Scientific Program

Conference Series Ltd invites all the participants across the globe to attend Annual Congress and Medicare Expo on Trauma & Critical Care Madrid, Spain.

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Day 2 :

Keynote Forum

Akram Fayed

University of Alexandria, Egypt

Keynote: Trauma to the Gravid Uterus

Time : 10:30-11:10

OMICS International Trauma 2016 International Conference Keynote Speaker Akram Fayed photo
Biography:

Akram M Fayed has completed his training in Egypt and USA and earned his Doctorate degree in Critical Care Medicine as well as the ABIM in 2005. Since then, he contributed by giving talks and presenting research activities in many national and international conferences. He is the Founder and Member of the Egyptian Society of Critical Care and Emergency. He is also a Member of SCCM, ESICM and others. He has a number of publications in CCM in elite journals. He is currently an Associate Professor of Critical Care Medicine, Faculty of Medicine, University of Alexandria, Egypt.

Abstract:

Trauma to the gravid uterus is the most common non obstetrical cause of death in pregnant women. It is important to suspect pregnancy in any female in the childbearing age presenting with trauma. Specific anatomical and physiological changes develop during the varying stages of pregnancy to the mother and the uterus make the likelihood of injury during pregnancy high. A number of mechanisms are involved in the blunt trauma of the gravid uterus incluing road traffic accidents, falls and domestic violence. Causes of death identified following trauma of the gravid uterus include: hypovolemic shock, head and neck injuries and respiratory failure. Important steps in management include: resuscitation and stabilization of the mother which takes a priority of the fetus. When vital signs cannot be stabilized, an emergency cesarean section could save the fetus. Prevention of gravid uterus trauma include public awareness of the magnitude of the problem, counseling regarding safety during driving and encouraging prompt reporting of domestic violence to the authority.

Break: Networking & Refreshments 11:10-11:30 @ Salamanca

Keynote Forum

Claudia M.Elsig

Calda Clinic, Switzerland

Keynote: The devastating effects of domestic violence

Time : 11:30-12:10

OMICS International Trauma 2016 International Conference Keynote Speaker Claudia M.Elsig photo
Biography:

Claudia Elsig has more than 20 years of experience in the area of psychiatric and psychotherapeutic medicine. She studied at the medical faculty of the Zurich University and after this completed an extensive and deepened training in various evidence-based psychotherapeutic methods. She specialised on psycho-traumatology. Out of a deep interest for the effects of psychological and physical traumas like post-traumatic stress disorder, depression, eating disorders, the whish in her grew to help those people individually, holistic and sustaining. On the way to a multi-specialist, she looked for the best mentors in Europe for behavioural therapy, hypnosis and EMDR. She passed through training in genetics and genetic consultation with the focus on addiction, depression and anxiety disorders and discovered the fascination of epigenetics. For years, she managed the special consultation for clinical hypnosis at a private clinic in Zurich. During the past years as a Medical Director and Manager of the Psychiatry Department in an international practice she deepened her knowledge on multiple types of addiction and their effects.rnIn 2004, she founded the Calda AG and developed an individual integrative treatment concept for psychological diseases. Currently, she is the manager of the Calda Clinic for in-patient clients at Lake Zurich and an outpatient, psychiatric-psychotherapeutic practice in Zollikon. Furthermore, she is a demanded referee and trainer.

Abstract:

Domestic violence covers a broad spectrum of physical and psychological abuse. In this presentation, the referee focuses on psychological violence in relationships and families, as psychological and sexual abuse usually are the dominating topics at trauma congresses. Psychological violence unfortunately still does not receive adequate attention; the publicity work is rather modest. Often it takes many years until those affected realise the vortex of verbal manipulation they were drawn into. Humiliations, insults and accusations paired with control, lies and threats aim to destroy the integrity and identity of the victim. The perpetrator creates psychological and materialistic dependencies. It can take just as long to liberate oneself from the entanglement of the violence spiral. Manifold symptoms can be the effects: chronic traumatising, depression, fears, addiction. The focus of this presentation is on therapeutic possibilities for those affected. However, the various types of narcissist personality disorders are presented shortly. Furthermore, the social-cultural dimension is included, the helplessness of authorities, courts, lawyers in case of divorce or separation. In this way, the attrition can continue on a legal level for a long time. It is therefore not sufficient to make this phenomenon known only amongst therapists and counselling centres. On a socio-political level still many changes have to take place in order to ensure sufficient protection for those affected and their children.

  • Elderly Trauma
    Trauma-Mass Casualties Incident
    Evolution in Emergency Medicine Practices
    Trauma-An International Perspective
Speaker

Chair

Andreas Engelbrecht

University of Pretoria, South Africa

Session Introduction

Willy Aasebo

Akershus University Hospital, Norway

Title: Can Death in Police Cells be Prevented ?

Time : 12:10-12:40

Speaker
Biography:

Willy Aasebo is a Specialist in Internal Medicine and Nephrology and Leader of section of Nephrology (Medical Department), Akershus University Hospital, Norway. He has published a few scientific articles about alcohol intoxication, deaths in police cells and some nephrological topics including transplantation.

Abstract:

Unexpected deaths in police cells are always tragic for the next of kin and custodial officers, but may also cause several problems both in a local society as well as in a larger community/country. Thus minimizing the number of deaths in police custody is desirable in many countries for obvious reasons. One of the aims of my research has been to find and compare death rates in police cells from as many countries as possible. However, as only a few reports have been published in medical literature, I searched for such reports in other databases using google, and even google translate. I found, only few reports on death rates from 15-16 different countries and the death rates varied between 0.14 deaths to 4-5 (and even higher) deaths per million inhabitants per year. The methodological difficulties in obtaining these death rates and the methodological differences between the reports as well as cultural and organizational differences between countries make it very difficult to compare death rates between countries. In 2002, a project was initiated in Norway aiming at reducing deaths in police cells. During the 90’s, a mean of 4 persons died each year. 81% of the deaths happened in persons arrested for drunkenness. In 1/3 of all deaths alcohol intoxication was the only cause of death. The project then recommended that a doctor should examine all persons before they were being placed in a cell if they were considered unable to take care of themselves. The intention was that dead drunk persons should not be placed in police cells, but, preferably, in a health facility unit. In 2013, we again investigated all deaths in Norwegian police cells during the previous 10 years period and compared with numbers from the first period (the 90’s). In the second period a mean of 1.1 deaths occurred each year in the police cells. The total death rate was reduced from 0.83 deaths per million inhabitants per year in the first period to 0.20 in the second period. Deaths caused by alcohol intoxication, including cerebral traumas in drunken persons, had almost been eliminated (one death in the second period). The most common cause of deaths in Norwegian police cells in period two was mixed intoxications (6 deaths during the second period) and suicides (3 deaths).

Break: Lunch Break 12:40-13:30 @ Salamanca

David Fuchs

Ziv Medical Center, Israel

Title: Trauma care across closed borders

Time : 13:30-14:00

Speaker
Biography:

David Fuchs, BARN, is a Trauma Co-ordinator of Ziv Medical Center. He has worked in Trauma Care and Emergency Medicine for over 20 years. He is a Senior Nurse in the Emergency Department and responsible for Acute Trauma Care, the Trauma Room, training in Trauma and Trauma research.

Abstract:

Since February 2013, Syrian citzens injured in the civil war have been treated in Israel. The closest hospital to the Israel-Syria border, Ziv Medical Center, has treated over 600 patients. Patients arrived initally with war related injuries, but, as word spread of the care they received, patients also came for the treatment of chronic medical conditions. As civil war continues, reports indicate a collapse of health services in many parts of Syria. The care provided in Israel has been life-saving for men, women and children; and yet, they are accepting care from people they have regarded for generations to be their enemy. Crossing the border into Israel may be regarded in Syria as an illegal or punishable act. The identity of the patients is, therefore, carefully protected. Crucial to their reception, orientation and reassurance as soon as they arrive in the hospital, is the communication, in Arabic, between the social worker and the patients. As such the social worker is a crucial member of the team. Initially, some of the patients arrived unaware that they had been transported to Israel. They were afraid, reluctant to eat the food and weary of the staff. Patients, however, were extremely grateful for the high level care that they received, and staff at the hospital were at pains to welcome them and put them at their ease. Children arrived with relatives or sometimes alone. The hospital organised radios and access to computers and books and received donations of clothing and games.

Wisam Matanis

Ziv Medical Center, Israel

Title: Teaching acute trauma management to medical students

Time : 14:00-14:30

Speaker
Biography:

Wisam Matanis is a surgical resident in Ziv Medical Center. He gained his basic Medical degree from the Technion- Israel Institute of Technology in Haifa, Israel. In addition to training in operative surgery, he has an active interest in undergraduate teaching and research.

Abstract:

Medical students may believe that Acute Trauma Management is the last thing they need to learn but in conflict and disaster zones, medical students play an important role in the trauma team. Rather than simply taking blood, fetching equipment and assisting in the transportation of patients, students need to understand trauma as a disease and the principles and practice of Acute Trauma Care. As part of their surgical rotation, medical students at Ziv Medical Center spend time in the trauma room learning, how monitoring and ventilation equipment works, how to connect these correctly, how to administer oxygen, work the suction, intubate, obtain venous access, apply limb splints and pelvic binders and to lead their own student teams (in turns) in trauma management for one hour drills twice weekly. These drills complement tutorials they have in trauma care (including molecular mechanisms) as part of their surgical teaching. At the end of the rotation, they have an examination in the trauma room (assessed drills which they take turns to lead) as well as a written and oral examination in trauma care and surgery. Some of the students work as paramedics, some as physician assistants, and on qualification in two years time, of course, as doctors. This training is vital to them, builds their confidence, enables them to participate fully in the resuscitation of trauma and critically ill septic patients or patients with massive gastrointestinal or obstetric haemorrhage. Students understand exactly what decisions are taken by seniors in the trauma room and why.

Break: Networking & Refreshments 14:30-14:50 @ Salamanca
Speaker
Biography:

Raphael Fedidat is a surgical resident in Ziv Medical Center. He gained his basic Medical degree in the Technion-Israel Institute of Technology in Haifa, Israel. He researched, designed and developed this technology himself.

Abstract:

The recording of morbidity and mortality amongst surgical in-patients in the departments of surgery is universal. Yet, the collection of accurate data for review, discussion and research is frequently retrospective and may even be at the last minute in preparation for departmental morbidity and mortality meetings. The surgical team at Ziv Medical Center has designed a database for the real time recording of complications which utilises the Clavien-Dindo classification and grading system. This enables surgical outcome to be compared with national and international data and for data to be easily retrieved. The database was designed and constructed from first principles by a surgical resident, charged with the responsibility for recording patient data in preparation for weekly departmental morbidity and mortality meetings. It is easy to use, all on one page, has a series of short drop down menus, and is comprehensive in terms of co-morbidity, procedure and complication. Its simplicity has been its success and complications may be recorded in a matter of seconds during or just after ward rounds. Data may be analysed within the database as well as exported in to Excel. Further applications for the database are being planned as a means for recording data used for research in all aspects of departmental surgical practice (rather than complications only) such as trauma, cancer resections and procedures for benign disease. The program also has great potential in the daily evaluation of critically ill patients.

Noman Shahzad

Aga Khan University Hospital, Pakistan

Title: Quality of life after damage control laparotomy for trauma

Time : 15:20-15:50

Speaker
Biography:

Dr Noman Shahzad is General Surgery Resident at The Aga Khan University Hospital (AKUH) Pakistan. AKUH is JCIA accredited hospital with state of the art trauma facility and intensive care unit. He has recently completed his licensure requirement to practice general surgery in Pakistan - Fellowship of College of Physicians and Surgeons of Pakistan. He is also Member of Royal College of Surgeons of England. He has keen interest in trauma surgery and critical care management and has published in this field.

Abstract:

Introduction: Though short term survival advantage of damage control laparotomy in management of critically ill trauma patients is established, there is little known about the long term quality of life of these patients. Facial closure rate after damage control laparotomy is reported to be 20-70 percent. Abdominal wall reconstruction in those who failed to achieve facial closure is challenging and can potentially affect quality of life of these patients. Methodology: We conducted retrospective matched cohort study. Adult patients who underwent damage control laparotomy from Jan 2007 till Dec 2013 were identified through medical record. Patients who had concomitant disabling brain injury or limb injuries requiring amputation were excluded. Age, gender and presentation time matched non exposure group of patients who underwent laparotomy for trauma but no damage control were identified for each damage control laparotomy patient. Quality of life assessment was done via telephonic interview at least one year after the operation, using Urdu version of EuroQol Group Quality of Life (QOL) questionnaire EQ5D after permission. Wilcoxon signed rank test was used to compare QOL scores and McNemar test was used to compare individual parameters of QOL questionnaire. Study was approved by institutional ethical review committee. Results: Out of 32 patients who underwent damage control laparotomy during study period, 20 fulfilled the selection criteria for which 20 matched non damage control group patients were selected. Median age of patients (IQ Range) was 33 (26-40) years. Facial closure rate in damage control laparotomy group was 40% (8/20). One third of those who did not achieve facial closure (4/12) underwent abdominal wall reconstruction. Self-reported QOL score of damage control laparotomy patients was significantly worse than non-damage control group (p = 0.032). There was no statistically significant difference in two groups regarding individual QOL measures. Significantly more patients in damage control group were requiring use of abdominal binder, and more patients in damage control group had to either change their job or had limitations in continuing previous job. Our study was not adequately powered to detect factors responsible for worse QOL in damage control group. Conclusion: Quality of life of damage control patients is worse than their age and gender matched patients who underwent trauma laparotomy but not damage control. Adequately powered studies need to be conducted to explore factors responsible for this finding for potential improvement.

Hassan Ravari

Mashhad University of Medical Sciences, Iran

Title: Causes and outcome of elderly trauma in our general trauma center

Time : 15:50-16:20

Speaker
Biography:

Hassan Ravari has completed his General Surgery from Shiraz University of Medical Sciences and Vascular Surgery from Tehran University of Medical Sciences. He is the Director of Vascular and Endovascular Surgery Research Center. He has published more than 28 papers in PubMed central.

Abstract:

Treatment of the elderly trauma patients in special centers can result in better treatment of potentially fatal injuries and satisfactory conditions at the time of discharge. The mortality rate in elderly trauma patients was reported 15-19%, which is twice as much as trauma patients with younger ages and 80% of spared trauma patients require long-term or permanent care. From September 2013 to August 2015, of 47425 patients who referred to Mashhad general trauma center 19527 patients were admitted according to the cause of trauma and ISS. During the study, 825 injury and trauma patients over 65 years were admitted, 166 of whom expired, which was 24.1% of all expired cases of all ages. There was a significant difference between elderly and other ages for causes of accident, strike of foreign body and quarrel but the difference was not significant for fall, bite, gunshot wound and self- striking. In our study, 2 major causes of trauma in the elderly were accident 52.7% and fall 33.2% . Although, a small proportion of injury and trauma patients as in this study in which 3.4% of those referred and 4.2% of the admitted patients consisted of the elderly, but a great proportion of trauma mortality in this group, which was 24.1%. This can be largely attributed to inattention to the elderly during driving and crossing streets, which are potential dangers for the well- being of the elderly. In conclusion, to decrease the mortality rate of this age group, extensive association of general surgeons, neurosurgeons, internist and orthopedist are required. Hospitalization of these patients in special units with skilled nurses can diminish the mortality rate. So, multidisciplinary special triage protocols, managements and discharge planning are needed.