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Emerg Med Australas · Oct 2022
Observational StudyPre-hospital emergency anaesthesia in trauma patients: An observational study from a state-wide Australian pre-hospital and retrieval service.
- Paul Maclure, Samuel Gluck, Kate Kerin, Laura Boyle, and Daniel Ellis.
- Department of Anaesthesia, Flinders Medical Centre, Adelaide, South Australia, Australia.
- Emerg Med Australas. 2022 Oct 1; 34 (5): 711-716.
ObjectiveTo assess the performance of an Australian pre-hospital and retrieval medicine (PHRM) service against the National Institute for Health and Care Excellence (NICE) standard which recommends that pre-hospital emergency anaesthesia (PHEA) in trauma patients should be conducted within 45-min of first contact with emergency services.MethodsRetrospective observational study of all adult trauma patients in which PHEA was conducted by the PHRM service covering a 5-year period from January 2015 to December 2019.ResultsOver the 5-year study period, 1509 (22%) of the PHRM service workload comprised primary retrievals from scene. Most 1346 (89%) of these cases had a primary diagnosis of trauma. Of these we have complete data for 328 of the 337 cases requiring a PHEA and 121 (37%) patients received this within the recommended 45-min time frame. The service attended in rapid response vehicles (n = 160, 49%), rotary wing (n = 151, 46%) and fixed wing (n = 17, 5%) transport modalities. For a service covering 983 482 km2 , the median distance travelled to patients was 35 (16-71) km and the median time to PHEA was 54 (38-80) min.ConclusionsIn a cohort of 337 patients treated by a dedicated PHRM service in South Australia, the median time to PHEA was 54 (38-80) min with only 37% of patients receiving PHEA within 45 min from the activation of the team. Despite differing patient demographics, the percentage of patients receiving PHEA within the recommended time frame was greater than a similar cohort from the UK. However, both data sets still fall short of recommended targets.© 2022 Australasian College for Emergency Medicine.
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