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Prehospital management of chest injuries in severely injured patients-a systematic review and clinical practice guideline update.
Waydhas, Christian; Prediger, Barbara; Kamp, Oliver; Kleber, Christian; Nohl, André; Schulz-Drost, Stefan; Schreyer, Christof; Schwab, Robert; Struck, Manuel Florian; Breuing, Jessica; Trentzsch, Heiko.
Afiliación
  • Waydhas C; Department of Trauma, Hand and Reconstructive Surgery, Essen University Hospital, Essen, Germany. christian.waydhas@uni-due.de.
  • Prediger B; Department of Surgery, BG Bergmannsheil University Hospital, Bochum, Germany. christian.waydhas@uni-due.de.
  • Kamp O; Institute for Research in Operative Medicine, Witten/Herdecke University, Cologne, Germany.
  • Kleber C; Department of Trauma, Hand and Reconstructive Surgery, Essen University Hospital, Essen, Germany.
  • Nohl A; Department of Orthopaedics, Trauma Surgery and Plastic Surgery, Leipzig University Hospital, Leipzig, Germany.
  • Schulz-Drost S; Centre of Emergency Medicine, BG Duisburg Hospital, Duisburg, Germany.
  • Schreyer C; Zentrum für Bewegungs- und Altersmedizin, Helios Kliniken Schwerin, Schwerin, Germany.
  • Schwab R; Department für Unfall- und Orthopädische Chirurgie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
  • Struck MF; Department of General, Visceral and Thoracic Surgery, Bundeswehr Central Hospital, Koblenz, Germany.
  • Breuing J; Department of General, Visceral and Thoracic Surgery, Bundeswehr Central Hospital, Koblenz, Germany.
  • Trentzsch H; Department of Anaesthesiology and Intensive Care Medicine, Leipzig University Hospital, Leipzig, Germany.
Eur J Trauma Emerg Surg ; 2024 Feb 03.
Article en En | MEDLINE | ID: mdl-38308661
ABSTRACT

PURPOSE:

Our aim was to review and update the existing evidence-based and consensus-based recommendations for the management of chest injuries in patients with multiple and/or severe injuries in the prehospital setting. This guideline topic is part of the 2022 update of the German Guideline on the Treatment of Patients with Multiple and/or Severe Injuries.

METHODS:

MEDLINE and Embase were systematically searched to May 2021. Further literature reports were obtained from clinical experts. Randomised controlled trials, prospective cohort studies, cross-sectional studies, and comparative registry studies were included if they compared interventions for the detection and management of chest injuries in severely injured patients in the prehospital setting. We considered patient-relevant clinical outcomes such as mortality and diagnostic test accuracy. Risk of bias was assessed using NICE 2012 checklists. The evidence was synthesised narratively, and expert consensus was used to develop recommendations and determine their strength.

RESULTS:

Two new studies were identified, both investigating the accuracy of in-flight ultrasound in the detection of pneumothorax. Two new recommendations were developed, one recommendation was modified. One of the two new recommendations and the modified recommendation address the use of ultrasound for detecting traumatic pneumothorax. One new good (clinical) practice point (GPP) recommends the use of an appropriate vented dressing in the management of open pneumothorax. Eleven recommendations were confirmed as unchanged because no new high-level evidence was found to support a change.

CONCLUSION:

Some evidence suggests that ultrasound should be considered to identify pneumothorax in the prehospital setting. Otherwise, the recommendations from 2016 remained unchanged.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials / Guideline / Observational_studies / Risk_factors_studies / Systematic_reviews Idioma: En Revista: Eur J Trauma Emerg Surg Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials / Guideline / Observational_studies / Risk_factors_studies / Systematic_reviews Idioma: En Revista: Eur J Trauma Emerg Surg Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania