Pre-Hospital Trauma Care in Road Traffic Accidents in Kashan, Iran

Abstract

BackgroundIran has one of the highest rates of road traffic accidents (RTAs) worldwide. Pre-hospital trauma care can help minimize many instances of traffic-related mortality and morbidity.ObjectivesThe aim of this study was to assess the characteristics of pre-hospital care in patients who were injured in RTAs, admitted to hospital. The focus was mainly directed at evaluating pre-hospital trauma care provided in city streets and roads out of the city.Patients and MethodsThis retrospective study was carried out on all trauma patients, transported by the emergency medical service (EMS) system, who were admitted to Kashan Shahid-Beheshti hospital during the period from March 2011 to March 2012. The patients’ demographic data, location of accident, damaged organs, mechanism of injury, injury severity, pre-hospital times (response, scene, transport), pre-hospital interventions and outcomes, were extracted from the data registry and analyzed through descriptive statistics using SPSS 18 software.ResultsFindings of this study showed that, 75% of RTAs occurred on city streets (n = 1 251). Motor-car accidents were the most frequent mechanism of RTA on city streets (n = 525) (42%), while car rollover was the most frequent mechanism of RTA on roads out of the city (n = 155) (44.4%). The mean pre-hospital time intervals (min); response, scene, and transport for all patients were 6.6 ± 3.1, 10.7 ± 5 and 13 ± 9.8, respectively. The mean pre-hospital time intervals (response, scene, transport) in roads out of the city were higher than those in city streets. There was a significant difference (P = 0.04) in the mortality rates due to RTAs between city streets (n = 46) and roads out of the city (n = 32).ConclusionsIn comparison with road traffic accidents on city streets, trauma patients in RTAs on roads out of the city have longer pre-hospital time intervals and more severe injuries; therefore, this group needs more pre-hospital resuscitation interventions.

Acidentes de trânsito com adultos e suas consequências após a alta hospitalar

“…Em Kashan, Irã, metade dos motociclistas acidentados apresentou TCE (85) . No mesmo estudo, 90% das mortes por acidentes foram causadas por esse trauma.…”

“…Um dos fatores críticos que interferem na gravidade e sobrevida das vítimas é o intervalo de tempo consumido até que o tratamento hospitalar seja realizado. Nesse sentido, o atendimento pré-hospitalar às vítimas é um fator fundamental para reduzir a morbimortalidade relacionada ao trânsito (85) .…”

“…No presente estudo, o tempo resposta alcançou uma média de 13,4 (dp= 6,8) minutos, o que está acima dos encontrados em estudos nacionais e internacionais (85,(96)(97)(98) .…”

“…Os valores médios de tempo encontrados em outros estudos mostram uma variação de 9,8 a 14,2 minutos (85,(99)(100)(101)(102) .…”

“…Esse achado merece destaque, pois estudos indicam que o aumento do tempo resposta no atendimento pré-hospitalar está associado a maiores chances de mortalidade e agravamento dos casos (85,97) .…”