Beck, Ben; Smith, Karen; Mercier, Eric; Bernard, Stephen; Jones, Colin; Meadley, Ben; Clair, Toby St; Jennings, Paul A; Nehme, Ziad; Burke, Michael; Bassed, Richard; Fitzgerald, Mark; Judson, Rodney; Teague, Warwick; Mitra, Biswadev; Mathew, Joseph; Buck, Andrew; Varma, Dinesh; Gabbe, Belinda; Bray, Janet; McLellan, Susan; Ford, Jane; Siedenburg, Josine; Cameron, Peter

Author(s)

Beck, Ben

Smith, Karen

Mercier, Eric

Bernard, Stephen

Jones, Colin

Meadley, Ben

Clair, Toby St

Jennings, Paul A

Nehme, Ziad

Burke, Michael

Bassed, Richard

Fitzgerald, Mark

Judson, Rodney

Teague, Warwick

Mitra, Biswadev

Mathew, Joseph

Buck, Andrew

Varma, Dinesh

Gabbe, Belinda

Bray, Janet

McLellan, Susan

Ford, Jane

Siedenburg, Josine

Cameron, Peter

Publication Date

2019-03-07

Abstract

Reviewing prehospital trauma deaths provides an opportunity to identify system improvements that may reduce trauma mortality. The objective of this study was to identify the number and rate of potentially preventable trauma deaths through expert panel reviews of prehospital and early in-hospital trauma deaths. We conducted a retrospective review of prehospital and early in-hospital (<24 h) trauma deaths following a traumatic out-of-hospital cardiac arrest that were attended by Ambulance Victoria (AV) in the state of Victoria, Australia, between 2008 and 2014. Expert panels were used to review cases that had resuscitation attempted by paramedics and underwent a full autopsy. Patients with a mechanism of hanging, drowning or those with anatomical injuries deemed to be unsurvivable were excluded. Of the 1183 cases that underwent full autopsies, resuscitation was attempted by paramedics in 336 (28%) cases. Of these, 113 cases (34%) were deemed to have potentially survivable injuries and underwent expert panel review. There were 90 (80%) deaths that were not preventable, 19 (17%) potentially preventable deaths and 4 (3%) preventable deaths. Potentially preventable or preventable deaths represented 20% of those cases that underwent review and 7% of cases that had attempted resuscitation. The number of potentially preventable or preventable trauma deaths in the pre-hospital and early in-hospital resuscitation phase was low. Specific circumstances were identified in which the trauma system could be further improved.

Affiliation

Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Faculty of Medicine, Laval University, Quebec City, Quebec, Canada. Electronic address: ben.beck@monash.edu..

Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Centre for Research and Evaluation, Ambulance Victoria, Victoria, Australia; Department of Community Emergency Health and Paramedic Practice, Monash University, Victoria, Australia..

Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Faculty of Medicine, Laval University, Quebec City, Quebec, Canada..

Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Centre for Research and Evaluation, Ambulance Victoria, Victoria, Australia; The Intensive Care Unit, The Alfred Hospital..

Ambulance Victoria, Victoria, Australia..

Department of Community Emergency Health and Paramedic Practice, Monash University, Victoria, Australia; Ambulance Victoria, Victoria, Australia..

Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Department of Community Emergency Health and Paramedic Practice, Monash University, Victoria, Australia; Ambulance Victoria, Victoria, Australia; Emergency and Trauma Centre, The Alfred, Victoria, Australia..

Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Centre for Research and Evaluation, Ambulance Victoria, Victoria, Australia; Department of Community Emergency Health and Paramedic Practice, Monash University, Victoria, Australia; Ambulance Victoria, Victoria, Australia..

Victorian Institute of Forensic Medicine, Victoria, Australia..

Victorian Institute of Forensic Medicine, Victoria, Australia; Department of Forensic Medicine, Monash University, Victoria, Australia..

Trauma Service, The Alfred, Victoria, Australia; National Trauma Research Institute, Victoria, Australia..

General Surgery, The Royal Melbourne Hospital, Victoria, Australia; Department of Surgery, The University of Melbourne, Victoria, Australia..

Trauma Service, The Royal Children's Hospital, Victoria, Australia; Department of Paediatrics, University of Melbourne, Victoria, Australia; Surgical Research Group, Murdoch Children's Research Institute, Victoria, Australia..

Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; National Trauma Research Institute, Victoria, Australia; Emergency and Trauma Centre, The Alfred, Victoria, Australia..

Trauma Service, The Alfred, Victoria, Australia; National Trauma Research Institute, Victoria, Australia; Emergency and Trauma Centre, The Alfred, Victoria, Australia..

Emergency Department, Royal Darwin Hospital, Northern Territory, Australia..

Department of Surgery, The University of Melbourne, Victoria, Australia; Radiology, The Alfred, Victoria, Australia..

Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Health Data Research UK, Swansea University Medical School, Swansea University, UK..

Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia..

Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia..

Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; National Trauma Research Institute, Victoria, Australia; Emergency and Trauma Centre, The Alfred, Victoria, Australia..

Citation

Injury . 2019 May;50(5):1009-1016. doi: 10.1016/j.injury.2019.03.003. Epub 2019 Mar 7.

Pubmed ID

https://pubmed.ncbi.nlm.nih.gov/30898389/?otool=iaurydwlib

Link

https://hdl.handle.net/10137/7487

Subject

Emergency medical services

Mortality

Pre-hospital care

Preventable

Trauma

Trauma systems

Title

Potentially preventable trauma deaths: A retrospective review.

Type of document

Journal Article

Entity Type

Publication

Author(s)	Beck, Ben Smith, Karen Mercier, Eric Bernard, Stephen Jones, Colin Meadley, Ben Clair, Toby St Jennings, Paul A Nehme, Ziad Burke, Michael Bassed, Richard Fitzgerald, Mark Judson, Rodney Teague, Warwick Mitra, Biswadev Mathew, Joseph Buck, Andrew Varma, Dinesh Gabbe, Belinda Bray, Janet McLellan, Susan Ford, Jane Siedenburg, Josine Cameron, Peter
Publication Date	2019-03-07
Abstract	Reviewing prehospital trauma deaths provides an opportunity to identify system improvements that may reduce trauma mortality. The objective of this study was to identify the number and rate of potentially preventable trauma deaths through expert panel reviews of prehospital and early in-hospital trauma deaths. We conducted a retrospective review of prehospital and early in-hospital (<24 h) trauma deaths following a traumatic out-of-hospital cardiac arrest that were attended by Ambulance Victoria (AV) in the state of Victoria, Australia, between 2008 and 2014. Expert panels were used to review cases that had resuscitation attempted by paramedics and underwent a full autopsy. Patients with a mechanism of hanging, drowning or those with anatomical injuries deemed to be unsurvivable were excluded. Of the 1183 cases that underwent full autopsies, resuscitation was attempted by paramedics in 336 (28%) cases. Of these, 113 cases (34%) were deemed to have potentially survivable injuries and underwent expert panel review. There were 90 (80%) deaths that were not preventable, 19 (17%) potentially preventable deaths and 4 (3%) preventable deaths. Potentially preventable or preventable deaths represented 20% of those cases that underwent review and 7% of cases that had attempted resuscitation. The number of potentially preventable or preventable trauma deaths in the pre-hospital and early in-hospital resuscitation phase was low. Specific circumstances were identified in which the trauma system could be further improved.
Affiliation	Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Faculty of Medicine, Laval University, Quebec City, Quebec, Canada. Electronic address: ben.beck@monash.edu.. Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Centre for Research and Evaluation, Ambulance Victoria, Victoria, Australia; Department of Community Emergency Health and Paramedic Practice, Monash University, Victoria, Australia.. Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Faculty of Medicine, Laval University, Quebec City, Quebec, Canada.. Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Centre for Research and Evaluation, Ambulance Victoria, Victoria, Australia; The Intensive Care Unit, The Alfred Hospital.. Ambulance Victoria, Victoria, Australia.. Department of Community Emergency Health and Paramedic Practice, Monash University, Victoria, Australia; Ambulance Victoria, Victoria, Australia.. Department of Community Emergency Health and Paramedic Practice, Monash University, Victoria, Australia; Ambulance Victoria, Victoria, Australia.. Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Department of Community Emergency Health and Paramedic Practice, Monash University, Victoria, Australia; Ambulance Victoria, Victoria, Australia; Emergency and Trauma Centre, The Alfred, Victoria, Australia.. Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Centre for Research and Evaluation, Ambulance Victoria, Victoria, Australia; Department of Community Emergency Health and Paramedic Practice, Monash University, Victoria, Australia; Ambulance Victoria, Victoria, Australia.. Victorian Institute of Forensic Medicine, Victoria, Australia.. Victorian Institute of Forensic Medicine, Victoria, Australia; Department of Forensic Medicine, Monash University, Victoria, Australia.. Trauma Service, The Alfred, Victoria, Australia; National Trauma Research Institute, Victoria, Australia.. General Surgery, The Royal Melbourne Hospital, Victoria, Australia; Department of Surgery, The University of Melbourne, Victoria, Australia.. Trauma Service, The Royal Children's Hospital, Victoria, Australia; Department of Paediatrics, University of Melbourne, Victoria, Australia; Surgical Research Group, Murdoch Children's Research Institute, Victoria, Australia.. Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; National Trauma Research Institute, Victoria, Australia; Emergency and Trauma Centre, The Alfred, Victoria, Australia.. Trauma Service, The Alfred, Victoria, Australia; National Trauma Research Institute, Victoria, Australia; Emergency and Trauma Centre, The Alfred, Victoria, Australia.. Emergency Department, Royal Darwin Hospital, Northern Territory, Australia.. Department of Surgery, The University of Melbourne, Victoria, Australia; Radiology, The Alfred, Victoria, Australia.. Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Health Data Research UK, Swansea University Medical School, Swansea University, UK.. Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia.. Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia.. Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia.. Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia.. Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; National Trauma Research Institute, Victoria, Australia; Emergency and Trauma Centre, The Alfred, Victoria, Australia..
Citation	Injury . 2019 May;50(5):1009-1016. doi: 10.1016/j.injury.2019.03.003. Epub 2019 Mar 7.
Pubmed ID	https://pubmed.ncbi.nlm.nih.gov/30898389/?otool=iaurydwlib
Link	https://hdl.handle.net/10137/7487
Subject	Emergency medical services Mortality Pre-hospital care Preventable Trauma Trauma systems
Title	Potentially preventable trauma deaths: A retrospective review.
Type of document	Journal Article
Entity Type	Publication

Potentially preventable trauma deaths: A retrospective review.

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