13.1 J,k Prehosp & Retrieval Prehospital Controversies, Working At Accident Scene Em Cam P776

Front 1

Which areas of prehospital care are controversial?

Back 1

Trauma care - ATLS e.g. intubation and IVF. Evidence for prehospital intubation is conflicting and incomplete/inadequate, Cam suggests intubation should not be performed until prospective RCT's performed. IVF prehospital has not been shown to improve outcomes despite intuitive 'benefits' e.g. In Severe head injury plus hypotension.

Cardiac arrest - role of ALS e.g. Intubation and IV drug therapy. Shown to increase ROSC but not survival to hospital discharge

Summary - advanced life support including intubation and IV therapy (drugs/fluids) prehospital in trauma and cardiac arrest unproven and expensive. RCT required to justify

Front 2

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Back 2

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Front 3

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Back 3

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