OBJECTIVE: To determine the reliability of reporting of information on risk factors from a standard accident report form used by ski patrols and a follow up mail questionnaire or telephone interview among injured skiers and snowboarders. SETTING: 19 ski areas in the Canadian province of Quebec between November 2001 and April 2002. PARTICIPANTS: 4377 injured skiers and snowboarders seen by the ski patrol, who completed a follow up mail questionnaire or telephone interview. MAIN OUTCOME MEASURES: Kappa and weighted kappa statistics were used to measure the chance corrected agreement for self reported ability, age, skiing time on day of injury, lessons, type of practice, use of helmet at time of injury, and hill difficulty. RESULTS: The kappa value for helmet use at the time of injury was 0.88 (95% confidence interval 0.87 to 0.90) and for other risk factors ranged from 0.45 (skiing time on day of injury) to 0.98 (age). Few differences were seen in reporting by body region of injury. Reporting consistency was lower for respondents who completed telephone interviews compared with those who completed mail questionnaires and those who responded more than four months after the injury. CONCLUSIONS: Moderate to almost perfect agreement, depending on the risk factor, exists between ski patrols' accident report forms and follow up information. Ski patrol reports can be a reliable and readily available source of information on risk factors for skiing and snowboarding. (+info)
(26/169) Best evidence topic report. Which facial views for facial trauma?
A short cut review was carried out to establish whether a reduced number of facial radiographs had acceptable clinical utility at detecting facial fractures after trauma. Altogether 614 papers were found using the reported search, of which five presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. A clinical bottom line is stated. (+info)
(27/169) Evaluation of protective equipment for prevention of injuries in rugby union.
BACKGROUND: Rugby union has a high rate of injury. The increased use of protective equipment may help mitigate these injuries. This study investigated the injury prevention effectiveness of the protective equipment used in rugby union. METHODS: A cohort of 304 rugby players in Dunedin, New Zealand was followed weekly during the 1993 club season to assess protective equipment use, participation in rugby, and injury outcomes. Generalized Poisson regression was used to model the rate of injury while adjusting for covariates such as level of competition, playing position, and injury history. RESULTS: The use of mouthguards appeared to lower the risk of orofacial injury [rate ratio (RR) = 0.56, 95% confidence interval (CI): 0.07-4.63], and padded headgear tended to prevent damage to the scalp and ears (RR = 0.59, 95% CI: 0.19-1.86). Support sleeves tended to reduce the risk of sprains and strains (RR = 0.58, 95% CI: 0.26-1.27). The risk of concussion was not lessened by the use of padded headgear (RR = 1.13, 95% CI: 0.40-3.16) or mouthguards (RR = 1.62, 95% CI: 0.51-5.11). There was no evidence of protective effects for any other equipment item (taping, shinguards, and grease). CONCLUSIONS: The protective equipment used in rugby union has limited effectiveness in preventing injuries. The results are supportive, however, of a role for mouthguards and padded headgear in preventing orofacial and scalp injuries, respectively, and for support sleeves in preventing sprains and strains. (+info)
(28/169) Percutaneous regional compared with local anaesthesia for facial lacerations: a randomised controlled trial.
OBJECTIVE: Facial lacerations are usually repaired after local infiltration of an anaesthetic agent. Regional nerve blocks of the face offer several theoretical advantages over local infiltration. This study compared the pain of injection and anaesthetic efficacy of percutaneous regional and local anaesthesia for facial lacerations. STUDY DESIGN: Randomised clinical trial. PARTICIPANTS: Convenience sample of emergency department patients with facial lacerations requiring suturing in anatomical areas innervated by a regional nerve (supraorbital, infraorbital, or mental). INTERVENTIONS: Facial lacerations treated using standard wound care. Lacerations were randomised to local or regional infiltration of lidocaine (lignocaine) 1% with adrenaline (epinephrine) 1:100 000 using a number 27 needle. OUTCOMES: Pain of injection on 100 mm visual analogue scale (VAS) and need for rescue anaesthetic infiltration before suturing. DATA ANALYSIS: Group comparisons were with Student's t test and chi(2) test. This study had 80% power to detect a 20 mm difference in pain of injection (two tailed, alpha = 0.05). RESULTS: 36 patients were randomised to local (18) and regional (18) anaesthesia. Mean (SD) age was 20 (14); 19% were female. Groups were similar in baseline characteristics. Patients in the regional anaesthesia group experienced more pain during infiltration than patients in the local anaesthesia group (42.4 mm v 24.8 mm, mean difference 17.6 mm (95% CI 0.3 to 35.6 mm) and were more likely to require additional infiltration of a local anaesthetic (28% v 0%, (95% CI 6% to 50%)) than patients in the local anaesthetic group. CONCLUSIONS: Local infiltration of anaesthetics for facial lacerations is less painful and results in more effective anaesthesia than percutaneous regional infiltration. (+info)
(29/169) Intra-arterial vasopressin injection for the treatment of massive bleeding from the external carotid artery after craniofacial trauma--technical note.
Vasopressin (0.8-1.0 IU), diluted with saline (10 IU vasopressin per 100 ml saline), was selectively injected into the external carotid artery (ECA) to control massive hemorrhage caused by inaccessible serious craniofacial injuries in two patients. This method produced remarkable angiographic vasoconstriction at the involved ECA branches and resulted in immediate hemostasis. Intra-arterial vasopressin injection is a useful option for the treatment of intractable traumatic hemorrhage from inaccessible ECA branches. (+info)
(30/169) An unusual case of a retained metallic arrowhead in the orbit and sphenoidal sinus.
A case of retained metallic arrowhead in orbit and sphenoidal sinus through an unusual route is reported. The eyeball was removed because of a possible risk of sympathetic ophthalmia. (+info)
(31/169) Perceptions of Chandigarh sports coaches regarding oro-facial injuries and their prevention.
Enthusiastic participation by the younger generation in sports exposes them to a high risk of injuries. In the present study, the perceptions of sports coaches regarding their knowledge and experience of such injuries is evaluated. The coaches considered helmet as the most common protective device followed by mouth guard and facemask. About 58% observed that boxing was associated with oro-facial injuries and protective devices were deemed mandatory by 68% in this event. About 45% saw over five injuries in the last year, mostly soft tissue facial injuries (47%) and tooth loss (33%). Most injuries were in hockey and 32% were due to hits by ball, stick or related hard objects. About 82% were related to nonuse of protective devices. The majority of coaches considered that oro-facial devices be made more popular among sportspersons for their safety while 28% felt they reduced efficiency. The author concludes that there is a need to popularize the use of oro-facial protective devices in a variety of sports events in our country by interacting with coaches, sports administrators and sportspersons as well as familiarizing the Indian dentists in this relatively new field. (+info)
(32/169) Gaps in injury statistics: multiple injury profiles reveal them and provide a comprehensive account.
OBJECTIVE: To demonstrate the benefit of using multiple injury profiles (MIP) as an alternative to "primary diagnosis," for the presentation and analysis of multiple injuries in populations. METHODS: Retrospective analysis of national trauma registry data in Israel between 1 January 1998 and 31 December 2002. Multiple diagnoses per patient were recorded. A primary diagnosis was selected for each patient and data were presented twice: first by selecting a primary diagnosis and then using multiple injury profiles. RESULTS: 23 909 transport casualties were included. Findings show that MIP enable the identification of all patients with a specific injury, even where secondary. The proportion of additional injuries recorded when using MIP ranged from 12% in head injuries to 270% for facial injuries. Based on the primary diagnosis patients with head, chest, and abdominal injuries had a 5-6% inpatient death rate each. Multiple injury profiles of the same population reveal that an isolated head injury has a 3% inpatient death rate, isolated chest and isolated abdomen have a 1% inpatient death rate, while combined head and chest casualties have a 21% inpatient death rate. CONCLUSIONS: Multiple injury profiles are a new approach that enables presenting an improved picture of injury in a population. (+info)