Universität zu Köln

Wyen, Hendrik, Lefering, Rolf, Maegele, Marc, Brockamp, Thomas, Wafaisade, Arasch, Wutzler, Sebastian, Walcher, Felix and Marzi, Ingo (2013). The golden hour of shock how time is running out: prehospital time intervals in Germany-a multivariate analysis of 15, 103 patients from the TraumaRegister DGU (R). Emerg. Med. J., 30 (12). S. 1048 - 1056. LONDON: BMJ PUBLISHING GROUP. ISSN 1472-0213

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Abstract

Objectives Although prehospital treatment algorithms have changed over the past years, the prehospital time of multiple trauma patients of some 70 min and the on-scene-treatment time (OST) of some 30 min have not changed since 1993. The aim of this study was to critically assess specific interventions and conditions at the scene in relation to their impact on prehospital rescue intervals. Methods We performed a retrospective data analysis of all multiple injured patients from the TraumaRegister DGU (English: German Trauma Society) from January 1993 to December 2010. Exclusion criteria were missing or implausible data regarding prehospital timelines. With OST as an independent variable, different models of multivariate regression were performed to identify parameters with relevant impact on the OST. Results 15 103 datasets were included in this study. Based on the mean OST of 32.7 (+/-18.6) min and a constant absolute term of 16.2 (+/-1.5) min, we identified seven procedures and nine environmental parameters with significant impact on OST. Intubation (9.3+/-0.8 min) and being a car occupant (8.0+/-0.8 min) were associated with the most prolonged OSTs. A Glasgow Coma Scale <= 8 (-4.5+/-0.7 min) and cardiopulmonary resuscitation (-2.8+/-1.7 min) resulted in its most relevant reduction. Admission to a Level III facility led to a reduced overall prehospital time (60.0+/-24.6 min) compared with Level 1 (70.0+/-28.5 min) and II (66.8+/-27.4 min) trauma centres. Conclusions This study identified characteristic interventions and conditions with significant impact on prehospital treatment times. Current treatment concepts should be re-evaluated with respect to these results.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Wyen, Hendrik UNSPECIFIED UNSPECIFIED UNSPECIFIED Lefering, Rolf UNSPECIFIED UNSPECIFIED UNSPECIFIED Maegele, Marc UNSPECIFIED UNSPECIFIED UNSPECIFIED Brockamp, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Wafaisade, Arasch UNSPECIFIED UNSPECIFIED UNSPECIFIED Wutzler, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Walcher, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED Marzi, Ingo UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-470433
DOI:	10.1136/emermed-2012-201962
Journal or Publication Title:	Emerg. Med. J.
Volume:	30
Number:	12
Page Range:	S. 1048 - 1056
Date:	2013
Publisher:	BMJ PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	1472-0213
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language POLYTRAUMATIZED PATIENTS; ENDOTRACHEAL INTUBATION; TRAUMA; MORTALITY; SERVICES; INTERVENTIONS; SURVIVAL; PROLONG; IMPACT; CARE Multiple languages Emergency Medicine Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/47043