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1 (2) : & (45 6#!"#$ %&' () *+,# - / (. 789# # 6,. :; () 85/10/24 :. 3 2 *1 MD MD MD #.9# J #.4 A3. J,( 6 E$=G2/IB J(HD) # +@ =-AB 7C!D EFG#) * : &@ &C<P 78D# K9( 85/10/21 :E$- M8# &@ NO9() K9( <= >()? 85/3/30 :C/ 78D# K9( 8" H: "+0! /4% #! " ;#! 4! 4!"+0! <" = 3 >?@! A : 4!"+0! :+ 6O. 7 K I* A #! " ;#! +J KL' M+L " >?@! 4 (N 2#P 3 6+O <LN " = 3 R$ 5 3#O! #O ST" U@ ' <Q+! >?@! : 3#O = #O #72 (=L " ST" X,# " 3# 3 5 #Y V!2 " (Basic " ATLS (Advance trauma life support) %2 %8 Z# " $!+! <LH5!V!2 " 3#O! \2 <L[' +! 6O. " +,Z#:#Z 32 <" # H5!V H" BTLS trauma life support) H5!V [1! U@ +,` %2 %8 $!+! <LH5!V #Y 4725 " U@ ]++ O8! %=P 2005 $ 2002 <O? 4 #' A7' %8 " +! I* 3 +! 3, " ++ (#! " ;#! " bv %+ # 3! 8) <NO <L'Z b$#$ 4 " + 6Nc 4! a"#8! 288 +>$ <# [Injury Severity Score (ISS)] bv %+ #7 5 #: <"VR7. = #O <'#! 37 (PSS)Physiologic L#7 I* a"#8! AT?Z d# " + Y /Q 4 33 #: *! " # = #O <'#! S " 37 5 XNe Severity Score +! 4! a"#8! 288!"#$ 37 f A7' # "= #'g? hz +! I* : " +,Z#: #e ++ <!"#$ "#: a"#8! 34%. 20/73 >?@! 4 (ISS) bv %+ #7 4!.#' " 6/ XNe PSS 4!. 27%? >?@! 4 ' #! " ;#!, 15 5 # ISS 6,>! M=Q 4 " + 7/43 #O S.(CI of difference=95% ) (-1/189-0/9107) +$! 37 "" 5 XNe 3!5 5!V Z# <T?,$,L I' I* <#e# :. 4!"+0! #! " ;#! KL' i 37 5 XNe <L6Ne#! KZ.AT?Z 62#. %+ bv 62#. %+ 7 K I* 4!"+0!!"#$ : dr_sagafi@yahoo.com (")*! +,*!"#$ %&$ '#! () (NGO) 3# 4! 4!"+0! #. /01! -2 2#. "#: + ()... -3

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3 99 & (45 6#!"#$ %&' () *+,# - / (. RTS3, XJ2 " s#r 6c b#r A + 0/13 MR+0/73BP+0/29 RR= I,'! N&! + RTS p+8! = 37 6O.[8 7] RTS.(1("+.) + 6Nc " <#:5+ AT?Z 62#. %+ PSS + ("+. :1 > physiologic severity score AT?Z 62#. %+ #7 3#' <# 3V 3#' zy2 6?O " 3V Y (PSS) 5 GCS (Glascow coma scale) N&! <.,> 6 %>?@! l #.! Y <L # <# U@ 5 + (Revised trauma scale) RTS 4Z <# Ne > / <! "#"!!! "# 2003 ( #Y ( #Y A 4! 4!"+0! + 6Nc 2005 ( #Y 32 " 2004 ( #Y XNe :+ N&! 7O! 'Z 3!5 c2 4 JZ,> 3!5 4?" >?@! "#8! c2 fe" 3! bq ' A7' 4?" 6Z " e 25 3!5 4 4! " + 6Nc a"#8! 93 6.SD = 8/5 CI=95% (17/3-19/2) 6 3#O! ST" a"#8! 3+ " c2 fe" 4 3!5 133 Z# %2 %8 " \2?" %!+e 8 6O. 6 e 73/12 d! P ' + 6Nc a"#8!.sd = 74/5 CI=95% (43/4-57/2) #O <!"#$ '#! a"#8! 3+ $ c2 fe" 4 3!5 + 6Nc ? # 3001! w2 " = -4/15) 6 6 2/83 d! P 3!5 4 '.SD=2/14 CI= 95% (3/05 + 3#O! ST" a"#8! 152 #Y 288 f78! 5 #Y 48 " f. = #Y 104 +>$ 4 5 ' ++ p7*! #Y ! # P 3#O! ST"!V " +,+ <+"# #Y 63 ' ++ X,! = 37 Z#: e 5 3 bq <LbV ` 32"#8! #n' 3` #v$ a"#8! 3#' #: <#Q (#,' X O7' " #$m 3# <" Z <#Q.!# " 6>r" + (#,' Am T+ 5 Y " IQ5 XQ 37* Q Z 3#O! ST" ' 2"#8! '<P <#:5+ ISS 3V f " bv A!$V X&! l #.[2] + Z 3Q <L+2" +>$ " 5 3!!,# 6Nc a"#8! <# #! " ;#! 3! " 2#. X7 f { <*. + " IO! 32"#8!!! #L *' #: " +! #t (N$ " i& a#p (")*! w2 " <5!V5 6 X! + H5!V 7 <L' 5 <,!5 ++. i&n! A 5 %J.6Z#:! 8 +8! 4#7$ L %=P <"VR7. 5 S! 4#7$ " S+$ IL Y SPSS12!# 5 <!V # <# + #$}!' " H9 288 X' +>$ ( 4 P,> 2005 $ 2002 <O? 4 # 35"' 32"#8! # 6Nc 3#O! 5 4! a"#8! #! 95%. ( 31/9 32"#8!, 4! L " " ( 18 5 #7' 32"#8! 5 (18/6%) #Y % " f 4#$ J +>! <L!"#$ 3'', "#: w 4#$m bv "#Z 31/4% &$ + " 62#. 17/4% I ",*Ye bv. y0q Q bv " + R@e 32"#8! X' 19/2% f78! H: (27%) ;#! 78 p78!, 3#: " # bv 28/5% A7' 4?" 3+ 5 XNe #Y 63 +>$ 4 5 ' + H: 6Z I* 4 < 5 7' ~L " + #' %Z +,,' +>$!. 3#! 94/9% O:#! f78! 5 #

4 #(=S2 / +@R )C%100!5 " (SD =0/095) 6/40 3#O! ST" "" 3!5 KZ 7/43 PSS ++ = #O 3!"+0! 4 ' 6,>! <!V #t 5 KZ 4 ](SD =0/909) 6Z.(2 ("+.) 95% CI (-1/172 $ -0/890) " +#' 6Z 7 K 6Ne#! ' (" "#: " 6 ## b$#$ PSS ++ = I*! ' " "#: 6,>! <!V #t 5 M=Q 4 ' +!V 6 7/43.(3("+.) 95 CI(0/996 $ 1/850) # &'% Z = #O 3+ 5 S +,. #!! 4 ](70/4%) 6 + 6Nc OV <# 90 <m A?* <2 7 K! I* 6Z!?Å*! + Y 3!"+0! 18/4% dz $.6 a"#8! U&J %J "+0! " + 5 3#O! ST" IL 3V ' X&! I' JZ.$ ]6Z#: #e <#Q (#,' 6&$ { " LbV ` 2"#8! ~L 3#O! ST" $ bv $ + #' 6Z A7' 3#O! ' (" "#: PSS.(" "#: = 37 PSS " 3#O! ST" PSS *! :2 % () &'% %/%)*+% %/)$&&$ '/$%&' (PSS),-# %/%1)21 # &'% %/%1)21 %/**%%1 %/)%)+% 0/$&+%." "#: PSS (" "#: PSS *! :3 % () %/)%)+% 2/11%$% e#q N 2003 ( 5 S O:#! 5 KZ 6 h# #!V 72 5 S %? %N %5 6O. "5 IL 4 5 É$ 3V O:#! +>$ ' "! (72 " 6 # 9/1% dz " 3! = X!' P 32"#8! 5 89/5% 3Q k$ 32"#8! 5 11/9% + f. # <L#O 37 72/2% ISS>8 ' $J 4 " +#' + 5 " d! "#: ISS <+, NP #t 5,>) +! +L!, PSS<6 32"#8! 44/4% " (+ 62#. ++ *$ un!' " h# ' BTLS " ATLS H5!V ' " #L 7 K 3! " 6Ne#! NO bn T"# <#. 6O. IL 3# 6 47L.[10 9]!#L I* 47L " s1 = Xn! <5#!?V 3 A <L6Ne#! " <LH5!V 3V H5!V "+ PSS=6/40 ]+ #O >?@!! <O*'+ 5 <* 6Nc <,>! M=Q = 37 PSS=7/43 " "" &'% 0/$&+% '/%%&* (PSS) $% $% PSS3 4 PSS.# / 5" 4 #t J 'Z A 3, ISS bv %+ #7! 20/37 (>! ISS 4! ( O` X' Z#:. SD =21/75 " 13 d! bv "#: 32"#8! 72/2% 37 X' # " ++ <+,NP (Moderately Injured Trauma Victims) (Severely Injured ++ bv "#: 40% " +, ISS>8 + <+,NP ISS>15 Trauma Victims) Z 4! 5 #! " ;#! 3! Ne %>?@!!V l #, "+2 H5!V 5 S ' [1] 6 36/4% 3#O! M#P 4 a"#8! 288 4!V 4 3V M#P " 3#O! #Y L 5 XNe a"#8! 63 f78! 27% KZ#P " #O %Z h# ÇQ p#n' " + H5!V I$ 6 3+ %Z S (6/5%) a"#8! 15 dz " + #' K I* 4 6Z! +,L 3!V 4 ]+ #'.6 #! " ;#! KL' 7

5 101 & (45 6#!"#$ %&' () *+,# - / (. #7L I$ " a#. ( " 5m <5 3!5 p>@e a#. 6.6 (&! Z" kp,! 7$!"#$ '#! 8 " 6[ \+ +$! " <!"#$ H5!V I* ' 3 >?@! 4 Ü 32"#8! Rr" NO " #! " ;#! KL' i ' <!"#$ 4?")*! #:! O, g? Z" '#7$ 37 " ST" 6Q 3=' <L,L M#J <. 4. 3, 7 K N " H5!V <" #,L #e Q '.=G /.9$@ #! ' T"# *!"#$ +$ 5 I! 5m <!?! N " 5!V <L 4"+$.I7 +e " #$ 1. Jahunlu HR, Husum H, Wisborg T. Mortality in land mine accidents in Iran. Prehosp Disast Med 2002; 17: Association for the Advancement of Automotive Medicine. The Abbreviated Injury Scale, 1990 Revision, Update 98. Des Plaines, IL; 1998: IX. 3. Champion HR, Copes WS, Sacco WJ et al. The Major Trauma Outcome Study: Establishing national norms for trauma care. J Trauma 1990; 30: Hans Husum MD Mads Gilbert MD.. Respinatory Rate as a preoccipital triage tool in Rural Trauma the Journal of Trauma-Volume 55 Number 3 September Champion HR,Sacco WJ, copes S,et al.a revision of the trauma score. J Trauma. 1989;29: Gardner MJ. CIA, Version 1.2 [computer program]. London:Brithish Medical Journal; Newcombe RG, Altman DG. Proportions and their #v$ * O? 4 3#O! #O 6Z " d# ' 4 2.6Z KL' #! " ;#!!V?" + 5 6>7. " #' #7' [1] O. #'!V 6N* 10% 32"#8! #! " ;#! Q d$ 32"#8! 5 #Y 73 a"#8! 288 f78! 5 37 ST" 7' ~L 6Z 3"+ I*! %J?" <L A7' " + + X,! = #O,7Q! 5 95% #: <!V #t 5 #' 6Z 3+! d$ ' r#z 4 #YJ r#z X! confidence interval " [7 6]! «+." "#: " <NO Z=Q» NO 37 5 XNe <ONe#! A7' 6Z! 4.[11] 6 7 Rr" I,' I' O:#! +>$ 5 I* 5 uq ;#! #Y 63 #: dz + #' %Z! S ' 2"#8!!V 7 K <LH5!V ' I+>!!.6 6/5% +,' I' %+ #! " ;#!!V +$! < #Z 3V 3+ " a"#8! ( ' Z" P,! y0q X; differences. IN: Altman DG, MAchin D, Bryant TN, Gardner MJ, eds. Statistics with confidence. Landon: British Medical Journal;2000: Obuchowski NA, Lieber ML. Confidence intervals for the receiver operating characteristics area in studies with small samples. Acad Radiol 1998;5: Husum H, Gilbert M, Wisborg T. Training prehospital trauma care in low-income countries: the Village University experience. Med Teach 2003; 25: Husum H, Gilbert M, Wisborg T, Heng YV, Murad M. Rural prehospital trauma systems improve trauma outcome in low-income countries: a prospective study from North Iraq and Cambodia. J Trauma 2003; 54: Husum H, Gilbert M, Wisborg T. Save Lives, Save Limbs. Life support to victims of mines, wars, and accidents. TWN,Penang1999.