Prehospital Doctors Debate PRO

Prehospital Doctors Add Little Value In Trauma

Dr Anthony HolleyEmergency Physician and Intensivist

Acknowledgements & Conflict

#MakePrehospitalCareGreatAgain

Prehospital Doctors Add Little Value In Trauma

Themes…..

This is my clinical realm

Call for Consensus on Methodology and Terminology to

Improve Comparability in the Study of Preventable Prehospital

Trauma Deaths: A Systematic Literature Review.

Acad Emerg Med. Oliver et al. 2016 Apr;23(4):503-10

Aggressive control of external haemorrhage

Airway - emergency anaesthesiaThoracostomies/ThoracotomyWarmed blood products

Experience/“Clinical judgement”

Critical Interventions

Event Frequency?

For anaesthesiologists, the Task Force commissioned by the Scandinavian Society of Anaesthesia and Intensive Care Medicine recommends endotracheal intubation.

Other physicians, as well as paramedics and other EMS personnel, are recommended the lateral trauma recovery position as a basic intervention combined with assisted mask-ventilation in trauma patients.

Proficiency of obtaining Grade I view at laryngoscopy was similar for physicians

(74.70%) and CCPs (77.36%).

After Dr Steve Rashford

With thanks from Dr Steve Rashford

The Hard Facts…..

• n = 25647• 701 (2.7%) “Life saving treatment”• 596 (2.3%) exceeded the

competencies of EMT• 225 (0.9%) ultimately discharged

home

0.09%