50 Percent Increase Recorded
The Chronicle also cites a rise in the number of “triple tragedies” in which three or more fatalities were recorded, increasing by 25 percent between 2010 and 2012. Among the most violent crashes were incidents involving fatigued oilfield workers and fracking crews.
Such incidents have led to Texas Highway 72, an 111 mile stretch of road connecting Three Rivers and Tilden, to be dubbed “death row.” 21 fatal accidents have been recorded along the deadly stretch of highway since 2011 – four of which resulted in three or more deaths.
Texas Auto and Commercial Vehicle Accident Statistics
- According to the Texas Department of Transportation (TxDOT), 3,377 people were killed in auto accidents in Texas in 2012.
- 1,833 of those deaths occurred in rural areas of Texas.
- 232,041 people were injured in auto accidents in Texas with 89,270 sustaining serious injuries.
- TxDOT recorded 29,356 commercial vehicle accidents in 2013.
- These collisions resulted in 531 deaths and 5,798 serious injuries.
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About The Study
On October 11th, the study was presented at this year’s American Academy of Pediatrics (AAP) National Conference and Exhibition by Dr. Joshua Abzug, director of pediatric orthopedics and assistant professor of orthopedics at the University of Maryland School of Medicine.
The elastic bandages associated with the splints often have insufficient mobilization and are applied directly to the skin, therefore causing complications. Although usually minor, these complications can sometimes lead to surgery and longer recovery times.
Other studies have been done regarding the complications of misapplied splints and related topics; however, "rather than just having anecdotal evidence, we wanted to have real data to show the people providing the splints and say, 'We need to make a change,' " said Dr Abzug.
There were 225 children involved in the study, ranging from ages 0 to 18. These patients had splints administered by emergency departments or urgent care facilities. The patients were brought to the pediatric orthopedic clinic where a orthopedic surgeon examined the splint and removed it in order to evaluate the injury along with possible soft tissue complications.
Patients, or the parents of the patients in some cases, were asked to fill out a detailed questionnaire regarding the splint. Questions asked included the name of the type of splint, which healthcare provider and facility placed the splint, and how long had the splint been on the child.
Dr. Abzug noted that the results were much more troubling than anticipated. Furthermore, while no major complications were seen, the minor complications should not be overlooked, especially because of the high incidence rate of misapplication.
- 93% of splints were put on incorrectly.
- 78% had elastic bandages placed against skin.
- 50% of the splints were not the correct length.
Of the 225 patients, 31 had undergone fracture reduction, but the splint was not removed.
Of the 194 patients that had the splint removed:
- 41% had skin and soft tissue complications
- 30% had excessive edema.
- 19% were on pressure points of the skin
- 2% were on pressure points overlying bony prominences.
- 6% caused direct injury to the skin and soft tissue.
Efforts to Reduce Misapplication of Splints
Dr. Abzug has proposed creating a do’s and don’ts chart and instructional cards of proper splint application.
Dr. Theodore Ganley, sports medicine director at Children's Hospital Philadelphia and an associate professor of orthopedic surgery at the University of Pennsylvania School of Medicine, also agrees that posters would be helpful, but he also suggests videos and direct training would benefit the medical community: "Fortunately, kids are resilient. They tolerate splints that aren't perfectly placed, and overall, they respond well to minor skin irritations. If there is a positive, it's that with instruction, those splint placement errors are correctable issues."
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New research over electronic cigarettes and their adverse events may result in new e-cig restrictions.
About E-Cigarettes and Their Effects
According to Medscape, it has been determined that almost one-third of adverse-event reports for e-cigarettes are related to secondhand exposure. E-cigarettes have been marketed as safe and smoke-free yet some studies are contradicting the advertisements.
Studies suggest that exhaled e-cigarette aerosol, which may contain nicotine, metal, and silicate particles, is less toxic than secondhand smoke from traditional cigarettes; however, there is little research on its effects to nonusers. The increase in the number of adverse-event reports reflects the rise in popularity of e-cigarettes as well as the percentage of nonuser reports.
The increase in reports caught the attention of the U.S. Food and Drug Administration (FDA). Dr. Beth Durmowicz, FDA medical officer, states, “We're seeing more and more passive-exposure reports. That was of interest to us.” Researchers examined 90 of the adverse-event reports that were submitted to the FDA between January 1, 2012 and June 30, 2014, of which 33 were nonusers.
Dr. Durmowicz says while the data is difficult to interpret, some of the adverse effects are consistent with nicotine toxicity. As a result, parents are suggested to keep e-cigarettes away from children and avoid using or recharging them near young people, as complaints are consistent with airway irritation, nicotine exposure, and other effects.
Repercussions of E-Cigarette Study
Dr. Durmowicz presented the research at the American Academy of Pediatrics 2014 National Conference and Exhibition and further comments, "We need to start to understand these products better, not only in users, where we have very few data, but also in nonusers.”
Consequently, electric cigarettes might eventually be banned from use in public spaces as with traditional cigarettes. Judith Groner, meeting delegate and attending physician at Nationwide Children's Hospital in Columbus, Ohio, states, "These are just emerging data right now. This is uncharted territory but it has big policy implications, there's this intuitive concept that these things are safe, but do we really know that?" Dr Groner further adds, “We are now seeing all these complaints about respiratory effects. The next step is to do more descriptive research, but by then, the horse is out of the barn."
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