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29 Av 5760 - August 30, 2000 | Mordecai Plaut, director Published Weekly
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Home and Family
Your Medical Questions Answered!
by Joseph B. Leibman, MD

Diplomate, Board Certification of Emergency Medicine

Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua Hospital

Know Your Enemy

Trauma, meaning physical injury, is the biggest killer of young people, and has become an epidemic. Trauma will almost always result in permanent scars, both physical and emotional, and often, because it causes many injuries at once, dangerous conditions can exist which escape our detection because so much is involved at once.

In Israel all physicians must complete a course in trauma life support, and all emergency physicians in the USA must as well. In Israel, special surgeons are certified in trauma treatment, while many other countries have specialized trauma centers. Trauma often requires very specialized radiological studies, and requires the ability to take an unstable trauma patient immediately to the operating room.

Who is at risk? Naturally old people with illnesses are most likely to die from trauma, but the following are also high risk even in the young. Severe head injury, broken neck, patient ejected from vehicle, car versus pedestrian, car versus train, crush injury, high falls, bullet injuries, and water injuries.

Some of these could be preventable by using good common sense. Ejections from vehicles is usually due to not using seat belts. Babies not in baby seats, or on the lap of the driver or passenger are at high risk for tragedy. Head injuries are much less likely in motorcyclists and bikers who wear helmets -- that includes children! Broken necks can be prevented through the use of airbags. Car versus pedestrian can be prevented by teaching children how to cross the street, and not walking in the street (a common Israeli practice). If there is a crossing light, wait for it to turn green.

We sometimes see unfortunate injuries in industrial sites from children playing in unfinished buildings or construction areas. High falls can be prevented by practicing good hiking safety if you are taking a trip into the country, and in the house by installing accordion-like fences at the top of the stairs if you have a crawler at home. Walkers are extremely dangerous since falls down steps have resulted in fatalities.

Summer is a great time for swimming, but remember, whether it be the ocean, pool, a kiddie pool, a river, or even a bathtub, a child should never be left unattended. Swim at places with a lifeguard, take a course in life saving, and use the buddy system of swimming, or leave one member of the party on land to watch while everyone else swims. Take the phone off the hook while bathing a little one.

Lastly, rocks are not toys, and neither are cars. Speed kills, and so does fatigue. Drive defensively, and if you find your young adult driving in an unsafe manner, don't let them drive. I hope I don't need to tell any of my readers that if you have drunk even a small amount of an alcoholic beverage, stay away from driving.

I don't think I have given you any new information, but if that was entirely true there would be a lot less trauma. Write me in care of the Yated.

A note from Glaxo, sponsor of this column: Glaxo technology has resulted in an antiviral that is effective against cold sores, chicken pox and the shingles: Valtrex. Once again, there is hope -- from Glaxo.

 

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