prehospital factors influence on the outcome severe trauma and polytrauma

prehospital factors influence on the outcome severe trauma and polytrauma

;Jokšić-Mazinjanin Radojka;Gojković Zoran;Vasović Velibor;Mikov Momir;Jokšić-Zelić Milena;Petrović Radmila;Saravolac Siniša;Isaković Valentina
abc: časopis urgentne medicine 2015 Vol. 15 pp. 41-46
237
radojka2015abc:prehospital

Abstract

AIM: - condition assessment of the injured on the basis of the pre-hospital records vital parameters and injuries mechanism using GCS (Glasgow Coma Score), RTS (Revised Trauma Score), MGAP (Injury mechanism, GCS, patient years and systolic blood pressure) and GAP score (GCS, the patient years and systolic blood pressure) - final results assessment of severe trauma patients on the basis of the mentioned values score - measures impact of the prehospital care on the outcome at the traumatized patient MATERIALS AND METHODS: The retrospective research was conducted at the Emergency Medical Services Novi Sad (EMS).The study included patients wherein the physician set trauma diagnosis on the field than the Emergency Center (EC) of the Vojvodina Clinical Center confirmed that this is serious trauma. RESULTS: The study included 47 patients, statistically significant more man than women. The average age was 50,70±17,72 year. Statistically significant the biggest number of the injures happened in the traffic accidents. For an objective assessment of the injure severity are used two anatomical score AIS (Abberviated Injury Scale) and ISS score (Injury Severity Score). All patients had ISS score over 15 and this put them in the group of severely injured patients. Four scores determined prehospitaly based on vital parameters records, states of consciousness, injury severity and mode of injury(blunt or penetrating injuries). Within each score the minimal survival is in the serious injury group. Survived 36 patients(76,60%)to discharge from hospital. Mostly not survived patients with head injury. The average value of pre-hospital scores were lower than in the survival group. Prehospital scores smaller values were correlated with lower survival but MGAP score was the best indicator of severe trauma. Only its average value in the group of patients who not survive pointed to serious trauma. Venous line is placed at three quarters of the patients, fluid resuscitation was performed prehospitaly in two thirds patients and pain therapy applied in negligible number of patients. CONCLUSION: Patients with severe head and neck injuries fall into the highest-risk group of patients. Into the first 24 hours after injury within them mostly coming up to the death. In addition as the value of vital parameters prehospitaly lower it is the higher risk of death. Alone prehospital treatment has no effect on the outcome of injuries since it is not done in the large percentage of the injured patients.

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