Injured Persons Research Articles

The compensation for harm: problems and prospects for further legislative reform

The compensation for harm is one of the most important legal ways to protect the violated civil rights and interests of the participants in civil relations. In modern market conditions, this method of protection is the main one for restoring the material condition or compensating for moral harm to the injured person. In the context of updating civil legislation and adapting it to EU legislation, there is a need for new approaches to the legal regulation of compensation for harm.
 The article examines the general terms of compensation for harm: the illegality of the behaviour of the person who caused the harm, the presence of harm, the causal relationship between the illegal behaviour and the harm, and the fault of the person who caused the harm.
 Special attention is paid to the issue of illegality (illegal behaviour) as a condition for compensation for damage. Here the theories of illegality are analysed: objective (normative) and objective-subjective.
 The definition of harm is investigated. The attention is focused on the ratio of the concepts of "harm" and "damages". Attention is drawn to the problems of legal regulation of the concept of moral harm. It is established that according to the practice of European Court of Human Rights, the content of moral (non-property) harm is determined differently in relation to individuals and legal entities. In addition, the methods of determining the amount of compensation for moral harm are analysed, in particular, the method of psychological research certified by the Ministry of Justice in Ukraine and registered in the Methodology of Psychological Research in Cases Involving the Infliction of Moral Suffering on a Person and Compensation for Moral Harm (registration number 14.1.75), which was put into effect from 18.01.2019.
 The article analyses the legal regulation of the causal relationship between illegal behaviour and harm in the Principles of European Tort Law (PETL).
 Based on the results of the research, it was concluded that in the future it is advisable to continue studying and improving the obligations to compensate for harm, in particular, the system of special torts provided for by Chapter 82 of the Civil Code of Ukraine is subject to revision.

Clinico-anatomical characteristic of the traffic-transport trauma in the megapolic environment. The third report: severity of injury

Objective. Formation of unified clinical characteristic of damages in participants of traffic, who were injured due to traffic-transport accidents in the megapolis environment.
 Materials and methods. Retrospective analysis of data, concerning 1139 injured persons, who were traumatized due to traffic-transport accidents and stationary treated in the Kyiv’s Clinical Hospital of Emergent Medical Help in the 2019 - 2020 yrs period, was accomplished.
 Results. The persons, suffering relatively nonsevere trauma – 83.67% - dominated in general investigated massive, while extremely severe and severe damages have been encountered in 7.97% injured persons only. Positive result of the traumatic process course was noted also in the biggest quantity of the injured persons with the trauma severity up to 16 points – in 74.56%, and among the dead individuals the first place was occupied by injured persons with the damage severity more than 45 points – in 44.0%. While the injury severity constituting more than 45 points, the part of the injured persons survived was 55.10%. All the injured participants of the traffic with nonsignificant (up to 16 points) injury severity score have had occupied first places, but the value of such an index was different in all of them. Among pedestrians there was a biggest part of the injured persons, owing the damage severity more than 45 points in accordance to the NISS scale – 7.62%. In these participants of traffic such damages occur in 3.2 times more frequently, than in the injured persons, who were inside of the vehicle (drivers, passangers). The injury severity essentially impacts the result of the traumatic process course in all participants of traffic.
 Conclusion. The trauma of severity up to 16 points in accordance to the NISS scale are obtaining 71.29% of the persons, injured due to the traffic-transport accidents. The severest traumas are obtained by the pedestrians. There was established, that the damage severity trustfully depends on factors of participation in traffic and impacts occurrence of negative result of the traumatic process course.

Determinants of Road Traffic Accident Occurrences in Amhara Region: A Case Study from Debre Markos to Injibara Road Section

Ethiopia is one of developing countries with the worst road traffic accident records in the world and it ranks second among east African countries. Even if Determinants of road traffic accidents have a major health concern in the world, unlike developed or high-income countries, many developing countries have made very little progress towards addressing this problem. Nonetheless, there are ways to strengthen the reduction of injured persons that will help to lower the toll from road RTAs. The purpose of this paper is to elucidate ways to accomplish these goals in the context of along the road section from considering the Debre Markos-Injibara (150km) road as a cause study. The determinants will established mainly through Descriptive and Inferential analysis. Inferential analysis was carried out using STATA software v14 program (odds ration model regression) and results were generated. This implies that the proportion of variation in the dependent variable (i.e. road traffic accidents) explained by the independent variables (i.e. length of roads, road geometry, road users, presence of road safety, environment and speeding). Based on the results of priority value analysis, out of the 11 sections of the subject road; the Burie, around Finote Selam, Banja, and Finote Selam were highly prone to accidents and corresponding values as: 13, 10.79, 10 and 9.64 respectively. Based on the findings recommendations were proffered on how to reduce the phenomenon of traffic accidents in the study area.

A Public Health Review into Two Decades of Domestic Trampoline Injuries in Children within Queensland, Australia.

Trampolining as an activity brings enjoyment and many health benefits, but at the same time it carries an injury risk. Most domestic trampoline users are children who are developing in skill, cognition, risk perception, physical strength and resilience to injury. Several common patterns of child trampoline injuries have been identified and countermeasures outlined in standards have been taken to reduce higher risk injury mechanisms, such as entrapment and falls from the trampoline through design, product and point of sale labelling. In Australia, the first national trampoline standard was published in 2003 which introduced improvements in trampoline design and requirements for labelling and padding. This work investigated the potential impact of these and subsequent changes based on almost two decades of emergency department trampoline injury data collected in Queensland, Australia. These data describe the changing representative proportion and pattern of trampoline injuries in Queensland over time by age, mechanism, gender, severity and nature of injury of injured persons up to the age of 14 years. The interrelationships between different injury characteristics were also analysed to propose the main factors influencing injury occurrence and severity. These findings seem to indicate that safety evolution in the form of enclosure nets, frame impact attenuation and entrapment protection have likely improved domestic trampoline safety. Other factors, such as adult supervision, minimum age and avoidance of multiple users, could further reduce injury but are harder to influence in the domestic setting.

HIV self-testing acceptability among injured persons seeking emergency care in Nairobi, Kenya

ABSTRACT Background Emergency department-based HIV self-testing (ED-HIVST) could increase HIV-testing services to high-risk, under-reached populations. Objectives This study sought to understand the injury patient acceptability of ED-HIVST. Methods Injury patients presenting to the Kenyatta National Hospital Accident and Emergency Department were enrolled from March to May 2021. Likert item data on HIVST assessing domains of general acceptability, personal acceptability, and acceptability to distribute to social and/or sexual networks were collected. Ordinal regression was performed yielding adjusted odds ratios (aOR) to identify characteristics associated with high HIVST acceptability across domains. Results Of 600 participants, 88.7% were male, and the median age was 29. Half reported having primary care providers (PCPs) and 86.2% reported prior HIV testing. For each Likert item, an average of 63.5% of the participants reported they ‘Agree Completely’ with positive statements about ED-HIVST in general, for themselves, and for others. In adjusted analysis for general acceptability, those <25 (aOR = 1.67, 95%CI:1.36–2.08) and with prior HIV testing (aOR = 1.68, 95%CI:1.27–2.21) had greater odds of agreeing completely. For personal acceptability, those with a PCP (aOR = 3.31, 95%CI:2.72–4.03) and prior HIV testing (aOR = 1.83, 95%CI:1.41–2.38) had greater odds of agreeing completely. For distribution acceptability, participants with a PCP (aOR = 2.42, 95%CI:2.01–2.92) and prior HIV testing (aOR = 1.79, 95%CI: 1.38–2.33) had greater odds of agreeing completely. Conclusions ED-HIVST is perceived as highly acceptable, and young people with prior testing and PCPs had significantly greater favourability. These data provide a foundation for ED-HIVST programme development in Kenya.

Psychological concern among ortho trauma patients: A narrative review

Injury pertaining to musculoskeletal system might be unexpected to the victim both physically and mentally. Injured person might be unprepared to be bombarded with sudden hospital visit, painful procedures and dependence on others. Presence of psychiatric illness might just aggravate the anxiety symptoms and make the prognosis poor.

Disparities on the Basis of Nationality, Ethnicity, and gender in Road Accident Compensation in Israel

AbstractThis study documents disparities on the basis of nationality, ethnicity, and gender in court awards regarding the loss of future earnings in road accident cases in Israel. We analyze a random selection of 236 court decisions in road accident cases that reached final decisions on their merits between 1978 and 2018 in which the nationality, ethnicity, and gender of victims were identifiable (via first and last names). We show that, although in Israel the reliance on sex- and race-based statistical data to calculate damages in tort cases is a prohibited practice, courts tend to reach lower estimates of future lost earnings for Mizrahi Jews, Arabs, and women than those of otherwise similarly situated Ashkenazi Jewish men. In the analyses, we hold injured persons’ earnings at the time of the accident and occupations constant. The effects we observe are significant in magnitude. The results of our study are particularly noteworthy given the fact that we document disparities that correspond with the already existing labor force inequalities and discrimination in hiring, salary, and promotion on the basis of nationality, ethnicity, and gender in Israel.

One and ahalf years of e-scooters in Hamburg

Since the spread of the so-called electric scooters (e-scooters) through rental services in Hamburg as of June 2019, accidents due to the use of this means of transportation have been regularly registered. The most frequent injury patterns among e‑scooter riders involved accidents concerning the upper extremities and the head. There was arelevant accumulation of drunk drivers among the injured persons. The aim of the study is to compare injury patterns in drunk versus non-drunk e‑scooter riders who had an accident. Data from the Department of Trauma Surgery at the University Medical Center Hamburg-Eppendorf were retrospectively analyzed for accidents involving e‑scooters and the resulting injury patterns. For this purpose, the gender, age, injury pattern of the persons, the course of the accident, and information on previous alcohol consumption were recorded descriptively for the period from June 2019 to December 2021. Drivers were on average32 (interval: 15-88 years) years old and those under the influence of alcohol were predominantly male (69.9%). Accidents occurred mainly in summer and at night. Common injury patterns were injuries to the face, head, and extremities. It should be noted that injuries to the face and head occurred more frequently under the influence of alcohol than in the cohort without alcohol. Education about the health and legal consequences of riding an e‑scooter under the influence of alcohol should be provided to all users. In addition, wearing ahelmet or banning driving at night are possible measures to reduce accidents associated with drunk riding.

Cytokine profile in critically ill patients and/or injured persons with secondary sepsis – influence of different pathogens

Background/Aim. The role of the complex sepsis-related immune response has not been fully clarified and remains a subject matter of investigation. Nowadays, sepsis is considered a dynamic syndrome characterized by many, often antagonistic phenomena, ranging from hyperinflammation to anergy and immunoparalysis. The aim of the study was to determine, based on the level of pro- and anti-inflammatory mediators in critically ill patients with secondary sepsis, whether the cytokine profile differs according to the type of bacterial causative agent, as well as to assess the prognostic value regarding the outcome. The outcome measure was in-hospital mortality. Methods. Blood serum samples were taken from 125 critically ill patients admitted to the Surgical Intensive Care Unit with severe secondary sepsis as a consequence of peritonitis, pancreatitis, or trauma. The average age of the patients was 57.7 ? 17.3 years. Of the total number of patients, 84 (67.2%) were males, and 41 (32.8%) were females. The levels of pro-inflammatory interleukin (IL)-1?, IL-1?, IL-6, IL-8, IL-12?70, IL-17?, tumor necrosis factor (TNF)-?, interferon (IFN)-?, IFN-?-inducible protein-10 (IP-10), monocyte chemoattractant protein-1(MCP-1), macrophage inflammatory protein (MIP)-1? and MIP-1?, as well as anti-inflammatory mediators IL-4, IL-10, IL-13, IL-27, IL- 31, and IL-33, were determined at three time intervals ? on the day of admission (the first day) and then on the third and fifth day. The type of the bacterial causative agent was determined using standard microbiological analyses. Results. On the third day of measurement, significant differences in the cytokine levels regarding the nature of bacteremia were determined in all pro- and anti-inflammatory cytokines, except for IL-8. In general, the lowest levels were observed in patients with polymicrobial blood cultures. On the first and fifth days of measurement, no significant differences in the cytokine levels regarding the nature of bacteremia were found. The only significant predictor of the fatal outcome on the first measurement day was IL-17?, Area Under the Receiver Operating Characteristic (ROC) Curve (AUC) of 0.665 (95% confidence interval 0.519?0.791; ? = 0.034) in the patients with secondary sepsis as a complication of peritonitis. Conclusion. According to the type of bacterial causative agent, the lowest levels of cytokines have been observed in patients with the polymicrobial blood culture. The low level of IL-17? on the first day of measurement is a good predictor of a fatal outcome in patients with peritonitis as an underlying condition of secondary sepsis. On the other hand, the levels of other cytokines correlated with the out-come only on the fifth day of measurement, and they were higher in survivors than in non-survivors.

CRUSH SYNDROME IN EARTHQUAKES - STAY AND PLAY OR LOAD AND GO?

Earthquakes are unpredictable natural disasters accompanied by material damage and many victims. In the case of a person remaining trapped under the collapsed material, the development of crush syndrome can occur. Crush syndrome is the result of traumatic rhabdomyolysis and is present in 2%-15% of all injured persons in an earthquake. It is not easy to recognize, and proper treatment is challenging. Persons who have a clear crush injury and/or have been immobilized for more than four hours should be considered potential victims of crush syndrome. Therefore, knowledge about crush syndrome must be comprehensive and accessible to all parties involved. In this paper, the management of crush syndrome victims, which includes the principles of triage, and medical and logistic principles as well, is presented. Triage principles are presented at the level of triage priorities, places, and diagnoses. Medical principles, crucial for crush syndrome, are presented regarding the duration of compression and time before or after extraction of the patient. Logistic principles provide an overview of the priorities and modes of transport in relation to distance of health institutions, and the importance of management and education associated with crush syndrome. Each country with recognized disasters (natural or man-made) in which crush-related victims are expected, will benefit if the knowledge about triage, medical and logistic principles for crush syndrome is incorporated in their educational programs and regularly updated.

Forensic characteristics of injuries in cyclists in collisions with other vehicles

In order to identify the features of the injuries formation in cyclists who were injured in a collision of moving vehicles with a blow to the rear wheel area of a bicycle moving at a slower speed in the same direction, the authors analyzed the results of forensic medical examinations in relation to 151 corpses of cyclists who died in road accidents aged 4 to 74 years. It was found that with this type of bicycle injury, the structures of the head, chest, lower extremities, as well as the structures of the abdomen were most often injured. Injuries to the structure of the head were characterized by the formation of depressed-comminuted fractures: more often frontal-temporal, less often occipital bone. Bilateral fractures of the ribs were also quite frequent types of damage, mainly the upper ribs (up to 5-6 ribs) were damaged, most often along the midclavicular and anterior axillary lines. Lung contusions have been identified in most of the injured persons with chest structure injury. Injuries to the abdominal organs and retroperitoneal space were recorded in 22.27% of cases, with liver and spleen ruptures in the majority of cases. Spinal injuries in cyclists were detected in 13.25% of cases, injuries in the cervical spine prevailed: cervico-occipital injuries and fracture-dislocations, mainly between 1-2 and 3-4 or 6-7 cervical vertebrae with separation or contusion of the spinal cord. Injuries to the structure and organs of the pelvis in road accidents in cyclists were observed very rarely, which made it possible to distinguish this type of bicycle injuries from other types of transport and blunt injuries, in particular from automobile injuries. Injuries to the structure of the limbs of the victims were noted quite often: fractures of the upper limbs occurred when falling on the road surface and injury to the lower limbs was formed both during the contact of two vehicles and when the victims fell on the road surface.

KLASİK DÖNEM OSMANLI HUKUKUNDA HAYVAN SAHİBİNİN SORUMLULUĞU

Hayvan sahibinin sorumluluğu İslam hukukunda düzenlenmiş olan sorumluluk türlerinden biridir. Dolayısıyla İslam hukukunun uygulandığı, Osmanlı devletinin klasik devrinde de; padişahların koyduğu kanunnamelerde, şeyhülislamların fetva kitaplarında veya uygulamadan bizzat örnek olarak kadı sicillerinde hayvan sahibinin sorumluluğu ile ilgili hükümlere rastlanmaktadır. İslam hukuku, hayvan sahibinin hayvanının verdiği belirli zararlardan sorumlu, belirli zararlardan ise sorumsuz olduğunu belirtmektedir. Hayvan sahibinin sorumluluğu, İslam hukukunda mali bir sorumluluk olarak düzenlenmiş, zarar görene tazminat ödenmesi yeterli görülmüştür. Osmanlı hukukunda ise kanunnamelerde, hayvan sahibinin tazmin sorumluluğunun yanı sıra tazir cezası kapsamında olarak dayak ve para cezası ile cezalandırılması da öngörülmüştür. Bu çalışmada İslam hukukunda hayvanların verdikleri zarardan, sahibinin sorumlu olup olmadıkları haller incelenecektir. İslam hukuku hükümleri ile çatışmayan, Osmanlı hukukunun klasik devrindeki uygulamalar; fetvalar, kadı sicilleri ve kanunnameler temelinde incelenecektir. Mezhep görüşlerinin farklılaştığı durumlarda, sadece temel noktalar üzerinde durulacaktır. Osmanlı’da Hanefi mezhebi uygulaması esas olduğu için, diğer mezheplerin görüşlerinin belirtilmediği yerlerde Hanefi görüşü açıklanmıştır. Makalenin amaçlarından biri, fıkıh kurallarının Osmanlı klasik devri uygulamasındaki yansımasını hayvan sahibinin sorumluluğu konusu özelinde göstermektir.

Clinico–anatomical characteristic of the traffic trauma in the megapolis environment.Second report: anatomical verification of injuries

Objective.Verification of clinic–anatomical characteristics of trauma as a consequence of traffic accident in the megapolis environment.&#x0D; Materials and methods. Retrospective analysis of the data obtained was conducted in 1159 injured persons, who were traumatized as a consequence of a traffic accident in megapolis.&#x0D; Results.There was established, that as a result of traffic accident in the megapolis environment, the injured persons most frequently obtained trauma of the head – 68.31%, of thoracic cage – 57.07%, and of the extremities – 53.99%. The majority of the injured persons survived have had the trauma of the head (67.13%), of the thoracic cage (55.74%) and extremities (53.63%), while mostly rare – pelvic trauma (15.70%). Among the injured persons, who died, the head injuries was noted in 94.0%, thoracic trauma – in 86.0%, and abdominal injuries – in 76.0%.&#x0D; Conclusion.Trauma as a consequence of traffic accident in the megapolis environment constitutes a multicomponent injury (2.4 damages in every injured person). The result of the traumatic process course depends on the injury composition (in the injured persons survived, the combination coefficient was 2.3, while in the dead – 3.8) and on damage of a certain anatomic–functional local site.The head, thoracic and pelvic sites have constituted the most dangerous localizations.

Experience of the trauma operative treatment of the lower extremities main vessels in the work injuries

Objective. The structure of combined osseous–vascular work injury of the lower extremities was studied, and the results of its operative treatment analyzed retrospectively.&#x0D; Materials and methods. The data concerning 147 patients with combined osseous–vascular work trauma of the lower extremities were analyzed. All the patients managed were from 19 to 48 yrs old, and their average age constituted 30.2 yrs old. The mine trauma with injuries of femoral and/or the shin bones and a. poplitea prevailed – in 129 (87.8%) and 116 (78.9%) observations, accordingly. There were performed 92 two–staged interventions in a common operative team with traumatologists.&#x0D; Results. Positive result of operative treatment was noted in 73 (79.3%) patients. The time span between the trauma moment and the operation beginning in this group of the patients have constituted from 2 to 5 h, while the degree of an acute arterial ischemia in accordance to V. S. Savelyev (1973) were signed as IIa–IIb. The operation duration have constituted from 3 to 4 h. All the patients have had a combined shock Degree II. The preoperative blood loss volume has been ranged from 1 to 2.5 l. The a. poplitea injury have had prevailed and occurred in 43 (58.9%) patients. In 6 (6.5%) patients after reconstructive intervention the extremity amputation was performed.&#x0D; Conclusion. Mostly favorable result was obtained in the injured persons, who were delivered early (upto 2 h) to specialized stationaries with conduction of preoperative antishock therapy.

ON THE PHASING OF THE CLINICAL COURSE OF PERSISTENT SUBDURAL HYDROMAS AND ON THE SELECTIVE-BY-PHASE APPROACH TO THE CHOICE OF SURGICAL INTERVENTION

The work is based on the analysis of the surgical treatment of 181 injured persons with traumatic subdural hydromas. The clynic and pathogenic peculiarities, as well as neurological symptoms of the subdural hydromas, without complications of satellite forms of traumatic brain injury, have been specified. For the first time has been noticed the quite common feature of subdural hydromas – clynic stages of development of subdural hydromas; neurological symptoms have been described, which is characteristic of the transformation of original, not complicated stage of subdural hydromas to complicated, persistent clynic stage. The usage of comparison of intra-surgical findings and clynic-neurological features enabled to identify of the correlation and dependence of pathanatomic states of the brain, caused by the damaging impact of the mass accumulation of liquid in a subdural hollow in case of persistent clynic forms of subdural hydromas. It has been specified that the persistent clynic form more often takes place in case of inertial injuries and in case of valve formation of hydromas. It is demonstrated that in the case of persistent clynic forms, limbic puncture and forced dehydration therapy are not appropriate, as they can worsen dislocation processes and the state of the injured. Based on the sufficient clynic material, it has been proven that in the complicated, persistent clynic stage, the only effective remedy is the extended brain-plastic kranitomiya, with introsurgic correction of the collated brain by means of the introduction of 10-15 milliliters of distilled solution or 20-25 cub. of air to lateral ventricles through their lower horn and thus creating in the end of supplementary, reserve space, by means of exfoliation around the trepan hole of skin-apponeurotic patch from the periosteum, in the depth of 10-15 sm, for “withdrawal” of cerebrospinal fluid, which is permanently entering subdural hollow, in order to avoid the formation of conditions for mass effect, compression and dislocation of the brain. Alongside the innovative surgical methods of treatment of the injured persons, it is recommended, with the aim of improvement in reanimation measures for brain flood supply and perfusion of the brain, the means which are upgrading left ventricles mass blood flood. In cases of complicated, persistent forms of subdural hydromas, it is highly advisable to apply repeated big surgery than prolonged conservative treatment and forced dehydration therapy.

Firefighters’ knowledge of the knowledge of procedures for clearing the respiratory tract in an injured person with suspected infection with biological material (SARS-CoV-2) — a nationwide cross- -sectional study

Introduction: The aim of the study was to assess the knowledge of the procedure for clearing the respiratory tract and updated qualified first aid (QFA) 1a and 2a procedures by firefighters serving in State Fire Service (SFS) rescue and firefighting units, and their knowledge of the transmission of the SARS-CoV-2 virus. Material and methods: The cross-sectional study covered 19 408 firefighters (officers serving in SFS rescue and firefighting units from all over Poland). The study was conducted using the diagnostic survey method, the Computer Assisted Web Interview (CAWI) technique consisting of a set of particulars regarding a specific officer and the appropriate medical part of the survey. Results: In the group of 19,408 respondents, 99.31% were men (n = 19,275), while women accounted for 0.69% (n = 133; p &lt; 0.001). The age of the respondents was in the range of 18–66 years, and the average age was 35.88 ± 7.14 years. The length of service was 11.95 ± 6.44 years. The knowledge of procedures 1a and 2a declared by the respondents [OR = 1.51 (95% CI: 1.22–1.86), x2 = 14.76], the ability to operate a suction unit [OR = 1.73 (95% CI: 1.44–2.08, x2 = 34.58)], the frequency of airway clearance training (p &lt; &lt; 0.001, x2 = 61.74). Only 15% of respondents used a suction unit on an injured person during operations. Conclusions: The knowledge of firefighters in the subject matter covered by the analysis is diverse, some firefighters have additional experience and practice from working in health care units. Professional development in the field of QFA supplemented with procedures 1a and 2a may translate into a lower risk of infection associated with airway clearing in the era of the pandemic. There is a visible need for constant training of SFS officers in terms of medical activities to maintain the knowledge of firefighters at a high initial level.

Multiple Trauma Can Have Many Different Symptoms

Multiple trauma can often be recognized by the emergency department based on the location and condition of the patient. The diagnostic focus is on checking vital signs. Blood pressure, EKG and breathing are key factors in determining whether an injured person can be taken to a hospital for treatment. Certain injuries can only be accurately determined in the clinic. An ultrasound examination gives the first findings about injuries to internal organs, including the chest. In addition, computerized tomography of the whole body is performed today. A classic X-ray can also contribute to the diagnosis, but often cannot be done depending on the condition of the patient with multiple trauma. Multiple trauma always means a serious injury, consisting of at least two injuries to the patient. Danger to life can only come from one or more injuries at the same time, depending on their severity.

A clinical case of gunshot shrapnel penetrating wound of the chest with injury to the inferior vena cava with migration of a foreign body along the blood stream

Damage to the major vessels in a retroperitoneal trauma belongs to the category of the most difficult, including damage to the inferior vena cava. The aim of the work is to demonstrate the features of clinical manifestations and tactical solutions of a gunshot fragment blind wound of the inferior vena cava with the migration of a foreign body along the blood stream. Materials and methods. A case of a gunshot fragment wound of the inferior vena cava with migration of the foreign body along the blood stream was studied. An injured person underwent sCT with and without contrast, FAST protocol, general blood test, biochemical blood test, CBV was determined using the formula of Moore, hourly diuresis was measured. Results. The patient was operated on for vital signs, the condition of the injured person was stabilized. During the revision of the abdominal cavity and paranephric tissue, no foreign body was identified. In the immediate postoperative period, the injured person underwent chest and abdominal CT, according to the data of that, a metal fragment was identified, which migrated along the inferior vena cava to the point of connection with the right atrium. The injured man was operated on at another specialized facility, where the foreign body was removed using a surgical magnetic tool. Conclusions. Fire damage to the inferior vena cava is classically accompanied by a severe general condition, massive blood loss, which requires urgent surgical interventions. Multi-component preoperative preparation, a clearly established diagnostic plan, a multidisciplinary approach based on the example of our clinical case allow saving life even in the most complex cases.

КРИТЕРІЙ СПРАВЕДЛИВОСТІ У ПРАКТИЦІ ЄВРОПЕЙСЬКОГО СУДУ З ПРАВ ЛЮДИНИ ЩОДО ВІДШКОДУВАННЯ МОРАЛЬНОЇ ШКОДИ

The article examines the criterion of justice and its content used by the European Court of Human Rights when considering applications of individuals and legal entities, including economic entities, for compensation moral damage, which is characterized by the fact that it is impossible to accurately calculate its size, by analyzing the content of the relevant articles of the European Convention on Human Rights, scientific research and Court’s precedent. The criterion of justice in its application by the Court when deciding claims for just satisfaction cannot be hypothetical, but must acquire signs of argumentativeness and practicality, taking into account the procedures in accordance with the Convention. In this research, we identified and analyzed elements of the just-criterion or the criterion of justice factors, which the Court in their unity considers. At the same time, categorization of criterion of justice factors has been carried out according to the level of connection with the applicant. This identification of the criterion of justice elements of in the context of compensation for moral damage will be able to give it the features of a structured practical tool for justice. In addition, the content of related concepts used in international law to denote various aspects and methods of compensation for damage to an injured person is revealed, including the meaning and content of the concept of “just satisfaction” under Art. 41 of the European Convention on Human Rights.

Mechanical Injury among Medicolegal Cases in the Department of Emergency in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

A medico-legal issue arises whenever an injured person visits a hospital. Therefore, all physicians who treat such patients have a legal duty to accurately document injuries as part of medical treatment. The study aimed to find out the prevalence of mechanical injury among medicolegal cases in the Department of Emergency in a tertiary care centre. A descriptive cross-sectional study was conducted among patients admitted to the Emergency Department of a tertiary centre from May 2018 to April 2020 after obtaining ethical approval from the Institutional Review Committee (Reference number: 356). Convenience sampling method was used among patients who met the eligibility criteria. All relevant data were extracted using hospital records. Point estimate and 95% Confidence Interval were calculated. Out of 3486 medicolegal cases registered in the Department of Emergency, 856 (24.55%) (28.37-29.96 at 95% Confidence interval) were cases of mechanical injuries. Males 616 (71.96%) outnumbered females for all types of mechanical injuries. Road Traffic Accident 527 (61.56%) was the leading cause of injury and lacerations 351 (29.52%) were the most common pattern of injury. The majority 628 (73.36%) of the injuries were simple in nature. The prevalence of mechanical injuries among medicolegal cases was similar in our study compared to other studies done in similar settings. The majority of the injuries were caused by traffic accidents, which could have been prevented if a safe system approach to road safety was followed. accidents; documentation; forensic medicine; injuries; Nepal.