• Refine Query
  • Source
  • Publication year
  • to
  • Language
  • 13
  • 8
  • 2
  • 2
  • 1
  • 1
  • 1
  • 1
  • 1
  • 1
  • 1
  • 1
  • Tagged with
  • 37
  • 37
  • 13
  • 13
  • 9
  • 8
  • 8
  • 7
  • 6
  • 5
  • 5
  • 5
  • 5
  • 4
  • 4
  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
31

Emergency medical transport of trauma patients a comparision of helicopter and ground ambulances /

Stewart, Kenneth Edward. January 2010 (has links) (PDF)
Thesis (Ph. D.)--University of Oklahoma. / Includes bibliographical references.
32

Can light passenger vehicle trajectory better explain the injury severity in crashes with bicycles than crash type?

Wahi, Rabbani Rash-ha, Haworth, Narelle, Debnath, Ashim Kumar, King, Mark, Soro, Wonmongo 03 January 2023 (has links)
Movements of cyclists and m.otor vehicles at intersections involve a wide variety of potential conflicting interactions. In Australia, the high numbers of motor vehicles, particularly light passenger vehicles, mixed with cyclists results in many bicycle-light passengervehicle (LPV) crashes (3,135 crashes during 2002-2014). About 68% of cyclist deaths at Australian intersections in 2016 were due to crashes between bicycles and LPVs (DITRLDG, 2016). The high number ofLPV crashes among fatalities among cyclists is an increasing safety concem. When an LPV collides with a cyclist, the resulting impact forces in.tluence the probability of cyclist injury severity outcom.e. Therefore, the goa1 at intersections should be to understand whether and which particular crash patterns are more injurious, in order to better inform approaches to reduce the impact forces to levels that do not result in severe injury outcomes. To examine how crash pattem (or mechanism) influences the injury severity of cyclists in bicycle-motor vehicle crashes at intersections, researchers typically describe the crash mechanism in terms of crash types, such as angle crashes, head--on crashes, rear-end crashes, and sideswipe crashes (e.g., Kim et al., 2007; Pai, 2011 ). While crash types explain crash mechanisms to some extent, this study hypothesiz.es that the trajectories of the crash involved vehicles may provide additional information because they better capture the movements of the vehicles prior to collision. Furthermore, it is argued that injury pattem might be in.tluenced by vehicle travel direction and manoeuvre (Isaksson-Hellman and Wemeke, 2017). For example, when a car is moving straight ahead it is likely to have a higher speed than when it is turning, and if cyclists are struck at a higher impact speed, they tend to sustain more severe injury (Badea-Romero and Lenard, 2013). While many studies have evaluated the association between cyclist injwy severity and crash types, the factors that might influence cyclist injury severity related to trajectory types (vehicle movement and travel direction) have not yet been thoroughly investigated. This study aims to examine the factors associated with cyclists' injury severity for 'trajectory types• compared with the typically used 'crash types' at intersections.
33

從臺北市自行車安全分析探討都市街道改善策略之研究 / An Improvement Strategy of Urban Streets According to the Bicycle Safety Analysis in Taipei City

劉秉宜, Liu, Pin Yi Unknown Date (has links)
過去都市的發展與道路規劃多以汽機車為主體,對於自行車的騎乘環境相對不夠友善,而隨著近年國內自行車使用率逐年攀升,據資料指出自行車發生事故的機率也有提高的趨勢,顯示自行車於道路上之安全性考量更需重視。故本研究將針對台北市自行車肇事資料進行深入探討,找出影響肇事嚴重度之因素,進而從規劃設計面研擬降低自行車事故之改善策略。 本研究係以民國98年至102年台北市自行車事故資料為分析對象,將肇事嚴重程度分為「死亡或頭部受傷」、「人員受傷」及「未受傷」三類,同時根據文獻回顧及實務上所能取得之資料,蒐集人、路、環境等24項研究變數。首先透過統計分析了解肇事資料之特性,而後再以多項式羅吉斯迴歸模型,分別針對整體事故以及不同空間及不同事故型態之自行車肇事資料,建構自行車肇事嚴重度模型,以釐清影響自行車事故之主要因素。 研究結果顯示,道路因素中事故位置為路口及路段對於自行車事故皆有顯著影響,其中路口造成死亡或受傷之機率更高;環境因素中,因彎道或建物造成視距不良對於增加自行車事故亦有顯著影響,而坡道則會降低事故發生之機率;在人的因素中,18歲以下和年齡越大、酒駕、直行或右轉,皆會增加因自行車事故致死或受傷之機率。最後依據實證之結果,謹從交通管理中的3E政策-交通工程(Engineering)、交通教育(Education)及交通執法(Enforcement)三面向之觀念及角度帶入都市設計層面,提出道路及環境改善措施,以提升都市街道之自行車騎乘環境,並透過教育宣導、推廣活動及相關法令規範等配套措施,藉以增加自行車之騎乘安全。
34

An assessment of the criminology significance of motor vehicle crash data within the criminal justice context

Roets, Andre 02 1900 (has links)
This research assessed the criminological significance of motor vehicle crash data within the criminal justice context. The study was conducted at the southern region Accident Bureau of the Ekurhuleni Metropolitan Police Department (EMPD). The objectives of this research are to: a. Explore and describe the extent and criminological impact of road traffic crashes on a macro level. b. Explore and describe the impact of road traffic crashes on a micro level. c. Explain the criminological significance of road traffic crash data in relation to effective road safety management. d. Evaluate and describe the attendance and recording procedure of road crashes. e. Evaluate and describe the supervisor’s responsibility in relation to the quality of crash data recorded. f. Evaluate and describe the effectiveness of crash statistics accessed by management and/or officials. g. Evaluate and explain the current prosecution procedure as part of the CJS. h. Evaluate existing policy about the crash-recording process applicable to operational law enforcement practitioners of the EMPD. i. Explore and describe the current state of motor vehicle insurance and its necessity from a criminological perspective. The researcher followed a mixed-methods approach, collecting quantitative data from recorded Accident Report Forms and qualitative data from interviews with participants active in their fields of expertise. Road crashes are characterised by injury and damage; victims suffer trauma and economic consequences, and the society and the economy as a whole are affected. The research suggests that accurate road crash data form a crucial component in the investigation, prosecution and development of road safety strategies in the quest towards improved road safety efforts. It also indicates that existing crash data are of such a sub-standard that traffic professionals will not be able to develop effective and efficient road safety strategies in pursuit of road safety / Criminology and Security Science / M.A. (Criminology)
35

Procena rezultata lečenja unutarzglobnih višekomadnih preloma gornjeg i donjeg okrajka potkolenice aparatom po Ilizarovu / Assessment of treatment results of intraarticulary multifragmentary fractures of upper and lower part of the lower leg by Ilizarov apparatus

Lalić Ivica 24 June 2016 (has links)
<p>Kompleksnost visokoenergetskih preloma platoa i pilona tibije i njihova udruženost sa značajnim povredama mekog tkiva oko pripadajućeg zgloba veoma je dobro opisana. Lečenje ima za cilj da multifragmentarni prelomi platoa i pilona tibije postanu stabilni, artikularno poravnani, bezbolni, da koleno i skočni zglob budu pokretni i da se minimizira rizik do nastanka posttraumatskog osteoartritisa. Aparat po Ilizarovu sa nategnutim iglama, koristi opterećenje da stvori jedinstvenu podr&scaron;ku za zglob i stabilnu imobilizacju preloma da se postigne njegovo srastanje. Ovo omogućuje ranu pokretljivost zgloba bez rizika od gubitka redukcije. Cilj istraživanja je procena i poređenje rezultata lečenja unutarzglobnih vi&scaron;ekomadnih preloma kostiju proksimalnog i distalnog okrajka potkolenice tretiranih spoljnjim unilateralnim rigidnim fiksatorom i aparatom po Ilizarovu primenom ASAMI ko&scaron;tanog skoring sistema i funkcionalnog skoring sistema po Karlstrom &ndash; Olerudu.Takođe je jedan od ciljeva istraživanja bio da se uoče faktori koji utiču na različite rezultate lečenja unutarzglobnih vi&scaron;ekomadnih preloma kostiju gornjeg i donjeg okrajka potkolenice tretiranih spoljnim unilateralnim rigidnim fiksatorom i aparatom po Ilizarovu. Istraživanje je dizajnirano kao kontrolisana komparativna klinička studija a podaci su se prikupljali retrospektivno i delom prospektivno na osnovu medicinske dokumentacije od 2008. do 2013. godine. Studija je u potpunosti izvedena na Klinici za ortopediju i traumatologiju Kliničkog centra Vojvodina u Novom Sadu. Studija je obuhvatila ukupno 103 ispitanika kod kojih je u toku 2008 do 2013. godine postavljena dijagnoza unutarzglobnog vi&scaron;ekomadnog preloma gornjeg ili donjeg okrajka tibije. Ispitanici koji su obuhvaćeni ovim kliničkim istraživanjem razvrstani su u tri grupe: Prvu grupu od 53 ispitanika činili su oni sa vi&scaron;ekomadnim unutarzglobnim otvorenim ili zatvorenim prelomima gornjeg ili donjeg okrajka kostiju potkolenice lečenih isključivo spoljnjim unilateralnim rigidnim fiksatorom. Drugu grupu ispitanika, njih 31, činili su oni sa vi&scaron;ekomadnim unutarzglobnim otvorenim ili zatvorenim prelomima gornjeg ili donjeg okrajka kostiju potkolenice lečenih isključivo aparatom po Ilizarovu. Treću grupu činila su 19 ispitanika sa vi&scaron;ekomadnim unutarzglobnim otvorenim ili zatvorenim prelomima gornjeg ili donjeg okrajka kostiju potkolenice koji su lečenje započeli spoljnjim unilateralnim rigidnim fiksatorom, a u kasnijem periodu zbog nastalih komplikacija (lo&scaron;e srastanje, produženo srastanje, nesrastanje, infekcija, pseudoartroza) lečenje nastavili konverzijom spoljnjeg unilateralnog rigidnog fiksatora u aparat po Ilizarovu. Osnovni izvor podataka za prikazano istraživanje bio je protokol formiran za svakog bolesnika pojedinačno, istorije bolesti i poliklinička evidencija. Za potrebe istraživanja dizajniran je protokol istraživanja gde su se prikupljeni podaci analizirali hronolo&scaron;ki : podaci o pacijentu, klinički nalaz na prijemu, postoperativni tok, monitoring aparata, klinički nalaz na otpustu i klinički nalaz na kontrolama od 6, 12 i 18 meseci. Kliničke nalaze na kontrolama na 6, 12 i 18 meseci beležili smo upotrebom skoring sistema ASAMI ( Udruženja za istraživanje i primenu metoda po Ilizarovu) &ndash; za ko&scaron;tane rezultate, i Karlstrom &ndash; Oleruda za procenu funkcionalnih rezultata. Neki do najvažnih rezultata dobijenih prilikom ovog istraživanja jesu da je najbrže vreme srastanja imala grupa Ilizarov, nakon 16&plusmn;2 nedelja. Grupa konverzija zabeležila je prosečno vreme srastanja u 17&plusmn;2 nedelji, dok je kod ispitanika u grupi fiksator zabeženo srastanje u 21&plusmn;4 nedelji. Pojava povr&scaron;nih i dubokih infekcija značajno je veća kod grupe tretiranih spoljnim unilateralnim fiksatorom nego kod grupa tretiranih aparatom po Ilizarovu. Vreme postizanje ranog, punog oslonca na operisani ekstremitet je značajno kraće kod grupe Ilizarov i konverzija nego kod grupe fiksator. Procena ko&scaron;tanih rezultata kori&scaron;ćenjem ASAMI bodovnog sistema ko&scaron;tanog srastanja ukazuje na statistički značajno bolje rezultate kod grupa Ilizarov i konverzija u odnosu na grupu spoljnji fiksator u periodu praćenja i analize na 6,12 i 18 meseci. Funkcionalni rezultati primenom sistema funkcionalne evaluacije po Karlstrom &ndash; Olerudu govore u prilog značajno statistički boljim rezultatima kod grupe Ilizarov i konverzija u odnosu na grupu spoljni fiksator u periodima praćenja i analize na 6,12 i 18 meseci. Na osnovu dobijenih rezultata dolazimo do zaključka da je tretman ispitanika sa multifragmentarnim, intraarikularnim prelomima gornjeg i donjeg okrajka kostiju potkolenice znatno efikasniji aparatom po Ilizarovu &scaron;to sveukupno daje smernice za brži i kvalitetniji oporavak ispitanika i njihov povratak svakodnevnim aktivnostima sa &scaron;to manjim posttraumatskim sekvelama.</p> / <p>The complexity of high-energy fractures of the tibia plateau and pilons and their association with significant violations of the soft tissue around the corresponding joint is well described in the literature. Main aim of the treatment is to multiple fractures of the tibia plateau and pilon become stable, articularly aligned, without pain, and with full motion in the knee and ankle joint with minimum risk for post-traumatic osteoarthritis. Ilizarov apparatus with taut needles is used to create a unique load support for the ankle and create conditions for good healing. This strong stability allows early joint movement, without risk of loss position of fracture parts. The aim of this research is assessment and comparation of the results of treatment, for intraarticular multiple fractures of the proximal and distal part of lower leg tretaed with unilateral external rigid fixator and Ilizarov apparatus, with ASAMI bone scoring system and functional scoring sistem by Karlstrom &ndash; Olerud. One of the goals of the study was to detect factors which affecting different treatment results of the intraarticular multiple fractures of the proximal and distal part of lower leg, tretaed with unilateral external rigid fixator and Ilizarov apparatus. The study was designed as a controlled comparative clinical study and data were collected retrospectively and prospectively form medical records from 2008 to 2013. The study has been fully implemented at the Department for orthopedic surgery and traumatology in the Clinical Center of Vojvodina in Novi Sad and included 103 patients who had intraarticular multiple fractures of the proximal and distal part of tibia. Subjects covered in this clinical study were classified into three groups: The first group of 53 patients were with intraartiulary multifragmentary open or closed fractures of the upper or distal part of lower leg, treated exclusively with unilateral external rigid fixator. The second group included 31 patients with intraarticular open or closed fractures of the upper or distal lower leg, treated exclusively with Ilizarov apparatus. 19 patients made the third group with intraarticulary open or closed fractures of the upper or distal lower leg, which were treated at the begining with unilateral external rigid fixator and later because of the complications (poor or prolonged healing, nonunion, infection and pseudoarthrosis) tretment was continued by Ilizarov apparatus. The main source of data for this study was protocol wich was established for each patient individually. In this protocol collected data analyzed by date: patient data, clinical findings at admission, postoperative course, monitoring apparatus, clinical findings at discharge and clinical findings at the controls which were at 6, 12 and 18 months after surgery. Clinical findings at control examinations (6, 12 and 18 months after surgery), we recorded by scoring system ASAMI (Association for the Study and Application of the Methods of Ilizarov) - that represent the results of the bone healing, and Karlstrom - Olerud for assessment functional outcomes. The most important results were: the fastest time of bone union was in the group of Ilizarov, and it was after 16 &plusmn; 2 weeks and the third group (conversion group) recorded an average time after 17 &plusmn; 2 weeks, while the patients in the first group (external fixator) had average time of union after 21 &plusmn; 4 week. The appearance of superficial and deep infection was significantly higher in the group treated with unilateral external fixator than in the group treated by the Ilizarov apparatus. Fastest full weight bearing on the injured leg, had patients in the group treated with Ilizarov apparatus. Evaluation of results using bone ASAMI fusion scoring system indicating a statistically significantly better results in the conversion and Ilizarov group compared to the group of external fixator in the period of monitoring at 6,12 and 18 months after surgery. Functional results by Karlstrom - Olerud scoring system show statistically significantly better results in the Ilizarov and conversion group contrary to the external fixator group in periods of monitoring at 6,12 and 18 months. Based on these results we conclude that the treatment of subjects with intraarticulary, multifragmentary fractures of the upper and lower part of the lower leg are more efficient after Ilizarov apparatus which provides overall guidance for faster and better recovery of patients and their return to their daily activities with minimal post-traumatic sequelae.</p>
36

An assessment of the criminology significance of motor vehicle crash data within the criminal justice context

Roets, Andre 02 1900 (has links)
This research assessed the criminological significance of motor vehicle crash data within the criminal justice context. The study was conducted at the southern region Accident Bureau of the Ekurhuleni Metropolitan Police Department (EMPD). The objectives of this research are to: a. Explore and describe the extent and criminological impact of road traffic crashes on a macro level. b. Explore and describe the impact of road traffic crashes on a micro level. c. Explain the criminological significance of road traffic crash data in relation to effective road safety management. d. Evaluate and describe the attendance and recording procedure of road crashes. e. Evaluate and describe the supervisor’s responsibility in relation to the quality of crash data recorded. f. Evaluate and describe the effectiveness of crash statistics accessed by management and/or officials. g. Evaluate and explain the current prosecution procedure as part of the CJS. h. Evaluate existing policy about the crash-recording process applicable to operational law enforcement practitioners of the EMPD. i. Explore and describe the current state of motor vehicle insurance and its necessity from a criminological perspective. The researcher followed a mixed-methods approach, collecting quantitative data from recorded Accident Report Forms and qualitative data from interviews with participants active in their fields of expertise. Road crashes are characterised by injury and damage; victims suffer trauma and economic consequences, and the society and the economy as a whole are affected. The research suggests that accurate road crash data form a crucial component in the investigation, prosecution and development of road safety strategies in the quest towards improved road safety efforts. It also indicates that existing crash data are of such a sub-standard that traffic professionals will not be able to develop effective and efficient road safety strategies in pursuit of road safety / Criminology and Security Science / M.A. (Criminology)
37

Прехоспитални фактори и траума скорови за процену тежине трауме и предвиђање исхода лечења повређеног пацијента / Prehospitalni faktori i trauma skorovi za procenu težine traume i predviđanje ishoda lečenja povređenog pacijenta / Prehospital factors and trauma scores in evaluating the severity of trauma and predicting the outcome

Jokšić-Mazinjanin Radojka 03 April 2019 (has links)
<p>Тешка траума се може дефинисати на неколико различитих начина. Најчешће коришћена дефиниција укључује коришћење Injury Severity Score ( ISS скор). Ако је вредност ISS скор &gt;15, ради се о тешкој трауми. Траума је временски осетљиво стање, због тога је за збрињавање тешко повређених пацијената неопходна добра сарадња различитих нивоа здравствене заштите и здравствених стручњака различитих специјалности. У претходних неколико деценија, због сложенијег процеса лечења и великих трошкова, дошло је до потребе за што објективнијом проценом стања повређеног и исхода лечења. Циљ: Упоредити сензитивност и специфичност T-RTS скорa (Triage Revised Trauma Score), CRAMS скалe (Circulation, Respiration, Abdomen, Motor and Speech), МGAP скора (Mechanism, Glasgow coma scale, Age, and arterial Pressure) и GAP скора (Glasgow coma scale, Age, and arterial Pressure) примењених на прехоспиталном нивоу, проценити могућности прехоспитално примењених RTS, CRAMS, МGAP и GAP скорова у предикцији исхода лечења повређеног пацијента и утврдити значај појединачних фактора, одређиваних на прехоспиталном нивоу током иницијалног прегледa повређеног, за процену тежине повреде и предикцију исхода лечења повређеног. Истраживање је проспективног, опсервационог карактера. У истраживање су укључени пацијенти старији од 18 година, које су лекари Заводa за хитну медицинску помоћ Нови Сад (ЗЗХМП НС) и Службe хитне медицинске помоћи Дома здравља Бечеј (СХМП ДЗ Бечеј) збрињавали на терену након трауме, а потом их транспортовали у Ургентни центар Клиничког центра Војводине (УЦ КЦВ). На основу вредности ISS скора пацијенти су сврстани у једну од две групе: група А- пацијенти код којих је ISS скор након завршене дијагностике изнад 15- тешка траума и група Б -пацијенти код којих је након завршене дијагностике ISS скор &le;15- лака траума. У групи А је било 50, а у групи Б 257 пацијената. За граничне вредности скорова које означавају да траума није лака, највећу сензитивност у оцени тежине трауме је имао GAP скор 98,8%, а највећу специфичност MGAP скор 62%. У предвиђању исхода лечења, највећу сензитивност је имао RTS скор за предикцију 95,2%, а специфичност GAP скор и CRAMS скала 87,5%. MGAP скор, а пошто је у снажној корелацији са њим и GAP скор, мерени прехоспитално, су се издвојили као независни предиктор у оцени тежине трауме и предвиђању исхода лечења повређеног. Т- RTS скор и CRAMS скала су се издвојили као појединачни предиктори у оцени тежине трауме, али не и као независни предиктори. RTS скор за предикцију нема статистичку значајност у предвиђању исхода лечења повређеног, за разлику од CRAMS скале која има, али се није издвојила као независни предиктор исхода лечења. Осим наведених траума скорова, као независни предиктори у оцени тежине трауме издвојили су се: систолни крвни притисак, SaO2 у периферној крви мерена пулсном оксиметријом, повреда главе и врата и повреда грудног коша. За предвиђање исхода лечења повређеног само се SaO2 у периферној крви мерена пулсном оксиметријом издвојила као појединачни предиктор, али не и као независни предиктор исхода.</p> / <p>Teška trauma se može definisati na nekoliko različitih načina. Najčešće korišćena definicija uključuje korišćenje Injury Severity Score ( ISS skor). Ako je vrednost ISS skor &gt;15, radi se o teškoj traumi. Trauma je vremenski osetljivo stanje, zbog toga je za zbrinjavanje teško povređenih pacijenata neophodna dobra saradnja različitih nivoa zdravstvene zaštite i zdravstvenih stručnjaka različitih specijalnosti. U prethodnih nekoliko decenija, zbog složenijeg procesa lečenja i velikih troškova, došlo je do potrebe za što objektivnijom procenom stanja povređenog i ishoda lečenja. Cilj: Uporediti senzitivnost i specifičnost T-RTS skora (Triage Revised Trauma Score), CRAMS skale (Circulation, Respiration, Abdomen, Motor and Speech), MGAP skora (Mechanism, Glasgow coma scale, Age, and arterial Pressure) i GAP skora (Glasgow coma scale, Age, and arterial Pressure) primenjenih na prehospitalnom nivou, proceniti mogućnosti prehospitalno primenjenih RTS, CRAMS, MGAP i GAP skorova u predikciji ishoda lečenja povređenog pacijenta i utvrditi značaj pojedinačnih faktora, određivanih na prehospitalnom nivou tokom inicijalnog pregleda povređenog, za procenu težine povrede i predikciju ishoda lečenja povređenog. Istraživanje je prospektivnog, opservacionog karaktera. U istraživanje su uključeni pacijenti stariji od 18 godina, koje su lekari Zavoda za hitnu medicinsku pomoć Novi Sad (ZZHMP NS) i Službe hitne medicinske pomoći Doma zdravlja Bečej (SHMP DZ Bečej) zbrinjavali na terenu nakon traume, a potom ih transportovali u Urgentni centar Kliničkog centra Vojvodine (UC KCV). Na osnovu vrednosti ISS skora pacijenti su svrstani u jednu od dve grupe: grupa A- pacijenti kod kojih je ISS skor nakon završene dijagnostike iznad 15- teška trauma i grupa B -pacijenti kod kojih je nakon završene dijagnostike ISS skor &le;15- laka trauma. U grupi A je bilo 50, a u grupi B 257 pacijenata. Za granične vrednosti skorova koje označavaju da trauma nije laka, najveću senzitivnost u oceni težine traume je imao GAP skor 98,8%, a najveću specifičnost MGAP skor 62%. U predviđanju ishoda lečenja, najveću senzitivnost je imao RTS skor za predikciju 95,2%, a specifičnost GAP skor i CRAMS skala 87,5%. MGAP skor, a pošto je u snažnoj korelaciji sa njim i GAP skor, mereni prehospitalno, su se izdvojili kao nezavisni prediktor u oceni težine traume i predviđanju ishoda lečenja povređenog. T- RTS skor i CRAMS skala su se izdvojili kao pojedinačni prediktori u oceni težine traume, ali ne i kao nezavisni prediktori. RTS skor za predikciju nema statističku značajnost u predviđanju ishoda lečenja povređenog, za razliku od CRAMS skale koja ima, ali se nije izdvojila kao nezavisni prediktor ishoda lečenja. Osim navedenih trauma skorova, kao nezavisni prediktori u oceni težine traume izdvojili su se: sistolni krvni pritisak, SaO2 u perifernoj krvi merena pulsnom oksimetrijom, povreda glave i vrata i povreda grudnog koša. Za predviđanje ishoda lečenja povređenog samo se SaO2 u perifernoj krvi merena pulsnom oksimetrijom izdvojila kao pojedinačni prediktor, ali ne i kao nezavisni prediktor ishoda.</p> / <p>Severe trauma could be defined in several ways. The most commonly used definition includes Injury Severity Score (ISS) and severe trauma is determined if ISS &gt;15. Trauma management is a time sensitive issue and a coordination between different levels of health system and many specialists is vital in the treatment of severe trauma. In the last decades, a need for the objective evaluation of the severity of trauma and its outcome was perceived due to the complex management and treatment of trauma and its costs. Aim of the study: to compare the sensitivity and specificity between prehospital scores T-RTS (Revised Trauma Score), CRAMS (Circulation, Respiration, Abdomen, Motors, Speech), MGAP (Mechanism, Glasgow Coma Scale, Age, Arterial Pressure) and GAP (Glasgow Coma Scale, Age, Arterial Pressure), to assess the predictability of prehospital scores (RTS, CRAMS, MGAP and GAP) in the outcome of traumatized patients, to determine the significance of individual factors, initially determined during the prehospital evaluation, in evaluating the severity of trauma and the outcome of treatment. Patients enrolled into this prospective observational study were older than 18, prehospitally treated on the trauma site by the doctors of the Institute of the Emergency Medicine Novi Sad and Health Centre Bečej &ndash; Emergency Medical Service and afterward transported into the Emergency Centre Novi Sad. Based on ISS values, patients were divided into two groups: Group A &ndash; severe trauma (50 patients; ISS&gt;15) and Group B &ndash; mild trauma (257 patients; ISS&le;15). For the broder values of scores, determining the severity of trauma, GAP had the highest sensitivity (98%), while MGAP had the highest specificity (62%). RTS had the highest sensitivity in predicting the outcome (95.2%), while GAP and CRAMS had specificity of 87.5%. Prehospital MGAP score, in strong correlation with GAP, was singled out for its independent predictive value in determining the severity of trauma and its outcome. T-RTS and CRAMS stood out to be individual &ndash; but not independent &ndash; predictors in evaluating the severity of trauma. RTS was not statistically significant in predicting the outcome, in contrast with CRAMS. However, CRAMS was not singled out as an independent predictor of the outcome. In addition to the scores, independent predictors of the severity of trauma were: systolic blood pressure, arterial oxygen saturation (SaO2) by using the pulse oximeter, head, neck and thorax injuries. Only SaO2 proved to be a single &ndash; but not independent &ndash; predictor of the outcome.</p>

Page generated in 0.04 seconds