TY - JOUR
T1 - On-scene time and outcome after penetrating trauma: an observational study
AU - Funder, Kamillia S.
AU - Steinmetz, Jacob
AU - Petersen, John Asger
AU - Petersen, John Asger
PY - 2011/9
Y1 - 2011/9
N2 - Background: Controversies exist as to whether one should rely on the 'scoop and run' or 'stay and play' approach in the case of penetrating trauma in the prehospital setting. Optimal prehospital care is much debated and the extent to which advanced life support (ALS) measures should be performed remains unclear. This study aimed to report the outcome of penetrating torso trauma in relation to the on-scene time and ALS procedures performed prehospitally. It was hypothesised that a longer on-scene time could predict a higher mortality after penetrating torso trauma. Methods: This was an observational cohort study of penetrating trauma patients treated by the Mobile Emergency Care Unit in Copenhagen with a 30-day follow-up. Between January 2002 and September 2009, data were prospectively registered regarding the anatomical location of the trauma, time intervals and procedures performed in the prehospital setting. Follow-up data were obtained from a national administrative database. The primary end point was 30-day survival. Results: Of the 467 patients registered, 442 (94.6%) were identified at the 30-day follow-up, of whom 40 (9%) were dead. A higher mortality was found among patients treated on-scene for more than 20 min (p=0.0001), although on-scene time was not a significant predictor of 30-day mortality in the multivariate analysis; OR 3.71, 95% CI 0.66 to 20.70 (p=0.14). The number of procedures was significantly correlated to a higher mortality in the multivariate analysis. Conclusion: On-scene time might be important in penetrating trauma, and ALS procedures should not delay transport to definite care at the hospital.
AB - Background: Controversies exist as to whether one should rely on the 'scoop and run' or 'stay and play' approach in the case of penetrating trauma in the prehospital setting. Optimal prehospital care is much debated and the extent to which advanced life support (ALS) measures should be performed remains unclear. This study aimed to report the outcome of penetrating torso trauma in relation to the on-scene time and ALS procedures performed prehospitally. It was hypothesised that a longer on-scene time could predict a higher mortality after penetrating torso trauma. Methods: This was an observational cohort study of penetrating trauma patients treated by the Mobile Emergency Care Unit in Copenhagen with a 30-day follow-up. Between January 2002 and September 2009, data were prospectively registered regarding the anatomical location of the trauma, time intervals and procedures performed in the prehospital setting. Follow-up data were obtained from a national administrative database. The primary end point was 30-day survival. Results: Of the 467 patients registered, 442 (94.6%) were identified at the 30-day follow-up, of whom 40 (9%) were dead. A higher mortality was found among patients treated on-scene for more than 20 min (p=0.0001), although on-scene time was not a significant predictor of 30-day mortality in the multivariate analysis; OR 3.71, 95% CI 0.66 to 20.70 (p=0.14). The number of procedures was significantly correlated to a higher mortality in the multivariate analysis. Conclusion: On-scene time might be important in penetrating trauma, and ALS procedures should not delay transport to definite care at the hospital.
U2 - 10.1136/emj.2010.097535
DO - 10.1136/emj.2010.097535
M3 - Journal article
C2 - 20935332
SN - 1472-0205
SP - 797
EP - 801
JO - Emergency Medicine Journal
JF - Emergency Medicine Journal
ER -