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Bien, d'accord un étude: https://jamanetwork.com/journals/jamasurgery/article-abstract/2654239

 

avec 103.029 patients, est préférable être transporter dans un hôpital avec voiture privée qui public ambulance.

 

Citation

Question  Does ground emergency medical services transport confer a survival advantage vs private vehicle transport for patients with penetrating injuries?

 

Findings  In this cohort study of 103 029 patients included in the National Trauma Data Bank, individuals transported by private vehicle were significantly less likely to die than similarly injured patients transported by ground emergency medical services, even when controlling for injury severity.

 

Meaning  Ground emergency medical services transport is not associated with improved survival compared with private vehicle transport among patients with penetrating injuries in urban trauma systems, suggesting prehospital trauma care may have a limited role in this subset of patients.

 

Importance  Time to definitive care following injury is important to the outcomes of trauma patients. Prehospital trauma care is provided based on policies developed by individual trauma systems and is an important component of the care of injured patients. Given a paucity of systems-level trauma research, considerable variability exists in prehospital care policies across trauma systems, potentially affecting patient outcomes.

 

Objective  To evaluate whether private vehicle prehospital transport confers a survival advantage vs ground emergency medical services (EMS) transport following penetrating injuries in urban trauma systems.

 

Design, Setting, and Participants  Retrospective cohort study of data included in the National Trauma Data Bank from January 1, 2010, through December 31, 2012, comprising 298 level 1 and level 2 trauma centers that contribute data to the National Trauma Data Bank that are located within the 100 most populous metropolitan areas in the United States. Of 2 329 446 patients assessed for eligibility, 103 029 were included in this study. All patients were 16 years or older, had a gunshot wound or stab wound, and were transported by ground EMS or private vehicle.

 

Results  Of the 2 329 446 records assessed for eligibility, 103 029 individuals at 298 urban level 1 and level 2 trauma centers were included in the analysis. The study population was predominantly male (87.6%), with a mean age of 32.3 years. Among those included, 47.9% were black, 26.3% were white, and 18.4% were Hispanic. Following risk adjustment, individuals with penetrating injuries transported by private vehicle were less likely to die than patients transported by ground EMS (odds ratio [OR], 0.38; 95% CI, 0.31-0.47). This association remained statistically significant on stratified analysis of the gunshot wound (OR,  0.45; 95% CI, 0.36-0.56) and stab wound (OR,  0.32; 95% CI, 0.20-0.52) subgroups.

Conclusions and Relevance  Private vehicle transport is associated with a significantly lower likelihood of death when compared with ground EMS transport for individuals with gunshot wounds and stab wounds in urban US trauma systems. System-level evidence such as this can be a valuable tool for those responsible for developing and implementing policies at the trauma system level.

 

 

Bien, seule USA et poignardés ou fusillés, je ne connais pas autre étude sur le sujet. Et en fait, seulement j'ai lu l'abstrait, , mais intéressant.

 

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Intéressant ;)

 

Mais du coup ils savent pourquoi le transport privé est plus sur ou pas ? le temps de trajet varie-t-il significativement ?

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il y a 16 minutes, FabriceM a dit :

Intéressant ;)

 

Mais du coup ils savent pourquoi le transport privé est plus sur ou pas ? le temps de trajet varie-t-il significativement ?

L'explication est qui l'ambulance arrivé plus tard (comparée avec voiture privée ) et que les médecins/paramedicaux sont tenus de respecter protocoles spécifiques qui demandent temps. Et dans ces cas, le temps fait toute la différence.

 

 

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On 10/26/2017 at 11:15 PM, FabriceM said:

Intéressant ;)

 

Mais du coup ils savent pourquoi le transport privé est plus sur ou pas ? le temps de trajet varie-t-il significativement ?

 

Le transport privé arrive plus tard (il faut d'abord facturer l'appel) donc les patients les plus graves sont déjà morts, ce qui améliore les statistiques qui démarrent à la prise en charge....

 

^_^

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J'ai l'impression, AMHU, qu'ils comparent le transport par voiture particulière (private vehicule) vs EMS qui ont des normes féférales (cf wiki Emergency medical services in the United States) ,EMS qui sont des ambulances privées ou publiques.

Douste-Blazy avait été poignardé et transporté dans sa voiture vers l'hôpital sans attendre les secours. Pour Lady Di polémique sur le SMUR qui serait resté trop longtemps sur place (1h30). Les plaies pénétrantes demandent d'être opéré rapidement.

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Le 30/10/2017 à 10:59, Antoninov a dit :

(il faut d'abord facturer l'appel) 

Càd?

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https://medicalxpress.com/news/2018-12-baby-born-uterus-transplanted-dead.html

 

"First baby born via uterus transplanted from dead donor"

 

Citation

In a medical first, a mother who received a uterus transplant from a dead donor gave birth to a healthy baby, researchers reported Wednesday.

The breakthrough operation, performed in September 2016 in Sao Paulo, Brazil, shows that such transplants are feasible and could help thousands of women unable to have children due to uterine problems, according to a study published in The Lancet.

 

The baby girl was born in December 2017, the medical journal added.

Until recently, the only options available to women with so-called uterine infertility were adoption or the services of a surrogate mother.

 

The first successful childbirth following uterine transplant from a living donor took place in 2014 in Sweden, and there have been 10 others since then.

But there are far more women in need of transplants than there are potential live donors, so doctors wanted to find out if the procedure could work using the uterus of a woman who had died.

 

Ten attempts were made—in the United States, the Czech Republic, and Turkey—before the success reported Wednesday

"Our results provide a proof-of-concept for a new option for women with uterine infertility," said Dani Ejzenberg, a doctor at the teaching hospital of the University of Sao Paulo.

He described the procedure as a "medical milestone".

 

"The number of people willing and committed to donate organs upon their own death are far larger than those of live donors, offering a much wider potential donor population," he said in a statement.

The 32-year-old recipient was born without a uterus as a result of a rare syndrome.

 

Four months before the transplant, she had in-vitro fertilisation resulting in eight fertilised eggs, which were preserved through freezing.

The donor was a 45-year-old woman who died from a stroke.

 

Her uterus was removed and transplanted in surgery that lasted more than ten hours.

 

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