TY - JOUR
T1 - The use of TRISS methodology to validate prehospital intubation by urban EMS providers
AU - Frankel, Heidi
AU - Rozycki, Grace
AU - Champion, Howard
AU - Harviel, J. Duncan
AU - Bass, Robert
PY - 1997
Y1 - 1997
N2 - The purpose of this study was to determine the impact of field orotracheal intubation (OI) by urban emergency medical technician-paramedics (EMT-Ps) on outcome compared with trauma score and injury severity score (TRISS) expectations. The records of all trauma patients intubated by EMT-Ps or hospital personnel were abstracted for OI attempts/ successes, use of neuromuscular blockade (NMB), scene time, discharge neurological status, and hospital survival compared with TRISS. EMT-Ps attempted 43% of all incubations; 81% were successful versus 98% by hospital staff (P< .05). NMB was used by 76% of hospital incubations versus none by EMS (P < .05). Scene time was 10.3 ± 3.2 minutes versus 11.6 ± 2.1 for patients intubated by emergency medical services (EMS) and hospital staff (P< .05). Sixty percent of patients intubated by EMS versus 68% by hospital staff had good/moderate discharge neurological status. Survival for patients intubated by EMS versus hospital staff was 11% and 40%, respectively, compared with 2% and 45% expected by TRISS. Field OI by urban EMT-Ps has a favorable impact on survival with good neurological outcome (P < .05).
AB - The purpose of this study was to determine the impact of field orotracheal intubation (OI) by urban emergency medical technician-paramedics (EMT-Ps) on outcome compared with trauma score and injury severity score (TRISS) expectations. The records of all trauma patients intubated by EMT-Ps or hospital personnel were abstracted for OI attempts/ successes, use of neuromuscular blockade (NMB), scene time, discharge neurological status, and hospital survival compared with TRISS. EMT-Ps attempted 43% of all incubations; 81% were successful versus 98% by hospital staff (P< .05). NMB was used by 76% of hospital incubations versus none by EMS (P < .05). Scene time was 10.3 ± 3.2 minutes versus 11.6 ± 2.1 for patients intubated by emergency medical services (EMS) and hospital staff (P< .05). Sixty percent of patients intubated by EMS versus 68% by hospital staff had good/moderate discharge neurological status. Survival for patients intubated by EMS versus hospital staff was 11% and 40%, respectively, compared with 2% and 45% expected by TRISS. Field OI by urban EMT-Ps has a favorable impact on survival with good neurological outcome (P < .05).
KW - Emergency medical services
KW - Endotracheal intubation
KW - Scoring systems
UR - http://www.scopus.com/inward/record.url?scp=0030678092&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0030678092&partnerID=8YFLogxK
U2 - 10.1016/S0735-6757(97)90174-1
DO - 10.1016/S0735-6757(97)90174-1
M3 - Article
C2 - 9375541
AN - SCOPUS:0030678092
SN - 0735-6757
VL - 15
SP - 630
EP - 632
JO - American Journal of Emergency Medicine
JF - American Journal of Emergency Medicine
IS - 7
ER -