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Missed injuries contribute to increased morbidity in trauma patients. A retrospective chart review was conducted of pediatric trauma patients from 2010 to 2013 with a documented missed injury. A significant percentage of missed injuries were identified (3.01% during July 2012 to December 2013 vs 0.39% during January 2010 to July 2012) with the addition of acute care trained pediatric nurse practitioners to the trauma service at a pediatric trauma center. The increase is thought to be due to improvement in charting, consistent personnel performing tertiary examinations, and improved radiology reads of outside films. Language: en

In order to establish effective suicide preventive programs, it is important to know the etiologic factors and causal relationships between suicide and behavior. Coroner data was analyzed for the 468 suicides that occurred in Indianapolis, Indiana during 1998-2001. The age-adjusted suicide rate was 14.08 per 100,000. Almost one-half of the victims had a mental illness and 26% had a history of alcohol/substance abuse. The leading risk factors for suicide were age, impaired health, psychosocial stressors, and access to firearms. This information can be used by health departments and mental health professionals to help reduce suicide.

Child passenger safety has been a major public health victory, but there is still work to be done. This case presentation is about a 5-year-old boy who placed the shoulder portion of the lap-shoulder seat belt behind his back who was recently killed in a motor vehicle crash. This article reviews what trauma nurses need to know about the latest improvements in child passenger safety practices. Also presented are important resources for trauma nurses to share with families to improve travel safety.

The recidivism rate for violent injuries in the United States has been reported as high as 45 per cent. Based on a retrospective review, the 5-year recidivism rate at the Indiana University/Wishard Trauma Center is 31 per cent, and the 1-year recidivism rate is 8.7 per cent. Individuals who have been admitted with a violent injury are screened by one of the Prescription for Hope (RxH) support specialists (SS). If the individual consents to participate, the SS conducts an in-depth assessment of risk factors. The SS and participant identify personal goals and develop a tailored service plan, which is outlined in a formalized agreement. In the first year of the RxH program (June 1, 2009, to May 31, 2010), 64 patients were enrolled. The most-often referred community services are in the category of social integration (84%). The SS have a 99 per cent success rate in getting clients to initiate services; 82 per cent have completed the services and 12 per cent are still using the services. As of the time of this writing, 34 subjects have been in RxH for at least 1 year. One patient returned to the trauma center in September 2010 with a repeat violent injury; this represents a 2.9 per cent 1-year recidivism rate. In the first 12 months of our program we did not have any participants return with a violent injury (0% recidivism), and we have only had one patient return to date. We conclude that the RxH SS model may play a significant role in decreasing the recidivism of violent injuries.

BACKGROUND: Suicide is an important public health concern. Firearms are the most common mechanism of suicide death. This study describes the epidemiology of fatal and nonfatal firearm suicide injuries (FSI) in one metropolitan area from 2002 through 2004 using a firearm injury surveillance system. METHODS: Records were obtained of all victims of firearm injuries from hospitals, police, and the coroner. All injuries categorized as suicide were included. RESULTS: Local age adjusted suicide rates were significantly higher than state or national rates for ages 15 to 24, and significantly higher than national rates for ages 25 to 44. Men were FSI victims more than five times as often as women were. There was no seasonal pattern identified. Handguns were used nearly three out of four times. Eighty-six percent of FSI victims died, two-thirds at the scene. Most wounds were in the head or chest. Mental illness or relationship problems were common. Most suicides occurred in a residence. CONCLUSIONS: Community level firearm injury surveillance effectively identifies local trends that may differ from national statistics. Collaboration among various groups is used to support injury prevention programs. These data can both complement and contribute to national statistics. Language: en