Accidental Trauma Research Articles

Agreement for posttraumatic stress symptoms among unaccompanied young refugees and professional caregivers

ABSTRACT Background: Prevalence rates for posttraumatic stress symptoms (PTSS) in unaccompanied young refugees (UYRs) are high. Research with biological parents indicates low agreement rates between self and caregiver reports for PTSS, although caregivers play an important role as gatekeepers to ensure appropriate treatment. Objective: This study examines youth and caregiver agreement on the endorsement of different trauma types, the PTSS severity score and symptom clusters, as well as the potential association between youth factors (age, comorbidity, and duration in facility) and disagreement. Method: The sample consisted of N = 610 UYRs, aged M = 16.75 (SD = 1.33, range: 12–20) years. Of these, 91.0% were male, and 43.4% were from Afghanistan, currently residing in German children and youth welfare facilities. Results: Agreement rates across trauma types were poor (accidental trauma: Cohen’s k = .13; community violence: Cohen’s k = .07; domestic violence: Cohen’s k = .19; sexual abuse: Cohen’s k = .38). Agreement rates for the PTSS severity score (ICC = .22) and symptom clusters were poor (re-experiencing: ICC = .27; avoidance: ICC = .02; negative alterations in cognitions and mood ICC = .12; hyperarousal: ICC = .25), with youth reporting significantly higher scores. Regression models showed that having comorbid symptoms and a shorter duration in the facility were associated with higher disagreement at the PTSS severity score (Adjusted ­R 2 = .21) and across symptom clusters (re-experiencing: Adjusted ­R 2 = .13; avoidance: Adjusted ­R 2 = .07; negative alterations in cognitions and mood: Adjusted ­R 2 = .16; hyperarousal: Adjusted­ R 2 = .16). Age was not significantly associated with disagreement rates. Conclusion: It is important to enhance the awareness and comprehension of caregivers regarding recognition of mental illnesses and their symptoms as well as assessing mental health among UYRs.

Inhibition of KIF5b-mediated Nav1.8 transport by ropivacaine contributes to axonal regeneration following sciatic nerve injury in rats

Peripheral nerve injury (PNI), typically caused by traumatic accidents or medical events, is currently one of the most common diseases that leads to limb disability. After PNI, tetrodotoxin-resistant voltage-gated sodium channel Nav1.8 is upregulated at the lesion site. Our earlier study suggested that ropivacaine promotes axon regrowth by regulating Nav1.8-mediated macrophage signaling. Nevertheless, the mechanism of ropivacaine in regulation of Nav1.8 expression remains incompletely understood. Kinesin family 5b (KIF5b) was reported to mediate the Nav1.8 axonal transport from dorsal root ganglia (DRGs) to lesion site. Herein, we investigated whether ropivacaine promotes axon regeneration through inhibition of KIF5b-mediated Nav1.8 transport. Reduced levels of KIF5b and Nav1.8 in DRGs coincide with their increase at the lesion site. Nav1.8 mRNA was significantly increased at the lesion site but not in DRGs. Surprisingly, ropivacaine reversed the alterations of Nav1.8 and KIF5b protein expression without affecting Nav1.8 mRNA level. Due to KIF5b overexpression in DRGs, Nav1.8 protein level was significantly decreased in DRGs and increased at the lesion site. We also found KIF5b overexpression significantly impaired behavioral functions, reduced the recovery index of compound muscle action potential (CMAP) amplitude, inhibited axonal regrowth, slowed M1 macrophage infiltration and shift to M2 phenotype, and delayed myelin debris clearance. Notably, all aforementioned results caused by KIF5b overexpression were alleviated by ropivacaine. Furthermore, we demonstrated that inhibition of Nav1.8 transport by A-803467 produced mitigating effects on the impairment of regenerative capacity induced by KIF5b overexpression similar to ropivacaine. These results suggest that ropivacaine promotes axonal regeneration at least partially by inhibiting KIF5b-mediated Nav1.8 forward transport.

Healing of periapical lesion by non-surgical endodontic therapy: A case report

Periapical lesions often arise as a consequence of pulpal diseases, and most inflammatory periapical lesions are initially managed with conservative non-surgical methods. The success of root canal treatment hinges on the thorough cleaning, shaping, and obturation of the root canal system. Calcium hydroxide and triple antibiotic paste (TAP) are preferred intracanal medicaments due to their effective antibacterial properties. This case report details the non-surgical management of a periapical lesion associated with the mandibular central incisors in a 18-year-old female who presented with periodic swelling and pus drainage in the labial sulcus, due to traumatic accident in the that area. The case underscores the effectiveness of using calcium hydroxide and TAP as interappointment endodontic dressings, leading to favorable clinical and radiographic outcomes for managing a periapical radiolucency.

Management Of Large Periapical Lesion With A Noninvasive Approach: A Case Report

Periapical lesions develop as a sequela to pulpal diseases. The majority of inflammatory periapical lesions are initially treated with conservative non-surgical procedures. The success of root canal treatment is based on thorough cleaning, shaping and obturation of the root canal system. Calcium hydroxide and triple antibiotic paste (TAP) are recommended as intracanal medicaments due to its antibacterial properties. This case report describes the non-surgical management of a large cyst-like periapical lesion in relation to the maxillary lateral incisor of a 19-year-old male with the chief complaint of periodic swelling and pus drainage from the palatine region with a history of a traumatic accident in the same area. The present case highlights the use of calcium hydroxide and TAP as an interappointment endodontic dressing for non-surgical management of large periapical radiolucency, which resulted in favourable clinical and radiographic outcomes

Neurogenic Arthropathies of the Lower Limbs: About A Case Followed in Rehabilitation at the Chu-Bogodogo

Abstract we report a case of pelvic limb neurogenic arthropathies (NA) in a young 25-year-old patient following severe cranioencephalic trauma in a road traffic accident. The aim of this clinical case was to report the contribution of physical medicine and rehabilitation in the management of neurogenic arthropathies. The patient was admitted to the Physical Medicine and Rehabilitation Department only six months after his trauma. Nervous system disorders were represented by a frontal syndrome and significant spasticity in the pelvic limbs. Deficiencies founds was pain, multiple joint stiffness of the pelvic limbs, induration of the thighs related to arthropathies objectified to the standard x-ray of the thighs. The rehabilitation approach consisted of postures associated with targeted cryotherapy of the muscles. The gait rehabilitation was done gradually between the parallel bars and then with a deanbulator Rehabilitation led to functional improvement, with the patient returning to independent walking using simple techniques. The presentation of this case study provided an overview of this pathology, its functional consequences and the role of Physical and Rehabilitation Medicine in the management of NA. The techniques we used have made it possible to limit the diffusion processes of neurogenic arthropathies by limiting inflammation through associated cryotherapy sessions. The presence of nervous system disorder such as frontal syndrome could have limited rehabilitation, but thanks to collaboration with psychiatrists the evolution was favorable and allowed the patient to actively participate in his rehabilitationThe case also underlined the importance of multidisciplinary patient management, which should be a goal for all practitioners. Keywords: arthropathies ; cryotherapy ; neurogenic ; rehabilitation ; traumatic brain injury

Comparison of Titanium versus Resorbable Intramedullary Nailing in Pediatric Forearm Fractures.

Pediatric forearm fractures, particularly involving the shaft or diaphysis, are common injuries typically resulting from accidental trauma during various activities. Traditional treatment involves closed reduction and casting; however, surgical intervention may be necessary in certain cases. The gold standard surgical approach utilizes elastic stable intramedullary nailing (ESIN), but a newer technique uses bioabsorbable intramedullary nails made of poly(lactic-co-glycolic acid) (PLGA). This study aims to compare the outcomes of these two surgical methods in pediatric diaphyseal forearm fractures. We retrospectively reviewed 86 patients who underwent operative treatment due to the diaphyseal fractures of the forearm in the Surgical Division, Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary between 2018 and September 2022. The mean age was 9.48 (ranging from 4 to 17). A total of 41 patients underwent surgery with PLGA implants (RESIN technique), while 45 patients were treated with titanium elastic nails (ESIN technique). Various factors including patient demographics, injury mechanisms, fracture characteristics, and complications were assessed. Both groups showed similar gender distribution, with a majority of fractures occurring in boys (the male-female ratio was 31:10 in the PLGA group, while in the titanium elastic nailing (TEN) group, this ratio was 29:16, with no statistical difference between the groups (p > 0.005). The average age of the patients treated with PLGA implants (8.439 years) was lower compared to those treated with titanium nails (10.422 years). A statistically significant difference was found regarding the average age of the two groups (p = 0.0085). Left-sided injuries were more prevalent in both groups (59% of the cases in the PLGA group and 69% in the TEN group, with no statistically significant difference, p = 0.716), and fractures typically involved both the radius and ulna. This represents 93% of the cases in the PLGA group and 80% in the TEN group. Regarding the involvement of bones, we also did not find a statistically significant difference (p = 0.123). The mechanisms of injury predominantly involved indirect force, such as falls (30 cases in the PLGA group and 27 cases in the TEN group), and no statistically significant difference was found (p = 0.139) regarding the mechanism of the injury. Complication rates were lower in the PLGA group (7%) compared to the titanium group (20%). The treatment of pediatric diaphyseal forearm fractures using PLGA implants appears to be a viable alternative to traditional titanium implants. Advantages include no need for secondary surgery and associated cost savings and reduced complication rate and stress associated with anesthesia and surgery. Prospective randomized trials are warranted to further validate these findings and explore long-term outcomes.

Fabrication and Biomedical Application of Alginate Composite Hydrogels in Bone Tissue Engineering: A Review.

Nowadays, as a result of the frequent occurrence of accidental injuries and traumas such as bone damage, the number of people causing bone injuries or fractures is increasing around the world. The design and fabrication of ideal bone tissue engineering (BTE) materials have become a research hotspot in the scientific community, and thus provide a novel path for the treatment of bone diseases. Among the materials used to construct scaffolds in BTE, including metals, bioceramics, bioglasses, biomacromolecules, synthetic organic polymers, etc., natural biopolymers have more advantages against them because they can interact with cells well, causing natural polymers to be widely studied and applied in the field of BTE. In particular, alginate has the advantages of excellent biocompatibility, good biodegradability, non-immunogenicity, non-toxicity, wide sources, low price, and easy gelation, enabling itself to be widely used as a biomaterial. However, pure alginate hydrogel as a BTE scaffold material still has many shortcomings, such as insufficient mechanical properties, easy disintegration of materials in physiological environments, and lack of cell-specific recognition sites, which severely limits its clinical application in BTE. In order to overcome the defects of single alginate hydrogels, researchers prepared alginate composite hydrogels by adding one or more materials to the alginate matrix in a certain proportion to improve their bioapplicability. For this reason, this review will introduce in detail the methods for constructing alginate composite hydrogels, including alginate/polymer composite hydrogels, alginate/bioprotein or polypeptide composite hydrogels, alginate/bioceramic composite hydrogels, alginate/bioceramic composite hydrogels, and alginate/nanoclay composite hydrogels, as well as their biological application trends in BTE scaffold materials, and look forward to their future research direction. These alginate composite hydrogel scaffolds exhibit both unexceptionable mechanical and biochemical properties, which exhibit their high application value in bone tissue repair and regeneration, thus providing a theoretical basis for the development and sustainable application of alginate-based functional biomedical materials.

Tannic acid coating gauze immobilized with thrombin with ultra-high coagulation activity and antimicrobial property for uncontrollable hemorrhage

Rapid and safe hemostasis is crucial for the survival of bleeding patients in prehospital care. It is urgent to develop high performance hemostatic material to control the massive hemorrhage in the military field and accidental trauma. In this work, an efficient protein hemostat of thrombin was immobilized onto commercial gauze, which was mediated by self-polymerization and anchoring of tannic acid (TA). Through TA treatment, the efficient immobilization of thrombin was achieved, preserving both the biological activity of thrombin and the physical properties of the dressing, including absorbency, breathability, and mechanical performance. Moreover, in the presence of TA coating and thrombin, Gau@TA/Thr could obviously shortened clotting time and enriched blood components such as plasma proteins, platelets, and red blood cells, thereby exhibiting an enhanced in vitro coagulation effect. In SD rat liver volume defect and artery transection hemorrhage models, Gau@TA/Thr still had outstanding hemostatic performance. Besides, the Gau@TA/Thr gauze had inherent antibacterial property and demonstrated excellent biocompatibility. All results suggested that Gau@TA/Thr would be a potential candidate for treating uncontrollable hemorrhage in prehospital care.

Imaging of the Pediatric Cranial Sutures in Abusive Head Trauma

Pediatric skull fractures are frequently encountered in accidental and abusive head trauma and often involve cranial sutures. However, skull fracture association with cranial sutural widening, crossing, or contacting ≥2 cranial sutures can be seen more commonly with abusive head trauma. Knowledge of cranial sutures and associated variants is helpful for an accurate diagnosis. 3D head CT is a significant aid in the identification of skull fractures contacting and crossing cranial sutures. Growing literature supports the elimination of concurrent skull radiographs (often performed as required components of follow-up skeletal surveys). Ultrashort TE/zero TE MRI is an emerging new imaging technique to consider for assessing skull fractures to aid in evaluating pediatric abusive head trauma.Learning Objective: To review skull fracture findings in abusive head trauma with attention paid to the cranial sutures (widening, crossing, or contacting ≥2 sutures). <list list-type="order"> <list-item>To recognize normal cranial sutural variants.</list-item> <list-item>To understand the role of CT versus radiographs in assessing skull fractures.</list-item> <list-item>To discuss ultrashort TE/zero TE MRI as an emerging technique for imaging skull fractures in abusive head trauma.</list-item> </list>

Traumatism of Grey Wolf (<i>Canis Lupus</i>, Canidae, Carnivora) Skulls in the Center of the European Part of Russia

A total of 297 wolf skulls from the collection of the Central Forest State Biosphere Reserve were studied for the presence of injuries. Of these, 129 (43.4 ± 2.9%) skulls had traumas of various origins or a deformed sagittal crest. Aside from the sagittal crest, the rate of traumas was 32.3 ± 2.7%. Based on the causes of origin, the traumas were divided into three groups: those received when hunting moose, as a result of aggressive intraspecific contacts, and accidental. Complicated fractures of dental crowns predominate among accidental traumas. Moose hunting traumas and intraspecific aggression are more common in subadult wolves than in adults, this being explicable by the elimination of injured animals. The incidence of accidental traumas, on the other hand, was increased with age. The level of traumas serves as a population characteristic indicating tension in the predator-prey system and the degree of intraspecific aggression.

Profiles of Trauma Exposure Type and Its Associations With Pain-Related Outcomes Among Adults With Chronic Pain: A 2-Year Longitudinal Study

Individuals with chronic pain report disproportionally higher rates of trauma, yet it is unclear whether different types of trauma (eg, sexual, accidental trauma) are associated with worse pain outcomes. The present study sought to 1) identify subgroups of people with chronic pain based on trauma type, and 2) determine whether subgroups differ in terms of pain characteristics over a 2-year period. Individuals with chronic pain (N = 1,451) participated in an online study and completed self-report questionnaires at baseline, 3-, 12-, and 24-month follow-up. Trauma was assessed via the Life Events Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Pain intensity and interference were measured via the Brief Pain Inventory, and pain distribution was evaluated using the Widespread Pain Index. Latent class analyses produced a 3-class solution consisting of individuals with high and diverse trauma (16.3%), high sexual trauma (18.4%), and low/accidental trauma (57.1%) with the rest of the sample endorsing no trauma history (8.2%). After controlling for key demographic variables and baseline outcome levels, individuals in the high- and diverse trauma group endorsed higher levels of pain severity and interference at the 3- and 12-month follow-ups compared with the group with no trauma (P < .01). Additionally, relative to the no trauma group, individuals in the high sexual trauma group reported higher levels of pain interference and more widespread pain at the 3-month follow-up (P < .05). The findings underscore the importance of screening for trauma and suggest that the type and variety of trauma experienced may be relevant to pain-related outcomes. PerspectiveThis article highlights how an individual’s unique trauma history may be related to their current pain experience. Knowledge of the type and frequency of past trauma may have relevant clinical implications for the treatment of chronic pain.

Acute Computer Tomography Findings in Pediatric Accidental Head Trauma-Review.

Head trauma in paediatric patients is a worldwide and constant issue. It is the number one cause for childhood mortality and morbidity. Children of all ages are susceptible to sustaining head trauma and the anatomical characteristics of the region put them in a high-risk category for developing severe traumatic brain injuries. Boys are more frequently victims of accidental head traumas, and their injuries are more severe than those encountered in girls. The mechanisms of the trauma are a determining factor for the types of lesions we find. The traumatic injuries fall into two categories, primary and secondary. Primary traumatic injuries can be severe and life threatening, and their presence needs to be documented in order to set the correct therapeutic conduct. Due to their importance, this pictorial review focuses on them and the images used herein are selected from the database of our hospital. It is important to distinguish each of the different injuries that can be encountered. At the same time, radiologists are advised to remember that for children up to five years of age, some non-accidental imaging findings may appear to coincide with those found in accidental head trauma.

Presence of Additional Pathology in Low-Grade Acromioclavicular Joint Injuries.

To determine if additional pathology is present in low-grade acromioclavicular (AC) joint injuries. Prospective case series. Patients were assessed by primary care sports medicine physicians at a single institution between 2019 and 2023. Patients aged 18 to 65 years diagnosed with a type I to III AC injury based on clinical and radiographic evaluation. Consenting patients underwent magnetic resonance imaging (MRI) evaluation within 21 days of injury. All injuries were treated nonoperatively. Additional pathologies identified on MRI were reported in a standardized fashion by fellowship-trained musculoskeletal radiologists. Twenty-nine patients (26 men/3 women) were consented with a mean (±SD) age of 28.6 ± 9.5 years. The mean time from injury to MRI was 8.1 ± 5.9 days. Twenty-three injuries were sport related, and 6 were accidental traumas. Based on MRI, injury type was reclassified in 16 of 29 patients, and 13 remained unchanged. Additional pathologies identified included 14 muscle injuries, 5 rotator cuff tears, 5 labral tears, 1 nondisplaced fracture, and 1 intra-articular body. MRI evidence suggests that most AC joint injuries are more severe than clinically diagnosed. Identifying additional pathology may alter diagnostic and treatment guidelines for type I to III AC joint injuries.

A retrospective study of the characteristics and toxicology of cases of lysergic acid diethylamide (LSD)- and psilocybin-related death in Australia.

Lysergic acid diethylamide (LSD) and psilocybin are used as recreational drugs, and there is renewed interest in their clinical use. The current study aimed to (1) determine the circumstances of death and case characteristics of LSD- and psilocybin-related death in Australia, 2000-23; and (2) determine the toxicological profile and major autopsy findings of these cases. This was a retrospective exploratory study of all cases of LSD- and psilocybin-related death in Australia, 2000-23, retrieved from the National Coronial Information System. A total of 43 cases were identified: 33 LSD and 10 psilocybin. The median ages were 24 years [interquartile range (IQR) = 13, range = 16-53] (LSD) and 26 years (IQR = 18.5, range = 20-58) (psilocybin), and fewer than five cases were female. The most common circumstance of death among both groups was traumatic accident (LSD 36.4%, psilocybin 40.0%). There were 12 cases of self-harm, all of which involved LSD, all by physical means. In a fifth, death was attributed to multiple drug toxicity (LSD 18.2%, psilocybin 20.0%). In one case, death was attributed solely to LSD toxicity, while in a further two cases death was attributed to a cardiovascular event following LSD consumption (one LSD only, one multiple drug toxicity). In four psilocybin cases, the cause of death was undetermined. The most common clinical presentation was severe agitation (LSD 27.3%, psilocybin 20.0%). Median blood concentrations were LSD 0.8μg/l (IQR = 1.7, range = 0.1-3), psilocin 20 μg/l (IQR = 53.5, range = 6-83). LSD was the only drug present in 25.0% of LSD cases and psilocybin in 20.0% of psilocybin cases. Pre-existing organ pathology was uncommon. Lysergic acid diethylamide (LSD)- and psilocybin-related death in Australia from 2000 to 2023 was primarily due to traumatic injury, whether through accident or self-harm. Cases of acute toxic reactions that were attributed solely to LSD were rare.

Eyes of empowerment: A case study on the impact of custom ocular prosthesis in restoring quality of life

Ocular prostheses serve as invaluable tools in restoring both visual symmetry and psychological well-being for individuals who have experienced ocular defects. This article presents a comprehensive overview of the fabrication and placement of custom acrylic ocular prosthesis in a 39-year-old male patient who suffered left eye loss following a traumatic accident. The patient's history underscores the profound impact of ocular trauma on self-image and quality of life, highlighting the importance of prosthetic rehabilitation. Meticulous attention was paid to every step of the fabrication process, including impression taking, color matching, and fitting, to ensure optimal aesthetic outcome and functionality. The successful placement of the prosthesis resulted in significant improvements in the patient's confidence and overall well-being. This case report emphasizes the approach required for successful ocular prosthetic rehabilitation and underscores the transformative impact of custom ocular prostheses in restoring quality of life for individuals with ocular defects.

Obesity as a Risk Factor for Adverse Outcomes After Pedestrian Trauma Accidents in the Pediatric Population.

The aim of the study is to determine whether overweight or obese children are at an increased risk for injury and adverse outcomes following pedestrian motor vehicle accidents. We performed a retrospective study of patients between the ages of 2 and 17 who were pedestrians injured in a collision with a motorized vehicle, presenting to a level 1 trauma center, between January 1, 2010, to December 31, 2021. Patients with admission weights falling above the 90th percentile of the Centers for Disease Control and Prevention's sex-specific growth charts were identified as overweight/obese, those below the cutoff were categorized as nonobese. Groups were compared regarding demographics, mechanism of injury, Injury Severity Score, and Abbreviated Injury Scale by body region of injury. Outcome measures included hospital admission, length of hospital stay, intensive care unit (ICU) admission, ICU length of stay, and mortality. Of the 306 patients included, 72 (23.5%) were overweight/obese and 234 (76.5%) were nonobese. The mean Injury Severity Score scores were higher among overweight/obese patients (5.37 vs 8.74, P = 0.008). Overweight/obese children were more likely to sustain severe abdominal injuries (Abbreviated Injury Scale ≥ 3) (12.2% vs 5.1%; odds ratio [OR], 2.64; 95% CI, 1.07-6.56; P = 0.030), be admitted to the hospital (94.5% vs 74.3%; OR, 12.07; 95% CI, 2.87-50.72; P < 0.001), require ICU admission (31.0% vs 20.0%, OR, 1.87; 95% CI, 1.03-3.36; P = 0.036), and require a longer ICU stay (0.9 vs 0.4 days, P = 0.014) compared with nonobese patients. Obese and overweight children are at increased risk for higher injury severity scores, severe abdominal injuries, and ICU admission after pedestrian motor vehicle accidents.

Emergency Department Triage Chief Complaints Among Children Evaluated for Physical Abuse Concerns.

The aims of this study were to describe chief complaints provided at emergency department triage for young children ultimately given a diagnosed with injuries concerning for physical abuse and compare chief complaints by hospital child protection team assessment (abuse most likely, accident most likely, undetermined) among children younger than 2 years who were the subject of a report to child protective services. This is a retrospective review of children evaluated by the child protection team at an urban children's hospital over a 5-year period. Children younger than 2 years who were the subject of a report to child protective services for suspected physical abuse were included. Chief complaints noted in emergency department triage notes were categorized as follows: 1, medical sign or symptom; 2, accidental trauma incident; 3, identified injury; 4, concern for abuse; or 5, multiple unrelated complaints. Child protection team assessments were categorized as follows: 1, abuse most likely; 2, accident most likely; or 3, undetermined. We used descriptive statistics and tests of association (χ 2 , Fisher exact, Kruskal-Wallis). Median age of the 422 children included was 4.9 months. Child protection team assessment was abuse most likely in 44%, accident most likely in 23%, and undetermined in 34%. Chief complaints in the overall sample were 39% medical, 29% trauma incident, 16% injury, 10% abuse concern, and 6% multiple unrelated. When the abuse most likely and accident most likely groups were compared, medical chief complaints were more common in the former (47% vs 19%, P < 0.001), whereas trauma incident chief complaints were more common in the latter (19% vs 64%, P < 0.001). Most common medical complaints in the abuse most likely group were altered mental status, abnormal limb use, swelling, pain, apnea, and vomiting. Many children found to have injuries concerning for abuse (47%) present without mention of trauma, injury, or abuse concern as part of the chief complaint. Our findings suggest important topics to include in training physicians about recognition of abuse.

KNOWLEDGE OF FIRST AID IN ACCIDENTS MEMBER OF KSR PMI BLITAR CITY

Proper first aid from the PMI Volunteer Corps through the 112 call center can help reduce the risk of death from traffic accidents. This study aims to determine the knowledge of members of KSR PMI Blitar City about first aid in accidents. The method used is descriptive quantitative with a sample of 33 respondents from KSR PMI Blitar City selected by purposive sampling. This research used a questionnaire as a research instrument and was conducted in March 2023 at the PMI Blitar City headquarters. The results showed that 42% of respondents had good knowledge. In accordance with the analysis of the answers on the definition indicator, the figure is 64% less, while the indicators for stages show the figure is 66% lacking, which is below the average of all indicators. Based on the results of the analysis, members of KSR PMI Blitar City can conduct programmed training at first aid stages to increase knowledge about accident trauma cases.Keyword: accident, knowledge, first aid

KNOWLEDGE OF FIRST AID IN ACCIDENTS MEMBER OF KSR PMI BLITAR CITY

Proper first aid from the PMI Volunteer Corps through the 112 call center can help reduce the risk of death from traffic accidents. This study aims to determine the knowledge of members of KSR PMI Blitar City about first aid in accidents. The method used is descriptive quantitative with a sample of 33 respondents from KSR PMI Blitar City selected by purposive sampling. This research used a questionnaire as a research instrument and was conducted in March 2023 at the PMI Blitar City headquarters. The results showed that 42% of respondents had good knowledge. In accordance with the analysis of the answers on the definition indicator, the figure is 64% less, while the indicators for stages show the figure is 66% lacking, which is below the average of all indicators. Based on the results of the analysis, members of KSR PMI Blitar City can conduct programmed training at first aid stages to increase knowledge about accident trauma cases.Keyword: accident, knowledge, first aid

The state of paediatric deceased-organ donation at a South African tertiary public- sector hospital: A 14-year analysis.

Solid-organ transplantation (SOT) has been proven to be a highly effective and life-saving treatment modality for adults and children suffering from end-stage organ failure. However, high paediatric waiting-list mortality has been reported, and children may suffer irreversible physical and deleterious psychological effects if not transplanted timeously. To identify in-hospital barriers to organ donation and gain a better understanding of the paediatric donor landscape. A retrospective descriptive study of consecutive deceased-donor referrals at Red Cross War Memorial Children's Hospital over a 14-year period, from 1 January 2007 to 31 December 2020. During the study period, 156 in-hospital deaths were recorded in the trauma unit and 1 425 in the paediatric intensive care unit. Ninety-three of the 1 581 patients (5.9%) were referred to the on-call transplant co-ordinator as potential organ donors, of whom 69% had been involved in a traumatic accident, including 52% in road traffic collisions. The mean age of the potential donors was 7 years with 60.2% being boys. On initial assessment, 67 of the 93 potential donors (72%) were assessed as eligible for donation of at least one solid organ. The transplant co-ordinator attempted to approach all families for consent; however, five families/next of kin could not be located despite multiple attempts. Among the remaining 62 eligible donors, 44 families/next-of-kin declined consent for solid-organ donation, resulting in a consent rate of 29% (n=18). Several families refused consent for religious reasons. One of the consented donors did not proceed to procurement as there were no suitable recipients. Seventeen donors proceeded to theatre, the intention being solid-organ procurement, but in 2 donors the organs were assessed as being unsuitable for transplant. From the remaining 15 donors, a total of 46 organs were procured and successfully transplanted: 14 livers, 30 kidneys and 2 hearts. During the 14-year study period, only 15 deceased donors could be utilised for SOT, as a result of low in-hospital referral (5.9%) and consent rates (29%). The reasons for low referral and consent rates are complex and often multifactorial, which the current study was not designed to investigate in sufficient detail. Future studies should be designed to further interrogate our findings, while accommodating for nuances specific to the paediatric deceased-donor population and their families.