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Original Articles
Comparative Evaluation of Emergency Medical Service Trauma Patient Transportation Patterns Before and After Level 1 Regional Trauma Center Establishment: A Retrospective Single-Center Study
Hyeong Seok Lee, Won Young Sung, Jang Young Lee, Won Suk Lee, Sang Won Seo
J Trauma Inj. 2021;34(2):87-97.   Published online March 24, 2021
DOI: https://doi.org/10.20408/jti.2020.0021
  • 3,064 View
  • 128 Download
  • 2 Citations
AbstractAbstract PDF
Purpose

This study examined emergency medical service (EMS) transportation patterns for adult trauma patients before and after establishing a level 1 regional trauma center (RTC) and to evaluate the transportation approach after prehospital severity screening.

Methods

This was a retrospective observational study of trauma patients aged ≥18 years admitted via EMS to the emergency department or a level 1 RTC, 1 year before to 3 years after RTC establishment. Patients with an Injury Severity Score (ISS) in the patient registration system were selected. Analyses were performed to determine transportation pattern changes by comparing patients pre- and post-RTC establishment and by yearly comparisons over the 4-year study period using the Mann-Whitney U test and chi-square test.

Results

Overall, 3,587 patients were included. The mean ISS was higher in the post-RTC group (n=2,693; 10.63±8.90, median 9.00) than in the pre-RTC group (n=894; 9.44±8.20, median 8.00; p<0.001). The mean transportation distance (9.84±13.71, median 5.80 vs. 13.12±16.15 km, median 6.00; p<0.001) was longer in the post-RTC group than in the pre-RTC group. Furthermore, proportionally fewer patients were transported from an area in the same city as the RTC after establishment (86.1% vs. 78.3%; p<0.001). Yearly comparisons revealed a gradually increasing trend in the hospital death rate (ptrend=0.031).

Conclusions

After establishing a level 1 RTC, the EMS transportation of severe trauma patients increased gradually along with the long-distance transportation of minor trauma patients. Therefore, improved prehospital EMS trauma severity assessments and level 1 RTC involvement in patient classification in the prehospital phase are necessary.

Summary

Citations

Citations to this article as recorded by  
  • Establishment of Emergency Teaching Model and Optimization of Discrete Dynamic Calculation in Complex Virtual Simulation Environment
    He Li, Yuansong Sun, Kai Song, Chunlin Yin, Gengxin Sun
    Mathematical Problems in Engineering.2022; 2022: 1.     CrossRef
  • Model for Predicting In-Hospital Mortality of Physical Trauma Patients Using Artificial Intelligence Techniques: Nationwide Population-Based Study in Korea
    Seungseok Lee, Wu Seong Kang, Sanghyun Seo, Do Wan Kim, Hoon Ko, Joongsuck Kim, Seonghwa Lee, Jinseok Lee
    Journal of Medical Internet Research.2022; 24(12): e43757.     CrossRef
Treatment of Partial Thickness Skin Defect with Cultured Allogenic Keratinocytes (Kaloderm.)
Sang Won Seo, Choong Hyun Chang, Min Su Cho, Yoon Gi Hong, Sae Wha Jeon
J Korean Soc Traumatol. 2007;20(1):1-5.
  • 1,291 View
  • 9 Download
AbstractAbstract PDF
PURPOSE
Grafting with autograft skin remains the most effective method for treating skin defects. When insufficient donor sites are present or patients are afraid of the operation, a skin graft is impossible. Cultured allogenic keratinocytes speed wound healing by providing cover and by producing growth factors and extracellular matrix protein. We report an application of cultured allogenic keratinocytes (Kaloderm., Tegoscience, Seoul, Korea) in the treatment of an acute partial thickness skin defect.
METHODS
From March 2005 to January 2006, 20 patients with a partial thickness skin defect were treated with cultured allogenic keratinocytes. The wound was covered with a sheet of cultured allogenic keratinocytes and ointment with Bactigras. gauze. The wound was inspected every two or three days. We regarded completion of epithelialization as wound healing.
RESULTS
The mean period between time of injury and time of Kaloderm. application was 7.5 days. The time taken from application of Kaloderm. to complete closure of the wounds was 7.2 days.
CONCLUSION
In view of the favorable outcome, cultured allogenic keratinocytes are safe and effective biologic dressing materials for use in the treatment of open wounds.
Summary
The Utility of Ultrasonography in the Emergency Department for the Diagnosis of Finger Tendon Injury
Jung Woo Park, Jang Young Lee, Won Suck Lee, Won Young Sung, Sang Won Seo, Jung Il Yang
J Trauma Inj. 2014;27(4):139-144.
  • 1,072 View
  • 3 Download
AbstractAbstract PDF
PURPOSE
Detection and determination of tendon injury in the finger or hand is not easy. Therefore, we aimed to study and evaluate the accuracy and the effectiveness of ultrasonography for the diagnosis of finger tendon injury.
METHODS
In this study, we enrolled patients, regardless of age and sex, with lacerations on their fingers. Patients with invisible wounds were excluded. We evaluated the accuracy and the effectiveness of ultrasonography and compared the results obtained from ultrasonography and with those obtained by visual observation of the injuries.
RESULTS
The sensitivity, the specificity and the accuracy of ultrasonography were found to be 66.7%, 100% and 91.3%, respectively (p<0.001) while those of physical examination were 71.4%, 98.3% and 91.3%, respectively. Small differences were observed between the sensitivities and specificities of the two examinations; however, the accuracies were the same (p<0.001). The area under the receiver operating characteristic (ROC) curve, which was used for diagnosis of tendon rupture using ultrasonography, was found to be 0.985 (95% confidence interval CI: 0.929-0.999),while that of physical examination was 0.938 (95% CI: 0.861-0.980).
CONCLUSION
Ultrasonography can be used an effective diagnostic tool for patients with finger tendon injury.
Summary

J Trauma Inj : Journal of Trauma and Injury