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Thread: Homicide Rates vs Trauma Care

  1. #1
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    Homicide Rates vs Trauma Care

    Here is a medical study about something I’ve been preaching for years. The actual murder rate would be five times as high as it is without the intervention of modern trauma care. It’s not that people aren’t trying to kill each other—it’s that modern trauma care allows a much lower percentage of victims to die.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1124155/...

  2. #2
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    Good point.

    Also, trauma is not my specialty but I figured I'd add this cheery little insight...

    "Injured in a shooting" runs the gamut from being discharged the next day to being brain dead but kept mechanically alive in a vegetable patc...er I mean a long term acute care hospital.

    To say nothing of people left with quadriplegia, traumatic brain injury, peripheral circulatory problems.

    Not all of the people who weren't murdered are actually still alive in any meaningful way or living the life they and their families would enjoy.

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  3. #3
    THE THIRST MUTILATOR Nephrology's Avatar
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    I would bet that a lot of this comes down to improvements in first response practices and systems. For example, advent and rapid expansion of professional paramedic services who can provide airway support/transfusion in the field, the expansion of tourniquet use among first response systems, etc.

    On the hospital side I'd bet this is probably not so much due to improvements in technology/treatment so much as major organizational shifts in the medical world (e.g. advent of emergency medicine and trauma surgery/surgical critical care as distinct medical specialties/subspecialties with dedicated hospital resources). It is easy to forget that emergency medicine did not exist as its own medical specialty until really quite recently. At my institution they did not formally separate from the Dept of Surgery until about 15 years ago.

    @Sensei probably has a lot more intelligent things to say about this topic than I do.

    Quote Originally Posted by 45dotACP View Post
    Good point.

    Also, trauma is not my specialty but I figured I'd add this cheery little insight...

    "Injured in a shooting" runs the gamut from being discharged the next day to being brain dead but kept mechanically alive in a vegetable patc...er I mean a long term acute care hospital.


    Sent from my moto g(6) using Tapatalk
    Yes - whenever I read about survival rates in trauma care I always look for the qualifier "neuro-intact"

  4. #4
    I know there is a lot of mixed feeling out there about Grossman anymore, but he's also suggested this for years.

  5. #5
    Quote Originally Posted by Nephrology View Post

    On the hospital side I'd bet this is probably not so much due to improvements in technology/treatment so much as major organizational shifts in the medical world (e.g. advent of emergency medicine and trauma surgery/surgical critical care as distinct medical specialties/subspecialties with dedicated hospital resources). It is easy to forget that emergency medicine did not exist as its own medical specialty until really quite recently. At my institution they did not formally separate from the Dept of Surgery until about 15 years ago.

    @Sensei probably has a lot more intelligent things to say about this topic than I do.



    Yes - whenever I read about survival rates in trauma care I always look for the qualifier "neuro-intact"
    Good point. When I started at the PD, our local ER was staffed by the local doctors. My GP covered Thursdays. Sometime in the early to mid 90s they started running exclusively with emergency medicine specialists.

  6. #6
    Quote Originally Posted by Nephrology View Post
    I would bet that a lot of this comes down to improvements in first response practices and systems. For example, advent and rapid expansion of professional paramedic services who can provide airway support/transfusion in the field, the expansion of tourniquet use among first response systems, etc.

    On the hospital side I'd bet this is probably not so much due to improvements in technology/treatment so much as major organizational shifts in the medical world (e.g. advent of emergency medicine and trauma surgery/surgical critical care as distinct medical specialties/subspecialties with dedicated hospital resources). It is easy to forget that emergency medicine did not exist as its own medical specialty until really quite recently. At my institution they did not formally separate from the Dept of Surgery until about 15 years ago.
    From the police perspective, when you've look at felonious police deaths and think about it:

    1973 - 134 officers killed
    1983 - 80 officers killed
    1993 - 70 officer killed
    2003 - 52 officers killed
    2013 -27 officers killed

    It's kind of easy to see that improvements in technology (over training) are primarily responsible for the decrease in officer deaths:

    Ballistic vests;
    Improvements in the EMS system springboarding off lessons learned in VN;
    Improvement in communications - many officers in the early 70's didn't have portables;
    Computerized record checks - manual in the 70's almost instantaneous today;
    Semi-auto pistols - not a major lifesaver, but makes a difference.

    We also tend to forget what a game changer cellular phones have been for safety in all situations for all people.

  7. #7
    Why Baltimore, with Johns Hopkins, is not kicking Chicago's ass. So unfair!

  8. #8
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    When I was responsible for investigating felony, non fatal assaults, I used to say, “Lifesaving techniques pioneered on the battlefields of Afghanistan and Iraq today increase my caseload tomorrow.”
    Polite Professional

  9. #9
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    Quote Originally Posted by PD Sgt. View Post
    When I was responsible for investigating felony, non fatal assaults, I used to say, “Lifesaving techniques pioneered on the battlefields of Afghanistan and Iraq today increase my caseload tomorrow.”
    I had a guy who was shot within sight of a fire houses' apron. Shot a lot. Like over 10 rounds through the torso and about that many again in this extremities. Just shot to shit, really. Fire/EMS was there before the 911 call was finished since they heard it and could see him. He's paralyzed, but he lived. I figure a few blocks up the street and he'd have been dead by the time the first medics got there.

    Just on my end, I see the differences between first responder training over the years. As cops we're trained on wound packing now. I couldn't do that as an EMT-I in Kansas in the late 90's.
    Sorta around sometimes for some of your shitty mod needs.

  10. #10
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    I suggest the long wars have a positive impact also - I believe that a lot of doctors and other medical professionals have rotated through the war zone and gained a lot of knowledge and that knowledge has been shared back to the trauma centers. I believe some military medical professionals also spent time in CONUS Trauma center centers pre-deployment.

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