Figures for the year ending September 2019 showed a 7% rise in offences involving knives or sharp instruments recorded by the police (to 44,771 offences). This is 46% higher than when comparable recording began (year ending March 2011) and the highest on record. The news is sadly littered with cases of knife crime and terror, and whilst we may have thought of stabbings as confined to small pockets of the country, sadly it now seems that we all have or all will be dealing with such cases.
The variability in injury and severity is vast from stabbings, however in extremis they are completely time critical, and striking the balance between performing only those life saving interventions on scene, during transport and in ED and getting to the final destination of theatre as quickly as possible.
In this podcast we discuss our thoughts on dealing with these cases; from the moment we get that call, all the way through to getting them into theatre.
As always we’d love to hear any thoughts or comments you have on the website and via twitter, and make sure you take a look at the references and guidelines linked below to draw your own conclusions.
Simon, Rob & James
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Offences involving the use of weapons: data tables. Office of National Statistics
How to stop the dying, as well as the killing, in a terrorist attack. Park CL. BMJ. 2020
Revised gunshot and knife wounds guidance: my view from A&E. A Boyle. GMC Blog. 2017
Presence of a pre-hospital enhanced care team reduces on scene time and improvestriage compliance for stab trauma. Cowley A. Scand J Trauma Resusc Emerg Med. 2019
Association of Prehospital Mode of Transport With Mortality in Penetrating Trauma: A TraumaSystem-Level Assessment of Private Vehicle Transportation vs Ground Emergency Medical Services. Wandling MW. JAMA Surg. 2018
Penetrating trauma. Kuhajda I. J Thorac Dis. 2014
Penetrating Neck Injury: Experiences of a London Major Trauma Centre. Shah N. ECR 2018
“To Protect and Serve…and Drop Off”. Penetrating Trauma in Philadelphia. St Emlyn’s
Pre-hospital spinal immobilisation: an initial consensus statement. Emergency Medicine Journal. Connor. 2013
Nurse leads project to help young people at risk of knife crime. Jones-Berry, S. Emergency Nurse. 2019
Do vented chest seals differ in efficacy? An experimental evaluation using a swine haemothorax model. Journal of Acute Care Surgery. Kheirabadi et al. 2017
The pre-hospital management of life-threatening chest injuries: A consensus statement from the Faculty of Pre-Hospital Care, Royal College of Surgeons of Edinburgh. Leech et al. Trauma. 2016
In a penetrating chest wound is a three-sided dressing or a one-way chest seal better at preventing respiratory complications? Walthall, K. Emergency Medicine Journal. 2015
Do vented chest seals differ in efficacy? An experimental evaluation using a swine hemopneumothorax model. Kheirabadi. Trauma Acute Care Surg. 2017
The prehospital management of chest injuries: a consensus statement. Faculty of Pre-hospital Care, Royal College of Surgeons of Edinburgh. Lee C. Emerg Med J. 2007
Relative bradycardia in patients with traumatic hypotension. Demetriades D. J Trauma. 1998
Foley catheter balloon tamponade for life-threatening hemorrhage in penetrating neck trauma. Navsaria P. World J Surg. 2006
Every minute counts: The impact of pre-hospital response time and scene time on mortality of penetrating trauma patients. Nasser AAH. Am J Surg. 2019