Prehospital trauma care: what do we really know?

PURPOSE OF REVIEW: The prehospital care of injured patients has been surrounded with much controversy over the years. This controversy exists regarding the specific interventions used on-scene and en-route to definitive care centers, regarding the overall approach to the care of these patients (advanced life support versus basic life support) and with regards to who should be providing this care. This section of the journal aims to review the most current literature concerning these topics as well as highlight some important and relevant literature preceding it. RECENT
FINDINGS: Studies examining overall prehospital care in terms of morbidity, mortality and cost have been published over the last year and important points from these studies are highlighted in the text. Unfortunately, there have not been any recent, appropriately powered, prospective studies that help in clarifying this controversy. An international study of prehospital care has recently been completed and is summarized. Recent studies looking at specific aspects of prehospital care (endotracheal intubation, intravenous access and therapy, rural trauma) are also outlined in the text.
SUMMARY: There is no convincing evidence that prehospital advanced life support in the urban setting provides any benefit to injured patients in terms of either morbidity or mortality.