Prehospital Interventions Performed in Afghanistan Between November 2009 and March 2014

Author:

Lairet Julio123,Bebarta Vikhyat S45,Maddry Joseph K4,Reeves Lauren4,Mora Alejandra4,Blackbourne Lorne6,Rasmussen Todd7

Affiliation:

1. Department of Emergency Medicine, Emory University School of Medicine, 531 Asbury Circle, Annex Building Suite N340, Atlanta, GA

2. Headquarters Georgia Air National Guard, 1000 Halsey Avenue Bldg. 447, Marietta, GA

3. Atlanta VA Medical Center, 1670 Clairmont Rd, Decatur, GA

4. 59th MDW/Chief Scientist Office, United States Air Force En Route Care Research Center, 3698 Chambers Pass Ste B, JBSA Ft Sam Houston, TX

5. Department of Emergency Medicine, University of Colorado School of Medicine, 12401 E. 17th Avenue, Aurora, CO

6. Trauma Medical Director, St David’s Round Rock Medical Center, 2400 Round Rock Ave, Round Rock, TX

7. F. Edward Hébert School of Medicine, Uniformed Services University of Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD

Abstract

Abstract Objective Care provided to a casualty in the prehospital combat setting can influence subsequent medical interactions and impact patient outcomes; therefore, we aimed to describe the incidence of specific prehospital interventions (lifesaving interventions (LSIs)) performed during the resuscitation and transport of combat casualties. Methods We performed a prospective observational, IRB approved study between November 2009 and March 2014. Casualties were enrolled as they were cared for at nine U.S. military medical facilities in Afghanistan. Data were collected using a standardized collection form. Determination if a prehospital intervention was performed correctly, performed incorrectly, or was necessary but was not performed (missed LSIs) was made by the receiving facility’s medical provider. Results Two thousand one hundred and six patients met inclusion criteria. The mean age was 25 years and 98% were male. The most common mechanism of injury was explosion 57%. There were 236 airway interventions attempted, 183 chest procedures, 1,673 hemorrhage control, 1,698 vascular access, and 1,066 hypothermia preventions implemented. There were 142 incorrectly performed interventions and 360 were missed. Conclusions In our study, the most commonly performed prehospital LSI in a combat setting were for vascular access and hemorrhage control. The most common incorrectly performed and missed interventions were airway interventions and chest procedures respectively.

Publisher

Oxford University Press (OUP)

Subject

Public Health, Environmental and Occupational Health,General Medicine

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