© 1974 Oxford University Press
research-article |
Casualty Care in Car Crashes
1 Department of Social and Preventive Medicine, Monash Medical School, Alfred Hospital Prahran, 3181
The treatment of injury is one method of reducing the losses to society of car crashes. The emergency medical care system in Australia operates in two phases, with first aid and emergency transport being the responsibility of the ambulance services, and definitive medical care taking place in hospitals. The division between the two phases is symbolized by the hospital doors.
Observations made in Melbourne at the scene of 100 car crashes, and follow-up observations of care given to over 300 injured people in hospital casualty departments identified discontinuities between ambulance services and hospital care. There was minimal communication between ambulance and hospital medical or nursing staff in three-quarters of cases, and no communication at all in one-sixth. There were a large number of transfers of patients to and from stretchers at various stages. These could have been eliminated by the use of change-over equipment. There was evidence that the triage of patients in casualty was not efficient at identifying those seriously ill. Deficiences were also found in the management of unconscious patients by the ambulance service and in hospital, and in the splinting of limb fractures in the casualty department. Overall, the quality of care given was rated as unsatisfactory in 6 per cent of ambulance cases and in 16 per cent of hospital casualty cases. These deficiencies could probably be remedied by organizational changes alone.