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Improved pre-hospital care efficiency due to the implementation of pre-hospital trauma life support (PHTLS®) algorithms

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

Pre-hospital trauma life support (PHTLS®) includes a standardized algorithm for pre-hospital care. Implementation of PHTLS® led to improved outcome in less developed medical trauma systems. We aimed to determine the impact of PHTLS® on quality of pre-hospital care in a European metropolitan area. We hypothesized that the introduction of PHTLS® was associated with improved efficiency of pre-hospital care for severely injured patients and less emergency physician deployment.

Methods

We included adult polytrauma (ISS > 15) patients that were admitted to our level one trauma center during a 7-year time period. Patients were grouped based on the presence or absence of a PHTLS®-trained paramedic in the pre-hospital trauma team. Group I (no-PHTLS group) included all casualties treated by no-PHTLS®-trained personnel. Group II (PHTLS group) was composed of casualties managed by a PHTLS® qualified team. We compared outcome between groups.

Results

During the study period, 187,839 rescue operations were executed and 280 patients were included. No differences were seen in patient characteristics, trauma severity or geographical distances between groups. Transfer times were significantly reduced in PHTLS® teams than non-qualified teams (9.3 vs. 10.5 min, P = 0.006). Furthermore, the in-field operation times were significantly reduced in PHTLS® qualified teams (36.2 vs. 42.6 min, P = 0.003). Emergency physician involvement did not differ between groups.

Conclusion

This is the first study to show that the implementation of PHTLS® algorithms in a European metropolitan area is associated with improved efficiency of pre-hospital care for the severely injured. We therefore recommend considering the introduction of PHTLS® in metropolitan areas in the first world.

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Author notes

  1. Michel Teuben and Nikolaus Löhr equally contributed.

Authors and Affiliations

  1. Department of Traumatology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland

    Michel Teuben, Kai Oliver Jensen, Roman Pfeifer, Ladislav Mica, Hans-Christoph Pape & Kai Sprengel

  2. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland

    Nikolaus Löhr

  3. Institute of Anesthesiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland

    Martin Brüesch

  4. City of Zurich, Schutz and Rettung, Neumuehlequai 40, 8021, Zurich, Switzerland

    Stephan Müller

Authors
  1. Michel Teuben
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  2. Nikolaus Löhr
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  3. Kai Oliver Jensen
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  4. Martin Brüesch
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  5. Stephan Müller
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  6. Roman Pfeifer
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  7. Ladislav Mica
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  8. Hans-Christoph Pape
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  9. Kai Sprengel
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Corresponding author

Correspondence to Michel Teuben.

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Teuben, M., Löhr, N., Jensen, K.O. et al. Improved pre-hospital care efficiency due to the implementation of pre-hospital trauma life support (PHTLS®) algorithms. Eur J Trauma Emerg Surg 46, 1321–1325 (2020). https://doi.org/10.1007/s00068-019-01141-1

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  • DOI: https://doi.org/10.1007/s00068-019-01141-1

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