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Fatal Injury: Characteristics and Prevention of Deaths at the Scene

Meislin, Harvey MD, FACEP; Conroy, Carol MPH, PhD; Conn, Kevin MD; Parks, Bruce MD

Journal of Trauma and Acute Care Surgery: March 1999 - Volume 46 - Issue 3 - p 457-461

Background Almost half of all trauma deaths occur at the scene. It is important to determine if these deaths can be prevented.

Methods Penetrating or blunt force trauma deaths were identified through the Office of the Medical Examiner during a 2-year period. Data were also obtained through review of these records.

Results There were 312 deaths at the scene that received no medical care. Almost 60% were firearm-related. About 80% of the victims were men, and 55% of these deaths occurred in people between 20 and 49 years old. Suicide accounted for nearly half of these deaths. Eighty percent of these injured people had Abbreviated Injury Scale scores of 5 or 6.

Conclusion Almost 60% of deaths at the scene occurred at the same time as injury and reflect severe injury to vital regions of the body. These findings suggest that primary prevention of the initial event causing injury may be more important than definitive prehospital emergency medical care to prevent these deaths.

From the Arizona Emergency Medicine Research Center (H.M., C.C., K.C.), Arizona Health Sciences Center, and the Pima County Office of the Medical Examiner (B.P.), Forensic Sciences Center, Tucson, Arizona.

This study was funded in part by the National Institutes of Health Medical Student Research Program.

Address for reprints: Harvey W. Meislin, MD, FACEP, Arizona Emergency Medicine Research Center, Arizona Health Sciences Center, P.O. Box 245057, 1501 North Campbell Avenue, Tucson, AZ 85724.

© 1999 Lippincott Williams & Wilkins, Inc.