Travma olgularında hastane öncesi yaşam desteği seçimi: Temel ya da ileri travma yaşam desteği

ÖZDOĞAN, Mehmet; TAVİLOĞLU, Korhan; AĞALAR, Fatih; ERYILMAZ, MEHMET ALİ; ÖZEL, Gürkan

Travma olgularında hastane öncesi yaşam desteği seçimi: Temel ya da ileri travma yaşam desteği

Mehmet ÖZDOĞAN, (Atatürk Eğitim ve Araştırma Hastanesi, Genel Cerrahi Kliniği, Ankara, Türkiye)

Fatih AĞALAR, (Kırıkkale Üniversitesi, Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Kırıkkale, Türkiye)

Mehmet ERYILMAZ, (GATA Acil Tıp Anabilim Dalı, Ankara, Türkiye)

Gürkan ÖZEL, (Paramedik, Denver, USA)

Korhan TAVİLOĞLU (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, İstanbul, Türkiye)

Ulusal Travma ve Acil Cerrahi Dergisi

10 2

Yıl: 2006 Cilt: 12 Sayı: 2 Sayfa Aralığı: 87 - 94 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Travma olgularında hastane öncesi yaşam desteği seçimi: Temel ya da ileri travma yaşam desteği

Öz:

Travmalı olgularda hastane öncesi dönemde uygulanması gereken tedavinin “İleri Travma Yaşam Desteği” (İTYD) ya da “Temel Yaşam Desteği” (TYD) şeklinde olması gerektiği üzerindeki tartışmalar sürmektedir. Bu derlemede travma hastalarına hastane öncesi dönemde uygulanan İTYD ve TYD tedavileri üzerine olan literatür gözden geçirildi; İTYD ve TYD içeren toplam 76 çalışma değerlendirildi. İntravenöz katater uygulaması, hastane öncesi sıvı tedavisi, hasta transport süresi, entübasyon ve ölüm oranları gibi değişkenler incelendi. Literatürdeki bilgilerin sahada travma hastalarına rutin olarak İTYD uygulanmasının gerekliliği konusunda net olmadığı sonucuna varıldı. Bu konudaki eksikliğin giderilmesi için travma hastalarında İTYD ve TYD’yi karşılaştıran prospektif, kontollü çalışmalara gereksinim vardır

Anahtar Kelime: Acil tıp servisleri Hasta taşıma Yaşam desteği sistemleri Yaralar ve yaralanmalar Acil tıp Geriyedönük çalışma Canlandırma

Konular: Tıbbi İnformatik Acil Tıp Temel Sağlık Hizmetleri Sağlık Bilimleri ve Hizmetleri

Prehospital life support in trauma patients: basic or advanced trauma life support

Öz:

The controversy between Advanced Trauma Life Support (ATLS) and Basic Life Support (BLS) in the prehospital care of trauma patients has not been resolved yet. The purpose of this study was to examine the literature with respect to the type of prehospital care applied to the trauma patients. A total of 76 papers on ATLS and/or BLS for trauma were reviewed regarding the variables such as intravenous catheter application, prehospital fluid resuscitation, transport time, intubation and mortality. As a conclusion, the data in the literature do not support the routine use of on-field ATLS in trauma patients. Prospective randomized trials comparing ATLS and BLS in prehospital management of trauma patients are needed to clarify this issue.

Anahtar Kelime: Retrospective Studies Resuscitation Emergency Medical Services Transportation of Patients Life Support Systems Wounds and Injuries Emergency Medicine

Konular: Tıbbi İnformatik Acil Tıp Temel Sağlık Hizmetleri Sağlık Bilimleri ve Hizmetleri

Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık

1. Bresnahan KA, Fowler J. Emergency medical care in Turkey: current status and future directions. Ann Emerg Med 1995;26:357-60.
2. Lechleuthner A, Emerman C, Dauber A, Bouillon B, Kubincanek JA. Evolution of rescue systems: a comparison between Cologne and Cleveland. Prehospital Disaster Med 1994;9:193-7.
3. VanRooyen MJ, Thomas TL, Clem KJ. International emergency medical services: assessment of developing prehospital systems abroad. J Emerg Med 1999;17:691-6.
4. Frame SB. Prehospital care. In: Mattox KL, Feliciano DV, Moore EE, editors. Trauma. 4th ed. New York: McGraw-Hill; 2000. p. 103-26.
5. Arnold JL. International emergency medicine and the recent development of emergency medicine worldwide. Ann Emerg Med 1999;33:97-103.
6. Taviloğlu K. TRK hakkında genel bilgiler. In: Ertekin C, Günay MK, Kurtoğlu M, Taviloğlu K, editörler. Travma ve Resüsitasyon Kurs Kitabı. ‹İtanbul: Logos Yayıncılık; 1998. s. 7-14.
7. Taviloglu K, Ertekin C, Guloglu R, Tokyay R, Akgun Y. Trauma and resuscitation course (TRC): evaluation of the first 2 years. [Article in Turkish] Ulus Travma Derg 2001;7:8-12.
8. van Olden GD, Meeuwis JD, Bolhuis HW, Boxma H, Goris RJ. Clinical impact of advanced trauma life support. Am J Emerg Med 2004;22:522-5.
9. Driscoll P, Wardrope J. ATLS: past, present, and future. Emerg Med J 2005;22:2-3.
10. van Olden GD, Meeuwis JD, Bolhuis HW, Boxma H, Goris RJ. Advanced trauma life support study: quality of diagnostic and therapeutic procedures. J Trauma 2004;57:381-4.
11. Trunkey D. Initial treatment of patients with extensive trauma. N Engl J Med 1991;324:1259-63.
12. Eisenberg MS, Bergner L, Hallstrom A. Out-of-hospital cardiac arrest: improved survival with paramedic services. Lancet 1980;1:812-5.
13. Bissell RA, Eslinger DG, Zimmerman L. The efficacy of advanced life support: a review of the literature. Prehospital Disaster Med 1998;13:77-87.
14. Liberman M, Mulder D, Sampalis J. Prehospital care of the patient with major trauma. J Trauma 2000;49:584-99.
15. Bunn F, Kwan I, Roberts I, Wentz R. Effectiveness of pre-hospital trauma care. Cochrane Injuries Group. 2001. Available from: http://www.cochrane-injuries.1shtm. ac.uk
16. Fowler R, Pepe PE. Prehospital care of the patient with major trauma. Emerg Med Clin North Am 2002;20:953-74.
17. Kowalenko T, Stern S, Dronen S, Wang X. Improved outcome with hypotensive resuscitation of uncontrolled hemorrhagic shock in a swine model. J Trauma 1992;33:349-53.
18. Krausz MM, Bar-Ziv M, Rabinovici R, Gross D. “Scoop and run” or stabilize hemorrhagic shock with normal saline or small-volume hypertonic saline? J Trauma 1992;33:6-10.
19. Bickell WH, Bruttig SP, Millnamow GA, O’Benar J, Wade CE. The detrimental effects of intravenous crystalloid after aortotomy in swine. Surgery 1991;110:529-36.
20. Bickell WH, Bruttig SP, Millnamow GA, O’Benar J, Wade CE. Use of hypertonic saline/dextran versus lactated Ringer’s solution as a resuscitation fluid after uncontrolled aortic hemorrhage in anesthetized swine. Ann Emerg Med 1992;21:1077-85.
21. Gross D, Landau EH, Klin B, Krausz MM. Treatment of uncontrolled hemorrhagic shock with hypertonic saline solution. Surg Gynecol Obstet 1990;170:106-12.
22. Pepe PE, Mosesso VN Jr, Falk JL. Prehospital fluid resuscitation of the patient with major trauma. Prehosp Emerg Care 2002;6:81-91.
23. Stern SA. Low-volume fluid resuscitation for presumed hemorrhagic shock: helpful or harmful? Curr Opin Crit Care 2001;7:422-30.
24. Bickell WH, Wall MJ Jr, Pepe PE, Martin RR, Ginger VF, Allen MK, Mattox KL. Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Engl J Med 1994;331:1105-9.
25. Sampalis JS, Tamim H, Denis R, Boukas S, Ruest SA, Nikolis A, et al. Ineffectiveness of on-site intravenous lines: is prehospital time the culprit? J Trauma 1997;43:608-15.
26. Dutton RP, Mackenzie CF, Scalea TM. Hypotensive resuscitation during active hemorrhage: impact on inhospital mortality. J Trauma 2002;52:1141-6.
27. Lawrence DW, Lauro AJ. Complications from i.v. therapy: results from field-started and emergency departmentstarted i.v.'s compared. Ann Emerg Med 1988;17:314-7.
28. Zornow MH, Prough DS. Fluid management in patients with traumatic brain injury. New Horiz 1995;3:488-98.
29. Wald SL, Shackford SR, Fenwick J. The effect of secondary insults on mortality and long-term disability after severe head injury in a rural region without a trauma system. J Trauma 1993;34:377-81.
30. Stern SA, Zink BJ, Mertz M, Wang X, Dronen SC. Effect of initially limited resuscitation in a combined model of fluid-percussion brain injury and severe uncontrolled hemorrhagic shock. J Neurosurg 2000;93:305-14.
31. Stern SA, Kowalenko T, Younger J, Wang X, Dronen SC. Comparison of the effects of bolus vs. slow infusion of 7.5% NaCl/6% dextran-70 in a model of near-lethal uncontrolled hemorrhage. Shock 2000;14:616-22.
32. Matsuoka T, Hildreth J, Wisner DH. Uncontrolled hemorrhage from parenchymal injury: is resuscitation helpful? J Trauma 1996;40:915-21.
33. Solomonov E, Hirsh M, Yahiya A, Krausz MM. The effect of vigorous fluid resuscitation in uncontrolled hemorrhagic shock after massive splenic injury. Crit Care Med 2000;28:749-54.
34. Lee WC, Nelson R. Field intravenous lines: are they worth it? J Trauma 1986; 26:678.
35. Lewis FR Jr. Prehospital intravenous fluid therapy: physiologic computer modelling. J Trauma 1986;26:804-11.
36. Wears RL, Winton CN. Load and go versus stay and play: analysis of prehospital i.v. fluid therapy by computer simulation. Ann Emerg Med 1990;19:163-8.
37. Jones SE, Nesper TP, Alcouloumre E. Prehospital intravenous line placement: a prospective study. Ann Emerg Med 1989;18:244-6.
38. Feldman R. IV line placement: a time study for prehospital providers. J Emerg Med Serv JEMS 1986;11:43-45.
39. Kaweski SM, Sise MJ, Virgilio RW. The effect of prehospital fluids on survival in trauma patients. J Trauma 1990;30:1215-8.
40. Pepe PE, Copass MK, Joyce TH. Prehospital endotracheal entubation-rationale for training emergency medical personnel. Ann Emerg Med 1985;14:1085-1092.
41. Jenkins WA, Verdile VP, Paris PM. The syringe aspiration technique to verify endotracheal tube position. Am J Emerg Med 1994;12:413-6.
42. Stewart RD, Paris PM, Winter PM, Pelton GH, Cannon GM. Field endotracheal intubation by paramedical personnel. Success rates and complications. Chest 1984;85:341-5.
43. Copass MK, Oreskovich MR, Bladergroen MR, Carrico CJ. Prehospital cardiopulmonary resuscitation of the critically injured patient. Am J Surg 1984;148:20-6.
44. Durham LA 3rd, Richardson RJ, Wall MJ Jr, Pepe PE, Mattox KL. Emergency center thoracotomy: impact of prehospital resuscitation. J Trauma 1992;32:775-9.
45. Nolan JD. Prehospital and resuscitative airway care: should the gold standard be reassessed? Curr Opin Crit Care 2001;7:413-21.
46. Eckstein M, Chan L, Schneir A, Palmer R. Effect of prehospital advanced life support on outcomes of major trauma patients. J Trauma 2000;48:643-8.
47. Boyd DR, Cowley RA. Comprehensive regional trauma/ emergency medical services (EMS) delivery systems: the United States experience. World J Surg 1983;7:149-57.
48. Lerner EB, Moscati RM. The golden hour: scientific fact or medical "urban legend"? Acad Emerg Med 2001;8:758-60.
49. Sampalis JS, Lavoie A, Williams JI, Mulder DS, Kalina M. Impact of on-site care, prehospital time, and level of in-hospital care on survival in severely injured patients. J Trauma 1993;34:252-61.
50. Feero S, Hedges JR, Simmons E, Irwin L. Does out-ofhospital EMS time affect trauma survival? Am J Emerg Med 1995;13:133-5.
51. Esposito TJ, Maier RV, Rivara FP, Pilcher S, Griffith J, Lazear S, et al. The impact of variation in trauma care times: urban versus rural. Prehospital Disaster Med 1995;10:161-6.
52. Grossman DC, Kim A, Macdonald SC, Klein P, Copass MK, Maier RV. Urban-rural differences in prehospital care of major trauma. J Trauma 1997;42:723-9.
53. Clevenger FW, Yarbrough DR, Reines HD. Resuscitative thoracotomy: the effect of field time on outcome. J Trauma 1988;28:441-5.
54. Gervin AS, Fischer RP. The importance of prompt transport of salvage of patients with penetrating heart wounds. J Trauma 1982;22:443-8.
55. Cunningham P, Rutledge R, Baker CC, Clancy TV. A comparison of the association of helicopter and ground ambulance transport with the outcome of injury in trauma patients transported from the scene. J Trauma 1997;43:940-6.
56. Petri RW, Dyer A, Lumpkin J. The effect of prehospital transport time on the mortality from traumatic injury. Prehospital Disaster Med 1995;10:24-9.
57. Pepe PE, Wyatt CH, Bickell WH, Bailey ML, Mattox KL. The relationship between total prehospital time and outcome in hypotensive victims of penetrating injuries. Ann Emerg Med 1987;16:293-7.
58. Lerner EB, Billittier AJ, Dorn JM, Wu YW. Is total outofhospital time a significant predictor of trauma patient mortality? Acad Emerg Med 2003;10:949-54.
59. Osterwalder JJ. Can the "golden hour of shock" safely be extended in blunt polytrauma patients? Prospective cohort study at a level I hospital in eastern Switzerland. Prehospital Disaster Med 2002;17:75-80.
60. Demetriades D, Chan L, Cornwell E, Belzberg H, Berne TV, Asensio J, et al. Paramedic vs private transportation of trauma patients. Effect on outcome. Arch Surg 1996;131:133-8.
61. Ummenhofer W, Scheidegger D. Role of the physician in prehospital management of trauma: European perspective. Curr Opin Crit Care 2002;8:559-65.
62. Liberman M, Mulder D, Lavoie A, Denis R, Sampalis JS. Multicenter Canadian study of prehospital trauma care. Ann Surg 2003;237:153-60.
63. Hedges JR, Sacco WJ, Champion HR. An analysis of prehospital care of blunt trauma. J Trauma 1982;22:989-93.
64. Aprahamian C, Thompson BM, Towne JB, Darin JC. The effect of a paramedic system on mortality of major open intra-abdominal vascular trauma. J Trauma 1983;23:687-90.
65. Potter D, Goldstein G, Fung SC, Selig M. A controlled trial of prehospital advanced life support in trauma. Ann Emerg Med 1988;17:582-8.
66. Jacobs LM, Sinclair A, Beiser A, D'Agostino RB. Prehospital advanced life support: benefits in trauma. J Trauma 1984;24:8-13.
67. Cwinn AA, Pons PT, Moore EE, Marx JA, Honigman B, Dinerman N. Prehospital advanced trauma life support for critical blunt trauma victims. Ann Emerg Med 1987;16:399-403.
68. Fortner GS, Oreskovich MR, Copass MK, Carrico CJ. The effects of prehospital trauma care on survival from a 50-meter fall. J Trauma 1983;23:976-81.
69. Ivatury RR, Nallathambi MN, Roberge RJ, Rohman M, Stahl W. Penetrating thoracic injuries: in-field stabilization vs. prompt transport. J Trauma 1987;27:1066-73.
70. Smith JP, Bodai BI, Hill AS, Frey CF. Prehospital stabilization of critically injured patients: a failed concept. J Trauma 1985; 25:65-70.
71. Gold CR. Prehospital advanced life support vs “scoop and run” in trauma management. Ann Emerg Med 1987;16:797-801.
72. Sampalis JS, Lavoie A, Williams JI, Mulder DS, Kalina M. Standardized mortality ratio analysis on a sample of severely injured patients from a large Canadian city without regionalized trauma care. J Trauma 1992;33:205-11.
73. Martin RR, Bickell WH, Pepe PE, Burch JM, Mattox KL. Prospective evaluation of preoperative fluid resuscitation in hypotensive patients with penetrating truncal injury: a preliminary report. J Trauma 1992;33:354-61.
74. Cayten CG, Murphy JG, Stahl WM. Basic life support versus advanced life support for injured patients with an injury severity score of 10 or more. J Trauma 1993;35:460-6.
75. Murphy JG, Cayten CG, Stahl WM, Glasser M. Dual response runs in prehospital trauma care. J Trauma 1993;35:356-62.
76. Dick WF. Anglo-American vs. Franco-German emergency medical services system. Prehospital Disaster Med 2003;18:29-35.

APA	ÖZDOĞAN M, AĞALAR F, ERYILMAZ M, ÖZEL G, TAVİLOĞLU K (2006). Travma olgularında hastane öncesi yaşam desteği seçimi: Temel ya da ileri travma yaşam desteği. , 87 - 94.
Chicago	ÖZDOĞAN Mehmet,AĞALAR Fatih,ERYILMAZ MEHMET ALİ,ÖZEL Gürkan,TAVİLOĞLU Korhan Travma olgularında hastane öncesi yaşam desteği seçimi: Temel ya da ileri travma yaşam desteği. (2006): 87 - 94.
MLA	ÖZDOĞAN Mehmet,AĞALAR Fatih,ERYILMAZ MEHMET ALİ,ÖZEL Gürkan,TAVİLOĞLU Korhan Travma olgularında hastane öncesi yaşam desteği seçimi: Temel ya da ileri travma yaşam desteği. , 2006, ss.87 - 94.
AMA	ÖZDOĞAN M,AĞALAR F,ERYILMAZ M,ÖZEL G,TAVİLOĞLU K Travma olgularında hastane öncesi yaşam desteği seçimi: Temel ya da ileri travma yaşam desteği. . 2006; 87 - 94.
Vancouver	ÖZDOĞAN M,AĞALAR F,ERYILMAZ M,ÖZEL G,TAVİLOĞLU K Travma olgularında hastane öncesi yaşam desteği seçimi: Temel ya da ileri travma yaşam desteği. . 2006; 87 - 94.
IEEE	ÖZDOĞAN M,AĞALAR F,ERYILMAZ M,ÖZEL G,TAVİLOĞLU K "Travma olgularında hastane öncesi yaşam desteği seçimi: Temel ya da ileri travma yaşam desteği." , ss.87 - 94, 2006.
ISNAD	ÖZDOĞAN, Mehmet vd. "Travma olgularında hastane öncesi yaşam desteği seçimi: Temel ya da ileri travma yaşam desteği". (2006), 87-94.

APA	ÖZDOĞAN M, AĞALAR F, ERYILMAZ M, ÖZEL G, TAVİLOĞLU K (2006). Travma olgularında hastane öncesi yaşam desteği seçimi: Temel ya da ileri travma yaşam desteği. Ulusal Travma ve Acil Cerrahi Dergisi, 12(2), 87 - 94.
Chicago	ÖZDOĞAN Mehmet,AĞALAR Fatih,ERYILMAZ MEHMET ALİ,ÖZEL Gürkan,TAVİLOĞLU Korhan Travma olgularında hastane öncesi yaşam desteği seçimi: Temel ya da ileri travma yaşam desteği. Ulusal Travma ve Acil Cerrahi Dergisi 12, no.2 (2006): 87 - 94.
MLA	ÖZDOĞAN Mehmet,AĞALAR Fatih,ERYILMAZ MEHMET ALİ,ÖZEL Gürkan,TAVİLOĞLU Korhan Travma olgularında hastane öncesi yaşam desteği seçimi: Temel ya da ileri travma yaşam desteği. Ulusal Travma ve Acil Cerrahi Dergisi, vol.12, no.2, 2006, ss.87 - 94.
AMA	ÖZDOĞAN M,AĞALAR F,ERYILMAZ M,ÖZEL G,TAVİLOĞLU K Travma olgularında hastane öncesi yaşam desteği seçimi: Temel ya da ileri travma yaşam desteği. Ulusal Travma ve Acil Cerrahi Dergisi. 2006; 12(2): 87 - 94.
Vancouver	ÖZDOĞAN M,AĞALAR F,ERYILMAZ M,ÖZEL G,TAVİLOĞLU K Travma olgularında hastane öncesi yaşam desteği seçimi: Temel ya da ileri travma yaşam desteği. Ulusal Travma ve Acil Cerrahi Dergisi. 2006; 12(2): 87 - 94.
IEEE	ÖZDOĞAN M,AĞALAR F,ERYILMAZ M,ÖZEL G,TAVİLOĞLU K "Travma olgularında hastane öncesi yaşam desteği seçimi: Temel ya da ileri travma yaşam desteği." Ulusal Travma ve Acil Cerrahi Dergisi, 12, ss.87 - 94, 2006.
ISNAD	ÖZDOĞAN, Mehmet vd. "Travma olgularında hastane öncesi yaşam desteği seçimi: Temel ya da ileri travma yaşam desteği". Ulusal Travma ve Acil Cerrahi Dergisi 12/2 (2006), 87-94.