Emergency medicine journal : EMJ
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Trauma to the heart is usually rapidly fatal, but survival can be improved with timely and appropriate surgical management. However, certain injuries require specialist cardiothoracic surgical intervention. ⋯ Laceration of the coronary arteries is difficult to manage, especially in the absence of specialty equipment. Appropriate protocols should be established to provide this service in order to optimise the management of patients with complicated trauma. A cardiac surgical take-away kit could facilitate the management of these difficult patients in a setting remote from the cardiac operating room.
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Reconfiguration of emergency services could lead to patients with life-threatening conditions travelling longer distances to hospital. Concerns have been raised that this could increase the risk of death. We aimed to determine whether distance to hospital was associated with mortality in patients with life-threatening emergencies. ⋯ Increased journey distance to hospital appears to be associated with increased risk of mortality. Our data suggest that a 10-km increase in straight-line distance is associated with around a 1% absolute increase in mortality.