Sample selection was performed using census manner, so all trauma patients with clinical evidence of VSIs admitted to the hospital, from 1 November 2018 until 30 October 2019, were included. The researchers adhered to the ethical principles of Helsinki recommendations.
Patients’ personal information were gathered, analyzed, and presented anonymously. The study proposal was approved by the ethics committee of Tehran University of Medical Sciences (codes: IR.1399.095 and IR.1399.096). This retrospective cross-sectional study was conducted on patients with traumatic VSIs admitted to the ED of Sina Hospital, a referral tertiary trauma center in Tehran, Iran. There was a significant correlation between trauma type (p = 0.001), upper and lower extremity trauma (p < 0.001), presence of distal ischemia and lack of pulse (p = 0.041), penetrating injury close to a major vessel (p = 0.006), type of injured vessels and arteries (p<0.001), injury to nerve (p = 0.011) and tendon (p = 0.007), presence of open fracture (p = 0.005), multiple trauma (p < 0.001), method of surgery (p < 0.001), and number of postoperative complications (p< 0.001) with poor outcome. The rest of the patients were discharged in perfect health. 1 (0.9%) patient died, 6 (5.4%) patients went through amputation, and 3 (2.7%) patients were discharged against medical advice. The most common associated injury was tendon rupture (63.4%) and nerve injuries were present in 60.7% of patients. Isolated arterial injury was diagnosed in 90 (80.4%) patients, isolated venous injuries in 12 (10.7%) cases, and combined arteriovenous injuries in 10 (8.7%) patients. 90 (80.4%) patients had at least one soft sign and 99 (88.4%) patients had at least one hard sign. Most of the patients were categorized as mild or moderate in terms of their ISS. When a parent or caregiver has shaken a baby, the doctor will examine a baby for signs of shaking or abuse if the parent has not reported the cause of the infant’s apparent injury.One hundred and twelve patients with the mean age of 33.5 ± 14.7 (range = 8 - 80) years were studied (90.2% male). Diagnostic SignsĪn infant brought in for assessment of both mild and severe head trauma symptoms will be examined for a number of other signs. A head injury to a child under 6 months of age or loss of consciousness episode for any period of time and/or following a forceful injury like a car accident, require a doctor's visit. The child may have neck pain, seizures, skull indentation, large bump and/or any changes in behavior.
Green explains that these are mild to moderate forms of head trauma that do require medical attention if the following symptoms occur: crying longer than 10 minutes, vomiting repeatedly, bleeding from the ears or nose, dripping of clear liquid from the ears or nose, inability to walk or talk normally, rapid swelling just above the ear, severe or worsening headache (or irritability in babies who can't speak yet). If a baby appears confused or off-balance she may have a concussion. Signs that a head injury may require medical attention include a brief, temporary loss of consciousness or a change in conscious state. Although these bumps may be painful or result in bruising, they are often harmless. Green explains that babies and toddlers will “bonk” their head many times during their development.