Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke · 2010
[Seriously injured patients transferred from local hospitals to a university hospital].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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Dehli Trond, Bågenholm Anna, Johnsen Liv-Hege, Osbakk Svein Are, Fredriksen Knut, Bartnes Kristian
Аннотация
BACKGROUND: We studied diagnostics and stabilizing surgery in severely injured patients transferred from local hospitals to a university hospital. The purpose was to identify a potential for improvement of regional trauma care.
MATERIAL AND METHODS: The material comprises all severely injured patients (Injury Severity [ISS] Score > 15) transferred from local hospitals to the University Hospital of Northern Norway in the period 01.01.2006 - 31.12.2007. Information about diagnostics, extent of injury and treatment during the first 24 hours after transferral was recorded by retrospective chart review. Emergency surgical interventions are defined according to plans for a national trauma system.
RESULTS: 6/74 patients underwent emergency surgery at the local hospital (chest tube insertion, external fracture fixation); eight after arrival at the university hospital (chest tube insertion, hemostatic packing of the abdomen and pelvis, external fracture fixation). 66/74 were CT-scanned locally; 37 with a CT multitrauma series (CT caput, neck, thorax, abdomen and pelvis). Of the 62 who had head CT scans performed at a local hospital, the cervical spine was not imaged for 10. For eight of 55 patients who had CT scans of the thorax/abdomen/pelvis intravenous contrast agent was not administered.
INTERPRETATION: Trauma care at local hospitals may be improved by more systematic imaging, a lower threshold for emergency surgery, and early communication with the university hospital.
MATERIAL AND METHODS: The material comprises all severely injured patients (Injury Severity [ISS] Score > 15) transferred from local hospitals to the University Hospital of Northern Norway in the period 01.01.2006 - 31.12.2007. Information about diagnostics, extent of injury and treatment during the first 24 hours after transferral was recorded by retrospective chart review. Emergency surgical interventions are defined according to plans for a national trauma system.
RESULTS: 6/74 patients underwent emergency surgery at the local hospital (chest tube insertion, external fracture fixation); eight after arrival at the university hospital (chest tube insertion, hemostatic packing of the abdomen and pelvis, external fracture fixation). 66/74 were CT-scanned locally; 37 with a CT multitrauma series (CT caput, neck, thorax, abdomen and pelvis). Of the 62 who had head CT scans performed at a local hospital, the cervical spine was not imaged for 10. For eight of 55 patients who had CT scans of the thorax/abdomen/pelvis intravenous contrast agent was not administered.
INTERPRETATION: Trauma care at local hospitals may be improved by more systematic imaging, a lower threshold for emergency surgery, and early communication with the university hospital.
Предметные рубрики MeSH
AdolescentAdultAgedAged, 80 and overChildChild, PreschoolClinical CompetenceEmergency Service, HospitalFemaleHospitals, UniversityHumansMaleMiddle AgedMultiple TraumaNorwayPatient TransferQuality Assurance, Health CareRetrospective StudiesTrauma CentersTrauma Severity IndicesWounds and InjuriesYoung Adult