How accurate is the identification of serious traffic injuries by Police? The concordance between Police and hospital reported traffic injuries

Police reported crash data are the primary source of crash information in most jurisdictions. However, the definition of serious injury within police-reported data is not consistent across jurisdictions and may not be accurate. With the Australian National Road Safety Strategy targeting the reduction of serious injuries, there is a greater need to assess the accuracy of the methods used to identify these injuries. A possible source of more accurate information relating to injury severity is hospital data. While other studies have compared police and hospital data to highlight the under-reporting in police-reported data, little attention has been given to the accuracy of the methods used by police to identify serious injuries. The current study aimed to assess how accurate the identification of serious injuries is in police-reported crash data, by comparing the profiles of transport-related injuries in the Queensland Road Crash Database with an aligned sample of data from the Queensland Hospital Admitted Patients Data Collection. Results showed that, while a similar number of traffic injuries were recorded in both data sets, the profile of these injuries was different based on gender, age, location, and road user. The results suggest that the ‘hospitalisation’ severity category used by police may not reflect true hospitalisations in all cases. Further, it highlights the wide variety of severity levels within hospitalised cases that are not captured by the current police-reported definitions. While a data linkage study is required to confirm these results, they highlight that a reliance on police-reported serious traffic injury data alone could result in inaccurate estimates of the impact and cost of crashes and lead to a misallocation of valuable resources.

The efficacy of Aloe vera, tea tree oil and saliva as first aid treatment for partial thickness burn injuries

Many alternative therapies are used as first aid treatment for burns, despite limited evidence supporting their use. In this study, Aloe vera, saliva and a tea tree oil impregnated dressing (Burnaid) were applied as first aid to a porcine deep dermal contact burn, compared to a control of nothing. After burn creation, the treatments were applied for 20 min and the wounds observed at weekly dressing changes for 6 weeks. Results showed that the alternative treatments did significantly decrease subdermal temperature within the skin during the treatment period. However, they did not decrease the microflora or improve re-epithelialisation, scar strength, scar depth or cosmetic appearance of the scar and cannot be recommended for the first aid treatment of partial thickness burns.

The optimal temperature of first aid treatment for partial thickness burn injuries

Using our porcine model of deep dermal partial thickness burn injury, various cooling techniques (15 degrees C running water, 2 degrees C running water, ice) of first aid were applied for 20 minutes compared with a control (ambient temperature). The subdermal temperatures were monitored during the treatment and wounds observed and photographed weekly for 6 weeks, observing reepithelialization, wound surface area and cosmetic appearance. Tissue histology and scar tensile strength were examined 6 weeks after burn. The 2 degrees C and ice treatments decreased the subdermal temperature the fastest and lowest, however, generally the 15 and 2 degrees C treated wounds had better outcomes in terms of reepithelialization, scar histology, and scar appearance. These findings provide evidence to support the current first aid guidelines of cold tap water (approximately 15 degrees C) for 20 minutes as being beneficial in helping to heal the burn wound. Colder water at 2 degrees C is also beneficial. Ice should not be used.

The optimal duration and delay of first aid treatment for deep partial thickness burn injuries

Using our porcine model of deep dermal partial thickness burn injury, various durations (10min, 20min, 30min or 1h) and delays (immediate, 10min, 1h, 3h) of 15 degrees C running water first aid were applied to burns and compared to untreated controls. The subdermal temperatures were monitored during the treatment and wounds observed weekly for 6 weeks, for re-epithelialisation, wound surface area and cosmetic appearance. At 6 weeks after the burn, tissue biopsies were taken of the scar for histological analysis. Results showed that immediate application of cold running water for 20min duration is associated with an improvement in re-epithelialisation over the first 2 weeks post-burn and decreased scar tissue at 6 weeks. First aid application of cold water for as little as 10min duration or up to 1h delay still provides benefit.

A review of first aid treatments for burn injuries

Throughout history there have been many different and sometimes bizarre treatments prescribed for burns. Unfortunately many of these treatments still persist today, although they often do not have sufficient evidence to support their use. This paper reviews common first aid and pre-hospital treatments for burns (water--cold or warm, ice, oils, powders and natural plant therapies), possible mechanisms whereby they might work and the literature which supports their use. From the published work to date, the current recommendations for the first aid treatment of burn injuries should be to use cold running tap water (between 2 and 15 degrees C) on the burn, not ice or alternative plant therapies.

Blast response of reinforced concrete pile using fully coupled computer simulation techniques

Pile foundations transfer loads from superstructures to stronger sub soil. Their strength and stability can hence affect structural safety. This paper treats the response of reinforced concrete pile in saturated sand to a buried explosion. Fully coupled computer simulation techniques are used together with five different material models. Influence of reinforcement on pile response is investigated and important safety parameters of horizontal deformations and tensile stresses in the pile are evaluated. Results indicate that adequate longitudinal reinforcement and proper detailing of transverse reinforcement can reduce pile damage. Present findings can serve as a benchmark reference for future analysis and design.

Blast response and failure analysis of pile foundations subjected to surface explosion

This paper presents the response of pile foundations to ground shocks induced by surface explosion using fully coupled and non-linear dynamic computer simulation techniques together with different material models for the explosive, air, soil and pile. It uses the Arbitrary Lagrange Euler coupling formulation with proper state material parameters and equations. Blast wave propagation in soil, horizontal pile deformation and pile damage are presented to facilitate failure evaluation of piles. Effects of end restraint of pile head and the number and spacing of piles within a group on their blast response and potential failure are investigated. The techniques developed and applied in this paper and its findings provide valuable information on the blast response and failure evaluation of piles and will provide guidance in their future analysis and design.

First aid treatment of burn injuries

The recommendations for the first aid treatment of burn injuries have previously been based upon conflicting published studies and as a result the recommendations have been vague with respect to optimal first aid treatment modality, temperature, duration and delay after which treatment is still effective. The public have also continued to use treatments such as ice and alternative therapies, however there is little evidence to support their use. Recently there have been several studies conducted by burn researchers in Australia which have enabled the recommendations to be clarified. First aid should consist of cool running water (2-15°C), applied for 20 minutes duration, as soon as possible but for up to 3 hours after the burn injury has occurred. Ice should not be used and alternative therapies should only be used to relieve pain as an adjunct to cold water treatment. Optimal first aid treatment significantly reduces tissue damage, hastens wound re-epithelialisation and reduces scarring and should be promoted widely to the public.

Vulnerability and damage analysis of reinforced concrete framed buildings subjected to near field blast events

Terrorists usually target high occupancy iconic and public buildings using vehicle borne incendiary devices in order to claim a maximum number of lives and cause extensive damage to public property. While initial casualties are due to direct shock by the explosion, collapse of structural elements may extensively increase the total figure. Most of these buildings have been or are built without consideration of their vulnerability to such events. Therefore, the vulnerability and residual capacity assessment of buildings to deliberately exploded bombs is important to provide mitigation strategies to protect the buildings' occupants and the property. Explosive loads and their effects on a building have therefore attracted significant attention in the recent past. Comprehensive and economical design strategies must be developed for future construction. This research investigates the response and damage of reinforced concrete (RC) framed buildings together with their load bearing key structural components to a near field blast event. Finite element method (FEM) based analysis was used to investigate the structural framing system and components for global stability, followed by a rigorous analysis of key structural components for damage evaluation using the codes SAP2000 and LS DYNA respectively. The research involved four important areas in structural engineering. They are blast load determination, numerical modelling with FEM techniques, material performance under high strain rate and non-linear dynamic structural analysis. The response and damage of a RC framed building for different blast load scenarios were investigated. The blast influence region for a two dimensional RC frame was investigated for different load conditions and identified the critical region for each loading case. Two types of design methods are recommended for RC columns to provide superior residual capacities. They are RC columns detailing with multi-layer steel reinforcement cages and a composite columns including a central structural steel core. These are to provide post blast gravity load resisting capacity compared to typical RC column against a catastrophic collapse. Overall, this research broadens the current knowledge of blast and residual capacity analysis of RC framed structures and recommends methods to evaluate and mitigate blast impact on key elements of multi-storey buildings.

Performance of buried tunnels subjected to surface blast incorporating fluid structure interaction

This paper uses finite element techniques to investigate the performance of buried tunnels subjected to surface blasts incorporating fully coupled Fluid Structure Interaction and appropriate material models which simulate strain rate effects. Modelling techniques are first validated against existing experimental results and then used to treat the blast induced shock wave propagation and tunnel response in dry and saturated sands. Results show that the tunnel buried in saturated sand responds earlier than that in dry sand. Tunnel deformations decrease with distance from explosive in both sands, as expected. In the vicinity of the explosive, the tunnel buried in saturated sand suffered permanent deformation in both axial and circumferential directions, whereas the tunnel buried in dry sand recovered from most of the axial deformation. Overall, response of the tunnel in saturated sand is more severe for a given blast event and shows the detrimental effect of pore water on the blast response of buried tunnels. The validated modelling techniques developed in this paper can be used to investigate the blast response of tunnels buried in dry and saturated sands.

Heat strain and hydration status of surface mine blast crew workers

Objective Dehydration and symptoms of heat illness are common among the surface mining workforce. This investigation aimed to determine whether heat strain and hydration status exceeded recommended limits. Methods Fifteen blast crew personnel operating in the tropics were monitored across a 12-hour shift. Heart rate, core body temperature, and urine-specific gravity were continuously recorded. Participants self-reported fluid consumption and completed a heat illness symptom inventory. Results Core body temperature averaged 37.46 +/- 0.13[degrees]C, with the group maximum 37.98 +/- 0.19[degrees]C. Mean urine-specific gravity was 1.024 +/- 0.007, with 78.6% of samples 1.020 or more. Seventy-three percent of workers reported at least one symptom of heat illness during the shift. Conclusions Core body temperature remained within the recommended limits; however, more than 80% of workers were dehydrated before commencing the shift, and tended to remain so for the duration.

Blast response and safety evaluation of a composite column for use as key element in structural systems

This paper presents the blast response, damage mechanism and evaluation of residual load capacity of a concrete–steel composite (CSC) column using dynamic computer simulation techniques. This study is an integral part of a comprehensive research program which investigated the vulnerability of structural framing systems to catastrophic and progressive collapse under blast loading and is intended to provide design information on blast mitigation and safety evaluation of load bearing vulnerable columns that are key elements in a building. The performance of the CSC column is compared with that of a reinforced concrete (RC) column with the same dimensions and steel ratio. Results demonstrate the superior performance of the CSC column, compared to the RC column in terms of residual load carrying capacity, and its potential for use as a key element in structural systems. The procedure and results presented herein can be used in the design and safety evaluation of key elements of multi-storey buildings for mitigating the impact of blast loads.

Design of a traumatic injury simulator for assessing lower limb response to high loading rates

Current military conflicts are characterized by the use of the improvised explosive device. Improvements in personal protection, medical care, and evacuation logistics have resulted in increasing numbers of casualties surviving with complex musculoskeletal injuries, often leading to lifelong disability. Thus, there exists an urgent requirement to investigate the mechanism of extremity injury caused by these devices in order to develop mitigation strategies. In addition, the wounds of war are no longer restricted to the battlefield; similar injuries can be witnessed in civilian centers following a terrorist attack. Key to understanding such mechanisms of injury is the ability to deconstruct the complexities of an explosive event into a controlled, laboratory-based environment. In this article, a traumatic injury simulator, designed to recreate in the laboratory the impulse that is transferred to the lower extremity from an anti-vehicle explosion, is presented and characterized experimentally and numerically. Tests with instrumented cadaveric limbs were then conducted to assess the simulator’s ability to interact with the human in two mounting conditions, simulating typical seated and standing vehicle passengers. This experimental device will now allow us to (a) gain comprehensive understanding of the load-transfer mechanisms through the lower limb, (b) characterize the dissipating capacity of mitigation technologies, and (c) assess the bio-fidelity of surrogates.

A comparison of MiL‐Lx and Hybrid‐III responses in seated and standing postures with blast mats in simulated under‐vehicle explosions

Blast mats that can be retrofitted to the floor of military vehicles are considered to reduce the risk of injury from under‐vehicle explosions. Anthropometric test devices (ATDs) are validated for use only in the seated position. The aim of this study was to use a traumatic injury simulator fitted with 3 different blast mats in order to assess the ability of 2 ATD designs to evaluate the protective capacity of the mats in 2 occupant postures under 2 severities. Tests were performed for each combination of mat design, ATD, severity and posture using an antivehicle under‐belly injury simulator. The differences between mitigation systems were larger under the H‐III compared to the MiL‐Lx. There was little difference in how the 2 ATDs and how posture ranked the mitigation systems. Results from this study suggest that conclusions obtained by testing in the seated position can be extrapolated to the standing. However, the different percentage reductions observed in the 2 ATDs suggests different levels of protection. It is therefore unclear which ATD should be used to assess such mitigation systems. A correlation between cadavers and ATDs on the protection offered by blast mats is required in order to elucidate this issue.

A standing vehicle occupant is likely to sustain a more severe injury than one who has flexed knees in an under‐vehicle explosion : a cadaveric study

The lower limb of military vehicle occupants has been the most injured body part due to undervehicle explosions in recent conflicts. Understanding the injury mechanism and causality of injury severity could aid in developing better protection. Therefore, we tested 4 different occupant postures (seated, brace, standing, standing with knee locked in hyper‐extension) in a simulated under‐vehicle explosion (solid blast) using our traumatic injury simulator in the laboratory; we hypothesised that occupant posture would affect injury severity. No skeletal injury was observed in the specimens in seated and braced postures. Severe, impairing injuries were observed in the foot of standing and hyper‐extended specimens. These results demonstrate that a vehicle occupant whose posture at the time of the attack incorporates knee flexion is more likely to be protected against severe skeletal injury to the lower leg.