Preventable and potentially preventable deaths in severely injured patients: a retrospective analysis including patterns of errors

Schoeneberg, Carsten; Schilling, M.; Hussmann, Bjoern; Schmitz, Daniel; Lendemans, Sven; Ruchholtz, Steffen

doi:10.1007/s00068-016-0670-9

Cited by 36 publications

(33 citation statements)

References 28 publications

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“…Uncontrolled hemorrhage and trauma-induced coagulopathy (TIC) are still the principle causes for preventable death after trauma and one out of four severely injured trauma patients admitted to the hospital is bleeding with variable signs of laboratory coagulopathy. 1 , 2 , 3 Meanwhile, TIC is recognized as an own clinical entity with substantial impact on both morbidity and mortality after trauma. 3 , 4 There has been speculation about the potential mechanisms underlying TIC but much of the data continues to be rather correlative than causative with robust links still lacking.…”

Section: Introductionmentioning

confidence: 99%

Updated concepts on the pathophysiology and the clinical management of trauma hemorrhage and coagulopathy

Maegele¹,

Huang

et al. 2017

Chinese Journal of Traumatology

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Uncontrolled hemorrhage and subsequent trauma-induced coagulopathy (TIC) are still the principle causes for preventable death after trauma and early detection and aggressive management have been associated with reduced mortality. Despite increasing knowledge about trauma resuscitation, best practice to treat this newly defined entity is still under debate. A synopsis of best current knowledge with reference to the updated European trauma guideline on the management of severe trauma hemorrhage and TIC is presented. The implementation of evidence-based local protocols and algorithms including clinical quality and safety management systems together with parameters to assess key measures of bleeding control and outcome is advocated.

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Section: Introductionmentioning

confidence: 99%

Updated concepts on the pathophysiology and the clinical management of trauma hemorrhage and coagulopathy

Maegele¹,

Huang

et al. 2017

Chinese Journal of Traumatology

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“…In the present study, a novel in vivo research model has been developed that resembles the clinical setting of patients who use alcohol and undergo TxT with subsequent hemorrhagic shock. Due to the high prevalence of patients with traumatic chest injuries (Esmer et al., ; Hildebrand et al., ) and hemorrhagic shock, as well as their close association with mortality and/or preventable deaths, the clinical relevance of this model is indisputable (Schoeneberg et al., ; Spahn et al., ). Moreover, the data on alcohols’ influence on patients' outcome after trauma are very conflictive, and highlight the relevance of a reproducible rodent model for achieving a better understanding of the underlying pathophysiologic mechanisms (Lustenberger et al., ; Relja et al., ; Stubig et al., ).…”

Section: Discussionmentioning

confidence: 99%

Acute Alcohol Binge Deteriorates Metabolic and Respiratory Compensation Capability After Blunt Chest Trauma Followed by Hemorrhagic Shock-A New Research Model

Wagner

Franz

Dieteren

et al. 2017

Alcohol Clin Exp Res

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“…Preventable death is a performance indicator, defined as the proportion of all deaths judged to have been preventable if optimal care had been given. Preventable death has become a standard tool when measuring and comparing the quality of trauma care and is essential in trauma research [128,129].…”

Section: Trauma Care and Triage In Low-and Middle-income Countriesmentioning

confidence: 99%

TRIAGE : Management of the trauma patient

Lampi¹

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Triage, derived from the French word for sorting, aims to assess and prioritize injured patients, regardless of whether the injuries are sustained from everyday road traffic accident with few injured or a mass casualty incident. Triage seeks to provide the greatest benefit to the largest number of casualties in order to minimize morbidity and mortality. Triage in a pre-hospital setting entails management and sorting of patients according to an assessment of medical need, prioritization, and evacuation. In-hospital triage aims to rapidly identify the most injured and ensure timely and appropriate treatment according to the patient's clinical urgency. A number of different systems for performing triage have been established and implemented globally. The methodology is recognized and utilized but there is still a need for an evidence-based strategy to optimize training and the efficacy of the different systems.The main aim of this thesis was to determine triage performance among prehospital personnel and investigate the potential advantage of a triage system for trauma patients. The papers included in this thesis evaluated the triage skills of physicians, pre-hospital personnel, and rescue services personnel by testing their performance before and after an educational intervention. The last paper evaluated potential benefits of using a triage system for trauma patients admitted to the emergency department at MOI Teaching and Referral Hospital in Eldoret, Kenya.The results presented in this thesis illustrate that triage skills are lacking among physicians. Experienced pre-hospital personnel are more skilled in performing triage than physicians. The triage skills of the rescue services personnel improved significantly after the educational intervention. Moreover, the potential benefit to trauma patients of implementing an in-hospital triage system in a resource-poor environment was shown. In conclusion, health care personnel, especially physicians without experience but highly involved in trauma patient management, seem to be in need of triage training. How to train, how to implement, and how to evaluate triage skills must be considered in order to develop effective training. POPULÄRVETENSKAPLIG SAMMANFATTNINGOrdet triage kommer från franskans "sortera" och är ett av det första stegen i omhändertagandet av skadade när det råder resursbrist. Från 1800-talets blodiga slagfält, till dagens skadeplats och akutmottagningar har sättet att triagera patienter utvecklats. Men då, som nu, är grundtanken den samma, att sortera och prioritera de skadade utifrån tillgängliga resurser och patienternas vårdbehov. Följaktligen har begreppet kommit att bli centralt inom ämnet katastrofmedicin. Att avlida till följd av skador i samband med allvarliga händelser men också skador i till exempel vardagstrafiken är ett globalt hälsoproblem. Tiden från olycka till sjukhusbehandling är en viktig och ofta avgörande överlevnadsfaktor för en patient. I det här sammanhanget talas det om "den gyllene timmen", som påvisar vikten av att få ...

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Preventable and potentially preventable deaths in severely injured patients: a retrospective analysis including patterns of errors

Abstract: Preventable and potentially preventable errors still occur in the treatment of severely injured patients. Errors in hemorrhage control and airway management are the most common human treatment errors. The knowledge of these errors could help to improve trauma care in the future.

Cited by 36 publications

References 28 publications

Updated concepts on the pathophysiology and the clinical management of trauma hemorrhage and coagulopathy

Updated concepts on the pathophysiology and the clinical management of trauma hemorrhage and coagulopathy

Acute Alcohol Binge Deteriorates Metabolic and Respiratory Compensation Capability After Blunt Chest Trauma Followed by Hemorrhagic Shock-A New Research Model

TRIAGE : Management of the trauma patient

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