TRANSFER OF MULTIPLY-INJURED PATIENTS FOR NEUROSURGICAL OPINION - A STUDY OF THE ADEQUACY OF ASSESSMENT AND RESUSCITATION

被引:23
作者
LAMBERT, SM [1 ]
WILLETT, K [1 ]
机构
[1] CHARING CROSS HOSP,DEPT TRAUMAT & ORTHOPAED SURG,LONDON W6 8RP,ENGLAND
来源
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED | 1993年 / 24卷 / 05期
关键词
D O I
10.1016/0020-1383(93)90058-E
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
A total of 21 consecutive referrals with multiple injuries (Injury Severity Score ISS) 17-66), admitted into the Regional Neurosurgical Unit (RNSU) over a 1-year period from August 1989, was analyzed to evaluate the risks associated with transfer of such patients from district general hospitals within the North West Thames Region. Injury assessment was deficient in nine cases. Four developed hypovolaemic shock during transfer, and in five resuscitation was inadequate Four had minor head injuries and two had no head injury, of these cases, one died. There were four fatalities: the mean ISS in this group was 42, and in all cases deficiencies in resuscitation and assessment before transfer were identified. There were seven major missed injuries. All patients had musculoskeletal injuries and 16 required orthopaedic intervention within 6 h. Interhospital transfer of this group of patients carries significant risks, may be unnecessary, and may delay other surgical priorities.
引用
收藏
页码:333 / 336
页数:4
相关论文
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  • [1] Andrews, Piper, Dearden, Et al., Secondary insults during intrahospital transport of head-injured patients, Lancet, 335, (1990)
  • [2] Bakay, Brain injuries in polytrauma, World J. Surg., 7, (1983)
  • [3] Baker, O'Neill, Haddon, Et al., The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care, J. Trauma, 14, (1974)
  • [4] Bone, Johnson, Weigelt, Et al., Early versus delayed stabilisation of femoral fractures, J. Bone Joint Surg., 71 A, (1989)
  • [5] Court-Brown, Annotation. The treatment of the multiply injuried patient in the United Kingdom, J. Bone Joint Surg., 72 B, (1990)
  • [6] Gentleman, Jennett, Hazards of inter-hospital transfer of comatose head-injured patients, Lancet, 2, (1981)
  • [7] Gentleman, Jennett, Audit of transfer of unconscious head-injured patients to a neurosurgical unit, Lancet, 335, (1990)
  • [8] Goris, Gimbrere, Niekerk, Et al., Early osteosynthesis and prophylactic ventilation in the multitrauma patient, J. Trauma, 22, (1982)
  • [9] Illingworth, Jennett, The shocked head injury, Lancet, 2, (1965)
  • [10] Johnson, Cadambi, Seibert, Incidence of adult respiratory distress syndrome in patients with multiple musculoskeletal injuries: effect of early operative stabilization of fractures, J. Trauma, 25, (1985)