Ladders: A weapon of mass destruction
Andrew Pearce
Outline
Ladders: A Weapon of Mass Destruction?
Dr Andrew Pearce
Trauma Consultant
Overview
• Ladders are bad
• People die falling off ladders
• These are preventable deaths
• These are elderly
• We can do something about this
• We need to understand more about this
Why do it?
• Apparent increase in numbers
• Apparent increase in elderly injured/dying
• Hospital stay length
• Use of blood products
• Can we do something to prevent?
Why do it?
• Backyard Blitz, Renovate or Detonate
• Better Homes and Gardens
• Bushfires, leaves in gutters
• DIY
Ladders
• Young fit people with isolated orthopaedic injuries?
• Darwinian selection for ethnic elderly males, climb the ladder, reach for the olive!
Study details
• Retrospective case review RAH Trauma Service
• July 2000-December 2003
• Fall from ladder, scaffold, building, tree
• 282 patients fulfilled criteria
Spectrum of injuries
• Six major intra-abdominal injuries sustained by patients at home
• 4 spleen required surgery
• 1 bladder rupture
• 1 liver laceration both managed conservatively
Hospital stay
• 197 patients (70%) were admitted >24 hours
• Median 3 days
• LOS increased with age and ISS
Death rate
• Home 4.6/100 patients injured
• Work 4.2/100 patients injured
• Deaths from home injuries had median age 20yrs > than working group
Conclusions
• What are the accidents due to?
• Ladder
• Improper use
• Lack of safety devices/supervision
• Weather
• Pre-existing medical condition
• ETOH/drugs
solutions
• Hospital posters, televisions
• Media awareness campaign
– tv, local/state newspaper
• Pamphlets, hospital, GP, hardware store
• Council, services, help for elderly
• Attorney General, ie baby bath seat
Further research
• Traumatox out soon
• Prospective study with questionnaire to patient
• Identify specific variables to target
• Remember your age and don’t see yourself as Superman!
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Ministry of Health
