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More than 50 percent of injury-related deaths in rural Ontario occur before patients reach hospital
Date:1/26/2010

ikely to die before ever reaching an operating room or being admitted to hospital."

According to the data, most deaths (54%) occurred before any hospital contact. Motor vehicle collisions were responsible for over half of all deaths. While only 15 percent of Ontario's population lives more than one hour away from a trauma centre, this small proportion of the population accounted for 37% of all trauma-related deaths during the study period. This finding highlights the higher risk of death associated with delayed access to trauma centre care.

Although all patients in the study group ultimately died, the researchers considered those who succumbed to their injuries in EDs or later in hospital were "potentially salvageable," because they had potential access to life-saving interventions.

Other research shows that care in a designated trauma centre is associated with a 25% lower risk of death among severely injured patients. Ontario has nine designated Level I adult trauma centres, all located in urban areas.

But delivering timely, appropriate trauma care is a challenge in Ontario, where 90 percent of the province is considered rural, says Dr. Nathens. In Ontario, there is no requirement that smaller, more rural hospitals have a trauma team to assist in providing early care to stabilize severely injured patients such that they can survive long enough to benefit from the highest level of trauma care available in trauma centres. Nor do Ontario hospitals require that emergency department staff in these smaller centres have any special training in the treatment of severely injured patients.

St. Michael's is partnering with the Ontario Telemedicine network to evaluate the usefulness of telemedicine in helping community hospitals deliver better early care to severely injured patients.

The new study, entitled "Identifying Targets for Potential Interventions to Reduce Rural Trauma Deaths: A Population-Based Analysis,
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Contact: Julie Saccone
sacconej@smh.toronto.on.ca
416-864-5047
St. Michael's Hospital
Source:Eurekalert

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