Injury
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Multicenter Study
The use of recombinant activated factor VII in trauma patients: Experience from the Australian and New Zealand haemostasis registry.
There is increasing use of rFVIIa (eptagog alpha, Novoseven) in injured patients with critical bleeding. The role of rFVIIa is not defined in this group of patients. Registries provide an opportunity to review the patients, reported response and adverse events for rFVIIa. ⋯ The best approach to managing critical bleeding in trauma patients is not agreed. The role of rFVIIa will only be clarified if there is a standardised approach to fluid management and transfusion of blood products. The registry allows tracking of current practice, outcomes and adverse events and will complement present phase 2 and 3 trials.
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Multicenter Study Comparative Study
Emergency Medical Service (EMS) systems in developed and developing countries.
To compare patient- and injury-related characteristics of trauma victims and pre-hospital trauma care systems among different developed and developing countries. ⋯ This study provides an early look at international variability in patient mix, process of care, and performance of different pre-hospital trauma care systems worldwide. International efforts should be devoted to developing a minimum standard data set for trauma patients.
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Multicenter Study Comparative Study
International comparison of prehospital trauma care systems.
Given the recent emphasis on developing prehospital trauma care globally, we embarked upon a multicentre study to compare trauma patients' outcome within and between countries with technician-operated advanced life support (ALS) and physician-operated (Doc-ALS) emergency medical service (EMS) systems. These environments represent the continuum of prehospital care in high income countries with more advanced prehospital trauma care systems. ⋯ These findings suggest that prehospital trauma care systems that dispatch a physician to the scene may be associated with lower early trauma fatality rates, but not necessarily with significantly better outcomes on other clinical measures. The reasons for these findings deserve further studies.
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Multicenter Study
Assessment of the status of resources for essential trauma care in Hanoi and Khanh Hoa, Vietnam.
The World Health Organization and the International Association for Trauma Surgery and Intensive Care have published the Guidelines for Essential Trauma Care. This provides recommendations for the human and physical resources needed to provide an adequate, essential level of trauma care services in countries at all economic levels worldwide. We sought to use this set of recommendations as a basis to assess the trauma care capabilities in two locations in Vietnam and thus to identify affordable and sustainable methods to strengthen trauma care nationwide. ⋯ This study has identified several low-cost ways in which to strengthen trauma care in Vietnam. These include greater use of continuing education courses for trauma care and more attention to trauma related curriculum in schools of medicine and nursing. These also include defining and assuring the availability of a core set of essential trauma related equipment and supplies. A policy recommendation that follows from the above findings is the need for programs to strengthen the organization and planning for trauma care.