Background Concussion recognition, treatment and management is crucial in supporting recovery and decreasing the risk of long-term brain damage. Long-term effects are often not recognized early enough to prevent post-concussion syndrome, resulting in an impact on social and professional lives. The need to standardize care is vital in preventing adverse concussion outcomes. Objective To determine if concussion knowledge, attitudes and practices (KAP) are significantly improved among physicians and nurses following completion of CATT. Design A pre/post-intervention questionnaire designed to measure changes in physician/nurse KAP. Setting Primary setting was hospital emergency departments in the Lower Mainland, British Columbia. Participants Physicians/nurses working in emergency departments/trauma care facilities. Intervention Based upon established international principles, CATT is an online toolkit (www.cattonline.com) providing learner-directed concussion awareness training for health practitioners as well as assessment resources (SCAT3, Child-SCAT3), links to clinical resources, patient handouts, journal articles (including the Zurich Consensus Statement), related websites, concussion videos and study cases. Main outcome measures Change in physician/nurse knowledge, attitudes and practices regarding concussion recognition, treatment and management. Results 44 physicians and 35 nurses were recruited. Post-intervention questionnaires were completed by 34 physicians (77.3%) and 25 nurses (71.4%). Physicians demonstrated a statistically significant positive change in concussion practices (P=.001). Change in physician knowledge was not significant, while attitudes had a negative change (P=.041). Positive change in physician knowledge was detected for those who typically see more than 10 concussions per year (P=.039). Nurses demonstrated statistically significant positive change in practices (P=.005) and attitudes (P=.035), but no change in knowledge. Conclusions CATT is effective in improving concussion knowledge and practices among physicians and nurses, which will potentially minimize adverse concussion outcomes and lower health care costs among concussion patients. Phase 2 includes a toolkit for Parents, Players and Coaches, currently undergoing an evaluation with sporting associations in BC.

ON April 9, 1942, the Hospital Ship Vi'ita was fifteen miles off and travelling in the opposite direction to H.M. Ships Hermes and Vampire when they were sunk by enemy dive-bombers. Two hours later Vita's boats were in the water piGking up survivors and casualties. T h e operation was completed about five hours after the action began. Out of a total of 595 survivors there were about 140 badly wounded, of whom 20 died within twelve hours. T h e wounds were of all types, including burns, but among them were a number of patients complaining of abdominal pain of varying severity, following injury to the abdomen by under-water explosion. These men had been in the vicinity of exploding depth-charges, and three were involved by the explosion of the destroyer's magazine. Some of these men gave a graphic description of how the explosion blew them right out of the water. There were no direct gunshot wounds of the abdomen in these patients, and it is the purpose of this paper to try to record the impressions gained at the bedside, at operation, and at post-mortem. .Particularly is it intended to record the management of these patients, for they present many interesting clinical problems. Unfortunately, detailed notes on the clinical findings and progress were frankly impossible. The majority were landed 48 hours later, and during that time the entire medical and sick-berth staff were actively engaged in feeding, nursing, and life-saving measures, so that there was little time for detailed note-taking. Operative findings were recorded.

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