Effect of Prehospital Advanced Life Support on Outcomes of Major Trauma Patients
- 1 April 2000
- journal article
- clinical trial
- Published by Wolters Kluwer Health
- Vol. 48 (4) , 643-648
- https://doi.org/10.1097/00005373-200004000-00010
Abstract
Determine whether prehospital advanced life support (ALS) improves the survival of major trauma patients and whether it is associated with longer on-scene times. A 36-month retrospective study of all major trauma patients who received either prehospital bag-valve-mask (BVM) or endotracheal intubation (ETI) and were transported by paramedics to our Level I trauma center. Logistic regression analysis determined the association of prehospital ALS with patient survival. Of 9,451 major trauma patients, 496 (5.3%) had either BVM or ETI. Eighty-one percent received BVM, with a mean Injury Severity Score of 29 and a mortality rate of 67%; 93 patients (19%) underwent successful ETI, with a mean Injury Severity Score of 35 and a mortality rate of 93%. Adjusted survival for patients who had BVM was 5.3 times more likely than for patients who had ETI (95% confidence interval, 2.3–14.2, p = 0.00). Survival among patients who received intravenous fluids was 3.9 times more likely than those who did not (p = not significant). Average on-scene times for patients who had ETI or intravenous fluids were not significantly longer than those who had BVM or no intravenous fluids. ALS procedures can be performed by paramedics on major trauma patients without prolonging on-scene time, but they do not seem to improve survival.Keywords
This publication has 21 references indexed in Scilit:
- Endotracheal Intubation in the Field Improves Survival in Patients With Severe Head InjuryArchives of Surgery, 1997
- Immediate versus Delayed Fluid Resuscitation for Hypotensive Patients with Penetrating Torso InjuriesNew England Journal of Medicine, 1994
- BASIC LIFE SUPPORT VERSUS ADVANCED LIFE SUPPORT FOR INJURED PATIENTS WITH AN INJURY SEVERITY SCORE OF 10 OR MOREPublished by Wolters Kluwer Health ,1993
- IMPACT OF ON-SITE CARE, PREHOSPITAL TIME, AND LEVEL OF IN-HOSPITAL CARE ON SURVIVAL IN SEVERELY INJURED PATIENTSPublished by Wolters Kluwer Health ,1993
- PROSPECTIVE EVALUATION OF PREOPERATIVE FLUID RESUSCITATION IN HYPOTENSIVE PATIENTS WITH PENETRATING TRUNCAL INJURYPublished by Wolters Kluwer Health ,1992
- Emergency Center Thoracotomy: Impact of Prehospital ResuscitationPublished by Wolters Kluwer Health ,1992
- The Effect of Prehospital Fluids on Survival in Trauma PatientsPublished by Wolters Kluwer Health ,1990
- Instinct and ActionPublished by American Medical Association (AMA) ,1985
- Prehospital cardiopulmonary resuscitation of the critically injured patientThe American Journal of Surgery, 1984
- Field Endotracheal Intubation by Paramedical PersonnelChest, 1984