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Abdominal and Genitourinary Trauma
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
Motor vehicle-related injuries are the most common cause of polytrauma11 while in the UK low falls are the commonest mechanism overall.5 The mechanisms in blunt trauma are direct strike to the abdomen transmitting force to the organs within it and deceleration when organs that are mobile within the abdominal cavity tear their mesenteries and vascular pedicles.12 Deceleration injuries in particular can cause subtle trauma to vascular pedicles that only manifest after a period of hours or days.
Orthopaedics
Published in Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan, Essential Notes for Medical and Surgical Finals, 2021
Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan
Usually occur due to a high-energy impact, often in the context of polytrauma. If there is a history of minor trauma only, suspect a pathological fracture. Fractures can affect the proximal, mid-shaft or distal femur and are associated with high risk of complications such as DVT, ARDS, fat embolus and MODS; this is reduced with early fracture fixation.
Spinal injuries
Published in Helen Whitwell, Christopher Milroy, Daniel du Plessis, Forensic Neuropathology, 2021
The symptoms from which a spinal injury victim may complain are, for the most part, restricted to local pain, plus awareness of any loss of motor or sensory function. Signs of underlying skeletal damage may include local bruising, swelling, tenderness or deformity but the capacity to search for such signs may be limited, particularly in the victim of polytrauma. Neurological examination is needed as soon as practically possible. In addition to recording power (Table 16.1), together with sensation and reflexes in the limbs, assessment should include the lower cranial nerves and function in the lower sacral dermatomes, including sacral reflexes.1 Findings should be documented, to provide a baseline from which to measure any subsequent deterioration or improvement. The absence of all motor, sensory and reflex function below the level of injury, soon after injury, may be due to spinal shock. This will resolve within 48 hours and, unless the conus has been damaged, sacral reflexes will then return. If, at this point, there is no voluntary motor or sensory function, the lesion is deemed to be complete. If, on the other hand, even a small amount of voluntary lower limb movement is seen, the individual will very likely recover sufficiently to walk again, given proper treatment. If there is sacral sparing evident at the outset, then the chances of functional recovery are also good.
Fidelity of a Traffic Safety Education Intervention for Combat Veterans
Published in Occupational Therapy In Health Care, 2021
Sandra M. Winter, Katelyn R. Caldwell, Babette A. Brumback, Mary E. Jeghers, Sherrilene Classen
This work is part of a randomized controlled trial (RCT) designed for Veterans from operations in Iraq and Afghanistan including Operation Iraqi Freedom, Operation Enduring Freedom, and Operation New Dawn. Post-deployed Veterans may experience driving difficulty due to Polytrauma or traumatic deployment exposures. Polytrauma can lead to functional impairments including visual and perceptual changes, increased distraction, and difficulty sequencing - all of which can negatively impact driving (Owens et al., 2007). Deployment training and other exposures contribute to battlemind driving. These techniques, such as speeding and straddling the center lane, were learned by Veterans to avoid combat-related conflicts. However, carryover of battlemind driving into civilian life can negatively impact fitness to drive (Hannold et al., 2013). For example, in a study of simulated driving performance, Veterans made significantly more critical driving errors when compared to civilian controls (Classen et al., 2011).
Attempted suicide leading to acquired brain injury: a scoping review
Published in Brain Injury, 2020
Ciara Higgins, Katy Rooney, Barbara O’Connell, Brian Waldron, Christine Linehan
There exists a very small body of research surrounding palliative care of this population, involving patients treated in hospice settings for life-limiting injuries sustained by a suicide attempt that are not immediately life-threatening (49,50). This research, comprising just two studies, highlights important components of care that could be applied to this population. It acknowledges the polytrauma experience by the individual, the need for interdisciplinary care and emphasizes the importance of supporting the individuals and their families in acceptance of this “double hardship” – the knowledge of how the injury occurred and the extensive disabilities sustained (3). This population carries a significant burden of mental illness as well as estranged interpersonal relationships and limited psychosocial supports, and rehabilitation supports should reflect these needs (50).
Utilization of Outpatient Social Work Services Among Veterans with Combat-Related Polytrauma: A Review and Case Analysis
Published in Military Behavioral Health, 2019
David L. Albright, Bruce A. Thyer, Raymond J. Waller
A blast injury is a trauma that results from an explosion. Sources include improvised explosive devices, land mines, roadside bombs, and rocket and mortar shells (DePalma, Burris, Champion, & Hodgson, 2005). Blast sequelae can result in complex, polytrauma injuries. The Veterans Administration (VA) defines polytrauma (PT) as “two or more injuries to physical regions or organ systems, one of which may be life threatening, resulting in physical, cognitive, psychological, or psychosocial impairments and functional disability” (US Department of Veterans Affairs, 2018, polytrauma). Polytrauma injuries can include bone fractures, burns, loss of limbs, posttraumatic stress disorder (PTSD), spinal cord injury, and traumatic brain injury (TBI; Friedemann-Sanchez, Sayer, & Pickett, 2008).