{"id":22430,"date":"2022-12-05T04:41:00","date_gmt":"2022-12-04T20:41:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=22430"},"modified":"2022-12-05T13:08:57","modified_gmt":"2022-12-05T05:08:57","slug":"icu-management-practice-%e5%88%9b%e4%bc%a4%e6%82%a3%e8%80%85%e9%99%a2%e5%89%8d%e6%97%b6%e9%97%b4%e4%b8%8e%e4%bd%8f%e9%99%a2%e7%97%85%e6%ad%bb%e7%8e%87","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=22430","title":{"rendered":"[ICU Management &#038; Practice]: \u521b\u4f24\u60a3\u8005\u9662\u524d\u65f6\u95f4\u4e0e\u4f4f\u9662\u75c5\u6b7b\u7387"},"content":{"rendered":"\n<h1 class=\"wp-block-heading\">Prehospital Time and In-Hospital Trauma Mortality<\/h1>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/res.cloudinary.com\/healthmanagement-org\/image\/upload\/f_auto,fl_lossy\/v1657598405\/cw\/00121706_cw_image.jpg\" alt=\"\"\/><\/figure>\n\n\n\n<p>Time has always been considered an essential determinant of outcome in the early care of trauma patients, and the concept of trauma as a time-sensitive condition has been part of education and policy for decades. However, data on system performance from physician-staffed EMS are far less abundant than data from EMS systems. Physician-staffed EMS is believed to add complexity by performing more interventions that could potentially result in longer total prehospital time. Proponents of the physician-led critical care team advocate a more tailored provision of advanced prehospital critical care.&nbsp;<\/p>\n\n\n\n<p>A new study explores the association between total prehospital time and in-hospital mortality in prehospital, physician-staffed trauma systems in France. The hypothesis is that total prehospital time is associated with increased mortality.&nbsp;<\/p>\n\n\n\n<p>The study duration was from January 2009 to December 2016, and data were derived from two regional trauma registries in France, one urban and one rural. Both registries had a physician-staffed emergency medical service.&nbsp;<\/p>\n\n\n\n<p>The study included 10,216 consecutive adult trauma patients admitted to either of the two regional trauma referral centres. 66.5% of the patients had at least one body region with an Abbreviated Injury Scale score of 3 or more. 12.4% of patients presented in shock, and 26.9% with severe head injury (Abbreviated Injury Scale score 3 points).<\/p>\n\n\n\n<p>The primary outcome of the study was all-cause in-hospital mortality. The primary exposure variable was total prehospital time, defined as the time from the arrival of the physician-led prehospital care team on the scene to the arrival at the hospital.&nbsp;<\/p>\n\n\n\n<p>Findings of the study show that increasing prehospital times (in 30-minute categories) were associated with an increase in the risk of in-hospital death. The odds of death increased by 9% for each 10-minute increase in prehospital time.&nbsp;<\/p>\n\n\n\n<p>Overall, the results show that longer total prehospital time is independently associated with increasing all-cause in-hospital mortality in a physician-staffed trauma system.&nbsp;<\/p>\n\n\n\n<p>These findings suggest that prehospital time management should be an important objective and highlight the need for streamlining prehospital trauma care and more clearly define the optimal intervention-to-time ratio.<\/p>\n\n\n\n<p>Source:&nbsp;<a href=\"https:\/\/jamanetwork.com\/journals\/jamasurgery\/fullarticle\/2751937\" target=\"_blank\" rel=\"noreferrer noopener\">JAMA<\/a><\/p>\n\n\n\n<p>Image Credit: iStock<\/p>\n\n\n\n<p><a href=\"https:\/\/healthmanagement.org\/c\/icu\/news\/ventilatory-settings-and-outcomes-in-ohca-patients\">\u00ab\u00ab&nbsp;Ventilatory Settings and Outcomes in OHCA patients<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/healthmanagement.org\/c\/icu\/news\/extended-prone-positioning-for-covid-19-ards\">Extended Prone Positioning for COVID-19 ARDS \u00bb\u00bb<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">References:<\/h4>\n\n\n\n<p>Gauss T, Ageron F, Devaud M&nbsp;et al. (2019)&nbsp;<a href=\"https:\/\/jamanetwork.com\/journals\/jamasurgery\/fullarticle\/2751937\" target=\"_blank\" rel=\"noreferrer noopener\">Association of Prehospital Time to In-Hospital Trauma Mortality in a Physician-Staffed Emergency Medicine System<\/a>.&nbsp;JAMA Surg<em>.<\/em>&nbsp;154(12):1117\u20131124.<\/p>\n\n\n\n<p>Published on : Tue, 12 Jul 2022<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Prehospital Time and In-Hospital Trauma Mortality Time  [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[24,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/22430"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=22430"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/22430\/revisions"}],"predecessor-version":[{"id":22431,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/22430\/revisions\/22431"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=22430"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=22430"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=22430"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}