Impact of Improved Emergency Medical Services and Emergency Trauma Care on the Reduction in Mortality from Trauma

Ornato, Joseph P.; Craren, Edward J.; Nelson, Norman M.; Kimball, Kenneth F.

doi:10.1097/00005373-198507000-00001

Cited by 71 publications

(24 citation statements)

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“…The implication from these studies is that a way out of our current trauma mortality is trauma care regionalization. In San Diego, CA, USA, audit of trauma care before and after implementation of a regional trauma care system [18], showed that improvements in evacuation, disposition and overall trauma care delivery are achieved with implementation. In Victoria, Australia, the preventable trauma death was significantly lower in Melbourne's designated trauma center than in other hospital groups [19].…”

Section: Discussionmentioning

confidence: 99%

Outcome For Hospitalized Road Trauma Patients at a Tertiary Hospital in Kenya

2005

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Section: Discussionmentioning

confidence: 99%

Outcome For Hospitalized Road Trauma Patients at a Tertiary Hospital in Kenya

2005

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“…Local and regional trauma systems are effective in decreasing traumarelated morbidity and mortality. [17][18][19][20][21][22][23][24][25][26][27] Despite being based on similar principles, a number of important differences exist between the organization of trauma care and that of stroke care. These differences are such that simply designating trauma systems as stroke systems would be inappropriate.…”

Section: Application Of Systems Approaches To Other Emergency Conditionsmentioning

confidence: 99%

Recommendations for the Establishment of Stroke Systems of Care

Schwamm¹,

Pancioli²,

Acker³

et al. 2005

Stroke

299

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“…Transport occurs by ground ambulance [1][2][3][4][5][6][7], by air [8][9][10], by bystanders [11][12] and even by taxi [12]. Yet pre-hospital care of injured patients has been surrounded by much controversy [13][14].…”

Section: Introductionmentioning

confidence: 99%

Advanced Versus Basic Life Support in the Pre‐Hospital Setting – The Controversy between the ‘Scoop and Run’ and the ‘Stay and Play’ Approach to the Care of the Injured Patient

Liberman

Branas

Mulder

et al. 2004

International Journal of Disaster Medicine

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Liberman M, Branas CC, Mulder DS, Lavoie A, Sampalis JS. Advanced versus basic life support in the pre-hospital setting -the controversy between the 'scoop and run' and the 'stay and play' approach to the care of the injured patient. International Journal of Disaster Medicine 2004; 2: 9-17Pre-hospital care for trauma patients is provided by emergency medical personnel using either basic life support (BLS) or advanced life support (ALS) techniques. BLS for the seriously injured trauma patient most notably involves 'scoop and run' in which medical interventions are performed while en route to an appropriate hospital. These interventions are non-invasive and include wound dressing, immobilization, fracture splinting, oxygen administration and non-invasive cardiopulmonary resuscitation. ALS encompasses all of the previously mentioned BLS techniques in addition to minimally invasive procedures such as endotracheal intubation, intravenous access for fluid replacement and administration of medications. System protocols often dictate that ALS providers 'stay and play' at the scene of a serious trauma in order to carry out these more advanced procedures. The rationale for the use of on-site ALS in trauma is that these interventions will reduce the rate of physiological and haemodynamic deterioration, thus stabilizing the patient prior to arrival at the hospital. It is expected that this will subsequently result in increased chances of survival. The paradox is that on-site ALS increases the amount of time that is spent on the scene, and hence increases the delay to definitive in-hospital care. The controversy regarding the prehospital care of trauma patients between ALS and BLS is ongoing. Due to this unresolved controversy, as well as historical, cultural and political factors, significant variations exist in the pre-hospital care available to trauma patients. Pre-hospital care throughout the world is therefore inconsistent and is provided in different ways by different crews with different equipment, protocols and training. This review will focus on the controversies which occur in the urban setting with regard to the overall approach to pre-hospital care as well as for specific pre-hospital interventions. The discussion will consist of an evidence-based approach to the topic of pre-hospital care and topics discussed will be based on past and current literature.

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Impact of Improved Emergency Medical Services and Emergency Trauma Care on the Reduction in Mortality from Trauma

Cited by 71 publications

References 0 publications

Outcome For Hospitalized Road Trauma Patients at a Tertiary Hospital in Kenya

Outcome For Hospitalized Road Trauma Patients at a Tertiary Hospital in Kenya

Recommendations for the Establishment of Stroke Systems of Care

Advanced Versus Basic Life Support in the Pre‐Hospital Setting – The Controversy between the ‘Scoop and Run’ and the ‘Stay and Play’ Approach to the Care of the Injured Patient

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