格拉斯哥昏迷评分13或14分的创伤患者的院前快速顺序插管及随后颅内病变的发生率。
Prehospital rapid-sequence intubation of patients with trauma with a Glasgow Coma Score of 13 or 14 and the subsequent incidence of intracranial pathology.
作者信息
Ellis Daniel Y, Davies Gareth E, Pearn John, Lockey David
机构信息
Department of Pre-hospital Care, The Royal London Hospital, London, UK.
出版信息
Emerg Med J. 2007 Feb;24(2):139-41. doi: 10.1136/emj.2006.040428.
Abstract
AIM
To identify the incidence of intracranial pathology in a population of patients with trauma with an on-scene Glasgow Coma Score (GCS) of 13 or 14, and the proportion that required prehospital intubation and ventilation.
METHOD
A retrospective review of a prehospital trauma database was carried out over a 12-month period, and 81 patients were reviewed. All had a traumatic mechanism of injury and had an on-scene GCS of 13 or 14 recorded by a prehospital doctor. 43 patients required prehospital rapid-sequence intubation. Overall, 31.5% of patients with a GCS of 13 or 14 had an abnormal computed tomography scan of the head and 20.5% had an intracranial haemorrhage.
RESULTS
For this group of patients with trauma with a drop of only one or two points on the GCS, the incidence of intracranial pathology was almost one in three and that of intracranial haemorrhage was one in five.
摘要
目的
确定现场格拉斯哥昏迷评分（GCS）为13或14分的创伤患者群体中颅内病变的发生率，以及需要院前插管和通气的比例。
方法
对一个院前创伤数据库进行了为期12个月的回顾性研究，共审查了81例患者。所有患者均有创伤性损伤机制，且院前医生记录的现场GCS为13或14分。43例患者需要院前快速顺序插管。总体而言，GCS为13或14分的患者中，31.5%的头部计算机断层扫描异常，20.5%有颅内出血。
结果
对于这组GCS仅下降一或两分的创伤患者，颅内病变的发生率几乎为三分之一，颅内出血的发生率为五分之一。
相似文献
1
Prehospital rapid-sequence intubation of patients with trauma with a Glasgow Coma Score of 13 or 14 and the subsequent incidence of intracranial pathology.
Emerg Med J. 2007 Feb;24(2):139-41. doi: 10.1136/emj.2006.040428.
2
Emergent intubation and CT scan pathology of blunt trauma patients with Glasgow Coma Scale scores of 3-13.
Prehosp Disaster Med. 1993 Jul-Sep;8(3):229-36. doi: 10.1017/s1049023x00040413.
3
Prehospital rapid sequence intubation for head trauma: conditions for a successful program.
J Trauma. 2006 May;60(5):997-1001. doi: 10.1097/01.ta.0000217285.94057.5e.
4
A comparison of the prehospital motor component of the Glasgow coma scale (mGCS) to the prehospital total GCS (tGCS) as a prehospital risk adjustment measure for trauma patients.
Prehosp Emerg Care. 2014 Jan-Mar;18(1):68-75. doi: 10.3109/10903127.2013.844870.
5
Should trauma patients with a Glasgow Coma Scale score of 3 be intubated prior to hospital arrival?
Prehosp Disaster Med. 2010 Nov-Dec;25(6):541-6. doi: 10.1017/s1049023x00008736.
6
Is prehospital endotracheal intubation associated with improved outcomes in isolated severe head injury? A matched cohort analysis.
Prehosp Disaster Med. 2014 Feb;29(1):32-6. doi: 10.1017/S1049023X13008947. Epub 2013 Dec 13.
7
Prehospital non-drug assisted intubation for adult trauma patients with a Glasgow Coma Score less than 9.
Emerg Med J. 2013 Nov;30(11):935-41. doi: 10.1136/emermed-2012-201578. Epub 2012 Nov 10.
8
The Impact of Prehospital Intubation With and Without Sedation on Outcome in Trauma Patients With a GCS of 8 or Less.
J Neurosurg Anesthesiol. 2017 Apr;29(2):161-167. doi: 10.1097/ANA.0000000000000275.
9
Does increased prehospital replacement volume lead to a poor clinical course and an increased mortality? A matched-pair analysis of 1896 patients of the Trauma Registry of the German Society for Trauma Surgery who were managed by an emergency doctor at the accident site.
Injury. 2013 May;44(5):611-7. doi: 10.1016/j.injury.2012.02.004. Epub 2012 Feb 28.
10
[Emergency anesthesia, airway management and ventilation in major trauma. Background and key messages of the interdisciplinary S3 guidelines for major trauma patients].
Anaesthesist. 2011 Nov;60(11):1027-40. doi: 10.1007/s00101-011-1957-1.
引用本文的文献
1
A retrospective review of patients with significant traumatic brain injury transported by emergency medical services within the south east of England.
Br Paramed J. 2019 Mar 1;3(4):1-7. doi: 10.29045/14784726.2019.03.3.4.1.
2
Pre-hospital anaesthesia and assessment of head injured patients presenting to a UK Helicopter Emergency Medical Service with a high Glasgow Coma Scale: a cohort study.
BMJ Open. 2019 Feb 19;9(2):e023307. doi: 10.1136/bmjopen-2018-023307.
3
Hypoxia and hypotension in patients intubated by physician staffed helicopter emergency medical services - a prospective observational multi-centre study.
BMC Emerg Med. 2017 Jul 11;17(1):22. doi: 10.1186/s12873-017-0134-5.
4
[Intensive care treatment of traumatic brain injury in multiple trauma patients : Decision making for complex pathophysiology].
Unfallchirurg. 2017 Sep;120(9):739-744. doi: 10.1007/s00113-017-0344-z.
5
AAGBI: Safer pre-hospital anaesthesia 2017: Association of Anaesthetists of Great Britain and Ireland.
Anaesthesia. 2017 Mar;72(3):379-390. doi: 10.1111/anae.13779. Epub 2017 Jan 3.
6
Revisiting the value of pre-hospital tracheal intubation: an all time systematic literature review extracting the Utstein airway core variables.
Crit Care. 2011;15(1):R26. doi: 10.1186/cc9973. Epub 2011 Jan 18.
7
A consensus-based template for uniform reporting of data from pre-hospital advanced airway management.
Scand J Trauma Resusc Emerg Med. 2009 Nov 20;17:58. doi: 10.1186/1757-7241-17-58.
本文引用的文献
1
Out-of-hospital endotracheal intubation: half empty or half full?
Ann Emerg Med. 2006 Jun;47(6):542-4. doi: 10.1016/j.annemergmed.2006.01.023. Epub 2006 Feb 28.
2
Out-of-hospital endotracheal intubation: where are we?
Ann Emerg Med. 2006 Jun;47(6):532-41. doi: 10.1016/j.annemergmed.2006.01.016. Epub 2006 Feb 28.
3
A meta-analysis of prehospital care times for trauma.
Prehosp Emerg Care. 2006 Apr-Jun;10(2):198-206. doi: 10.1080/10903120500541324.
4
Factors influencing emergency intubation in the pre-hospital setting--a multicentre study in the German Helicopter Emergency Medical Service.
Br J Anaesth. 2006 Jan;96(1):67-71. doi: 10.1093/bja/aei275. Epub 2005 Nov 25.
5
A follow-up analysis of factors associated with head-injury mortality after paramedic rapid sequence intubation.
J Trauma. 2005 Aug;59(2):486-90. doi: 10.1097/00005373-200508000-00037.
6
Ventilation patterns in patients with severe traumatic brain injury following paramedic rapid sequence intubation.
Neurocrit Care. 2005;2(2):165-71. doi: 10.1385/NCC:2:2:165.
7
The impact of prehospital endotracheal intubation on outcome in moderate to severe traumatic brain injury.
J Trauma. 2005 May;58(5):933-9. doi: 10.1097/01.ta.0000162731.53812.58.
8
The impact of hypoxia and hyperventilation on outcome after paramedic rapid sequence intubation of severely head-injured patients.
J Trauma. 2004 Jul;57(1):1-8; discussion 8-10. doi: 10.1097/01.ta.0000135503.71684.c8.
9
Guidelines for emergency tracheal intubation immediately after traumatic injury.
J Trauma. 2003 Jul;55(1):162-79. doi: 10.1097/01.ta.0000083335.93868.2c.
10
The effect of paramedic rapid sequence intubation on outcome in patients with severe traumatic brain injury.
J Trauma. 2003 Mar;54(3):444-53. doi: 10.1097/01.TA.0000053396.02126.CD.
Zotero 插件