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Inventi Impact: Emergency Medicine

Articles

  • Inventi:htr/79/14
    PROPENSITY FOR PERFORMING INTERVENTIONS IN PRE-HOSPITAL TRAUMA MANAGEMENT â?? A COMPARISON BETWEEN PHYSICIANS AND NON-PHYSICIANS
    30-Jun-2014 Research 2014 : July - September
    Mathias C Blom, Ludwig Aspelin, Kjell Ivarsson

    Background: In 2005, the Advanced Life Support (ALS) teams delivering pre-hospital care in RegionSkane in\nsouthern Sweden received additional support by physicians, who were part of ââ?¬Å?Pre-hospital acute teamsââ?¬Â (PHAT).\nThe study objective is to compare the incidence of pre-hospital medical interventions for trauma-patients cared for\nby conventional ALS teams and patients who received additional support by PHAT.\nMethods: Trauma patients with Injury Severity Score (ISS) >9 were identified retrospectively in the national quality\nregistry KVITTRA at three hospitals in RegionSkane, for the time period October 2005 to December 2008.\nInterventions include e.g. tracheal intubation, administration of i.v. fluids, neck immobilization and spine board\nusage. Confounding effects from trauma severity, trauma mechanism, vital parameters, age and sex were addressed\nin multivariate models.\nResults: Data from 202 cases was included. 9 pre-hospital interventions were assessed. The incidence of\nendotracheal intubation and immobilisation of extremities was higher among patients in the PHAT-group\ncompared to the ALS-only group (16.3% vs. 6.9%, p = 0.034) and (12.8% vs. 4.3%, p = 0.027) respectively. PHATs\npresence remained a significant predictor of these interventions also after taking confounding factors into account\n(OR 5.5, CL 1.5-19.7) and (OR 3.2 CI 1.0-9.8).\nPHAT was involved in a greater proportion of cases with <50.0% of survival (19.8% vs. 12.1%, p = 0.134). The average\nISS was higher among cases receiving PHAT support in strata ISS 16-24 and ISS > 24 than cases in corresponding\nstrata cared for by ALS teams alone (ISS 20.0 vs. 17.0, p = 0.048 and ISS 34.0 vs. 29.0, p = 0.019).\nConclusions: The incidence of endotracheal intubation and immobilization of extremities was greater among\npatients supported by PHAT, compared to patients cared for by ALS teams alone. This finding has to be interpreted\nin the light of a selection-bias where PHAT support was directed to more severely injured patients

    How to Cite this Article
    Compliant Citation: Blom et al.: Propensity for performing interventions in pre-hospital trauma management - a comparison\nbetween physicians and non-physicians. Journal of Trauma Management & Outcomes 2014 8:3, doi:10.1186/1752-2897-8-3.\n© 2014 Blom et al.; licensee BioMed Central Ltd. \nThis is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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