Hospital costs associated with agricultural machinery injuries in Ontario

To assist those responsible for agricultural safety, we: (1) piloted an approach to costing hospitalized farm injuries; and, (2) described ambulance and inpatient costs associated with these injuries in Ontario. Hospital discharge records (hospital separations) for farm machinery injuries in Ontario (n = 1,610) were identified by ICD9-CM E-codes for 1985–1993. Ambulance costs were estimated by the Ontario Ministry of Health. For each case, the hospital costs were calculated by multiplying the case-specific resource intensity weight by the average inpatient cost per weighted case. The costs (1993 Canadian dollars) ranged from $768 to $62,643 and totaled $6.9 million over the study period. Males accounted for 89.8% of the total costs. Tractor injuries accounted for a large proportion of costs (34.3%). The median costs per case varied by type of machinery, ranging from $2,043 for ploughs/disks to $3,366 for augers. Entanglement injuries were responsible for the largest proportion of costs (40.7%), while tractor rollovers accounted for the highest median cost ($3,065). Although these figures represent a fraction of the total costs associated with farm injuries, the results provide one basis from which to justify and target preventive initiatives. This approach to costing may also be widely applicable to other health issues. Am. J. Ind. Med. 32:502–509, 1997. © 1997 Wiley-Liss, Inc.     

垂杨柳医院儿童意外损伤资料分析

目的了解城乡结合部儿童意外损伤的原因及危险因素.方法对我院1998年4月～2000年12月意外损伤的96例儿童进行回顾性分析.结果儿童意外损伤,城市前3位为动物致伤、中毒和跌落伤,分别为42.9%、21.4%和17.8%,农村为中毒,动物致伤和烫伤,分别为55.7%、8.6%和7.1%;中毒农村高于城市,动物致伤和跌落伤城市高于农村,2者比较差异有显著性(P＜0.01);中毒城市乡均以一氧化碳为首位,其次,城市以药物,农村以有机磷和灭鼠药为主;3岁前儿童意外损伤以窒息和气管异物为主,3岁以上以动物致伤和跌落伤为主;意外损伤致死23例,占意外损伤儿童的23.5%(23/98),致死原因主要为车祸和溺水.结论城乡结合部儿童重点预防中毒、动物致伤、跌落伤和烫伤,同时防止车祸和溺水导致儿童意外死亡.     

Incidence of traumatic head or brain injuries in catchment area of Academic Hospital Maastricht in 1997

OBJECTIVE: To measure the incidence of traumatic head or brain injury in the catchment area of the Academic Hospital Maastricht (AZM), the Netherlands. DESIGN: Retrospective. METHOD: Data were collected about head injury patients who visited the emergency room of the AZM in 1997 by separate forms that were filled out for each patient who came to the emergency room. Data were added from admission records and radiology records. The AZM had a catchment area of approximately 231,000 people. RESULTS: The emergency room was attended by 1933 patients with traumatic head or brain injury. Head trauma without signs of brain injury was diagnosed in 1440 patients (74%) mild brain injury in 467 (24%) and moderate or severe brain injury in 26 (1%). The mean age was 30 years (range: 0-97) and 29% of all patients were below the age of 15. Two-thirds (67%) of patients were male. An X-ray of the skull was performed in 15% of the cases. In 7% of these X-rays a relevant abnormality was found. Eleven per cent of patients were admitted for observation. The incidence rate of traumatic head or brain injury in 1997 was 836/100,000 and the incidence of admission 88/100,000. The causes were a fall (43%), traffic accident (22%), violence (15%), sports injuries (7%), accidents during work (4%), or other/unknown (9%). CONCLUSION: Most patients with head or brain injury had mild injuries (99%, sole head injury or mild brain injury). Compared with other studies, the annual frequency of hospital admissions was low.     

Toronto hospital reduces sharps injuries by 80%, eliminates blood collection injuries. A case study: Toronto East General Hospital pioneers healthcare worker safety

Needlestick and other sharps injuries are a key Canadian public health issue, affecting 70,000 people per year and costing some dollar 140 million. A safety program at Toronto East General Hospital--focusing on blood collection and patient injection--achieved an 80% reduction in injuries within one year (from 41 in 2003 to eight in 2004), with blood collection injuries eliminated entirely.     

胸部损伤

胸部损伤包括胸壁软组织损伤、肋骨骨折、气胸、血胸、创伤性窒息、肺爆震伤、心脏挫伤、心脏破裂 (心包填塞 )等 ,治疗方法各异。下面对最常见的胸部损伤性疾病予以介绍。1　多根多处肋骨骨折根据外力对胸壁作用的部位与范围不同 ,发生骨折的肋骨数量与部位也不相同 ,最简单的为单根单折 ,范围大者可出现多根多折 ,有时甚至发生双侧多根多处肋骨骨折。多根多处肋骨骨折对病人的呼吸与循环影响较大 ,本节作重点阐述。1 1　病理生理　 (1 )纵隔移位 :由于胸壁软化无支撑作用而下陷 ,使负压减小 ,病人在静止状态下 ,纵隔向负压大的一侧 (健侧…     

Fingertip injuries

The fingertip is a complex anatomic unit highly specialized in function and particularly prone to injury. Its complex design and the difficulty of secondary repairs demand great care in initial evaluation, diagnosis, and treatment for optimal long-term outcome. The goals of treatment should be to preserve length, maintain sensation, mobilize early, return function expediently, and be mindful of cosmesis.