Opinions of trauma practitioners regarding prehospital interventions for critically injured patients

Jeffrey P. Salomone, Jeffrey S. Ustin, Norman E. McSwain, David V. Feliciano, David V Shatz, Ernest F. Block, Kenneth L. Mattox

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

Background: Significant controversy surrounds the prehospital management of trauma patients. Methods: A questionnaire describing clinical scenarios was mailed to a random sample of 345 trauma practitioners. Results: The 182 trauma practitioners (52.8%) who returned the surveys were predominantly general or trauma surgeons (83.5%) in academic or university practice (68.1%). For a patient with a severe traumatic brain injury, 84.5% of trauma practitioners recommended that emergency medical services personnel attempt intubation at least once when transport time was 20 to 40 minutes. For a patient with a gunshot wound to the epigastrium in decompensated shock, the majority of trauma practitioners believed that a relatively hypotensive state should be maintained, regardless of transport time. Trauma practitioners (52.2%) have recommended the use of the pneumatic antishock garment for transports of 20 to 40 minutes for patients with an unstable pelvic fracture and decompensated shock. Conclusions: Most trauma practitioners believe that emergency medical services providers should attempt intubation for a patient with a severe traumatic brain injury, should treat decompensated shock in a patient with penetrating torso trauma but maintain the patient in a relatively hypotensive state, and should apply and inflate the pneumatic antishock garment for a suspected pelvic fracture accompanied by decompensated shock if the patient is 20 to 40 minutes from a trauma center. The recommendations of trauma practitioners regarding appropriate prehospital care are significantly influenced by the time required for transport to the trauma center.

Original languageEnglish (US)
Pages (from-to)509-517
Number of pages9
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume58
Issue number3
DOIs
StatePublished - Mar 2005
Externally publishedYes

Keywords

  • Airway management
  • Emergency medical services
  • Intravenous fluid resuscitation
  • Pneumatic antishock garment
  • Prehospital care
  • Trauma

ASJC Scopus subject areas

  • Surgery

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