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Letter To The Editor

Published online by Cambridge University Press:  24 October 2011

Torben Wisborg  and
Mads Gilbert
Torben Wisborg
Affiliation:
Professor, University of Tromsoe, Consultant Anaesthesiologist, Hammerfest Hospital, Norway
Mads Gilbert
Affiliation:
Professor, University of Tromsoe, Consultant Anaesthesiologist and Head, Department of Acute Medicine, University Hospital of Northern Norway, Norway
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Information

Type
Letter To The Editor
Information
Prehospital and Disaster Medicine , Volume 26 , Issue 4 , August 2011 , pp. 315
Copyright
Copyright Wisborg © World Association for Disaster and Emergency Medicine 2011

To the Editor:

In their paper “Trained Lay First Responders Reduce Trauma Mortality: A Controlled Study of Rural Trauma in Iraq”Reference Murad and Husum1 Mudhafar K Murad and Hans Husum are publishing a follow-up study of previously published findings from our mutual patient material,Reference Wisborg, Murad, Edvardsen and Husum2 but now added two years of observation time. The first study,Reference Wisborg, Murad, Edvardsen and Husum2 however, is not cited in the paper. Instead, Murad and Husum are citing a study said to be published by themselves (Murad M, Husum H: What makes a survivor? Ten-year results from a prehospital trauma system in Iraq. Bull World Health Org 2010). This study is not retrievable in any electronic indices. Could you please provide the complete reference?

Anyway, their findings of the positive effects of lay first responders can be confirmed in the previous material,Reference Wisborg, Murad, Edvardsen and Husum2 and are important for trauma victims in low- and middle income countries.

One of the cornerstones of the present and previous studies is the physiological assessment of trauma victim’s clinical condition at the site of injury and at hospital admission. Both studies are employing a simplified version of the Revised Trauma ScoreReference Boyd, Tolson and Copes3 as described in previous studies4,5. However the authors have this time changed the cut-off values for the individual categories in the score.

In the 1997-2004 material previously publishedReference Wisborg, Murad, Edvardsen and Husum2 we used the following categories for respiratory rate and systolic blood pressure:

One of us (TW) registered most of the data used from the period 1997–2004, and knows positively that the paramedics and lay first responders are reporting only points within categories and not exact values. Therefore it is impossible to recalculate points and thus the score. How did the authors compare 1997–2004 with 2005–2006 when categories were changed? Are the two cohorts of the material really comparable?

References

Murad, MK, Husum, H. Trained Lay First Responders Reduce Trauma Mortality: A Controlled Study of Rural Care in Iraq. Prehosp Disaster Med 2010;25(6):533–541.CrossRefGoogle ScholarPubMed
Wisborg, T, Murad, MK, Edvardsen, O, Husum, H. Prehospital trauma system in a low-income country: system maturation and adaptation during eight years. J Trauma 2008;64:1342–8.Google Scholar
Boyd, CR, Tolson, MA, Copes, WS: Evaluating trauma care: The TRISS method. J Trauma 1987;27:370–378.CrossRefGoogle ScholarPubMed
Husum, H, Gilbert, M, Wisborg, T, Heng, YV, Murad, M. Rural prehospital trauma systems improve trauma outcome in low-income countries: a prospective study from North Iraq and Cambodia. J Trauma 2003; 54: 1188–96.CrossRefGoogle ScholarPubMed
Husum, H, Gilbert, M, Wisborg, T, Heng, YV, Murad, M. Respiratory rate as a prehospital triage tool in rural trauma. J Trauma 2003; 55: 466–70.CrossRefGoogle ScholarPubMed