Skip to main content
SpringerLink
Log in

The Challenges of Delivering Acute Medical Services to Trauma Patients in Remote Locations

  • Conference paper
Anaesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E.

  • 217 Accesses

Abstract

Trunkey in 1983 proposed the concept of the’ trimodal distribution of trauma deaths’, with 50% of deaths occurring immediately following an accident, 30% of deaths in the first 4 h, and 20% of deaths beyond 4 h [1]. The concept of the ’Golden Hour’ of trauma stresses the importance of early medical intervention within the 1st hour to prevent the organ damage that may result in later in-hospital deaths. The applicability and accuracy of these concepts has been questioned, but prompt resuscitation and delivery of the severely injured patient to definitive care is a crucial determinant of improved patient outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Trunkey DD (1983) Trauma. Sci Am 249: 20–27

    Article  Google Scholar 

  2. Guss DA, Meyer FT, Neumann TS, et al (1989) The impact of a regionalized trauma system on trauma care in San Diego County. Ann Emerg Med 18: 1141–1145

    Article  PubMed  CAS  Google Scholar 

  3. Sampalis JS, Denis R, Lavoie A, et al (1999) Trauma care regionalization: a process-outcome evaluation. J Trauma 46: 565–579

    Article  PubMed  CAS  Google Scholar 

  4. Shepherd L, Auger T, Wisborg T, Williams J (2001) Trauma in rural and remote areas. In: Soreide E, Grande C (eds) Prehospital trauma care. Dekker, New York, pp 703–717

    Google Scholar 

  5. Montalvo R, Wingard DL, Bracker M, Davidson TM (1998) Morbidity and mortality in the wilderness. West J Med 168: 248–254

    PubMed  CAS  Google Scholar 

  6. Gentile DA, Morris JA, Schimelpfenig T, et al (1992) Wilderness injuries and illnesses. Ann Emerg Med 21: 853–861

    Article  PubMed  CAS  Google Scholar 

  7. Flowe KM, Cunningham PRG, Foil MB (1995) Rural trauma. Surg Ann 27: 29–39

    CAS  Google Scholar 

  8. Baker SP, Whitfield RA, O’Neil B (1988) County mapping of injury mortality. J Trauma 28: 741–745

    Article  PubMed  CAS  Google Scholar 

  9. Baker SB, O’Neil B (1987) Geographic variations in mortality from motor vehicle crashes. N Eng J Med 316: 1384–1387

    Article  CAS  Google Scholar 

  10. Grossman DC, Hart LG, Rivara FP, et al (1995) From roadside to bedside: the regionalisation of trauma care in a remote rural county. J Trauma 38: 14–21

    Article  PubMed  CAS  Google Scholar 

  11. Baxt WG, Moody P (1987) The impact of a physician as part of the aeromedical team in patients with blunt trauma. JAMA 257: 3246–3250

    Article  PubMed  CAS  Google Scholar 

  12. Moylan JA, Fitzpatrick KT, Beyer J, Georgiade GS (1988) Factors improving survival in multisystem trauma patients. Ann Surg 207: 679–685

    Article  PubMed  CAS  Google Scholar 

  13. Bartolacci RA, Munford BJ (1998) Air medical response to blunt trauma: effect on early survival. Med JAust 169: 612–616

    CAS  Google Scholar 

  14. Garner A, Rashford S, Lee A, Bartolacci R (1999) Addition of physicians to paramedic helicopter services decreases blunt trauma mortality. Aust NZ J Surg 69: 697–701

    Article  CAS  Google Scholar 

  15. Safety study-Commercial Emergency Medical Service Helicopter Operations (1988) National Transportation Safety Board, Washington, DC, report no. NTSB/SS-88/01

    Google Scholar 

  16. Geis C, Madsen P (2001) Working in the prehospital environment: safety aspects and teamwork. In: Soreide E, Grande C (eds) Prehospital trauma care. Dekker, New York, pp 83–97

    Google Scholar 

  17. Spaite DW, Criss EA, Valenzuela TD, Meislin HW (1998) Prehospital advanced life support for major trauma: critical need for clinical trials. Ann Emerg Med 32: 480–489

    Article  PubMed  CAS  Google Scholar 

  18. Stocchetti N, Furlan A, Volta F (1996) Hypoxaemia and arterial hypotension at the accident scene in head injury. J Trauma 40: 764–767

    Article  PubMed  CAS  Google Scholar 

  19. Chesnut RM (1995) Secondary brain insults after head injury: clinical perspectives. New Horiz 3: 366–375

    PubMed  CAS  Google Scholar 

  20. Owens TM, Watson WC, Prough DS, et al (1995) Limiting initial resuscitation of uncontrolled hemorrhage reduces internal bleeding and subsequent volume requirements. J Trauma 39: 200–207

    Article  PubMed  CAS  Google Scholar 

  21. Bickell WH, Wall MJ Jr, Pepe PE et al (1994) Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Eng J Med 331: 1105–1109

    Article  CAS  Google Scholar 

  22. Messick WJ, Rutledge R, Meyer AA (1992) The association of advanced life support training and decreased per capita trauma death rates: an analysis of 12,417 trauma deaths. J. Trauma 33: 850–855

    Article  PubMed  CAS  Google Scholar 

  23. Rogers FB, Osier TM, Shackford SR, et al (1999) Study of the outcome of patients transferred to a level 1 hospital after stabilisation at an outlying hospital in a rural setting. J Trauma 46: 328–333

    Article  PubMed  CAS  Google Scholar 

  24. Esposito TJ, Sanddal ND, Hansen JD, Reynolds S (1995) Analysis of preventable trauma deaths and inappropriate trauma care in a rural state. J Trauma 39: 955–962

    Article  PubMed  CAS  Google Scholar 

  25. Cales RH (1984) Traumatic mortality in Orange County: the effects of the implementation of a regional trauma system. Ann Emerg Med 13: 1–10

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Intensive Care Unit, Liverpool Hospital, University of New South Wales, Sydney, Australia

    D. J. Penney, A. Flabouris & M. J. A. Parr

Authors
  1. D. J. Penney
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Flabouris
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. J. A. Parr
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Clinical Sciences Section of Anaesthesia, Intensive Care and Pain Clinic, Trieste University School of Medicine, Trieste, Italy

    Antonino Gullo M.D. (Head) (Head)

Rights and permissions

Reprints and permissions

Copyright information

© 2002 Springer-Verlag Italia

About this paper

Cite this paper

Penney, D.J., Flabouris, A., Parr, M.J.A. (2002). The Challenges of Delivering Acute Medical Services to Trauma Patients in Remote Locations. In: Gullo, A. (eds) Anaesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E.. Springer, Milano. https://doi.org/10.1007/978-88-470-2099-3_30

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-2099-3_30

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0176-3

  • Online ISBN: 978-88-470-2099-3

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation