Abstract
Aim: The FIRST study (French Intensive care Recorded in Severe Trauma) was designed in order to describe the French management of severe blunt trauma in collaboration with 14 University hospitals. Procedure: Epidemiological, clinical data of pre- and in-hospital evolution were prospectively recorded for 3090 patients admitted in ICU within 72 hours after trauma and/or managed by a prehospital medical team of a participant center. Results: The mean age is 42 years old (SD 18), 61% of patients are road traffic victims, 30% are miscellaneous accidents victims (domestic, sports...)and 7% are involved in work accident and 2% in other type of accident. More than 50% of patients are intubated during prehospital care. Median Coma Glasgow Score is 12; IQR [6; 15]. After prehospital management, mean arterial pressure evolves from 89 mmHg (SD 29) to 84 mmHg (SD 23). Mean prehospital fluid loading is 788 ± 862 ml and 16% of patients receive prehospital continuous catecholamine infusion. Nearly 25% of patients are initially admitted in a general hospital before University hospital transfer. Such strategy increases delay admission to University hospital (1,9 hours, IQR [1,3-2,5 hours] to 6,4 hours, IQR [5,0-8,4 hours], p <0,001. Many patients were not managed by a medical prehospital team (7%) and whole-body CT on admission is not systematically performed. The injury severity score (median ISS: 25; IQR [18; 34]) may explain the time stay in intensive care unit (7 days), IQR [2-19 days] where 57% of patients have sepsis complications, and the global mortality of 23% at the 30 th day. Conclusion: This study shows that all recommendations are well followed and promotes the installation of formalized regional care systems.
Translated title of the contribution | Current support for severe blunt trauma patients in France: Initial assessment of the FIRST study (French Intensive care Recorded in Severe Trauma) |
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Original language | French |
Pages (from-to) | 156-163 |
Number of pages | 8 |
Journal | Annales Francaises de Medecine d'Urgence |
Volume | 2 |
Issue number | 3 |
DOIs | |
Publication status | Published - May 2012 |
Externally published | Yes |
Keywords
- Emergency medicine
- Epidemiological study
- Intensive care
- Medical prehospital management
- Mobile Intensive Care Unit
- Severe Blunt trauma