+ Site Statistics
References:
52,654,530
Abstracts:
29,560,856
PMIDs:
28,072,755
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn

+ Translate
+ Recently Requested

Prehospital advanced trauma life support for critical blunt trauma victims



Prehospital advanced trauma life support for critical blunt trauma victims



Annals of Emergency Medicine 16(4): 399-403



The ability of paramedics to deliver advanced trauma life support (ATLS) in an expedient fashion for victims of trauma has been strongly challenged. In this study, the records of 114 consecutive victims of blunt trauma who underwent laparotomy or thoracotomy were reviewed. Prehospital care was rendered by paramedics operating under strict protocols. The mean response time (minutes .+-. SEM) to the scene was 5.6 .+-. 0.27. On-scene time was 13.9 .+-. 0.62. The time to return to the hospital was 8.0 .+-. 0.4. On-scene time included assessing hazards at the scene, patient extrication, spine immobilization (n = 98), application of oxygen (n = 94), measurement of vital signs (n = 114), splinting of 59 limbs, and the following ATLS procedures: endotracheal intubation (n = 31), IV access (n = 106) , ECG monitoring (n = 69), procurement of blood for tests including type and cross (n = 58), and application of a pneumatic antishock garment (PASG) (n = 31). On-scene times were analyzed according to the number of ATLS procedures performed: insertion of one IV line (n = 46), 14.8 .+-. 1.03 minutes, two IV lines (n = 28), 13.4 .+-. 0.92; one IV line plus intubation (n = 7), 14.0 .+-. 2.94; two IV lines plus intubation (n = 9), 17.0 .+-. 2.38; and two IV lines plus intubation plus PASG (n = 13), 12.4 .+-. 1.36. Of the 161 IV attempts, 94% were completed successfully. Of 36 attempts at endotracheal intubation, 89% were successful. Sixteen additional trauma patients were studied prospectively: the time required to place an IV line was 2.98 .+-. 0.37 minutes. Of 87 patients who had any vital signs in the field, 73 survived (83%). We conclude that paramedics functioning under direct medical control can perform basic life support and ATLS procedures at the scene in an expeditious manner.

(PDF emailed within 0-6 h: $19.90)

Accession: 006167336

Download citation: RISBibTeXText

PMID: 3826807

DOI: 10.1016/s0196-0644(87)80358-x



Related references

Prehospital advanced life support for critically injured victims of blunt trauma. Annals of Emergency Medicine 15(5): 628, 1986

Prehospital advanced life support for victims of trauma. Ugeskrift for Laeger 151(31): 1970-1972, 1989

Standardised primary care of multiple trauma patients. Prehospital Trauma Life Support und Advanced Trauma Life Support. Der Unfallchirurg 112(10): 846-853, 2010

Prehospital interventions for penetrating trauma victims: a prospective comparison between Advanced Life Support and Basic Life Support. Injury 44(5): 634-638, 2013

Prehospital Advanced Life Support for Out-of-Hospital Cardiac Arrest in Blunt Trauma Patients. JAMA Surgery: -, 2018

Prehospital Trauma Life Support (PHTLS) training of ambulance caregivers and impact on survival of trauma victims. Resuscitation 83(10): 1259-1264, 2013

Study design in prehospital trauma advanced life support-basic life support research: a critical review. Annals of Emergency Medicine 20(8): 857-860, 1991

Prehospital advanced life support for major trauma: critical need for clinical trials. Annals of Emergency Medicine 32(4): 480-489, 1998

Advanced Trauma Life Support and Prehospital Trauma Life Support on the road: an educational imperative. Bulletin of the American College of Surgeons 94(3): 23-27, 2009

Prehospital advanced trauma life support for critical penetrating wounds to the thorax and abdomen. Journal of Trauma 25(9): 828-832, 1985

Prehospital life support in trauma patients: basic or advanced trauma life support. Ulusal Travma Ve Acil Cerrahi Dergisi 12(2): 87-94, 2006

Association of Prehospital Advanced Life Support by Physician With Survival After Out-of-Hospital Cardiac Arrest With Blunt Trauma Following Traffic Collisions: Japanese Registry-Based Study. JAMA Surgery: E180674-E180674, 2018

Prehospital spine immobilization for penetrating trauma--review and recommendations from the Prehospital Trauma Life Support Executive Committee. Journal of Trauma 71(3): 763-9; Discussion 769-70, 2012

PHTLS ® (Prehospital Trauma Life Support) provider courses in Germany - who takes part and what do participants think about prehospital trauma care training?. Journal of Trauma Management & Outcomes 8(): 7-7, 2014

Effect of the prehospital trauma life support program (PHTLS) on prehospital trauma care. Journal of Trauma 42(5): 786-790, 1997