Document Detail


Prevalence of prehospital hypoxemia and oxygen use in trauma patients.
MedLine Citation:
PMID:  24083926     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: This study estimates the prevalence of injured patients requiring prehospital supplemental oxygen based on existing recommendations, and determines whether actual use exceeds those recommendations.
PATIENTS AND METHODS: Prehospital oxygen use and continuous peripheral oxygen saturation measurements were prospectively collected on a purposive sample of injured civilians transported to an urban level 1 trauma center by paramedics. Structured chart review determined injury characteristics and outcomes. Supplemental oxygen administration indications were hypoxemia (peripheral oxygen saturation ≤ 90%), hemorrhagic shock (systolic blood pressure < 100 mmHg), or paramedic suspicion of traumatic brain injury.
RESULTS: Paramedics enrolled 224/290 screened subjects. Median (range) age was 34 (18-84) years, 48.7% were nonwhite, 75.4% were male, and Injury Severity Score was 5 (1-75). Half (54.5%) were admitted; 36.2% sustained a penetrating injury. None underwent prehospital endotracheal intubation. Hypoxemia occurred in 86 (38.4%), paramedics suspected traumatic brain injury in 22 (9.8%), and 20 (8.9%) were hypotensive. Any indication for supplemental oxygen (107/224 [47.8%, 95%CI 41.3%-54.3%]) and prehospital administration of oxygen (141/224 [62.9%, 95%CI 56.2%-69.2%]) was common. Many (35/141 [24.8%]) received oxygen without indication.
CONCLUSIONS: On the basis of current guidelines, less than half of adult trauma patients have an indication for prehospital supplemental oxygen, yet is frequently administered in the absence of clinical indication.
Authors:
Jason McMullan; Dario Rodriquez; Kimberly Ward Hart; Christopher J Lindsell; Kay Vonderschmidt; Beth Wayne; Richard Branson
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Publication Detail:
Type:  Journal Article; Observational Study; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Military medicine     Volume:  178     ISSN:  1930-613X     ISO Abbreviation:  Mil Med     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-10-02     Completed Date:  2014-06-30     Revised Date:  2014-08-07    
Medline Journal Info:
Nlm Unique ID:  2984771R     Medline TA:  Mil Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1121-5     Citation Subset:  IM    
Copyright Information:
Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Anoxia / therapy*
Brain Injuries / therapy
Emergency Medical Services
Female
Guideline Adherence*
Humans
Hypotension / therapy
Male
Middle Aged
Oxygen Inhalation Therapy / utilization*
Practice Guidelines as Topic
Prospective Studies
Wounds and Injuries / therapy*
Young Adult
Grant Support
ID/Acronym/Agency:
5UL1RR026314-03/RR/NCRR NIH HHS; UL1 RR026314/RR/NCRR NIH HHS; UL1 TR000077/TR/NCATS NIH HHS
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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