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European Journal of Trauma and Emergency Surgery

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01.02.2013 | Original Article

Prehospital care in patients with severe traumatic brain injury: does the level of prehospital care influence mortality?

verfasst von: M. M. F. Aubuchon, B. Hemmes, M. Poeze, J. Jansen, P. R. G. Brink

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 1/2013

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Abstract

Introduction and purpose

The controversy between the “scoop and run” versus the “stay and play” approach in severely injured trauma patients has been an ongoing issue for decades. The present study was undertaken to investigate whether changes in prehospital care for patients with severe traumatic brain injury in the Netherlands have improved outcome.

Methods

In this retrospective study, files (n = 60) were analyzed from a prospectively collected database including all patients admitted to one of six hospitals in the Limburg region in the Netherlands with a Glasgow Coma Scale (GCS) score ≤8 on admittance over the period from January 2006 to December 2008. All patients had traumatic brain damage proven on computed tomography (CT) or magnetic resonance imaging (MRI). Relevant prehospital and clinical data from the present cohort were compared to data from a similar study (n = 30) conducted 20 years ago. The primary outcome assessed was mortality.

Results

The two study groups had similar characteristics with regard to the GCS score. In the historic cohort, Basic Life Support (BLS) and the “scoop and run” approach in patients with major traumatic brain injury was common, with an average time on scene of 7.5 min. Currently, prehospital care is performed mainly on the level of prehospital Advanced Life Support (ALS), with the average time on scene being about four times as long as in the historic cohort. However, the overall mortality rate for the current cohort compared to the historic cohort has not changed.

Conclusion

Despite more on-site ALS in severely head injured patients nowadays compared to the historic cohort, there was no reduction in mortality.

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Titel: Prehospital care in patients with severe traumatic brain injury: does the level of prehospital care influence mortality?
verfasst von: M. M. F. Aubuchon
B. Hemmes
M. Poeze
J. Jansen
P. R. G. Brink
Publikationsdatum: 01.02.2013
Verlag: Springer-Verlag
Erschienen in: European Journal of Trauma and Emergency Surgery / Ausgabe 1/2013
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-012-0218-6

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Prehospital care in patients with severe traumatic brain injury: does the level of prehospital care influence mortality?

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