Predisposing Factors in Traumatic Injury

Predisposing Factors in Traumatic Injury

Alcohol And Other Drug(AOD)

Such educational and preventive efforts rarely take place with hospitalized trauma patients whose injuries are related to alcohol and other drug use. However, when injury is viewed as a disease, clinicians are more likely to address underlying risk factors, such as a family history of AOD use, episodes of heavy drinking, and other areas of unsafe behavior such as the failure to use seatbelts.

From the disease perspective, many interacting risk factors contribute to the occurrence of a traumatic event such as a motor vehicle crash. A poorly lit road with dangerous curves increases the risk of a vehicle crash. Add to that icy conditions and an adolescent short on driving experience, attention, and concentration but long on risk-taking behavior, and the risk of a crash increases greatly. Add alcohol consumption to this mix, and from this perspective, the situation appears to be one that almost certainly will end in a crash.

When injury is viewed as a disease, clinicians are more likely to address underlying risk factors, such as a family history of AOD use, episodes of heavy drinking, and other areas of unsafe behavior such as the failure to use seatbelts.

 Risk Factors for Traumatic Injury

Epidemiologists and other researchers have made enormous strides in their understanding of factors leading to injury.researchers have attempted to model risk factors for injury in order to develop more effective prevention strategies. Several sophisticated models of risk factors and matrices for prevention strategies have been used factors other than AOD use that increase the risk of traumatic injury can be classified into four areas: physical, environmental, socioeconomic, and personality/psychological factors. As described above, several factors often interact to contribute to a traumatic injury. Reducing the level of any single factor, such as improving the lighting and paving of roads, can greatly reduce resulting injuries.

 

Physical factors.

Physical factors are those related to the individual person, such as age, gender, and physical health. Younger persons, especially males, are at increased risk of injury because they are generally more active than older persons. Elderly people with poor vision, weak lower extremities, and impaired or decreased balance are at greater risk of falling; because of progressive bone loss they may also sustain severe injuries as the result of relatively low-impact forces.

Environmental factors

Environmental factors increase the risk of traumatic injury. Certain countries have passed legislation to reduce speed limits, increase the legal drinking age, and make helmets mandatory for motorcyclists and bicyclists, thereby greatly reducing people's risk of injury. Environmental factors can also relate to an individual's access to guns and use of cars or alcohol and other drugs, as well as to the safety of the person's location, such as his or her living near a body of water or in a high-rise building.

Socioeconomic factors.

Socioeconomic factors such as being employed in a high-risk job or living in a high-crime neighborhood or in a poorly maintained building with few safety features also contribute to the risk of traumatic injury. Driving old or poorly maintained cars also increases the risk. Other socioeconomic factors are related to the breakdown of families that is often associated with poverty. Young people may join gangs to replace the family bonds, and enter a culture where violence is promoted and accepted as a routine of daily life.

Personality/psychological factors

Risk taking, antisocial behaviors, and mental illness contribute to risk. Persons who have depression are at increased risk of suicide, and those with schizophrenia or other psychotic disorders may lack the judgment to remove themselves from dangerous situations, or carelessness in using mobile and the other high technologies equipment's and electronics

Never use your Mobile phone while driving, boarding/leaving buses, crossing road and in all public places where you have to be attentive. Mobile use is the major cause of traffic accidents!!

DR FIRAS ALKURDI
EMTM, MBBS.

Alcohol And Other Drugs (AODs)

 

Alcohol And Other Drugs (AODs)

Use Of Alcohol And Other Drugs Has Been Recognized As A Major Independent Risk Factor In Unintentional Fatal And Nonfatal Injuries And In Intentional Injuries Such As Assaults, Homicides, And Suicides. Indeed, Some Clinicians Believe That Traumatic Injury Is A Marker Of Alcohol Abuse .  Although The Role Of Drugs Other Than Alcohol In Traumatic Injuries Has Not Been As Thoroughly Investigated, Studies Have Shown That Cocaine, Amphetamines, And Marijuana, Especially In Combination With Alcohol, Play A Significant Role In Traumatic Injuries Of All Kinds, Especially Motor Vehicle Crashes And Traffic Collision

The Risk Of Injury Is Increased Both By Immediate Use Of Alcohol And Other Drugs (Impairment And Intoxication) And By Chronic AOD Use And The Evidence Of  Alcoholism Has Been Found In Some Samples Of Trauma Patients. Many Aspects Of AODs And Their Effects Play A Role, Including The Following:

The Risk Alcohol And Other Drugs (AODs)

1. AODs Decrease The Level Of Alertness.
2. AODs Impair Motor Function, Diminishing Coordination And Balance And Increasing Reaction Time.
3. AODs Impair Judgment.
4. AODs Impair Perception And Cognitive Abilities.
5. AODs Increase Risk-Taking Behavior And Especially Feelings Of Invulnerability (Especially Among Adolescents And Young Adults).
6. AODs Affect The Emotions And Reduce Inhibitions, Intensifying Feelings Of Anger And Depression And Increasing Impulsivity.
7. Use Of AODs Is Associated With Increased Violent Behavior.
8. Chronic AOD Use Can Render A Person More Medically Fragile, And Thus Injuries Sustained Are More Severe.
9. Obtaining AODs, Especially Illicit Drugs, May Place The Individual In An Unsafe Environment

Untreated AOD Use Disorders Play A Significant Role In Reinjury

Persons Who Experience One Traumatic Head Injury Have Been Found To Be At Greatly Increased Risk For Reinjury. For Example, After One Head Injury, A Person Is Three Times More Likely Than Someone In The General Population To Sustain A Second Head Injury. After A Second Injury, The Relative Risk For A Third Injury Increases To Eight Times The Normal Risk . After One Head Injury, A Person Is Three Times More Likely Than Someone In The General Population To Sustain A Second Head Injury. After A Second Injury, The Relative Risk For A Third Injury Increases To Eight Times The Normal Risk.

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DR FIRAS ALKURDI
EMTM, MBBS.

Disease Or Risk Factors In Traumatic Injury

Disease Or Risk Factors In Traumatic Injury

A different approach to this patient group is to view traumatic injuries as a disease, like heart disease, with many potential risk factor . For example, the initial medical workup of a patient who has had a heart attack generally includes several questions related to family history of heart disease, nicotine use, co-morbidity, diet, and level of activity. These questions are asked to clarify the clinical picture and to help the patient understand the underlying cause of his or her condition and the required treatments—and to prevent further illness. A different approach to this patient group is to view traumatic injuries as a disease, like heart disease, with many potential risk factors. Such educational and preventive efforts rarely take place with hospitalized trauma patients whose injuries are related to alcohol and other drug use. However, when injury is viewed as a disease, clinicians are more likely to address underlying risk factors, such as a family history of AOD use, episodes of heavy drinking, and other areas of unsafe behavior such as the failure to use seatbelts.

From the disease perspective, many interacting risk factors contribute to the occurrence of a traumatic event such as a motor vehicle crash. A poorly lit road with dangerous curves increases the risk of a vehicle crash. Add to that icy conditions and an adolescent short on driving experience, attention, and concentration but long on risk-taking behavior, and the risk of a crash increases greatly. Add alcohol consumption to this mix, and from this perspective, the situation appears to be one that almost certainly will end in a crash. When injury is viewed as a disease, clinicians are more likely to address underlying risk factors, such as a family history of AOD use, episodes of heavy drinking, and other areas of unsafe behavior such as the failure to use seatbelts. factors other than AOD use that increase the risk of traumatic injury can be classified into four areas: physical, environmental, socioeconomic, and personality/psychological factors. several factors often interact to contribute to a traumatic injury. Reducing the level of any single factor, such as improving the lighting and paving of roads, can greatly reduce resulting injuries.

Physical factors. Physical factors are those related to the individual person, such as age, gender, and physical health. Younger persons, especially males, are at increased risk of injury because they are generally more active than older persons. Elderly people with poor vision, weak lower extremities, and impaired or decreased balance are at greater risk of falling; because of progressive bone loss they may also sustain severe injuries as the result of relatively low-impact forces.

Environmental factors. Environmental factors increase the risk of traumatic injury. Certain States have passed legislation to reduce speed limits, increase the legal drinking age, and make helmets mandatory for motorcyclists and bicyclists, thereby greatly reducing people's risk of injury. Environmental factors can also relate to an individual's access to guns and use of cars or alcohol and other drugs, as well as to the safety of the person's location, such as his or her living near a body of water or in a high-rise building.

Socioeconomic factors. Socioeconomic factors such as being employed in a high-risk job or living in a high-crime neighborhood or in a poorly maintained building with few safety features also contribute to the risk of traumatic injury. Driving old or poorly maintained cars also increases the risk. Other socioeconomic factors are related to the breakdown of families that is often associated with poverty. Young people may join gangs to replace the family bonds, and enter a culture where violence is promoted and accepted as a routine of daily life.

Personality/psychological factors. Risk taking, antisocial behaviors, and mental illness contribute to risk. Persons who have depression are at increased risk of suicide, and those with schizophrenia or other psychotic disorders may lack the judgment to remove themselves from dangerous situations.

 

DR FIRAS ALKURDI
EMTM, MBBS.

Traumatic Injury . part 2

Traumatic Injury

Is Defined As Tissue Damage Caused By External Force Or Violence. Acute Injury Results From The Rapid Transfer (As Little As A Few Seconds Or Less) Of Excessive Amounts Of One Of The Five Forms Of Energy (Kinetic, Thermal, Chemical, And Electrical Energy And Radiation) Or The Excessive Removal Of One Of These Forms (For Example, In Asphyxiation Or Hypothermia). Acute Injury Can Be Intentional, Such As Injuries Resulting From Assaults Or Self-Infliction. Unintentional Injuries Result, For Example, From Falls. Injuries May Be Fatal Or Nonfatal. Kinetic Injuries Are Often Classified As Penetrating (Passing Into The Body), Such As A Stab Wound Or Gunshot Wound, Or Blunt (Striking The Outside Of The Body), Such As Internal Injuries Resulting From A Fall.

This Definition Differentiates Traumatic Injury From Overuse Injuries Such As Carpal Tunnel Syndrome And From Chronic Disease, In Which Tissue Damage Occurs Over A More Extended Time.

In General, There Is Wide Agreement On The Types And Severity Of Injuries That Should Be Treated In The Hospital. Although Severity Of Injury Is The Main Factor In Determining Whether A Patient Is Hospitalized, Some Patients, Such As Those With Mild Head Injuries Or An Altered Mental Status, Who May Not Need Hospitalization For Their Primary Injury, Are Sometimes Hospitalized For A Short Time For Observation. Social Factors, Such As Lacking Caregiver Supports And Being Homeless, Sometimes Play A Role In The Decision To Hospitalize, Although This Decision Is Becoming Increasingly Difficult Because Of Stringent Admission Criteria Set By Third-Party Payers. In General, Hospitalized Trauma Patients Are Those With Moderate To Severe Injuries Requiring Specialized Evaluation And Treatment.

The Trauma Patient In The Opinion Of The Doctors At E.R

Clinically, Trauma Patients Can Be Viewed In Several Ways. Physicians Focus On The Patients' Immediate Needs, According To The Physicians' Specialties. Because These Patients Are Often Near Death Or In Danger Of Sustaining Permanent Disability From Conditions Needing Immediate Treatment, Views Of Them Are Often Narrow And Necessarily Focused On The Injury. The Emergency Department Physician And Staff, As Well As The Trauma Physician, Generally See The Patient From The Perspective Of The Mechanism Of Injury, Which Alerts Them To Look For Particular Types Of Injuries.

Neurosurgeons Or Orthopedic Surgeons Mainly View The Patient From The Perspective Of The Organ Or Organ System Injured. For Example, To A Specialist Called In To Deal With The Patient's Brain Injury Or Shattered Hip Bone, The Mechanism Of Injury Is Not As Important As The Site Of The Injury And The Type Of Injury. Similarly, Physical Rehabilitation Specialists May Focus On Restoring The Patient's Muscle Strength Or Range Of Limb Movement Or Independent Functioning.

As Can Be Seen, These Views Of The Trauma Patient Begin With The Point Of Injury And Focus On The Outcomes Of The Traumatic Event. This Approach Can Be Fragmented And Does Not Result In A Holistic Picture Of Trauma Patients. In Terms Of Injury Prevention, These Views Of Trauma Patients Have Served Them Poorly.

To Be Continued Next Week In Part 3 With Different Views Of Trauma

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DR FIRAS ALKURDI
EMTM, MBBS.

trauma

Trauma

Trauma patients are people from all age groups, geographic areas, and socioeconomic classes: the elderly woman who falls and breaks her hip, the middle-aged pedestrian who is hit by a car while walking his dog on a familiar road or struck by lightning on the golf course, the adolescent with a gunshot wound or a neck injury from diving, the young adult metal worker or farm worker whose hand is injured in heavy machinery, or the child burned in a fire -- these people sustain traumatic injuries

The main purpose of this issue is to familiarize persons in the alcohol and other drug (AOD) treatment field with hospitalized trauma patients, including the types of injury they sustain, the physical and psychological effects of these injuries, and the typical course of treatment for trauma patients—from acute emergency treatment in hospitals and trauma centers through rehabilitation and return to the community.

The purpose of this issue is to familiarize persons in the AOD treatment field with hospitalized trauma patients, including the types of injury they sustain, the physical and psychological effects of these injuries, and the typical course of treatment for trauma patients.

A variety of factors increase the likelihood that a person will sustain a traumatic injury, and this article presents a model for conceptualizing these factors and their relation to injury. In this view, a traumatic injury is seen not as an "accident" but as a condition resulting from the interaction of many factors. An assumption of this view of injury as a public health problem is that, like heart disease, it can to a large extent be prevented when risk factors are reduced.

This report does not attempt to provide a comprehensive description of traumatic injuries and their treatment. Only the major types of traumatic injury are described in detail, while others are highlighted. Particular points covered about each type of traumatic injury include its major causes, its incidence in the general population, and the proportion of patients for whom AOD use and dependence contribute to the injury.

It is hoped that when reading this chapter, persons in the AOD treatment field begin to consider this diverse patient population in terms of identifying and treating the AOD-abusing and -dependent individual. This population is similar to other AOD treatment populations with co-morbidity conditions, such as persons with dual diagnoses (mental illness and AOD use disorders) or with serious, chronic medical conditions. Both conditions must be treated for the overall prognosis to improve. It is hoped that models or strategies for working with this patient group will suggest themselves to readers.

 

Traumatic injury has been recognized as a leading public health problem, and policymakers at all levels have attempted to implement injury-prevention measures. As discussed and will be addressed in more detail later in this report, alcohol-and-other- drug use plays a major role in traumatic injury. Persons with untreated AOD problems who have sustained one traumatic injury are at increased risk of re-injury. Because of the growing emphasis on injury prevention, it is likely that hospitalized trauma patients will come increasingly to the attention of the AOD treatment field

To be continued next week with different views of trauma definition ,type and management

DR FIRAS ALKURDI
EMTM, MBBS.

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International Motor Sports Injuries and Extrication Management

GP2 Asia 2011 big accident at yas marina at Abu Dhabi

Its Good Experience To Have A Look On This Movie To Find Out How Medical Intervention Is Quick And Great On Time
Regards
Dr Firas Al kurdi

Dear colleague

 

Its great honor to me and high privilege to join journal do autodromo To start sharing knowledge and information about emergency medicine and trauma accidents, either in the motor sports or high speed vehicles , and I am looking forward to read your comments or sharing me any issue regarding emergency accidents and trauma .

Regards
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DR FIRAS ALKURDI
EMTM, MBBS.