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To evaluate a system with decentralized trauma care, a review was made of all 158 traffic fatalities in 1981 in the southern part of Sweden. The region has 15 well-equipped and well-staffed small- and medium-sized hospitals and two university hospitals with extensive resources. The patients are usually brought by ambulance to the closest receiving facility. Only three persons could possibly have been saved—one suffering from a lacerated femoral artery and two patients in whose cases missed diagnoses (eg, bowel rupture or cardiac tamponade) might have contributed to the fatal outcome. The present investigation reveals that high survival rates after traffic trauma can be achieved with a conventional Swedish trauma care system.
Ottosson A, Krantz P. Traffic Fatalities in a System With Decentralized Trauma Care: A Study With Special Reference to Potentially Salvageable Casualties. JAMA. 1984;251(20):2668–2671. doi:10.1001/jama.1984.03340440026021
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