Severe traumatic brain injury- physician provided pre-hospital care and early neurosurgical treatment are associated with improved survival

Toni Pakkanen,Ilkka Virkkunen,Antti Kämäräinen,Arvi Yli-Hankala,Heini Huhtala,Tom Silfvast,Tarja Randell

doi:10.1186/1757-7241-23-s2-o9

Abstract

Method A 6-year period observational data on pre-hospital TBI management in physician versus paramedic staffed EMS systems were retrospectively analysed. Inclusion criteria were isolated TBI with Glasgow coma scale (GCS) ≤ 8 on-scene or during transportation. Patients with lifethreatening multiple trauma, secondary transfers and patients deceased on-scene were excluded. Evaluation was based on patient records one year after the incident. For assessment of neurological outcome, modified Glasgow Outcome Score (GOS) was used. The time and cause of death were recorded.

Highlights

Worldwide, traumatic brain injury (TBI) is a leading cause of death and permanent disability [1]
And appropriate management of TBI is critical to the survival of these patients [1]
The aim of this study was to compare the outcome of TBI patients in two emergency medical service (EMS) systems

Summary

Introduction

Traumatic brain injury (TBI) is a leading cause of death and permanent disability [1]. And appropriate management of TBI is critical to the survival of these patients [1]. The aim of this study was to compare the outcome of TBI patients in two emergency medical service (EMS) systems. Outcome was observed favouring physician provided pre-hospital care - 38 % of the physician and 31 % of the paramedic treated EMS patients had a good neurological recovery (GOS 4-5) with independent life one year after the event. The overall oneyear mortality rate was lower in the physician staffed EMS group: 43 % vs 57 % (p < 0.01)

Objectives

Methods

Results

Conclusion