Changes in rural trauma prehospital times following the Rural Trauma Team Development Course training

被引：20

作者：

Malekpour, Mahdi ^{[1
]}

Neuhaus, Nina ^{[1
]}

Martin, David ^{[1
]}

Widom, Kenneth ^{[1
]}

Rapp, Megan ^{[1
]}

Leonard, Diane ^{[1
]}

Baro, Susan ^{[1
]}

Dove, James ^{[1
]}

Hunsinger, Marie ^{[1
]}

Blansfield, Joseph ^{[1
]}

Shabahang, Mohsen ^{[1
]}

Torres, Denise ^{[1
]}

Wild, Jeffrey ^{[1
]}

机构：

[1] Geisinger Med Ctr, Dept Surg, Sect Trauma & Acute Care Surg, Danville, PA 17822 USA

来源：

AMERICAN JOURNAL OF SURGERY | 2017年 / 213卷 / 02期

关键词：

Rural Trauma Team Development Course; Trauma; Outcome; Transfer; Time; METAANALYSIS; CENTERS; BENEFIT; DELAY;

D O I：

10.1016/j.amjsurg.2016.06.015

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

BACKGROUND: The majority of the US population live in urban areas, yet more than half of all trauma deaths occur in rural areas. The Rural Trauma Team Development Course (RTTDC) is developed to improve the outcomes of rural trauma and we aimed to study its effect on patient transfer. METHODS: Trauma referrals 2 years before the RTTDC training were compared with referrals 2 years after the course. RESULTS: Of the 276 studied patients, 97 were referred before the RTTDC training and 179 patients were referred after the course. Transfer acceptance time was significantly shorter after the RTTDC training (139.2 +/- 87.1 vs 110 +/- 66.3 min, P = .003). The overall transfer time was also significantly reduced following the RTTDC training (257.4 +/- 110.8 vs 219.2 +/- 86.5 min, P = .002). Patients receiving pretransfer imaging had a significantly higher transfer time both before and after RTTDC training (all Ps < .01). Mortality was nearly halved (6.2% vs 3.4%) after the RTTDC training. CONCLUSION: The RTTDC training was associated with reduced transfer acceptance time and reduced transfer time. (C) 2016 Elsevier Inc. All rights reserved.

引用

页码：399 / 404

页数：6

共 16 条

[1] Access to trauma centers in the United States [J].

Branas, CC ;

MacKenzie, EJ ;

Williams, JC ;

Schwab, CW ;

Teter, HM ;

Flanigan, MC ;

Blatt, AJ ;

ReVelle, CS .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2005, 293 (21) :2626-2633

[2] A meta-analysis of prehospital care times for trauma [J].

Carr, Brendan G. ;

Caplan, Joel M. ;

Pryor, John P. ;

Branas, Charles C. .

PREHOSPITAL EMERGENCY CARE, 2006, 10 (02) :198-206

[3] Unnecessary Imaging, Not Hospital Distance, or Transportation Mode Impacts Delays in the Transfer of Injured Children [J].

Chatoorgoon, Kaveer ;

Huezo, Karen ;

Rangel, Erika ;

Francois, Nathaly ;

Schweer, Lynn ;

Daugherty, Margot ;

Koehn, Margie ;

Ricketts, Crystal ;

Brown, Rebeccah L. ;

Garcia, Victor F. ;

Falcone, Richard A., Jr. .

PEDIATRIC EMERGENCY CARE, 2010, 26 (07) :481-486

[4] Survival Benefit of Transfer to Tertiary Trauma Centers for Major Trauma Patients Initially Presenting to Nontertiary Trauma Centers [J].

Garwe, Tabitha ;

Cowan, Linda D. ;

Neas, Barbara ;

Cathey, Timothy ;

Danford, Brandon C. ;

Greenawalt, Patrice .

ACADEMIC EMERGENCY MEDICINE, 2010, 17 (11) :1223-1232

[5]

Haley Theodore, 2009, Am J Surg, V198, P858, DOI 10.1016/j.amjsurg.2009.05.030

[6] Transfer times to definitive care facilities are too long - A consequence of an immature trauma system [J].

Harrington, DT ;

Connolly, M ;

Biffl, WL ;

Majercik, SD ;

Cioffi, WG .

ANNALS OF SURGERY, 2005, 241 (06) :961-966

[7] Does the Rural Trauma Team Development Course Shorten the Interval From Trauma Patient Arrival to Decision to Transfer? [J].

Kappel, David A. ;

Rossi, Daniel C. ;

Polack, Edward P. ;

Avtgis, Theodore A. ;

Martin, Matthew M. .

JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2011, 70 (02) :315-319

[8] OUTCOME OF PATIENTS WITH BLUNT TRAUMA TRANSFERRED AFTER DIAGNOSTIC OR TREATMENT PROCEDURES OR 4-HOUR DELAY [J].

KEARNEY, PA ;

TERRY, L ;

BURNEY, RE .

ANNALS OF EMERGENCY MEDICINE, 1991, 20 (08) :882-886

[9] Imaging May Delay Transfer of Rural Trauma Victims: A Survey of Referring Physicians [J].

Lee, Cortney Y. ;

Bernard, Andrew C. ;

Fryman, Lisa ;

Coughenour, Jeff ;

Costich, Julia ;

Boulanger, Bernard ;

Chang, Phillip ;

Kearney, Paul A. .

JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2008, 65 (06) :1359-1363

[10] Effect of real-time teleradiology on the practice of the emergency department physician in a rural setting: Initial experience [J].

Lee, JKT ;

Renner, JB ;

Saunders, BF ;

Stamford, PP ;

Bickford, TR ;

Johnston, RE ;

Hsaio, HS ;

Phillips, ML .

ACADEMIC RADIOLOGY, 1998, 5 (08) :533-538

← 1 2 →