ISSN:
1432-1246
Keywords:
Key words Occupational accidents
;
Traumatic-hemorrhagic shock
;
Emergency treatment
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract The study investigates the quality of the management of occupational accidents and of accidents on the way to or from work. Special consideration is given to the prevention and effective early treatment of traumatic-hemorrhagic shock, which in serious accidents is often the pathophysiological cause of reversible or irreversible damage of organ systems, disability or death. In a series of 725 consecutive occupational accidents, accidents on the way to or from work and road accidents over a period of 2 years, and in 31 additional individual cases, the emergency treatment and further care of patients with incipient or advanced shock were examined. Assessment was based on protocols of initial emergency treatment and medical records of further hospital care. Specific attention was given to the development of shock-induced organ damage. When the emergency physician arrived at the site of the accident, of the 725 cases, 82 patients showed early signs of shock, 37 were in advanced shock, and 24 were dead. In accidents with early intervention of experienced medical personnel, securing of the airways, control of bleeding and sufficient substitution of volume and oxygen were usually done professionally, but analysis of the management of other cases showed delays and various shortcomings. In 25% of those who died, protracted circulatory shock due to insufficient volume substitution was the cause of death. Occupational rehabilitation failed in two thirds of the patients with advanced shock, but only in one third of the patients with incipient shock. The study demonstrates that immediate intervention by non-professionals in first aid, rapid arrival of the emergency care team, sufficient volume and oxygen substitution along with other emergency measures, and rapid transport to an appropriate trauma care facility, all improved the prognosis of the accident victims. Specific areas for improvement in the management of accident victims were found, especially in co-operation and co-ordination among non-professional first aid providers, occupational health and auxiliary personnel, and emergency medicine professionals.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/PL00014212
Permalink
