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dc.contributor.authorSunde Geir Arne
dc.contributor.authorSandberg Marten
dc.contributor.authorLyon Richard
dc.contributor.authorFredriksen Knut
dc.contributor.authorBurns Brian
dc.contributor.authorHufthammer Karl Ove
dc.contributor.authorRoislien Jo
dc.contributor.authorSoti Akos
dc.contributor.authorJäntti Helena
dc.contributor.authorLockey David
dc.contributor.authorHeltne Jon-Kenneth
dc.contributor.authorSollid Stephen JM
dc.date.accessioned2017-12-18T08:17:38Z
dc.date.available2017-12-18T08:17:38Z
dc.date.issued2017
dc.identifier.urihttps://erepo.uef.fi/handle/123456789/5086
dc.description.abstractBackground The effective treatment of airway compromise in trauma and non-trauma patients is important. Hypoxia and hypotension are predictors of negative patient outcomes and increased mortality, and may be important quality indicators of care provided by emergency medical services. Excluding cardiac arrests, critical trauma and non-trauma patients remain the two major groups to which helicopter emergency medical services (HEMS) are dispatched. Several studies describe the impact of pre-hospital hypoxia or hypotension on trauma patients, but few studies compare this in trauma and non-trauma patients. The primary aim was to describe the incidence of pre-hospital hypoxia and hypotension in the two groups receiving pre-hospital tracheal intubation (TI) by physician-staffed HEMS. Methods Data were collected prospectively over a 12-month period, using a uniform Utstein-style airway template. Twenty-one physician-staffed HEMS in Europe and Australia participated. We compared peripheral oxygen saturation and systolic blood pressure before and after definitive airway management. Data were analysed using Cochran–Mantel–Haenszel methods and mixed-effects models. Results Eight hundred forty three trauma patients and 422 non-trauma patients receiving pre-hospital TI were included. Non-trauma patients had significantly lower predicted mean pre-intervention SpO2 compared to trauma patients. Post-intervention and admission SpO2 for the two groups were comparable. However, 3% in both groups were still hypoxic at admission. For hypotension, the differences between the groups were less prominent. However, 9% of trauma and 10% of non-trauma patients were still hypotensive at admission. There was no difference in short-term survival between trauma (97%) and non-trauma patients (95%). Decreased level of consciousness was the most frequent indication for TI, and was associated with increased survival to hospital (cOR 2.8; 95% CI: 1.4–5.4). Conclusions Our results showed that non-trauma patients had a higher incidence of hypoxia before TI than trauma patients, but few were hypoxic at admission. The difference for hypotension was less prominent, but one in ten patients were still hypotensive at admission. Further investigations are needed to identify reversible causes that may be corrected to improve haemodynamics in the pre-hospital setting. We found high survival rates to hospital in both groups, suggesting that physician-staffed HEMS provide high-quality emergency airway management in trauma and non-trauma patients.en
dc.language.isoENen
dc.publisherSpringer Natureen
dc.relation.ispartofseriesBMC Emergency Medicineen
dc.relation.urihttp://dx.doi.org/10.1186/s12873-017-0134-5en
dc.rightsCC BY http://creativecommons.org/licenses/by/4.0/en
dc.subjectPhysician staffed HEMSen
dc.subjectAirway managementen
dc.subjectIntubationen
dc.subjectAir ambulanceen
dc.subjectHelicopter emergency medical servicesen
dc.subjectAdvanced trauma life supporten
dc.subjectCritical careen
dc.titleHypoxia and hypotension in patients intubated by physician staffed helicopter emergency medical services - a prospective observational multi-centre studyen
dc.description.versionpublished versionen
dc.contributor.departmentSchool of Medicine / Clinical Medicineen
uef.solecris.id49111817en
dc.type.publicationinfo:eu-repo/semantics/articleen
dc.rights.accessrights© Authorsen
dc.relation.doi10.1186/s12873-017-0134-5en
dc.description.reviewstatuspeerRevieweden
dc.relation.articlenumber22
dc.relation.issn1471-227Xen
dc.relation.volume17en
dc.rights.accesslevelopenAccessen
dc.type.okmA1en
dc.type.versioninfo:eu-repo/semantics/publishedVersionen
uef.solecris.openaccessOpen access -julkaisukanavassa ilmestynyt julkaisu


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