Ehrhardt John D, Newsome Kevin, Das Snigdha, McKenney Mark, Elkbuli Adel
From the Department of Surgery, Kendall Regional Medical Center, Miami, Florida, USA.
Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, Florida, USA.
Ann Surg Open. 2022 Mar 14;3(1):e149. doi: 10.1097/AS9.0000000000000149. eCollection 2022 Mar.
Boating has exposed humans to elemental hazards for centuries. What was once a lifelong craft and time-honored skillset is now, with modern technology, a popular recreational activity. Boating safety has inherent limitations and has been historically challenging to enforce. These circumstances have given way to a rising number of watercraft-associated injuries and fatalities. This review aims to investigate the diagnosis, work-up, and management of watercraft-related injuries, including blunt mechanisms, propeller wounds, water-force trauma, associated marine infections, and submersion injuries, as well as outline gaps in current public health policy on watercraft injuries, potential interventions, and available solutions. Motorboats and personal watercraft differ in size, power modality, and differential risk for injury. Accidents aboard watercraft often share commonalities with motor vehicles and motorcycles, namely: rapid deceleration, ejection, and collision with humans. The complexity of care is added by the austere environment in which many watercraft accidents occur, as well as the added morbidity of drowning and hypothermia. Wounds can also become infected by marine organisms, which require wound care and antimicrobial therapy specific to the aquatic environment in which the injury occurred. The treatment of these patients can be further exacerbated by the prolonged transportation times due to complicated water rescue. There are many measures that can prevent or abate watercraft injuries, but inconsistent regulations and enforcement may impair the success of these interventions. Further research is needed to identify possible solutions to common causes of watercraft injuries, such as inconsistent lifejacket use and bow riding.
几个世纪以来，划船让人类面临各种自然危险。曾经是一门需要终生学习的技艺和历史悠久的技能组合，如今借助现代技术，已成为一项广受欢迎的娱乐活动。划船安全存在固有局限性，而且在历史上一直难以实施监管。这些情况导致与船只相关的受伤和死亡人数不断上升。本综述旨在研究与船只相关损伤的诊断、检查和管理，包括钝性机制损伤、螺旋桨创伤、水力创伤、相关的海洋感染和溺水损伤，同时概述当前关于船只损伤的公共卫生政策中的差距、潜在干预措施和可用解决方案。摩托艇和个人水上交通工具在尺寸、动力模式以及受伤风险方面存在差异。船只事故往往与机动车和摩托车事故有共同之处，即：快速减速、被抛出以及与人体碰撞。许多船只事故发生在恶劣环境中，这增加了护理的复杂性，同时溺水和体温过低导致的发病率也有所增加。伤口还可能被海洋生物感染，这需要针对受伤发生的水生环境进行伤口护理和抗菌治疗。由于复杂的水上救援导致运输时间延长，这些患者的治疗可能会进一步恶化。有许多措施可以预防或减轻船只损伤，但法规和执法不一致可能会影响这些干预措施的成效。需要进一步研究，以确定解决船只损伤常见原因的可能方案，例如救生衣使用不一致和船头乘坐等问题。
