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Hartung B, Schäuble A, Peldschus S, Schüssler M, Meyer HL. The Documentation of Injuries Caused by Traffic Accidents. DEUTSCHES ARZTEBLATT INTERNATIONAL 2024; 121:27-36. [PMID: 38055024 PMCID: PMC10916764 DOI: 10.3238/arztebl.m2023.0145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Persons injured in traffic accidents may have injuries of characteristic types that are of significance for the complex reconstruction of the accident and whose medicolegally sound clinical documentation is highly important. This is of particular relevance for the approximately 55 000 persons who are severely injured in traffic accidents in Germany each year. Gaps in documentation are often disadvantageous for the injured persons. METHODS This review is based on pertinent publications retrieved by a selective literature review, with additional consideration of relevant textbooks in traffic medicine and legal medicine, as well as the guidelines of the AWMF (Association of the Scientific Medical Societies in Germany). RESULTS Injuries in traffic accidents typically differ depending on the mode of participation of the injured person in traffic. They must be examined with a view toward the sequence of events of the accident and documented in medicolegally sound fashion. In particular, because of the different mechanical forces involved, it is important to document the seat that the injured person occupied in the automobile, the nature of the collision (pedestrian vs. automobile; bicycle, e-bike, e-scooter, and motorcycle accidents), and the protective devices that were in use. CONCLUSION The precise documentation of injuries and examination findings, with critical consideration of their plausibility in relation to the sequence of events of the accident as far as it is known, is an important duty of the physician. This documentation serves as the basis for further judicial steps leading to compensation when legally appropriate.
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Affiliation(s)
- Benno Hartung
- Institute of Forensic Medicine, Essen University Hospital, Essen, Germany
| | | | - Steffen Peldschus
- Institute of Forensic Medicine, Biomechanics and Accident Analysis, LMU Munich, Munich, Germany
| | - Maximilian Schüssler
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, Essen University Hospital, Essen, Germany
| | - Heinz-Lothar Meyer
- Clinic for Trauma, Hand and Reconstructive Surgery Essen University Hospital, Essen, Germany
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Almeida GCMD, Medeiros FDCDD, Pinto LO, Moura JMBDO, Lima KC. Prevalence and factors associated with traffic accidents involving motorcycle taxis. Rev Bras Enferm 2017; 69:382-8. [PMID: 27280576 DOI: 10.1590/0034-7167.2016690223i] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 11/14/2015] [Indexed: 05/29/2023] Open
Abstract
RESUMO Objetivo: identificar a prevalência de acidentes motociclísticos envolvendo mototaxistas e fatores associados. Método: estudo transversal e exploratório, com aplicação de questionários aos mototaxistas das 32 praças de Caicó, Rio Grande do Norte, Brasil (N=420). Resultados: os mototaxistas têm alta carga horária de trabalho diária (12 horas em média) e foi verificado que 63,6% já se envolveram em pelo menos um acidente motociclístico. A ocorrência de acidentes motociclísticos foi associada significativamente apenas com escolaridade (p<0,001), não havendo associação significativa com as demais variáveis, tais como idade (p=0,132), tempo de serviço (p=0,744) e carga horária de trabalho (p=0,830). Conclusão: é necessário implementar ações preventivas e educativas com os mototaxistas e usuários do serviço acerca dos acidentes e condutas emergenciais, devido à constante exposição a acidentes durante sua rotina de trabalho.
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Affiliation(s)
- Gilmara Celli Maia de Almeida
- Universidade do Estado do Rio Grande do Norte, Departamento de Odontologia, Caicó RN , Brazil, Universidade do Estado do Rio Grande do Norte, Departamento de Odontologia. Caicó-RN, Brasil., Universidade do Estado do Rio Grande do Norte
| | - Fabianna da Conceição Dantas de Medeiros
- Universidade do Estado do Rio Grande do Norte, Faculdade de Ciências da Saúde, Caicó RN , Brazil, Universidade do Estado do Rio Grande do Norte, Faculdade de Ciências da Saúde. Caicó-RN, Brasil., Universidade do Estado do Rio Grande do Norte
| | - Lígia Oliveira Pinto
- Universidade do Estado do Rio Grande do Norte, Faculdade de Odontologia, Caicó RN , Brazil, Universidade do Estado do Rio Grande do Norte, Faculdade de Odontologia. Caicó-RN, Brasil., Universidade do Estado do Rio Grande do Norte
| | - Jamile Marinho Bezerra de Oliveira Moura
- Universidade do Estado do Rio Grande do Norte, Departamento de Odontologia, Caicó RN , Brazil, Universidade do Estado do Rio Grande do Norte, Departamento de Odontologia. Caicó-RN, Brasil., Universidade do Estado do Rio Grande do Norte
| | - Kenio Costa Lima
- Universidade Federal do Rio Grande do Norte, Departamento de Odontologia, Natal RN , Brazil, Universidade Federal do Rio Grande do Norte, Departamento de Odontologia. Natal-RN, Brasil., Universidade Federal do Rio Grande do Norte
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Ang BH, Chen WS, Lee SWH. Global burden of road traffic accidents in older adults: A systematic review and meta-regression analysis. Arch Gerontol Geriatr 2017; 72:32-38. [PMID: 28527382 DOI: 10.1016/j.archger.2017.05.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 01/16/2017] [Accepted: 05/07/2017] [Indexed: 11/16/2022]
Abstract
PURPOSE OF THE STUDY This study aims to estimate the burden of road traffic accidents and death among older adults. DESIGN AND METHODS A systematic literature review was conducted on 10 electronic databases for articles describing Road Traffic Accident(RTA) mortality in older adults until September 2016. A random-effects meta-regression analyses was conducted to estimate the pooled rates of road traffic accidents and death. RESULTS A total 5018 studies were identified and 23 studies were included. Most of the reported older adults were aged between 60 and 74 years, with majority being male gender and sustained minor trauma due to Motor-Vehicle Collision (MVC). The overall pooled mortality rate was 14% (95% Confidence Interval, CI: 11%, 16%), with higher mortality rates in studies conducted in North America (15%, 95% CI: 12%, 18%) and older adults admitted to trauma centers (17%, 95% CI: 14%, 21%). Secondary analysis showed that the very elderly adults (aged >75years) and pedestrians had higher odds of mortality death (Odds Ratio, OR: 2.05, 95% CI: 1.25, 3.38; OR: 2.08, 95% CI: 1.63, 2.66, respectively). IMPLICATION A new comprehensive trauma management guidelines tailored to older adults should be established in low and middle-income countries where such guidelines are still lacking.
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Affiliation(s)
- Boon Hong Ang
- School of Science, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia
| | - Won Sun Chen
- School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia; Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Global Asia in the 21 st Century (GA21) Platform, Monash University Malaysia, Malaysia.
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Paixão LMMM, Gontijo ED, Drumond EDF, Friche AADL, Caiaffa WT. Acidentes de trânsito em Belo Horizonte: o que revelam três diferentes fontes de informações, 2008 a 2010. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2015; 18:108-22. [DOI: 10.1590/1980-5497201500010009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 08/11/2014] [Indexed: 11/21/2022] Open
Abstract
OBJETIVO: Analisar a contribuição de três diferentes fontes de informações na descrição de acidentes de trânsito em Belo Horizonte. MÉTODOS: Estudo exploratório dos Sistemas de Informação da Empresa de Transportes e Trânsito, de Internações Hospitalares e Mortalidade, com análise de proporções, coeficientes e medidas de associação. RESULTADOS: Preenchimento inadequado nas três fontes, destacando o uso de equipamentos de segurança e de álcool pelo condutor. Perfil de homens, jovens, ocupantes de motocicleta ou pedestres semelhante nos três sistemas. Além do alto coeficiente de mortalidade dos residentes em Belo Horizonte (19,4 por cem mil habitantes) no período, observou-se aumento dos acidentes e de vítimas não fatais com concomitante elevação na taxa de internação (34%) e custos hospitalares (53%) e maior envolvimento de motocicletas, proporcionalmente à frota. Os homens condutores apresentaram mais chance de serem feridos ou mortos. Passageiros ou pedestres apresentaram 1,8 vezes a chance de morrer, comparados aos condutores. Verificou-se aumento (12%) das mortes em via pública com 55% de positividade nos exames toxicológicos e 50% mais chance de acidentes fatais nos finais de semana. CONCLUSÃO: Apesar da incompletude dos registros, foi possível caracterizar como principais fatores associados aos acidentes os pedestres idosos, motociclistas, o uso de álcool e excesso de velocidade. O estudo demonstrou a complementaridade das três fontes de dados, com seus diferentes objetivos e permitiu revelar importantes aspectos da cadeia de eventos relacionados aos acidentes e vítimas de trânsito, desde sua ocorrência até a eventual evolução fatal, fornecendo informações relevantes da magnitude do problema para guiar estratégias de controle.
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Lopes MCBT, Whitaker IY. Measuring trauma severity using the 1998 and 2005 revisions of the Abbreviated Injury Scale. Rev Esc Enferm USP 2014. [DOI: 10.1590/s0080-623420140000400010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objetivo: Comparar a gravidade das lesões e do trauma mensurada pelas versões da Abbreviated Injury Scale 1998 e 2005 e verificar a mortalidade nos escores Injury Severity Score e New Injury Severity Score nas duas versões.Método: Estudo transversal e retrospectivo analisou lesões de pacientes de trauma, de três hospitais universitários do município de São Paulo, Brasil. Cada lesão foi codificada com Abbreviated Injury Scale 1998 e 2005. Os testes estatísticos aplicados foram Wilcoxon, McNemar-Bowker, Kappa e teste Z.Resultados: A comparação das duas versões resultou em discordância significante de escores em algumas regiões corpóreas. Com a versão 2005 os níveis de gravidade da lesão e do trauma foram significantemente reduzidos e a mortalidade foi mais elevada em escores mais baixos. Conclusão: Houve redução da gravidade da lesão e do trauma e alteração no percentual de mortalidade com o uso da Abbreviated Injury Scale 2005.
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de Oliveira NLB, de Sousa RMC. [Risk for injuries among motorcyclists involved in traffic incidents]. Rev Esc Enferm USP 2012; 46:1133-40. [PMID: 23223729 DOI: 10.1590/s0080-62342012000500014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Accepted: 02/14/2012] [Indexed: 11/21/2022] Open
Abstract
The objective of this study was to identify, among motorcyclists involved in traffic incidents, the factors associated with risk of injuries. In 2004, in the city of Maringá-PR, it was determined that there were a total of 2,362 motorcyclists involved in traffic incidents, according to records from the local Military Police. Multivariate analysis was applied to identify the factors associated with the presence of injury. A significantly higher probability of injury was observed among motorcyclists involved in collisions (odds Ratio= 11.19) and falls (odds Ratio= 3.81); the estimated odds ratio for females was close to four, and those involved in incidents including up to two vehicles were 2.63 times more likely to have injuries. Women involved in motorcycle falls and collisions with up to two vehicles stood out as a high-risk group for injuries.
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Baena CP, Soares MCF. Subsídios reunidos junto à equipe de saúde para a inserção da fisioterapia na estratégia Saúde da Família. FISIOTERAPIA EM MOVIMENTO 2012. [DOI: 10.1590/s0103-51502012000200020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Esta pesquisa visou obter subsídios para a inserção do fisioterapeuta na Estratégia Saúde da Família em Rio Grande/RS. Estudo quantitativo, delineamento transversal com 196 trabalhadores. Utilizou-se instrumento semiestruturado com os temas: princípios norteadores do SUS/ESF, identificação de situações com potencialidade para a atuação fisioterápica, percepção sobre preparo da equipe para enfrentá-las e infraestrutura das unidades. Foi realizada a distribuição de frequências das variáveis, a comparação das médias (ANOVA) e o teste de Tukey. As médias das notas atribuídas aos princípios integralidade, equidade e universalidade diferiram entre si (p = 0,00), sendo 6,3 ± 2,4, 7,0 ± 2,4 e 7,8 ± 2,2, respectivamente. As situações mais prevalentes foram: hipertensão (90,8%), diabete (89,8%), doenças osteomusculares (88,2%), DPOC (84,7%), pessoas acamadas (83,7%), dificuldade para caminhar (83,7%) e deficientes físicos (82,7%). Quanto ao preparo da equipe, a maioria dos trabalhadores afirmou se sentir despreparado para: atraso do desenvolvimento neuropsicomotor (51,7%), treino de marcha (51,8%), atenção a deficientes físicos (68,1%) e amputados (57,0%). Na avaliação da infraestrutura das unidades, a maioria acusou bom estado do prédio e unidades, com salas para atendimento especializado (31,6%). Os dados evidenciam as possibilidades de ação do fisioterapeuta na ESF, visando aumentar a resolubilidade da mesma.
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Lacerda RA, Nunes BK, Batista ADO, Egry EY, Graziano KU, Angelo M, Merighi MAB, Lopes NA, Fonseca RMGSD, Castilho V. [Evidence-based practices published in Brazil: identification and analysis of their types and methodological approches]. Rev Esc Enferm USP 2011; 45:777-86. [PMID: 21710089 DOI: 10.1590/s0080-62342011000300033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Accepted: 01/17/2010] [Indexed: 11/22/2022] Open
Abstract
This is an integrative review of Brazilian studies on evidence-based practices (EBP) in health, published in ISI/JCR journals in the last 10 years. The aim was to identify the specialty areas that most accomplished these studies, their foci and methodological approaches. Based on inclusion criteria, 144 studies were selected. The results indicate that most EBP studies addressed childhood and adolescence, infectious diseases, psychiatrics/mental health and surgery. The predominant foci were prevention, treatment/rehabilitation, diagnosis and assessment. The most used methods were systematic review with or without meta-analysis, protocol review or synthesis of available evidence studies, and integrative review. A strong multiprofessional expansion of EBP is found in Brazil, contributing to the search for more selective practices by collecting, recognizing and critically analyzing the produced knowledge. The study also contributes to the analysis itself of ways to do research and new research possibilities.
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Oliveira NLBD, Sousa RMCD. Traffic accidents with motorcycles and their relationship to mortality. Rev Lat Am Enfermagem 2011; 19:403-10. [DOI: 10.1590/s0104-11692011000200024] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2009] [Accepted: 05/24/2010] [Indexed: 11/21/2022] Open
Abstract
This study characterizes traffic accidents involving motorcycles according to local conditions, data concerning the type of accident, date and time, and identifies among these variables those associated with the death of victims. This retrospective study uses data from traffic collision reports from 2004 and death records from the institute of forensic medicine. A total of 99.4% of the events occurred in urban areas, where illumination (87.4%), weather conditions (80.6%); and traffic signs (70.6%) were satisfactory. Collisions between motorcycles and cars or pickup trucks prevailed (55.5%), followed by motorcycle falls (18.0%). In relation to the type of collision, the highest percentage was observed in broadside collision category (35.2%). There were differences between the groups of fatalities and survivors in relation to the area and illumination in the collision’s site, in addition to the types of collision and impact. The conclusion is that local conditions and types of collision and impact stand out among the multiple variables defining the severity of accidents involving motorcycles.
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