Effect of Prehospital ALS on Outcomes of Major Trauma Patients

Effect of Prehospital ALS on Outcomes of Major Trauma Patients

Objective: Determine whether prehospital advanced life support (ALS) improves the survival of major trauma patients and whether it is associated with longer on-scene times.

Methods: 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.

Results: 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 5 0.00). Survival among patients who received intravenous fluids was 3.9 times more likely than those who did not (p 5 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.

Conclusion: ALS procedures can be performed by paramedics on major trauma patients without prolonging on-scene time, but they do not seem to improve survival.

 

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Emergency Live is the only multilingual magazine dedicated to people involved in rescue and emergency. As such, it is the ideal medium in terms of speed and cost for trading companies to reach large numbers of target users; for example, all companies involved in some way in the equipping of specialised means of transport. From vehicle manufacturers to companies involved in equipping those vehicles, to any supplier of life- saving and rescue equipment and aids.

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