Prehospital advanced XXXX life support for critical penetrating wounds to the thorax and abdomen.

@entity1 @entity130
The role of advanced @entity130 life support (ATLS) in the prehospital care of the critically injured is highly controversial. This study analyzes the efficacy of ATLS in the management of critical penetrating wounds of the thorax and abdomen. In the 2 1/2-year period ending July 1984, 203 consecutive @entity1 underwent emergency laparotomy or thoracotomy for gunshot and stab wounds. All @entity1 were treated in the field by advanced paramedics (EMT-P). For gunshot wounds the mean time (+/- S.E.M.) responding to the scene was 4.5 (+/- 0.29) minutes, on the scene 10.1 (+/- 0.41) minutes, and returning to the hospital 6.4 (+/- 0.32) minutes. For stab wounds the mean time responding to the scene was 4.8 (+/- 0.21) minutes, on the scene 9.5 (+/- 0.37) minutes, and returning to the hospital 5.7 (+ 0.30) minutes. The number of intravenous lines started averaged 1.8 per @entity1 . Eighty-one @entity1 had PASG applied and 28 @entity1 underwent endotracheal intubation (21 orally, seven nasally). Thirty-three @entity1 had no obtainable blood pressure, of whom six survived (18%). One hundred sixty (94%) of the remaining 170 @entity1 who had any initial blood pressure survived. One hundred nine (55%) @entity1 had an increase in BP greater than or equal to 10 mm Hg (average, 35.6 mm Hg), 64 (32%) had no significant change, and 25 (13%) had a fall greater than or equal to 10 mm Hg (average, 24.2 mm Hg) from the field to the emergency department. Twenty (80%) of the 25 @entity1 with a fall in blood pressure survived.(ABSTRACT TRUNCATED AT 250 WORDS)
