European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Oct 2021
Impact on polytrauma patient prehospital care during the first wave of the COVID-19 pandemic: a cross-sectional study.
The extraordinary situation caused by the onset of COVID-19 has meant that at prehospital level, the number of treatments, profile and time taken to respond for treating time-dependent pathologies has been greatly affected. However, it is not known whether the prehospital profile of polytrauma patients (PTP) has been affected. ⋯ During the first wave of the pandemic, the number of polytrauma patients decreased and there was a change in the profile of severity and type of accident.
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The aim of this study was to identify risk factors for morbidity and mortality in patients with rib fractures with focus on identifying a more exact age-dependent cut-off for increased morbidity and mortality. ⋯ Increased mortality in patients with rib fractures starts at 65 years of age without a further increase until age ≥ 80. NRF does not predict increased mortality independent of age. Severe TBI is the most common cause of death in patients 16-75 years, as opposed to respiratory complications in patients 80 years-old or greater.
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The mortality rate from road traffic accidents (RTAs) in Nigeria is almost double that of the USA. In Nigeria, the first emergency medical services (EMS) system was established in March 2001, The Lagos State Ambulance Service (LASAMBUS). The objectives of this study are to (1) determine the burden of RTAs in Lagos, (2) assess RTA call outcomes, and (3) analyze LASAMBUS's response time and causes for delay. ⋯ LASAMBUS response rates are significantly lower than response rates in high-income countries such as the USA and lead to increased RTA mortality rates. Eliminating causes for delay will improve both LASAMBUS effectiveness and RTA victims' health outcomes. Changing the public perception of LASAMBUS and standardizing LASAMBUS' contact information will aid this as well.
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Eur J Trauma Emerg Surg · Oct 2021
Major trauma care in Hong Kong and Germany: a trauma registry data benchmark study.
Trauma remains a leading cause of death and effective trauma management within a well-developed trauma system has been shown to reduce morbidity and mortality. A trauma registry, as an integral part of a mature trauma system, can be used to monitor the quality of trauma care and to provide a means to compare local versus international standards. Hong Kong and Germany both have highly developed health care services. We compared the performance of trauma systems including outcomes among major trauma victims (ISS > 15) over a 3-year period (2013-2015) in both settings using trauma registry data. ⋯ Hong Kong had a higher mortality rate and a statistically significantly higher standardized mortality ratio (SMR) after RISC II adjustment. However, multiple differences existed between trauma systems and patient characteristics.
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Eur J Trauma Emerg Surg · Oct 2021
Injuries of the sternoclavicular region indicate concomitant lesions and need distinguished imaging.
To evaluate injuries of the sternoclavicular region as indicator injury for relevant concomitant injuries and to evaluate the modalities of initial imaging. We hypothesised a high incidence of concomitant injuries as well as a deficiency of X-ray as the initial gold standard. ⋯ Injuries of the sternoclavicular complex are indicators for the presence of multiple injuries. A CT scan of the sternoclavicular region including ipsilateral apex of the lung and upper rib cage comprised a large proportion of concomitant injuries. Mapping those injuries during initial imaging improves treatment process, avoids underdiagnostic, and decreases uncertainties.