Inmate trauma

I thought I'd cover the orange jumpsuit population since I work at the only hospital contracted to accept these patients in our county. Although it isn't the bulk of our patient population, we certainly do get incarcerated victims. Interestingly, the most common trauma mechanism in jail is blunt assault, whereas it is penetrating trauma (stab wounds) in state prison. The second most common mechanism is fall in jail and blunt assault in prison.

A common co-morbidity for both facility types is seizures. Psychiatric history is also common. Oftentimes these co-morbidities play a role in the inmate's trauma admission. For example, it is relatively common for an inmate to come in as a fall secondary to a seizure. Psychiatric illness can propagate an assault.

Sometimes we get inmates that come with a shady story about mechanism. You'll get a guy telling an elaborate story about how he fell getting out of the shower cell and yet his injuries are highly consistent with assault (like bilateral facial fractures!).

You also get often mysterious "fall from bunk" followed by an endless complaint of parasthesias. Of course everything must be taken seriously, just in case, so they get a full workup in hospital that include MRIs, neurology consults, neuro checks and observation. After days in hospital and the results are negative, as they often are, they go back to jail/prison.

But, despite their tendency to want to linger in the hospital, they are more often than not very polite and friendly! Perhaps it's because the environment is so different from their ususal day-to-day.