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The Capital Region of Denmark - a part of Copenhagen University Hospital
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On-scene time and outcome after penetrating trauma: an observational study

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  1. A simple clinical assessment is superior to systematic triage in prediction of mortality in the emergency department

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  2. Is there a diurnal difference in mortality of severely injured trauma patients?

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  3. Is air transport of stroke patients faster than ground transport? A prospective controlled observational study

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  1. Patient experience of spinal immobilisation after trauma

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  2. Ketamine as a Rapid Sequence Induction Agent in the Trauma Population: A Systematic Review

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  3. Restrictive vs liberal oxygen for trauma patients-the TRAUMOX1 pilot randomised clinical trial

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Background Controversies exist as to whether one should rely on the 'scoop and run' or 'stay and play' approach in the case of penetrating trauma in the prehospital setting. Optimal prehospital care is much debated and the extent to which advanced life support (ALS) measures should be performed remains unclear. This study aimed to report the outcome of penetrating torso trauma in relation to the on-scene time and ALS procedures performed prehospitally. It was hypothesised that a longer on-scene time could predict a higher mortality after penetrating torso trauma. Methods This was an observational cohort study of penetrating trauma patients treated by the Mobile Emergency Care Unit in Copenhagen with a 30-day follow-up. Between January 2002 and September 2009, data were prospectively registered regarding the anatomical location of the trauma, time intervals and procedures performed in the prehospital setting. Follow-up data were obtained from a national administrative database. The primary end point was 30-day survival. Results Of the 467 patients registered, 442 (94.6%) were identified at the 30-day follow-up, of whom 40 (9%) were dead. A higher mortality was found among patients treated on-scene for more than 20 min (p=0.0001), although on-scene time was not a significant predictor of 30-day mortality in the multivariate analysis; OR 3.71, 95% CI 0.66 to 20.70 (p=0.14). The number of procedures was significantly correlated to a higher mortality in the multivariate analysis. Conclusion On-scene time might be important in penetrating trauma, and ALS procedures should not delay transport to definite care at the hospital.
Original languageEnglish
JournalEmergency medicine journal : EMJ
Pages (from-to)797-801
Number of pages5
DOIs
Publication statusPublished - 2011

ID: 32209220