Search Results (44)

Background/Objectives: Cervical spine injuries (CSIs) are life-threatening conditions commonly resulting from road traffic accidents and falls; improper first aid management can significantly worsen neurological outcomes. Public awareness and correct first aid response are critical for preventing secondary injury; despite this, available data from the southern provinces of Saudi Arabia remain insufficient. This study aimed to assess public awareness and first aid preparedness for CSIs across four southern regions of Saudi Arabia. Methods: A cross-sectional design was employed across multiple regions, encompassing 1179 adults from Jazan, Aseer, Al-Baha, and Najran between 2025 and 2026. A validated online questionnaire was employed for data collection to assess CSI awareness, recognition of injury signs, and appropriate first aid responses. Awareness scores of ≥60% were classified as good. Multiple linear regression analysis was performed to identify independent predictors of awareness. Results: The mean awareness score was 16.0 ± 4.8 out of a possible total of 20 points, corresponding to 80% of the total score, with 87% of participants demonstrating good awareness. The majority of respondents recognized the importance of spinal immobilization (89%), maintaining head–neck alignment (95%), and contacting emergency services before intervention (93%). Correct responses to emergency scenarios were recorded in 83% of participants. Notably, only 39% had attended formal medical or trauma training, and merely 3% reported real-life first aid experience. Training attendance (β = 1.39, p < 0.001) and marital status (married; β = 1.37, p = 0.004) were identified as independent predictors of higher awareness scores. Conclusions: Although general public awareness of CSI first aid is high, formal training participation remains critically low, revealing a substantial gap between knowledge and practice. Integrating structured first aid training into community, workplace, and primary healthcare settings is essential to improve trauma outcomes and reduce preventable disability. Full article

Care home staff are routinely exposed to stressful and traumatic events, increasing risks of psychological distress, burnout, and reduced workforce resilience. Psychological First Aid (PFA), recommended by the World Health Organization, provides an evidence-based framework for delivering immediate emotional and practical support; however, its adaptation for care home contexts is limited. This study aimed to co-produce and adapt an existing PFA training resource for care home staff using a person-based approach (PBA) to enhance contextual relevance, acceptability, and feasibility. A two-phase qualitative design guided by PBA principles was used. Phase 1 integrated stakeholder workshops, semi-structured interviews, and literature review to generate guiding principles, a logic model, and preliminary training content. We adapted the WHO PFA “Look–Listen–Link” framework alongside existing open-access materials. Phase 2 used think aloud interviews to optimize usability and contextual fit. Thematic and sentiment analysis identified key needs: high exposure to traumatic events, inconsistent organisational support, desire for measurable skill development, the importance of transferable competencies, and motivational factors. Participants emphasized the need for flexibility, inclusivity, and realistic care-home-specific examples. Adaptations included bite-sized interactive modules, blended delivery options, and reflective exercises. The final co-produced intervention aligns with trauma-informed principles and organisational realities. Further work is needed to access feasibility, acceptability, and fidelity in real-world settings, offering a transferable model for adapting psychological interventions in other high-stress care environments internationally. Full article

Background/Objectives: Traumatic dental injuries (TDIs), particularly avulsion, require immediate and appropriate first aid to ensure favorable outcomes. Adolescents are often the first responders during school or sports activities, yet their preparedness remains unclear. This study aimed to assess the knowledge, attitude, and awareness of adolescents regarding the emergency management of TDIs. Methods: A descriptive cross-sectional survey was conducted among 400 adolescents aged 15 to 18 years from four randomly selected colleges in Mangaluru, Karnataka. A structured, validated 16-item questionnaire assessed demographic characteristics and domains of knowledge (6 items), attitude (6 items), and awareness (6 items). Data was analyzed using descriptive statistics, chi-square tests, and one-way ANOVA. Results: The mean knowledge score was 2.50 ± 1.04 (95% CI: 2.40–2.60), indicating limited knowledge of dental trauma management; only 26.3% of participants recognized that avulsed permanent teeth can be replanted and 7% identified an appropriate storage medium. The mean attitude score was comparatively high (4.38 ± 1.12; 95% CI: 4.27–4.49), with 88.8% of students willing to assist an injured peer, reflecting a large attitude–knowledge discrepancy (Cohen’s d = 1.47). The mean awareness score was 2.24 ± 1.24 (95% CI: 2.12–2.36), indicating limited awareness of preventive practices, including low mouthguard use (11.5%). Shapiro–Wilk testing confirmed non-normal distribution of KAA scores (p < 0.05); accordingly, non-parametric analyses showed no significant differences across schools, academic streams, gender, or education level (Kruskal–Wallis and Mann–Whitney U tests; p > 0.05). Conclusions: Despite favorable attitudes toward assisting peers, adolescents demonstrated limited knowledge and awareness regarding the emergency management and prevention of traumatic dental injuries, particularly in tooth replantation, appropriate storage media, and mouthguard use, highlighting the need for targeted, school-based dental first-aid education programs. Full article

Introduction: Ureteral stents are widely used in the specialty of urology to preserve renal function and provide ureteral patency in cases of urolithiasis, strictures, malignancy, and trauma. This paper presents a novel application of prophylactic ureteral stents deployed under MRI-guidance for ureteral protection in the setting of in-bore salvage cryoablation therapy for recurrent and metastatic prostate cancer. This is the first known case series of ureteral stent placement using near real-time MRI. Materials and Methods: A retrospective chart review was performed for all patients who underwent MRI-guided ureteral stent placement prior to in-bore cryoablation therapy from 2021 to 2022. Each case was managed by an interdisciplinary team of urologists and interventional radiologists. Preoperative and postoperative data were collected for descriptive analysis. Physics safety testing was conducted on the cystoscope and viewing apparatus prior to its implementation for stent deployment. Results: A total of seven males, mean age 73.4 years (range 65–81), underwent successful prophylactic, cystoscopic MRI-guided ureteral stent placement prior to cryoablation therapy of their prostate cancer. No intraoperative complications occurred. A Grade 2 postoperative complication of pyelonephritis and gross hematuria following stent removal occurred in one case. The majority of patients were discharged the same day as their procedure. Conclusions: This case series demonstrates the feasibility of in-bore cystoscopic aided MRI guidance for ureteral stent placement. Ureteral stents can be used to increase the safety margin of complex cryoablation treatments close to the ureter. Furthermore, by following the meticulous MRI safety protocols established by MRI facility safety design guidelines, MRI conditional tools can aid therapy in the burgeoning interventional MRI space. Full article

Marine mammals may be particularly vulnerable to climate change. While some climate-change-induced impacts on these species have been recognised, the potential consequences of storminess have been less well-defined, and understanding of its significance largely relies on anecdotal evidence. To quantify the relationship between storminess and its possible impacts on grey seal pups (Halichoerus grypus), data from marine wildlife rescue databases and hospitalisation records (2015–2024) within the British Isles were examined (n = 20,686). Daily mean windspeed was used as a proxy for storminess. Significant relationships were found between storminess and pups presenting with malnourishment, head trauma, flipper injury, other wounds, and infections. This study provides the first empirical evidence of the explicit impacts of storminess on seal pup health, with all the presenting conditions increasing and higher rates of call-outs and pup admissions to rescue centres following stormy weather also recorded. Given the predicted increase in storm severity, these findings will aid rescue and rehabilitation planning by helping to predict when rescuers can anticipate increased admissions and the potential injuries that pups may experience following storms. The potential significance to the long-term conservation of the species is also highlighted. Full article

Background: Ophthalmic emergencies are acute conditions that progress rapidly, posing a significant threat to a patient’s vision and requiring urgent intervention to prevent permanent visual impairment. This study aimed to assess the general awareness of ocular chemical burns and the adequacy of the immediate response measures while also seeking to improve the understanding of these injuries and contribute to promoting a healthier society. Methods: A comprehensive literature review was performed, and the most frequently reported questions were incorporated into the original survey. An anonymous questionnaire, available both online and in print, was developed to conduct a cross-sectional study to assess the general knowledge of the causes, symptoms, and appropriate first aid measures to be applied in cases of chemical ocular trauma. Results: Between April and May 2024, 175 individuals completed the questionnaire and were included in the study. More than half (54%) of the tested population demonstrated a poor level of knowledge about chemical ocular injuries, and only 30.9% of the respondents correctly indicated the need for imminent treatment. Twenty percent of the respondents could not identify whether alkalis or acids are more hazardous. Additionally, 5.7% of the respondents falsely considered consultation with an emergency department a priority before thorough irrigation. Most of the respondents (60.6%) incorrectly indicated that the appropriate first aid measures and treatment depend on the substance involved, and 68.1% of the respondents stated that treatment in the emergency department should be delayed, allowing for anamnesis collection and thorough examination. Conclusions: Ocular chemical injuries can substantially impact an individual’s quality of life. The present study found that the public knowledge concerning ocular chemical trauma, and the necessary immediate treatment is insufficient. Public education is vital, as delaying prompt and thorough irrigation at the chemical injury site may result in irreversible complications. Full article

Epistaxis, commonly referred to as nosebleeds, is a frequent clinical presentation with etiologies spanning from localized trauma to systemic conditions and medication effects. Despite its high prevalence, management approaches vary significantly depending on the cause and severity. To provide a comprehensive review of current management strategies for epistaxis, focusing on initial interventions, evaluation techniques, and preventive measures. A structured review of the literature was conducted to identify effective strategies for the initial management, evaluation, and prevention of epistaxis. Emphasis was placed on practical applications for clinicians in both emergency and outpatient settings. Initial Management: Direct pressure and topical vasoconstrictors remain the first-line interventions. Persistent cases may require nasal packing or cautery. Evaluation: Identification of underlying causes such as hypertension, coagulopathies, and structural nasal abnormalities is crucial, particularly in recurrent or severe cases. Laboratory tests and imaging may aid in diagnosis and management planning. Prevention: Patient education on nasal hygiene, avoidance of nasal trauma, and maintenance of a humidified environment are critical in reducing recurrence. Integrating effective initial management with thorough evaluation and preventive strategies significantly improves patient outcomes. Full article

Introduction: Traumatic dental injuries (TDIs) present a significant challenge for healthcare professionals. Nurses, often the first point of contact for patients, may lack essential knowledge in dental trauma first aid, as noted in the existing literature. Objective: To assess the knowledge of traumatic dental injuries (TDIs) among undergraduate nursing students before and after a targeted educational intervention. Materials and Methods: This quasi-experimental study evaluated the effectiveness of an educational intervention involving 300 nursing students from two universities in Seville. The educational intervention was led by specialist dentists. A pre-test survey was administered to assess students’ baseline knowledge. The session included a lecture on TDI management, followed by a simulation in which students practiced emergency splinting techniques for referral to a dentist. A post-test survey was then conducted to measure changes in students’ knowledge and attitudes towards dental trauma. Results: Only 25.4% of students had prior training in dental trauma. After the intervention, there was a significant improvement in students’ self-assessed knowledge of first aid for TDIs (p < 0.05). A high percentage of students also reported increased confidence in their ability to reimplant a tooth. Statistical analysis of pre- and post-intervention survey results showed a substantial increase in average scores (p < 0.05). Conclusions: Nursing students initially exhibited limited knowledge in managing dental trauma but demonstrated a positive attitude toward learning this new skill. The targeted educational intervention significantly enhanced their understanding, underscoring the need to incorporate such training into nursing curricula. By improving nursing students’ competence in managing dental injuries, this training can help better preserve dental structures and improve the prognosis for dental trauma cases. Full article

Background: Traumatic dental injuries (TDIs) are a common complication in sports, with an overall prevalence ranging from 0.71% to 60%. Kickboxing is a high-risk combat sport for trauma to the facial region. Methods: A total of 142 5-to-65-year-old amateur athletes participated in the survey with a questionnaire that was released during their regular practice days. The questionnaire was structured into three parts: (1) questions about age, gender, type, and time of sports practice; (2) questions about dental injuries, personal experience, and awareness of emergency management, particularly about tooth avulsion; (3) questions about wearing a mouthguard for TDI prevention. Results: A total of 13 percent of athletes suffered a TDI while training or fighting. Regarding first aid, 61% of the participants in this survey are aware of the possibility of replanting a tooth after its avulsion; 10% believe that the tooth should be replanted within 15 min, and 37% of athletes believe that it should be kept wet. The mouthguard is known to the majority of athletes (94%), and 66% were informed by the coach; 68% of the athletes use it. Seventy-four percent of the mouthguards were purchased in a sports shop. Conclusions: A relatively low prevalence of TDIs was observed in players in the sample. A lack of information about the emergency management of tooth avulsion and about the type of mouthguard to wear emphasizes the importance of educational training by dentists to athletes and coaches. Full article

The primary aim of this study is to assess the knowledge, attitudes, and skills of primary school teachers regarding the management of musculoskeletal trauma through first aid interventions and to determine the effectiveness of a sustainable training program. The preparedness of 138 teachers who received first aid training for trauma intervention and the impact of these trainings on health practices were examined by pre- and post-tests. It was determined that 87% of the teachers participating in the study had not received emergency trauma training before. Pre-training test results showed that the participants had a low level of awareness. However, the increase in mean scores from 6 to 16 and the decrease in standard deviation after the training revealed a significant increase in teachers’ knowledge, attitudes, and skills. These results suggest that emergency trauma training programs significantly increase teachers’ ability to respond to emergencies and emphasize the importance of sustainable first aid training. Analyses based on gender and branch revealed that post-training test scores were similar and all teachers showed high performance. The findings emphasize the need for systematic and comprehensive emergency trauma training programs for all teachers and the importance of these programs for sustainable health and safety practices. Full article

Introduction: Trauma is a major problem which has a significant health, social, and economic impact. Particularly, pediatric trauma carries substantial mortality and morbidity. This is a great concern for subspecialized general and pediatric surgeons. Therefore, a global initiative for pediatric trauma care is warranted and should be initiated. Aim: The international association “Global Initiative for Children’s Surgery” (GICS) would like to propose and organize a children’s trauma care (CTC) initiative. This initiative should comprehensively address pediatric trauma management globally, especially in low- and middle-income countries (LMICs). The initiative seeks to achieve a structured cooperation and collaboration with respective sister organizations and local stakeholders. Methods: The initiative will address these relevant aspects: 1. first aid; 2. prehospital primary trauma care; 3. hospital primary trauma care; 4. advanced care (ATLS); 5. diagnostic facilities; 6. operation room (OR) equipment; 7. specialized surgical services; 8. rehabilitation; 9. registry, research, and auditing; 10. specialization in pediatric trauma; 11. capacity and confidence building in pediatric trauma; 12. prevention. The GICS CTC provided activities have been recorded and evaluated in a structured manner. This statement paper is based on data of a narrative review as well as expert opinions. Results: The Trauma Working Group of GICS provided specialized trauma prevention leaflets available for translation to different languages. A one-day children’s primary trauma course has been designed to be delivered at the physical GICS meetings. Exercising advocacy, the group addressed several meetings on prevention of pediatric trauma, which included the 75th United Nations General Assembly (UNGA) (2020), GICS IVth meeting in Johannesburg (2020), Norwich (UK) Joint SPRINT Symposium on Pediatric Surgery for Pediatricians (2021), the second online Pan African Pediatric Surgical Association (PAPSA) meeting (2021), the seventh World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS) in Prague (2022), and GICS pediatric trauma webinar (2023). Additionally, the working group participated in the preparations of a pediatric trauma module for the World Health Organization (WHO) and published several related studies. The contents of the selected articles added relevant information to the categories stated above. Conclusions: The CTC initiative of GICS is proposed as a mean to address pediatric trauma comprehensively through a process of collaboration and advocacy with existing organizations to achieve awareness, health education, prevention, health, and training. Further, it will support the provision of suitable facilities to health institutions. The establishment of a specialization in pediatric trauma is encouraged. GICS CTC initiative aims to improve pediatric trauma care in LMICs by developing injury prevention strategies; optimizing the use of locally available resources; obtaining commitment by LMICs governments; improvement in all fields of hospital care; improvements in infrastructure, education and training, and attention to data registry and research. Full article

Critical care injuries, such as burn trauma, require specialized skillsets and knowledge. A clinical decision support system to aid clinicians in providing burn patient management can increase proficiency and provide knowledge content for specific interventions. In austere environments, decision support tools can be used to aid in decision making and task guidance when skilled personnel or resources are limited. Therefore, we developed a novel software system that utilizes augmented reality (AR) capabilities to provide enhanced step-by-step instructions based on best practices for managing burn patients. To better understand how new technologies, such as AR, can be used for burn care management, we developed a burn care application for use on a heads-up display. We developed four sub-set applications for documenting and conducting burn wound mapping, fluid resuscitation, medication calculations, and an escharotomy. After development, we conducted a usability study utilizing the System Usability Scale, pre- and post- simulation surveys, and after-action reviews to evaluate the AR-based software application in a simulation scenario. Results of the study indicate that the decision support tool has generalized usability and subjects were able to use the software as intended. Here we present the first use case of a comprehensive burn management system utilizing augmented reality capabilities to deliver care. Full article

To establish classifications and to obtain pre- and post-operative information on patient-specific alignments, it is necessary to measure different angular values accurately and precisely, mainly on weight-bearing, full-length anteroposterior X-rays of the lower limbs (LLRs). This study evaluated angular measurements’ validity and absolute reliability on LLRs with a self-developed, computer-aided measurement system (TraumaMeter v.873). Eight independent observers measured the preoperative mechanical hip-knee-ankle (mHKA) angle of 52 lower extremities (26 cases) in a blinded fashion on three occasions separated by two weeks. We obtained an intra-observer mean bias error (MBE) of 0.40°, a standard deviation (SD) of 0.11°, and a 95% confidence interval (CI) of 0.37°–0.43°. We also obtained an inter-observer MBE of 0.49°, an SD of 0.15°, and a 95% C of 0.45°–0.53°. The intra-observer MBE for the measurement pair between the second and the first measurement round (T2T1) was 0.43°, the SD was 0.13°, and the 95% CI was 0.39°–0.47°; the MBE between the third and the second round (T3T2) was 0.37°, with an SD of 0.10° and a 95% CI of 0.34°–0.40°; and the MBE between the third and the first round (T3T1) was 0.40°, with an SD of 0.10° and a 95% CI of 0.37°–0.43°. The interobserver MBE for the first round of measurements was 0.52°, with an SD of 0.16° and a 95% CI of 0.48°–0.56°; the MBE for the second round was 0.50°, with an SD of 0.15° and a 95% CI of 0.46°–0.54°; and the MBE for the third round was 0.46°, with an SD of 0.14° and a 95% CI of 0.42°–0.50°. There were no statistically significant differences in the inter-observer errors for the three tests. In the case of the intra-observer analysis, there were differences between T2T1 and between T3T2, but these differences were minimal, with no overlaps in the lower or upper values, respectively, of the confidence intervals. These results led us to conclude that the TraumaMeter v.873 software extension for measuring lower-limb angles in LLRs is an accurate tool with low intra- and inter-observer variability. Full article

Type 2 diabetes mellitus (T2D) poses a significant global health challenge and demands effective self-management strategies, including continuous blood glucose monitoring (CGM) and lifestyle adaptations. While CGM offers real-time glucose level assessment, the quest for minimizing trauma and enhancing convenience has spurred the need to explore non-invasive alternatives for monitoring vital signs in patients with T2D. Objective: This systematic review is the first that explores the current literature and critically evaluates the use and reporting of non-invasive wearable devices for monitoring vital signs in patients with T2D. Methods: Employing the PRISMA and PICOS guidelines, we conducted a comprehensive search to incorporate evidence from relevant studies, focusing on randomized controlled trials (RCTs), systematic reviews, and meta-analyses published since 2017. Of the 437 publications identified, seven were selected based on predetermined criteria. Results: The seven studies included in this review used various sensing technologies, such as heart rate monitors, accelerometers, and other wearable devices. Primary health outcomes included blood pressure measurements, heart rate, body fat percentage, and cardiorespiratory endurance. Non-invasive wearable devices demonstrated potential for aiding T2D management, albeit with variations in efficacy across studies. Conclusions: Based on the low number of studies with higher evidence levels (i.e., RCTs) that we were able to find and the significant differences in design between these studies, we conclude that further evidence is required to validate the application, efficacy, and real-world impact of these wearable devices. Emphasizing transparency in bias reporting and conducting in-depth research is crucial for fully understanding the implications and benefits of wearable devices in T2D management. Full article

Firefighting is inherently dangerous, though recently concerns have shifted from traditional fireground injuries (burns and asphyxiation) to a focus on mental and behavioral health. Although firefighters are remarkably resilient, research suggests many suffer negative psychological consequences from repeated exposures to trauma. While the Stress First Aid (SFA) model has gained increased attention and adoption among fire departments as a model for behavioral health training, it has not been formally evaluated. This cluster randomized controlled trial used a crossover design comparing the immediate SFA group to delayed SFA control to test the impact of the SFA on firefighters’ mental and behavioral health changes after 10–12 months (n = 400; Mage = 37.6, 4.8% women). A convenience sample of 79 firefighters (Mage = 41.4; 8.7% women) provided evaluations on one or more of the training modules. Participants reported satisfaction with all training components (Peer team training 97.6%, Online SFA 94.9%, Curbside Manner 88.4%, After Action Review 89.4%) and reported success in changing personnel’s perception of their department’s ability to respond to behavioral health issues (SFA M = 3.93, Control 3.50; t = 2.52, p = 0.042). Future work should focus on additional resources and training to augment existing efforts to help departments continue their efforts. Full article