PREHOSPITAL MANAGEMENT OF PATIENTS WITH SEVERE THORACIC INJURY

The physiological variables of oxygen saturation, blood pressure and p ulse rate were compared in the pre-hospital phase and on arrival at ho spital in a group of 63 patients with severe chest injury. Eighty-nine pre-hospital thoracic drainage procedures were carried out. Pre-hospi tal Advanced Trauma Life Support (ATLS) was associated with a signific ant improvement in all three variables. Median oxygen saturation incre ased by 17 per cent (P < 0.001), median blood pressure increased from 90 to 120 mmHg (P < 0.007) and median pulse rate decreased from 125 to 105 (P < 0.001). Pre-hospital intervention is indicated for tension p neumothorax, and contraindicated for haemothorax without respiratory c ompromise. In other situations further evidence is required, and stand ard ATLS protocols should be used until this is available.