Distance to Trauma Care and Mortality

Question –  What is the association of injury incident location with mortality?

Findings – This cross-sectional study of 16 082 adults found an 8% increase in the odds of death for every 5-mile increase in distance to the nearest trauma center and an 3% increased odds of death for every 5-year increase in neighborhood median age.

Meaning – Characteristics of injury incident locations may contribute to injury mortality and should be considered when planning trauma care systems.

Jarman MP, Curriero FC, Haut ER, Pollack Porter K, Castillo RC. Associations of Distance to Trauma Care, Community Income, and Neighborhood Median Age With Rates of Injury Mortality. JAMA Surg. 2018 Feb 7. doi: 10.1001/jamasurg.2017.6133. [Epub ahead of print] PubMed PMID: 29417146.

Full Article: https://jamanetwork.com/journals/jamasurgery/fullarticle/2671392

Prehospital Transport in Penetrating Trauma

Question – Does ground EMS transport confer a survival advantage vs. private vehicle transport for patients with penetrating injuries?

Findings – In this cohort study of 103,029 patients, 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 (odds ratio [OR], 0.38; 95% CI, 0.31-0.47).

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.

Wandling MW, Nathens AB, Shapiro MB, Haut ER. Association of Prehospital Mode of Transport With Mortality in Penetrating Trauma: A Trauma System-Level Assessment of Private Vehicle Transportation vs Ground Emergency Medical Services. JAMA Surg. 2017 Sep 20. doi: 10.1001/jamasurg.2017.3601. [Epub ahead of print] PubMed PMID: 28975247.

Full Article: https://jamanetwork.com/journals/jamasurgery/fullarticle/2654239


The study of anatomy began in the year 1,600 BC along the lower reaches of the Nile River. For my classmates and me, however, the rite of passage that is human gross anatomy started more than 3,600 years later on Monday, September 30th, 2013. For many of us, this was the first time seeing a dead body.

Before I continue I would like to take a moment to thank the donors. I sincerely hope that every donor and their family knows how much their gift and sacrifice is helping us learn. Seeing illustrated diagrams and attending lectures is no way to master this complex and intricate subject. I am both grateful and honored for this opportunity and will always respect and cherish my donor.

Anatomy, a tradition that has helped train thousands of physicians and surgeons before me, is the part of medical school that all students remember and have strong feelings about. It also happens to be the part that is the most difficult to describe. That fact became evident for me when I was on the phone with my mother later that day. She asked how my first dissection went and the only response I could come up with on the spot was “great.” I did not know what to say. How do I explain what it feels like to spend hours cutting apart another human’s body? How does one describe being in a room with twenty-one cadavers? Every single donor in the anatomy lab was someone’s daughter or son, sister or brother, mother or father. They had all lived, they had all died, and they had all chosen to donate themselves to our class. The whole experience was ethereal.

I whispered “thank you” to my donor as I picked up my scalpel to make the first incision. At that exact moment I realized that my teacher and guide was not the doctor running human anatomy, but rather the donor laying right there in front of me.