The history of violence in Colombia (South America), initially presented as an obstacle for the adequate operations of the emergency medical system. But with the development of a modern system, articulated with the different basic and... more
The history of violence in Colombia (South America), initially presented as an obstacle for the adequate operations of the emergency medical system. But with the development of a modern system, articulated with the different basic and advanced emergency response institutions, altogether with a process of academic structuring coordinated by the Colombian Association of Prehospital Care (ACAPH), has allowed that this unfortunate experience serve as a model for governmental educational policy development for voluntary groups that participate in the scene response and for the medical and paramedical personnel both private and public that perform prehospitalc care.
Introduction Trauma is a leading cause of mortality and comprises an important cause of functional impairment among young people worldwide. The trauma registry (TR) is an integral component of modern comprehensive trauma care systems.... more
Introduction Trauma is a leading cause of mortality and comprises an important cause of functional impairment among young people worldwide. The trauma registry (TR) is an integral component of modern comprehensive trauma care systems. Nevertheless, TRs have not been yet established in most developing countries. The objective of this study was to summarize the challenges, results, and lessons learned from a trauma program including initial results from a TR at tertiary-care public hospitals of Buenos Aires, Argentina. Material and methods This is a descriptive study of the implementation of a trauma program in 14 hospitals and analysis of the initial results in the period between January 2010 and December 2018, using data from Fundación Trauma TR. Patients fitting injury definition that remained in hospital for more than 23 h were included. Injured patients were divided by age groups. Data on patients’ demographics, mechanism of injury and severity, complications, treatments, and in-hospital mortality were analyzed between groups. A descriptive analysis is presented. Results There were 29,970 trauma cases during the study period. Median age was 23 years (RIC 12, 39) with a 2.4:1 male-tofemale ratio. Road traffic injuries (RTI) were the leading mechanism (30.8%) of admission and head was the most frequently injured body region (33.2%). Two-thirds of RTIs were motorcycle-related. Overall in-hospital mortality was 6.1%. Intentional self-harm in adult males and burns in adult females had the highest mortality rates (17.6% and 17.9%, respectively). Conclusions and discussion The implementation of a trauma program within a public–private collaborative program in a resource-limited environment is feasible. The hospital-based TR can be used as a tool for injury surveillance, monitoring of the quality of trauma care, development of a trauma system, and to guide public health policies.
Together we are STRONG! TOGETHER "WE CAN" "Get e.r. done" www.indianatrauma.org is evidence of what CAN be done when folks at the MOST responsible.... MOST knowledgable, and MOST CORE central place of leadership state resoundingly... more
Together we are STRONG! TOGETHER "WE CAN" "Get e.r. done" www.indianatrauma.org is evidence of what CAN be done when folks at the MOST responsible.... MOST knowledgable, and MOST CORE central place of leadership state resoundingly "Can't solve your problems... don't have any data... don't have any funding"
Trauma treatment systems in specialized centers were established in health services in high-income countries more than 30 years ago. The effectiveness of these centers has been evaluated. Their results show an increase in patients’... more
Trauma treatment systems in specialized centers were established in health services in high-income countries more than 30 years ago. The effectiveness of these centers has been evaluated. Their results show an increase in patients’ survival rates and a minimization in post-trauma after effects Most of the times, direct import of these models is not possible in low and middle income countries, because their implementation would require availability of economic resources that is not affordable in these countries. An approach based on the evidence showed by these studies with positive results, but adjusted according to the reality of public health in each one of these countries, is necessary. It is aimed at giving better opportunities to the traumatically-injured people worldwide. This article presents a review of the Essential Trauma Care Project of the World Health Organization, and the approach advantages if used in countries like Colombia.
Organised trauma systems and designated trauma centres for improving outcomes in injured patients. Organised trauma systems and designated trauma centres for improving outcomes in injured patients (Protocol)
Background - It is recognized with increasing frequency that trauma is a major public health problem in developing countries. The objective of this article is to outline the background and need for trauma registries in developing... more
Background - It is recognized with increasing frequency that trauma is a major public health problem in developing countries. The objective of this article is to outline the background and need for trauma registries in developing countries, and provide our experiences with the initial development of one such trauma registry in Colombia. Methods - The trauma registry was developed and implemented in the main public hospital in the city of Neiva, Colombia, with data collection beginning February of 2008. At the same time that data was being collected in Colombia an electronic database was developed in Canada. Results - During the initial one year trial of the registry, we collected data on over 2.300 trauma patients, including Revised Trauma Scores (RTS) and Kampala Trauma Scores (KTS) for future comparison. Conclusions - It is our hope that this article and registry template will serve to encourage others to continue implementing trauma registries in developing countries.
Dear Editor, Fourth National Audit project of The Royal College of Anesthetists and the Difficult Airway Society outlines ‘cannot intubate/cannot ventilate (CVCI) as a serious clinical case is facing by physicians in Emergency... more
Dear Editor, Fourth National Audit project of The Royal College of Anesthetists and the Difficult Airway Society outlines ‘cannot intubate/cannot ventilate (CVCI) as a serious clinical case is facing by physicians in Emergency Departments, Intensive Care Units or wards. Cricothyroidotomy is a crucial issue in CVCI, indeed the aforementioned audit demonstrates that surgical techniques were consistently effective in accessing the airways, albeit not always with a good patient outcome. This is probably due to inappropriate delays in deciding to establish an emergency surgical airway. The contrast between the apparently high failure rate of needle cricothyroidotomy and the success of formal surgical techniques is a topic worthy of considerably more study.
