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  1. Preventable dealth evaluation of the appropriateness of the on-site trauma care provided by Urgences-Santé physicians.

    Article, Communication - En anglais

    Royal College of Physicians and Surgeons of Canada. Annual meeting. Toronto ON CAN, 1994/09.

    The study is based on 44 preventable deaths occurring in a cohort of 360 patients with major trauma.

    These cases were reviewed by a committee of nine experts.

    The mean Injury Severity Score (ISS) was 28, and most cases had injuries to the head/neck (68%) and chest (64%). The mean (±SD) observed prehospital times, and those considered the maximum allowable by the committee, were 40.6 ± 12.0 minutes for head/neck injuries and 23.9 ± 12.2 minutes for chest injuries (p<0.05).

    Intravenous (IV) lines were started in 38 (86%) of the patients.

    The committee classified this procedure as harmful for 16 (42%) and neutral for 19 (50%). Among the 18 (46%) that were intubated, this intervention was considered harmful for 17% and neutral for 39%. In two of the three patients for whom a pneumatic antishock garment was applied, this procedure was considered harmful.

    Of the 34 patients that required direct transport at a level I trauma center, 50% were transferred to such a hospital.

    These results show significant prehospital delays and high rates of inappropriate IV line initiation and intubation in trauma patients receiving on-site care by physicians.

    We conclude that prehospital care protocols for trauma patients should emphasize prompt transport and specific on-site care algorithms.

    Mots-clés Pascal : Canada, Amérique du Nord, Amérique, Evaluation, Pratique professionnelle, Secours première urgence, Période préhospitalière, Mortalité, Soin, Traumatisme, Homme

    Mots-clés Pascal anglais : Canada, North America, America, Evaluation, Professional practice, First emergency care, Prehospital period, Mortality, Care, Trauma, Human

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    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 96-0081017

    Code Inist : 002B27B14C. Création : 199608.