Survival of Seriously Injured Patients First Treated in Rural Hospitals

Mullins, Richard J.; Hedges, Jerris R.; Rowland, Donna; Arthur, Melanie; Mann, N. Clay; Price, Daniel D.; Olson, Christine J.; Jurkovich, Gregory J.

doi:10.1097/00005373-200206000-00002

Cited by 43 publications

(22 citation statements)

References 18 publications

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“…Suicides, homicides, and falls (which together with automobile accidents make up 80% of violent deaths) all also carry higher mortality rates in rural America. [1][2][3][4][5] Of the remaining 10 causes of violent death, rural mortality rates are higher (only poisonings are lower in rural environments). 1,2 In spite of this, little is known as to why this disparity exists, although many explanations have been suggested.…”

Section: Introduction a N Injury In Rural Areas Of The Unitedmentioning

confidence: 99%

Telemedicine Reduces Discrepancies in Rural Trauma Care

Ricci

Caputo²,

Amour³

et al. 2003

Telemedicine Journal and e-Health

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Patients injured in rural areas die at roughly twice the rate of those patients with similar injuries in urban areas. A multitude of explanations have been suggested for higher mortality rates from trauma in the rural areas of the United States. Since rural emergency room (ER) staff see far fewer traumas than ER staff at large metropolitan trauma centers, their lack of exposure to this low-volume problem certainly contributes to the problem. To address discrepancies in trauma education and the delivery of care in our rural region, a telemedicine system was utilized to provide rapid consultation from surgeons at the level 1 trauma center and to provide enhanced educational opportunities for rural ambulance emergency first responders. Clinical outcome measures and evaluation questionnaires were designed in advance of implementation. Forty-one "tele-trauma consults" were performed over the first 30 months of the project, all for major, multi-system trauma. Though many clinical recommendations were made, the system was judged to be life saving in three instances, and both rural and trauma center providers felt the system enhanced clinical care. In addition, educational sessions for rural first responders were well attended and favorably reviewed. Early results of a telemedicine system provide encouragement as a means to address discrepancies in the outcomes after major trauma in rural areas, although more work needs to be completed and evaluated.

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Section: Introduction a N Injury In Rural Areas Of The Unitedmentioning

confidence: 99%

Telemedicine Reduces Discrepancies in Rural Trauma Care

Ricci

Caputo²,

Amour³

et al. 2003

Telemedicine Journal and e-Health

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“…It was associated with a greater tendency for patients with major injuries to be triaged to a higher level hospital 11 and increased adherence to emergency department process measures, 12 but it also lengthened the process of interfacility transfer to a level I or II center 13 and either modestly increased or had no measurable impact on mortality. 13,14 Because trauma system design and implementation continues to evolve throughout the United States, it is critical to identify the relative merits or disadvantages of inclusive systems. We set out to identify the impact of inclusive systems on both the process and outcome of care in the severely injured.…”

mentioning

confidence: 99%

Inclusive Trauma Systems: Do They Improve Triage or Outcomes of the Severely Injured?

Utter,

Maier,

Rivara

et al. 2006

The Journal of Trauma: Injury, Infection, and Critical Care

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152

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Severely injured trauma patients have greater inpatient survival in inclusive trauma systems even though they are no more likely to be hospitalized at a regional trauma center. Consideration should be given to continuing implementation of systems with an inclusive configuration, especially in light of other theoretical benefits of these systems, such as better dispersing of trauma care resources in the event of natural disasters or terrorist events.

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“…The impact of the delay in receiving definitive care has significant implications for patient outcomes. Overall, patients spend 2-4 hours at non-trauma hospital, 11-18% of those die awaiting transfer [3]. Surgery within 4 hours of injury has been shown to reduce mortality by as much as 60% among patients with acute subdural hematoma [4].…”

Section: Managementmentioning

confidence: 99%

Prehospital Triage and Emergency Room Care in TBI

Chmayssani¹

2014

Emergency Medicine

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Survival of Seriously Injured Patients First Treated in Rural Hospitals

Cited by 43 publications

References 18 publications

Telemedicine Reduces Discrepancies in Rural Trauma Care

Telemedicine Reduces Discrepancies in Rural Trauma Care

Inclusive Trauma Systems: Do They Improve Triage or Outcomes of the Severely Injured?

Prehospital Triage and Emergency Room Care in TBI

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