J Emerg Med
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There have been conflicting reports regarding the applicability of Trauma Injury Severity Score (TRISS) methodology to evaluate trauma care in a developing country setting. The objective of this study was to apply TRISS methodology to evaluate trauma care in the public hospitals of a Caribbean developing country. A prospective, observational study was conducted in the three major general hospitals in Trinidad. ⋯ The M statistic was 0.98 and the overall Z statistic was 5.81. The ROC curve analysis showed TRISS to be a fair discriminator in the study case-mix with an area under the curve of 0.82 (95% confidence interval 0.69-0.96). There is a considerable disparity between predicted and observed outcomes when trauma patients are evaluated by the TRISS methodology in a developing country setting.
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The HemCon Bandage (HemCon Medical Technologies Inc., Portland, OR) is a hemostatic dressing made of chitosan, a complex carbohydrate derived from chitin. The objective of this study was to determine the effectiveness of the HemCon Bandage in a civilian emergency medical services system. The HemCon Bandage was added to the trauma kits of a fire agency and data were collected from June 1, 2005 to August 31, 2006. ⋯ The HemCon Bandage failed to stop bleeding within 10 min in 7 cases. User error was a factor in 6 of the 7 failures. The HemCon Bandage is an effective adjunct for uncontrolled external hemorrhage when traditional measures, such as pressure and gauze dressings, fail.