Prof Pius Ehiawaguan Iribhogbe Delivered his Inaugural Lecture which is the 188th inaugural Lecture Series in University of Benin titled “INJURY: Rumination of a Trauma Surgeon”. The Lecture attracted a Large crowd as the Uniben Auditorium was full to capacity. Prof Pius Ehiawaguan Iribhogbe is presently the Deputy Vice Chancellor Academies University of Benin, a Professor of Trauma and General Surgery from
the college of medicine. The program was held at the university main auditorium on Thursday 04th May 2017.
The lecturer Prof Pius said to ruminate is to think slowly and deeply about something. The subject of injury is worth ruminating about. There is hardly anyone in this hall who has never suffered injury. Injuries can be minor. Injuries can be deadly. Injuries kill all over the world every second, every minute and every hour. Injury is a disease just like cancer, just like HIV. It obeys the same epidemiological principles like other diseases. It has causes, effects and treatment. But we hardly stop to think about it. We always think that it cannot happen to us.
He explained with a question “What is injury? Cambridge International dictionary defines it as physical harm or damage done to a living thing. Oxford Advanced learner dictionary defines it as harm done to a person’s or an animal’s body”
- Injury can be physical or Psychological.
- Dynamic Relationship between the two:
He gave an instance of a student out of school on hospital bed in the trauma ward following a motor vehicle crash will also have psychological injury. In the like manner a driver with severe psychological disturbance due to indebtedness or marital challenges may be involved in a motor vehicle crash. Scientifically injury is defined as a harmful event which arises from the release of specific forms of energy or barriers to normal flow of energy.
Speaking to the audience he crave their indulgence to allow his project medical photographs for illustration. These photographs may be unpleasant. he apologize, More than 90% of all injury related deaths occur in low and medium income countries (LMIC) which are basically developing nations.
The highest interpersonal violence rates occur in the Americas among males 15-29 years. Among females Africa has the highest mortality rates from inter personal violence while women in China have a suicide rate twice that of women in other parts of the world.In Nigeria the leading cause of trauma mortality remains road traffic injuries encompassing motor vehicle crashes, motorcycle crashes and pedestrians hit by vehicles. We reported on road traffic accident trends in Nigeria
The father of the science of injury prevention is Dr. William Haddon the first director of the National Highway Traffic Safety Administration, in the United States of America
This is a conglomeration of adaptive responses by the body following injury. The responses protect the circulation, maintain homeostasis, provide energy and help in wound healing. The duration and intensity of these responses depend on the severity of the injury.
The cardiovascular response attempts to maintain perfusion to the various organs in the presence of bleeding. The inhibitory impulses from the baro receptors diminish following bleeding and loss of blood volume. The vasomotor centre in the medulla is activated leading to effects such as tachycardia, elevated blood pressure and sweating. Later blood is shunted from the skin, kidneys and intestines to vital organs like the heart and brain. Hence the urine output drops and the extremities are cold and clammy.
There is salt and water retention from the effects of aldosterone. The rennin-angiotensin system is activated. Angiotensin II a potent vasoconstrictor contributes to efforts by the body to maintain blood pressure for improved perfusion.
A major part of his work load in the trauma unit is dealing with abdominal trauma.
All organs within the abdomen are subject to injuries with varied probabilities.
The thoracoabdominal region (Between the nipples and the subcostal margin) shares organs with the chest. Oftentimes the trauma surgeon and the cardiothoracic surgeon dance together here.
In general abdominal trauma presents as blunt or penetrating.
Bleeding is a key player in the second peak of death following trauma. Blood transfusion often times is necessary. We evaluated the risk of blood transfusion hepatitis C virus. Trauma scientists continue to research into ways to minimize blood transfusion.
His role in the Crash-2 trial is worthy of mention. This was a multi centre trial in 40 countries involving 274 hospitals and coordinated by the London school of Hygiene and Tropical Medicine, University of London. The CRASH stands for Clinical Randomization of an Antifbrinolytic (tranexamic acid) in Significant Haemorrhage.
He was so active in this trial that he was invited to London in 2010 as a member of the Writing Committee. he stated that Carbon monoxide is a highly toxic gas produced by incomplete combustion of hydrocarbons. It is a colorless, odorless and non irritant toxin. Exposure may come from diverse sources. These include improper placement of gasoline generators in indoor locations, or close to air conditioning intake systems, running vehicle engines in enclosed spaces, closed room with burning charcoal, snow obstructed vehicle exhaust and faulty gas appliances, air-conditioning and room heating systems.
Signs of CO poisoning are often subtle and easily misdiagnosed. They may be acute or chronic.
Another example of unusual trauma is that one that results from having free objects in your vehicle. He said he remember a case of two girls transporting their mother’s corpse in a casket in a bus with two uncles. They had a motor vehicle crash with peculiar injuries which they had to report
He said the training has been highly successful. their activities and advocacy drew the attention of the Federal Government. The Honorable Minister for Health Prof. Onyeabuchi launched the National ND training curriculum for paramedic technology in 2014 incorporating part of the UBTH training curriculum. The UBTH was also designated as a special centre for the realization of the program on the training of paramedics. The HND curriculum is currently in process of completion.
Today there are forty paramedics working in the Emergency services of the UBTH since 2012 courtesy of the CMD Prof Michael Ibadin. Their roles include emergency work in the ED in conjunction with doctors and nurses, patient transport intra and inter hospital, pilot EMS service such as responding to emergency prehospital, advocacy on accident prevention and advocacy, community service in various areas and working with the Federal Road Safety Commission particularly during the so called “EMBER months”
He recommended that The Nigerian government at all levels must develop the political will to tackle trauma head on. It is a social responsibility. Trauma care is expensive and responsible governments around the world invest in it. Also it is even more expensive not to pay attention to trauma when we take into cognizance the morbidity, mortality, property damage, insurance costs and man hours lost.
The government must develop EMS and organised trauma systems. The Federal Ministry of Health must design a National Trauma system, utilize resources available and improve on hospital and manpower development with particular focus on trauma and emergency departments.
Paramedics are in Nigeria now. They must be integrated into the National Health Care system as in advanced Nations. Organisations such as the Federal Road Safety Commission, National Emergency Management Agency, the Nigerian Police and the Nigerian Army, Airforce and Navy should be encouraged to employ paramedics
He concluded by saying Trauma remains a major cause of morbidity and mortality in our Nation. Major victims of this scourge are the economic workforce (15-49 years).
Injuries prevalent in Nigeria are mainly unintentional injuries and follow injury mechanisms such as road traffic crashes, and gunshot injuries from armed robbers.
Poverty and ignorance contribute to the incidence of trauma in Nigeria. Injury preventive strategies can help to mitigate the incidence of injuries but poor societal attitude due to ignorance and poverty remains impediment to achieving this goal.
Nigeria has a high figure of preventable trauma deaths which occur mainly prehospital and in the Emergency departments. The absence of organized Emergency Medical Services, Paramedics and organized Trauma systems remain our Achilles heel
At the end of the lecture the vice chancellor prof . F.F Orumwense appreciated the lecturer for the research work and a well delivered lecture, thereafter decorated Prof Pius Ehiawaguan with a medal to usher him into the honor roll of the University of Benin Inaugural Lecturer’s.
Present at the event were the Vice- Chancellor of the university, Prof F.F.O Orumwense,DVC Administration prof J.Ehiorobo, ,School Liberian Dr Evelyn Idiodi ,Deans, Directors, Professors ,Emeritus Professors, his royal highnesses and top government functionaries, the Federal Road Safety Commission Vice Chancellor from sister university staff and student of the great university of Benin.
View Colorful Pictures Captured at the Event from the Gallery…….
Watch the Video of the 188th Inaugural Lecture Series titled “Injury: Rumination of A Trauma Surgeon” delivered by Professor Pius Ehiawaghuan Iribhogbe( Professor of Trauma and General Surgery) University of Benin.