| Prehospital intubation in patients with severe head injury. | |
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MedLine Citation:
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PMID: 11130490 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Prehospital intubation and airway control is routinely performed by paramedics in critically injured patients. Despite the advantages provided by this procedure, numerous potential risks exist when this is performed in the field. We reviewed the outcome of patients with severe head injury, to determine whether prehospital intubation is associated with an improved outcome. METHODS: A retrospective review of registry data of patients admitted to an urban trauma center with severe head injury (field Glasgow Coma Scale score of < or =8 and head Abbreviated Injury Scale score of > or =3) was performed. Patients were stratified by methods of airway control performed by prehospital personnel: not intubated, intubated, or unsuccessful intubation. Mortality was determined for each group. To control for significant variables between these populations, matching and multivariate analysis were performed. RESULTS: Patients requiring prehospital intubation or in whom intubation was attempted had an increased mortality (81% and 77%, respectively) when compared with nonintubated patients (43%). The mortality for patients who had prehospital intubation performed did not demonstrate an improved survival using matching. In fact, intubated patients had a significantly higher relative risk (RR) of mortality when compared with nonintubation (RR = 1.74,p < 0.001) and unsuccessful intubation patients (RR = 1.53, p = 0.008) CONCLUSION: For patients with severe head injury, prehospital intubation did not demonstrate an improvement in survival. Further prospective randomized trials are necessary to confirm these results. |
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Authors:
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J A Murray; D Demetriades; T V Berne; S J Stratton; H G Cryer; F Bongard; A Fleming; D Gaspard |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of trauma Volume: 49 ISSN: 0022-5282 ISO Abbreviation: J Trauma Publication Date: 2000 Dec |
Date Detail:
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Created Date: 2000-12-20 Completed Date: 2001-01-11 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0376373 Medline TA: J Trauma Country: United States |
Other Details:
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Languages: eng Pagination: 1065-70 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgery, Los Angeles County, University of Southern California Medical Center, Los Angeles County Department of Health Services, 90033, USA. jamurray@hsc.usc.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Child Craniocerebral Trauma / mortality*, therapy* Emergency Treatment / statistics & numerical data* Female Glasgow Coma Scale Humans Injury Severity Score Intubation, Intratracheal* Logistic Models Los Angeles / epidemiology Male Outcome Assessment (Health Care)* Registries Retrospective Studies Risk Factors Survival Analysis |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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