Background: The triage is the first step in medical hierarchy for better management before treatment and transport in mass casualty incident (MCI). Therefore, an accurate, valid and timely triage will safe life and limbs, especially, when done by expert and experienced staff in MCI triage. This study planned to evaluate the MCI triage skills of the medical staff like doctors and nurses at Hamad General Hospital Emergency Department (HGH ED). They were provided a table top exercise (TTX) about MCI triage to improve the skills and knowledge followed by impact assessment. The study trial was planned and performed at emergency department of (tertiary hospital) Hamad general hospital at Doha Qatar.

Emergency department physicians can easily underestimate the severity of damage underlying the innocuous looking high-pressure injection injuries. These work-related injuries lead to significant lifelong morbidity as functionality is compromised in most cases, even after recovery due to high rates of amputation. Hence it is important to consider all high-pressure injection injuries as surgical emergencies. A detailed case history including pressure of the instrument, nature of the material, volume injected, angle of injection and time since injury should guide the treatment. Immediate debridement, antibiotic therapy and postoperative care are essential in all cases. Success of the treatment largely depends on early initiation of the therapy. Relying exclusively on non-surgical interventions may not be favorable in most cases as the injected material will continue damaging the internal tissues. Patients have to undergo a long recovery period with physiotherapy to regain the functionality of the affected region. However, the sensory and motor functions will never be returned to normal levels in these injuries.

Different forms of trauma have been a leading cause of death as seen in the Accident and Emergency specially in the age group of 1-50 years. Most of the usual causes outlined in the published literature include road traffic accidents, stab wounds, falls from height and gunshot wounds. The abdomen is traumatized in about 10-15% of cases; this would be attributed to its large surface area compared with other parts of the body. This prospective study was carried out over a period of one year starting January 2015 till December 2015, involving 500 cases with isolated abdominal injuries in some of the Gulf states and Iraq major hospitals. We highlight the incidence, gender distribution, available modalities of investigation and methods of improving management and prognosis of abdominal trauma in these variable hospitals. There were 500 purely abdominal trauma patients involved in the review over this one-year period. Penetrating injuries were seen in 66 patients (13.2%) and nonpenetrating in 434 patients (86.8%). Gunshot injuries and fall from heights were (2.02%) and (3.05%) of the injuries respectively. The overall ratio of non-penetrating to penetrating injuries was approximately 6:1. Wound sepsis was the most common complication of patients that underwent surgical exploration; mortality rate was (10%). The major cause of death was irreversible hypovolemic shock due to severe blood loss either prior to arrival in hospital or uncontrollable hemorrhage in the operating room and extreme coagulopathy in the immediate post-operative period. We advocate rapid transportation and prompt resuscitative measures, availability of modern technological investigations as well as surgical and intensive therapy skills in improving the outcome for victims of abdominal trauma regardless of the etiology. Spreading more awareness of the major factors in the causation of vehicular accidents and health education for drivers and road users, conspicuous display of speed limits as well as identification of the known accident black spots where road traffic accidents have historically been concentrated will be of significance in the prevention of future accidents and complications.

Introduction: Pain is a very common reason for presenting to the Emergency Department (ED). While the causes for pain are diverse, ranging from fractures and other injuries to chest or abdominal pain or headache, the provision of effective, timely analgesia should be one of the principal goals of emergency staff . Inadequate pain relief and poor treatment in pain management in ED was highlighted by Wilson and Pendleton and they coined the term oligoanalgesia to describe this phenomenon. They found that only 44% of patients with pain received analgesics in the ED, and sub therapeutic dosing was common. Methods: This was a prospective observational study conducted in HGH ED after approval from Department of Emergency Medicine Audit & Ethical Committee, investigators were divided over shifts in ED for 2 weeks. Total of 448 patients were recruited. Inclusion criteria were any patient presented to Ed in acute pain over the last 24 hour, age >18 years old. Patients in life threatening conditions, major trauma, altered mental status or communication difficulties were excluded. Results: Total of 448 patients were recruited. Of which 358 number were males, 90 Number were females. Trauma-related cases composed about 100 number (22.3%) of the pain cases. The number of pain medications prescribed to patients throughout the ED course and upon discharge was recorded. Conclusion: The administration of pain-relieving medications in the ED was associated with significant pain reduction upon disposition. However, pain was still inadequately treated and scoring was not adequately recorded in patient files. Need for proper structured approach for pain management in HGH ED is warranted.