Physician-staffed helicopter emergency medical service has a beneficial impact on the incidence of prehospital hypoxia and secured airways on patients with severe traumatic brain injury

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http://hdl.handle.net/10138/225138

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Pakkanen , T , Kamarainen , A , Huhtala , H , Silfvast , T , Nurmi , J , Virkkunen , I & Yli-Hankala , A 2017 , ' Physician-staffed helicopter emergency medical service has a beneficial impact on the incidence of prehospital hypoxia and secured airways on patients with severe traumatic brain injury ' , Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , vol. 25 , 94 . https://doi.org/10.1186/s13049-017-0438-1

Title: Physician-staffed helicopter emergency medical service has a beneficial impact on the incidence of prehospital hypoxia and secured airways on patients with severe traumatic brain injury
Author: Pakkanen, Toni; Kamarainen, Antti; Huhtala, Heini; Silfvast, Tom; Nurmi, Jouni; Virkkunen, Ilkka; Yli-Hankala, Arvi
Contributor: University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, Clinicum
Date: 2017-09-15
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/10138/225138
Abstract: Background: After traumatic brain injury (TBI), hypotension, hypoxia and hypercapnia have been shown to result in secondary brain injury that can lead to increased mortality and disability. Effective prehospital assessment and treatment by emergency medical service (EMS) is considered essential for favourable outcome. The aim of this study was to evaluate the effect of a physician-staffed helicopter emergency medical service (HEMS) in the treatment of TBI patients. Methods: This was a retrospective cohort study. Prehospital data from two periods were collected: before (EMS group) and after (HEMS group) the implementation of a physician-staffed HEMS. Unconscious prehospital patients due to severe TBI were included in the study. Unconsciousness was defined as a Glasgow coma scale (GCS) score Results: Data from 181 patients in the EMS group and 85 patients in the HEMS group were available for neurological outcome analyses. The baseline characteristics and the first recorded vital signs of the two cohorts were similar. Good neurological outcome was more frequent in the HEMS group; 42% of the HEMS managed patients and 28% (p = 0.022) of the EMS managed patients had a good neurological recovery. The airway was more frequently secured in the HEMS group (p <0.001). On arrival at the emergency department, the patients in the HEMS group were less often hypoxic (p = 0.024). In univariate analysis HEMS period, lower age and secured airway were associated with good neurological outcome. Conclusion: The introduction of a physician-staffed HEMS unit resulted in decreased incidence of prehospital hypoxia and increased the number of secured airways. This may have contributed to the observed improved neurological outcome during the HEMS period.
Subject: Prehospital 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)
SEVERE HEAD-INJURY
RAPID-SEQUENCE INTUBATION
PRACTICAL SCALE
SURVIVAL
MORTALITY
MANAGEMENT
3126 Surgery, anesthesiology, intensive care, radiology
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