RA Partridge, AS Virk, RE Antosia (Brown Univ, Providence, RI; Deaconess-Waltham Hosp, Mass; Harvard Med School, Boston)
Causes and Patterns of Injury from Ladder Falls
Acad Emerg Med 5: 31-34, 1998.
Introduction: Falls from ladders are amongst frequent cases seen in the Emergency Department (ED). Upto 20% fatal falls in the workers aged more than 55 years are ladder falls. Ladder fall injuries seen in the Emergency Department of a Community Hospital have been reviewed retrospectively, to evaluate factors with a likelihood to reducing the falls.
Methods: All patients registering into the ED between January 1993 and December 1995, because of a ladder fall injury were included in the review.
Results: Fifty-nine patients with 86 injuries met the inclusion criteria. All were males and the mean height from fall being 7.2 feet. Only 8 patients required admission, of which one died of a subdural haematoma.
Injuries sustained :
Fractures – 36% pts.
Sprains – 27% pts.
Contusions – 24% pts.
Commonest causes for fall were in correct ladder placement and no one to hold the ladder at the time of the fall.
These injuries could have been prevented by education on the safe use of ladders.
JP Sutyak, V Passi, JS Hammond (Univ of Medicine and Dentistry of New Jersey, New Brunswick)
Air Bags Alone Compared With the Combination of Mechanical Restraints and Air Bags: Implications for the Emergency Evaluation of Crash Victims.
South Med J 90: 915-919, 1997.
It is well known amongst all emergency physicians that the use of mechanical restraints when used along with air bags decrease the mortality and morbidity significantly in crash victims. This can be primarily attributed to a lower severity of injury to the chest and abdomen. Hence the use of airbags should be reinforced along with the use of mechanical restraints.
Y-C Wong, L-J Wang, K-E Lim, et al (Chang Gung Mem Hosp, Taoyuan Hsien, Taiwan)
Periaortic Hematoma on Helical CT of the Chest: A Criterion for Predicting Blunt Traumatic Aortic Rupture.
AJR 170: 1523-1525, 1998.
Helical CT, which provides less artifact and decreases the number of equivocal or uninterpretable scans compared with conventional CT, is recommended for emergency practise. This retrospective study, although small is unique and brings a significant aspect to limelight- the utility of a periaortic hematoma for predicting traumatic aortic rupture. The sensitivity, specificity and negative and positive predictive values of helical CT of chest for traumatic aortic rupture being 100%, 77%, 100% and 73% respectively. However, a larger prospective study using the same criterion is recommended.