Comparison of Injury Severity and Resource Utilization in Pediatric Firearm and Sharp Force Injuries
Title | Comparison of Injury Severity and Resource Utilization in Pediatric Firearm and Sharp Force Injuries PDF eBook |
Author | Ashley Wolf |
Publisher | |
Pages | 22 |
Release | 2019 |
Genre | |
ISBN |
Importance: Pediatric firearm injuries are a serious and growing public health problem. Firearm injuries have a high case-fatality, but we lack a full knowledge of their injury severity and healthcare utilization compared to other penetrating injuries, especially among critically injured children. Objective: Describe resource utilization, injury severity, and short-term clinical outcomes for pediatric firearm injuries and compare those to non-firearm penetrating sharp force injuries in children. Design: Retrospective cohort study utilizing the National Trauma Data Bank (NTDB) data years 2007-2016. Setting: Multicenter database study. Participants: Encounters for firearm injury or cut/pierce injury in children 17 years or younger. Exposure: Firearm injury encounters were compared to cut/pierce injury encounters. Outcomes: Intensive care unit (ICU) admission, hospital and ICU length of stay (LOS), and injury severity score (ISS). Results: We identified 25,155 encounters for firearm injuries and 21,270 encounters for cut/pierce injuries. The majority of firearm injuries and cut/pierce injuries were suffered by males (85.8% vs. 74.6%) and adolescents aged 15-17 (74.8% vs. 51.2%). A greater proportion of those with firearm injuries were African-American (61.3%) than those with cut/pierce injuries (31.1%). A greater proportion of firearm injuries (30.5%) than cut/pierce injuries (12.8%) were admitted to the ICU. Firearm injuries resulted in a higher mean Injury Severity Score (ISS), longer mean hospital and ICU length of stay (LOS) compared to cut/pierce injuries. Firearm injuries accounted for 126,027 hospital days and 39,255 ICU days while cut/pierce injuries accounted for 58,705 hospital days and 8,353 ICU days. After adjusting for age, sex, year, and hospital, firearm injuries were 2.3 (95% CI: 2.1-2.5) times more likely to require ICU admission and were associated with higher ISS scores compared to cut/pierce injuries, even among critical injuries. Multinomial logistic regression demonstrated higher risk of prolonged hospital (RRR 4.11 95%CI: 3.46-4.89) and ICU LOS (RRR 2.16 95%CI: 1.91-2.45) for firearm injuries compared to cut/pierce injuries. Conclusions and Relevance: Pediatric firearm injuries carry a greater injury severity and health care utilization compared to other penetrating injuries even among critical injuries, demonstrating that mechanism of injury is an important consideration in pediatric penetrating trauma. This highlights the importance of public health measures to reduce the risk of pediatric firearm injuries.
The Silent Epidemic of Gun Injuries
Title | The Silent Epidemic of Gun Injuries PDF eBook |
Author | Melvin Delgado |
Publisher | Oxford University Press |
Pages | 289 |
Release | 2022 |
Genre | Firearms accidents |
ISBN | 0197609767 |
"There are numerous preconceived notions about this topic, as well as profound concerns on how gun violence is altering the life course of residents, family members, neighborhoods, and the nation as a whole. Some of these notions will be widely embraced while others may enjoy limited acceptance. Regardless of stance, we can acknowledge that gun violence undermines a quest for a healthy and productive life. Further, making this book urban focused, has race and socio-economic class assume prominence bringing a social justice and equity lens (Zakrison, Williams, & Crandall, 2021)"--
Urban Gun Violence
Title | Urban Gun Violence PDF eBook |
Author | Melvin Delgado |
Publisher | Oxford University Press, USA |
Pages | 405 |
Release | 2021 |
Genre | Social Science |
ISBN | 0197515517 |
"Gun violence is a national threat and no more so than in the nation's urban communities, particularly taking its toll on people of color. Urban violence focused self-help organizations are vehicles for the dead to speak to us, and let us not forget that they once lived among us. These voices get captured and amplified through these organizations - their family become our family. The headlines their deaths created are not allowed to get relegated to history and continue to live giving meaning to a profound social justice cause. This book honors those who have died and continuing to give voice to their lives and preventing others from joining this chorus. The theme that we must forgive ourselves before we can forgive the offender is strong and pervasive among those who are survivors and engaged in self-help initiatives"--
Guns in American Society [3 volumes]
Title | Guns in American Society [3 volumes] PDF eBook |
Author | Jaclyn Schildkraut |
Publisher | Bloomsbury Publishing USA |
Pages | 1188 |
Release | 2022-12-01 |
Genre | Social Science |
ISBN | 1440867747 |
The revised third edition of the landmark Guns in American Society provides an authoritative and objective survey of the history and current state of all gun-related issues and areas of debate in the United States. Guns in American Society: An Encyclopedia of History, Politics, Culture, and the Law is a comprehensive and evenhanded three-volume reference resource for understanding all of the political, legal, and cultural factors that have swirled around gun rights and gun control in America, past and present. The encyclopedia draws on a vast array of research in criminology, history, law, medicine, politics, and social science. It covers all aspects of the issue: gun violence, including mass shootings in schools and other public spaces; gun control arguments and organizations; gun rights arguments and organizations; the firearms industry; firearms regulation, legislation, and court decisions; gun subcultures (for example, hunters and collectors); leading opinion-shapers on both sides of the gun debate; technological innovations in firearm manufacturing; various types of firearms, from handguns to assault weapons; and evolving public attitudes toward guns. Many of these entries place the topics in both historical and cross-cultural perspective.
Trauma Induced Coagulopathy
Title | Trauma Induced Coagulopathy PDF eBook |
Author | Hunter B. Moore |
Publisher | Springer Nature |
Pages | 802 |
Release | 2020-10-12 |
Genre | Medical |
ISBN | 3030536068 |
The first edition of this publication was aimed at defining the current concepts of trauma induced coagulopathy by critically analyzing the most up-to-date studies from a clinical and basic science perspective. It served as a reference source for any clinician interested in reviewing the pathophysiology, diagnosis, and management of the coagulopathic trauma patient, and the data that supports it. By meticulously describing the methodology of most traditional as well as state of the art coagulation assays the reader is provided with a full understanding of the tests that are used to study trauma induced coagulopathy. With the growing interest in understanding and managing coagulation in trauma, this second edition has been expanded to 46 chapters from its original 35 to incorporate the massive global efforts in understanding, diagnosing, and treating trauma induced coagulopathy. The evolving use of blood products as well as recently introduced hemostatic medications is reviewed in detail. The text provides therapeutic strategies to treat specific coagulation abnormalities following severe injury, which goes beyond the first edition that largely was based on describing the mechanisms causing coagulation abnormalities. Trauma Induced Coagulopathy 2nd Edition is a valuable reference to clinicians that are faced with specific clinical challenges when managing coagulopathy.
Fleisher & Ludwig's Textbook of Pediatric Emergency Medicine
Title | Fleisher & Ludwig's Textbook of Pediatric Emergency Medicine PDF eBook |
Author | Richard G. Bachur |
Publisher | Lippincott Williams & Wilkins |
Pages | 4199 |
Release | 2015-11-11 |
Genre | Medical |
ISBN | 1496326989 |
Before the 1st edition of the Textbook of Pediatric Emergency Medicine published, there was no official pediatric emergency medicine subspecialty in either pediatrics or emergency medicine. This book defined many of the treatments, testing modalities procedural techniques and approaches to care for the ill and injured child. As such, it was written with both the pediatrician and the emergency physician in mind. The Textbook of Pediatric Emergency Medicine, has an entirely new editorial board and templated chapters focusing on evidence-based diagnosis and management of pediatric patients in the ED. The book’s content has been rewritten to eliminate and eliminate redundancy, creating succinct sections that pertain to patient care in the ED. Templated chapters include: Clinical Outcomes/Goals of Therapy Current Evidence Clinical Considerations Clinical Recognition: Triage Initial Assessment Management/Diagnostic Testing Clinical indications for discharge or admission, including parental instructions References In the ED, nurses and physicians work closely as a paired team, thus this edition reflects that partnership and offers content tailored to it. Online ancillaries, found in the bundled eBook, include Learning Links for nursing considerations and clinical pathways that outline the key steps to take when managing critically ill patients.
Strengthening Forensic Science in the United States
Title | Strengthening Forensic Science in the United States PDF eBook |
Author | National Research Council |
Publisher | National Academies Press |
Pages | 348 |
Release | 2009-07-29 |
Genre | Law |
ISBN | 0309142393 |
Scores of talented and dedicated people serve the forensic science community, performing vitally important work. However, they are often constrained by lack of adequate resources, sound policies, and national support. It is clear that change and advancements, both systematic and scientific, are needed in a number of forensic science disciplines to ensure the reliability of work, establish enforceable standards, and promote best practices with consistent application. Strengthening Forensic Science in the United States: A Path Forward provides a detailed plan for addressing these needs and suggests the creation of a new government entity, the National Institute of Forensic Science, to establish and enforce standards within the forensic science community. The benefits of improving and regulating the forensic science disciplines are clear: assisting law enforcement officials, enhancing homeland security, and reducing the risk of wrongful conviction and exoneration. Strengthening Forensic Science in the United States gives a full account of what is needed to advance the forensic science disciplines, including upgrading of systems and organizational structures, better training, widespread adoption of uniform and enforceable best practices, and mandatory certification and accreditation programs. While this book provides an essential call-to-action for congress and policy makers, it also serves as a vital tool for law enforcement agencies, criminal prosecutors and attorneys, and forensic science educators.