Pre-hospital severe traumatic brain injury - comparison of outcome in paramedic versus physician staffed emergency medical services

Show full item record



Permalink

http://hdl.handle.net/10138/163557

Citation

Pakkanen , T , Virkkunen , I , Kamarainen , A , Huhtala , H , Silfvast , T , Virta , J , Randell , T & Yli-Hankala , A 2016 , ' Pre-hospital severe traumatic brain injury - comparison of outcome in paramedic versus physician staffed emergency medical services ' Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , vol. 24 , 62 . DOI: 10.1186/s13049-016-0256-x

Title: Pre-hospital severe traumatic brain injury - comparison of outcome in paramedic versus physician staffed emergency medical services
Author: Pakkanen, Toni; Virkkunen, Ilkka; Kamarainen, Antti; Huhtala, Heini; Silfvast, Tom; Virta, Janne; Randell, Tarja; Yli-Hankala, Arvi
Contributor: University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, Anestesiologian ja tehohoitolääketieteen yksikkö (-2009)
Date: 2016-04-29
Language: eng
Number of pages: 7
Belongs to series: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
ISSN: 1757-7241
URI: http://hdl.handle.net/10138/163557
Abstract: Background: Traumatic brain injury (TBI) is one of the leading causes of death and permanent disability. Emergency Medical Services (EMS) personnel are often the first healthcare providers attending patients with TBI. The level of available care varies, which may have an impact on the patient's outcome. The aim of this study was to evaluate mortality and neurological outcome of TBI patients in two regions with differently structured EMS systems. Methods: A 6-year period (2005 - 2010) observational data on pre-hospital TBI management in paramedic-staffed EMS and physician-staffed EMS systems were retrospectively analysed. Inclusion criteria for the study were severe isolated TBI presenting with unconsciousness defined as Glasgow coma scale (GCS) score Results: During the 6-year study period a total of 458 patients met the inclusion criteria. One-year mortality was higher in the paramedic-staffed EMS group: 57 % vs. 42 %. Also good neurological outcome was less common in patients treated in the paramedic-staffed EMS group. Discussion: We found no significant difference between the study groups when considering the secondary brain injury associated vital signs on-scene. Also on arrival to ED, the proportion of hypotensive patients was similar in both groups. However, hypoxia was common in the patients treated by the paramedic-staffed EMS on arrival to the ED, while in the physician-staffed EMS almost none of the patients were hypoxic. Prehospital intubation by EMS physicians probably explains this finding. Conclusion: The results suggest to an outcome benefit from physician-staffed EMS treating TBI patients.
Subject: Pre-hospital Emergency Care (MeSH)
Emergency Medical Services (MeSH)
Critical Care (MeSH)
Traumatic Brain Injury (MeSH)
Airway Management (MeSH)
Endotracheal Intubation (MeSH)
Patient Outcome Assessment (MeSH)
Glasgow Outcome Scale (MeSH)
RAPID-SEQUENCE INTUBATION
SEVERE HEAD-INJURY
PRACTICAL SCALE
CARE
IMPACT
TRIAL
3126 Surgery, anesthesiology, intensive care, radiology
Rights:


Files in this item

Total number of downloads: Loading...

Files Size Format View
s13049_016_0256_x.pdf 603.7Kb PDF View/Open

This item appears in the following Collection(s)

Show full item record