case Experience on PTSD of Safety/Health Manager's -The Moderated Mediation Effect of Social Support through Job Stress- (안전/보건관리자의 외상 사건 경험이 외상 후 스트레스 장애에 미치는 영향 -직무스트레스를 통한 사회적지지의 조절된 매개효과-)

  • Shim, Jae-Beom;Lee, Mi-Eun
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.31 no.1
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    • pp.38-49
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    • 2021
  • Objectives: This study was conducted to analyze the impact of safety/health managers' experience of trauma case on their post traumatic stress disorder and the mediation effects of job stress and the moderated mediation effects of social support. Method: Using a structured questionnaire, data were collected from 241 workplace safety/health managers with experience in trauma case. The collected data were analyzed using SPSS(IBM. Ver.26.0) and verified through SPSS PROCESS Macro (Ver. 3.4). Results: The trauma case experience and the job stress, which is a mediation variable, had a statistically significant positive effect on post-traumatic stress disorder, and the job stress had a positive mediation effect in the relationship between the trauma case experience and post-traumatic stress disorder. Social support had a statistically significant negative moderation effect in the relationship between the trauma case experience and job stress; social support had a moderated mediation effect on the indirect effect of a job stress on the post-traumatic effect through a trauma case experience. Conclusion: The above findings suggest that work-related job stress management is important in order to reduce safety/health managers' post-traumatic stress disorder caused by the experience of trauma case, and that social support is essential to reduce the job stress, which can later be used as a basis for further studies.

Impact of interhospital transfer on outcomes for trauma patients: impact of direct versus non-direct transfer (비외상센터에서 외상센터로의 전원이 예후에 미치는 영향)

  • Yang, Wook Tae;Min, Mun Ki;Ryu, Ji Ho;Lee, Daesup;Lee, Kang Ho;Shin, Jin Wook;Yeom, Seok Ran;Han, Sang Kyun
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.5
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    • pp.415-422
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    • 2018
  • Objective: This study compared the prognosis of patients who visited the trauma center directly (direct visit group) with those transferred from the non-trauma center (transferred group). Methods: The patients, who were 18 or older with Injury Severity Score of 15 or more in the trauma center at Busan, were studied from October 2015 to October 2016. To compare the treatment time between the direct visit and transferred group, first treatment time, final treatment time, and time to visit the trauma center were examined. To compare the prognosis, this study compared the 48-hour, 7-day, and in-hospital mortality rate as well as the duration of intensive care unit (ICU) and total hospital stay. To analyze the factors affecting the outcome of transferred group, the physician's level and procedures that had been performed at the non-trauma center were examined. Results: The mortality was similar in the direct visit and transferred group (48-hour 7.6% vs. 4.6%, P=0.111; 7-day 11.1% vs. 7.2%, P=0.89; and in-hospital 14.6% vs. 11.3%, P=0.214). The length of ICU and total hospital stay were similar in the two groups. The mortality was higher in the patients in the transferred group when using intubation, transfusion, and pressure intensifier. The intubated patients showed higher mortality according to logistic regression. Conclusion: The mortality, length of ICU, and hospital stay were similar but the time to visit the trauma center and the final treatment time were longer in transferred group. Stabilizing the patient at the near non-trauma center may be more helpful for some patients.