Pre-Hospital Endotracheal Intubation and Positive Pressure Ventilation Is Associated with Hypotension and Decreased Survival in Hypovolemic Trauma Patients: An Analysis of the National Trauma Data Bank

Shafi, Shahid; Gentilello, Larry M.

doi:10.1097/01.ta.0000196434.88182.77

Cited by 81 publications

(48 citation statements)

References 35 publications

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“…In the prehospital setting, several studies have explored the efficacy of ETI in trauma and pediatric patients. [38][39][40][41][42] These studies have suggested that prehospital ETI may lead to an increase in mortality in these specific patient populations, although their retrospective, nonrandomized designs do not permit evaluation of casuality. Results from the current study indicated that individuals experiencing OOHCA may be another subset of prehospital patients who experience increased mortality when receiving prehospital ETI.…”

Section: Discussionmentioning

confidence: 99%

The Association Between Prehospital Endotracheal Intubation Attempts and Survival to Hospital Discharge Among Out‐of‐hospital Cardiac Arrest Patients

Studnek

Thestrup

Vandeventer

et al. 2010

Academic Emergency Medicine

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Objectives: The benefit of prehospital endotracheal intubation (ETI) among individuals experiencing out-of-hospital cardiac arrest (OOHCA) has not been fully examined. The objective of this study was to determine if prehospital ETI attempts were associated with return of spontaneous circulation (ROSC) and survival to discharge among individuals experiencing OOHCA.Methods: This retrospective study included individuals who experienced a medical cardiac arrest between July 2006 and December 2008 and had resuscitation efforts initiated by paramedics from Mecklenburg County, North Carolina. Outcome variables were prehospital ROSC and survival to hospital discharge, while the primary independent variable was the number of prehospital ETI attempts.Results: There were 1,142 cardiac arrests included in the analytic data set. Prehospital ROSC occurred in 299 individuals (26.2%). When controlling for initial arrest rhythm and other confounding variables, individuals with no ETI attempted were 2.33 (95% confidence interval [CI] = 1.63 to 3.33) times more likely to have ROSC compared to those with one successful ETI attempt. Of the 299 individuals with prehospital ROSC, 118 (39.5%) were subsequently discharged alive from the hospital. Individuals having no ETI were 5.46 (95% CI = 3.36 to 8.90) times more likely to be discharged from the hospital alive compared to individuals with one successful ETI attempt. Conclusions:Results from these analyses suggest a negative association between prehospital ETI attempts and survival from OOHCA. In this study, the individuals most likely to have prehospital ROSC and survival to hospital discharge were those who did not have a reported ETI attempt. Further comparative research should assess the potential causes of the demonstrated associations.ACADEMIC EMERGENCY MEDICINE 2010; 17:918-925 ª

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Section: Discussionmentioning

confidence: 99%

The Association Between Prehospital Endotracheal Intubation Attempts and Survival to Hospital Discharge Among Out‐of‐hospital Cardiac Arrest Patients

Studnek

Thestrup

Vandeventer

et al. 2010

Academic Emergency Medicine

View full text Add to dashboard Cite

show abstract

“…[22] Current thinking prioritizes methods for the decrease of pre-hospital time by addressing only life-threatening injuries through control of bleeding, cervical-spine stabilization, and similar interventions. [23] Rapid transport to the hospital is critically important. [24] In the current study, the interval between the accident and hospitalization was 41.3±79.8 minutes and most patients arrived at the hospital 30-60 minutes after trauma.…”

Section: Discussionmentioning

confidence: 99%

Trauma patterns in patients attending the Emergency Department of Jazan General Hospital, Saudi Arabia

Hokkam¹,

Gonna²,

Zakaria³

et al. 2015

World Journal of Emergency Medicine

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BACKGROUND: Modern civilization and the sharp rise in living standards have led to dramatic changes in trauma pattern in Saudi Arabia. This study aimed to describe the different patterns of injuries of patients attending the Emergency Department of Jazan General Hospital (JGH) in the southwest corner of Saudi Arabia. METHODS:A total number of 1 050 patients were enrolled in the study. A pre-organized data sheet was prepared for each patient attended the Emergency Department of JGH from February 2012 to January 2013. It contains data about socio-demographics, trauma data, clinical evaluation results, investigations as well as treatment strategies. RESULTS:The mean age of the patients was 25.3±16.8 years. Most (45.1%) of the patients were at age of 18-30 years. Males (64.3%) were affected by trauma more common than females. More than half (60.6%) of the patients were from urban areas. The commonest kind of injury was minor injury (60%), followed by blunt trauma (30.9%) and then penetrating trauma (9.1%). The mean time from the incident to arrival at hospital was 41.3±79.8 minutes. The majority (48.2%) of the patients were discharged after management of trivial trauma, whereas 2.3% were admitted to ICU, 7.7% transferred to inpatient wards, and 17.7% observed and subsequently discharged. The mortality rate of the patients was 2.6%.CONCLUSION: Trauma is a major health problem, especially in the young population in Saudi Arabia. Blunt trauma is more frequent than penetrating trauma, with road traffi c accidents accounting for the majority.

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“…Key objective data points collected were defined as factors known to affect patient care or outcomes during EMS and ED care transfers (2,3,(6)(7)(8)(9)(10)(11)(12). The tabulated information included heart rate, blood pressure, respiratory rate, the Glasgow Coma Scale/level of consciousness (GCS/LOC), and eight demographic data points (i.e., age, medical history, allergies, medications, events surrounding the chief complaint, active problems/ injuries, intravenous access, and treatment given before arrival).…”

Section: Data Collectionmentioning

confidence: 99%

The Impact of Professionalism on Transfer of Care to the Emergency Department

Panchal¹,

Gaither²,

Svirsky³

et al. 2015

The Journal of Emergency Medicine

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Pre-Hospital Endotracheal Intubation and Positive Pressure Ventilation Is Associated with Hypotension and Decreased Survival in Hypovolemic Trauma Patients: An Analysis of the National Trauma Data Bank

Abstract: Pre-hospital endotracheal intubation in trauma patients is associated with hypotension and decreased survival. This may be mediated by the effect of positive pressure ventilation during hypovolemic states.

Cited by 81 publications

References 35 publications

The Association Between Prehospital Endotracheal Intubation Attempts and Survival to Hospital Discharge Among Out‐of‐hospital Cardiac Arrest Patients

The Association Between Prehospital Endotracheal Intubation Attempts and Survival to Hospital Discharge Among Out‐of‐hospital Cardiac Arrest Patients

Trauma patterns in patients attending the Emergency Department of Jazan General Hospital, Saudi Arabia

The Impact of Professionalism on Transfer of Care to the Emergency Department

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