Temporal changes in the prehospital management of trauma patients: 2014–2021 - 22/02/24
, Pedro G. Teixeira , Joseph DuBose , Marc D. Trust , Tatiana CP. Cardenas , Simin Golestani , Jessica Efird , James Kempema , Jessica Zimmerman , Clea Czysz , Michelle Robert , Sadia Ali , Lawrence H. Brown , Carlos VR. Brown Abstract |
Introduction |
Aggressive prehospital interventions (PHI) in trauma may not improve outcomes compared to prioritizing rapid transport. The aim of this study was to quantify temporal changes in the frequency of PHI performed by EMS.
Methods |
Retrospective chart review of adult patients transported by EMS to our trauma center from January 1, 2014 to 12/31/2021. PHI were recorded and annual changes in their frequency were assessed via year-by-year trend analysis and multivariate regression.
Results |
Between the first and last year of the study period, the frequency of thoracostomy (6% vs. 9%, p = 0.001), TXA administration (0.3% vs. 33%, p < 0.001), and whole blood administration (0% vs. 20%, p < 0.001) increased. Advanced airway procedures (21% vs. 12%, p < 0.001) and IV fluid administration (57% vs. 36%, p < 0.001) decreased. ED mortality decreased from 8% to 5% (p = 0.001) over the study period. On multivariate regression, no PHI were independently associated with increased or decreased ED mortality.
Conclusion |
PHI have changed significantly over the past eight years. However, no PHI were independently associated with increased or decreased ED mortality.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Highlights |
• | EMS provide basic and advanced prehospital interventions for trauma patients. |
• | Interventions performed by our EMS changed significantly over the last eight years. |
• | No prehospital interventions were independently associated with either increased or decreased ED mortality on multivariate logistic regression. |
Keywords : Trauma prehospital, Prehospital interventions, Emergency medical services
Plan
Vol 228
P. 88-93 - février 2024 Retour au numéro
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