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Polytrauma patient residence time to the emergency department of a public general hospital in Attica


Published: Jul 8, 2017
Keywords:
Polytrauma patient emergency department traffic accident time to treatment-length of stay injury severity
Αthanasios Evangelatos
Εfstathia Armata
Georgia Fasoi
Μartha Stavropoulou – Κelesi
Christina Marvaki
Dimitrios Papageorgiou
Abstract

Introduction: In Emergency Department (ED) polytrauma patients accept emergency nursing  care and follows a  complete diagnostic procedure and therapy. The required time is called time to treatment-length of stay  trauma patients in ED.

Aim:  The aim of the present study was the registry of the trauma patient management and treatment to the ED of a public general hospital in Attica.

Material and Methods: The studied sample consisted of 95 trauma patients aged over 14 years old with Injury Severity Score >15 (ISS>15) who were admitted to the ED of a general hospital in Athens and having to complete the whole diagnosis and treatment in the ED from February of 2014 until January of 2015. Data analysis was performed with the statistical package SPSS ver. 19.

Results: The majority of the trauma patients were Greek men aged until 45 years old. The first reason of transportation was traffic accident, drifting was the second reason. The mean time of trauma patients at ED until their admission  to the appropriate clinic, was 3, 3 hours (210 min), and has been influenced by the diagnostic tests time, the diagnostic tools and the number of the doctors, per major, who have been concerned the trauma patient. The Injury Severity Score has been influenced by the number of the doctors per major, the method of diagnosis and the admission to the appropriate department. The trauma patients who were not wearing seat belt and drifting, have the most seriously trauma according to the ISS. From the Patients who had 3-8  Glasgow Coma Scale   the 45.5% (n:5)  had admitted to Intensive Care Unit, respectively the 18.2% (n:2) had admitted at neurosurgery and surgery clinic.

Conclusions: Polytrauma patient residence time to the Emergency Department is determinant and directly related with mortality and the overall outcome of the polytrauma patient during his hospitalization
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References
Advanced Trauma Life Support for Doctors Students Course Manual, Eight Edition. 2008.
Stewart R, Myers J, Dent D, Ermis P, Gray G, Villareal R et al: Seven hundred fifty –three consecutive deaths in a level I trauma center:The argument for injury Prevention. J. Trauma 2003 ;54(1):66-70.
Greenspan L, Lellan M, Greig H: Abbreviated Injury Severity Score. A scoring chart. J.Trauma 2010;25(1):60-4.
Link J, Krause H, Nogner N, Papadopoulos G. A new Concept for Intrahospital transport of Critically ill patients. Critical Care Med 1990; 18(12):1427-1429.
World Health Organization .The World Health Report: Injury Survellance guidelines. Geneva.2008.
Injury in World: A concluding public health problem Committee on trauma research, commission on Life Sciences and the institute of Medicine, Washington DC, National Academy Press. 2012.
Newgard C, Shimcker R, Hedges J. Trickett, J. Davis D. Emergency Medical Services Intervals and Survival in Trauma Assessment of the Golden Hour in a North American Prospective Cohort. Ann Emergency Med 2010;55(3):235-246.
Τσαούση Γ, Λαυρεντίεβα Α, Ευθυμίου Α, Βόλακλη Ε κ.α. Κλινική Μελέτη: Eπιδημιολογία, κλινικά χαρακτηριστικά και προγνωστικοί δείκτες έκβασης των πολυτραυματιών. Ελληνική Αναισθησιολογική Εταιρεία 2005;38:129-136.
Τζιάλλας Β, Τζιάλλας Δ, Λίγκα Β. Έρευνα :Σύγκριση των αιτιών Εισαγωγής νέων ηλικίας 18-30 ετών και νεαρού ενήλικου πληθυσμού (31-40 ετών) στις Μ.Ε.Θ μετά από τροχαίο ατύχημα. Το βήμα του Ασκληπιού 2010;9(4):473-489.
Hashim H, Iqbal S. Motorcycle accident in the main cause of maxillofacial injuries in Penang Mainland ,Malaysia. Dent Trauma 2011;27(1):19-22.
Park K,Hwang S,Lee JS, Kim Y,Kwon S.Individual risk factors for road traffic injury deaths, nationwide study in South Korea. Asia Public Health 2010;22(3):320-31.
Payal P, Sonu G , Anil G, Prach V: Management of polytrauma patients in Emergency Department: An Experience of a care health institution of Northen India.World J Emerg Med 2013;4(1):15-19.
Mowery N,Dougherty S,Hildreth A,Holmes J,Chang M,Martin et al. Emergency department length of stay is an independent predictor of hospital mortality in trauma activation patients. J Trauma 2011;70(6):1317-25.
Allgower M.,Trauma systems in Europe. American Journal of Surgery 1991;161(2):226-9.
Haas N,Hoffman R,Mauch C,von Fournier C,Sudkamp N. The management of polytramatized patients in Germany. Critical Orthopaedics and Related Research 1995;30(7)463-6.
Tai N, Bircher M.Trauma Systems in England.A strategy for Major Trauma Workforce Generation and Sustainability.Royal College of Surgeons of English Briefing Note London 2014.
Markopoulou A, Argyriou G, Charalampidis E, Koufopoulou A, Nestor A, Nanas S, Marvaki C. Time to Treatment for critically ill-polytrauma patients in emergency department. Health Science Journal 2013;7(1):81-89.
Υοοn P,Steiner I, Reinhadt G. Analysis of factors influencing length of stay in the emergency department. CJEM 2003;5(3):155-61.
http://www ygeia on line.gr./Τραύματα στήθους και κοιλιάς /November/26/2008.
Ίντας Γ, Στεργιάννης Π, Βασιλόπουλος Γ, Φιλντίσης Α. Έκβαση βαριά πασχόντων σε σχέση με το χρόνο παραμονής τους στο ΤΕΠ. Το Βήμα του Ασκληπιού 2011;10(3):417-436.
Wurmb E, Fruhwald P,Hopfner W,Keil T,Kredel M,Brederlau J et al. Whole-Body Multislice Computed Tomography as the first line diagnostic tool in patients with Multiple injuries: The focus on time. Journal of Trauma-Injury Infection and Critical Care 2009;66(3):658-65.
Hessmann M, Hofmann A, Kreither K, Lott C, Rommens P. The Benefit of Multislice CT in the Emergency Room. Management of Polytraumatized Patients. Acta Chirurgika Belgica 2006;106(5):500-7.
Wurmb E, Quaiser C, Balling H, Kredel M, Muellenbach R, Kenn W, Rower N, Brederlau J. Whole-body multislice computed tomography improves trauma care in patients requiring surgery after multiple trauma. Emergency Medicine Journal 2011;28(4):300-4.
Hilbert P, Nieden K, Hofmann G, Hoeller I, Koch R, Stuttmann R. New aspects in the emergency room management of critical injured patients. A multi-slice CT oriented care algorithm. Injury 2007;38(5):552-8.
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