摘要:

To study the association between actual and claimed belt usage, to determine drivers' attitudes toward seatbelts, and to identify some of the factors associated with the use and nonuse of seatbelts, we administered a one-page questionnaire to 1,103 drivers attending their annual brake tag inspection in New Orleans, Louisiana. Actual belt use was unobtrusively recorded at the same time. Fifty-one per cent of drivers stated that they wore seatbelts always or most of the time, 52% agreed that seatbelts should be worn, and 28% favored mandatory seatbelt use. Yet only 5.4% of drivers were actually observed wearing seatbelts. Drivers who had experienced a previous auto injury that required a doctor's visit were 1.7 times as likely to be wearing seatbelts as those without prior injury, yet only 8% of the injured were wearing them. The results of the survey are discussed in relation to the discrepancy between attitudes towards seatbelts and observed seatbelt use.

ISSN:0022-5282    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

A technique has been devised by which a misplaced central venous catheter can be repositioned in the superior vena cava by using a #2 vascular Fogarty catheter. This technique is easier and more dependable than the J-guide wire technique and spares the patient repeated attempts at subclavian vein cannulation.

ISSN:0022-5282    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

When a functionally important digit is injured as part of a multiple digit injury, transpositional digital replantation is worth considering to preserve greater hand function and to avoid or minimize the necessity for secondary reconstructive procedures. We present two such cases with transpositional digital replantation. The indications for this technique are: 1) multiple digit injury, 2) severe crush injury, 3) the possibility of preserving more and better joints in some fingers, and 4) injury distal to Tamai's zone V (11). The benefits of this procedure are that function can be better with the more completely preserved digits replanted into the most useful positions and of similar lengths. Difficulties are encountered when there are large discrepancies in size of surviving digits, and problems with soft-tissue coverage, tendon repair, a 'step' at the fracture site after bone fixation, and with vessel anastomosis. Use of this procedure can result in preservation of hand function and fewer secondary reconstructive procedures.

ISSN:0022-5282    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Because of the widespread use of ammonia in industry and agriculture there is a growing opportunity for ammonia burns to occur. Two fatal cases are presented. The injury is thermal as well as chemical, to skin, eyes, airway and lungs. Prompt (5–10 seconds) irrigation of the eyes is required, and immediate treatment of airway and pulmonary injuries. Fluid resuscitation and skin wound care are similar to that of other burns. Presence or absence of abnormal chest findings on admission is the best prognostic factor.

ISSN:0022-5282    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Persistent jaundice and abdominal distention were noted postoperatively in a 37-year-old white male who had undergone splenectomy and suture of a liver laceration following a motorcycle accident. Abdominal paracentesis yielded bile-stained fluid. Endoscopic retrograde cholangiography (ERC) demonstrated rupture of the hepatic duct at its bifurcation which had been missed on initial laparotomy. ERC was valuable in planning and subsequently performing a hepatojejunostomy. We found no previous report of using ERC to diagnose and locate a missed bile duct injury.

ISSN:0022-5282    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Single dislocation of a joint in a finger is common, but simultaneous dislocation of both joints is a rare occurrence. Two further cases are reported with review of the literature.

ISSN:0022-5282    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

A case of posterior fracture-dislocation of the elbow with a comminuted radial head fracture which subsequently went on to nonunion is reported. Radiographs at followup revealed a pseudoarthrosis of the radial neck, with at least part of the normal pronation and supination occurring through the pseudoarthrosis site.

ISSN:0022-5282    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The rarity of bile duct injury secondary to blunt abdominal trauma leads to frequent delays in diagnosis and inappropriate management. An illustrative case is therefore described and 94 reported cases are reviewed. In 53% of patients, operation was delayed more than 24 hours. Early clinical findings of hypovolemia and acute abdomen are related to associated injuries. Late findings are abdominal distention and jaundice due to the biliary injury. Early diagnosis is facilitated by diagnostic paracentesis. Patients operated on during the first 24 hours after the injury had a statistically higher incidence of bile duct injury distal to the cystic duct (p< 0.05) and of complete ductal severance (p< 0.05). The association of location distal to the cystic duct and complete severance was highly significant (p< 0.001). Management should include biliary exploration. Cholangiography using concentrated water-soluble contrast agents may help to find the anatomy of obscure injuries. The choice of surgical repair must be individualized according to the location and the magnitude of the injury.

ISSN:0022-5282    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Obtaining control of bleeding inferior vena caval (IVC) lacerations poses problems such as iatrogenic tears with vascular clamps and/or increased blood loss due to dissection and mobilization. We present three cases where balloon catheters were introduced through the laceration proximally and distally to obtain control of bleeding followed by repair with very minimal further dissection. All patients survived. This technique is recommended for rapid, effective control of such injuries.

ISSN:0022-5282    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0022-5282    

出版商:OVID    

年代:1985

数据来源: OVID