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J Evid Based Med. 2017 Aug;10(3):212-221. doi: 10.1111/jebm.12256.

Prehospital notification for major trauma patients requiring emergency hospital transport: A systematic review.

Author information

1
Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
2
Cochrane Consumers and Communication, Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
3
National Trauma Research Institute, Melbourne, Australia.
4
Central Clinical School, Monash University, Melbourne, Australia.
5
Lund University, Lund, Sweden.
6
The Alfred Hospital, Melbourne, Australia.
7
JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
8
College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada.
9
Information Specialist (consultant), Canada.
10
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
11
Lokmanya Tilak Municipal General Hospital, Mumbai, India.
12
Ambulance Victoria, Melbourne, Australia.
13
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.

Abstract

OBJECTIVE:

This systematic review aimed to determine the effect of prehospital notification systems for major trauma patients on overall (<30 days) and early (<24 hours) mortality, hospital reception, and trauma team presence (or equivalent) on arrival, time to critical interventions, and length of hospital stay.

METHODS:

Experimental and observational studies of prehospital notification compared with no notification or another type of notification in major trauma patients requiring emergency transport were included. Risk of bias was assessed using the Cochrane ACROBAT-NRSI tool. A narrative synthesis was conducted and evidence quality rated using the GRADE criteria.

RESULTS:

Three observational studies of 72,423 major trauma patients were included. All were conducted in high-income countries in hospitals with established trauma services, with two studies undertaking retrospective analysis of registry data. Two studies reported overall mortality, one demonstrating a reduction in mortality; (adjusted odds ratio (OR) 0.61, 95% confidence interval (CI) 0.39 to 0.94, 72,073 participants); and the other demonstrating a nonsignificant change (OR 0.61, 95% CI 0.23 to 1.64, 81 participants). The quality of this evidence was rated as very low.

CONCLUSION:

Limited research on the topic constrains conclusive evidence on the effect of prehospital notification on patient-centered outcomes after severe trauma. Composite interventions that combine prehospital notification with effective actions on arrival to hospital such as trauma bay availability, trauma team presence, and early access to definitive management may provide more robust evidence towards benefits of early interventions during trauma reception and resuscitation.

KEYWORDS:

advanced trauma life support care; emergency medical service communication systems; prehospital emergency care; review; systematic; trauma

PMID:
28467026
DOI:
10.1111/jebm.12256
[Indexed for MEDLINE]

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