Decreased mortality after prehospital interventions in severely injured trauma patients
Abstract
Background We test the hypothesis that prehospital interventions (PHIs) performed by skilled emergency medical service providers during ground or air transport adversely affect outcome in severely injured trauma patients. Methods Consecutive trauma activations (March 2012 to June 2013) transported from the scene by air or ground emergency medical service providers were reviewed. PHI was defined as intubation, needle decompression, tourniquet, cricothyroidotomy, or advanced cardiac life support. Results In 3,733 consecutive trauma activations (71% blunt, 25% penetrating, 4% burns), age was 39 years, 74% were male, Injury Severity Score (ISS) was 5, and Glasgow Coma Score (GCS) was 15, with 32% traumatic brain injury (TBI) and 7% overall mortality. Those who received PHI (n = 130, 3.5% of the trauma activations) were more severely injured: ISS (26 vs. 5), GCS (3 vs. 15), TBI (57% vs. 31%), Revised Trauma Score (RTS, 5.45 vs. 7.84), Trauma and Injury Severity Score (TRISS, 1.32 vs. 4.89), and mortality (56% vs. 5%) were different (all p Conclusion In our urban trauma system, PHIs are associated with a lower incidence of mortality in severely injured trauma patients and do not delay transport to definitive care. Level of evidence Prognostic/epidemiologic study, level III; therapeutic study, level IV.
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Advanced airway management can be performed in the prehospital setting without delaying transfer to a trauma center.
“there is evidence to support the argument that advanced airway management can be performed in the prehospital setting without delaying transfer to a trauma center.8,9”
From Airway Management in Trauma (2018) · cites this paper as [9]
When performed by skilled emergency medical services (EMS) providers, advanced airway management is associated with a significant decrease in mortality.
“More recent data suggest that when performed by skilled emergency medical services (EMS) providers, advanced airway management is associated with a significant decrease in mortality.9,10”
From Airway Management in Trauma (2018) · cites this paper as [9]
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Kovacs, G., & Sowers, N. (2018) · Emergency Medicine Clinics of North America · doi:10.1016/j.emc.2017.08.006 · Cited by 115 · see citing works
- Authors
- Meizoso, J. P., Valle, E. J., Allen, C. J., Ray, J. J., Jouria, J. M., Teisch, L. F., Shatz, D. V., Namias, N., Schulman, C. I., & Proctor, K. G.
- Affiliations
- University of Miami (US)
- ORCID
- Venue
- Journal of Trauma and Acute Care Surgery
- Published
- 2015-08
- Volume
- 79
- Issue
- 2
- Pages
- 227-231
- ISSN
- 2163-0755 (ISSN-L)
- OpenAlex
- W1014566921
- Cited by
- 96
- References
- 0
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 8 · 2023: 13 · 2022: 7 · 2021: 6 · 2020: 13 · 2019: 7 · 2018: 10 · 2017: 12 · 2016: 9 · 2015: 1
- FWCI
- 10.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Trauma: Injury, Infection, and Critical Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
- Health Sciences › Medicine › Surgery › Trauma Management and Diagnosis
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Trauma, Hemostasis, Coagulopathy, Resuscitation
- Keywords
- prehospital interventions, trauma mortality, emergency medical services, airline industry, land transport, traumatic brain injury, intubation, needle decompression, tourniquet, cricothyroidotomy, advanced cardiac life support
- MeSH terms
- Adult, Clinical Competence, Emergency Medical Services, Emergency Medical Technicians, Female, Florida, Humans, Male, Middle Aged, Retrospective Studies, Time Factors, Transportation of Patients, Urban Population, Wounds and Injuries, Trauma Severity Indices, Young Adult, Propensity Score
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