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Given current discussions about the benefits of having large specialist trauma centres, Sophia read with interest a paper advocating the use of telemedicine in trauma care. Researchers in Mississippi report upon the impact of introducing telemedicine on the management of rural trauma patients treated at local community hospitals. 814 trauma patients presented to local community hospitals. Of these, 351 were in the pre-telemedicine era and were all transferred to the trauma centre for definitive management. The remaining 463 patients presented after telemedicine was introduced. All of these had a virtual consult with the trauma centre, following which only 51 patients were transferred there. The authors conclude that not only did telemedicine identify severely injured trauma patients rapidly, expediting transfer to the trauma centre, but it also significantly decreased the trauma centre costs by conserving its resources for the most severely injured patients and expanding the rural local community hospitals trauma capabilities, without a significant change in mortality (J Trauma 2008;64:92–8).


Following its introduction in 1974, the injury severity score (ISS) became the standard scoring system for patients …

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