New research from the Ontario Prehospital Advanced Life Support (OPALS) project shows there is no benefit — and perhaps harm — to providing advanced life support to patients with trauma injuries prior to transport to hospital.
The third study from the OPALS project — likely the world’s most important research into the care provided to patients before they reach hospital — evaluated outcomes of patients with major traumatic injuries before and after system-wide implementation of prehospital advanced life-support programs in 17 cities. The study found that, among the 1373 patients who received basic life support and the 1494 who received advanced life support subsequent to experiencing major trauma, there was no difference (81.1% vs. 81.8% respectively) in the rate of survival to hospital discharge.
"Our findings support those who believe that definitive trauma care is best provided in the operating room and that prehospital interventions may be associated with increased complications or may delay transfer to hospital," write study authors Dr. Ian Stiell and colleagues.
The authors conclude that emergency medical services should "carefully reevaluate the indications for and applications of prehospital advanced life-support measures for patients with major trauma.
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