Citation

Dehli T, Bågenholm A, Johnsen LH, Osbakk SA, Fredriksen K, Bartnes K. Tidsskr. Nor. Laegeforen. 2010; 130(15): 1455-1457.

Vernacular Title

Alvorlig skadede overfort til universitetssykehus.

Affiliation

trond.dehli@unn.no Hjerte-, lunge- og karkirurgisk avdeling Akuttmedisinsk klinikk.

Copyright

(Copyright © 2010, Norske Laegeforening)

DOI

10.4045/tidsskr.09.0796

PMID

20706304

Abstract

Background. We studied diagnostics and stabilizing surgery in severely injured patients transferred from local hospitals to a university hospital. The purpose was to identify a potential for improvement of regional trauma care. Material and methods. The material comprises all severely injured patients (Injury Severity [ISS] Score > 15) transferred from local hospitals to the University Hospital of Northern Norway in the period 01.01.2006 - 31.12.2007. Information about diagnostics, extent of injury and treatment during the first 24 hours after transferral was recorded by retrospective chart review. Emergency surgical interventions are defined according to plans for a national trauma system. Results. 6/74 patients underwent emergency surgery at the local hospital (chest tube insertion, external fracture fixation); eight after arrival at the university hospital (chest tube insertion, hemostatic packing of the abdomen and pelvis, external fracture fixation). 66/74 were CT-scanned locally; 37 with a CT multitrauma series (CT caput, neck, thorax, abdomen and pelvis). Of the 62 who had head CT scans performed at a local hospital, the cervical spine was not imaged for 10. For eight of 55 patients who had CT scans of the thorax/abdomen/pelvis intravenous contrast agent was not administered. Interpretation. Trauma care at local hospitals may be improved by more systematic imaging, a lower threshold for emergency surgery, and early communication with the university hospital.

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