Evidence map›Paper›PMID 35524778›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2023

Indications for prehospital intubation among severely injured children and the prevalence of significant traumatic brain injury among those intubated due to impaired level of consciousness.

Nir Samuel, Yoav Hoffmann, Stav Rakedzon, Ari M Lipsky, Aeyal Raz, Hen Ben Lulu, Hany Bahouth, Danny Epstein

Abstract readMulticenter Study
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In one paragraph

Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.0field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
  3. Traumatic brain injury: the research continues with higher data quality evolving!European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Nir SamuelPediatric Emergency Department, Schneider Children's Medical Center, Petah Tikva, Israel.
Yoav HoffmannPediatric Intensive Care Unit, Galilee Medical Center, Nahariya, Israel.
Stav RakedzonDepartment of Internal Medicine B, Rambam Health Care Campus, Haifa, Israel.
Ari M LipskyEmergency Department, Emek Medical Center, Afula, Israel.
Aeyal RazAnesthesiology Department, Rambam Health Care Campus, Haifa, Israel.
Hen Ben LuluTrauma and Emergency Surgery, Rambam Health Care Campus, Haifa, Israel.
Hany BahouthRuth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.
Danny EpsteinCritical Care Division, Rambam Health Care Campus, Haifa, Israel. danyep@gmail.com.ORCID http://orcid.org/0000-0001-7032-7007
Rambam Health Care Campus · ILEmek Medical Center · ILSchneider Children's Medical Center · ILWestern Galilee Hospital · IL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrehospital endotracheal intubation (PEI) of head injured children with impaired level of consciousness (LOC) aims to minimize secondary brain injury. However, PEI is controversial in otherwise stable children. We aimed to investigate the indications for PEI among pediatric trauma patients and the prevalence of clinically significant traumatic brain injury (csTBI) among those intubated solely due to impaired consciousness.

methodsThis is a multicenter retrospective cohort study of children who underwent PEI in northern Israel between January 2014 and December 2020 by six EMS agencies and were transported to two trauma centers in the area. We extracted data from EMS records and trauma registries.

resultsPEI was attempted in 179/986 (18.2%) patients and was successful in 92.2% of cases. Common indications for PEI were hypoxemia not corrected by supplemental oxygen (n = 30), traumatic cardiac arrest (n = 16), and facial injury compromising the airway (n = 13). 112 patients (62.6%) were intubated solely due to impaired or deteriorating LOC. Among these patients, 68 (62.4%) suffered csTBI. The prevalence of csTBI among those with field Glasgow Coma Scale (GCS) of 3, 4-8, and > 8 was 81.4%, 55.8%, and 28.6%, respectively (p < 0.001). Among children ≤ 10 years old intubated due to impaired LOC, 50% had csTBI.

conclusionImpaired LOC is a major indication for PEI. However, a significant proportion of these patients do not suffer csTBI. Older age and lower pre-intubation GCS are associated with more accurate field classification. Our data indicate that further investigation and better characterization of patients who may benefit from PEI is necessary.

Indexed as

Brain Injuries, TraumaticEmergency Medical ServicesChildConsciousnessGlasgow Coma ScaleHumansIntubation, IntratrachealPrevalenceRetrospective StudiesAirwayPediatric traumaPrehospital endotracheal intubationPrehospital trauma careTraumatic brain injury

Identifiers

PMID35524778
OpenAlexW4229069165

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.