First aid strategy for severe traumatic patients in hospital.
OBJECTIVE
To study the emergency management principles of severe trauma in hospital (injury severity score larger than or equal to 16).


METHODS
We used "ATP principle" to manage severe traumatic patients. The ATP principle is composed of: 1) attending surgeons offering initial management (A); 2) teamwork commencement immediately after patients admitted to hospital (T); 3) parallel principle, ie, emergency resuscitation, evaluation and laboratory test performed simultaneously (P). Clinical effects before and after applying ATP principle were retrospectively analyzed and compared.


RESULTS
During January 1, 2002 to December 31, 2003, 338 patients were treated without applying ATP principle, in which ISS was 25.9+/-6.4, 152 cases died with the mortality being 39.2%, and the time stayed in emergency department and the time to operation room after admission were (102.8+/-16.7) min, (140.3+/-20.6) min, respectively. During January 1, 2004 to December 31, 2005, 438 patients were treated based on ATP principle, in which ISS was 28.6+/-7.8, 87 cases died with the mortality being 19.9%, and the time in emergency department and the time to operation room after admission were (69.5+/-11.5) min, (89.6+/-9.3) min, respectively. ISS showed no significant difference between the two groups (P larger than 0.05) but the mortality, the time stayed in emergency department and the time to operation room after admission were greatly reduced and showed significant difference between the two groups (P less than 0.05).


CONCLUSIONS
Applying ATP principle to treat severe traumatic patients can shorten emergency treatment time in hospital and decrease mortality.
Emergency Surgery Department, Gongli Hospital of Shanghai Pudong New District, Shanghai 200135, China. linengp@163.com
Neng-ping
NP
Li
Wei-min
WM
Fang
Yong-feng
YF
Gu
Xiao-bing
XB
Lu
Jian-nong
JN
Cong
Xiao-ping
XP
Hui
Zhao-fen
ZF
Lin
Wen-fang
WF
Li
Xing-yi
XY
Yang
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D012189:Retrospective Studies; D014218:Triage; D014947:Wounds and Injuries / Q000145:classification / Q000401:mortality / Q000628:therapy*