First Aid Management of Traumatic Hemorrhagic Shock Patients from Qinghai-Tibet Plateau : A Systematic Review and Meta-analysis

Abstract

Abstract Background: Threats from natural disasters, traffic accidents, violent conflicts and other public emergencies have increased the incidence of traumatic hemorrhagic shock (THS) patients from the Qinghai-Tibet plateau. Because of the high-altitude environment affects human physiological indicators, the first aid management measures for patients with THS may be different from those in low-altitude areas.However, there is no relevant first aid management guidelines have been issued.This study aims to analyze the first aid management measures of HTS patients from the Qinghai-Tibet plateau, and evaluate optimal treatment strategies. Methods: By searching PubMed, Medline, Embase, CNKI, CBMdisc, VIP and the Cochrane Database of Systematic Reviews, searched from inception until July 19, 2022. And conducted a meta-analysis of non-controlled studies with sub-group analysis for first aid management measures. Mortality and 95% confidence interval (CI) of the patients were used as the final pooled statistics. Results: Overall, 349 articles were identified, of which 13 relevant articles were identified following screening. First aid management measures of THS involve the 4 aspects: 1. oxygen supply, 2. hypothermia control, 3. blood circulation supplement, and 4. drug application. The mortality of patients with oxygen supply of 6-8L / min (Mortality 2%, 95%CI -0~5%) was lower than that of patients with oxygen supply of 4-6L / min (Mortality 16%, 95%CI 16~25%). The mortality of patients with hypothermia control (Mortality 3%, 95%CI 1~5%) was lower than that of patients with no hypothermia control (Mortality 11%, 95%CI 7~14%). Conclusions: Optimal first aid management measures weren’t available in terms of blood circulation supplement and drug administration. High-flow oxygen supply and control have a positive effect on the first aid of THS patients from Qinghai-Tibet Plateau.