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Arch Emerg Med. 1989 June; 6(2): 90–96.
PMCID: PMC1285576

A review of trauma deaths in an accident and emergency department.


There were 56 deaths following trauma in the adult Accident and Emergency Department of the University Hospital, Nottingham, over a 5-year period from 1983 to 1987. Forty-six of these deaths followed road-traffic accidents. The trauma deaths made up 16% of all adult deaths and 0.13 per thousand new attenders. We found evidence of inappropriate management in four cases, all relating to inadequate volume replacement. In two patients, the degree of hypovolaemia was not appreciated and in the other two, volume replacement was not commenced within 30 min of arrival in the department. Prompt treatment of hypovolaemic shock with appropriate fluids in adequate quantities cannot be overemphasized.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Baker SP, O'Neill B, Haddon W, Jr, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974 Mar;14(3):187–196. [PubMed]
  • Baker SP, O'Neill B. The injury severity score: an update. J Trauma. 1976 Nov;16(11):882–885. [PubMed]
  • Beckett MW, Longstaff PM, McCabe MJ, Sulch DA, Ward MJ. Deaths in three accident and emergency departments. Arch Emerg Med. 1987 Dec;4(4):227–232. [PMC free article] [PubMed]
  • Dearden CH, Rutherford WH. The resuscitation of the severely injured in the accident and emergency department--a medical audit. Injury. 1985 Jan;16(4):249–252. [PubMed]
  • Ramsay G. Intravenous volume replacement: indications and choices. Br Med J (Clin Res Ed) 1988 May 21;296(6634):1422–1423. [PMC free article] [PubMed]
  • Shalley MJ, Cross AB. Which patients are likely to die in an accident and emergency department? Br Med J (Clin Res Ed) 1984 Aug 18;289(6442):419–421. [PMC free article] [PubMed]
  • Redmond AD. Emergency care. Arch Emerg Med. 1984 Mar;1(1):1–3. [PMC free article] [PubMed]

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