Emergency department thoracotomy in Jamaica: a case controlled study.
Int J Surg
; 5(5): 311-5, 2007 Oct.
Article
em En
| MEDLINE
| ID: mdl-17513183
Increasing numbers of severely injured patients have been presenting to Emergency Rooms worldwide due to advances in pre-hospital trauma care. Some of these patients may be candidates for Emergency Department Thoracotomy (EDT). Large advisory bodies have identified selection criteria for EDT in Developed Countries, but there are no regional statistics to guide the selection process in Developing Caribbean Nations. This study evaluates outcomes with EDT at the University Hospital of the West Indies in Jamaica in order to determine factors that could predict survival in this setting. A retrospective study was performed over 11 years from January 1995 to January 2006 examining patients who had EDT at the University Hospital of the West Indies. There were 13 procedures performed over 11 years, with two early survivors (15%) and one patient surviving to discharge. The factors that have been found to be significant predictors of mortality include gunshot injuries, extra-thoracic injury location, inadequate pre-hospital resuscitation, prolonged transportation time and the absence of signs of life on arrival to hospital. Several health care limitations have been uncovered in this setting that must be improved if we are to expect improved outcomes. Focused preparation of the Emergency Room is an initial step that can be easily achieved. We also need to define strict management protocols using selection criteria that are tailored to our local environment in order to exclude futile procedures in unsalvageable patients.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Traumatismos Torácicos
/
Ferimentos Penetrantes
/
Toracotomia
/
Serviços Médicos de Emergência
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Caribe ingles
/
Jamaica
Idioma:
En
Revista:
Int J Surg
Ano de publicação:
2007
Tipo de documento:
Article
País de publicação:
Estados Unidos