ABSTRACT
The number of road vehicle accidents during travel outside Europe and/or under difficult conditions increases about 5% every year. Road accidents account for a third to half of medical evacuations as well as for the most serious injuries. The risk of accidents and their potential gravity may be enhanced by the poor condition of roads and vehicles. Personal factors including fatigue, speed, alcohol, drugs, and poor vision also play a major role. Physicians should warn travelers planning road trips of all these hazards and of any specific local conditions prevailing in certain destinations. Prevention depends on the age of the traveler and on any disabilities that he/she might have. Packing a first aid kit and inspecting safety equipment before the trip and at regular intervals during the trip are indispensable. Knowledge of emergency first aid procedures is highly recommendable. While avoiding excessiveness of any kind, the physician should encourage suitable psychological and material preparation in function of travel plans. This preparation should be aimed at reducing the risk of road accident particularly in developing countries. Counseling can be useful in reducing the risk of road accidents particularly in developing countries.
Subject(s)
Accidents, Traffic/prevention & control , Travel , Accidents, Traffic/statistics & numerical data , Age Factors , Alcohol Drinking/adverse effects , First Aid , Humans , Patient Education as Topic , Risk FactorsABSTRACT
Emergency care is estimated on the basis of experience at Tours University Hospital (20,000 emergencies per year). The study deals with adult patients with multiple injuries in relation to the overall activity of the department, from 1981 to 1989. The accuracy of the diagnosis and the severity criteria are essential parameters for an exploitable study. The analysis of the surgical parameters shows an overall increase in the severity of bone and visceral injuries. The overall increase from 157,686 surgical unit codes (proportional to the complexity of the operation) in 1981 to 601,109 in 1988 markedly exceeds the increase in the number of patients, from 16,404 to 22,608. Out of about 4,000 emergent operations per year, 12% involve patients with multiple injuries. The consequence of the fourfold increase in these individual treatments, especially in light surgery and surgery with a stay in hospital not exceeding 24 hours, is a sixfold increase in biological examinations and a threefold increase in radiological examinations. The cost of care in the Emergency Department makes up to 1% of the general budget of the hospital. In order to achieve a valuable control of these structures, a permanent participation of the upstream (SAMU-Emergency Medical Assistance Department) and downstream (specialist departments) medical teams is essential, in order to properly assess the diagnostic and therapeutic performances and to obtain the best possible fit between the complete evaluation of the lesions and the minimum costs.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Emergency Medical Services/organization & administration , Multiple Trauma/diagnosis , Emergencies , Emergency Medical Services/economics , France , Humans , Multiple Trauma/surgery , Trauma Severity IndicesABSTRACT
The accuracy of diagnosis in multiple trauma can be greatly improved by the use of standardized assessment routines and uniform documentation. In the three groups of patients reviewed, the diagnostic error rate decreased from 23 percent in 1979 to 1980 to 8 percent in 1981 to 1982, and decreased further to 7.6 percent in 1983 to 1984. Our latest results show that a margin of error still persists. We believe that standardization of assessment routines in the difficult area of emergency medical practice is in the patient's best interest.
Subject(s)
Emergencies , Wounds and Injuries/diagnosis , Diagnostic Errors , France , Hospitals, University , Humans , Wounds and Injuries/mortality , Wounds and Injuries/surgeryABSTRACT
The accuracy of diagnosis in multiple trauma can be greatly improved by the use of standardized assessment routines and standard documentation. In the two groups of patients reviewed the diagnostic error rate fell from 23% in the period 1979-1980 to 8% for the period 1981-1982.
Subject(s)
Wounds and Injuries/diagnosis , Diagnostic Errors , Documentation , Emergency Service, Hospital , Humans , Medical Audit , Medical Records , Methods , Wounds and Injuries/complicationsSubject(s)
Pancreas/injuries , Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Pancreas/surgery , Pancreatectomy , Postoperative Complications , Reoperation , Time FactorsSubject(s)
Education, Medical , Emergency Service, Hospital , Wounds and Injuries/diagnosis , HumansSubject(s)
Pancreas/injuries , Wounds, Nonpenetrating/surgery , Adolescent , Adult , Aged , Female , Humans , Male , Middle AgedSubject(s)
Pancreas/injuries , Wounds, Nonpenetrating/surgery , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Wounds, Nonpenetrating/diagnosisABSTRACT
The emergency department has become a major portal of entry in university hospitals for patients with life-threatening conditions as well as for nonurgent cases. A fourfold increase in 10 years (28,263 patients in 1977) allows an analysis of admissions according to the Abbreviated Injury Scale and of the value of diagnosis. Results emphasize the need for complementary surgical consultant and operatory structures, a rapid and good quality approach and a specific coordination on an equal basis between the emergency department and other specialized departments. Teaching of practical emergency care should be adapted and increased.
