PREHOSPITAL CARE

Prehospital rapid-sequence intubation of patients with trauma with a Glasgow Coma Score of 13 or 14 and the subsequent incidence of intracranial pathology

Daniel Y Ellis, Gareth E Davies, John Pearn, David Lockey

Department of Pre-hospital Care, The Royal London Hospital, London, UK

Correspondence to:
Correspondence to:
Dr D Y Ellis
The Cottage, Upper Street, Dyrham, South Gloucestershire SN14 8HN, UK; danellis{at}doctors.org.uk

Aim: To identify the incidence of intracranial pathology in a population of patients with trauma with an on-scene Glasgow Coma Score (GCS) of 13 or 14, and the proportion that required prehospital intubation and ventilation.

Method: A retrospective review of a prehospital trauma database was carried out over a 12-month period, and 81 patients were reviewed. All had a traumatic mechanism of injury and had an on-scene GCS of 13 or 14 recorded by a prehospital doctor. 43 patients required prehospital rapid-sequence intubation. Overall, 31.5% of patients with a GCS of 13 or 14 had an abnormal computed tomography scan of the head and 20.5% had an intracranial haemorrhage.

Results: For this group of patients with trauma with a drop of only one or two points on the GCS, the incidence of intracranial pathology was almost one in three and that of intracranial haemorrhage was one in five.

Abbreviations: GCS, Glasgow Coma Score; RSI, rapid-sequence intubation

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This article has been cited by other articles:

• Gunning, M, O'Loughlin, E, Fletcher, M, Crilly, J, Hooper, M, Ellis, D Y (2009). Emergency intubation: a prospective multicentre descriptive audit in an Australian helicopter emergency medical service. Emerg. Med. J. 26: 65-69 [Abstract] [Full Text]