Falls from heights while clearing snow in Akita prefecture: Re-evaluation after preventive countermeasures and public service.

BACKGROUND: This study was performed to re-examine the incidence of falls from heights while clearing snow in Akita prefecture after implementation of preventive countermeasures and a public service campaign. METHODS: This was a retrospective analysis of registration data from the section regarding prevention against natural disasters in the Akita prefectural office. The study population comprised all patients who fell from heights while clearing snow and were transported to the emergency department from December 2015 to March 2018. RESULTS: In total, 168 individuals (159 male, 9 female) fell from heights while clearing snow. Their mean age was 65.7 years (range, 19-92 years). The largest proportion of falls occurred in January (54.2%; 91 patients). The most common region in which the falls occurred was the inland part of the southern district of Akita prefecture, which accounted for 73.8% of the falls (124 patients). Individuals aged ≥65 years constituted 52.9% of the patients (n = 89). The most common mechanism of injury was a fall from a rooftop, which accounted for 62.5% of the falls (105 patients), followed by a fall from a ladder (31.0%; 52 patients). The most common sites of injury were the upper and lower extremities (39.2%; 66 patients), followed by the spine (36.3%; 61 patients). Seven of the patients died. CONCLUSIONS: Compared with a previous study by Hatakeyama et al. (Falls from heights while clearing snow in Akita Prefecture. Rinsyou Seikeigeka Clin Orthop Surg 2013 Nov; 48(11): 1091-4 [in Japanese]), the total number of patients who fell from heights while clearing snow decreased by one-half. However, the number of persons aged ≥65 years increased and constituted 52.9% of the patients, reflecting the rapidly expanding older population in Akita prefecture.

Ultrasound-Guided Peripheral Nerve Blocks Performed by Orthopedic Surgeons: A Retrospective, Multicenter Study in Akita Prefecture, Japan.

The shortage of doctors is a societal problem, especially in rural areas such as Akita Prefecture, Japan. Therefore, it is not unusual in Akita for orthopedic surgeons to perform upper and lower limb surgeries under ultrasound-guided peripheral nerve blocks managed by the operators themselves. Multicenter studies of ultrasound-guided peripheral nerve blocks performed by orthopedic surgeons have not been reported. The purpose of this study was to clarify the safety and reliability of ultrasound-guided peripheral nerve blocks performed by orthopedic surgeons in Akita. A total of 1,674 upper extremity surgery cases operated under ultrasound-guided peripheral nerve blocks at 8 hospitals in Akita prefecture from April 2016 to April 2018 were investigated retrospectively. These blocks were performed by a total of 37 orthopedic surgeons, including senior surgeons and residents. In 321 of the 1,674 cases (19%), local anesthetics were added to the surgical field. Two cases with special factors were converted to general anesthesia. There were 2 cases of complications associated with the nerve block, but they were all transient and recovered promptly. The block site and the hospital where the block was performed showed a significant relationship with the addition of local anesthetics to the surgical site (P < 0.001). Surgery time, age at surgery, and surgical site showed no significant relationships with the addition of local anesthetics. The volume of the anesthetic used for the nerve block showed a significant inverse relationship with the addition of local anesthetics (P=0.040). Many orthopedic surgeons in Akita prefecture began to perform ultrasound-guided peripheral nerve blocks, which had a reliable anesthesia effect with no noticeable complications, whether performed by residents or senior orthopedic surgeons, and this is a useful anesthetic technique for orthopedic surgeons.