Singbartl G
Anasth Intensivther Notfallmed. 1985 Oct;20(5):251-60.
In a prospective study in 147 unconscious patients (Glasgow-Coma-Scale less than or equal to 7) we examined the relevance of preclinical care for posttraumatic prognosis-basic life support (BLS) referring to ventilation/oxygenation and circulation, as well as advanced trauma-specific treatment (ATT) referring to medication and positioning. Procedures providing oxygenation and stable cardiovascular function are found to be most important. The overall survival rate amounts to 53.7 per cent (79 of 147 patients). Whereas 56.6 per cent (77 of 136 patients) of the patients being preclinically attended by a physician, survive, the survival rate is only 18.2 per cent (2 of 11 patients) among those not medically cared for. 31.9 per cent (47 of 147 patients) receive trauma-adequate optimal prehospital care, and an additional 29.2 per cent (43 of 147 patients) obtain an acceptable treatment, whereas the remaining 38.8 per cent (57 of 147 patients) must be considered insufficiently for care. Patients with optimal preclinical care have a statistically significant higher survival rate in comparison to the whole group of patients-70.2 per cent vs. 53.7 per cent-and to those receiving a less sufficient attention-70.2 per cent vs. 46.0 per cent. Besides the severity of the cerebral trauma, the quality of the preclinical medical attention, too, has been proven to be of great importance for post-traumatic course and outcome in patients with severe head injury.
在一项针对147名昏迷患者（格拉斯哥昏迷量表评分小于或等于7分）的前瞻性研究中，我们研究了院前护理对创伤后预后的相关性——基础生命支持（BLS）涉及通气/氧合和循环，以及高级创伤特异性治疗（ATT）涉及药物治疗和体位摆放。发现提供氧合和稳定心血管功能的措施最为重要。总生存率为53.7%（147名患者中的79名）。在院前由医生护理的患者中，生存率为56.6%（136名患者中的77名），而在未接受医疗护理的患者中，生存率仅为18.2%（11名患者中的2名）。31.9%（147名患者中的47名）接受了充分的最佳院前护理，另外29.2%（147名患者中的43名）获得了可接受的治疗，而其余38.8%（147名患者中的57名）的护理必须被认为是不足的。与整个患者组相比，接受最佳院前护理的患者生存率在统计学上显著更高——70.2%对53.7%——与那些接受较少充分关注的患者相比——70.2%对46.0%。除了脑外伤的严重程度外，院前医疗护理的质量也已被证明对重型颅脑损伤患者的创伤后病程和结局非常重要。
