Evaluation of injury

Chapter 26. Dean, J. H., et al. Immune system evaluation of injury. 

Morrow PE, Leach LJ, Smith FA, et al. 1982b. Metabolic fate and evaluation of injury in rats and dogs following exposure to the hydrolysis products of uranium hexafluoride. Implications for a bioassay program related to potential releases of uranium hexafluoride. Govt Rep Announce Ind, Issue 11. NTIS/NUREG/CR-2268. 

Morrow PE, Leach LJ, Smith FA, Gelein RM, Scott JB, Beiter HD, Amato FJ, Picano JJ, Yuile cl and Consler TG (1982) Metabolic Fate and Evaluation of Injury in Rats and Dogs Following Exposure to the Hydrolysis Products of Uranium Hexafluoride, NUREG/CR-2268, New York. 

TOXIC INHALATIONAL INJURY Physical Aspects Clinical Effects Physiology Evaluation of Injury... 

Our aim in this book is to provide students, researchers and practitioners with the tools and concepts required to conduct systematic evaluations of injury prevention initiatives and safety programs. Successful evaluations will advance the discipline of occupational safety by building a body of... 

Rehman A, Robinson P (2005) Sonographic evaluation of injuries to the pectoralis muscles. AJR Am J Roentgenol 184 1205-1211... 

During the design, conducting, and evaluation of toxicology studies, there is a constant need to be aware of the numerous factors that may influence the nature, severity, and probabiUty of induction of toxic injury. Some of the more important are Hsted below. 

Risk evaluation of accidents serves a dual purpose. It estimates tlie probability tliat an accident will occur iuid also assesses tlic severity of the consequences of an accident. Consequences may include dmnage to tlie surrounding environment, financial loss, or injury to life. This cliapter is primarily concerned witli tlie metliods used to identify hazards and tlie causes and consequences of accidents. Issues dealing witli healtli risks have been explored in die previous chapter. Risk assessment of accidents provides an effective way to help ensure eidier diat a mishap does not occur or reduces die likelihood of an accident. The result of the risk assessment allows concerned parties to take precaudons to prevent an accident before it liappens. 

Tlie reader should also note that tlie risk to people can be defined in terms of injury or fatality. The use of injuries as a basis of risk evaluation may be less disturbing tlian tlie use of fatalities. However, tliis introduces problems associated with degree of injury and comparability between different types of injuries. Further complications am arise in a risk assessment when dealing witli multiple hazards. For example, how are second-degree bums, fragment injuries, and injuries due to toxic gas e.xposure combined Even where only one type of effect (e.g., tlueshold to.xic exposure) is being evaluated, different durations of e.xposure can markedly affect tlie severity of injury. 

SKELETAL MUSCLE RELAXANTS. These drugs may cause drowsiness. Because of the risk of injury, the nurse evaluates the patient carefully before allowing the patient to ambulate alone. If drowsiness does occur, assistance with ambulatory activities is necessary. If drowsiness is severe, the nurse notifies the primary health care provider before the next dose is due... 

PlaaGL. 1988. Experimental evaluation of haloalkanes and liver injury. FundamAppl Toxicol 10 563-570. 

Free-radical generation occurs normally in the human body, and rates of free-radical generation are probably increased in most diseases (see Table 13.1). Their importance as a mechanism of tissue injury is still uncertain, largely because the assays used to measure them have, until recently, been primitive. The development of new assays applicable to humans (such as the assays of oxidative DNA damage described above) should allow rapid evaluation of the role of free radicals in disease pathology and provide a logical basis for the therapeutic use of antioxidants. A rationale is presented in Fig. 13.3. Attempts to use antioxidants in the treatment of human disease can be divided into three main areas ... 

Although most CF patients have shorter half-lives and larger volumes of distribution than non-CF patients, some patients exhibit decreased clearance. Possible causes include concomitant use of nephrotoxic medications, presence of diabetic nephropathy, history of transplantation (with immunosuppressant use and/or procedural hypoxic injury), and age-related decline in renal function in older adult patients. Additionally, CF patients are repeatedly exposed to multiple courses of IV aminoglycosides, which can result in decreased renal function. Evaluation of previous pharmacokinetic parameters and trends, along with incorporation of new health information, is key to providing appropriate dosage recommendations. 

The success of treatment is measured by the early termination of seizures, without adverse drug effects or brain injury. Therefore, it is essential to start pharmacologic treatment as soon as possible. First-line treatment for SE should halt seizure activity within minutes of administration. In patients who are unarous-able following treatment, an EEG should be done to rule out continued excessive electrical brain activity and confirm termination of seizures. A physical exam and evaluation of the patient s laboratory results can help determine if the cause or complications of seizure activity are being appropriately treated. 

Assess the patient s symptoms to determine if empirical care is appropriate or whether diagnostic evaluation is warranted. Determine the timing of injury (if applicable), duration of pain, type and degree of pain, and exacerbating factors. Determine if the musculoskeletal disorder interferes with usual activities or range of motion. 

Qualitative consequence evaluation involves defining broad categories, which are based on the general level of injury and damage that could... 

From the calculated building damage versus response relationship and the empirical probability of serious injury or fatality versus damage relationship discussed above, the relationship between explosion overpressure (or other effects) and probability of serious injury or fatality may be constructed in a manner that accounts for the detailed structural characteristics of plant buildings. The steps involved are similar to risk screening (Chapter 4), with the addition of detailed quantitative structural evaluation of plant buildings and detailed quantitative frequency assessment as described in the next section. 

Gray, J.E. (1978). Pathological evaluation of injection injury. In Sustained and Controlled Release Drug Delivery Systems (Robinson, J., Ed.). Marcel Dekker, New York, pp. 351-405. 

The toxicologist looks not only at the rates of occurrence of various adverse effects, but also examines the question of whether the severity of certain forms of injury is significantly greater in treated animals. Severity is not always quantifiable - it is in the eye of the pathologist. So some judgment beyond what the statistician can offer through an objective analysis is always necessary to complete an evaluation. 

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