Prehospital Management of Hypotensive Trauma in HEMS
Overview
- Phase
- Not Applicable
- Intervention
- Drugs administration
- Conditions
- Hypotension and Shock
- Sponsor
- Azienda Usl di Bologna
- Enrollment
- 500
- Locations
- 15
- Primary Endpoint
- 30 days mortality
- Status
- Recruiting
- Last Updated
- last year
Overview
Brief Summary
Up to today, inadequate evidences and knowledge exist about the best prehospital management of hypotensive trauma patients and its clinical consequence on the in-hospital recovery and mortality.
Also new emerging therapies such as prehospital blood transfusion and REBOA (resuscitative endovascular balloon occlusion of the aorta) are lacking strong evidences in, eventually, reducing hospital mortality and improving outcomes.
Moreover, prehospital emergency medicine is throughout Italy an heterogeneous system that has no unique standard operating procedures and, even among HEMS (helicopter emergency medical service), management and therapies on complex trauma patients may vary upon local policies.
With this study we aim to enroll hypotensive trauma patients and study factors of prehospital rescue that can be associated with in-hospital mortality and recovery, eventually even with hospital outcome. For each patients data as demographic, kind of trauma (mechanism, injury scores), therapies and maneuvers will be recorded and then analyzed in comparison with in-hospital data such as need for transfusion, ABG parameters, length of stay (in-ward and ICU), need of therapies like invasive ventilation and renal replacement therapy, recovery and outcome
Investigators
Eligibility Criteria
Inclusion Criteria
- •Age \> 18 years
- •Witnessed traumatic event managed by HEMS
- •Shock at first evaluation (Systolic blood pressure \< 90 mmHg)
- •Suspect or obvious ongoing haemorrage
Exclusion Criteria
- •Patients in cardiac arrest at HEMS arrival in which resuscitation is not started or interrupted by HEMS crew
Arms & Interventions
Trauma patients in shock
The study focuses on hypotensive trauma patients assisted by HEMS teams
Intervention: Drugs administration
Trauma patients in shock
The study focuses on hypotensive trauma patients assisted by HEMS teams
Intervention: Resuscitative endovascular balloon occlusion of the aorta
Trauma patients in shock
The study focuses on hypotensive trauma patients assisted by HEMS teams
Intervention: Blood transfusions
Trauma patients in shock
The study focuses on hypotensive trauma patients assisted by HEMS teams
Intervention: Prehospital management
Trauma patients in shock
The study focuses on hypotensive trauma patients assisted by HEMS teams
Intervention: Prehospital eFAST
Outcomes
Primary Outcomes
30 days mortality
Time Frame: 30 days
Secondary Outcomes
- survival from prehospital to hospital admmission(1 day)
- Hospital length of stay(6 months)
- Transport time(24 hours)
- Blood products transfused during the first 24 hours after hospital admission(24 hours)