P10. The influence of prehospital time on trauma patient outcome: a systematic review

A.M.K. Harmsen, G.F. Giannakopoulos, P.R. Moerbeek, E.P. Jansma, H.J. Bonjer, F.W. Bloemers

Donderdag 28 mei 2015

12:00 - 13:00u
Categorieën: posters

Parallel sessie: Posters

Time is considered an essential determinant in the care of trauma patients. Salient tenet of trauma care is the ‘golden hour’, the immediate time after injury when resuscitation and stabilization are perceived to be most beneficial. Several prehospital strategies exist regarding time and transport of trauma patients. Literature shows little empirical knowledge on the exact influence of prehospital times on trauma patient outcome. The objective of this study was to systematically review the correlation between prehospital time intervals and the outcome of trauma atients.

A systematic review was performed. Studies reporting on prehospital time intervals for Emergency Medical Services (EMS), outcome potential confounders for trauma patients were included. The primary outcome was the influence on mortality.

Twenty level III-evidence articles were considered eligible for this systematic review. Results demonstrate a decreased in odds of mortality for the undifferentiated trauma patient when response-time or transfer-time are shorter. On the contrary increased on-scene time and total prehospital time are associated with increase odds of survival for this population. Nevertheless rapid transport does seem beneficial for patients suffering penetrating trauma, in particular hypotensive penetratingly injured patients and patients with a traumatic brain injury.

Swift transport is beneficial for patients suffering neurotrauma and the hemodynamically unstable penetratingly injured patient. For hemodynamically stable undifferentiated trauma patients, increased on-scene-time and total prehospital time does not increase odds of mortality. For undifferentiated trauma patients, focus should be on the type of care delivered prehospital and not on rapid transport.