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      ACCIDENTES ATENDIDOS EN UN ÁREA BÁSICA DE SALUD DE GIRONA, ESPAÑA Translated title: Accidents Attended in a Basic Health Area of Girona, Spain

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          Abstract

          Fundamentos: Los accidentes constituyen una patología poco estudiada en el ámbito de la Atención Primaria. Son una de las consultas más frecuentes en los servicios de urgencias y los Centros de Atención Primaria realizan la primera asistencia a la mayoría de los accidentados. Conocer la incidencia y las características clínico-epidemiológicas de los accidentes atendidos en una Área Básica de Salud puede aportar información sobre cuáles pueden ser susceptibles de actividades de prevención. Métodos: Diseño: estudio descriptivo. Emplazamiento: atención primaria. Muestra: todos los pacientes (389) que fueron atendidos por accidente en el Centro de Atención Primaria, entre octubre-98 y mayo-99. Variables: edad, sexo, lugar del accidente, tipo de lesión, localización, agentes implicados, intencionalidad, pruebas complementarias, tratamiento y derivación. Análisis estadísticos: estimación de medias, desviación estándar, estimación de proporciones e intervalos de confianza del 95%. Resultados: Incidencia: 4,1% (IC95%: 3,7-4,5%). Sexo: varones 59% (IC95%:54,2-64%) y mujeres 40,9% (IC95%: 36-45,8%). Edad: menores de 20 años, el 50,4% (IC95%:45,4-55,4%);.Actividad de mayor accidentalidad: ocio 24,4% (IC95%: 20,2-28,7%). Lugar: hogar 36,2% (IC95%: 31,5-41%). Lesión más frecuente: contusiones 39,6% (IC95%:34,7-44,4%).Localización más frecuente: extremidad superior 37,5% (IC95%: 32,7-42,3%); Agente mayoritariamente implicado: herramientas y máquinas: 15,9% (IC95%:12,3-19,6%). El 92,2% (IC95%: 89,3-94,7%) fueron casuales. Tipo de visita: el 83,3% (IC95%: 79,6-87%) fueron atendidos con carácter urgente; el 79,5% (IC95%:75,4-83,5%) recibió tratamiento con cura y/o fármacos. El 9,8% (IC95%:6,8-12,7%) requirió derivación hospitalaria, Un 13,3% (IC95%: 0-16,7%) requirió pruebas complementarias. Conclusiones: El mayor porcentaje de accidentalidad se da en población joven, por lo que se evidencia la necesidad de incorporar intervenciones de educación sanitaria para la prevención de accidentes dirigidas a dicha población.

          Translated abstract

          Background: Accidents have been largely unstudied in the area of Primary Care. They are one of the most frequent motives for consultation in the Emergency Services and the first assistance that accident victims receive is usually in primary care centres. Establishment of the incidence and clinicoepidemiological characteristics of the accidents attended in a Basic Health Area can provide important information about which of these could be susceptible to preventive actions. Methods: Design: descriptive study. Location: primary care: Sample: all the patients attended for accidents (389) in the Primary Care Centre between October 1998 and May 1999. Variables: age, sex, place of the accident, type of lesion, location of lesions, agents involved, intentionality, complementary tests, treatment and referral. Statistical analysis: estimation of means, standard deviation, proportions and 95% confidence intervals. Results: Incidence: 4.1% (CI95%: 3.7-4.5%). Sex: males 59% (CI95%: 54.2-64%) and females 40.9% (CI95%: 36-45.8%). Age: younger than 20 years, 50.4% (CI95%: 45.4-55.4%). Most common activity associated with accidents: leisure 24.4% (CI95%: 20.2-28.7%). Place: home 36.2% (C95%: 31.5-41%). Most frequent lesion: contusion 39.6% (CI95%: 34.7-44.4%). Most frequent site of lesion: arms 37.5% (CI95%: 32.7-42.3%). Most common agent involved: tools and machinery 15.9% (CI95%: 12.3-19.6%). Of these, 92.2% (CI95%: 89.3-94.7%) were accidental. Type of visit: 83.3% (CI95%: 79.6-87%) were attended as emergencies; 79.5% (CI95%: 75.4-83.5%) received treatment with dressings and/or medication. Of these, 9.8% (CI95%: 6.8-12.7%) required referral to a hospital, 13.3% (CI95%: 10-16.7%) required complementary tests. Conclusions: Most accidents occur in young people and educational campaigns to prevent accidents and directed towards this population group are clearly needed.

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          Most cited references37

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          Musculoskeletal injuries are the most common injuries in youth sports. A number of growth-related factors unique to the adolescent age group play an important role in the epidemiology, types, and management of these injuries. These mainly relate to the physical and psychosocial growth and development during adolescence and are discussed in this article. Overuse injuries are more commonly seen in this age group in the primary care setting. Shoulder impingement, elbow and shoulder injuries related to throwing, stress injuries of the wrist, spondylolysis, and anterior knee pain are some of the overuse injuries reviewed in this article.
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              The use of the accident and emergency department.

              Many studies have shown that a high proportion of patients attending accident and emergency (A&E) departments have only trivial or non-urgent complaints. A&E staff treat these inappropriate attenders while recognizing that this detracts from the care given to more serious cases. Dwindling resources and higher attendances make it a matter of necessity that inappropriate attenders be treated by general practitioners or equivalent primary care services. In this study, the authors examined the feasibility of methods of reducing inappropriate attendance. The authors investigated patients' ability to accurately assess the urgency of their condition and, hence, their need for A&E services. The authors concluded that there is probably no practical way of reducing inappropriate attendance that does not involve risk to a proportion of patients. The possibility of extending the role of the A&E department to provide more general primary care is discussed.
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                Author and article information

                Journal
                resp
                Revista Española de Salud Pública
                Rev. Esp. Salud Publica
                Ministerio de Sanidad, Consumo y Bienestar social (Madrid, Madrid, Spain )
                1135-5727
                2173-9110
                February 2002
                : 76
                : 1
                : 57-64
                Affiliations
                [01] Girona orgnameInstitut Català de la Salut orgdiv1Área Básica de Salud Girona-4
                Article
                S1135-57272002000100007 S1135-5727(02)07600100007
                10.1590/s1135-57272002000100007
                0b1747c1-c952-4b2a-a5e9-6a22a1be0eb4

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 29, Pages: 8
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                SciELO Public Health

                Categories
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                Adolescent,Accidentes,Accidents,Adolescencia,Primary care,Atención Primaria

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