Figure 5 Causes of death of casualties with ISS 9-24. Time of death and its relations 1) Alcohol: most victims with positive blood alcohol died at the scene (p < 0.001); those with negative blood alcohol had similar time-of-death results when comparing the numbers of deaths at the scene or at a hospital (Figure 6). Figure 6 Relation of alcohol intoxication to moment of death.   2) ISS: Median

ISS gradually decreases when considering the number of deaths at the scene (ISS=43), on route to a hospital (ISS=35) or at a hospital (ISS=30) respectively (p < 0.001).   Surgical procedures For those arriving alive at a hospital (238), selleck screening library 106 (44.53%) underwent surgery. Thoracic drainage was performed on 34 patients (32.1%), followed by a laparotomy on 29.2% and craniotomy on 23.6%. Orthopedic procedures, tracheotomies and other procedures were performed on just a few cases. Discussion Most deaths observed in motorcycle crashes occur in young men and alcohol had a prominent role. Tests for blood alcohol levels are positive in many more motorcyclists than registered since these tests cannot be performed when there is either massive body destruction or urgent medical treatment. Literature has recognized that alcohol is the major contributing EPZ004777 chemical structure risk factor to fatal crashes [10, 17]. Brazil has very strict laws on the question of driving under the influence of

alcohol and this appears to be an influence in the reduction of accidents and deaths, as also demonstrated in other parts of the world [17]. Almost half of the patients reached a hospital alive, but the other half didn’t survive before pre-hospital teams had arrived at the scene of the accident, or before advanced trauma treatment

could be put into practice. In accordance with local cultural habits regarding the consumption Endonuclease of alcohol, accidents frequently occur on Saturday nights. Most accidents occurred in urban areas, but the most severe and potentially fatal injuries occurred on highways, where higher speeds are reached, which in turn Momelotinib in vivo exacerbates the severity of accidents. When motorcycle accidents occur, injuries are often found in multiple body parts, being much more common than only in isolated ones. Even in relatively simple accidents, it is usual for wounds to the head and extremities to be found simultaneously. Associated with other injuries or not, head trauma was the most common injury found, despite the use of helmets being obligatory in Brazil, and this trend can be witnessed worldwide and is documented in associated literature [17–19]. This suggests that the trauma dynamics are so aggressive that even the use of appropriate equipment is not enough to avoid brain damage. Helmets, actually, change the forces applied on the head, but even so, those forces are extremely high, causing skin and muscle injuries when directly applied, or brain injuries when indirectly applied [18].