All trauma deaths (n=154) from two rural (population density 6.08/sq mi) socio-demographically matched study areas, covering a one year time span, were analyzed to determine the rate of preventable death and inappropriate care. The overall preventable mortality rate was 17%, with 10 preventable deaths in Area A (11.5%) and 16 preventable deaths in Area B (23.9%). Preventable deaths were identified by phase of care with 2 (7.7%) occurring as a result of deficiencies in the prehospital phase, 14 (53.8%) due to inadequacies of care in the emergency department and 10 (38.5%) occurring in the post emergency department. The distribution of inappropriate care rendered for all deaths (preventable and non-preventable) in each phase of care was 15.7% in the prehospital phase, 62.8% in the emergency department and 21.6% in the post emergency department. Errors or omissions in care occurred in airway management (n=8), hemorrhage control (n=3), delay in treatment (n=11) and improper management of chest trauma (n=15). The etiology of trauma showed a significant rate of motor vehicle related trauma, with 72 deaths as a result of vehicle crashes, 10 from auto-pedestrian incidents, 5 from motorcycle crashes and 4 involving motor vehicle/train collisions. Of the motor vehicle crashes, 45 (63%) involved single vehicle rollovers with 51% of those involving the ejection of one or more of the fatalities. Additional study of rural preventable trauma mortality and the continued refinement of this analytical process is recommended. Findings of this and other rural studies indicate a need to further develop and enhance trauma care systems, particularly in rural areas of the United States.

  • Supplemental Notes:
    • Sponsored by the National Highway Traffic Safety Administration.
  • Corporate Authors:

    Critical Illness and Trauma Foundation

    P.O. Box 1249
    Big Timber, MT  United States  59011
  • Authors:
    • Esposito, T J
    • Reynolds, S A
    • Sanddal, N D
    • Hansen, J D
    • Rinker, C F
    • Dale, G
    • Maningas, P J
    • O'Reilly, P J
    • Bleicher, J
    • Petrashek, B
  • Publication Date: 1992-12


  • English

Media Info

  • Features: References; Tables;
  • Pagination: 32 p.

Subject/Index Terms

Filing Info

  • Accession Number: 00719474
  • Record Type: Publication
  • Source Agency: National Highway Traffic Safety Administration
  • Report/Paper Numbers: HS-807 973
  • Contract Numbers: DTNH22-90-C-05016
  • Files: HSL, TRIS, USDOT
  • Created Date: Mar 25 1996 12:00AM