This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on Web of Science (25)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Frederick P. Rivara, MD, MPH; Ronald V. Maier, MD; Beth A. Mueller, DrPH; Gregory A. Luna, MD, MPH; Barbara G. Dicker, MA; Clifford M. Herman, MD; John W. Kenagy, MD; Michael K. Copass, MD; C. James Carrico, MD

JAMA. 1989;261(4):566-570.

Abstract
The prehospital, emergency department, and in-hospital care of 84 patients who died following a pedestrain— or bicycle—motor vehicle collision in a four-county area was retrospectively reviewed using a systematic, detailed scoring system. The purpose of the study was to examine the effectiveness of an advanced paramedic—regionalized trauma care system and to examine the usefulness of a systematic evaluation tool in identifying preventable and possibly preventable deaths. Among the 84 deaths, one was judged to be preventable and 18 possibly preventable. The one preventable death occurred in the emergency department, while the possibly preventable deaths more commonly occurred after 48 hours and were due to central nervous system injury, sepsis, and multiple organ failure. Prolonged prehospital and emergency department time and failure to establish an airway were the most common problems identified as contributing to fatal outcome. The use of explicit criteria was demonstrated to be an effective addition to the analysis of trauma care systems.

(JAMA 1989;261:566-570)

Author Affiliations
From The Harborview Injury Prevention and Research Center (Drs Rivara, Maier, Luna, Herman, and Copass); the Departments of Pediatrics (Dr Rivara), Epidemiology (Drs Rivara and Mueller and Ms Dicker), and Surgery (Drs Maier, Luna, Herman, Kenagy, Copass, and Carrico), University of Washington; and the Northwest Regional Trauma Center (Drs Maier, Luna, Herman, Copass, and Carrico), Seattle.

Footnotes
Reprint requests to The Harborview Injury Prevention and Research Center, 325 Ninth Ave, Seattle, WA 98104 (Dr Rivara).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?