Trauma Monthly
Volume:25 Issue: 2, Mar-Apr 2020

Ipsilateral fractures of the femur and tibia result in a flail knee joint condition referred to as “floating knee”. Associated knee ligament injuries are common and have been reported to be frequently missed in initial evaluations. We report the diagnosis and treatment of the concomitant patellar tendon rupture during fixation of the distal femur and proximal tibia fractures in a patient who presented with floating knee and a history of osteomyelitis. This case further highlights the paramount importance of careful assessment of the knee in patients who present with floating knee injuries. We also recommend that MRI and ultrasonography be used to prevent ignored patellar tendon ruptures in such patients; particularly when physical exam is challenging or an intra-articular injury is present.

Severe musculoskeletal injuries, resulting in bone and soft-tissue loss, are often caused by high-energy trauma (i.e. falling from heights and road accidents), and many ultimately lead to extreme limitations in motor functions due to fracture complications or amputations. Traumatic bone injuries are very rare in children and are usually detected following open fractures, and their initial or delayed treatment depends on the conditions of the patient’s soft tissue. Here, a rare case of A 13-year-old male patient was referred to the under study hospital due to a roll over car accident with a crush injury, both-bone fracture of the forearm, and radius defects, and the spontaneous repair of the post-traumatic radius defect healing without delayed intervention is presented.

Prisoners of War (POWs) undergo different physical and/or psychological tortures. According to the Third Geneva Convention, each government is obliged to protect POWs from any harm, especially torture. Although torture of POWs has been considered in international documents such as the 3rd Red Cross Convention for Prevention of Torture, this issue seems to have been ignored so far. Thus, the current article discusses this issue.

This review aimed to describe an important, yet neglected, way to protect POWs from torture.

The behaviors of Iraqi and Iranian authorities toward the soldiers that were selected to take care of POWs were compared. This review study is based on a narrative search that included articles published on the Iraq-Iran war (1980-88).

According to international laws, there is no ethical justification for the torture of POWs, especially after many years of captivity. During the Iraq-Iran war, Iraqi authorities recruited soldiers who had been harmed in some way by the war to handle Iranian POWs. The presence of war victims as care providers to POWs in detention camps may provide grounds for the torture and maltreatment of POWs.

Prohibiting the presence of war victims in detention camps could be one important and effective way to protect POWs from torture and maltreatment.

Communication increases awareness of patient problems, productivity and job satisfaction, improving decision-making in patient discharge and transfer, and reducing hospital stay duration, medical costs, and nurses’ stress and burnout.
This study aimed to audit the communication of nurses with trauma patients in the emergency department.
This quasi‑experimental study was conducted at the Baqiyatallah University of Medical Sciences in 2018. The data collection tool was a valid and reliable checklist for nurses' communication skills with trauma patients with 3 subscales and 31 items. Before the intervention, 35 nurses who were randomly selected were evaluated based on the communication checklist, and then the collected data was analyzed. Based on the results and the assessment of weaknesses, the necessary training was provided to the nurses. After the intervention, the participants' communication skills were analyzed using the same checklist and the results were compared. Descriptive statistics and parametric tests such as paired T-test were used to analyze the data.
The means age of participants was 39.5±9.3 years, and the majority of them were males.The mean scores of communication status before and after intervention were (10.00±3.29) and (26.26±2.30), respectively, among the 35 participating nurses. There was a significant difference between pre-and post-intervention (p <0/001) in terms of total communication skills scores, indicating the effectiveness of the intervention.
The audit of nurses' communications with patients in the emergency department as well as training based on the improvement of weaknesses may be effective in improving nurses’ communication skills, and this may promote the level of communication skills, behavioral changes, and positive effects on the clinical situation of trauma patients.

Arbaeen is one of the world’s largest religious gatherings. It is held in Karbala, Iraq, and can pose many significant challenges to the health of pilgrims and the host population as well as the health system of Iraq. The present study was conducted to reflect an overview of the health-related challenges associated with the Arbaeen ceremonies. This qualitative study was conducted from October 6 (ten days before Arbaeen ceremonies) to October 16, 2019, in Najaf, Karbala, and the route pilgrims walk in Iraq. Semi-structured and in-depth interviews were conducted with disaster and emergency specialists, health experts, nurses, general physicians, and specialist doctors. Twelve experts and six pilgrims were interviewed. Thematic analysis was used to analyze the data. The findings were categorized into three main groups: treatment issues, public health, and infrastructure. The main complaints pilgrims had were bone and joint pain, muscle spasms, headache, toothache, pharyngitis, rhinorrhea, and common cold, purulent throat, and gastrointestinal symptoms. The main problems of those with chronic conditions included having forgotten to take medications or running out of medications. Food and water safety and sanitary conditions were inappropriate. Iraq’s health system was not prepared to fulfill the health needs of the people at such a gathering. Arbaeen ceremonies impose a heavy burden on Iraq’s healthcare system and cause numerous health challenges. Moreover, Iraq’s healthcare system does not have the capacity or readiness to meet the challenges of this event; international aid from the countries whose citizens attend the event are needed. Although the Iranian Red Crescent cooperated extensively, the collaboration must be more coordinated and broadened.

Many people suffer from burn injuries annually. Epidemiologic studies are necessary to reveal the prevalence and related factors of burns to assist in designing an appropriate plan to reduce its mortality and morbidity. This study aimed to analyze the epidemiology and etiological factors of 1938 burn patients admitted to a burn unit in Qazvin, Iran. This was a retrospective study of medical records of patients admitted to the burn unit of Shahid Rajaee Hospital from March 21, 2014 to March 20, 2016. The collected data included age, gender, percentage of burns, etiology, date of admission, date of discharge, and total burn surface area (TBSA). Descriptive statistics were used to describe the basic features of the studied variables. The mean age of the 1938 burn patients was 29.08±20.52 years. The results showed that more males (n=1391, 71.8%) than females (n=547, 28.2%) were involved in burn injuries. Fire flame (n=1019, 52.6%) and scald (n=529, 27.3%) were major etiological factors of burns. Adult males (n=458, 23.6%), and preschool boys (n= 407, 21.0%) were at the highest risk for burn through the study period. The mean total body surface area (TBSA) was 13.34 (SD ±12.40) ranging from 1% to 9%, and burns of less than 20% TBSA represent the large majority of burns (n=1653, 85.3%). This study indicates that the majority of burn injuries were of the fire flame and scald types. Preventive programs targeting the population under higher risk of burns are needed to reduce the burden of burns.

Natural and man-made disasters have significant effects on the physical, psychological, and emotional health of society. Nurses play an essential role in disaster management. Therefore, nurses should have specific core competencies to provide care for affected people during disaster situations. This study aimed to assess hospital nurses’ disaster competencies in such situations. This cross-sectional, descriptive study was conducted using a self-report questionnaire that included 50 questions on NCDS (Nurse Competence Disaster Scale) in four domains. The questionnaires were distributed among 142 nurses working in three teaching hospitals in Kerman, Iran, in 2018. The average percentage scores of nurses on their responses to questions in the domains of management, ethical aspects, personal aspects, and technical aspects of disaster competencies were 39.76%, 19.53%, 32.02%, and 75.06%, respectively. In multiple regression analysis, nurses’ participation in maneuvers and their work experience exerted the strongest influence on disaster nursing core competencies. Nurses who had practice during maneuvers had higher competency scores by 19.63 units than those who had no practice (p=0.0001). Moreover, the competency scores of nurses with more than 11 years of work experience were higher by 11.42 units than the others (p=0.0001). According to the results of the current study, strategies such as disaster drills and continuing education programs need to be developed for nurses to improve their disaster core competency.