Emergency medicine journal : EMJ
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Comparative Study
Prehospital trauma management: a national study of paramedic activities.
The benefits of prehospital trauma management remain controversial. This study aimed to compare the processes of care and outcomes of trauma patients treated by paramedics, who are trained in advanced prehospital trauma care, with those treated by ambulance technicians. ⋯ This large scale national study shows that paramedics show good triage skills and clinical judgement when managing trauma patients. However, the value of the individual interventions they perform could not be ascertained. Further controlled trials are necessary to determine the true benefits of advanced prehospital trauma life support.
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Rural and island areas of Scotland benefit from the availability of the Scottish Ambulance Service paramedic staffed helicopter for transfers and primary scene responses. There are a small number of patients who require advanced airway management, invasive procedures, or critical care interventions to stabilise them before transport to definitive care. ⋯ Given the potential difficulties of training paramedics to use these infrequently used skills it may be preferable to establish a formalised system to access suitably trained medical staff. This case series illustrates the clinical challenges and potential benefits of such a service and discusses the practicalities involved.