Trauma Deserts: Distance From a Trauma Center, Transport Times, and Mortality From Gunshot Wounds in Chicago

Crandall, Marie; Sharp, Douglas; Unger, Erin; Straus, David C.; Brasel, Karen J.; Hsia, Renee Y.; Esposito, Thomas J.

doi:10.2105/ajph.2013.301223

Cited by 152 publications

(154 citation statements)

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“…Public health and medical researchers have been primarily concerned with elucidating the role of firearms in the nature and severity of injuries from a primary prevention and medicinal perspective. This literature examines the role and influence of responses to criminal acts that directly contribute to victim injury outcomes (see Crandall, Sharp, Unger, et al, 2013;Papadopoulous, Kanakaris, Danias, et al, 2013).…”

mentioning

confidence: 99%

Elaborating the Correlates of Firearm Injury Severity: Combining Criminological and Public Health Concerns

Grommon

Rydberg

2014

Victims & Offenders

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This research addresses recent calls to incorporate multidisciplinary approaches in the study of firearm violence by utilizing an elaborated criminal events perspective to explore the correlates of firearm injury severity. A unique dataset of non-fatal firearm injury data are derived from official police reports, allowing the use of a medically-validated measure of injury trauma in place of more typical injury indicators. The relative and collaborative contributions of criminological and public health indicators for explaining variation in levels of injury severity are assessed. Multinomial logit models suggest that critical injuries are more likely among older victims, victims who knew their assailants, and victims who refused to cooperate with police. Additionally, the likelihood of critical victim injuries decreased as the time to report an incident to the police increased. The strongest correlates were measures of incident circumstances and the number of gunshot wounds a victim received. In all, these results reveal that a combination of measures from both fields is needed to provide a deeper understanding of injury severity outcomes.

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confidence: 99%

Elaborating the Correlates of Firearm Injury Severity: Combining Criminological and Public Health Concerns

Grommon

Rydberg

2014

Victims & Offenders

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“…According to a study in the United Kingdom, every 10km added to this distance was associated with a 1% increase in absolute mortality 15 . According to another study, in Chicago (USA), this distance between the event and treatment facilities was even smaller, 5 kilometers, for evacuating patients with gunshot wounds to a specialized trauma center 13 .…”

Section: Discussionmentioning

confidence: 99%

“…A 10-kilometer radius was drawn around each competition venue 13 , illustrated with a colored circle, referring to the probable inflow of persons to be treated in case of hospital referral. This allowed identifying large areas that would concentrate health care.…”

Section: Geoprocessingmentioning

confidence: 99%

Preparedness for the Rio 2016 Olympic Games: hospital treatment capacity in georeferenced areas

et al. 2016

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Recently, Brazil has hosted mass events with recognized international relevance. The 2014 FIFA World Cup was held in 12 Brazilian state capitals and health sector preparedness drew on the history of other World Cups and Brazil's own experience with the 2013 FIFA Confederations Cup. The current article aims to analyze the treatment capacity of hospital facilities in georeferenced areas for sports events in the 2016 Olympic Games in the city of Rio de Janeiro, based on a model built drawing on references from the literature. Source of data were Brazilian health databases and the Rio 2016 website. Sports venues for the Olympic Games and surrounding hospitals in a 10km radius were located by geoprocessing and designated a "health area" referring to the probable inflow of persons to be treated in case of hospital referral. Six different factors were used to calculate needs for surge and one was used to calculate needs in case of disasters (20/1,000). Hospital treatment capacity is defined by the coincidence of beds and life support equipment, namely the number of cardiac monitors (electrocardiographs) and ventilators in each hospital unit. Maracanã followed by the Olympic Stadium (Engenhão) and the Sambódromo would have the highest single demand for hospitalizations (1,572, 1,200 and 600, respectively). Hospital treatment capacity proved capable of accommodating surges, but insufficient in cases of mass casualties. In mass events most treatments involve easy clinical management, it is expected that the current capacity will not have negative consequences for participants.

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“…Health care professionals know that within rural areas or urban "trauma deserts," proximity to a trauma center can influence mortality [2]. Higher-levelof-care transfers to trauma centers, which occur frequently as a result of regionalization of trauma care, also utilize precious resources.…”

mentioning

confidence: 99%

Caring for the Wounded—the Ethics of Trauma Surgery

2018

AMA Journal of Ethics

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In a fraction of a second, trauma changes us. Trauma injures organs, fractures bones, and makes us bleed, but it also leads to suffering, demoralization, and fear. While physical injuries can often be neatly classified, emotional and spiritual injuries cannot. These burdens are shouldered by many, not just those who are physically injured. Families, friends, communities, and even those who care for the injured are also wounded.Trauma professionals' decisions can change us, too. Trauma surgeons must make highstakes decisions, often in rapid succession and without knowledge of a patient's identity or history. In our field, the "golden hour"-the hour just after an injury when medical care is most likely to prevent death-is dogma [1]. For this reason, action almost always outpaces deliberation. Choices such as whether to give blood, go to the operating room, amputate, or try to salvage a mangled extremity are often made without an understanding of our patients' life goals and values. As a result, we almost always sacrifice respect for autonomy in favor of what we presume to be our patients' best interest.

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Trauma Deserts: Distance From a Trauma Center, Transport Times, and Mortality From Gunshot Wounds in Chicago

Abstract: Relative "trauma deserts" with decreased access to immediate care were found in certain areas of Chicago and adversely affected mortality from GSWs. These results may inform decisions about trauma systems planning and funding.

Cited by 152 publications

References 23 publications

Elaborating the Correlates of Firearm Injury Severity: Combining Criminological and Public Health Concerns

Elaborating the Correlates of Firearm Injury Severity: Combining Criminological and Public Health Concerns

Preparedness for the Rio 2016 Olympic Games: hospital treatment capacity in georeferenced areas

Caring for the Wounded—the Ethics of Trauma Surgery

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