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Prevalence of prehospital hypoxemia and oxygen use in trauma patients.

Publication ,  Journal Article
McMullan, J; Rodriquez, D; Hart, KW; Lindsell, CJ; Vonderschmidt, K; Wayne, B; Branson, R
Published in: Mil Med
October 2013

OBJECTIVE: This study estimates the prevalence of injured patients requiring prehospital supplemental oxygen based on existing recommendations, and determines whether actual use exceeds those recommendations. PATIENTS AND METHODS: Prehospital oxygen use and continuous peripheral oxygen saturation measurements were prospectively collected on a purposive sample of injured civilians transported to an urban level 1 trauma center by paramedics. Structured chart review determined injury characteristics and outcomes. Supplemental oxygen administration indications were hypoxemia (peripheral oxygen saturation ≤ 90%), hemorrhagic shock (systolic blood pressure < 100 mmHg), or paramedic suspicion of traumatic brain injury. RESULTS: Paramedics enrolled 224/290 screened subjects. Median (range) age was 34 (18-84) years, 48.7% were nonwhite, 75.4% were male, and Injury Severity Score was 5 (1-75). Half (54.5%) were admitted; 36.2% sustained a penetrating injury. None underwent prehospital endotracheal intubation. Hypoxemia occurred in 86 (38.4%), paramedics suspected traumatic brain injury in 22 (9.8%), and 20 (8.9%) were hypotensive. Any indication for supplemental oxygen (107/224 [47.8%, 95%CI 41.3%-54.3%]) and prehospital administration of oxygen (141/224 [62.9%, 95%CI 56.2%-69.2%]) was common. Many (35/141 [24.8%]) received oxygen without indication. CONCLUSIONS: On the basis of current guidelines, less than half of adult trauma patients have an indication for prehospital supplemental oxygen, yet is frequently administered in the absence of clinical indication.

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Published In

Mil Med

DOI

EISSN

1930-613X

Publication Date

October 2013

Volume

178

Issue

10

Start / End Page

1121 / 1125

Location

England

Related Subject Headings

  • Young Adult
  • Wounds and Injuries
  • Strategic, Defence & Security Studies
  • Prospective Studies
  • Practice Guidelines as Topic
  • Oxygen Inhalation Therapy
  • Middle Aged
  • Male
  • Hypoxia
  • Hypotension
 

Citation

APA
Chicago
ICMJE
MLA
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McMullan, J., Rodriquez, D., Hart, K. W., Lindsell, C. J., Vonderschmidt, K., Wayne, B., & Branson, R. (2013). Prevalence of prehospital hypoxemia and oxygen use in trauma patients. Mil Med, 178(10), 1121–1125. https://doi.org/10.7205/MILMED-D-13-00126
McMullan, Jason, Dario Rodriquez, Kimberly Ward Hart, Christopher J. Lindsell, Kay Vonderschmidt, Beth Wayne, and Richard Branson. “Prevalence of prehospital hypoxemia and oxygen use in trauma patients.Mil Med 178, no. 10 (October 2013): 1121–25. https://doi.org/10.7205/MILMED-D-13-00126.
McMullan J, Rodriquez D, Hart KW, Lindsell CJ, Vonderschmidt K, Wayne B, et al. Prevalence of prehospital hypoxemia and oxygen use in trauma patients. Mil Med. 2013 Oct;178(10):1121–5.
McMullan, Jason, et al. “Prevalence of prehospital hypoxemia and oxygen use in trauma patients.Mil Med, vol. 178, no. 10, Oct. 2013, pp. 1121–25. Pubmed, doi:10.7205/MILMED-D-13-00126.
McMullan J, Rodriquez D, Hart KW, Lindsell CJ, Vonderschmidt K, Wayne B, Branson R. Prevalence of prehospital hypoxemia and oxygen use in trauma patients. Mil Med. 2013 Oct;178(10):1121–1125.

Published In

Mil Med

DOI

EISSN

1930-613X

Publication Date

October 2013

Volume

178

Issue

10

Start / End Page

1121 / 1125

Location

England

Related Subject Headings

  • Young Adult
  • Wounds and Injuries
  • Strategic, Defence & Security Studies
  • Prospective Studies
  • Practice Guidelines as Topic
  • Oxygen Inhalation Therapy
  • Middle Aged
  • Male
  • Hypoxia
  • Hypotension