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BACKGROUND: Cardiac injury caused by a sharp object is a medical and surgical therapeutic challenge. Mortality risk factors have been identified but there are major discrepancies in the literature. The aim of this study was to analyse the management of victims of penetrating cardiac injuries before and after admission to hospital and the anatomical characteristics of these injuries in order to facilitate diagnosis of the most critical patients. METHODS: To carry out this study, we conducted a retrospective analytical study with epidemiological data on victims of penetrating cardiac injuries. We included two types of patients, with those who underwent autopsy in our institution after death from sharp injury to the heart or great vessels and those who survived with treatment in the emergency department or intensive care unit between January 2015 and February 2022. RESULTS: We included 30 autopsied patients and 12 survivors aged between 18 and 73 years. Higher mortality was associated with prehospital or in-hospital cardiorespiratory arrest (OR = 4, CI [1.71-9.35]), preoperative mechanical ventilation (OR = 10, CI [1.53-65.41]), preoperative catecholamines (OR = 7, CI [1.12-6.29]), preoperative and perioperative adrenaline (OR = 13, CI [1.98-85.46] and [1.98-85.46]), penetrating cardiac injury (OR = 14, CI [2.10-93.22]), multiple cardiac injuries (OR = 1.5, CI [1.05-2.22]) and an Organ Injury Scaling of the American Association for the Surgery of Trauma (AAST-OIS) score of 5 (OR = 2.9, CI [1.04-8.54]; p = 0.0329) with an AUC-ROC curve value of 0.708 (CI [0.543-0.841]). CONCLUSIONS: This study identified risk mortality factors in penetrating cardiac injury patients. These findings can help improve the diagnosis and management of these patients. The AAST-OIS score may be a good tool to diagnose critical patients.

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Introduction Sharp object injuries in the medical field present a considerable occupational hazard for healthcare workers (HCWs), encompassing a spectrum of consequences from immediate discomfort to enduring health consequences. These injuries may expose HCWs to potential infections. Despite efforts to control sharp object injuries in healthcare environments, they are present at every stage involving using or disposing of medical sharp instruments. In Jordan, limited research has focused on sharp object injuries, with most data included from studies concentrating on practicing nurses or nursing students. Consequently, further research is necessary to comprehend the causes behind the high sharp object injury rate and the insufficient knowledge of safety practices and preventive guidelines. Objectives This study was conducted to investigate the impact of sharp object injuries on HCWs, underlying causes, and potential consequences causes of needlestick injuries. To highlight perspective and preventive imperatives. Methods and patients This retrospective institutional-based cross-sectional chart analysis was conducted by reviewing all sharp object injuries report sheets and extracting data directly from these reports for analysis. The study encompassed all reported cases occurring between 2018 and 2023. All the participants' data handling was accomplished according to the Declaration of Helsinki (2013) and the Health Insurance Portability and Accountability (HIPAA) Acts.  Results A total of 146 self-reported hospital workers were included in the study. Within the final cohort, 52.73% of the participants were male (77/146), with an average age at diagnosis of 38.6±7.87 years (ranging from 20 to 52 years). Conversely, females comprised 47.27% of the cohort population (69/146) and had an average age at diagnosis of 34.73±6.73 years (ranging from 19 to 47 years). The age group 20-29 years was the most prominent age group, statistical analysis of age and gender data revealed significant differences. The overall prevalence of sharp object injuries was 11.83%, indicating that a sizable portion of HCWs is at risk of exposure to bloodborne pathogens. Among the different professional categories, Physicians constituted the majority of sharp object injuries reported victims in 41 cases (28.08%), followed by nurses in 38 cases (26.02%). Statistical analysis of the profession's data revealed significant differences (P<0.001). Notably, sharp object injuries were most reported in wards. The leading procedures that caused sharp object injuries were identified as during needle recapping in 53 instances (36.30%), then followed by medical waste treatment in 32 cases (21.92%). The left hand was the most affected body part, reported in 83 cases (56.84%). All injured individuals reported the incident promptly. No seroconversions were documented within the reviewed cases during the study period. Conclusion Injuries caused by sharp objects persist as a significant danger for hospital employees, posing immediate harm and long-term health risks linked to bloodborne pathogens. The findings stress the continuous responsibility of healthcare institutions to prioritize staff safety by addressing the root causes of sharp object injuries and fostering reporting and prevention cultures. Underreporting reasons are diverse, encompassing factors like time constraints, fear of consequences, and the misconception of injury insignificance.

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BACKGROUND: Impalement of the body is a rare injury and comes with varied presentation. There is no set classification or defined protocols for managing this injury. This case report aims to create awareness among trauma surgeons about unusual presentation and management of such case. CASE SUMMARY: A 45-year-old man presented to the emergency department with a sharp penetrating wooden plank at right clavicular region between the neck and shoulder following a road traffic accident. The vehicle had crashed into a roadside wooden hut, thus causing an impalement injury. He was meticulously worked up and taken to emergency theatre. The wooden plank was removed and the wound healed uneventfully. Postoperatively, he had fairly good shoulder function and was able to return back to work successfully. CONCLUSION: Each impalement injury brings in challenges in management as no two cases are the same. The varied presentation and risks involved should be known to medical professionals handling the emergency. Coordinated multidisciplinary team approach is needed for successful outcome.

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A foreign body (FB) is an object or item that is foreign to the area in which it is found. FB in the airway, accompanied by the esophagus, is a common overnight emergency in pediatric otolaryngology. Here we report a case of a healthy 11-month-old girl who presented in the emergency room with stridor and a weak cry. The patient was admitted as a case of croup (laryngotracheobronchitis) and treated with multiple antibiotics for more than five days but showed no improvement, then consulted the ear, nose, and throat team (ENT).

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Sharp pointed objects in the esophagus are extremely hazardous and can lead to complications such as mucosal ulcerations, perforations, obstruction, abscess, and fistula formation. Patients exhibit symptomatology based on the location within the proximal or distal esophagus. Ingestion of a sharp foreign object warrants emergent endoscopic removal, particularly when lodged in the esophagus. We present two young children, a 30-month-old male and a 10-month-old male, who underwent emergent endoscopic evaluation following the ingestion of a jingle bell and a Christmas ornament hanger, respectively. Types of ingested sharp foreign bodies may vary during the holiday season and present unique diagnostic and therapeutic challenges for pediatric physicians. Additionally, foreign body ingestions are not limited to children including teenagers and should also be considered in infants. Here, we report two young patients who ingested unique holiday ornaments and describe the management of these impacted esophageal foreign bodies.

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INTRODUCTION AND IMPORTANCE: Foreign body (FB) ingestion is a common challenge for pediatric health care providers globally. Although endoscopic approach for FB extraction is recommended, surgery remains life giving specifically in developing countries. We presented a novel surgical approach called 'Gilan maneuver' for removal of FB which lodged in duodenal loop. CASE PRESENTATION: An eighteen months old male infant referred to emergency department while he lied on his mother's arm. Parents stated their son has ingested a sharp metallic pointy thick needle which applies for cattle injection. On examination mid epigastric tenderness was remarkable. Laboratory finding was normal. Plain thoracoabdominal radiologic study confirmed the diagnosis. Patient underwent explorative laparotomy and the needle was removed through 'Gilan maneuver' in which mucosal unfolding of duodenal loop facilitated dislodgement of the FB and it was extracted on the jujenal side. CLINICAL DISCUSSION: Duodenal lodge of sharp FB is rare and could be masked by gastric deposition diagnosis. Mucosal folding, narrow luminal diameter, retroperitoneal adherence, and hard surgical anatomy of the duodenal loop make both sharp and large FBs spontaneous dislodgement and favorable surgical outcome relatively unanticipated. CONCLUSION: Despite rarity of duodenal deposition of FB it is possible and could be harmful due to adjacent unforgiving organs. Although endoscopic extraction of FB is generally recommended in guidelines, surgical approach is safe and could be considered.

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Background and objective Occupation-related injuries (ORIs) are undesirable and harmful situations among healthcare workers (HCWs) and may have serious consequences. In this study, we aimed to identify and analyze ORI incidences, risk groups, and the outcomes of a training program to prevent them. Materials and methods Between January 2011 and December 2019, HCWs who applied for infection prevention and control (IPC) due to ORIs (percutaneous needlestick and sharp-object injury or contact with blood or body fluids) were included in the study. Their characteristic features, vaccine histories, injury types, viral serologies, and administered prophylaxis were recorded. After 2014, a periodic ORI training program was started. We used joinpoint regression analysis to compare the ORI incidences before and after the education program. Results During the nine-year study period, 965 ORIs were registered. The mean age of HCWs was 39.3 ± 8.4 years, and 67.9% of them were female. The total injury incidence for all professions was 34.1 (95% CI: 33.1-37.5) per 1,000 HCWs. The injury incidences were significantly higher in nurses compared to other HCWs (p<0.01). Most of the injuries occurred in the ward setting (37%). HCWs were injured most commonly while administering treatment (36.7%). The trend analysis for the incidence of injuries showed no significant change throughout the study period. The trend in personal protective equipment (PPE) use showed a significant increase (annual percentage change: 1.7, p<0.01). Conclusions The major finding of this study with respect to its implication on the healthcare system is that nurses are an important risk group for ORIs. Although the ORI incidence did not change during the study period, a significantly increased use of appropriate PPE following a systematic training program implementation was observed.

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A case from practice is presented - the infliction of fatal self-harm with clerical scissors with the formation of a comminuted depressed terrace-like fracture of the cranial vault. The given case is interesting for forensic experts, first of all, because it demonstrates the possibility of suicide with an unusual object - scissors and an area of injury that is unlikely for self-infliction - the vault of the skull.

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Adults with foreign body ingestion are mainly secondary to psychiatric disorders, alcoholic intoxication, and secondary gains. Conservative management without any intervention is successful in 80% of the ingested foreign bodies. Risk factors for complication include sharp objects, objects larger than 6 mm, recurrent ingestion, and previous gastrointestinal tract surgeries. Sharp objects specifically account for 35% perforation rates and impactions, most commonly at the ileocecal valve. There is limited evidence on the role of colonoscopy after the distal migration of foreign bodies into the ileum and colon. In our case report, we present a case of a 53-year-old-male with a history of recurrent foreign body ingestion secondary to a multitude of psychiatric disorders. It describes multiple foreign body ingestions, leading to failure of a screw at the ileocecal valve at day 5 of ingestion, despite conservative management with serial bowel preparations and abdominal radiographs. There is limited evidence on the management of foreign bodies after distal migration to the ligament of Trietz. Existing literature and guidelines suggest surgically managing the sharp foreign bodies after the failure of conservative management for three to five days. In the case report, we have attempted to emphasize the noninvasive, colonoscopic approach as initial management in removing impacted foreign bodies. This abstract has been presented and accepted at the American college of gastroenterology meeting held from October 22, 2021, to October 27, 2021, in Las Vegas as a poster.

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OBJECTIVE: The aim of this study was to assess the prevalence of needle-stick and sharp object injuries among staff nurses in Dessie referral hospital, Amhara region, Ethiopia, 2018. RESULTS: Among the 151 study participants, 98 (65%) respondents were males. Seventy-five (48.1%) participants had 4-10 years of experience. The overall prevalence of needle stick and sharp object injury among staff nurses in Dessie referral hospital was 43%. In this study, nurses who worked in the emergency department were 11× more likely to experience needle stick and sharp object injury compared with nurses who worked in outpatient department P = 0.004 [AOR = 11.511 95% CI 2.134, 62.09)]. Participants who were worked in adult health department were 10× more likely experience needle stick and sharp object injury when compared with participants who were worked in outpatient department P = 0.006 [AOR = 9.742 95% CI 1.904, 49.859)]. The major implication of these study findings on the health system is the importance of given emphasis for nurses in relation with needle stick and sharp injury.

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A 52-year-old female presented to our clinic after accidentally ingesting a push-through pack (PTP). After determining that the PTP was present in the stomach, we successfully and safely removed it endoscopically by using a handmade endoscopic hood fashioned from a cut endotracheal tube. Foreign body ingestion is a common clinical problem, and most ingested foreign bodies pass spontaneously. However, the ingestion of sharp objects, such as PTPs, increases the risk of complications, and urgent endoscopy is recommended to remove such objects. Previous studies have reported the use of other devices, both commercial and handmade, for the safe endoscopic removal of foreign bodies. The novel design of our handmade hood for the removal of the PTP, which was fashioned from a cut endotracheal tube, was beneficial in terms of maintaining a wide visual field, patient safety and tolerance, and easy preparation compared to previously reported commercial and handmade devices. It may be a viable and safe device for the retrieval of PTPs and other sharp foreign bodies.

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PURPOSE: To evaluate the epidemiological characteristics, the etiological factors, the type and severity of injury, visual outcome, and prognostic factors of open globe injuries in children. MATERIALS AND METHODS: This was a retrospective non-comparative case study. A chart review was performed of patients aged 16 years or younger presented at the Eye Unit of the Federal Medical Centre Makurdi, Nigeria, between January 2001 and December 2006. Data were collected on patient demographics, geographic locale of injury, type of ocular injury and vision. Statistical significance was indicated by P < 0.05. RESULTS: The study sample comprised 78 children. A statistically significantly greater number of males (n = 51) sustained injury compared to females (n = 27; P < 0.05). The mean age of the study sample was 9.7 ± 2.40 years (range, 1 year 2 months to 15 years 8 months). The age-group that sustained injury most commonly was 6 years to 10 years. Left eyes were more likely to be affected, accounting for 53 (68.0%) cases. There were 54% (n = 42) of patients injured at home and 51.0% (n = 40) were injured while playing. The most common injury was corneoscleral laceration, (67.9% [n = 24] eyes). Only 30.0% (n = 23) patients presented within the first 24 hours of the injury, 38.5% (n = 30) of patients were visually impaired and 25.6% (n = 20) patients were blind on presentation. Visual acuity at last follow up indicated that 39.7% (n = 31) patients were visually impaired and 39.7% (n = 31) were blind. CONCLUSION: More public health efforts should be geared towards preventing potential causes of ocular injury at home and at playgrounds.

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Objective To evaluate the effectiveness of occupation-safety education for prevention of sharp object injury among Chinese student nurses.Methods We searched PubMed,Springer,OVID,CNKI,Wanfang,and VIP databases for studies comparing the effect of education versus non-education for nursing students to prevent sharp object injury.Results 13 eligible studies were included in this metaanalysis.The pooled data revealed that sharp object injury was statistically significantly reduced in the education group.Furthermore,a significant more proportion of students in the education group dealt with the injury correctly.Conclusions Occupation-safety education is effective for student nurses to prevent sharp object injury.

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BACKGROUND: Nurses are often exposed to needlestick and sharp-object injuries (NSIs). This study aimed to investigate the post-exposure reporting rate of NSIs among nurses. METHODS: The subjects were 84 nurses from 4 hospitals (3 hospitals with 300 or more beds and 1 hospital with less than 300 beds) who had experienced at least 1 NSI within a 6-month period. The instrument was a self-administered questionnaire, which was based on the EPINet report form and a questionnaire for NSIs among resident physicians, which was used by Choi et al. Data were collected between April 9 and June 15, 2009, and analyzed using descriptive statistics and the chi-square test, which was performed using SPSS with a significance level of 0.05. RESULTS: Among the 84 nurses who had experienced at least 1 NSI within 6 months, only 14.3% had reported the NSIs, and 58.4% of these subjects reported the NSI immediately after sustaining the injury. The most common reason for not reporting was "the patients were found out to be uninfectious" (81.9%) followed by "too busy" (65.3%). The incidence of post-exposure reporting was negatively related to the number of NSIs (chi-square=13.871, p<0.001) and positively related to assessments of infectivity of the patients (chi-square=4.248, P=0.039) and other persons' recommendations to report NSIs (chi-square=4.092, P=0.043). CONCLUSION: The post-exposure reporting rate was very low. The factors responsible for this low rate should be investigated in a more systematic manner, and more measures should be undertaken to increase the reporting rate among nurses.

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