Emergency Treatment Guidelines Improve Survival of People with Severe Head Injury

A large study of more than 21,000 people finds that training emergency medical services (EMS) agencies to implement prehospital guidelines for traumatic brain injury (TBI) may help improve survival in patients with severe head trauma. The findings were published in JAMA Surgery. The study was supported by NINDS.

“This demonstrates the significance of conducting studies in real-world settings and brings a strong evidence base to the guidelines,” said Dr. Patrick Bellgowan, program director at NINDS.

“It suggests we can systematically increase the chances of saving the lives of thousands of people who suffer severe traumatic brain injuries.”

Based on scores of observational studies, guidelines for prehospital management of TBI that were developed in 2000, and updated in 2007, focused on preventing low oxygen, low blood pressure and hyperventilation in people with head injury.

Collectively, the studies suggested that controlling those factors before patients arrived at the hospital could improve survival, but actual adherence to the guidelines had not been examined.
The Excellence in Prehospital Injury Care study, led by Dr. Daniel Spaite at the University of Arizona, trained EMS agencies across Arizona in the TBI guidelines and compared patient outcomes before and after the guideline implementation.

All patients in the study experienced head injury with loss of consciousness.