My life in your hands: the prehospital clinician's role in improving clinical outcomes for trauma patients
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Abstract
Trauma is a leading cause of death and disability globally, with the majority of the clinical burden being the result of bleeding and neurotrauma. Given that trauma has the potential to impact just about anyone, improving clinical outcomes across a range of demographics is a topic of great interest in emergency medicine research. The role of prehospital clinicians in trauma care has been debated, with some studies suggesting that interventions provided in the prehospital setting have the potential to do more harm than good and others suggesting that prompt intervention is vital to a good outcome. My intention for this thesis is to evaluate the efficacy and practicality of a variety of current prehospital medical practices and suggest changes and areas of further investigation that have the potential to improve outcomes for patients with severe trauma. From a clinical perspective, changes in practices should focus on reducing the consequences of hemorrhage and neurotrauma, although other interventions, which have the potential to improve functional outcomes, should not be neglected. From an operational perspective, much of the current research in the field examines appropriate resource use and triage criteria, and reducing rates of undertriage in older trauma patients in particular should remain a priority, especially in light of the aging global population. It is also evident that cognitive load is often a significant issue in the setting of prehospital trauma care, and reducing cognitive load through technologic aids is worth exploring. Mobile apps and machine learning also show great promise as tools for research, intervention, and quality assurance, and proper deployment of these technologies in the prehospital setting could lead to better patient outcomes.
Description
2024