Facial fractures and snowmobile accidents

Snowmobile accidents are now common in winter; there is a local pattern of facial fractures associated with accidents involving these machines. Facial fractures connected with snowmobile accidents over a period of two successive winters were reviewed; 14 were found to be of special interest because of their severity and localized extent. Compared with motor vehicle accidents most of these fractures were isolated; the patients often had suffered only minimal trauma elsewhere. After reviewing the histories of these patients it was clear that alcohol, night driving, inadequate facial protection and the use of unknown terrain were common precipitating factors. Elimination of these hazards and the use of appropriate protective head-gear would probably reduced the number and severity of such injuries.

Motor cycle helmets and facial injuries

The design of motor cycle helmets has been changing over the years and at the present time there are two basic types in popular use: "full-face" and "jet" helmets. Both helmet types give good protection to the brain, but, one would think, different degrees of facial protection. A special study of traffic crashes has indicated that full-face helmets provide significantly greater protection against facial injury than do jet helmets. The study also indicated that the wearers of full-face helmets have no greater risk of involvement in road traffic crashes than do the wearers of jet helemts. It is suggested that the use of full-face helmets should be encouraged and consideration given to the revision of helmet standards to require the provision of facial protection.

Five years experience with operating room clean rooms and personnel-isolator systems

Two horizontal flow, laminar airflow type clean rooms have been used for almost all clean orthopedic surgery at St. Luke's Hospital in Denver since March 1971. This experience covers approximately 4000 cases, including 1100 total hip and total knee arthroplasties. Three different types of helmet aspirator systems have also been evaluated. Our conclusions from this experience are: (1) All types of orthopedic surgery may be easily and conveniently performed in the clean room and with scrubbed personnel wearing helmet aspirator systems; (2) mechanical upkeep of the clean room is minimal; (3) airborne bacteria counts have been reduced at least 80 percent compared to a regular operating room, and more than 90 percent when scrubbed personnel wear the helmet aspirator system; (4) sterile surface contamination, including the wound, has been reduced at least 80 percent; and (5) the deep infection rate for total hip replacements with at least a 2-year follow-up has been 7.6 percent (10/131) in a regular operating room and 1.6 percent (5/319) in the clean room. With the combined use of the clean room, helmet aspirator systems, and perioperative antibiotics, no infections have occurred in an additional 350 cases with a 1-year follow-up.

Chrome alloy welding fume study

Breathing zone samples obtained at a production arc welding operation employing approximately 90 welders demonstrated excessive exposure to chromium from the welding of high chromium alloy steel. Breathing zone samples were collected inside welding helmets. Methods considered for reducing employee exposure included local exhaust ventilation and the use of air-supplied helmets. Air-supplied helmets were chosen as best suited for the production scheme and suitable devices were subsequently developed that reduced breathing zone contaminant levels well below applicable standards.

Woodpeckers and head injury

The woodpecker is an experiment in Nature, a model for the investigation of mechanisms of basic importance for head injury and its prevention. A preliminary anatomical study of the woodpecker's head suggests that it may be fruitful to explore impact protective systems which are radically different from those in common use.

Ocular injuries in hockey

Ocular injuries suffered by 38 hockey players during a three-year period were studied. The severity of the injuries required hospitalization for 16 of the patients. Twelve players require follow-up care for possible late complications from the following conditions: angle recession (seven cases), subluxated lens (three cases), traumatic cataract (three cases), detachment of the retina (two cases), and enucleation (one case). The use of a full-face protective mask affixed to an adequate helmet is recommended for all hockey players.

Effects of a welding helmet and dust respirators on respiration at rest and during exercise

The influence of welders' protective devices on respiration at rest and during exercise was studied under laboratory conditions. During exercise the devices caused increased ventilation and increased arterial carbon dioxide tension. In the case of the welding helmet the increase was probably a consequence of increased dead space. It is concluded that the physiological affects on respiration are of minor importance in themselves, but they should be taken into account when the degree of exposure to welding fumes is evaluated.

Eye injuries in Canadian hockey

Increasing public concern led the Canadian Ophthalmological Society, in January 1974, to form a committee to study the incidence, types and causes of hockey eye injuries and to devise means of reducing such injuries. Retrospective and current studies were undertaken, and face protectors were tested. In both pilot studies, sticks were the commonest cause and the highest number of eye injuries was in players 11-15 years old. An average of 15% of all injured eyes were rendered legally blind. Cooperation with hockey authorities has resulted in changed rules and their sticter enforcement, and formulation of standards for face protection approved by the Canadian Standards Association. In this interim report the committee recommends that all amateur hockey players wear eye protectors and urges ophthalmologists to participate in efforts to improve the design of protective equipment.

Cervicocranium and the aviator's protective helmet

An analogy based on the likenesses of the APH-6 aviator's protective helmet and the hangman's noose has some interesting relationships to aircraft accident investigation and to the associated traumatic pathology. A superficial examination of the similarities might propose that the inferior edge of the helmet, when considered part of the continuous circle completed by the nape strap and the chin strap, forms a loop which can be likened to a hangman's noose. The analogy might be extended to the comparison of lesions made about the neck by the straps or the edge of the helmet compared with abrasions and contusions that might be associated with a rope encircling the same structures. Such a hangman's noose, when the knot is at the side of the head (subaural), produces fractures of the base of the skull tending to extend bitemporally through the basisphenoid. When the knot is anterior and beneath the chin (submental), the hangman's noose causes a fracture dislocation at the axis. Characteristically, the posterior arch is fractured and, interestingly enough, the odontoid process is not involved. Many of us anticipate that a fractured, displaced odontoid process is the prototype lesion which so precariously endangers the patient with cervical cord compromise and death similar to the hangman's fracture. More recent assessments of the mortality of the odontoid fracture suggest less than 10%.

Helmets and head protection in CF ejections 1967-1973

During the period 1967-1973, helmet retention and minor head injuries were significant problems in ejections from Canadian Forces (CF) aircraft. There were 73 ejections in which Canadian-designed helmets were worn. Eight-four percent of those who lost their helmets and 38% of those who retained their helmets received minor head injuries. This paper reports on analysis of helmet loss versus air speeed and Q force. Specific problems are addressed, including the fitting and method of wearing helmets, and some guidelines for enhancing helmet retention are recommended.

Some epidemiologic features of motorcycle collision injuries. II. Factors associated with severity of injuries

Male drivers sustained relatively more serious motorcycle collision injuries than did male passengers, female drivers, or female passengers. For male drivers, severity of injury was related to age. The relative frequency of serious head injury was highest for drivers not wearing helmets who were involved in collisions at low or high speeds. Severity of injury was related to speed at the time of collision but not in all types of collisions. Factors associated with the incidence of collisions were not identical to those related to the severity of the injury sustained.

Christchurch traffic trauma survey: Part 2, victims and statistics

The results of a survey carried out at Christchurch Hospital examining the problem of traffic trauma are described. The majority of casualties were in the 15-24 age group and motorcyclists were especially prominent. The type and severity of injuries is discussed for each role, e.g., driver, passenger etc. The availability and use of safety equipment (seat belts and crash helmets) by the victims who came to hospital is also detailed. Accidents were found to occur predominantly (88 percent) in urban areas and very close to the victim's home.

MEDICAL PROBLEMS OF WEARING A COALMINER'S SAFETY HELMET

A survey of 324 men, who voluntarily reported an injury to that part of the head normally covered by a miner's safety helmet, took place at 18 collieries (16,732 men) during the period March 31 to September 30, 1962. The most prevalent site for injury was the top of the head in surface workers, and the forehead in underground workers. Normally surface workers do not wear a helmet. Underground workers expose their forehead when they wear their safety helmets in an upwards-tilted position. One reason for this practice is that the helmet has become too small due to shrinkage of the sweat-dampened leather headband which occurs after the helmet has been left for some time in the hot pit-head bath lockers. A helmet which had a wide, unshrinkable, easily adjustable headband made of smooth material was worn by 31 men who had dermatitis or soreness of that part of the skin normally covered by a safety helmet. After six months 26 of these men had no signs or symptoms, confirming that the main cause of helmet dermatitis is friction. A direct relationship between skin rash and sweating was observed in only four of these men.