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Advanced trauma care should wait till hospital

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Advanced life support should be given to trauma patients on arrival at hospital and not at the scene, according to Canadian researchers.

Latest findings from an ongoing study called the Ontario Prehospital Advanced Life Support project shows there is no benefit, and perhaps harm, in paramedics providing advanced life support to patients with trauma injuries prior to transport to hospital.

There was almost no difference in survival rates among 1,373 major trauma patients who received basic life support – oxygen, ventilation with a bag valve mask, immobilisation and dressings – and 1,494 who received advanced life support – endotracheal intubation and intravenous fluid therapy. The survival rates to discharge were 81.1% versus 81.8%, respectively.

‘Our findings support those who believe that definitive trauma care is best provided in the operating room and that pre-hospital interventions may be associated with increased complications or may delay transfer to hospital,’ said the authors online in the Canadian Medical Association Journal.

'The implications of this study are that community emergency medical services should carefully re-evaluate the use of advanced life-support measures for most trauma patients,' they added.

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Readers' comments (1)

  • sadly this research has arrived too late for all those multi-disciplinary A&E units which have been downsized or closed across the country, in favour of A&E units in major hospitals often impossible to access easily and quickly from trauma sites.

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