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Med J Aust. 1999 May 3;170(9):416-9.

Management of severe trauma in intensive care units and surgical wards.

Author information

1
Intensive Care Unit, Northern Hospital, Melbourne, Vic. gduke@tnh.vic.gov.au

Abstract

OBJECTIVE:

To evaluate the management of severe trauma in intensive care, high dependency and general surgical wards of Victorian hospitals.

DESIGN:

Retrospective case review by multidisciplinary committees.

SUBJECTS:

The first 256 people who died from road traffic accidents who were alive on the arrival of emergency services between 1 July 1992 and 30 June 1994.

MAIN OUTCOME MEASURES:

(1) Severity of injury according to clinical diagnosis, autopsy findings and recognised trauma-scoring methods; (2) errors in management, identified as contributing or not contributing to the cause of death, and categorised as "management", "system", "diagnostic" or "technique" errors.

RESULTS:

Most patients (61%) were admitted to an intensive care unit (ICU), and 19.5% were admitted to high dependency or general surgical wards. Of 2187 errors of care identified, 11.8% occurred in ICU and 6.7% in wards, with the remainder occurring during the earlier phases of care. Most errors were classified as management errors (82% of ICU errors and 88% of ward errors). Fifty-two per cent of ICU errors and 71% of ward errors were judged to contribute to the patient's death.

CONCLUSIONS:

A significant number of errors of trauma management occur in the intensive care and general surgical ward. Improvement in late trauma care may reduce the number of preventable trauma deaths.

PMID:
10341772
[Indexed for MEDLINE]

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