Prehospital rapid-sequence intubation of patients with trauma with a Glasgow Coma Score of 13 or 14 and the subsequent incidence of intracranial pathology.
OBJECTIVE
To identify the incidence of intracranial pathology in a population of patients with trauma with an on-scene Glasgow Coma Score (GCS) of 13 or 14, and the proportion that required prehospital intubation and ventilation.


METHODS
A retrospective review of a prehospital trauma database was carried out over a 12-month period, and 81 patients were reviewed. All had a traumatic mechanism of injury and had an on-scene GCS of 13 or 14 recorded by a prehospital doctor. 43 patients required prehospital rapid-sequence intubation. Overall, 31.5% of patients with a GCS of 13 or 14 had an abnormal computed tomography scan of the head and 20.5% had an intracranial haemorrhage.


RESULTS
For this group of patients with trauma with a drop of only one or two points on the GCS, the incidence of intracranial pathology was almost one in three and that of intracranial haemorrhage was one in five.
Ellis
Daniel Y
DY
Department of Pre-hospital Care, The Royal London Hospital, London, UK. danellis@doctors.org.uk
Davies
Gareth E
GE
Pearn
John
J
Lockey
David
D
D001927:Brain Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging / Q000628:therapy; D019992:Databases as Topic; D004632:Emergency Medical Services; D015600:Glasgow Coma Scale; D006801:Humans; D015994:Incidence; D020300:Intracranial Hemorrhages / Q000453:epidemiology / Q000209:etiology; D007442:Intubation, Intratracheal; D009104:Multiple Trauma / Q000628:therapy; D012121:Respiration, Artificial; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014947:Wounds and Injuries / Q000150:complications / Q000628:therapy*