Citation

Husum H, Gilbert M, Wisborg T, Van Heng Y, Murad M. Mil. Med. 2003; 168(11): 934-940.

Affiliation

Tromsoe Mine Victim Resource Center, P.O. Box 80, N-9038, University Hospital of Northern Norway. tmc@unn.no

Copyright

(Copyright © 2003, Association of Military Surgeons of the United States)

DOI

unavailable

PMID

14680051

Abstract

OBJECTIVE: The aim of this study was to explore the effect of low-cost prehospital trauma systems on trauma outcome in land mine victims and to study prehospital risk indicators for better triage of land mine injuries. METHODS: A 5-year prospective study of the effect of in-field advanced life support provided by local paramedics was conducted in mine-infested areas in North Iraq and Cambodia. RESULTS: After implementation of a rural rescue system, there was a significant reduction in trauma mortality from 26.2% in 1997 to 11.8% in 2001 (95% confidence interval for difference, 5.1%-23.6%). The mortality rate was significantly higher in fragmentation mine victims, 25.2%, as compared with blast mine victims, 5.7% (95% confidence interval for difference, 14.4%-24.6%). The severity of associated fragment injuries in patients with traumatic amputations is a solid risk predictor (area under the curve in receiver operating characteristics plots > 0.9). CONCLUSIONS: Low-cost prehospital trauma systems improve trauma outcome in land mine victims where prehospital transit times are high. The fragment wounds represent the main challenge for trauma care providers.

Language: en