A study of blood product use in patients with major trauma in Scotland: analysis of a major trauma database.

Objectives: (1) To define blood product requirements in patients with trauma whose underlying injuries are consistent with major blood loss; (2) to use these data to estimate the annual number of patients in Scotland who sustain significant trauma and require substantial blood product replacement; and (3) to place these data in the context of recent findings concerning the efficacy of recombinant factor VIIa in patients with major trauma.

Methods: A retrospective case note review study was conducted for patients who presented with trauma at each of four Scottish hospitals. The four sites were selected from the 26 hospitals that were the source of data for the Scottish Trauma Audit Group (STAG) database.

Catastrophe for a campanologist.

A campanologist was involved in a nonfatal hanging incident. On presentation she had no midline bony tenderness and only subtle abnormalities on plain X-ray films of her cervical spine; however, a CT scan showed a type III odontoid peg fracture. We believe this is the first reported cervical spine fracture sustained while bell-ringing.