It is concluded from this hospital-based study that the mandatory seat belt law was associated with increased seat belt use in vehicle accident victims. However, current data from the Road Traffic Agency indicated that there is still an alarming number of fatalities. This clearly suggests that additional public health measures are needed to address the epidemic of motor vehicle trauma in Jamaica.

The majority of transferred head-injured patients sustained mild injuries with a third requiring surgical procedures and 19% requiring Intensive Care Unit care. Appropriate educational, training and transfer programmes and transfer policies must be implemented to minimize inappropriate transfers.

Reduction in unnecessary admissions, cost savings and increased efficiency may result from standardization of admission criteria for head-injured patients and consistent implementation of guidelines for admission without increased risk to patients.

A review of all the cases of bile duct injuries seen at the University Hospital of the West Indies since the introduction of laparoscopic cholecystectomy reveals that 60% of all cases resulted from open cholecystectomy and Roux en Y hepaticojejunostomy was the most common surgery offered for major bile duct injury.

In this group of patients, ultrasonograplry and leucocyte counts were not adequately sensitive to be useful as discriminating diagnostic tools in patients with suspected acute appendicitis

Acute chest syndrome remains a significant problem in patients with sickle cell disease subjected to laparoscopic cholecystectomy.

The majority of 216 cases of gastric cancer seen over a ten-year period was in the elderly; they were of the intestinal variety and located in the antrum. These patients presented with epigastric pain and often did not undergo curative surgery.

The authors conducted a descriptive retrospective record-based incidence study of all admissions to the Emergency Department (ED) during a hurricane. Injuries that took place during the hurricane period represented 40% of the total patients seen. Overall, the coping mechanism of the ED was adequate for this magnitude of disaster.

The transfer of head-injured patients, many with multiple injuries, is not being performed in a manner consistent with modern medical practice. There is urgent need for implementation of a standardized protocol for the transfer of such patients in Jamaica.