Comparison of Provider Types Who Performed Prehospital Lifesaving Interventions: A Prospective Study
Abstract
Learning Objectives: Life Saving interventions (LSIs) are important procedures that reduce morbidity. In the combat theater, providers with different levels of training now operate in the prehospital setting. Our objective was to describe prehospital LSIs performed, performed incorrectly, and missed (procedures not performed, but were indicated) by provider type to facilitate future practice guidelines. Methods: We prospectively recorded LSIs performed on patients transported to 6 combat hospitals. Trained site investigators evaluated patients on arrival and recorded demographics, vital signs, LSIs performed, if the LSI was performed correctly, and if the LSI was missed. LSIs included airway, thoracic, extremity, vascular access procedures, and resuscitation techniques. From a larger dataset, we analyzed which provider type was recorded. Provider types were Medic (emergency medical technician); Advanced Medic (Pararescueman/ Special Ops/IDMT); Doctor/Nurse; or Other. Incidence and proportions were compared with chi-square or fisher s exact tests. A p<0.05 was considered significant. Results: 529 LSIs were performed on 170 patients. 49% of LSIs were performed by Medics, 19% Advanced Medics, 11% Doctor/Nurses, and 21% Other (p=0.008). Of complex LSIs, Medics performed 43% of intubations, 33% of cricothyrotomies, 33% of blood infusions, and 60% of chest needles. Advanced medics performed 14% of intubations, 33% of cricothyrotomies, 11% of blood infusions, and 20% of chest needles. Doctor/Nurses performed 14% of intubations, 28% of blood administrations, and no cricothyrotomies or chest needles. Doctors/nurses performed 50% (5/10) of chest seals, p<0.0001. Fluid infusion was performed more by medics (70%, p<0.0001) as was hypothermia prevention (58%, p=0.04). 3.4% of LSIs were incorrectly performed. 3% of the LSIs were missed. LSIs performed incorrectly or missed was not different among provider types.
Document Details
- Document Type
- Technical Report
- Publication Date
- Dec 01, 2014
- Accession Number
- ADA623609
Entities
People
- Vikhyat S Bebarta
Organizations
- United States Army Institute of Surgical Research