Ambulance management of patients with penetrating truncal trauma and hypotension in Melbourne, Australia.
ambulance
emergency medical service
fluid resuscitation
hypotension
penetrating truncal trauma
Journal
Emergency medicine Australasia : EMA
ISSN: 1742-6723
Titre abrégé: Emerg Med Australas
Pays: Australia
ID NLM: 101199824
Informations de publication
Date de publication:
04 2020
04 2020
Historique:
received:
12
08
2019
revised:
12
11
2019
accepted:
27
11
2019
pubmed:
13
2
2020
medline:
19
8
2021
entrez:
13
2
2020
Statut:
ppublish
Résumé
Penetrating truncal trauma with hypotension is uncommon in Australia. Current pre-hospital clinical practice guidelines based on overseas studies recommend expedited transport to definitive trauma care and that i.v. fluid should only be administered to maintain palpable blood pressure. A retrospective review included all adult patients with penetrating truncal trauma and hypotension (systolic blood pressure <90 mmHg) attended by emergency medical services in Victoria between January 2006 and December 2018. Patient pre-hospital characteristics and hospital outcomes are described using descriptive statistics. Predictors of fluid resuscitation and mortality were examined using logistic regression analyses. Between 2006 and 2018 there were 101 hypotensive, penetrating truncal injury major trauma patients in Melbourne, Victoria transported by road ambulance to a major trauma service. The median age of these patients was 38 years (interquartile range [IQR] 27-50) and 85% were male. Median scene time was 16.6 min (IQR 12-26) and median pre-hospital time was 53.0 min (IQR 38-66). Intravenous fluid resuscitation was given in 54.5% of cases. The mechanism of injury was stabbing in 91.1% and gunshot wound in 8.9%. Urgent surgery was required in 72.3% of cases, 32.7% of patients were admitted to the intensive care unit and there were eight deaths (8.3%). Penetrating truncal trauma with hypotension is rare in Melbourne, Australia with most patients having the injury caused by stabbing rather than shooting. Compared with outcomes reported in the USA and Europe, the mortality rate is low.
Identifiants
pubmed: 32048445
doi: 10.1111/1742-6723.13450
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
336-343Subventions
Organisme : Transport Accident Commission
Pays : International
Organisme : Department of Health and Human Services, State Government of Victoria
Pays : International
Informations de copyright
© 2020 Australasian College for Emergency Medicine.
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