Abstract
We analyzed over 30,518 examples of traffic injury cases transferred to emergency department in the level 1 trauma centers in Japan which Revised Trauma Score（RTS ）were normal on the scene, but worsened at the time of hospital arrival and the confirmed Injury Severity Score（ISS）were not such severe. There were 6.685 cases which were a totally 99.4％ when Spot RTS was normal and ISS was under 15 points, including 218 cases which were only one point less . 2 points less was 30 cases, 3 points less was 9 cases and 4point less was only one case. The breakdowns of injury included 19 cases of cerebral injury, 5 cases skull base fracture and a open fracture of vault of skull openness dome part bone fracture. This suggests that we have to consider the possibility of brain damage from indirect contusion. Also there were 5 femur shaft fracture, 3 open tibia fracture, 1 open pelvic fracture and a popliteal vein rupture. Control of bleeding and stabilization of the bone fracture is particularly needed before the entrance. This result leads that the mechanism of injury is one of the factor increasing the number of mild injury cases transporting to Emergency department. Upon this, we look forward to the immediate establishment of the system in early transmission to secondary medical care hospital after stabilization and revision of transfer standard determined by the mechanism of injury.
