This study reviewed 103 deaths resulting from trauma in a 30 months period at the Emergency Department of Chung Ang Gil Hospital to evaluate problems in prehospital and hospital resuscitative care.
@ES The results were summerized as fofollws:
@EN 1. Among 103 patients who died of trauma, 71 patients were male (68.9%) and 32 patients were female (31.1%). The mortality rate was 0.095% of all 107,741 patients who admitted to the Emergency Department. (Death On Arrival was 0.53% (573
cases)
and
Death After Arrival was 0.24% (256 cases) during the same period.)
2. The patients who arrived at the Emergency Department from 30 to 60 minutes after onset of urgent situation was 43.7% but within 1 minutes only 10.7%. The cases transfered by ambulances was only 19.4%, most of rest were moved by public or
private
vehicies.
3. The cause of trauma was Traffic Accident in 75%, among them 42.7% were pedestrian injury.
4. The time interval between arrival at Emergency Department and onset of cardiac arrest was commonly within 10 minutes in 40.8% of patients. In 43.7% of patients, death was pronounced within 30 minutes after onset of cardiac arrest.
5. The trauma resuscitation were performed as primary surveys and then secondary procedures.
6. The primary surveys were completed in about 3 minutes after the patients arrival : access of airway (89.3%), oxygen administration (86.4%), IV access (92.2%), and EKG monitoring (81.6%).
The secondary procedures were initiated within 10 minutes : endotracheal intubation (81.6%), CVP monitoring (46.6%), paracentesis & DPL (44.7%) and thoracentesis & chest tube insertion (21.4%).
6. The main causes of death were brain injury (36.4%) and irreversible shock (32.0%). On physical examination, the most frequent injuried site was head and neck as 35.4%.
7. The mean ISS of all deaths was 45.24±13.59, the mean GCS was 6.44±3.36 and the mean RTS was 3.20±2.38. By the TRISS method, the mean Ps of deaths was 0.244. Unexpected death, who were died inspite of Ps≥0.5, were 23 cases.
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