Articles: emergency-medical-services.
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Evaluation of trauma care must be an integral part of any system designed for care of seriously injured patients. However, outcome review should offer comparability to national standards or norms. The TRISS method offers a standard approach for evaluating outcome of trauma care. ⋯ Methods for calculating statistics associated with TRISS are presented. The Z and M statistics are explained with the nonstatistician in mind. We feel this article is a source for those interested in developing or upgrading trauma care evaluation.
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Trauma is the fourth leading cause of death for all Americans, with a mortality rate of 61 deaths per 100,000 people. Although the definitive place for the management of major abdominal or thoracic hemorrhage, as well as neurological or orthopedic problems, is the operating room in a tertiary care hospital, trauma is a time-related disease, and the more quickly hemorrhage is controlled and appropriate management initiated, the better the outcome. ⋯ Once the airway is cleared, any anatomical or physiologic compromise that limits ventilation is identified and corrected, hemorrhage is controlled, and the cervical spine, if injury is suspected, is protected. The secondary survey (Part 2) is a comprehensive examination.
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Acute, critical patients require a rapidly applied, highly refined diagnostic approach if their chances for survival are to be maximized. EMS systems have made great strides in addressing the management challenges confronting them, especially via the development and refinement of severity assessment instruments. ⋯ The methodology for the development of the latter has not yet even been explored in the EMS literature. It is hoped that this sharing of Port Worth's recent experiences will help other EMS professionals who find themselves either in the early stages of major system redesign or the initiation of a new EMS system.