Articles: trauma.
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Eur J Trauma Emerg S · Dec 2008
Mortality Distribution in a Trauma System: From Data to Health Policy Recommendations.
Trimodal distribution of deaths and the golden hour concepts are in part responsible for the genesis of all modern trauma systems but these concepts have been challenged recently. Our aim was to describe distribution of death in trauma using data from a trauma system and discuss what could be done from the organizational point of view to improve outcome. ⋯ A tetramodal pattern of death distribution could be described. Our data support the need to focus on the treatment of severe head injuries namely in the intensive care environment.
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To assess the current stage of trauma system development and trauma surgery training in Europe. ⋯ Despite the great variation from country to country, three trends in developing trauma care and education can be identified: trauma system development based exclusively on major (life-threatening) trauma care (the old United States model), combining trauma and emergency surgery into a single regionalized system (the acute care surgery model), or maintaining the orthopedic surgery-orientated all-inclusive trauma care model as practiced in most central European countries today. Although each country and region might proceed along their own line depending on local circumstances, some kind of general guidelines and recommendations at least at the European Union level would be urgently needed.
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Scand J Trauma Resus · Nov 2008
Pre-notification of arriving trauma patient at trauma centre: a retrospective analysis of the information in 700 consecutive cases.
Pre-notification of an arriving trauma patient, given by transporting emergency medical unit, is needed in terms of facilitating the admitting emergency department to get ready for the patient before the patient actually arrives. In the present study we retrospectively analyzed the pre-hospital information provided by 700 consecutive pre-notification mobile phone calls in terms to asses the response of trauma team activation regard to pre-notified information such as vital signs and level of consciousness, mechanism of injury (MOI), and estimated elapsed time (EET) from the time of pre-notification phone call to arrival. ⋯ Pre-notification phone call is of a crucial importance in organizing every day activities at a busy trauma centre, but it should not take place in too much advance. In any case, a pre-notification phone call, even on short notice, gives emergency department personnel some time to prepare for the incoming patient.
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Eur J Trauma Emerg S · Oct 2008
Physical and Psychosocial Factors Associated with Neck Pain after Major Accidental Trauma.
Neck pain after physical trauma is common; but previous research regarding the role of psychological and physical predictors for neck pain is inconsistent. A retrospective survey of consecutive patients presenting to a metropolitan trauma centre with major accidental trauma was performed between 1 and 6 years post injury. Possible predictor variables (demographic, injury severity, and psychosocial factors) were determined from the hospital trauma registry and the questionnaire. ⋯ Neck pain was significantly more likely to be severe in patients with a cervical spine fracture, with pre-existing chronic illnesses, those with post-traumatic stress disorder (PTSD) at the time of follow up, those who had retained the services of a lawyer regarding the injury, and those with lower education levels. Psychosocial factors are important predictors of neck pain after major physical trauma. These findings do not support models for post-traumatic neck pain that are restricted to physical factors.