Purpose: Pre-hospital trauma life support (PHTLS) includes a standardized algorithm for pre-hospital care. Implementation of PHTLS led to improved outcome in less developed medical trauma systems. We aimed to determine the impact of PHTLS on quality of pre-hospital care in a European metropolitan area. We hypothesized that the introduction of PHTLS was associated with improved efficiency of pre-hospital care for severely injured patients and less emergency physician deployment.
Methods: We included adult polytrauma (ISS > 15) patients that were admitted to our level one trauma center during a 7-year time period. Patients were grouped based on the presence or absence of a PHTLS-trained paramedic in the pre-hospital trauma team. Group I (no-PHTLS group) included all casualties treated by no-PHTLS-trained personnel. Group II (PHTLS group) was composed of casualties managed by a PHTLS qualified team. We compared outcome between groups.
Results: During the study period, 187,839 rescue operations were executed and 280 patients were included. No differences were seen in patient characteristics, trauma severity or geographical distances between groups. Transfer times were significantly reduced in PHTLS teams than non-qualified teams (9.3 vs. 10.5 min, P = 0.006). Furthermore, the in-field operation times were significantly reduced in PHTLS qualified teams (36.2 vs. 42.6 min, P = 0.003). Emergency physician involvement did not differ between groups.
Conclusion: This is the first study to show that the implementation of PHTLS algorithms in a European metropolitan area is associated with improved efficiency of pre-hospital care for the severely injured. We therefore recommend considering the introduction of PHTLS in metropolitan areas in the first world.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00068-019-01141-1 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Impact of trauma center designation level on survival in trauma during pregnancy: Observational study across US trauma centers.
Am J Emerg Med
January 2025
Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon; Emergency Medical Services and Pre-hospital Care Program, American University of Beirut Medical Center, Beirut, Lebanon. Electronic address:
Background: Trauma is the leading non obstetric cause of death in pregnant women. Pregnancy above 20 weeks falls under special considerations group in the Center for Disease Control and Prevention (CDC) field triage criteria. Trauma centers' designation level in the United States is based on available resources for care.
View Article and Find Full Text PDFEvaluating the effectiveness of handheld ultrasound in primary blast lung injury: a comprehensive study.
Sci Rep
January 2025
Department of Military Traffic Injury Prevention and Control, Daping Hospital, Army Medical University, No. 10 Changjiang Branch Road, Yuzhong District, Chongqing, 400042, China.
The incidence of blast injuries has been rising globally, particularly affecting the lungs due to their vulnerability. Primary blast lung injury (PBLI) is associated with high morbidity and mortality rates, while early diagnostic methods are limited. With advancements in medical technology, and portable handheld ultrasound devices, the efficacy of ultrasound in detecting occult lung injuries early remains unclear.
View Article and Find Full Text PDFEndotracheal tube as chest tube: a back-up alternative in resource limited settings.
Emerg Med J
January 2025
Department of Anesthesiology & Trauma Center / HEMS Lifeliner 1, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
Thoracostomies, and subsequent placements of chest tubes (CTs), are a standard procedure in several domains of medicine. In emergency medicine, thoracostomies are indicated to release a relevant hemothorax or pneumothorax, particularly a life-threatening tension pneumothorax. In many cases, an initial finger-assisted thoracostomy is followed by placement of a CT to ensure continuous decompression of blood and air.
View Article and Find Full Text PDFPeripheral oxygen saturation levels as a guide to avoid hyperoxia: an observational study.
Scand J Trauma Resusc Emerg Med
January 2025
Department of Acute Care, University Medical Centre Groningen, Groningen, the Netherlands.
Background: As iatrogenic hyperoxia has been related to adverse outcomes in critically ill patients, guidelines advise to titrate oxygen to physiological levels. In the prehospital setting where partial arterial oxygen (PaO) values are often not readily available, titration of oxygen is based on peripheral oxygen saturations (SpO2). In this study we aimed to investigate the efficacy of SpO guided oxygen titration in the prevention of hyperoxia.
View Article and Find Full Text PDFEarly coagulation changes as predictors of adverse outcomes in patients with severe burn and inhalation injuries.
Burns
January 2025
Department of Critical Care Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200120, China. Electronic address:
Background: Disorders of the coagulation pathway are triggered in patients with severe burn and inhalation injuries in the early stages. There are multiple early coagulation indices identified to correlate with adverse outcomes.
Method: A retrospective analysis of patients with severe burn and inhalation injuries from 12 centers in mainland China was performed to identify early changed coagulation indices with predictive value associated with four major 28-day adverse outcomes (death, anticoagulation, mechanical ventilation, continuous renal replacement therapy) by logistic regression.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!