Prehospital notification for major trauma patients requiring emergency hospital transport

A systematic review

Anneliese Synnot, Adrian Karlsson, Lisa Brichko, Melissa Chee, Mark Fitzgerald, Mahesh C Misra, Teresa Howard, Joseph Mathew, Thomas Rotter, Michelle Fiander, Russell L Gruen, Amit Gupta, Satish Dharap, Madonna Fahey, Michael Stephenson, Gerard O'Reilly, Peter A Cameron, Biswadev Mitra, the Australia-India Trauma System Collaboration

Research output: Contribution to journalArticleResearchpeer-review

4 Citations (Scopus)

Abstract

Objective This systematic review aimed to determine the effect of prehospital notification systems for major trauma patients on overall (<30 days) and early (<24 hours) mortality, hospital reception, and trauma team presence (or equivalent) on arrival, time to critical interventions, and length of hospital stay. Methods Experimental and observational studies of prehospital notification compared with no notification or another type of notification in major trauma patients requiring emergency transport were included. Risk of bias was assessed using the Cochrane ACROBAT-NRSI tool. A narrative synthesis was conducted and evidence quality rated using the GRADE criteria. Results Three observational studies of 72,423 major trauma patients were included. All were conducted in high-income countries in hospitals with established trauma services, with two studies undertaking retrospective analysis of registry data. Two studies reported overall mortality, one demonstrating a reduction in mortality; (adjusted odds ratio (OR) 0.61, 95% confidence interval (CI) 0.39 to 0.94, 72,073 participants); and the other demonstrating a nonsignificant change (OR 0.61, 95% CI 0.23 to 1.64, 81 participants). The quality of this evidence was rated as very low. Conclusion Limited research on the topic constrains conclusive evidence on the effect of prehospital notification on patient-centered outcomes after severe trauma. Composite interventions that combine prehospital notification with effective actions on arrival to hospital such as trauma bay availability, trauma team presence, and early access to definitive management may provide more robust evidence towards benefits of early interventions
Original languageEnglish
Pages (from-to)212-221
Number of pages10
JournalJournal of Evidence-Based Medicine
Volume10
Issue number3
DOIs
Publication statusPublished - Aug 2017

Keywords

  • advanced trauma life support care
  • emergency medical service communication systems
  • prehospi-tal emergency care
  • review
  • systematic
  • trauma

Cite this

Synnot, Anneliese ; Karlsson, Adrian ; Brichko, Lisa ; Chee, Melissa ; Fitzgerald, Mark ; Misra, Mahesh C ; Howard, Teresa ; Mathew, Joseph ; Rotter, Thomas ; Fiander, Michelle ; Gruen, Russell L ; Gupta, Amit ; Dharap, Satish ; Fahey, Madonna ; Stephenson, Michael ; O'Reilly, Gerard ; Cameron, Peter A ; Mitra, Biswadev ; the Australia-India Trauma System Collaboration. / Prehospital notification for major trauma patients requiring emergency hospital transport : A systematic review. In: Journal of Evidence-Based Medicine. 2017 ; Vol. 10, No. 3. pp. 212-221.
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title = "Prehospital notification for major trauma patients requiring emergency hospital transport: A systematic review",
abstract = "Objective This systematic review aimed to determine the effect of prehospital notification systems for major trauma patients on overall (<30 days) and early (<24 hours) mortality, hospital reception, and trauma team presence (or equivalent) on arrival, time to critical interventions, and length of hospital stay. Methods Experimental and observational studies of prehospital notification compared with no notification or another type of notification in major trauma patients requiring emergency transport were included. Risk of bias was assessed using the Cochrane ACROBAT-NRSI tool. A narrative synthesis was conducted and evidence quality rated using the GRADE criteria. Results Three observational studies of 72,423 major trauma patients were included. All were conducted in high-income countries in hospitals with established trauma services, with two studies undertaking retrospective analysis of registry data. Two studies reported overall mortality, one demonstrating a reduction in mortality; (adjusted odds ratio (OR) 0.61, 95{\%} confidence interval (CI) 0.39 to 0.94, 72,073 participants); and the other demonstrating a nonsignificant change (OR 0.61, 95{\%} CI 0.23 to 1.64, 81 participants). The quality of this evidence was rated as very low. Conclusion Limited research on the topic constrains conclusive evidence on the effect of prehospital notification on patient-centered outcomes after severe trauma. Composite interventions that combine prehospital notification with effective actions on arrival to hospital such as trauma bay availability, trauma team presence, and early access to definitive management may provide more robust evidence towards benefits of early interventions",
keywords = "advanced trauma life support care, emergency medical service communication systems, prehospi-tal emergency care, review, systematic, trauma",
author = "Anneliese Synnot and Adrian Karlsson and Lisa Brichko and Melissa Chee and Mark Fitzgerald and Misra, {Mahesh C} and Teresa Howard and Joseph Mathew and Thomas Rotter and Michelle Fiander and Gruen, {Russell L} and Amit Gupta and Satish Dharap and Madonna Fahey and Michael Stephenson and Gerard O'Reilly and Cameron, {Peter A} and Biswadev Mitra and {the Australia-India Trauma System Collaboration}",
year = "2017",
month = "8",
doi = "10.1111/jebm.12256",
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Synnot, A, Karlsson, A, Brichko, L, Chee, M, Fitzgerald, M, Misra, MC, Howard, T, Mathew, J, Rotter, T, Fiander, M, Gruen, RL, Gupta, A, Dharap, S, Fahey, M, Stephenson, M, O'Reilly, G, Cameron, PA, Mitra, B & the Australia-India Trauma System Collaboration 2017, 'Prehospital notification for major trauma patients requiring emergency hospital transport: A systematic review', Journal of Evidence-Based Medicine, vol. 10, no. 3, pp. 212-221. https://doi.org/10.1111/jebm.12256

Prehospital notification for major trauma patients requiring emergency hospital transport : A systematic review. / Synnot, Anneliese; Karlsson, Adrian; Brichko, Lisa; Chee, Melissa ; Fitzgerald, Mark; Misra, Mahesh C; Howard, Teresa; Mathew, Joseph; Rotter, Thomas; Fiander, Michelle; Gruen, Russell L; Gupta, Amit; Dharap, Satish; Fahey, Madonna; Stephenson, Michael; O'Reilly, Gerard ; Cameron, Peter A; Mitra, Biswadev; the Australia-India Trauma System Collaboration.

In: Journal of Evidence-Based Medicine, Vol. 10, No. 3, 08.2017, p. 212-221.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Prehospital notification for major trauma patients requiring emergency hospital transport

T2 - A systematic review

AU - Synnot, Anneliese

AU - Karlsson, Adrian

AU - Brichko, Lisa

AU - Chee, Melissa

AU - Fitzgerald, Mark

AU - Misra, Mahesh C

AU - Howard, Teresa

AU - Mathew, Joseph

AU - Rotter, Thomas

AU - Fiander, Michelle

AU - Gruen, Russell L

AU - Gupta, Amit

AU - Dharap, Satish

AU - Fahey, Madonna

AU - Stephenson, Michael

AU - O'Reilly, Gerard

AU - Cameron, Peter A

AU - Mitra, Biswadev

AU - the Australia-India Trauma System Collaboration

PY - 2017/8

Y1 - 2017/8

N2 - Objective This systematic review aimed to determine the effect of prehospital notification systems for major trauma patients on overall (<30 days) and early (<24 hours) mortality, hospital reception, and trauma team presence (or equivalent) on arrival, time to critical interventions, and length of hospital stay. Methods Experimental and observational studies of prehospital notification compared with no notification or another type of notification in major trauma patients requiring emergency transport were included. Risk of bias was assessed using the Cochrane ACROBAT-NRSI tool. A narrative synthesis was conducted and evidence quality rated using the GRADE criteria. Results Three observational studies of 72,423 major trauma patients were included. All were conducted in high-income countries in hospitals with established trauma services, with two studies undertaking retrospective analysis of registry data. Two studies reported overall mortality, one demonstrating a reduction in mortality; (adjusted odds ratio (OR) 0.61, 95% confidence interval (CI) 0.39 to 0.94, 72,073 participants); and the other demonstrating a nonsignificant change (OR 0.61, 95% CI 0.23 to 1.64, 81 participants). The quality of this evidence was rated as very low. Conclusion Limited research on the topic constrains conclusive evidence on the effect of prehospital notification on patient-centered outcomes after severe trauma. Composite interventions that combine prehospital notification with effective actions on arrival to hospital such as trauma bay availability, trauma team presence, and early access to definitive management may provide more robust evidence towards benefits of early interventions

AB - Objective This systematic review aimed to determine the effect of prehospital notification systems for major trauma patients on overall (<30 days) and early (<24 hours) mortality, hospital reception, and trauma team presence (or equivalent) on arrival, time to critical interventions, and length of hospital stay. Methods Experimental and observational studies of prehospital notification compared with no notification or another type of notification in major trauma patients requiring emergency transport were included. Risk of bias was assessed using the Cochrane ACROBAT-NRSI tool. A narrative synthesis was conducted and evidence quality rated using the GRADE criteria. Results Three observational studies of 72,423 major trauma patients were included. All were conducted in high-income countries in hospitals with established trauma services, with two studies undertaking retrospective analysis of registry data. Two studies reported overall mortality, one demonstrating a reduction in mortality; (adjusted odds ratio (OR) 0.61, 95% confidence interval (CI) 0.39 to 0.94, 72,073 participants); and the other demonstrating a nonsignificant change (OR 0.61, 95% CI 0.23 to 1.64, 81 participants). The quality of this evidence was rated as very low. Conclusion Limited research on the topic constrains conclusive evidence on the effect of prehospital notification on patient-centered outcomes after severe trauma. Composite interventions that combine prehospital notification with effective actions on arrival to hospital such as trauma bay availability, trauma team presence, and early access to definitive management may provide more robust evidence towards benefits of early interventions

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KW - emergency medical service communication systems

KW - prehospi-tal emergency care

KW - review

KW - systematic

KW - trauma

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