Analysis of Preventable Trauma Deaths and Inappropriate Trauma Care in a Rural State
Published 1 November 1995
Thomas J. Esposito, Nels D. Sanddal, Joseph D. Hansen, Stuart Reynolds
Citations191
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
The rural preventable death rate from trauma is not dissimilar to that found in urban areas before the implementation of a trauma care system, and inappropriate care rendered in the emergency department related to airway and chest injury management occurs at a high rate.
Abstract
The rural preventable death rate from trauma is not dissimilar to that found in urban areas before the implementation of a trauma care system. Inappropriate care rendered in the emergency department related to airway and chest injury management occurs at a high rate. This seems to be the major contributor to preventable trauma deaths in rural locations. Education of emergency department primary care providers in basic principles of stabilization and initial treatment may be the most cost-effective method of reducing preventable deaths in the rural setting.
Keywords
Medicine
PubMedThe injury severity score: a method for describing patients with multiple injuries and evaluating emergency care.
8,022 Citations1974Susan P. Baker, Brian O’Neill +2 more
The Journal of Trauma: Injury, Infection, and Critical CareTHE INJURY SEVERITY SCORE
7,298 Citations1974Susan P. Baker, Brian O’Neill +2 more
Results of this investigation indicate that the Injury Severity Score represents an important step in solving the problem of summarizing injury severity, especially in patients with multiple trauma.
PubMedEvaluating trauma care: the TRISS method. Trauma Score and the Injury Severity Score.
1,976 Citations1987Carl Boyd, M Tolson +1 more
This article is a source for those interested in developing or upgrading trauma care evaluation, as well as a means of comparison of outcome for different populations of trauma patients.
The Journal of Trauma: Injury, Infection, and Critical CareA Revision of the Trauma Score
1,937 Citations1989Howard R. Champion, William J. Sacco +4 more
T-RTS, the sum of coded values of GCS, SBP, and RR, demonstrated increased sensitivity and some loss in specificity when compared with a triage criterion based on TS and GCS values, and RTS demonstrated substantially improved reliability in outcome predictions compared to the TS.
The Journal of Trauma: Injury, Infection, and Critical CareEvaluating Trauma Care
1,809 Citations1987Carl Boyd, Mary Ann Tolson +1 more
The TRISS method offers a standard approach for evaluating outcome of trauma care and should offer comparability to national standards or norms.
Archives of SurgerySystems of Trauma Care
549 Citations1979John G. West
It is suggested that survival rates for major trauma can be improved by an organized system of trauma care that includes the resources of a trauma center.
The Journal of Trauma: Injury, Infection, and Critical CareThe Effect of Regionalization upon the Quality of Trauma Care as Assessed by Concurrent Audit before and after Institution of a Trauma System: A Preliminary Report
339 Citations1986S. R. SHACKFORD, P HOLLINGWORTH-FRIDLUND +1 more
JAMAPreventable trauma deaths. A review of trauma care systems development
326 Citations1985Richard H Cales
Archives of SurgeryImpact of Regionalization
277 Citations1983John G. West
A severe reduction in the number of deaths judged preventable was indicated and a more aggressive approach to the traumatized patient was noted as indicated by an increased percentage of patients who received appropriate surgical intervention.
The Journal of Trauma: Injury, Infection, and Critical CareAn Analysis of Errors Causing Morbidity and Mortality in a Trauma System
191 Citations1992James W. Davis, David B. Hoyt +7 more
The most common single error across all phases of care was failure to appropriately evaluate the abdomen, and although errors in the resuscitative and operative phases were more common, critical care errors had the greatest impact on preventable death.
The Journal of Trauma: Injury, Infection, and Critical CarePreventable Trauma Deaths
186 Citations1986David J. Kreis, Gustavo Plasencia +6 more
The severely injured should be triaged directly to trauma centers, and there is a need in Dade County, Florida, for an organized trauma system.
PubMedAssuring quality in a trauma system--the Medical Audit Committee: composition, cost, and results.
134 Citations1987S R Shackford, Peggy Hollingsworth-Fridlund +2 more
The Journal of Trauma: Injury, Infection, and Critical CareAssuring Quality in a Trauma System—The Medical Audit Committee
113 Citations1987Steven R. Shackford, Peggy Hollingsworth-Fridlund +2 more
A multidisciplinary concurrent audit of the quality of medical care within a trauma system was carried out by a committee of physicians, nurses, and health officials representing trauma centers, nontrauma hospitals, and the public agency administrating the trauma system.
The Journal of Trauma: Injury, Infection, and Critical CareLimitations of the TRISS Method for Interhospital Comparisons
112 Citations1991C. Gene Cayten, William M. Stahl +3 more
The value of the TRISS method for interhospital comparisons of trauma care was studied using data for 5,616 consecutive patients from three trauma centers and five community hospitals to compare mortality rates.
The Journal of Trauma: Injury, Infection, and Critical CareINTER-RATER RELIABILITY OF PREVENTABLE DEATH JUDGMENTS
111 Citations1992Ellen J. MacKenzie, Donald M. Steinwachs +3 more
Journal of the American College of Emergency PhysiciansAnalysis of 425 consecutive trauma fatalities: An autopsy study
110 Citations1974Donald D. Trunkey, Robert C. Lim
It is confirmed that the young productive age group is most at risk for accidental death and regionalization of trauma centers may aid in the reduction of mortality from accidental death.
The Journal of Trauma: Injury, Infection, and Critical CareIdentification of Preventable Trauma Deaths
90 Citations1992DAVID S. WILSON, JOHN McELLIGOTT +1 more
It is concluded that individual case review can be severely flawed and therefore should not be used to measure institutional quality of patient care and recommended that assessment of institutional performance should be based on objective evaluation methods, which require the study of patient population outcomes.
Annals of SurgeryAnalyses of Preventable Deaths by Mechanism of Injury Among 13,500 Trauma Admissions
88 Citations1991C. Gene Cayten, William M. Stahl +2 more
Preventable deaths were evaluated by mechanism of injury for 13,500 trauma admissions to eight hospitals over 2 years and problems were identified in the hospital care of patients, especially those with LF, leading to sepsis and multiple organ failure.
The Journal of Trauma: Injury, Infection, and Critical CareEVALUATION OF THE QUALITY OF HOSPITAL CARE FOR MAJOR TRAUMA
84 Citations1976Joseph A. Moylan, Don E. Detmer +2 more
Injury severity score rather than length of stay appears to be a better method for selecting patients at greater risk for poor care.
The Journal of Trauma: Injury, Infection, and Critical CareFAT EMBOLI SYNDROME
76 Citations1976J. A. Moylan, Marvin L. Birnbaum +2 more
A review of the medical records of 30 patients with major trauma found one third had fat emboli syndrome characterized by hypoxemia, confusion, and petechiae, and the free fatty acid binding capacity of albumin is discussed.
The Journal of Trauma: Injury, Infection, and Critical CarePatterns of Death, Complication, and Error in the Management of Motor Vehicle Accident Victims
70 Citations1983Daniel Lowe, Hugh L. Gately +3 more
A regional trauma system with categorization and designation of hospitals providing trauma care would have eliminated or improved deficiencies, resulting in improved outcomes for a significant percentage of these patients.
The Journal of Trauma: Injury, Infection, and Critical CareReview of Care of Fatally Injured Patients in a Rural State
68 Citations1983Thomas F. Certo, Frederick B. Rogers +1 more
Review of fatally injured patients with non-CNS injuries reaching the ER alive in an entire state from 1975-1979 suggests that stabilization and resuscitation are necessary before transfer and that bypass to a regional trauma center would not have been likely to be effective in such a rural state.
The Journal of Trauma: Injury, Infection, and Critical CareREGIONAL CATEGORIZATION AND QUALITY OF CARE IN MAJOR TRAUMA
51 Citations1977Don E. Detmer, Joseph A. Moylan +4 more
A statewide evaluation of major inpatient trauma treatment was completed demonstrating the relationship of emergency medical service categorization and quality of trauma care.
Archives of SurgeryValidation of Autopsy Method for Evaluating Trauma Care
50 Citations1982John G. West
A second study evaluating a similar series of motor vehicle deaths, using data from hospital records as well as autopsies, confirms that the autopsy method accurately identifies and understates the problem it exposes.
The Journal of Trauma: Injury, Infection, and Critical CareANALYSIS OF A RURAL TRAUMA PROGRAM USING THE TRISS METHODOLOGY
48 Citations1994Larry Karsteadt, Cathy L. Larsen +1 more
A significant improvement in survival rates resulted compared with baseline Major Trauma Outcome Study (MTOS) norms, and patient outcomes were evaluated using TRISS methodology.
The Journal of Trauma: Injury, Infection, and Critical CareResults of a Multi-Institutional Outcome Assessment
41 Citations1992Riyad Karmy-Jones, Wayne S. Copes +7 more
Use of TRISS standardizes the peer review process, resulting in a more reliable base for development and improvement of trauma center QA programs, and provides a consistent and objective QA methodology.
Journal of the American College of Emergency PhysiciansMajor trauma in the rural mountain west
40 Citations1977Bruce A. Houtchens
Reducing the magnitude of this rural hospital component of trauma facilities will require application of the same standards of initial evaluation and management which have proved effective in major medical center emergency department settings.
Archives of SurgeryAnalysis of Surgical Participation in the Advanced Trauma Life Support Course
23 Citations1992Thomas J. Esposito
Participation of surgeons in ATLS courses is low, particularly among rural practitioners, and performance of procedures taught in the course is rare.
The Journal of Trauma: Injury, Infection, and Critical CareDRESSING COMPARISON IN THE HEALING OF DONOR SITES
22 Citations1976RONALD M. GEMBERLING, Timothy A. Miller +2 more
Clinical effectiveness of commonly used impregnated gauze on the healing of donor sites, and rate and quality of healing were found to be virtually the same regardless of the dressing used.
Annals of Emergency MedicineRural trauma care: A study of trauma care in a rural emergency medical services region
17 Citations1984Mary Jeanne Krob, Albert E. Cram +4 more
The data suggest that the rural trauma system might improve if there were training programs that promote recognition of significant injury, more aggressive resuscitation, and expeditious transfer of the injured patients.
The Journal of Trauma: Injury, Infection, and Critical CareTo the Editor
2 Citations1993Ronald F. Maio, Richard E. Burney