Prehospital times, transport mode and physician-only interventions, by treatment allocation
Factor | Original head injury definition (GCS<9) | Modified severe head injury definition (GCS 3–12 and AIS≥3) | ||||
---|---|---|---|---|---|---|
Standard care | Physician care | p Value* | Standard care | Physician care | p Value* | |
Time intervals (min) | ||||||
Time from beginning of emergency call to first arrival at patient | 9 (7–13) | 10 (8–13) | 0.15 | 9 (7–14) | 10 (7–13) | 0.57 |
Time spent at the scene | 16 (11–27) | 22 (15–33) | <0.01 | 17 (11–29) | 23 (15–32) | 0.02 |
Transport time from scene to hospital | 13 (10–21) | 13 (9–18) | 0.47 | 15 (10–21) | 13 (9–17) | 0.09 |
Total prehospital time | 44 (33–56) | 48 (38–62) | 0.02 | 43 (33–59) | 49 (38–61) | 0.14 |
Patient transport mode | ||||||
Helicopter transport | 21 (12%) | 36 (19%) | 0.08 | 23 (15%) | 34 (19%) | 0.34 |
Physician-only interventions | ||||||
Neuromuscular-blockade-assisted intubation | 18 (10%) | 96 (49%) | <0.001 | 22 (14%) | 105 (58%) | <0.001 |
Tube/open thoracostomy | 5 (3%) | 1 (1%) | 0.07† | 5 (3%) | 0 | 0.01† |
Crystalloid >1000 mL | 12 (7%) | 24 (12%) | 0.07 | 12 (8%) | 30 (16%) | 0.01 |
Any Packed Red Blood Cells | 6 (3%) | 12 (6%) | 0.22 | 8 (5%) | 12 (7%) | 0.57 |
Any 7.5% saline or 20% mannitol | 5 (3%) | 29 (15%) | <0.001† | 5 (3%) | 31 (17%) | <0.001† |
Rates of correction or prevention of hypoxia and hypotension | ||||||
Hypoxia at first contact | 30 (24%) | 37 (22%) | 0.73 | 27 (23%) | 30 (19%) | 0.42 |
Hypoxia at hospital arrival | 14 (14%) | 5 (4%) | <0.001† | 15 (10%) | 8 (5%) | 0.05 |
Hypotension at first contact | 58 (34%) | 63 (32%) | 0.80 | 38 (25%) | 42 (24%) | 0.76 |
Hypotension at hospital arrival | 13 (7%) | 13 (7%) | 0.79 | 17 (11%) | 20 (11%) | 0.98 |
Statistics are given as n (%) or median (IQR). Hypotension, systolic BP <90 mm Hg; Hypoxia, SpO2 <92%.
*The Wilcoxon rank-sum test was used for continuous data and χ2 tests were used for categorical variables.
†Conditional binomial test.
AIS, Abbreviated Injury Scale.