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Interinstitutional transfers to a trauma center
1Department of Surgery, University of British Columbia, Vancouver General Hospital, Canada.
American Journal of Surgery
|May 1, 1990
Summary
This study reviewed 412 trauma transfers, finding most were appropriate but highlighting needs for better physician screening and regionalized care to optimize patient transport and outcomes.
Area of Science:
- Trauma Surgery
- Emergency Medicine
- Health Services Research
Background:
- Trauma transfer is crucial for patients requiring specialized care.
- Understanding referral patterns and transfer challenges is vital for optimizing outcomes.
Purpose of the Study:
- To analyze patient demographics, referral patterns, and identify problems associated with trauma transfers.
- To evaluate the appropriateness and safety of trauma patient transfers to a Level I Trauma Center.
Main Methods:
- Retrospective review of 412 trauma patient records over a one-year period.
- Analysis of patient demographics, Injury Severity Score (ISS), injury mechanisms, and reasons for transfer.
- Examination of transport methods, timeliness, and identified transfer management issues.
Main Results:
- The average Injury Severity Score (ISS) was 15, with 34% having an ISS ≥ 16.
- Vehicular accidents (47%) and falls (26%) were primary injury mechanisms.
- Musculoskeletal (38%) and neurosurgical (17%) issues most frequently prompted transfers; airway and hemodynamic instability were key management problems.
Conclusions:
- The majority of trauma transfers were indicated and safely executed.
- Opportunities exist to improve patient screening, regionalized care, and pre-transfer stabilization communication.
- Enhanced regional planning and communication can reduce avoidable transfers and improve care for critically injured patients.