Enduring association between irritable bowel syndrome and war trauma during the Nicaragua civil war period:A population-based study

BACKGROUND Psychosocial and physical trauma are known risk factors for irritable bowel syndrome(IBS),including in war veterans,whereas war exposure in civilians is unclear.Nicaragua experienced two wars,1970-1990:The Sandinistas Revolution(1970s)and The Contra War(1980s).Our aim was to investigate the role of exposure to war trauma in the subsequent development of IBS in the context of an established health surveillance system(11000 households).AIM To investigate in a civilian population the relationship between exposure to war trauma and events and the subsequent development of IBS in the context of an established public health and demographic surveillance system in western Nicaragua.METHODS We conducted a nested population-based,cross-sectional study focused on functional gastrointestinal disorders based on Rome II criteria.1617 adults were randomly selected.The Spanish Rome II Modular Questionnaire and Harvard Trauma Questionnaire were validated in Nicaragua.War exposure was assessed with 10 measures of direct and indirect war trauma and post-war effects.Multiple exposures were defined by≥3 measures.RESULTS The prevalence of IBS was 15.2%[Female(F)17.1%,Male(M)12.0%],war exposure 19.3%(F 9.3%,M 36.7%),and post-traumatic stress disorder(PTSD)5.6%(F 6.4%,M 4.3%).Significant associations with IBS in the civilian population were observed(adjusted by gender,age,socioeconomic status,education):physical and psychological abuse[adjusted odds ratio(aOR):2.25;95%confidence interval:1.1-4.5],witnessed execution(aOR:2.4;1.1-5.2),family member death(aOR:2.2;1.2-4.2),and multiple exposures(aOR:2.7;1.4-5.1).PTSD was independently associated with IBS(aOR:2.6;1.2-5.7).CONCLUSION An enduring association was observed in the Nicaragua civilian population between specific civil war-related events and subsequent IBS.Civilian populations in regions with extended armed conflict may warrant provider education and targeted interventions for patients.

History (Whose Story?)“Written With Lighting”: A Cinematic Representation of the “Traumatic Past “of the Germans in World War Ⅰ

The powerful ability of film to present the traumatized German war veteran that traces how some of the most vulnerable members of society, marginalized and persecuted as ‘enemies of the nation,’ attempted to regain authority over their own minds and reclaim the authentic memory of the Great War under Weimar Germany and the Third Reich. The mentally disabled survivor of the trenches became a focus of debate between competing social and political groups, each attempting to construct their own versions of the national community and the memory of the war experience. By examining the psychological effects of war on ordinary Germans and the way these war victims have shaped perceptions of madness and mass violence, the expressionist cinema explores how the classical German cinema of the Weimar Republic was haunted by the horrors of World War I and the the devastating effects of the nation's defeat. This paper purposes to analyse how this post-traumatic cinema transformed extreme psychological states into visual expression;how it pushed the limits of cinematic representation with its fragmented story lines, distorted perspectives, and stark lighting;and how it helped create a modernist film language that anticipated film noir and remains incredibly influential today.

Collective Trauma and National Behavior in Times of Threat The Israeli Public and the 2014 War in Gaza

This paper analyzes the impact of past trauma on national behavior in times of threat, applying Volkan＇s （2001, 2004） theory of multigenerational impact of trauma on large groups, and La Capra＇s （2014） theory of the use of the concept of individuals＇ trauma for understanding the behavior of traumatized collectives. The study of the Israeli response to the abduction and murder of three teenagers in summer 2014 is consistent with these theories, and shows how a collective with trauma in its past behaves similarly to a posttraumatic person. The paper contends that due to its traumatic past, the Jewish Israeli public perceived a tragic but limited （from a national security standpoint） hostile action as a grave collective threat, which invoked past demons and brought back existential fears. These feelings were inflamed by the Israeli media and leaders, paving the way for an escalation of the event into an armed battle.

The Interpretations of “Mother Images” and Their “Self-Trauma-Healing Mechanism” in Kipling's War Poetry

Rudyard Kipling is the first British writer to win the Nobel Prize for literature in 1907.Due to the influence of the First World War and the huge blow of his own beloved son John's death on the battlefield,Kipling's later writing pays more attention to the pain and trauma which the war brings,and the noble qualities of love,belief,and tenacity in human nature after the baptisms of pain and trauma.This paper selects two poems—"My Boy Jack"and"A Nativity"in Kipling's later poetry creation career.Freud's "trauma" and treatment theories are employed to study the two mothers' "self- trauma- healing mechanism"in face of pain and trauma,and to interpret the two mother images that experience the war-torn pain and trauma,and achieve their spiritual salvation at last.Through the transformation of the two mothers,Kipling wants to mourn his beloved son's death and expresses his determination and hope of faith and commitment in order to heal his inner pain and trauma,which unwittingly realizes Freud's trauma-healing theory.Key words:

Effect of a cervical collar on optic nerve sheath diameter in trauma patients

BACKGROUND:As advocated in advanced trauma life support and prehospital trauma life support protocols,cervical immobilization is applied until cervical spine injury is excluded.This study aimed to show the difference in optic nerve sheath diameter(ONSD)between patients with and without a cervical collar using computed tomography(CT).METHODS:This was a single-center,retrospective study examining trauma patients who presented to the emergency department between January 1,2021,and December 31,2021.The ONSD on brain CT of the trauma patients was measured and analyzed to determine whether there was a difference between the ONSD with and without the cervical collar.RESULTS:The study population consisted of 169 patients.On CT imaging of patients with(n=66)and without(n=103)cervical collars,the mean ONSD in the axial plane were 5.43±0.50 mm and 5.04±0.46 mm respectively for the right eye and 5.50±0.52 mm and 5.11±0.46 mm respectively for the left eye.The results revealed an association between the presence of a cervical collar and the mean ONSD,which was statistically significant(P<0.001)for both the right and left eyes.CONCLUSION:A cervical collar may be associated with increased ONSD.The effect of this increase in the ONSD on clinical outcomes needs to be investigated,and the actual need for cervical collar in the emergency department should be evaluated on a case-by-case basis.

Retrospective analysis of eFAST ultrasounds performed on trauma activations at an academic level-1 trauma center

BACKGROUND:Point-of-care ultrasound(POCUS)has become increasingly integrated into the practice of emergency medicine.A common application is the extended focused assessment with sonography in trauma(eFAST)exam.The American College of Emergency Physicians has guidelines regarding the scope of ultrasound in the emergency department and the appropriate documentation.The objective of this study was to conduct a review of performed,documented and billed eFAST ultrasounds on trauma activation patients.METHODS:This was a retrospective review of all trauma activation patients during a 10-month period at an academic level-one trauma center.A list comparing all trauma activations was crossreferenced with a list of all billed eFAST scans.Medical records were reviewed to determine whether an eFAST was indicated,performed,and appropriately documented.RESULTS:We found that 1,507 of 1,597 trauma patients had indications for eFAST,but 396(27%)of these patients did not have a billed eFAST.Of these 396 patients,87(22%)had documentation in the provider note that an eFAST was performed but there was no separate procedure note.The remaining 309(78%)did not have any documentation of the eFAST in the patient’s chart although an eFAST was recorded and reviewed during ultrasound quality assurance.CONCLUSION:A significant proportion of trauma patients had eFAST exams performed but were not documented or billed.Lack of documentation was multifactorial.Emergency ultrasound programs require appropriate reimbursement to support training,credentialing,equipment,quality assurance,and device maintenance.Our study demonstrates a significant absence of adequate documentation leading to potential revenue loss for an emergency ultrasound program.

Trauma patterns in patients attending the Emergency Department of Jazan General Hospital, Saudi Arabia

BACKGROUND: Modern civilization and the sharp rise in living standards have led to dramatic changes in trauma pattern in Saudi Arabia. This study aimed to describe the different patterns of injuries of patients attending the Emergency Department of Jazan General Hospital(JGH) in the southwest corner of Saudi Arabia.METHODS: A total number of 1 050 patients were enrolled in the study. A pre-organized data sheet was prepared for each patient attended the Emergency Department of JGH from February 2012 to January 2013. It contains data about socio-demographics, trauma data, clinical evaluation results, investigations as well as treatment strategies.RESULTS: The mean age of the patients was 25.3±16.8 years. Most(45.1%) of the patients were at age of 18–30 years. Males(64.3%) were affected by trauma more common than females. More than half(60.6%) of the patients were from urban areas. The commonest kind of injury was minor injury(60%), followed by blunt trauma(30.9%) and then penetrating trauma(9.1%). The mean time from the incident to arrival at hospital was 41.3±79.8 minutes. The majority(48.2%) of the patients were discharged after management of trivial trauma, whereas 2.3% were admitted to ICU, 7.7% transferred to inpatient wards, and 17.7% observed and subsequently discharged. The mortality rate of the patients was 2.6%.CONCLUSION: Trauma is a major health problem, especially in the young population in Saudi Arabia. Blunt trauma is more frequent than penetrating trauma, with road traffic accidents accounting for the majority.

The impact of emergency department length of stay on the outcomes of trauma patients requiring hospitalization: a retrospective observational study

BACKGROUND: We aimed to explore the impact of the emergency department length of stay(EDLOS) on the outcome of trauma patients.METHODS: A retrospective study was conducted on all trauma patients requiring hospitalization between 2015 and 2019. Patients were categorized into 4 groups based on the EDLOS(<4 h, 4–12 h,12–24 h, and >24 h). Data were analyzed using Chi-square test(categorical variables), Student’s t-test(continuous variables), correlation coefficient, analysis of variance and multivariate logistic regression analysis for identifying predictors of short EDLOS and hospital mortality.RESULTS: The study involved 7,026 patients with a mean age of 32.1±15.6 years. Onefifth of patients had a short EDLOS(<4 h) and had higher level trauma team T1 activation(TTA-1), higher Injury Severity Score(ISS), higher shock index(SI), and more head injuries than the other groups(P=0.001). Patients with an EDLOS >24 h were older(P=0.001) and had more comorbidities(P=0.001) and fewer deaths(P=0.001). Multivariate regression analysis showed that the predictors of short EDLOS were female gender, GCS, SI, hemoglobin level, ISS, and blood transfusion. The predictors of mortality were TTA-1(odds ratio [OR]=4.081, 95%CI: 2.364–7.045), head injury(OR=3.920, 95%CI: 2.413–6.368), blood transfusion(OR=2.773, 95%CI: 1.668–4.609), SI(OR=2.132, 95%CI: 1.364–3.332), ISS(OR=1.077, 95%CI: 1.057–1.096), and age(OR=1.040, 95%CI: 1.026–1.054). CONCLUSIONS: Patients with shorter EDLOS had different baseline characteristics and hospital outcomes compared with patients with longer EDLOS. Patients with prolonged EDLOS had better outcomes;however, the burden of prolonged boarding in the ED needs further elaboration.

Rapid sequence induction(RSI) in trauma patients: Insights from healthcare providers

BACKGROUND: We aimed to describe the current practice of emergency physicians and anaesthesiologists in the selection of drugs for rapid-sequence induction(RSI) among trauma patients.METHODS: A prospective survey audit was conducted based on a self-administered questionnaire among two intubating specialties. The preferred type and dose of hypnotics, opioids, and muscle relaxants used for RSI in trauma patients were sought in the questionnaire. Data were compared for the use of induction agent, opioid use and muscle relaxant among stable and unstable trauma patients by the intubating specialties.RESULTS: A total of 102 participants were included; 47 were anaesthetists and 55 were emergency physicians. Propofol(74.5%) and Etomidate(50.0%) were the most frequently used induction agents. Significantly higher proportion of anesthesiologist used Propofol whereas, Etomidate was commonly used by emergency physicians in stable patients(P=0.001). Emergency physicians preferred Etomidate(63.6%) and Ketamine(20.0%) in unstable patients. The two groups were comparable for opioid use for stable patients. In unstable patients, use of opioid differed significantly by intubating specialties. The relation between rocuronium and suxamethonium use did change among the anaesthetists. Emergency physicians used more suxamethonium(55.6% vs. 27.7%, P=0.01) in stable as well as unstable(43.4 % vs. 27.7%, P=0.08) patients.CONCLUSION: There is variability in the use of drugs for RSI in trauma patients amongst emergency physicians and anaesthesiologists. There is a need to develop an RSI protocol using standardized types and dose of these agents to deliver an effective airway management for trauma patients.

Life-threatening complications of ascariasis in trauma patients:a review of the literature

BACKGROUND:Ascariasis is one of the most common human parasitic infections worldwide. In some rare cases,ascariasis may cause serious consequences even sudden death. This study was undertaken to review the life-threatening complications of ascariasis in trauma patients reported in the literature.DATA SOURCES:Relevant articles about ascariasis and trauma were searched from Pubmed,Google scholar,Scirus,and Wanfang databases.RESULTS:Twenty-four patients with ascariasis were collected from 21 articles searched. Most of these patients were from tropical and subtropical countries. Of the 24 patients,12 were children. Their major complications occurred in the airway passage and digestive tract. There were 3 fatal cases in these patients. Twelve of the 24 patients described in 10 articles were reported in the last 10 years.CONCLUSIONS:Early diagnosis and prompt intervention are essential to minimize the high morbidity and mortality of these serious complications in trauma patients. Physicians should be aware of the possibility of Ascaris infection in a trauma patient from endemic area of ascariasis. History of Ascaris infection and routine examination of feces for Ascaris eggs may be helpful to make a correct diagnosis.

Indications for the surgical management of pancreatic trauma: An update

Pancreatic trauma is rare compared to other abdominal solid organ injuries,accounting for 0.2%-0.3% of all trauma patients. Moreover, this type of injury may frequently be overlooked or not readily appreciated on initial clinical examinations and investigations. The organ injury scale determines the severity of the trauma. Nonetheless, there are conflicting recommendations for the best strategy in severe cases. Overall, conservative management of induced severe traumatic pancreatitis is adequate. Modern imaging modalities such as ultrasound scanning and computed tomography scanning can detect injuries in fewer than 60% of patients. However, magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography(ERCP) have diagnostic accuracies approaching 90%-100%. Thus, management options include ERCP and stent placement or distal pancreatectomy in cases of complete gland transection and wide drainage only for damage control surgery, which can prevent mortality but increases the risk of morbidity. In the majority of cases, surgical intervention is not required and should be reserved for only severe grade Ⅲ to grade Ⅴ injuries.

Difficulties Experienced in Trauma Nursing Practice by Expert Emergency Nurses in Japan

The objective of this study was to determine the difficulties experienced in trauma nursing practice by expert emergency nurses in Japan. Ten nurses who worked at emergency and critical care centers in Japan were directly involved in nursing patients were selected by purposive sampling and underwent semi-structured interviews regarding the difficulties they experienced in trauma nursing. The nurses were specialists in critical care nursing or were certified emergency nurses. The interview responses were analyzed by the qualitative descriptive method. The following six categories of difficulties associated with the direct care of trauma patients and their family members encountered in trauma nursing practice were identified: [Initial handling of highly urgent trauma patients], [Understanding and observing the condition of patients who are in the treatment stage], [Judging when to transition to end-stage care for patients difficult to save], [Mitigating suffering and expanding safe activities of daily living for trauma patients], [Transitional care with a long-term perspective for trauma patients], and [Relationships with the family members of patients who died]. Three categories of difficulties related to the role of the expert nurse in trauma nursing practice were identified: [Person-to-person coordination and cooperation for a trauma patient], [Playing an educational role for the nursing staff], and [Pursuing expertise in trauma nursing and gaining empirical knowledge]. The findings suggested a need to establish systems for training and consultative support and opportunities to create meaning by reflecting on fulfillment and nursing practice.

Supraglottic jet oxygenation and ventilation(SJOV) for resuscitation of injured soldiers and people in war field

Dear Editor,Soldiers or people in battlefield settings are frequently injured with acute trauma, resulting in respiratory depression, hypoxia and associated morbidity and mortality. Traumatic brain injury(TBI) is with as much as 80%–90% of mild to moderate in combat casualties and contributed significantly to morbidity and mortality in battlefield settings. Correction of hypoxia at as capable as possible is expected to reduce or minimize the morbidity/mortality due to acute brain injury. An easy, quick and safe setup to promote oxygenation/ventilation of injured military personnel or peoples by non-medical personnel in battlefield settings immediately after acute injury before transfer to hospital is expected to reduce the morbidity/mortality due to injury mediated respiratory depression.

Clinical and Demograhical Characteristics of Patients with Maxillofacial Trauma in the Emergency Department

Objective: We aimed to investigate the clinical and demographical characteristics of patients admitted to the Emergency Department (ED) due to maxillofacial trauma (MFT). Methods: This sectional and retrospective study was conducted in Ankara Numune Education and Research Hospital ED between 1st March 2010 and 31st March 2017. Into the study, patients with MFT older than 15 years of age were included. Characteristics of patients were recorded. Patients’ characteristics were compared according to presence of fractures. Results: Mean age of the patients was 41.1 ± 18.0 years and a statistically significant relationship was determined between age and presence of fracture (p > 0.05). Of the patients, 74.5% was male and fracture presence was significantly more in males than females (p 0.05). Conclusion: The MFT is a pathology that either leads to its own, or can lead to life-threatening consequences as a result of additional organ injuries. The physician evaluating the patient should determine the MFT and additional pathologies and ensure that the interventions start as soon as possible.

Video-Assisted Thoracic Surgery as a Less-Invasive Management for Acute Hemothorax in Blunt Trauma

Purpose: We report our experience of Video-assisted thoracic surgery (VATS) to treat acute blunt traumatic hemothorax using mini-thoracotomy. Methods: We designed a prospective study to determine if VATS with mini-thoracotomy benefits for patients with blunt traumatic hemothorax compared with conventional repair through full thoracotomy. Twenty-five patients underwent emergency operation for acute hemothorax from 2000. Five patients with less than 5% probability of survival (PS) were excluded, leaving 20 as the subjects. Results: Ten patients underwent conventional thoracotomy (conventional group) and the other 10 patients underwent VATS with mini-thoracotomy (VATS group). There was no difference between conventional group and VATS group in injury severity score (29.1 and 27.0) or PS (81.2% and 80.7%). Hospital mortality rates were 10% in conventional group and 0% in VATS group (N.S). Total amounts of intra-operative bleeding and post-operative transfusion until day 7 were 735 ml and 19.3 units in conventional group and 303 ml and 9.2 units in VATS group respectively (N.S). The length of ICU stay was 9.7 days in conventional group and 5.9 days in VATS group (N.S). Conclusion: VATS with mini-thoracotomy can be alternative for patients with blunt traumatic hemothorax in most emergency operations.

Management of Traumatic Injuries of Road Traffic Accident Victims in the City of Ouagadougou at the University Hospital Trauma Emergency Department-Yalgado Ouédraogo

Purpose: To evaluate the management of traumatic injuries of accident victims in the city of Ouagadougou admitted to the trauma emergencies of the University Hospital of Ouagadougou. Material and Method: This was a descriptive prospective study of road traffic accident victims in the city of Ouagadougou on their arrival at trauma emergencies and on the 7th and 30th day after their discharge. A total of 991 patients were identified. The sex ratio was 1.94 with a male predominance. The average age of the patients was 31.5 years. The ratio of caregivers to patients on a 24-hour shift was 7/47, excluding patients hospitalized in the corridors. Results: We note that 81.94% of patients were transported by the fire brigade. The average time to first contact with a caregiver was 11 minutes. Upon admission, accident victims were accompanied in 84% of cases. The combination of paracetamol and néfopam was the most prescribed analgesic (50.2%). The average time between admission and X-ray completion was 101 minutes. Benign skin lesions were the most frequent (48.82%), followed by osteoarticular lesions of the limbs (fractures and dislocations). Ceftriaxone, and the combination of Amoxicillin + Clavulanic Acid, were the most prescribed antibiotics. Dressings and sutures (44.63%) were the most commonly performed treatments, followed by orthopaedic restraints (37.88%) and open fracture areas in 14.34%. The average time between admission and orthopaedic and/or surgical treatment was 04 hours 25 minutes. Patients discharged against medical advice accounted for 10.80% of cases. In 95% of cases, patients were satisfied with their management. Conclusion: The management of patients admitted to trauma emergencies is satisfactory, but difficulties remain in terms of delays in management. It is imperative to take into account certain factors involving both staff and working conditions in order to reduce the time required to provide care and improve user satisfaction in this emergency unit.

Influence of Psychological Intervention before Emergent Ocular Trauma Surgery on Patients' Negative Emotions

Purpose:.To investigate the effect of preoperative psychological intervention on alleviating negative emotions in patients undergoing emergent ocular trauma surgery.Methods:..A total of 100 patients undergoing emergent ocular trauma surgery were selected using convenience sampling and randomly divided into control(n=49) and experimental(n =51) groups. Patients in the control group received conventional nursing and their counterparts in the observation group were treated with individualized psychological interventions including psychological support, relaxation training, and humanistic care based on conventional nursing care..Self-rating anxiety scale(SAS), self-rating depression scale(SDS), and fear visual analog scale(FVAS) scores were statistically compared between the two groups.Results:.The scores of SAS, SDS, and FAVS were significantly lower in the experimental group than in the control group(all P<0.001).Conclusion:.Comprehensive psychological intervention effectively eliminates negative emotions in patients undergoing emergent ocular trauma surgery and accelerates their physical and mental recovery.

Chest Trauma at the Emergency Department of the Gabriel TouréUniversity Hospital Bamako, Mali

In Mali, chest injuries remain a real public health problem and are associated with heavy morbidity and mortality. Faced with a resurgence of urban civil violence and the explosion of road accidents, we decided to conduct this study in order to describe the epidemiological, clinical and therapeutic aspects of thoracic trauma in the emergency department. Method and Material: This is a descriptive prospective study over a period of one year in the emergency department of the CHU Gabriel Touré. Including all patients admitted for thoracic trauma. Analysis and Entry: Data were entered and analyzed on SPSS software version 20.0. The test was significant for a p value < 0.05. Results: We recorded 21,090 appeals in our structure among which 1284 patients were suspected of thoracic trauma. The diagnosis of thoracic trauma was retained in 119 (0.56%) patients. All patients were transported to the emergency room without prehospital medicalization. Clinical presentation was dominated by dyspnea in 54.6% of patients, however pain was the almost constant symptom in conscious victims. Various traumatic mechanisms had caused these lesions of the thorax, of which road traffic accidents represented half of the causes, followed by urban civil violence in 28.6% of patients. Landslides and falls from a great height were responsible for 19.5% of chest injuries. Open chest trauma was the type of lesion found in a third of the cases. This type of injury was exclusively due to blows and injuries during the brawls. Standard chest radiography was performed as the first intention in 60% of patients compared to 10.9% for the pleuropulmonary ultrasound. Thirteen patients required ventilatory assistance after orotracheal intubation. The average length of stay was 65.23 hours. During the period of our study, the overall mortality was 1.85% in the emergency departments with a lethality specific to chest trauma of 15%. Conclusion: Urban violence with its share of ballistic wounds determined the severity of this condition.

The Selective Conservative Management of Small Traumatic Pneumothorax Following Stab Injuries of the Chest in Emergency Department Patients

Background: Chest trauma is a catastrophic event that affects large number of population and leads to morbidity, disability and mortality. The definition of an occult pneumothorax is uncontested. It is a pneumothorax that was not suspected on the basis of clinical examination or plain radiography, but was ultimately detected with CT and usually treated conservatively. We evaluated the success of selective conservative management of small pneumothorax following stab chest injuries, in Emergency Department patients. Methods: This prospective study was conducted on 30 adult patients admitted to the emergency department with small traumatic pneumothorax following stab injury. All enrolled patients (n = 30) were assessed for the following, demographic data, laboratory investigations, chest x-ray and CT scan. The outcomes measured were discharge safely after successful conservative management, Initial conservative then invasive measurement. Results: There was a statistically significant difference between conservative and non-conservative types of management in the incidence of complications after 1 week follow up (p = 0.001). Conclusion: The majority of asymptomatic small pneumothorax patients following a stab injury can be managed conservatively. Haphazard chest tube insertion and aging may lead to complications in such patients.

Waiting Times and Length of Stay of Trauma Patients in a Botswana Referral Hospital Emergency Department

Background: Mortality and morbidity due to trauma are a significant public health challenge. There is paucity of data on the waiting times and length of stay (LOS) of trauma patients in emergency departments in Botswana. The aim of this study was to determine the Emergency Department (ED) waiting times and LOS of trauma patients at Princess Marina Hospital in Gaborone, Botswana. Methods: This was a retrospective medical records review of waiting times (time from triage to review by ED medical officer) and LOS (time from triage to disposition from the emergency department). The waiting times for the different assigned acuities were assessed against the South African Triage System (SATS) standards. All trauma patients seen from 19/11/2018 to 18/12/2018 were included in the study. Prolonged length of stay was defined as duration > 6 hours. Categorical data was summarized with frequencies while numeric data was summarized with medians and interquartile ranges. Results: A total of 187 trauma patients’ files were analyzed. Of these, 72 (38.5%) were females. The median waiting time was 3.8 hours and the maximum was 19.2 hours. The median length of stay (LOS) was 8.8 hours with a maximum of 37.2 hours. Only 53 (28.3%) of the participants had a LOS of less than 6 hours. None of the emergent patients were seen immediately. Only 5 (4.0%) of the very urgent patients were seen within the target of 10 minutes. Finally, only 10 (20.4%) of urgent patients were seen within the target time of 1 hour. Conclusion: The waiting times and length of stay in Princess Marina Hospital were mostly above the recommended standards. Urgent interventions are needed to reduce waiting times and length of stay for trauma patients. More studies are needed to explore the sources of delay and investigate possible solutions to this public health challenge.