Prehospital deaths in the Yorkshire Health Region.

Abstract

These data were reviewed independently by an orthopaedic surgeon, an accident and emergency physician, a neurosurgeon, and an anaesthetist. Each, while blinded to the opinions of the other reviewers, gave an opinion as to whether the patient could have survived their injuries, given cardiopulmonary care by general public bystanders and prehospital care by a trained paramedic team. The deaths were categorised into "potential survivor", "definite death", and "unclear/insufficient information".The four sets of independent opinions were then read in conjunction to ascertain the degree of agreement between specialists on the most likely outcome in each case. For each patient the number of "potential survivor" and "definite death" responses was recorded.

Assessment of Causes of Preventable Deaths in Pre-hospital SettingsAssessment of Causes of Preventable Deaths in Pre-hospital Settings

“…In another study about pre-hospital deaths performed by Limb et al (8) in the Yorkshire health region, the mean age of instant death was higher in comparison to our study. Also, the mean age difference in our study (about 8 years) was higher than similar studies including Limb's study in England, which had a 1 year difference (8).…”

“…Also, the mean age difference in our study (about 8 years) was higher than similar studies including Limb's study in England, which had a 1 year difference (8). In this study, 83.8% of traumatic patient deaths were due to traffic accidents, 1.9% from hard material crashes, 10.6% from falling from heights, 1.9% from explosions, 1.2% from a penetrating wound and 0.6% from other mechanisms.…”

“…73.3% (22 cases) and 20% (6 cases) were transported by EMS and other vehicles, respectively. This mortality rate was a little more than other studies including Lim's in England (62%), Mac Leod's in the USA (78%), Mark Gunst's in the USA (61%), and Meel's in South Africa (74%) (8,10,12,13). Patients who had transfered by EMS were the main way of achieving to Artesh hospital (62%) and Shohadaye hafome tir hospital (48%) (14,15).…”

“…Certainly preventable deaths in Limb's study in England were reported to be 1-2%, in Sandall's study in the USA this was 0.7%, and in Falconer's study in New Zealand this was 10%. Thus, the rate in our study was the highest (8,17,18). Hussain and Redmond (9) declared the total rate of pre-hospital preventable deaths in England to be 39%, Mac Leod to be 7%, Mark Gunst to be 24%, Wilson in Brazil to be 1%, Meel to be 12% and Flaconer's in Newsland to be 45% (7,10,12,13,17).…”

Emergency Medical Services Outcome Assessment in Lagos, Nigeria: Review of Cases of ‘’Brought in Dead‘’ Patients

“…The aim in a well-organized emergency medical service is to drive towards a reduced percentage of preventable deaths [6]. A total of 144 cases of BID captured in this study despite its limitations are reflective of the inadequacies inherent in the pre-hospital care in Nigeria as well as in Lagos State even though Lagos is still the only state with an ambulance transport system in operation.…”