Baker RA, Worth K, Pourrajabi N, Martin J, Mitchell S, Baker S. 22(1). 71 - 75. (Journal Article)
Abstract
Background: An austere field amputation can be a life-saving procedure for an entrapped patient when standard equipment is not available or operable. The objective of this study was to use hand tools to perform cadaveric amputations in < 2 minutes. Methods: Timed guillotine amputation of the extremities on three cadavers was attempted using four available hand tools: a multitool, a rescue tool, a hunting knife, and a fixedblade knife. The primary outcome was successful amputation of the extremity in < 2 minutes. Results: Amputation success was different among the tools. The multitool amputated 78% of attempts; the hunting knife, 67%; the rescue knife, 56%; and the fixed-blade knife, 44%. The distal tibia/fibula and radius/ ulna were amputated successfully in 100% of attempts, whereas none of the tools could amputate the femur. The multitool received the best subjective ranking - 1.4 (p = .001) - by amputators, with the fixed-blade knife receiving the worst score. Conclusions: In the rare circumstance that an emergent field amputation requires a hand tool, the multitool is a capable instrument for a distal extremity amputation.
Keywords: amputation; knife; saw; prehospital; field; emergency
Knapik JJ. 22(1). 121 - 129. (Journal Article)
Abstract
High-intensity functional training (HIFT) involves high-volume and high-intensity physical activities with short rest periods between movements and use of multiple joint exercises. This article reports the results of a systematic review and meta- analysis of studies involving injuries during HIFT. Individual studies were selected for review if they involved individuals =18 years of age and provided quantitative data on injury prevalence and/or injury rates during HIFT. Twenty-eight studies involving 11,089 participants met the inclusion criteria. There was considerable variability in individual studies with injury prevalences ranging from 12% to 74% and injury rates from 0.04 to 18.90 injuries/1000 h of training. Meta-analyses indicated that the overall injury prevalence was 36% (95% confidence interval [95% CI] = 32-41%) and overall injury rate 4.3 injuries/1000 h (95% CI = 3.35-5.23). Injury rates among the five available prospective cohort studies was considerably higher, 9.9 injuries/1000 h (95% CI = 3.3-16.4). The most commonly injured anatomical locations (with % of total injuries) were the shoulder (26%), back/spine (26%), knee (14%), wrist/hands/fingers (12%), arm/elbow (10%), and ankle/foot (6%). Given the higher injury rates among prospective studies that likely more effectively tracked injuries over time, more prospectively designed studies are required before the injury rate during HIFT can be appropriately quantified.
Keywords: high-intensity functional training; training; injury prevalence; injury rates; movements; physical training