title: Current pre-hospital traumatic brain injury management in China.
abstract: BACKGROUND
  Traumatic brain injury (TBI) is associated with most trauma-related deaths. Secondary brain injury is the leading cause of in-hospital deaths after traumatic brain injury. By early prevention and slowing of the initial pathophysiological mechanism of secondary brain injury, pre-hospital service can significantly reduce case-fatality rates of TBI. In China, the incidence of TBI is increasing and the proportion of severe TBI is much higher than that in other countries. The objective of this paper is to review the pre-hospital management of TBI in China.
  
  
  METHODS
  A literature search was conducted in January 2014 using the China National Knowledge Infrastructure (CNKI). Articles on the assessment and treatment of TBI in pre-hospital settings practiced by Chinese doctors were identified. The information on the assessment and treatment of hypoxemia, hypotension, and brain herniation was extracted from the identified articles.
  
  
  RESULTS
  Of the 471 articles identified, 65 met the selection criteria. The existing literature indicated that current practices of pre-hospital TBI management in China were sub-optimal and varied considerably across different regions.
  
  
  CONCLUSIONS
  Since pre-hospital care is the weakest part of Chinese emergency care, appropriate training programs on pre-hospital TBI management are urgently needed in China.
authors.affiliation: School of Public Health and Social Work & Institute Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD 4059, Australia.
authors.forename: Kou
authors.initials: K
authors.lastname: Kou
authors.affiliation: School of Public Health and Social Work & Institute Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD 4059, Australia.
authors.forename: Xiang-Yu
authors.initials: XY
authors.lastname: Hou
authors.affiliation: School of Public Health and Social Work & Institute Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD 4059, Australia.
authors.forename: Jian-Dong
authors.initials: JD
authors.lastname: Sun
authors.affiliation: Royal Brisbane and Women's Hospital Metro North Hospital and Health Service, Butterfield Street Herston QLD 4029, Australia.
authors.forename: Kevin
authors.initials: K
authors.lastname: Chu
keywords: China; Emergency medicine; Pre-hospital; Traumatic brain injury