Document Detail

Prevalence of prehospital hypoxemia and oxygen use in trauma patients.
MedLine Citation:
PMID:  24083926     Owner:  NLM     Status:  MEDLINE    
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.
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
Aged, 80 and over
Anoxia / therapy*
Brain Injuries / therapy
Emergency Medical Services
Guideline Adherence*
Hypotension / therapy
Middle Aged
Oxygen Inhalation Therapy / utilization*
Practice Guidelines as Topic
Prospective Studies
Wounds and Injuries / therapy*
Young Adult
Grant Support

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

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