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Rural Trauma Care Can, Should Be Better

Cheryl Clark, for HealthLeaders Media, October 6, 2010

Two reports last month on how rural area hospitals handle trauma indicate there's lots of low-hanging fruit for providers who want to improve trauma care and save more lives.

Both studies published in the Journal of Trauma give a stronger voice to those who say we need to have better trauma coverage across the country, because many lives of many people, a significant portion of whom are young, productive workers, could be saved.

Both studies imply that better transfer arrangements from hospitals and providers with limited skills and resources to certified trauma centers is essential.

The first study, "Identifying Targets for Potential Interventions to Reduce Rural Trauma Deaths: A Population Based Analysis," looked at 3,486 trauma deaths in the largely rural province of Ontario, Canada between 2002 and 2003.

David Gomez, MD, and collaborators at St. Michael's Hospital in the University of Toronto, found that a significant portion of these deaths occurred not on the way to the hospital, but in a rural hospital's emergency room. In other words, these victims managed to survive the distance to the hospital but when they got there, the hospital was unable to save them.

"This study provides new insights in to rural trauma deaths and suggests the potential value of targeted interventions at the policy and provider levels to improve the delivery of preliminary trauma care in rural environments."

The authors wrote that many practices, cultures, and circumstances in rural areas might have led to these injuries, including a lower rate of the use of protective devices, crashes of motor vehicles going at higher speeds on rural roads, higher prevalence of alcohol while driving, and longer times between the injury's occurrence and its discovery.

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