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  1. Stabilization of rural multiple-trauma patients at level III emergency departments before transfer to a level I regional trauma center.

    Article - En anglais

    Study objective 

    To determine whether triage and stabilization of severely injured rural trauma victims in outlying Level III emergency departments before transfer to Level I trauma centers results in outcomes similar to national normative data.

    Design 

    Retrospective review of trauma transfers and deaths during a 4-year period.

    Setting 

    Two Level 111 EDs in rural, upstate New York and an urban Level I regional trauma center.

    Participants 

    Fifty multiple-trauma victims with a Trauma Triage Score (T-RTS) of ¾11 or less.

    Forty-three patients were stabilized before transfer, and 7 died in the rural Level III ED.

    Results 

    There were 45 blunt injuries and 5 penetrating injuries.

    Mean patient age was 34 years (range, 9 months to 97 years).

    The Revised Trauma Score (RTS) on admission to the Level III ED was calculated for each patient (median score, 5.97 ; interquartile range (IQR), 4.09 to 6.90), as was the ultimate Injury Severity Score (ISS) (median score, 23 ; IQR, 13 to 29).

    With TRISS methodology, probabilities of survival (Ps) and death (Pd) were calculated.

    Results were compared with the Major Trauma Outcome Study (MTOS) by use of current coefficients derived from Walker-Duncan regression analysis of MTOS data.

    The predicted number of deaths was 13.5, whereas the actual number was 12, Z statistic, - 710.

    There were two unexpected survivors and three unexpected deaths.

    Mots-clés Pascal : Polytraumatisme, Stabilisation, Malade, Echelon local, Echelon régional, Unité soin intensif, Etats Unis, Amérique du Nord, Amérique, Transport sanitaire, Organisation santé, Homme, Traumatisme

    Mots-clés Pascal anglais : Multiple injury, Stabilization, Patient, Local scope, Regional scope, Intensive care unit, United States, North America, America, Medical transport, Public health organization, Human, Trauma

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

    Cote : 95-0208438

    Code Inist : 002B27B14C. Création : 09/06/1995.