[Efficiency of helmets in the prevention of temporobasal injuries].
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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.
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Clean surgical wounds may be contaminated from three separate sources: endogenously from the patient himself; exogenously from direct contamination by unsterile instruments, drapes, gowns, hands, or gloves; and by bacteria settling from that final common pathway, the air over the operative field. The advent of total joint replacement precipitated a renewed consciousness in the orthopedic community of the disastrous consequences a wound infection can have upon the orthopedic patient. Deep infection around a total joint replacement can convert a procedure with a 95 percent probability of success to a total disaster, leaving the patient worse than prior to operation. Most orthopedists use at least two accepted methods of preventing deep wound infection in the postoperative period: the application of topical antibiotics during surgery, and the intravenous infusion of systemic antibiotics during and after surgery for a brief period. In addition, many orthopedic surgeons are operating in clean air rooms with body exhaust systems; others are operating in an ultraviolet environment. Orthopedic surgery in the ultraviolet environment has been used at the brigham hospitals since 1973. The infection rate has dropped from 3.8 percent to 1.04 percent in a series of 2000 patients. However, inconveniences and hazards have been experienced in the use of ultraviolet radiation in the operating room.
A "German helmet" field defined by depleted uranium or Asarcola blocks was used to reduce the dose to the lens. With the uranium blocks, the lenticular dose was reduced to about 60% of the central axis dose (CAD). The Asarcola blocks reduced the lenticular dose to about 43% of the CAD. Even further reduction (15% CAD) was achieved by tilting the gantry 5 degrees or 10 degrees.
A series of experiments were performed to determine the dose reduction afforded to radiosensitive organs in the head and neck by various protective devices. These included spectacles with plastic, standard glass, photochromic and lead-glass lenses, a thyroid collar and a lead-acrylic face mask. The measurements were performed using an anthropomorphic phantom loaded with lithium fluoride thermoluminescent dosemeters, in conditions realistic of clinical practice. Irradiations were performed using scattered radiation produced by a pelvic phantom, for X-ray beams generated at 80 kVp and 110 KVp. It was found that the reduction in dose to the lens of the eye ranged between 0% and 97%, whilst the dose to the thyroid and oesophagus was reduced by between 76% and 97%, and was dependent on the protective device and tube potential employed. A reduction in brain dose of up to 81% was also measured, for the lead-acrylic face mask. Also presented is the ratio of organ dose to dose to the bridge of the nose for thyroid, oesophagus, brain and sinuses, as measured for the case of no head or neck protection.
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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.
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.
All-terrain vehicles (ATVs) are becoming increasingly popular recreational devices. Multiple injuries have been associated with ATV accidents. This report reviews pediatric injuries treated at a regional pediatric trauma center, with special attention to facial trauma, as well as the ATV injury data for the United States.
Approximately 600 children under the age of 15 years, die each year in bicycle-related accidents. Over 80% of these deaths involve trauma to the head. Almost one fourth of all significant brain injuries in children are bicycle related. In spite of these significant statistics, bicycle helmet use in Puerto Rico has not received the necessary publicity to increase their use. Pediatricians should encourage helmet use and counsel parents about the important of this device. A case control study of accidents among bicycle riders experiencing a crash demonstrates that safety helmets reduce the risk of head injury by 85% and brain injury by 88%. The recommendation of current safety counseling practices should be incorporated as part of the routine pediatrician visit. Educational campaigns targeted at parents and children focusing on the incidence of consequences of bicycle crashes should be the primary goal for all primary practitioners, since the effectiveness of helmets in preventing head injuries might substantially increase helmet ownership among children. To assess the prevalence of bicycle helmet ownership and the associated factors with this, we surveyed 146 school age children evaluated at the Pediatrics Clinics of the University Hospital Dr. Ramón Ruiz Arnau from January to March 1991. We concluded that only 7.5% of our sample use the helmets.
High-speed cinematograph films of a drilling woodpecker were examined by direct visual inspection and by a microdensitometer and computer-imaging technique. These showed (1) that the drilling trajectory is essentially linear, with very little, if any, rotation of the head; (2) that there is minimal movement after impact; (3) that the impact velocity is of the order of 600 to 700 cm/s; and (4) that the impact deceleration is of the order of 1,000 g. Dynamic and morphologic findings in the woodpecker may be highly relevant to the prevention of concussion and brain injury in man. Taken in the context of modern packaging technology and other animal and mathematical modelling research, they suggest that brain injury preventive systems could be greatly improved over those now in common use.
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.
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Between 1987 and 1988 there were 47 serious or fatal injuries among bicycle riders in the city of Tel Aviv-Yafo (Serious injury was defined as being hospitalized for at least 24 hours). Collisions with vehicles, mostly cars, were responsible for about 80% of these cases. Two-thirds of the accidents occurred in adults aged 20 and over. We were able to trace the records of 24 of the 47 who were injured. Head trauma was the most common form of severe injury, occurring in 11 of the 24 cases. Two of the 11 died instantly and one died after 14 days of hospitalization, all from severe brain damage. Eight suffered severe head trauma, 7 of which had brain injury and 2 of the 7 were left with severe residual brain damage. In view of the efficacy of bicycle helmets in preventing head trauma there is a great need to expand their use among bicyclists in Israel.
A mentally retarded self-mutilating child developed a large skull defect at the site of repeated trauma. The bony defect involved only the outer table and had smooth bony margins.
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