Brace for impact

204 Pages·2014·4.38 MB·English

B Brace For Impact!
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A thesis on medical care following an airplane crash
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Ingri Postma
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Brace For Impact!
A thesis on medical care following an airplane crash
Ingri Louise Esther Postma
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ISBN/EAN: 978-90-6464-783-3
© 2014 Ingri Postma
Een elektronisch versie van dit proefschrift is beschikbaar op de volgende websites
http://www.orthopeden.org/wetenschap_en_opleiding/proefschriften
http://www.annafonds.nl/pagina/Voltooide+proefschriften/1942/
http://www.trauma.nl/proefschriften/all
Cover design & lay-out:
Ferdinand van Nispen, Citroenvlinder-dtp.nl, Bilthoven, The Netherlands
Printed by:
GVO drukkers & vormgevers B.V. | Ponsen & Looijen, Ede, The Netherlands
The publication of this thesis was supported by:
Annafonds, AMC Graduate School, Biomet, Chipsoft, Chirurgie AMC, Depuy Synthes,
Leuk Orthopedie, Medirisk, Nederlandse Orthopedische Vereniging, Nederlandse
Vereniging voor Traumatologie, Neuro Orthopedisch Centrum, POCO, Schiphol
Group, Stimuleringsfonds Spaarne ziekenhuis, VUMC Netwerk Acute Zorg.
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Brace For Impact!
A thesis on medical care following an airplane crash
ACADEMISCH PROEFSCHRIFT
ter verkrijging van de graad van doctor
aan de Universiteit van Amsterdam
op gezag van de Rector Magnificus
prof. dr. D.C. van den Boom
ten overstaan van een door het college voor promoties
ingestelde commissie,
in het openbaar te verdedigen in de Aula der Universiteit
op vrijdag 6 juni 2014, te 11:00 uur
door
Ingri Louise Esther Postma
geboren te Rotterdam
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Promotiecommissie
Promotor: Prof. dr. J.C. Goslings
Co-promotores: Dr. F.W. Bloemers
Dr. T.S. Bijlsma
Dr. M.J. Heetveld
Overige leden: Prof. dr. C. Breederveld
Prof. dr. C.N. van Dijk
Prof. dr. T.M. van Gulik
Prof. dr. M. Maas
Prof. dr. P. Patka
Prof. mr. P. van Vollenhoven
Faculteit der Geneeskunde
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Contents
List of abbreviations 8
Part 1. General Events
Chapter 1 General introduction and outline of the thesis 13
Chapter 2 February 2009 airplane crash at Amsterdam Airport 19
Schiphol: An overview of injuries and patient
distribution
Prehosp Disaster Med. 2011 Jul-Aug;26(4):299-304.
Part 2. Pre-hospital Phase
Chapter 3 Mass casualty triage after an airplane crash near 33
Amsterdam
Injury. 2013 Aug;44(8):1061-7.
Chapter 4 Patient distribution in a mass casualty event of an 51
airplane crash
Injury. 2013 Nov;44(11):1574-8
Chapter 5 Preparing for mass casualty incidents and disasters. 65
Part 1: How to determine hospitals’ critical treatment
capacity
Chapter 6 Preparing for mass casualty incidents and disasters. 81
Part 2: How to design a patient distribution protocol
in a high risk area like an international airport
Part 3. In-hospital Phase
Chapter 7 Radiological work-up after mass casualty incidents: 91
are ATLS guidelines applicable?
Eur Radiol (2014) 24:785-791
Chapter 8 Spinal injuries in an airplane crash. A description of 105
incidence, morphology and injury mechanism
Submitted for publication
Chapter 9 Delayed diagnosis of Injury in survivors of the 121
February 2009 crash of flight TK 1951
Injury. 2012 Dec;43(12):2012-7.
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Part 4. The Aftermath
Chapter 10 Analysis of biomechanical aspects of non-fatal 137
Injuries in a major airplane crash
Submitted for publication
Chapter 11 The risk of PTSD and depression after an airplane 159
crash: how is it associated to physical injury?
Submitted for publication
Chapter 12 Summary, general conclusions and future 175
perspectives
Samenvatting en conclusies en vooruitzichten 185
Dankwoord 197
CV 200
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Definitions and abbreviations
Abbreviated Injury Scale: A numeric system to categorise injuries according to body
region and severity. Every injury corresponds to a 6 figure number, with the last
number on a scale of 1-6. A minor injury is coded with number 1, 5 is a critical injury
and a 6 is lethal.
Hospital Trauma Level: Hospitals are designated a trauma care level by the Dutch
government, were Level I hospitals have a coordinating role in the regional trauma
network. Level I hospitals are equipped with all trauma care facilities; Level II
hospitals have “certain” trauma care facilities, some of which are extensive, almost
to the standard of Level I hospitals; and Level-III hospitals contain basic trauma care
facilities.
Injury Severity Score: A score combining the 3 highest scores on the Abbreviated
Injury Scale (AIS), of 3 different body regions of a patient. The squares of these 3
numbers are added to calculate the Injury Severity Score (ISS).
Multiple Casualty Incident: A hazardous impact with as many casualties that the
available orginazational and medical resources, or their management systems, are
severely challenged.
Multi Trauma patient: (Dutch: poly-traumatisée) severely injured patient with
multiple injuries leading to an ISS above 16.
Occupants: All people occupying the airplane.
Triage Categories: In case of a mass casualty incident (MCI), casualties are triaged at
the scene following the critical/ immediate (P1), serious/urgent (P2), minor/delayed
(P3) triage classification according to the Triage Sieve and Sort system used by the
MIMMS (Major Incident Medical Management and Support).
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