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Jeffrey P. Salomone, MD, NREMT-P
Atlanta, Ga

Arch Surg. 2000;135:319.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Considerable controversy exists regarding the prehospital management of critically injured patients by EMS personnel. A "scoop and run" approach may neglect key issues, such as a compromised airway, while prolonged attempts at resuscitation in the field simply cannot stabilize a patient in need of operative intervention. Few prospective, randomized clinical trials exist that address those advanced life support (ALS) interventions performed in the prehospital setting that improve patient outcome.

The previous study by Demetriades et al (Arch Surg. 1996;131:133-138) documented a higher mortality rate in trauma patients cared for by EMS personnel compared with that of patients privately transported. That study was not so much an indictment of prehospital ALS for trauma patients as it was illustrative of a system lacking adequate medical supervision (ie, EMS scene times averaging more than 20 minutes). With the introduction of quality improvement measures, the EMS scene time . . . [Full Text of this Article]

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ABSTRACT | FULL TEXT