Temporal changes in the prehospital management of trauma patients: 2014-2021

Affiliations

¹ Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: James.bradford@utexas.edu.
² Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: pgteixeira@austin.utexas.edu.
³ Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: joseph.dubose@austin.utexas.edu.
⁴ Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: mdtrust@ascension.org.
⁵ Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: tatiana.cardenas@ascension.org.
⁶ Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: sgolestani@mcw.edu.
⁷ Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: Jessica.efird@ascension.org.
⁸ Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: jkempema@ascension.org.
⁹ Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: jessicaturner@utexas.edu.
¹⁰ Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: cczysz@ascension.org.
¹¹ Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: michelle.robert@ascension.org.
¹² Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: Sali2@ascension.org.
¹³ Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: lhbrown@ascension.org.
¹⁴ Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: carlos.brown@austin.utexas.edu.

PMID: 37567816
DOI: 10.1016/j.amjsurg.2023.08.001

Temporal changes in the prehospital management of trauma patients: 2014-2021

James M Bradford et al. Am J Surg. 2024 Feb.

. 2024 Feb:228:88-93.

doi: 10.1016/j.amjsurg.2023.08.001. Epub 2023 Aug 6.

Authors

Affiliations

¹ Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: James.bradford@utexas.edu.
² Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: pgteixeira@austin.utexas.edu.
³ Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: joseph.dubose@austin.utexas.edu.
⁴ Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: mdtrust@ascension.org.
⁵ Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: tatiana.cardenas@ascension.org.
⁶ Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: sgolestani@mcw.edu.
⁷ Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: Jessica.efird@ascension.org.
⁸ Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: jkempema@ascension.org.
⁹ Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: jessicaturner@utexas.edu.
¹⁰ Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: cczysz@ascension.org.
¹¹ Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: michelle.robert@ascension.org.
¹² Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: Sali2@ascension.org.
¹³ Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: lhbrown@ascension.org.
¹⁴ Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, United States. Electronic address: carlos.brown@austin.utexas.edu.

PMID: 37567816
DOI: 10.1016/j.amjsurg.2023.08.001

Abstract

Introduction: Aggressive prehospital interventions (PHI) in trauma may not improve outcomes compared to prioritizing rapid transport. The aim of this study was to quantify temporal changes in the frequency of PHI performed by EMS.

Methods: Retrospective chart review of adult patients transported by EMS to our trauma center from January 1, 2014 to 12/31/2021. PHI were recorded and annual changes in their frequency were assessed via year-by-year trend analysis and multivariate regression.

Results: Between the first and last year of the study period, the frequency of thoracostomy (6% vs. 9%, p = 0.001), TXA administration (0.3% vs. 33%, p < 0.001), and whole blood administration (0% vs. 20%, p < 0.001) increased. Advanced airway procedures (21% vs. 12%, p < 0.001) and IV fluid administration (57% vs. 36%, p < 0.001) decreased. ED mortality decreased from 8% to 5% (p = 0.001) over the study period. On multivariate regression, no PHI were independently associated with increased or decreased ED mortality.

Conclusion: PHI have changed significantly over the past eight years. However, no PHI were independently associated with increased or decreased ED mortality.

Keywords: Emergency medical services; Prehospital interventions; Trauma prehospital.

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Conflict of interest statement

Declaration of competing interest There was no funding that was received for this study. We thank you for the consideration for publication of our manuscript Temporal Changes in the Prehospital Management of Trauma Patients: 2014–2021. This is an original article using data collected and analyzed at our institution. This manuscript has not been published in any other editorial nor is it under consideration for publication elsewhere. Results of this data were presented as a poster at the 2022 Annual Meeting of the American Association for the Surgery of Trauma in Chicago, Illinois. If accepted, it will not be published in the same form elsewhere. I, James Bradford, have reviewed and edited the submission to omit any identifying information. I hereby submit this self-blinded manuscript for consideration in The American Journal of Surgery.

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Temporal changes in the prehospital management of trauma patients: 2014-2021

Affiliations

Temporal changes in the prehospital management of trauma patients: 2014-2021

Authors

Affiliations

Abstract

Conflict of interest statement

References

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous