Comments on: Aggressive Paramedic Care Holds No Benefit for Trauma Patients

By: Jon

Jon — Thu, 18 Sep 2008 08:31:54 +0000

I may be over simplifying this but hasn’t it always been the case that the temptation to ’stay and play’ rather than ‘load and go’ may adversely affect patient outcome. I have witnessed (as a Paramedic) a patient with extensive traumatic life threatening injuries following a motorcycle RTC having been fully ‘packaged’ and ready for transport, then held up on scene for a further 30 mins after the arrival of HEMS because they had a greater range of PALS procedures. The fact that this patient was only 10 mins flying time from definitive care seemed to be secondary.
That is not to say there is a time and place to stay and play but with greater skills comes greater responsibility and if that responsibility is exercised correctly I personally have no doubt that PALS is always going to be better for the patient than just BLS.

By: Tug

Tug — Fri, 08 Aug 2008 11:37:10 +0000

An interesting article but without actually reading the paper your summary is misleading. Aggresive Paramedic Care may not hold bennefit for trauma patients? How do we know that it was the advanced life support that caused the reduced positive outcomes? There is very strong circumstantial evidence their but it needs very careful follow up.
There are large differences in North american and UK practice. Why is there no comment on the recent NCEPOD report “Trauma. Who Cares?”. This report was startling in its findings that a large number of trauma patients have poor or worsening outcomes up to three weeks post incident because of poor pre-hospital airway management.
With response times being key at present I do not see trauma training or refreshers being high on the priority list.