Avaliação da gravidade do trauma em condutores de motocicleta vítimas de acidentes de trânsito no Rio Grande do Norte

Descriptive exploratory study, prospective, with quantitative approach, performed on the Monsenhor Walfredo Gurgel Hospital Complex (MWGHC), in Natal/RN, aiming to identify injuries by body area and wound severity on drivers who suffered motorcycle accidents, evaluate the severity of injuries and trauma on these drivers and identify the existence of association between wound and trauma severity and some of the accident s characteristics. The population comprised 371 motorcycle drivers, with data collected between October and December 2007. We used as instruments the Abberviated Injury Scale (AIS), Injury Severity Score (ISS) and the Glasgow Coma Scale (GCE1). The results show that, concerning characterization, there was a predominance of the male gender (88.4%), aged between 18 and 24 years (39.90%), originating from the Natal metropolitan region (55.79%), with fundamental-level instruction (51.48%), catholic (75.78%), married (47.98%). 23.18% work on commerce-related activities and 75.20% have income of up to 2 minimum wages. As for the accident s characteristics, the predominant shift was the afternoon (46.36%), received up to one hour after the event (50.67%), transported by countryside ambulances colleagues and relatives (51.21%), 25.34% had the accident on Sunday; 53.91% suffered falls and vehicle rolls; among the collisions there was a predominance of the motorcycle-automoblie type (28.03%); 52,6% were licensed and among these 50.76% had up to one year of license; 65.50% declared not having suffered previous accidents; 65.77% declared waring helmets in the time of the accident; 57.41% said not to have used drugs, and among those who used, alcohol was the most consumed (98.10%). The lowest score evaluated by GCS1 (3 to 8) was linked to drivers who suffered accidents on Saturday (10.3%), those who were not wearing helmets (14.29%) and the victims of motorcycle-pedestrian/animal crashes (13.33%). The body areas most affected had AIS between 1 and 3 (95.76%) and were: external surface (39.90%) and head/neck (33.20%). As for trauma severity, the highest scores (ISS>25) belonged to those who consumed alcohol (30.73%), suffered falls or vehicle rolls (48.9%) and those attended to 3 hours or longer after the accident (50%). We conclude that for motorcycle drivers who suffered accidents, age, gender, weekday, type of accident, use of drugs and the absence of helmet use signal both to the risk of occurrence of these events, as well as for the greater severity of injuries and trauma.

Avaliação de um método de cromatografia em fase gasosa head space e estudo da estabilidade do etanol em amostras de sangue

The ethanol is the most overused psychoactive drug over the world; this fact makes it one of the main substances required in toxicological exams nowadays. The development of an analytical method, adaptation or implementation of a method known, involves a process of validation that estimates its efficiency in the laboratory routine and credibility of the method. The stability is defined as the ability of the sample of material to keep the initial value of a quantitative measure for a defined period within specific limits when stored under defined conditions. This study aimed to evaluate the method of Gas chromatography and study the stability of ethanol in blood samples, considering the variables time and temperature of storage, and the presence of preservative and, with that check if the conditions of conservation and storage used in this study maintain the quality of the sample and preserve the originally amount of analyte present. Blood samples were collected from 10 volunteers to evaluate the method and to study the stability of ethanol. For the evaluation of the method, part of the samples was added to known concentrations of ethanol. In the study of stability, the other side of the pool of blood was placed in two containers: one containing the preservative sodium fluoride 1% and the anticoagulant heparin and the other only heparin, was added ethanol at a concentration of 0.6 g/L, fractionated in two bottles, one being stored at 4ºC (refrigerator) and another at -20ºC (freezer), the tests were performed on the same day (time zero) and after 1, 3, 7, 14, 30 and 60 days of storage. The assessment found the difference in results during storage in relation to time zero. It used the technique of headspace associated with gas chromatography with the FID and capillary column with stationary phase of polyethylene. The best analysis of chromatographic conditions were: temperature of 50ºC (column), 150ºC (jet) and 250ºC (detector), with retention time for ethanol from 9.107 ± 0.026 and the tercbutanol (internal standard) of 8.170 ± 0.081 minutes, the ethanol being separated properly from acetaldehyde, acetone, methanol and 2-propanol, which are potential interfering in the determination of ethanol. The technique showed linearity in the concentration range of 0.01 and 3.2 g/L (0.8051 x + y = 0.6196; r2 = 0.999). The calibration curve showed the following equation of the line: y = x 0.7542 + 0.6545, with a linear correlation coefficient equal to 0.996. The average recovery was 100.2%, the coefficients of variation of accuracy and inter intra test showed values of up to 7.3%, the limit of detection and quantification was 0.01 g/L and showed coefficient of variation within the allowed. The analytical method evaluated in this study proved to be fast, efficient and practical, given the objective of this work satisfactorily. The study of stability has less than 20% difference in the response obtained under the conditions of storage and stipulated period, compared with the response obtained at time zero and at the significance level of 5%, no statistical difference in the concentration of ethanol was observed between analysis. The results reinforce the reliability of the method of gas chromatography and blood samples in search of ethanol, either in the toxicological, forensic, social or clinic

Alcoolemia em vítimas fatais de acidentes de trânsito no Rio Grande do Norte empregando cromatografia em fase gasosa - head space

Alcohol is one of the few psychotropic drugs that their consumption has admitted legally and sometimes encouraged by the society. Studies show alcohol as the highest consumption of drugs among young people and society in general, probably because of its availability and easy access. The abuse causes public health problems, which was closely related to the violence, socioeconomic problems and the high number of automobile accidents. Transit is one of the main sectors affected by the effects of alcohol, observing a high incidence in the studies. About half of automobile accidents occurs after the consumption of alcoholic beverage, and the vast majority of cases related to high concentrations of alcohol in the bloodstream. The relationship of drunk with traffic accidents is in fact evident everywhere in the world, including Brazil, where studies have shown a high relationship between alcohol consumption and traffic accidents. This study determined the alcohol in fatal victims of traffic accidents in the state of Rio Grande do Norte and established the profile of this population compared with those found in Brazil and other countries. Samples of blood of ethanol added to fulfillment of the standardization of chromatographic conditions and procedures for the analysis, being employed in the determination of alcohol in blood samples of 277 victims of traffic accidents, collected at the Institute of Scientific Technical Police of Rio Grande do North (ITEP) in the year 2007. The blood alcohol level was determined in these samples correlated with the sex, age and marital status of the victim and the location, day of week and month when the accident occurred, is doing a statistical analysis and outlining a profile of the victims of an accident at transit in the state of Rio Grande do Norte. The parameters of standardization studied ensured the quality of the analytical method and, consequently, to obtain reliable laboratory results. Being given the best temperature for injector (150 ºC), detector (250 ºC) and column (50 ºC) with a flow of gas in the column of 2mL/minutos and analysis of time of 12 minutes. The method was linear in the range of 0.01 to 3.2 g / L (r2 = 0.9989) with average recovery of 100.2% and precision with coefficient of variation less than 15%. The analysis carried out on victims of fatal road traffic accidents, ethanol detected in the blood in 66.43% of the victims and these, 96% showed concentration ≥ 0.2 g / L, 87.73% of victims were male, while 12.27% female. The younger age group (1535 years) was the most involved (52,35%) and most single (55.60%). The accidents occurred with greater prevalence in the day on Monday (27%) followed by Sunday (24,19%) and Saturday (15,52%) and it was found that the prevalence of injuries varied between the different months of the year, and in February (14.4%) and April (10.47%) the months that had a higher number of accidents, however this oscillation showed no statistically significant difference. Also no significant difference was observed between the tracks of concentration found in men and women. The standardized method showed to be efficient, given satisfactorily to the goals of this work, and the high levels of alcohol found in victims of fatal road traffic accidents are consistent with several studies of literature, and the profile of the victim also supported by presenting in its most young adults, male and single

Caracterização do acidente de trânsito e gravidade do trauma: um estudo em vítimas de um hospital de emergência de Natal

Descriptive exploratory study, with quantitative approach and prospective data performed on the Monsenhor Walfredo Gurgel Hospital Complex (MWGH), in Natal/RN, aiming to classify the type of motor vehicle involved in the accident, the public roadway s user quality and the more frequent injuries; to evaluate the severity of trauma in traffic accident victims; characterized the severity of the injuries and the trauma, and the type of motor vehicle involved. The population comprises 605 traffic accident victims, with data collected between October and December 2007. We used as a support for the evaluation of severity of injuries and trauma the Glasgow Coma Scale (GCSl), the Condensed Abbreviated Injury Scale (CAIS) and the Injury Severity Score (ISS). The results show that 82.8% of the victims were male; 78.4% were aged 18 to 38; the victims originating from the State s Countryside prevailed (43.1%); 24.3% of the population had completed middle-level instruction; 23.1% worked on commerce and auxiliary activities; most (79.4%) was catholic; 48.8% were married/consensual union; 76.2% earned up to two monthly minimum wages; Sunday was the day with the most accidents (25.1%); 47.4% were attended to in under an hour after the event; the motorcycle on its own was responsible for 53.2% of the accidents; 42.3% were attended to by the SAMU; 61.8% were victims of crashes; over half (53.4%) used individual protection equipment (IPE); 49.4% were helmets and 4.0% the seatbelt; 61.3% were motorcycle drivers; 43.3% of the accidents took place in the afternoon shift; from 395 drivers, 55.2% were licensed, and 50.7% among those had been licensed for 1 to 5 years; 90.7% of the victims had GCS1 between 13 and 15 points at the time of evaluation; the body area most affected was the external surface (35.9%); 38.8% of the injuries were light or moderate (AIS=1 and AIS=2); 83.2% had light trauma (ISS between 1 and 15 points). In face of the results, we can conclude that there is a risk for the elevation of injury severity and trauma resulting from traffic accidents, when these events are related to certain variables such as gender, age, weekday, the interval between the accident and the first care, ingestion of drugs, type of accident, the public roadway s user quality, the use of IPE, day shift, body regions and the type of motor vehicle involved in the accident

Trauma em idosos atendidos pelo serviço pré-hospitalar móvel

O The aim of this study was to characterize the occurrence of trauma in the elderly population served by the mobile pre-hospital service, in Natal, Rio Grande do Norte. This is a descriptive, transversal and quantitative approach and whose population consisted of 2,080 trauma victims. The sample, of systematic random type, consisted of 400 elderly people, aged from 60 years old, assisted by the Office of Mobile Emergency in Natal / RN, between January 2011 and December 2012. Data collection began after consent and assent of the institution of a Research Ethics Committee under No. 309 505. It was proceeded to documentary retrospective analysis of records of this service through a form of self-development, validated by expert judges considered reliable (α> 0.75) and valid (CVI = 0.97) in their clarity and relevance. Data were tabulated by the Statistical Package for Social Sciences, version 20.0. The results show that older victims have an average age of 74.19 years old, with a prevalence of female involvement by chronic diseases, especially hypertension, average usage of 2.2 routine medications with vital signs within normal limits. The trauma prevailed during the daytime, in the residence of the victims, north of the city and on weekends. Among the mechanisms of trauma were falls, traffic accidents and physical aggression, whose most common type was brain-cerebral trauma and the main consequences were suture wounds and closed fractures. Basic Support Units were as more driven to pre-hospital care (87.8%) and the main destination place consisted of a referral hospital for emergency of the state (57.5%). Among the most commonly performed procedures by nursing staff immobilization with rigid board and neck collar and the peripheral venipuncture, and the main component used for volume replacement to saline were highlighted. There was a significant relationship between the deaths and the mechanism of injury, mechanism of injury and procedures, except medication administration procedures carried out, except immobilization and unit for service. It is highlighted the prevalence of trauma in the elderly, poor follow-up Pre-Hospital Trauma Life Support protocol and the paucity of records and nursing procedures performed. There is need for a protocol of care specific to elderly trauma victims and education strategies for the prevention of such events