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Scalp, facial and gunshot injuries
Published in Helen Whitwell, Christopher Milroy, Daniel du Plessis, Forensic Neuropathology, 2021
Most fatal stab wounds are inflicted to the trunk, particularly the chest, but penetrating wounds to the head are occasionally encountered (Figure 6.14). Stab wounds should be recorded by site, external dimensions, direction of travel and depth. Although some knives leave injuries that indicate whether they are single or double edged, this is often not possible to determine. Movement of the knife in relation to the victim may cause variation in the size of the surface wound. Some weapons have serrated edges, but this is often not possible to determine from the wound. Stab wounds aimed at the head may penetrate the skull, but if they do not the wound may be significantly affected by movement against the skull. Some stabbing weapons, notably scissors, may produce more irregular wounds. Blunter stabbing weapons, such as screwdrivers, may also produce penetrating wounds. In these cases, the screwdriver can produce a small slit-like laceration, belying the degree of damage caused by the passage of the weapon into the brain (Figures 6.15 and 6.16).
The Medicolegal Autopsy
Published in Kevin L. Erskine, Erica J. Armstrong, Water-Related Death Investigation, 2021
There are basic differences between incised and stab wounds. Typically, incised wounds are superficial, being longer on the skin than they go deep into the skin, and are caused by dragging the perpendicular or nearly perpendicular blade across the skin’s surface. Incised wounds that are very superficial do not bleed to a great extent. By contrast, stab wounds extend deeper into the body and thus are greater in depth than the length on the skin surface, and have a greater propensity to involve injury to the internal organs and blood vessels. The skin has some resistance to penetration, but once breached, especially when the instrument has a very sharp edge, it takes very little perpendicular or obliquely applied force to extend the wound into the underlying tissue and organs, unless bone or cartilage is encountered.
Postmortem Radiology and Digital Imaging
Published in Cristoforo Pomara, Vittorio Fineschi, Forensic and Clinical Forensic Autopsy, 2020
Giuseppe Bertozzi, Francesco Pio Cafarelli, Andrea Giovanni Musumeci, Giulio Zizzo, Giampaolo Grilli, Cristoforo Pomara
In CT imaging, parenchymal laceration usually assumes a conical shape with the basis at the entrance wound. Similar considerations can be made about the exit hole. Moreover, the entry hole is characterized by an inner cortical bone layer, which is more comminuted than the outer layer; on the contrary, the exit hole in cases of perforating injuries is characterized by an outer layer, which is more comminuted than the inner layer. Stab wounds, on the other hand, are uncommon affecting the body parts, because of natural protection and resistance opposed by the cranial table to severe instruments. Knives, screwdrivers, scissors, pencils, ice picks, and stilettoes are usually involved in casualties, leading to death for vessel lacerations with massive intracranial hemorrhages or brainstem or vital brain damage. PMCT, which is useful in identifying fractures, hemorrhages, trajectory, and encephalic or thoracic areas affected by these lesions, is limited only by metal artifact/high-density foreign material artifact.
The effect of personal protective equipment use on nurses’ tendencies to make medical errors and types of their medical errors: a cross-sectional study
Published in International Journal of Occupational Safety and Ergonomics, 2023
Cennet Çiriş Yildiz, Dilek Yildirim, Kardelen Günay
In this study, the majority of the nurses stated that they made medical mistakes about applying the wrong medicine (30.8%) and the wrong dose of medicine (25.6%). In previous studies, the most common types of medical errors made by nurses were found to be medication errors [19,20], wrong drug administration (44.8%) [21] and wrong-dose administration (52.3%) [19]. Additionally, in this study, the most common types of medical errors in the hospital where the nurses were working included needle-stab wounds, hospital infections and bedsores. It is estimated that 385,000 stab wounds occur annually in the USA [22]. Sharek and Classen [23] determined the most common type of error as nosocomial infections with a rate of 27.8%. Mitchell et al. [24] determined that there are 165,000 nosocomial infections per year in Australian hospitals. The rate of hospital infections, which is evaluated within the scope of medical errors, is one of the most significant criteria that show the quality of care. It is thought that this was due to the inadequacy of notification systems and the carelessness of the personnel [12].
Abstracts from the Seventh Annual Baylor University Medical Center Medical Education Research Forum 2021
Published in Baylor University Medical Center Proceedings, 2021
Kashif Waqiee Ahmed, Thomas Cox, Jennifer Olvera, Natalie Gittus, Kirsten Ryan, Cristie Columbus
Posttraumatic diaphragmatic hernias generally occur in the setting of blunt or penetrating trauma. Common causes include stab wounds, gunshots, impalements, and crush injuries such as motor vehicle crashes. The clinical presentation and development of symptoms can vary widely. We present the case of a 51-year-old man who presented to the emergency department with a 3-day history of left shoulder pain and nausea. Abdominal computed tomography and x-ray revealed a diagnosis of posttraumatic diaphragmatic hernia with a segment of infarcted bowel that demonstrated pneumatosis intestinalis. After his diagnosis, the patient was taken to surgery to repair the hernia and also had a partial colectomy for the resection of necrotic bowel. The patient reported a remote history of a motor vehicle accident 3 years earlier with crush injuries to his chest and atelectasis of the right lung base noted at the time of injury. This case highlights the significant delay that can occur between initial trauma and development of symptoms in a posttraumatic diaphragmatic hernia.
Saving Lives with Tourniquets: A Review of Penetrating Injury Medical Examiner Cases
Published in Prehospital Emergency Care, 2020
C. Bonk, B.W. Weston, C. Davis, A. Barron, O. McCarty, S. Hargarten
A total of 1,804 homicide cases were reviewed with an average of 120 homicides per year (Figure 1). The majority of deaths were from penetrating injuries (84.3%), and most were younger (mean age: 31 years), male (84.5%), and African-American (73.8%) (Table 1). Moreover, gunshot wounds (1,366; 89.8%) were the most common mechanism type of injury, followed by stab wounds (151; 9.9%). Isolated penetrating extremity wounds accounted for 22 of the penetrating injury cases (1.45%), while concurrent extremity and central injuries accounted for an additional 409 (26.9%) of the cases (Table 2). Of these concurrent extremity and central injuries, 13 (3.2%) had the extremity injury as the likely cause of death. Among all extremity injuries in this multiple injury group, 404 (92.2%) were deemed amenable to tourniquet placement (Table 3), including all 22 of the isolated extremity injuries.