title: Prehospital rapid-sequence intubation of patients with trauma with a Glasgow Coma Score of 13 or 14 and the subsequent incidence of intracranial pathology.
abstract: 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.
authors.affiliation: Department of Pre-hospital Care, The Royal London Hospital, London, UK. danellis@doctors.org.uk
authors.forename: Daniel Y
authors.initials: DY
authors.lastname: Ellis
authors.forename: Gareth E
authors.initials: GE
authors.lastname: Davies
authors.forename: John
authors.initials: J
authors.lastname: Pearn
authors.forename: David
authors.initials: D
authors.lastname: Lockey
mesh_terms: 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*