References
Pre-hospital management of major haemorrhage following trauma: part one
Abstract
Major haemorrhage remains the highest preventable cause of death following trauma, accounting for 30–40% of trauma mortality (
Globally, major trauma is the leading cause of death among children and young adults under the age of 40 (Krug et al, 2000). While there are no current complete data on the incidence of major trauma and mortality rates in England, the most recent available data collected by the Trauma Audit and Research Network (TARN) estimate that there were 20 000 incidents of major trauma in 2007, with at least 5400 of these leading to death (National Audit Office (NAO), 2010). However, these data are over a decade old and may not be representative of current incidence. Advances in pre-hospital care, such as the introduction of tranexamic acid (TXA), and implementations of systematic trauma quality improvement systems over the past decade have been associated with reduced mortality rates (O'Reilly et al, 2013).
Within the UK, 12 ambulance service trusts respond to 999 and 111 calls, collectively receiving 6.15 million cases in 2008-09, which resulted in an emergency response (NAO, 2010). It is estimated that 20 000 of these calls are regarding major trauma, suggesting that major trauma is a relatively small proportion of a paramedic's workload (NAO, 2010). However, owing to the nature and severity of injuries, pre-hospital interventions to rectify life-threatening problems are essential to improve patient outcomes.
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