• Christian Macke, Marika Sarakintsis, Marcel Winkelmann, Philipp Mommsen, Mohamed Omar, Christian Schröter, Christian Krettek, and Christian Zeckey.
• Trauma Department, Visceral and Transplant Surgery, Hannover Medical School, Hannover, Germany.
• J Emerg Med. 2018 Jun 1; 54 (6): 827-834.

BackgroundEntrapment is a challenging and crucial factor in the prehospital setting. Few studies have addressed whether entrapment has an influence on on-scene treatment or on the following hospital course.ObjectivesHere we aimed to investigate the influence of entrapment on prehospital management and on the hospital course of polytrauma patients.MethodsWe performed a retrospective analysis of consecutive patients with an Injury Severity Score ≥16 and aged 16-65 years that were admitted between 2005 and 2013 to a Level I trauma center. Two groups were built: entrapped (E) and nonentrapped patients (nE). These groups were evaluated for multiple prehospital and clinical parameters, including on-scene time, prehospital interventions, and posttraumatic complications.ResultsThere were 310 patients (n = 194 no entrapment [Group nE], n = 116 with entrapment [Group E]) enrolled. The on-scene time was significantly longer in Group E than Group nE. Moreover, this group received a significantly higher volume of colloidal solution. Regarding the Injury Severity Score and Abbreviated Injury Scale (AIS), there were no significant differences between the groups, except for the AISextremities, which was significantly increased in Group E. The overall hospital stay and the initial theater time were significantly longer in Group E than Group nE. No significant differences were present for the occurrence of systemic inflammatory response syndrome, multiple organ dysfunction syndrome, and acute respiratory distress syndrome, nor for Acute Physiology and Chronic Health Evaluation II and estimated and final mortality.ConclusionIn polytraumatized patients, entrapment has a minor influence on the outcome and treatment in the prehospital and hospital setting when using physician-based air rescue. However, entrapped patients are prone to sustain more severe trauma to the extremities.Copyright © 2018 Elsevier Inc. All rights reserved.

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