Citation

Forrester JD, August A, Cai LZ, Kushner AL, Wren SM. Disaster Med. Public Health Prep. 2019; ePub(ePub): 1-9.

Affiliation

Department of Surgery,Stanford University Medical Center,Stanford,California.

Copyright

(Copyright © 2019, Society for Disaster Medicine and Public Health, Publisher Cambridge University Press)

DOI

10.1017/dmp.2019.42

PMID

31203832

Abstract

ABSTRACTIntroduction:The term "golden hour" describes the first 60 minutes after patients sustain injury. In resource-available settings, rapid transport to trauma centers within this time period is standard-of-care. We compared transport times of injured civilians in modern conflict zones to assess the degree to which injured civilians are transported within the golden hour in these environments.

METHODS: We evaluated PubMed, Ovid, and Web of Science databases for manuscripts describing transport time after trauma among civilian victims of trauma from January 1990 to November 2017.

RESULTS: The initial database search identified 2704 abstracts. Twenty-nine studies met inclusion and exclusion criteria. Conflicts in Yugoslavia/Bosnia/Herzegovina, Syria, Afghanistan, Iraq, Israel, Cambodia, Somalia, Georgia, Lebanon, Nigeria, Democratic Republic of Congo, and Turkey were represented, describing 47 273 patients. Only 7 (24%) manuscripts described transport times under 1 hour. Transport typically required several hours to days.

CONCLUSION: Anticipated transport times have important implications for field triage of injured persons in civilian conflict settings because existing overburdened civilian health care systems may become further overwhelmed if in-hospital health capacity is unable to keep pace with inflow of the severely wounded.

Language: en

Keywords

conflict; global health; global surgery; trauma surgery; war