J Trauma
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This study assessed the performance of the trauma team leader in 50 consecutive trauma resuscitations at Liverpool Hospital over a two-month period. The trauma team consists of intensive care (ICU), emergency, and surgical registrars, three nurses, a wardsman, a radiographer, and a social worker. The team leader position alternates between the ICU and emergency registrar on a fortnightly roster. ⋯ Medical skills were uniformly well performed. Poor communication with other team members were the main pitfall of the team leader in this study. The team leader score may prove a useful tool in improving the quality of the trauma team.
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To determine the potential risks of the use of oral contrast medium for bowel opacification in abdominal trauma computed tomography (CT) scanning. ⋯ Bowel opacification is important for optimal CT evaluation of abdominal trauma and can be used with confidence. Attention to proper preparation and administration of the contrast material and, more importantly, control of the patient's airway by appropriate tracheal intubation are essential to assure the safety of the procedure.
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Multicenter Study
Validation of TRISS and ASCOT using a non-MTOS trauma registry.
To validate the Trauma and Injury Severity Score (TRISS) and A Severity Characterization of Trauma (ASCOT) models for patients with blunt injuries using an independent trauma registry, and to develop new TRISS and ASCOT models for types of patients with blunt injuries and examine their fit. ⋯ New TRISS and ASCOT coefficients should be derived if survival for patients with blunt injuries is to be predicted accurately in independent trauma registries. Also, it may be wise to consider developing separate models for subgroups of patients, particularly if hospitals in the registry have different mixes of patient types.
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To determine the current role of rural hospitals and prehospital agencies in the care of motor vehicle crash victims in a remote, rural county prior to the statewide regionalization of trauma care. Specifically, we determined the proportion of crashes that required a response by emergency medical services (EMSs), the timeliness of the response, the proportion of patients treated in local hospitals, and the factors that predicted referral to trauma centers. ⋯ The linkage of data from police, prehospital agencies, and hospitals can reveal important information about the sequence of health care for trauma patients. The rural hospitals in this county currently play a major role in the stabilization and treatment of motor vehicle crash victims.
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To identify characteristics of blunt trauma admissions associated with mortality and to derive a linear logistic model for predicting the probability of mortality. ⋯ The authors propose that use of this model may provide a more accurate evaluation of the mortality of British trauma admissions than would be obtained using models based on data from American trauma cases.