Air medical transport of severely head-injured patients undergoing paramedic rapid sequence intubation

Air Medical Journal
Jennifer C PosteDavid B Hoyt

Abstract

The San Diego Paramedic Rapid Sequence Intubation (RSI) Trial documented an increase in mortality with paramedic RSI of patients with severe traumatic brain injury. This analysis explores the impact of air medical transport of trial patients on outcome. Adult trauma victims with severe traumatic brain injury (Glasgow Coma Scale score of 3 to 8) were prospectively enrolled. Paramedics performed RSI using midazolam and succinylcholine; air medical crews could be called at the discretion of ground paramedics, generally for anticipated prolonged transports. Patients were matched to historical controls using the following parameters: age, gender, mechanism, injury of severity score, and abbreviated injury scale scores for each body system. Patients transported by air and ground were compared with regard to demographics, clinical parameters, vital signs, arterial blood gas data, and outcome. A total of 336 patients were included (79 air medical and 257 ground transports). No significant differences arose between the groups with regard to demographic, clinical, vital sign, and arterial blood gas data. Air medical patients had decreased mortality (28% vs 31%, OR 0.9), and ground patients had increased mortality versus matched controls ...Continue Reading

References

Jun 19, 1987·JAMA : the Journal of the American Medical Association·W G Baxt, P Moody
Feb 1, 1993·The Journal of Trauma·R M ChesnutM A Foulkes
Mar 1, 1993·Journal of Pediatric Surgery·F A PigulaD W Vane
Feb 20, 1999·Magnetic Resonance in Medicine : Official Journal of the Society of Magnetic Resonance in Medicine·M WeckesserH W Müller-Gärtner
Jul 3, 1999·American Journal of Respiratory and Critical Care Medicine·D ChiumelloA S Slutsky
Oct 20, 1999·The Australian and New Zealand Journal of Surgery·A GarnerR Bartolacci
May 4, 2000·The New England Journal of Medicine·UNKNOWN Acute Respiratory Distress Syndrome NetworkArthur Wheeler
Jan 17, 2002·Journal of Neurosurgery·Michael N DiringerWilliam J Powers

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Citations

Jan 20, 2011·Critical Care : the Official Journal of the Critical Care Forum·Hans Morten LossiusDavid J Lockey
Oct 3, 2008·Neurosurgical Focus·Shirley I Stiver, Geoffrey T Manley
Jun 28, 2006·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Daniel G Hankins
Jun 28, 2006·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Tami O Tiamfook-MorganStephen H Thomas
Dec 16, 2006·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Daniel P DavisLinda Robinson
Apr 16, 2013·Annals of Emergency Medicine·M Kit DelgadoJeremy D Goldhaber-Fiebert
Feb 18, 2006·Critical Care Medicine·Daniel P DavisDavid B Hoyt
Sep 18, 2007·Resuscitation·Daniel P Davis
Nov 28, 2006·The Surgical Clinics of North America·Eileen M Bulger, Ronald V Maier
Aug 13, 2014·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Daniel W SpaiteKurt R Denninghoff
Oct 4, 2005·Journal of Emergency Nursing : JEN : Official Publication of the Emergency Department Nurses Association·Dianne M Danis
Jul 28, 2005·Annals of Emergency Medicine·Daniel P DavisDavid B Hoyt
Nov 9, 2012·The Journal of Trauma and Acute Care Surgery·Julie MayglothlingUNKNOWN Eastern Association for the Surgery of Trauma
Oct 13, 2006·Current Opinion in Anaesthesiology·Venkatesh Srinivasa, Bhavani Shankar Kodali
Nov 14, 2006·The Journal of Trauma·Susanne TracyJoseph J Tepas
Apr 12, 2008·The Journal of Trauma·Daniel P DavisDavid B Hoyt
May 15, 2010·Forensic Science, Medicine, and Pathology·Christopher J O'Donnell, Melissa A Baker
Apr 5, 2008·Current Opinion in Critical Care·Daniel P Davis

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Brain Injury & Trauma

brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.