Article
Surgery
Courtney Wham, Theresa Morin, Angela Sauaia, Robert McIntyre, Shane Urban, Kevin McVaney, Mitchell Cohen, Alexis Cralley, Ernest E. Moore, Eric M. Campion
Summary: This study suggests that prehospital ETCO2 measured by NCC or ILVC may be predictive of mortality in injured patients.
AMERICAN JOURNAL OF SURGERY
(2023)
Article
Medicine, General & Internal
Russell L. Gruen, Biswadev Mitra, Stephen A. Bernard, Colin J. McArthur, Brian Burns, Dashiell C. Gantner, Marc Maegele, Peter A. Cameron, Bridget Dicker, Andrew B. Forbes, Sally Hurford, Catherine A. Martin, Stefan M. Mazur, Robert L. Medcalf, Lynnette J. Murray, Paul S. Myles, Sze J. Ng, Veronica Pitt, Stephen Rashford, Michael C. Reade, Andrew H. Swain, Tony Trapani, Paul J. Young
Summary: This study aimed to investigate whether early administration of tranexamic acid as a treatment for trauma-induced coagulopathy in patients with advanced trauma systems would increase the likelihood of survival with a favorable functional outcome. The results showed no significant difference in the survival rate with a favorable functional outcome at 6 months between patients treated with tranexamic acid and those treated with placebo.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Emergency Medicine
Mattias Renberg, Martin Dahlberg, Mikael Gellerfors, Elham Rostami, Mattias Gunther
Summary: This study evaluated the use of prehospital and emergency department tracheal intubation in managing penetrating trauma patients in Sweden. The results showed that prehospital intubation was associated with higher mortality rate, primarily due to traumatic cardiac arrest.
SCANDINAVIAN JOURNAL OF TRAUMA RESUSCITATION & EMERGENCY MEDICINE
(2023)
Article
Emergency Medicine
Sabina Braithwaite, Christopher Stephens, Kyle Remick, Whitney Barrett, Francis X. Guyette, Michael Levy, Christopher Colwell
Summary: Definitive management of trauma requires treatment in a hospital setting, and rapid treatment and transportation of trauma patients to a trauma center can improve survival rates and treatment outcomes. Management of airway, oxygenation, ventilation, and physiologic optimization must be balanced with timely patient delivery. The optimal prehospital airway management strategy for trauma has not been clearly defined, and should be based on individual patient assessments.
PREHOSPITAL EMERGENCY CARE
(2022)
Article
Medicine, General & Internal
Lukas Reinert, Steffen Herdtle, Christian Hohenstein, Wilhelm Behringer, Jasmin Arrich
Summary: This study aimed to identify predictors for first-pass intubation success in the prehospital emergency setting. The retrospective analysis of prehospital advanced airway management data in Germany revealed that factors such as direct vocal cord view, unfavorable Cormack-Lehane classification, general practitioner as medical specialty, and location and type of EMS were independent predictors for first-pass intubation success.
JOURNAL OF CLINICAL MEDICINE
(2022)
Review
Emergency Medicine
Veronica K. Weihing, Ellen H. Crowe, Henry E. Wang, Irma T. Ugalde
Summary: In a systematic review of prehospital pediatric airway management, studies varied in scope, design, and conclusions. Current research suggests that there are equal or worse outcomes with the use of endotracheal intubation compared to other airway techniques. Additional clinical trials are needed to evaluate the merits of this practice.
ACADEMIC EMERGENCY MEDICINE
(2022)
Review
Medicine, General & Internal
Fang Ji, Xiaohui Zhou
Summary: This systematic review and meta-analysis examined the impact of prehospital intubation on mortality rates of traumatic brain injury patients. The results showed that traumatic brain injury patients who received prehospital intubation had higher odds of mortality.
SCOTTISH MEDICAL JOURNAL
(2023)
Article
Surgery
Madeline B. Thomas, Shane Urban, Heather Carmichael, Jordan Banker, Ananya Shah, Terry Schaid, Angela Wright, Catherine G. Velopulos, Michael Cripps
Summary: This study compared patients with attempted prehospital endotracheal intubation to those intubated promptly upon emergency department arrival. The results showed that patients who underwent prehospital endotracheal intubation had a longer time on scene compared to those intubated in the emergency department, but there was no difference in overall mortality. Among patients with prehospital arrest, prehospital endotracheal intubation was associated with a shorter time to death and longer total transport time, but there was no difference in observed mortality.
Article
Emergency Medicine
Teresa Maek, Ulrike Fochtmann, Anna von Loewenich, Pascal Jungbluth, Werner Zimmermann, Rolf Lefering, Sven Lendemans, Bjoern Hussmann
Summary: The study found that the guidelines for prehospital intubation are generally followed in clinical practice for the majority of injured children compared to adults (approximately 70% of cases). Children aged 0-6 years were the least likely to actually be intubated, with the Glasgow Coma Scale score having the greatest influence on the decision to intubate.
BMC EMERGENCY MEDICINE
(2022)
Article
Critical Care Medicine
Natalie Bulger, Brenna Harrington, Josh Krieger, Andrew Latimer, Saman Arbabi, Catherine R. Counts, Michael Sayre, Charles Maynard, Eileen M. Bulger
Summary: This study retrospectively observed adult trauma patients who were intubated in the prehospital setting from 2016 to 2019. It was found that prehospital ETCO2 values lower than 25 mm Hg may predict hemorrhagic shock.
JOURNAL OF TRAUMA AND ACUTE CARE SURGERY
(2021)
Article
Medicine, General & Internal
Jan Gewiess, Christoph Emanuel Albers, Hans-Christoph Pape, Hannes Bangerter, Wolf-Dieter Zech, Marius Johann Baptist Keel, Johannes Dominik Bastian
Summary: This study used ISS data to analyze trauma mechanisms, causes of death, injury patterns, and potential survivability in prehospital trauma victims. It found that severity of injuries to the head/neck and chest regions was higher, with a significant amount of victims dying from CNS-related injuries. Efforts should be made to improve rescue efforts for highly traumatized patients.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Emergency Medicine
Eujene Jung, Yong Soo Cho, Seok Jin Ryu, Dong Ki Kim, Ji Ho Lee, Jun Ho Han
Summary: This study aimed to compare the effects of prehospital endotracheal intubation (ETI) and bag-valve mask (BVM) ventilation on the mortality and functional recovery of traumatic brain injury (TBI) patients, as well as the interaction effect of carbon dioxide level. The study found that prehospital intubation did not significantly affect survival outcomes and functional recovery in patients with severe TBI. However, patients with hypocarbia had lower survival outcomes.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2022)
Review
Critical Care Medicine
Kazuhiko Omori, Ian Roberts
Summary: The public enquiry following the Manchester Arena mass casualty incident highlighted the need for intramuscular administration of tranexamic acid to trauma patients. UK paramedics are now authorized to administer it in pre-hospital settings. In Japan, despite Japanese scientists inventing tranexamic acid, pre-hospital administration by emergency life-saving technicians is not yet authorized. This paper provides a summary of the evidence on the use of tranexamic acid in patients with traumatic bleeding, including new evidence on the intramuscular route.
JOURNAL OF INTENSIVE CARE
(2023)
Article
Emergency Medicine
Ryan Huebinger, Hei Kit Chan, Justin Reed, N. Clay Mann, Benjamin Fisher, Lesley Osborn
Summary: This study retrospectively analyzed the national database of prehospital encounters in 2020 and 2021 to evaluate trends in penetrating trauma rates. The results showed higher trauma rates nationwide from March 2020 to July 2021 compared to the baseline. The rates of penetrating trauma from May to December 2021 were lower than those from May to December 2020. All census regions had increased trauma rates during the period from March 2020 to July 2021.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2023)
Article
Medicine, General & Internal
Christophe A. Fehlmann, Michele Chan, Romain Betend, Fiona Novotny-Court, Melanie Suppan, Georges L. Savoldelli, Laurent Suppan
Summary: The success rate of prehospital endotracheal intubation is not dependent on the medical specialty background of the physician, but anesthesiologists are more likely to proceed with intubation in patients without cardiac arrest.
JOURNAL OF CLINICAL MEDICINE
(2022)