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Sun Nov 25 04:11:17 GMT 2007

Karim,

Even though we Yanks like to be the best, those statistics (ISS>15:  US: 16% vs UK 30%; ISS>24:  US: 30% vs UK 46%) are hard to understand. I was in Scotland in '90 and visited the A/E Rooms in Aberdeen, Glasgow, and Edinburgh, and things seemed to be fine with me. A little different in terms of who-does-what in the resuscitation bay, but things got done. I wonder if the comparison takes in account the fact that we see far more penetrating trauma in the US than the UK? My guess (since I actually drove on the wrong side of the road for a month while there) is that the bulk of your major trauma is high-speed vehicular. Severe blunt trauma tends to have multisystem organ problems that are not as common in penetrating trauma and that may have pumped up your mortality rate. Maybe we are comparing apples to oranges?

DB

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