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Prehospital notification for major trauma patients requiring emergency hospital transport: A systematic review
Author(s) -
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,
Mitra Biswadev
Publication year - 2017
Publication title -
journal of evidence‐based medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.885
H-Index - 22
ISSN - 1756-5391
DOI - 10.1111/jebm.12256
Subject(s) - medicine , observational study , psychological intervention , emergency medicine , emergency medical services , odds ratio , confidence interval , major trauma , emergency department , medical emergency , nursing
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 during trauma reception and resuscitation.