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At least 217 records · Page 12Linked to original sources
PubMed1993

Rupture of the thoracic aorta by broadside impacts in road traffic and other collisions: further angiographic observations and preliminary autopsy findings.

Violent lateral blunt impacts to the chest, such as inflicted in broadside automobile collisions, can cause traumatic rupture of the thoracic aorta. Unfortunately, because this injury is among the least common in blunt chest trauma, and given that it is not caused by the expected "classic" frontal collision, its diagnosis is often delayed or altogether missed. In most of these events, quite unlike the classic isthmus rupture of deceleration accidents, the injury appears to be partial shearing of the distal aortic arch, probably just above the isthmus. The aortic injury is often part of a wounding pattern typical of a lateral collision, in which critical intra-abdominal injuries are located on the side of the patient that was on the receiving end of the impact. Findings in 13 such patients are presented and discussed. The point is also made that because seatbelts and air bags do not protect car occupants against broadside impacts, their mandatory use will not lower the rate of occurrence of aortic shearing in lateral collisions, and as a result the numerical prominence of these injuries compared with that of aortic isthmus ruptures in the statistics of road traffic collisions may be expected to increase.

Accidents, Aviation↗
PubMed1990

The 'problem' with automation: inappropriate feedback and interaction, not 'over-automation'.

As automation increasingly takes its place in industry, especially high risk industry, it is often blamed for causing harm and increasing the chance of human error when failures do occur. I propose that the problem is not the presence of automation, but rather its inappropriate design. The problem is that the operations under normal operating conditions are performed appropriately, but there is inadequate feedback and interaction with the humans who must control the overall conduct of the task. When the situations exceed the capabilities of the automatic equipment, then the inadequate feedback leads to difficulties for the human controllers. The problem, I suggest, is that the automation is at an intermediate level of intelligence, powerful enough to take over control that used to be done by people, but not powerful enough to handle all abnormalities. Moreover, its level of intelligence is insufficient to provide the continual, appropriate feedback that occurs naturally among human operators. This is the source of the current difficulties. To solve this problem, the automation should either be made less intelligent or more so, but the current level is quite inappropriate. The overall message is that it is possible to reduce error through appropriate design considerations. Appropriate design should assume the existence of error, it should continually provide feedback, it should continually interact with operators in an effective manner, and it should allow for the worst situations possible. What is needed is a soft, compliant technology, not a rigid, formal one.

Accidents, Aviation↗
PubMed1989

A long-term psychosocial follow-up study of burned adults.

A clinical psychiatric follow-up study of 70 burned adults was performed 3-13 years after the burn injury. The majority of patients had minor injuries. Twenty-three percent suffered from definite psychosocial problems at follow up. Patients with severe injuries more often had problems (44%) than patients with minor injuries (16%). Outcome was not related to premorbid psychopathology except for patients with more severe injuries. A combination of variables describing length of hospital stay, the presence of scars, premorbid psychopathology, experiencing death threat when injured and deviant behaviour during the hospital stay was found to be the best predictor of negative psychosocial outcome (positive predicting power 83%; sensitivity 94%).

Accidents↗
PubMed1975

A clinical and follow-up study of right and left bundle branch block.

The experience with bundle branch block at the USAF School of Aerospace Medicine was reviewed. The clinical and follow-up status was evaluated in 394 subjects with right bundle branch block (RBBB) and 125 subjects with left bundle branch block (LBBB). The majority of subjects were asymptomatic at the time of bundle branch block diagnosis. The subjects were divided into subfroups based on electrocardiographic (EEG) findings to determine if any one subfroup was at higher risk for initial or follow-up morbidity of cardiobascular disease or follow-up mortality. At initial diagnosis and clinical evaluation, 94% of RBBB and 89% of LBBB subjects had no evidence of cardiobascular disease. In the RBBB group, 3 and 2% had cornary heart disease and hypertension, respectively; in LBBB subjects, 9 and 7% had cornary heart disease and hypertension, respectively. No one ECG subfroup in either the RBBB or LBBB group had a higher incidence of cardiobascular disease. Complete follow-up information was available in 94% of the RBBB subgroup subjects and 91% of the LBBB group. In the follow-up period, new cases of coronary heart disease and hypertension occurred in 6% of the RBBB group and 5 and 8%, respectively, in the LBBB group. Fourteen (4%) RBBB and nine (8%) LBBB subjects died during the follow-up period. No differences for follow-up groups. Progressive electrical dysfunction in the form of complete heart block occurred in one subject each absence, and degree of associated cardiobascular disease. Furthermore, within the age limits of the present aeromedical implications of bundle block are discussed.

Accidents, Aviation↗
PubMedDate not supplied

Extraordinary analgesic requirement in a patient previously unexposed to narcotics.

Patient-controlled analgesia (PCA) is a relatively new therapeutic modality that allows patients to administer doses of intravenous narcotics, using a syringe pump and sequencing device. We used PCA to deliver analgesic therapy to a 35-year-old man seriously injured in an aviation accident. Although the patient gave no previous history of narcotic use or abuse, he required morphine dosing rates as high as 56 mg/h to maintain adequate analgesia. The delivery of relatively high doses of narcotic was not accompanied by significant sedation, as might be expected. The patient underwent two surgical procedures while on PCA therapy. Following each procedure, dosing requirements increased, but within three days after each operation, dosing tapered. The patient was converted to oral hydromorphone therapy, which gradually was tapered and then discontinued. PCA should be considered a useful therapeutic adjunct in the management of patients refractive to empirical narcotic analgesic regimens.

Adult↗
PubMed2005

Unique occupational hazards of Alaska: animal-related injuries.

OBJECTIVE: During 1992-2000, an average of 40 fatal occupational injuries and 12,400 nonfatal occupational injuries and illnesses related to animals were recorded each year in the United States, most involving domestic farm animals. Although Alaska has a relatively small farming industry, it supports several industries that require workers to regularly be in contact with animals. This study examines the pattern and characteristics of animal-related occupational injuries in Alaska. METHODS: Two data sources were accessed: the Alaska Trauma Registry for nonfatal injuries requiring hospitalization and the Alaska Occupational Injury Surveillance System for fatal injuries. The case definition included events in which the source of the injury was an animal or animal product (Occupational Injury and Illness Classification Manual source code 51). RESULTS: In Alaska during 1991-2000, there were 43 animal-related occupational injuries requiring hospitalization and 25 animal-related fatalities. There were only 2 fatal events: 1 bird-strike aircraft accident killing 24 military personnel and 1 bear attack. The majority of the nonfatal injury events were related to marine wildlife (n = 20), with the rest related to either domesticated (n = 11) or nondomesticated (n = 12) mammals. Of events reporting a hospital charge (23 of 43), the average cost was over dollar 9700 per person. CONCLUSIONS: The catastrophic aircraft crash increased bird-control efforts near airports around the state. The nonfatal animal-related injuries have received less notice, although they result in thousands of dollars in hospital costs and lost workdays. Fishing-industry workers in particular should be made aware of potential injuries and educated on how to treat them when away from definitive medical care.

Accidents, Aviation↗
PubMed1992

Was disease involved in the decimation of Guam's avifauna?

Between 1982 and 1986, 402 (290 live, 112 dead) exotic, migrant or native resident birds on Guam were surveyed for disease-causing agents to determine the role of disease in the decline of native forest bird populations on Guam. Traumatic injury, primarily from collisions with motor vehicles and predation, was the most prevalent (46%) cause of death. Thirty-eight percent of the carcasses examined were in poor body condition largely as a result of inadequate nutrition in captive native birds and poultry and adipose exhaustion in errant migrants. A variety of commensal or opportunistic bacteria, including Salmonella spp., were cultured from 220 birds, and nothing remarkable was found in 15 fecal samples. Lastly, no haematozoans, the suspected cause for the decline of the Hawaiian avifauna, were observed in blood slides examined from 260 birds. Based on the results of the survey and other lines of evidence presented in the discussion, we concluded there were no data implicating disease in the decline of Guam's avifauna.

Accidents, Aviation↗
PubMed1999

Odontological identification in two high-impact, high-temperature accidents.

Here we report on two high-impact accidents both of which were complicated by fire. The first accident involved a light aircraft which crashed in a gorge while performing a low, slow flight. Both victims were found to have experienced extensive dental fracturing. The second accident was a high speed motor vehicle crash followed by incineration which left the two victims without dental fracturing. In the absence of comparative data on the effect of burning on teeth the cause of the foregoing remains unanswered.

Accidents, Aviation↗
PubMed2000

The incidence, nature, and severity of injuries in New Zealand civil aviation.

BACKGROUND: Strategies to improve aviation safety can be directed at the pre-crash, in-crash, or post-crash phases of aircraft crashes. For resources to be made available for in-crash interventions, and for these to be well designed, it is necessary in the first instance to have a detailed understanding of the injuries sustained in crashes. The purpose of this study was to describe the incidence, nature, and severity of injuries sustained in aircraft crashes and other related events in civil aviation in New Zealand. METHODS: National injury databases were searched for fatalities and hospitalizations sustained in aircraft crashes and related events, and cases were linked with Civil Aviation Authority accident records to identify the aircraft involved. Rates were based on estimates of total hours flown by active pilots. RESULTS: There were 104 fatalities identified for the period 1988-1992, giving a rate of 2.57 per 100,000 flight hours. There were 120 hospitalizations identified for the period 1988-1993, giving a rate of 2.45 per 100,000 flight hours. Most fatalities involved injury to multiple body regions, with at least one injury being sufficient in itself to cause death in 48% of cases. For hospitalizations, the lower extremities (23%), spine (20%), and head and face (18%) were the body regions most commonly injured, with fractures being predominant. While the majority of fatalities and hospitalizations occurred in fixed- and rotary-wing aircraft, the highest rates were for microlight and home-built aircraft. CONCLUSIONS: Different patterns of injury were evident for fixed- and rotary-wing aircraft. Reasons for these are suggested. Future research will seek to determine the relative risk associated with potentially modifiable risk factors.

Abbreviated Injury Scale↗
PubMed2000

Coordination of mental health and community agencies in disaster response.

Within the past 10 years, the American Red Cross has responded to dramatic disasters and terrorist events that have resulted in significant loss of life and traumatic stress responses. These disasters have included events as diverse as earthquakes, explosions, and aviation accidents.

Community Mental Health Services↗