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Background. Computed tomography (CT) is a vital tool in the workup of patients with closed head trauma. The aim of this study was to investigate the necessity of serial CT scans in patients with blunt head trauma. Methods. This is a retrospective study analyzing trauma patients between January and June 2012. Data were analysed by using frequencies, Kolmogorov-Smirnov (K-S), and Chi-square tests. Results. Of the total 351 control Head CTs, it was seen there were no different in 346 (98.6%). In CTs of another 3 patients (0.9%), there were increasing or new, in the other 2 (0.6%) there was a decrease in the pathology present. Of 24 (6.8%) patients who had a hemorrhage in the first CT, there was an increase in the hemorrhage in one of them, a decrease of the pathology in 2 of them. Of 27 (7.7%) patients who had fracture in first CT, 2 had a new intracranial hemorrhage. The relation of the results between the first and second CTs were statistically significant (P < 0.001, χ 2 test). Conclusion. Repeated CT scans after 6 hours in EDs observation rooms are not necessary if first CT is normal in most situations. Special attention may be needed in patients with an underlying chronic disease.

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SUMMARY

Background International COVID-19 guidelines recommend that health care workers (HCWs) wear filtering facepiece (FFP) respirators to reduce exposure risk. However, there are concerns about FFP respirators causing hypercapnia via rebreathing carbon dioxide (CO 2 ). Most previous studies measured the physiological effects of FFP respirators on treadmills or while resting, and such measurements may not reflect the physiological changes of HCWs working in the emergency department (ED). Objective Our aim was to evaluate the physiological and clinical impacts of FFP type II (FFP2) respirators on HCWs during 2 h of their day shift in the ED. Methods We included emergency HCWs in this prospective cohort study. We measured end-tidal CO 2 (ETCO 2 ), mean arterial pressure (MAP), respiratory rate (RR), and heart rate values and dyspnea scores of subjects at two time points. The first measurements were carried out with medical masks while resting. Subjects then began their day shift in the ED with medical mask plus FFP2 respirator. We called subjects after 2 h for the second measurement. Results The median age of 153 healthy volunteers was 24.0 years (interquartile range 24.0–25.0 years). Subjects’ MAP, RR, and ETCO 2 values and dyspnea scores were significantly higher after 2 h. Median ETCO 2 values increased from 36.4 to 38.8 mm Hg. None of the subjects had hypercapnia symptoms, hypoxia, or other adverse effects. Conclusion We did not observe any clinical reflection of these changes in physiological values. Thus, we evaluated these changes to be clinically insignificant. We found that it is safe for healthy HCWs to wear medical masks plus FFP2 respirators during a 2-h working shift in the ED.

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High pressure injection injuries most commonly occur in industrial accidents. In accident due to high pressure gun injuries, the nature of injected materials, the degree of toxicity, and the amount injected will affect the clinical outcome. Early vigorous treatment is essential to reduce morbidity. We reported a case of hand injuries due to inadvertent use of a high pressure injector device for haemostasis. 46-year-old male technician tried to stop bleeding from his injured hand by directing air jet from a high pressure injector to the wound resulting in significant subcutaneous emphysema. Adequate training and knowledge on occupational safety should be reinforced to avoid similar accidents.

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