Factors affecting injury severity of rear-seat occupants

Objective@#Previous studies focused primarily on drivers or front-seat passengers in motor vehicle accidents. Recent research has shown improvements in front-seat occupant protection. This study examined the risk factors contributing to severe injury in rear-seat occupants. @*Methods@#This study was conducted retrospectively. The variables related to the crash data were acquired from the Emergency Department-based Injury In-depth Surveillance registry and electronic medical record of the authors’hospital between 2019 and 2020. Multivariate logistic regression analysis was used to identify the risk factors contributing to severe injury in rear-seat occupant. @*Results@#One hundred and forty rear-seat occupants were analyzed. The occupants were categorized by the abbreviated injury scale into severe (n=39; 27.9%) and non-severe injury (n=101; 72.1%). The collision with a large-size vehicle (odds ratio [OR], 4.278; 95% confidence interval [CI], 1.617-18.000; P=0.015) and fixed objects (OR, 3.459; 95% CI, 1.347-8.883; P=0.049) was independently associated severe injury. Seatbelt use was also an independent risk factor of severe injury (OR, 2.649; 95% CI, 1.178-5.940; P=0.018). Common severe injuries encountered in rear seats were chest (12.1%), spine (9.3%), and abdomen (5.7%). @*Conclusion@#In contrast to the fact that seat belt use reduces the severity of injuries, seatbelt use was associated with severe injury in this study. Further research will be needed to assess the effects of seatbelt use. In addition, awareness should be raised about the relationship between the accident mechanism, seatbelt use, and the commonly injured body region.

Is it reasonable emergency department doctor must activate the whole trauma team if they meet the patients who fell above 20 feet?

Objective@#Many trauma centers use their own criteria for major trauma patients, and these criteria are organized according to physiological causes and their related mechanisms. Mechanism related criteria have high sensitivity but low specificity. We confirmed 20 feet as a single factor for trauma team activation criteria. @*Methods@#This study was retrospectively conducted in the Pusan National University Hospital trauma center, which is a level 1 trauma center in Busan. Patients were grouped as group 1, a fall from less than 20 feet; and group 2, a fall from more than 20 feet. We compare the two groups of prognostic factors using logistic regression analysis. @*Results@#The relationship between the height of the fall and the patient’s prognosis showed a positive relationship on the logistic regression analysis. Yet the cut-off value of a 20 foot height showed poor predictive power for the patient’s prognosis. @*Conclusion@#In conclusion, as trauma team activation criteria, a 20 foot height seems to be a reasonable aspect of patients’ clinical prognosis between above 20 feet and below 20 feet. Yet it seems to be controversial as a cut-off value. Thus, more studies will be needed to identify a specific height for trauma team activation.

A Case of Zoletil, Veterinary Anesthetic Poisoning

Zoletil is a non-narcotic, nonbarbiturate, injectable veterinary anesthetic agent, which is routinely used as a veterinary anesthetic. Zoletil is an equal weight (1:1 ratio) combination of tiletamine hydrochloride and zolazepam hydrochloride. Tiletamine is a dissociative anesthetic agent with pharmacological similarity to ketamine, and zolazepam is a nonphenothiazine, diazepinone minor tranquillizer similar to diazepam. Zoletil is the term used in Europe and Telazol is used in the USA. Adverse effects of zoletil in animals include salivation, vomiting, tachycardia, seizures, central nervous system stimulation, apnea, and prolonged recovery time. A 30-year old male who was poisoned with zoletil visited our emergency center and presented with several symptoms. We report on a case of Zoletil poisoning.