Search

Objective: The adherence of the physicians to guidelines in resuscitation of the patients is of great importance since it can predict the outcome. To evaluate the adherence of the physicians of our center in hydration of traumatic patients with crystalloids regarding the Advanced Trauma Life Support (ATLS) guidelines. Methods: We designed an algorithm obtained from ATLS guidelines using vital signs and status of bleeding of the traumatic patients to classify them. After categorizing the patients according to the algorithm, we evaluated the adherence of the physicians to the guideline in hydration of traumatic patients with crystalloids. Results: This is a cross-sectional study in which 998 traumatic patients who were admitted to the emergency ward of Rajaee trauma hospital were enrolled. Most of the patients were men (89.6%) and the most common causes of traumatic injuries were traffic accidents. Proper hydration was seen in only 14.7% of the patients. Most of the patients were overhydrated (85%) regarding both our algorithm and the patients’ base excess. Conclusion: The present study showed that the adherence of physicians in our center in resuscitation with crystalloid was low. Also, most of the traumatic patients were overhydrated with crystalloids. It is suggested that physicians retrain concerning the side effects of over hydration. In addition, we need a user friendly and more applicable guideline for hydration with crystalloids.

Payesh2010; 9: 83-89Accepted for publication: 1 March 2009[EPub a head of print-3 November 2009] Objective(s): This study was conducted for external evaluation of one intervention that has been carried out by traffic police. In this study the efficacy of provisional driver licensing on reducing traffic injuries and the intensity of injuries (fatal or non-fatal) was investigated.Methods: Data on traffic accidents and injuries from one year before till two years after the implementation of provisional driver licensing were obtained from traffic police data base. After data cleaning and stratification traffic injuries and mortalities, the implementation of graduate driver licensing compared in those in early years of their driving experience.Results: Drivers under 23 years of age consisted 22.8% of total road traffic injuries (RTIs) in the year prior to the implementation of graduate driver licensing. This proportion reduced to 15.5% and 16.1% in the first and second year after implementation, respectively, among holders of provisional B1 type driver license (P