[Seriously injured patients transferred from local hospitals to a university hospital].
BACKGROUND
We studied diagnostics and stabilizing surgery in severely injured patients transferred from local hospitals to a university hospital. The purpose was to identify a potential for improvement of regional trauma care.


METHODS
The material comprises all severely injured patients (Injury Severity [ISS] Score > 15) transferred from local hospitals to the University Hospital of Northern Norway in the period 01.01.2006 - 31.12.2007. Information about diagnostics, extent of injury and treatment during the first 24 hours after transferral was recorded by retrospective chart review. Emergency surgical interventions are defined according to plans for a national trauma system.


RESULTS
6/74 patients underwent emergency surgery at the local hospital (chest tube insertion, external fracture fixation); eight after arrival at the university hospital (chest tube insertion, hemostatic packing of the abdomen and pelvis, external fracture fixation). 66/74 were CT-scanned locally; 37 with a CT multitrauma series (CT caput, neck, thorax, abdomen and pelvis). Of the 62 who had head CT scans performed at a local hospital, the cervical spine was not imaged for 10. For eight of 55 patients who had CT scans of the thorax/abdomen/pelvis intravenous contrast agent was not administered.


CONCLUSIONS
Trauma care at local hospitals may be improved by more systematic imaging, a lower threshold for emergency surgery, and early communication with the university hospital.
Dehli
Trond
T
Hjerte-, lunge- og karkirurgisk avdeling, Akuttmedisinsk klinikk, Universitetssykehuset Nord-Norge, 9038 Tromsø, Norway. trond.dehli@unn.no
Bågenholm
Anna
A
Johnsen
Liv-Hege
LH
Osbakk
Svein Are
SA
Fredriksen
Knut
K
Bartnes
Kristian
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D004636:Emergency Service, Hospital / Q000592:standards; D005260:Female; D006785:Hospitals, University / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000175:diagnosis / Q000601:surgery; D009664:Norway; D010360:Patient Transfer; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D014193:Trauma Centers / Q000592:standards; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000175:diagnosis / Q000601:surgery; D055815:Young Adult