All posts by TheTraumaPro

FebruaryTraumaMedEd Newsletter

The February newsletter is here! Click the image below or the link at the bottom to download. This month’s topic is Prevention, providing information on:

  • EAST evidence-based review on distracted driving
  • New developments on distracted driving
  • Can texting bans be bad?
  • Distracted driving and police officers
  • Reporting unsafe drivers
  • Seat best use in trauma professionals

Subscribers had the newsletter emailed to them over the weekend. If you want to subscribe (and download back issues), click here.

Download the newsletter

A Million Ways To Die?

Some interesting facts on how likely you or your patients are to die from a given cause this year:

  • choking on a non-food object – 1 in 96,300
  • drowning in a bathtub – 1 in 724,900
  • firearm discharge – 1 in 4,101,000
  • contact with a powered lawnmower – 1 in 4,606,000
  • strenuous movement – 1 in 23,030,000
  • handheld power tool accident – 1 in 24,950,000
  • contact with hot food (?) – 1 in 74,850,000
  • escalator accident – 1 in 90,470,000
  • vending machine accident – 1 in 112,000,000
  • win the Powerball (sorry, this won’t kill you) – 1 in 175,223,510
  • shark attack – 1 in 251,800,000
  • noise exposure (?) – 1 in 281,400,000
  • fall from playground equipment – 1 in 299,400,000
  • scorpion sting – 1 in 299,400,000

Motorcyclists Just Aren’t What They Used To Be

Used to be, motorcyclists were young men riding modest machines. But I’m sure all of you have noticed the changing demographic. Nowadays, they tend to be middle aged (or older!) men, who are losing their hair, growing their waistline, and taking warfarin.

At the same time, I’ve noted more significant injuries from motorcycles, and deadlier outcomes. A recent study has now quantified this and confirmed my impression. Brown University researchers analyzed data in the National Electronic Injury Surveillance System, focusing on the injuries and outcomes of motorcycle crashes over an 8 year period.

Some of the more interesting tidbits:

  • Of course, most injured riders were male (86%)
  • Injuries occurred most frequently in younger age groups, and least frequently in older age groups
  • Odds of having injuries requiring hospitalization doubled in the middle age group (40-59), and tripled in the older age group (60+)
  • Similar trends were seen in injury severity as age increased
  • The number of injuries in middle aged riders increased 62% from year 1 to year 8
  • The number of injuries in older riders increased 247% during the study!
  • Injuries in the middle aged and older groups tended to be upper torso and head/neck

Bottom line: Subjective impressions of injury trends in older motorcycle riders are borne out by this study. Why? As we age, we have less reserve, more comorbidities, loss of elasticity and bone density, and a host of other lesser factors. Additionally, older riders can often afford more expensive (“better”?) bikes that may tax their ability to ride safely in unexpected conditions. Trauma professionals need to be aware of these trends and always treat these patients as if they have life-threatening injuries until you can prove otherwise.

Related posts:

Reference: Injury patterns and severity among motorcyclists treated in US emergency departments, 2001–2008: a comparison of younger and older riders. Injury Prevention, ePub Feb 6, 2013.

Technology: More On Bioprinting Body Parts

I believe that bioprinting (using 3D printers to create organs, skin grafts and other stuff we need) will be the next big thing. Lots of people are working in the field now, and the printed products are getting much more sophisticated. 

Tracheas and bladders have already been done. But now, how about an ear? Loss of an ear is very disfiguring and, like other injuries to the head and face, can create a fair amount of psychological trauma. Bioengineers at Weill Cornell Medical College have now printed an ear that is nearly indistinguishable from the ones we are born with.

Bioprinter creating an ear encapsulated in hydrogel.

The technique used here is a little different than others I have described. In this case, a digitized image of the subject’s other ear is used to print a “negative”, actually a mold that can create the new ear. The mold is filled with a collagen mixture (from rat tails!), and then injected with cartilage cells (from cows!). The collagen serves as a structure over which the cartilage can grow. 

The whole process is fast. It takes half a day to model the mold, a day to print it, 30 minutes to inject the gel, and the ear is ready 15 minutes later. Obviously, it has no skin so must be implanted under a prepared skin area in the patient. Over a few months, the cartilage grows and replaces the collagen within the ear. 

The next step is to use human collagen and cell cultures. Ideally, if the patient can be the source, there should be no chance of future rejection. Expect more advances in this technology creating more ways to rebuild our patients.

Related posts:

Reference: High-Fidelity Tissue Engineering of Patient-Specific Auricles for Reconstruction of Pediatric Microtia and Other Auricular Deformities, PLoS ONE, 2013, DOI: 10.1371/journal.pone.0056506.