Injury
-
A prospective analysis of 207 trauma patients, from three internationally recognized trauma centres, showed that trauma teams in which staff carry out allocated tasks simultaneously have the quickest resuscitation times. This finding was further tested by introducing these changes into a fourth centre. A comparison of resuscitation stage times was made in 26 patients before and 24 patients after the introduction of the organizational changes. ⋯ The time taken to complete the resuscitation was reduced by over half from 122 to 56 min. Significant time reductions applied even when variations in the type of patient, the team size or seniority of the team leader was taken into account. Recommendations for the organization of trauma teams are made.
-
The TRISS method has been claimed to be useful in the evaluation of trauma care. The aim of this study was to compare our data with Major Trauma Outcome Study (MTOS) results in North America, and to note differences and strive to improve care in our system. Data were collected from 163 consecutively admitted trauma patients to the Intensive Care Unit, Accident and Emergency Centre, Belgrade, Yugoslavia. ⋯ This applies especially to the group of patients over 54 years of age who suffered blunt trauma, whose higher mortality (23 observed and 15.6 expected out of 50 patients) can be attributed to the ISS score being almost double that of the MTOS population of comparable age. Penetrating trauma patients, in spite of severe injuries, had better survival than predicted. The TRISS method, in spite of its limitations, proved a useful method of evaluating trauma care, and can be run on a small computer without the necessity for special staff.
-
This is an epidemiological study based on Coroners' records analysing mode of injury and place and cause of death. The aim of the study is to provide data on the incidence and patterns of death from trauma and to assess the need for changes in trauma management. All traumatic deaths occurring in the South West Thames Region during 1988 were studied. ⋯ The majority of deaths from trauma occur before arrival at a hospital, particularly in the semi-rural areas. Improvements in hospital trauma care could have only a limited effect on the death rate in existing circumstances. If important reductions in deaths from severe injury are to be made then prevention and prehospital care need to be improved.
-
Comparative Study
The use of power tools in the insertion of cortical bone screws.
Cortical bone screws are commonly used in fracture surgery, most patterns are non-self-tapping and require a thread to be pre-cut. This is traditionally performed using hand tools rather than their powered counterparts. ⋯ A series of experiments has been performed which show that the thread pattern cut with either method is identical and that over-penetration with the powered tap is easy to control. The conclusion reached is that both methods produce consistently reliable results but use of power tools is much faster.