Trauma: Should You Stay or Should You Go?

Trauma: Should You Stay or Should You Go?

News Nov 21, 2012

WASHINGTON-The results of a 14-year study of trauma patients brought to a level I trauma center come close to settling the debate over the "load and go" versus "stay and stabilize" approach to patient care in the out-of-hospital setting: the answer depends on whether the injuries are penetrating or blunt ("Emergency Medical Services Out-of-Hospital Scene and Transport Times and Their Association with Mortality in Trauma Patients Presenting to an Urban Level I Trauma Center").

The study—the first of its kind to analyze data spanning more than a decade—was published recently in Annals of Emergency Medicine.

"We observed an association between longer out-of-hospital times, in particular scene times, and mortality in patients with penetrating trauma," said lead study author C. Eric McCoy, MD, MPH, of the University of California Irvine School of Medicine in Orange, Calif. "Given the challenges of providing out-of-hospital care to heterogeneous populations through a heterogeneous delivery system, it is imperative that the medical community identify patients who may benefit from timely care before abandoning the notion that faster is better for all patients in the out-of-hospital setting."

Researchers analyzed records for 19,167 trauma patients. Eighty-four percent of the injuries were blunt and 16 percent were penetrating. For patients with penetrating trauma, higher odds of mortality were observed when treatment delivered at the scene exceeded 20 minutes. Longer transport times were not associated with increased odds of mortality in patients with penetrating trauma. For patients with blunt trauma, there was no association between scene or transport times and increased odds of mortality.

"Our findings support the 'golden hour' concept of trauma care and are consistent with the previously demonstrated hospital-based beneficial effect on survival," said Dr. McCoy. "Our study also supports the conclusion that even if transport time is longer because of geographical distance from the scene to a trauma center, seriously injured patients benefit by being transported to trauma centers for hospital-based care."

Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, the national medical society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research, and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies. For more information visit www.acep.org.

 

Source
ACEP
Dr. Vincent Duron from the Columbia University Medical Center in New York received a $100,000 research grant to enhance standard pediatric trauma care.
The First Responders-Comprehensive Addiction and Recovery Act Grant will provide training and other resources to assist paramedics, law enforcement and health workers to prevent and treat opioid addiction.
The quake ironically struck on the anniversary of a 1985 earthquake that killed thousands of people in Mexico City.

A bus driver with a record of drunk driving crashed into another bus after speeding through an intersection in Queens, New York City, resulting in 3 deaths and multiple seriously injured patients. 

The new devices replace aging ones, allowing paramedics to provide better patient care and communicate more efficiently with the hospital.
The U.S. Department of Health and Human Services has awarded an additional $144.1 million in grants to prevent and treat opioid addiction in support of President Trump’s commitment to combat the opioid crisis.
The driver ran through a crowd of people after losing control of his vehicle, seriously injuring 11 people, several of whom were children.
The bills will provide more privacy for car accident victims who are bombarded by medical and legal offices pushing their services.
Caleb Sharpe, a student at Freeman High School, shot one student dead with a semi-automatic rifle and injured three other students until a custodian tackled and disarmed him.

An explosion at the London Tube Station has left 22 people injured and is being treated as a terrorist incident.

For more on this story, click here.

Physicians will provide free diagnoses and may even send prescriptions to the pharmacy for patients who have been displaced from Hurricane Irma.
Tourniquets are among the items in the medical kits, which are frequently used while ensuring scene safety before EMS personnel can treat patients.
While some hospitals affected by Hurricane Irma are beginning to open again, over 400 healthcare facilities statewide remain without power, water and sewer service.

An emergency crew responded to a call of a woman in labor in her home during Hurricane Irma.

The Orlando Fire Department began answering calls this morning after being on lockdown for eight hours while Hurricane Irma brought 50mph winds into the city.