Biomaterial Database

Road traffic fatalities in Victoria, Australia and changes to the trauma care system. 2001

F T McDermott, and S M Cordner, and A B Tremayne, and

The Consultative Committee on Road Traffic Fatalities in Victoria, Southbank, Victoria, Australia. annt@vifp.monash.edu.au

BACKGROUND The aim was to identify organizational and clinical errors in the management of road traffic fatalities and to use this information to improve Victoria's trauma care system. METHODS A multidisciplinary committee evaluated the complete ambulance, hospital and autopsy records of 559 consecutive road traffic fatalities, who were alive on arrival of ambulance services, in five substantial time periods between 1992 and 1998. Patients who survived more than 30 days were excluded. Errors or inadequacies in each phase of management, including those contributing to death, were identified and an assessment was made of the potential preventability of death. RESULTS Findings between 1992 and 1998 were similar. In 1998, 1672 problems were identified in 110 deaths with 1024 (61 per cent) contributing to death. Eight hundred and forty-two (50 per cent) of the total problems occurred in the emergency department. There were frequent problems in initial patient reception and medical consultation, resuscitation, investigation and assessment (especially of the abdomen and head), and in transfer to the operating theatre or to a higher-level hospital. Victoria's combined preventable and potentially preventable death rate has been unchanged between 1992 and 1998 (34-38 per cent). CONCLUSIONS The problems identified led to a Ministerial Taskforce on Trauma and Emergency Services in Victoria as a consequence of which a new trauma system is now being implemented.

UI	MeSH Term	Description	Entries
D008485	Medical Audit	A detailed review and evaluation of selected clinical records by qualified professional personnel for evaluating quality of medical care.	Audit, Medical,Audits, Medical,Medical Audits
D010360	Patient Transfer	Interfacility or intrahospital transfer of patients. Intrahospital transfer is usually to obtain a specific kind of care and interfacility transfer is usually for economic reasons as well as for the type of care provided.	Patient Dumping,Care Transition,Health Care Transition,Patient Transition,Patient Turfing,Transition of Care,Care Transition, Health,Care Transitions,Care Transitions, Health,Dumping, Patient,Health Care Transitions,Patient Transfers,Patient Transitions,Patient Turfings,Transfer, Patient,Transfers, Patient,Transition, Care,Transition, Health Care,Transition, Patient,Transitions, Care,Transitions, Health Care,Transitions, Patient,Turfing, Patient,Turfings, Patient
D003142	Communication	The exchange or transmission of ideas, attitudes, or beliefs between individuals or groups.	Miscommunication,Misinformation,Social Communication,Communication Programs,Communications Personnel,Personal Communication,Communication Program,Communication, Personal,Communication, Social,Communications, Social,Miscommunications,Misinformations,Personnel, Communications,Program, Communication,Programs, Communication,Social Communications
D003645	Death, Sudden	The abrupt cessation of all vital bodily functions, manifested by the permanent loss of total cerebral, respiratory, and cardiovascular functions.	Sudden Death
D004632	Emergency Medical Services	Services specifically designed, staffed, and equipped for the emergency care of patients.	Emergency Care,Emergency Health Services,Emergicenters,Prehospital Emergency Care,Emergency Care, Prehospital,Emergency Services, Medical,Medical Services, Emergency,Services, Emergency Medical,Emergency Health Service,Emergency Medical Service,Emergency Service, Medical,Emergicenter,Health Service, Emergency,Health Services, Emergency,Medical Emergency Service,Medical Emergency Services,Medical Service, Emergency,Service, Emergency Health,Service, Emergency Medical,Service, Medical Emergency,Services, Emergency Health,Services, Medical Emergency
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000063	Accidents, Traffic	Accidents on streets, roads, and highways involving drivers, passengers, pedestrians, or vehicles. Traffic accidents refer to AUTOMOBILES (passenger cars, buses, and trucks), BICYCLING, and MOTORCYCLES but not OFF-ROAD MOTOR VEHICLES; RAILROADS nor snowmobiles.	Traffic Collisions,Traffic Crashes,Traffic Accidents,Accident, Traffic,Collision, Traffic,Collisions, Traffic,Crashes, Traffic,Traffic Accident,Traffic Collision
D014218	Triage	The sorting out and classification of patients or casualties to determine priority of need and proper place of treatment.	Triages
D014739	Victoria	A state in southeastern Australia, the southernmost state. Its capital is Melbourne. It was discovered in 1770 by Captain Cook and first settled by immigrants from Tasmania. In 1851 it was separated from New South Wales as a separate colony. Self-government was introduced in 1851; it became a state in 1901. It was named for Queen Victoria in 1851. (From Webster's New Geographical Dictionary, 1988, p1295 & Room, Brewer's Dictionary of Names, p574)
D019300	Medical Errors	Errors or mistakes committed by health professionals which result in harm to the patient. They include errors in diagnosis (DIAGNOSTIC ERRORS), errors in the administration of drugs and other medications (MEDICATION ERRORS), errors in the performance of surgical procedures, in the use of other types of therapy, in the use of equipment, and in the interpretation of laboratory findings. Medical errors are differentiated from MALPRACTICE in that the former are regarded as honest mistakes or accidents while the latter is the result of negligence, reprehensible ignorance, or criminal intent.	Medical Mistakes,Surgical Errors,Critical Incidents, Medical,Critical Medical Incidents,Errors, Medical,Errors, Surgical,Medical Error of Commission,Medical Error of Omission,Medical Errors of Commission,Medical Errors of Omission,Medical Mistake,Mistake, Medical,Mistakes, Medical,Never Event,Surgical Error,Wrong-Patient Surgery,Wrong-Procedure Errors,Wrong-Site Surgery,Commission Medical Error,Commission Medical Errors,Critical Incident, Medical,Critical Medical Incident,Error, Medical,Error, Surgical,Error, Wrong-Procedure,Errors, Wrong-Procedure,Event, Never,Events, Never,Incident, Critical Medical,Incident, Medical Critical,Incidents, Critical Medical,Incidents, Medical Critical,Medical Critical Incident,Medical Critical Incidents,Medical Error,Medical Incident, Critical,Medical Incidents, Critical,Never Events,Omission Medical Error,Omission Medical Errors,Surgeries, Wrong-Patient,Surgeries, Wrong-Site,Surgery, Wrong-Patient,Surgery, Wrong-Site,Wrong Patient Surgery,Wrong Procedure Errors,Wrong Site Surgery,Wrong-Patient Surgeries,Wrong-Procedure Error,Wrong-Site Surgeries