Hello electusunus and All, "I often work in the ER and I have never heard of anyone recommending them - they do suggest that if you are injured to at least try to do it between the hours of 8am -5 pm for best chance of survival."
Why is that? ................ 0800 to 1700 for best chance? I don't ride when it is dark unless I get caught out - flat or something unusual - but I have a friend that was training for Paris Brest Paris and rode all hours of the night and day - and crashed on a drain and broke his arm one sleepy night. I guess he got the bad hours at the ER.
I couldn't find an ER survival reference to time but found the following: (Bold emphasis added)
http://seniorliving.about.com/...a/emergency_room.htm Some advance planning can make your emergency room visit safer and less costly.
http://www.ncbi.nlm.nih.gov/pubmed/10225282 OUTCOME MEASURES: Survival to leave the emergency department, survival to leave hospital.
RESULTS: There were 77 cardiac arrests occurring within the department, and of these 42 (55%) survived to be admitted to hospital. Forty-two arrests involved a rhythm of VT/VF with 81% of these arrests surviving to be admitted. Thirty-five patients had other cardiac rhythms of whom 23% survived to admission. Primarily cardiac causes of arrest occurred in 52 patients with a survival rate of 60%.
Overall 33 patients (43%) survived to be discharged from hospital. CONCLUSION: Survival from cardiac arrest is a useful measure of performance of an accident and emergency department. It is a condition that has definite outcomes, and is easily auditable. Figures can be compared between departments by comparing cases with the same aetiology or arrest rhythm thus reducing the influence of cases with a poorer outcome. This would provide an additional indicator for comparison of departments other than those currently used. A national database of outcome of cardiac arrests could be created to allow valid comparisons between departments.
Unfallchirurg. 1998 Mar;101(3):160-75.
[Must the accident victim be protected from the emergency physician?]. [Article in German]
Regel G,
Seekamp A,
Pohlemann T,
Schmidt U,
Bauer H,
Tscherne H.
Unfallchirurgische Klinik, Medizinische Hochschule Hannover. Abstract
Quality control in preclinical medical care has become a matter of concern in recent years. In order to evaluate the quality of treatment one has to set standards. Most of the current standards were defined by different preclinical care organisations and are also accepted in the unique emergency medical care protocol used in the Federal Republic of Germany. Considering these standards, we retrospectively analyzed the preclinical treatment of all multiple trauma patients admitted to our department between 1985 and 1996. The major issues of this analysis were the diagnoses, the indications for invasive measures and the performance. Regarding the triage, for example, it was noted that 28% of patients who should have been admitted to a level I trauma center considering the severity of their injury were first admitted to a level III hospital and needed to be transferred later. In 7% of patients two additional mistakes and in 4% of patients more than two mistakes in the triage were noted. On the other hand, there are records of patients who were considered to be only slightly injured but received invasive treatment. Preclinical intubation and mechanical ventilation was not performed in 16.5% although the severity of injury clearly demanded it. A thoracic drain tube was not positioned in 38% of patients suffering from severe thoracic trauma (AISThorax > or = 4). Insufficient application of resuscitation volume (< 2500 ml on admission) was evident in 17% of all documented patients.
According to our results, the initial evaluation of severity of injury is still a major problem and leads to wrong decisions for treatment. Although the qualification of ambulance physicians has been standardized for some years, there are still clear deficits in the preclinical management of trauma patients that need to be targeted. I continue to try to avoid the ER if possible - it is a dangerous place. Cheers,
Neal
Cheers, Neal
+1 mph Faster