A review of trauma deaths in an accident and emergency department.

Abstract

SUMMARYThere were 56 deaths following trauma in the adult Accident and Emergency Department of the University Hospital, Nottingham, over a 5-year period from 1983 to 1987. Forty-six of these deaths followed road-traffic accidents.The trauma deaths made up 16% of all adult deaths and 0-13 per thousand new attenders. We found evidence of inappropriate management in four cases, all relating to inadequate volume replacement. In two patients, the degree of hypovolaemia was not appreciated and in the other two, volume replacement was not commenced within 30 min of arrival in the department.Prompt treatment of hypovolaemic shock with appropriate fluids in adequate quantities cannot be overemphasized.

The pattern of Deaths in the Accident and Emergency Units of Ekiti State University Teaching Hospital

“…Many studies have also reported non-trauma emergencies as the leading cause of death in the AEU [16,17,19,20,24] with stroke and other cardiovascular diseases being the most common among the non-trauma causes [2,14,16,18,[20][21][22], [25]. In general, most previous studies agree that the death rate from trauma is higher in males than in females [8,[26][27][28][29]. In this study, the male-to-female death ratio from trauma was 7.4:1.…”

Quality Indicators for Evaluating Trauma Care

“…We identified 103 terms used to identify or describe QIs in our review. Although the field of quality improvement is fundamentally a process of change Peer review of trauma deaths to evaluate quality of care and determine whether the death was potentially preventable 19 Case series 13,19,34,39,50,69,76,79,85,87,99,115,[119][120][121]124,188,189,200 ; 18 cohort studies 10,18,37,49,62,86,109,113,122,140,145,149,151,178,187,194,196,207 ; 3 before-and-after case series 51,118,166 ; 2 nonrandomized controlled trials 16,205 ; and 1 cross-sectional study 17 Hospital mortality a 17 Cohort studies 7,43,49,52,63,…”

Implementation of the World Health Organization Trauma Care Checklist Program in 11 Centers Across Multiple Economic Strata: Effect on Care Process Measures

“…The initial resuscitation of trauma patients is a period of time critical to patient outcome, with a well-described potential for error reduction [7][8][9][10]. Opportunities for quality improvement have been identified during airway management, fluid resuscitation, and diagnosis of life-threatening injuries [11][12][13][14][15].…”