title: Declaration of a state of emergency in Trinidad and Tobago: effect on the trauma admissions at the National Referral Trauma Centre.
abstract: OBJECTIVE
  To determine the effect of a State of Emergency (SOE) on penetrating injuries at the main trauma center in Trinidad and Tobago.
  
  
  METHODS
  Emergency room registers were accessed in order to identify all patients treated for penetrating injuries from July 1, 2010 through December 30, 2012. This study period was chosen to include injuries one year before and one year after the SOE that spanned from August 21, 2011 to December 5, 2011. Data were analyzed using SPSS version 19 and a P value<.05 was considered statistically significant.
  
  
  RESULTS
  There were 1,067 patients treated for penetrating injuries. There were significantly more injuries from gunshots compared to stab wounds (64.7% vs 35.3%; P<.001), and this pattern was maintained during the SOE (54.7% vs 45.3%; P=.37). There was a significant fall in mean monthly admissions for penetrating trauma during the SOE when compared to the 12-month period before its imposition (17.7, SD=4.0 vs 38.9, SD=12.3; CI, 5.6-36.8; P=.0108). One year later, mean monthly admissions for penetrating trauma were similar to those during the SOE (22.7, SD=2.1 vs 17.6, SD=4.0; CI, -2.3-12.3; P=.1295). The incidence of gunshot wounds remained low and stab wounds increased.
  
  
  CONCLUSIONS
  This study has demonstrated that there was a reduction in the incidence of penetrating trauma at the national trauma center after the SOE, with a shift from gunshot to stab wounds.
authors.affiliation: Department of Clinical Surgical Sciences,University of the West Indies,St Augustine Campus,Trinidad and Tobago.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Ramdass
authors.affiliation: Department of Clinical Surgical Sciences,University of the West Indies,St Augustine Campus,Trinidad and Tobago.
authors.forename: Shamir O
authors.identifier: http://orcid.org/0000-0003-3377-0303
authors.initials: SO
authors.lastname: Cawich
authors.affiliation: Department of Clinical Surgical Sciences,University of the West Indies,St Augustine Campus,Trinidad and Tobago.
authors.forename: Suresh
authors.initials: S
authors.lastname: Pooran
authors.affiliation: Department of Clinical Surgical Sciences,University of the West Indies,St Augustine Campus,Trinidad and Tobago.
authors.forename: David
authors.initials: D
authors.lastname: Milne
authors.affiliation: Department of Clinical Surgical Sciences,University of the West Indies,St Augustine Campus,Trinidad and Tobago.
authors.forename: Earnest
authors.initials: E
authors.lastname: Ali
authors.affiliation: Department of Clinical Surgical Sciences,University of the West Indies,St Augustine Campus,Trinidad and Tobago.
authors.forename: Vijay
authors.initials: V
authors.lastname: Naraynsingh
mesh_terms: D004189:Disaster Planning; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D011634:Public Health; D012307:Risk Factors; D014193:Trauma Centers / Q000458:organization & administration*; D014300:Trinidad and Tobago / Q000453:epidemiology; D014948:Wounds, Gunshot / Q000453:epidemiology*; D014951:Wounds, Stab / Q000453:epidemiology*
keywords: POSGH Port of Spain General Hospital; SOE State of Emergency; Trinidad; emergency; gunshot; trauma; violence