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  1. From roadside to bedside : the regionalization of trauma care in a remote rural county.

    Article - En anglais

    Objective 

    To determine the current role of rural hospitals and prehospital agencies in the care of motor vehicle crash victims in a remote, rural county prior to the statewide regionalization of trauma care.

    We determined the proportion of crashes that required a response by emergency medical services (EMSs), the timeliness of the response, the proportion of patients treated in local hospitals, and the factors that predicted referral to trauma centers.

    Subjects 

    All motor vehicle occupants, pedestrians or pedal-cyclists who were involved in a motor vehicle collision with a response by emergency medical system personnel or the county coroner.

    Intervention 

    None.

    Main Outcome Measures 

    EMS response times, emergency department and hospital discharge disposition, Injury Severity Scores, hospital length of stay, procedures, deaths.

    Results 

    Twelve percent of 669 crashes reported to the police led to the dispatch of EMS.

    Crashes with EMS involvement were more likely to include occupants without restraints, who were ejected from the vehicle or who had alcohol as a contributing circumstance.

    Compared with patients who were admitted locally, referred patients had a significantly higher mean Injury Severity Score, hospital length of stay, and rate of operative procedures.

    Of the 13 crash-related deaths during the year, nine were declared dead at the scene before EMS arrival, three were asvstolic at the time of EMS arrival at the scene, and one died at a referral hospital.

    Mots-clés Pascal : Washington, Etats Unis, Amérique du Nord, Amérique, Accident circulation, Organisation, Secours première urgence, Milieu rural, Epidémiologie

    Mots-clés Pascal anglais : Washington, United States, North America, America, Traffic accident, Organization, First emergency care, Rural environment, Epidemiology

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 95-0137605

    Code Inist : 002B16N. Création : 09/06/1995.