22nd European Congress of Trauma & Emergency Surgery

Chairs

Prof. Dr.

Difference between emergency doctor and trauma team doctor in dealing with minor injury of disaster: One local hospital review of Taiwan

Abstract text (incl. references and figure legends) Introduction: Simple triage and rapid treatment(START) is used as triage method in these disasters and green status patients is the most in accidents. The more medical consultation combine with more emergency room(ER) stay duration.In this study the function and efficiency of emergency physicians will be discussed and want to know how to change this condition. Material &amp; Methods: This is one cross-sectional study of single hospital. Under START method green status of accidents patients are included. The consultation frequency, medical management duration and ER stay duration are compared between ER and trauma team physicians. The Mann-Whitney Test, Spearman's correlation analysis, Regression analysis and odds ratios are used for statistics analysis. The 23th SPSS is used in statistics. Results: 53 patients of are included. 14 patients are under the service of trauma team physicians. ER Physicians take over 39 patients. Spearman's correlation analysis and regression analysis show that longer medical management duration combine with longer ER stay duration. In Mann-Whitney Test trauma team physicians take more consultation with longer ER stay duration noted. The odds ratio for the difference of medical management duration and ER stay duration between two groups are 37.636 (95% CI, 4.437–319.254; P &lt; 0.05). Conclusions: Emergency doctors are more familiar with the disaster response. The trauma physician induces the more consultation that is combined with medical management duration and ER stay duration. The manpower should be separated into multiple functional groups and emergency physicians are cooperated with other specialists in dealing with these victims. The ineffectual consultation will be decreased and ER jam condition can be improved References: K. Goniewicz, M. Goniewicz, F.M. Burkle et al The Impact of Experience, Length of Service, and Workplace Preparedness in Physicians" Readiness in the Response to Disasters J. Clin. Med. 9: 3328, 2020Disclosure: Do you have a significant financial interest, consultancy or other relationship with products, manufacturer(s) of products or providers of services related to this abstract? (If not, please enter "No" in the text field.) No

Disaster and military medicine

Education

Poster

The effects of a long and uncertain surgical appointment on the pre-operative psychological status of patients awaiting arthroscopic knee surgery

Abstract text (incl. references and figure legends) Introduction Postponements of surgery present a constant challenge for both the healthcare system and patients, which can have many adverse effects on patients&quot; health. Due to the COVID-19 pandemic, the number of postponed surgeries has multiplied, something unseen in recent decades. Patients" preoperative anxiety can be traced back to a wide range of reasons, to which the pandemic also contributed. Material &amp; Methods 83 patients between the ages of 18 and 60 waiting for arthroscopic knee surgery registered at the Traumatology Department of the University of Szeged were included in the study on an anonymous, voluntary basis. The study group included 54 patients whose surgery was postponed one or more times during the second or third wave of the pandemic, or whose surgical appointment was postponed. The control group consisted of 29 patients whose complaints arose after the end of the third wave of the pandemic, and whose doctor, after the necessary examinations, planned and booked their surgery. Patients filled out the WBI-5, STAI, PSS, RS questionairs. Results According to the results, there is a significant difference in the level of well-being, perceived stress and anxiety among patients who experienced mood changes due to the pandemic situation, compared to those who did not. Patients whose surgery had been postponed several times are characterized by worse well-being and higher anxiety. The duration of the surgical postponement does not influence the psychological state of the patients.In terms of anxiety, including trait and state anxiety, the highest score was shown when the notification of the surgical postponement was provided by assistants, followed by doctors, while the lowest level of anxiety was shown when postponement was reported by email notification. Conclusions The patient"s problem is not primarily with the long appointment time interval, but instead with the need to mentally prepare for the surgery at each instance, and to then process the disappointment caused by the postponement.Disclosure: Do you have a significant financial interest, consultancy or other relationship with products, manufacturer(s) of products or providers of services related to this abstract? (If not, please enter "No" in the text field.) No

Prof.

Application of transosseous extrafocal osteosynthesis in the treatment of gunshot injuries of the limbs

Abstract text (incl. references and figure legends) Introduction The aim of the study is to show the effectiveness of the use of external fixation devices as an intermediate stage in the treatment of gunshot injuries of the limbs with long bone fractures and soft tissue defects in order to track the dynamics of soft tissue healing and to resolve the issue of the further choice of final fixation. Preventive immobilization using external fixation devices is performed: in cases of multiple fractures of long tubular bones with contusion or extensive soft tissue defects in the first hours after hospitalization in the system of mandatory anti-shock measures; in case of a combined or combined injury, especially if vital indications require surgical treatment of the chest and abdominal organs. Materials &amp; Methods Transosseous extrafocal osteosynthesis with Kostyuk's rod devices for gunshot and mine-explosive fractures of long tubular bones was performed in 27 patients. Explosive mine fractures prevailed - 17 cases, gunshot shrapnel fractures - 10. Localization of injury: tibia - 12, femur - 8, humerus - 7. Results Postoperative infectious complications were found in 7 (25.9%) patients who underwent limb amputation. Another 20 patients underwent autoplasty or alloplasty of bone defects with periosseous or intramedullary osteosynthesis after skin and soft tissue healing. If necessary, skin plastic or skin-muscle flap plastic is also applied. The functional result of the limb after the use of external fixation devices was on average - 65.4%. Conclusions The simplicity of the design of rod devices, convenience and speed of use provide the possibility of correction and reposition of bone fragments during treatment, and if necessary, replacement of preventive immobilization with treatment by other methods. References Manual on the technique of osteosynthesis with AZF-K external fixation devices / A.N. Kostyuk - K.: Lazurit-polygraph LLC, 2015. - 144 p.Disclosure: Do you have a significant financial interest, consultancy or other relationship with products, manufacturer(s) of products or providers of services related to this abstract? (If not, please enter "No" in the text field.) No

Emergency surgery

Distal extraarticular and minimally dislocated intraarticular fractures of the tibia

Abstract text (incl. references and figure legends) Introduction. Operative treatment of fractures of the distal third of the lower leg continues to be a debatable topic in the specialized literature. These are high-energy injuries at a young age caused by height, sport trauma or road accidents. Material and method. For the set goal, we followed 19 patients operated on in our clinic for the period from May 2021 to June 2022 (1 year and 2 months). Thirteen of the patients were men and six were women. The average age for men is 44.3 years and for women 61.5 years. In men, high-energy altitude injuries from parachute jump predominate, and in women- twisting injuries with a fixed foot, mainly ski trauma. 18 of the patients underwent delayed emergency surgery within 3 to 6 days of trauma after critical reassessment of soft tissue status. In one of the patients, the insertion of an external fixator was necessary due to the development of bullous edema, which necessitated a two-stage osteosynthesis. Results. All patients were followed functionally and radiographically up to 6 postoperative months. We reported complete bone union radiographically between 4 and 6 months, a mean of 95 points on the AOFAS point scale with a maximum score of 100. We used the Karlstrom-Olerud criteria to report functional outcomes. We registered excellent results in 12 patients, good in 6 and poor in one patient. There was no patient with nonunion in our series. In four of the patients, we observed soft tissue complications, within the framework of delayed healing of the operative wounds. A deep bone infection was found in one patient, necessitating premature removal of the osteosynthesis material. Conclusion. Extra-articular fractures of the distal tibia are a pathology that requires special attention and a surgical approach to the soft tissues. This is determined by the anatomy of the area and addressing the soft tissue trauma is the key to proper bone healing.Disclosure: Do you have a significant financial interest, consultancy or other relationship with products, manufacturer(s) of products or providers of services related to this abstract? (If not, please enter "No" in the text field.) I have no financial interest.

Skeletal trauma and sports medicine

A group casualties, as a fire burn mass disaster

Abstract text (incl. references and figure legends) Introduction Doctrine of a burn disaster management is mostly organised and planned by military – sanitary authorities and civil disaster health care services. Regarding a disaster fire/burn plan, a Burn centre must be able, by a law, to admit a group of fire/burn victims 24 hours a day. There is no exact consensus how many patients could be hospitalised. If a Burn centre seems to be overloaded, some triaged victims must be transported to other burn units. Nearly every five years we come across with a burned group hospitalisation and the last one is analysed. Material &amp; Methods Six burned patients were admitted to a Ljubljana Burn centre due to a dust explosion in a tyre factory. In emergency ward they where triaged as 1 outpatient burn, 3 minor burns and 2 big burns. At start, they had been transported by ambulances of an urgent medical care service. By a rescue scheme it was still a micro level. There was no need for extra additional emergency support. One patient was directed to a clinics, 5 of them were admitted to a Burn centre department. Two patients with major burns were intubated and transferred to an intensive care unit (ICU). Three minor burn patients had entered parallely a department through a non-ICU, where they were treated by a surgeon. Results It must be stressed, that a double-lane enter of victims had shortened a time of acceptance. There was a successful cooperation of a plastic surgeon and anesthesiologists. In surgical working process a plastic surgeon on call was mobilised for wound toileting and getting patients ready for surgery next day. Some ward and scrub nurses were mobilised for additional help. Next day a primary surgery of major burns was done, while minor burns were operated in the next five days. All burned victims survived. Conclusions Burn centre must be ready for a group burn disaster. Outer vertical communication and inner horizontal action must be guaranteed with full responsibility and self sacrifice of a staff.Disclosure: Do you have a significant financial interest, consultancy or other relationship with products, manufacturer(s) of products or providers of services related to this abstract? (If not, please enter "No" in the text field.) No

Medical particularities in victims management and evacuation operations during coastal disasters. The use of new technologies as prediction and prognosis multiplier

Abstract text (incl. references and figure legends) This study object is to search the role of new technologies during health crisis management from the Health Units in Coastal disasters. This presentation aims to review the existing technologies and to compare if they exist in the Hellenic and international guidelines and planning. The existence of this kind of technologies seems more and more obligatory these past few years, since there is an increase in the number and severity of disastrous events and health crises. Every society and public service needs to be armored against this kind of danger. First Response Systems, public hospitals and health units, even more so, as they are in the front line, absorbing the majority of consequences, created by mass casualty incidents. Hellenic dogma and preparedness plans are based in the principles of management of a major event that were established in order to follow the Olympic Games of 2004 standards and specifications. Some improvements have been made from then, due to the flood and megafires disasters especially the last years, making the use of such technologies essential and bounden. Hence, new suggestions and additions to the already existing form are proposed in order to have a modern, drastic and effective total health crisis management.Disclosure: Do you have a significant financial interest, consultancy or other relationship with products, manufacturer(s) of products or providers of services related to this abstract? (If not, please enter "No" in the text field.) No

Poster Session 1
Disaster and military medicine

Appointment

Chairs

Programme

Poster Session 1Disaster and military medicine

Appointment

Chairs

Programme

Poster Session 1
Disaster and military medicine