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Abdullah Saleh Alruwaili
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Alruwaili, A.; Khorram-Manesh, A.; Ratnayake, A.; Robinson, Y.; Goniewicz, K. Use of Prehospital Intensive Care Units in Emergencies. Encyclopedia. Available online: https://encyclopedia.pub/entry/51468 (accessed on 20 May 2024).
Alruwaili A, Khorram-Manesh A, Ratnayake A, Robinson Y, Goniewicz K. Use of Prehospital Intensive Care Units in Emergencies. Encyclopedia. Available at: https://encyclopedia.pub/entry/51468. Accessed May 20, 2024.
Alruwaili, Abdullah, Amir Khorram-Manesh, Amila Ratnayake, Yohan Robinson, Krzysztof Goniewicz. "Use of Prehospital Intensive Care Units in Emergencies" Encyclopedia, https://encyclopedia.pub/entry/51468 (accessed May 20, 2024).
Alruwaili, A., Khorram-Manesh, A., Ratnayake, A., Robinson, Y., & Goniewicz, K. (2023, November 13). Use of Prehospital Intensive Care Units in Emergencies. In Encyclopedia. https://encyclopedia.pub/entry/51468
Alruwaili, Abdullah, et al. "Use of Prehospital Intensive Care Units in Emergencies." Encyclopedia. Web. 13 November, 2023.
Use of Prehospital Intensive Care Units in Emergencies
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This entry is adapted from the peer-reviewed paper 10.3390/healthcare11212892

 Amidst a rising tide of trauma-related emergencies, emergency departments worldwide grapple with the challenges of overcrowding and prolonged patient wait times. Addressing these challenges, the integration of prehospital intensive care units has appeared as a promising solution, streamlining trauma care and enhancing patient safety. Nevertheless, the feasibility of such an initiative becomes murky when considered globally. A country’s emergency medical services must achieve specific milestones in education, competency, resource availability, and performance to effectively harness the potential of a prehospital intensive care unit. While certain nations are equipped, others lag, highlighting a global disparity in readiness for such advanced care modalities.

intensive care unit prehospital trauma ambulances

1. Introduction

Trauma stands as one of the foremost causes of mortality across the globe, a weighty concern for public health and medical communities alike. A substantial number of these mortalities occur in prehospital settings, accounting for more than 50% in the civilian arena and a staggering 90% in military contexts. The ramifications are vast, prompting an urgent reassessment of prehospital emergency care systems [1][2].
As the world rapidly evolves, so does the landscape of prehospital care, presenting an intricate matrix of challenges and innovations for emergency medical services (EMS) worldwide. This constant evolution is punctuated by ground-breaking treatments such as novel bleeding control practices like REBOA (resuscitative endovascular balloon occlusion of the aorta), the introduction of whole blood and blood products, and tranexamic acid [3][4][5][6].
Adding layers to this dynamic milieu are the diverse EMS systems in place across nations. The Franco-German and Anglo-American models exemplify this disparity, each bringing to the fore unique trauma patient management approaches rooted in their intrinsic technological and expertise variances. The Franco-German model, for instance, boasts the advantage of an onboard physician, a factor that potentially tilts the scales in terms of trauma outcomes and other medical conditions [7][8][9].
The introduction of prehospital intensive care units (PICUs) signifies a critical juncture in this narrative. These units, tailored for high-income countries (HICs), stand as an answer to the spiraling demands on EMS—a counterintuitive scenario where there is a surge in non-severe cases even as severe ones are still sparse [9]. The perennial challenge of emergency department (ED) overcrowding, a phenomenon fueled by a confluence of organizational loopholes, ingrained clinical practices, and individual competencies, calls for a fresh examination of prehospital care paradigms [10][11]. The changing role of paramedics and prehospital nurses in this shifting landscape, augmented by the march of mobile technology, signifies a pivotal shift in clinical culture and competencies [12][13][14][15].
Yet, the enticing potential of PICUs comes with its own set of demands—chiefly, a heavy investment in human resources and sustained, rigorous training. United Kingdom-centric research reveals an inconsistent landscape of physician-based prehospital critical care, emphasizing the pivotal role of training in driving positive outcomes [15]. Furthermore, the on-ground realities of the EMS workforce bring to light a contrast: while paramedics bear the brunt of diagnosis and treatment responsibilities, their critical care colleagues possess specialized yet seldom-employed skills—ones that can tip the balance between life and death but also come fraught with risks [9][15][16]. This complexity is epitomized by an expert-driven Delphi study, which painstakingly crafted an emergency care system model, including 177 distinct components, underscoring the intricate nature of emergency care [16].
Crucially, while HICs’ experiences offer invaluable insights, low- and middle-income countries (LMICs) striving to strengthen their EMS and trauma systems must exercise caution. A verbatim adoption of HICs’ guidelines can lead to resource misalignment and budgetary pressures. Striking a balance—one that harmoniously integrates existing resources, involves relevant stakeholders, and champions cost-effective strategies—is critical [5][17][18].

2. PICU Configurations

2.1. Type and Size of the PICU

The types, sizes, personnel, training, and equipment in PICU care are varied based on the resources and capabilities of each EMS system. The results showed that PICUs can be configured as air types such as helicopter emergency medical services (HEMS), fixed-wing aircraft, air ambulance vehicles (AAVs), or ground-type EMS (GEMS), including the Mobile Intensive Care Unit (MICU), rapid response vehicles (RRVs), or ground ambulance. For air-type PICUs, HEMS is the most common type that was reported in nine studies from Australia, Germany, Denmark, France, and Japan. Some articles reported HEMS alone [19][20][21][22][23], while four articles mentioned HEMS operating in combination with GEMS [24][25][26][27].
According to Meadley et al. [21], intensive care flight paramedics (ICFPs), who undergo extensive education and training and have clinical skills such as adult and pediatric rapid sequence intubation (RSI), cricothyroidotomy, intraosseous needle insertion, intravenous and arterial cannula insertion, in-field blood gas analysis, blood transfusion, needle thoracostomy, and advanced analgesia, have been used to perform winch operations, which involve extracting patients from inaccessible and austere areas with diverse terrain and climate in Victoria, Australia. MECU is a ground ambulance staffed by a skilled physician and a paramedic who provide advanced life support procedures and resuscitation to critically ill or injured patients or patients with cardiac arrest [28][29][30][31]. Nielsen et al. [30] and Brown et al. [31] reported the use of MECU in Denmark, providing prehospital airway management for unconscious non-trauma patients, while Mikkelsen et al. [29] investigated the outcome of ‘life-saving missions’ by the MECU in Odense, Denmark. The size of a PICU was not explicitly reported in most of the studies (10 out of 13). It refers to the number and capacity of the vehicles or aircraft used for prehospital care. Two other studies [21][22] mentioned that five HEMS were operated across the region of Victoria, Australia. No studies indicated the capacity of PICU vehicles or aircraft used for prehospital care.

2.2. Personnel

Findings show that PICUs are staffed by providers who are trained and skilled in advanced life support and other specialized skills. Physicians, specifically anesthesiologists, emergency physicians, and paramedics, are the most reported PICU staff. Studies also reported paramedics with specialized training, including intensive care paramedics (ICPs) and intensive care flight paramedics (ICFPs), emergency medical technicians (EMTs), emergency nurses, and aircrew as PICU staff. In most of the studies, physicians attended patients alone or together with other crew members or physicians [24][27][30]. In addition, physicians also supervise [19] or consult paramedics and approve treatment provided by them [20][22]. Some studies reported that the presence of expert physicians in a prehospital setting was found to be beneficial for the survival of patients with cardiac arrest, who need respiratory support, and those with trauma (85% of 701 included patients) [29][30].

2.3. Training

Personnel working in PICUs in EMS undergo specialized training in prehospital critical care. They are trained to provide advanced life support interventions, manage critical conditions, and stabilize patients during transport. Moreover, providers were trained to provide basic or intermediate care to trauma patients, such as oxygen administration, vascular access, and defibrillation [21][31]. The most reported advanced skill training includes advanced airway management, cricothyroidotomy, and advanced life support training [19][20][25][30][31]. In addition, some ICFPs had additional qualifications or skills to perform advanced care such as intubation or blood transfusion [20][21][22][31]. Hansen et al. [26] reported that physicians working on MECU had sub-specialized training in prehospital critical care. Findings also show that most life-saving interventions provided in prehospital settings exceed the competencies of the EMT or PM [29]. On the other hand, studies also reported that interventions that require advanced skills are less performed in the scene [21]. All providers in PICUs need to be authorized and pass regular skill reaccreditation [21][22].

2.4. Equipment

Studies have reported various types of medical equipment that are typically found in PICUs. They are equipped with advanced medical equipment and monitoring devices to provide comprehensive care during transport. This includes airways, vascular access devices, cardiac monitors, defibrillators, infusion pumps, eFAST/FAST, ultrasonography, and other life-saving equipment necessary for critical care interventions. However, some of the equipment is specific to certain types of PICU or interventions, such as extraction devices or pigtail catheters [21][23][31]. The most common were airway devices that mainly advanced airways [19][21][27], followed by blood product sets [21][32].

3. Protocols and Practices of the PICU

3.1. Protocols

Studies reported various protocols and guidelines to guide the dispatch, triage, assessment, and treatment of patients in the prehospital setting [19][20][22][25][26][28][29][31]. These included clinical practice guidelines, standard trauma care protocols, criteria-based protocols, standard operating procedures, competence-based practice, or injury classification protocols [20][22][26][29]. Some protocols were common to most types of PICU, while others were specific to certain types of PICU or interventions [25].
Documentation of patient information was often performed using regional or national registries or databases, such as electronic patient care records or databases, quality assurance databases, or MECU databases [19][20][21][22][25][26][28][29][31]. However, there were inconsistencies in documentation across the studies, and some studies reported missing data linkage or inconsistent charting [27][30].

3.2. Dispatch Process and Practice

The PICU dispatch process varied among the studies, depending on the context, the type, and the severity of the patient’s condition [25][28][29]. There were different dispatch systems used, such as a nationwide Emergency Medical Dispatch (EMD), a criteria-based dispatch system, and a computer-aided dispatch system [25][26][28][31]. The PICU service was activated based on predefined criteria or information from the caller or by request from the treating medical team or the emergency medical technicians (EMTs) in the primary ambulance [25][26][28][29][31]. However, studies did not report the dispatch process or criteria at all, while others reported some information on the mission duration or dispatch operation procedures [19][20][21][22][23][24][27][30].

3.3. Assessment and Triage

The triage and assessment of patients in the PICU were mainly based on physiological parameters such as respiratory rate, systolic blood pressure, heart rate, Glasgow Coma Scale (GCS), shock index, or injury severity score (ISS). Studies also reported the use of anatomical triage, ultrasound assessment, focused assessment with sonography for trauma (FAST), or return of spontaneous circulation (ROSC) to evaluate the patient’s condition [19][20][21][22][23][26][28][29][31]. The assessment was often graded into categories or scales to indicate the severity of the patients [21][26][28][29]. The use of anatomical triage and the Australian triage scale were the only triage approaches reported by two studies [26][31].

3.4. Clinical Procedures

Findings show that endotracheal intubation, to secure the airway of trauma patients, was the most reported clinical procedure performed by the PICU [20][24][27][28][30]. Other clinical procedures reported included blood transfusion, rapid sequence intubation (RSI), extraction devices, and other diagnostic or therapeutic procedures using ultrasound or pigtail catheters [20][25][27]. Some procedures are specific to certain contexts or cases, such as pericardial drainage in a “doctor helicopter” for multiple trauma cases with pericardial tamponade [23] and winch extraction to extricate and transfer patients from remote or inaccessible locations [21]. One study reported that PICUs were involved in mass casualty incident (MI) management, though they only scooped and ran, and no other clinical interventions or transfers were provided in prehospital settings [26].

3.5. Communication and Transportation

Radio communication was used to coordinate with dispatch centers, receiving hospitals, or emergency services in some studies [23][25][26][28]. According to Hansen et al. [26], EMS uses a unified radio communication channel during MI or an otherwise independent communication channel. Regarding transportation, a primary response, i.e., transferring patients from the scene to the hospital, is the most commonly reported, except in two studies that reported interfacility transfers [21][23]. The transportation type, time, and distance were dependent on the location and availability of the service, and most of the patients were transported by GEMS rather than HEMS [24][27].

4. Benefits of PICUs in Trauma Care

Prehospital ICUs (PICUs) can have benefits for trauma patients compared to standard ambulances. PICUs can improve survival, reduce complications, and enhance the quality of care for some trauma patients [21][23][28]. One study reported that the frequency and duration of hypoxia in the post-intubation period were reduced after the application of apneic oxygenation in patients with severe trauma [20]. There was a statistically significant benefit from apneic oxygenation in reducing the frequency of peri-intubation hypoxia (SpO2 ≤ 90%) for patients with initial SpO2 > 95%. Another study found that paramedics administering RCCs in a prehospital setting is feasible and can improve median systolic blood pressure and shock index. There were no transfusion-related complications identified, while further research suggested that optimal use of resuscitative fluids is warranted [19]. Another study reported that prehospital medical management in trauma patients is associated with a reduction in 30-day mortality, and direct transfer of the casualties by HEMS (SMUR helicopter) to a trauma center is also associated with a decrease in mortality risk [27]. A case report of the successful treatment of blunt traumatic cardiac tamponade in a 55-year-old man also reported that the out-of-hospital pericardial drainage in a “doctor-helicopter” ambulance saved the patient’s life [23].

5. Challenges and Research Priorities for PICUs in Trauma Care

Prehospital intensive care units (PICUs) face several challenges in trauma care, which potentially need to be prioritized in research. Some of the challenges reported by the studies include the implementation, evaluation, and improvement of PICU practices [23][26][30]. For instance, a data linkage study in Australia found that prehospital Code Crimson (CC) activation was highly specific to the need for hemorrhage control intervention in hospitals [25]. The study suggested the need to improve the sensitivity of prehospital CC activation and further research on criteria to triage and select patients most likely to benefit from intervention. Moreover, there are also communication gaps and safety threats to EMS personnel during MI response, while the role of PICUs during such incidents needs further research [26]. There were also gaps in ethical decision-making documentation in prehospital life-and-death situations, which needs the implementation of a standard template in the prehospital medical records [28]. Another study also found that most of the treatment necessary to save the patient’s life was administered out of the competence of the attending EMT or PM and argued that specialists in anesthesiology should be applied in the prehospital setting to provide advanced procedures [29]. Therefore, there is a need to provide further education and training to EMTs and PMs to improve their competencies and skills in prehospital care. The study also recommended that further education and training should be provided to EMTs and PMs to improve their competencies and skills in prehospital care. The study also reported that the majority of trauma patients had low-acuity injuries, and thus there is a need to focus research, training, and resources solely on high-acuity patients, which will not cater to the needs of the majority [31]. As most of the studies were limited in design, there is a need for further research with a strong design or large sample size to identify the potential benefits associated with interventions in different subgroups [19][24][25] or long-term complications with the treatments [20][22].

References

  1. Rossiter, N.D. Trauma—The forgotten pandemic? Int. Orthop. SICOT 2022, 46, 3–11.
  2. Prottengeier, J.; Albermann, M.; Heinrich, S.; Birkholz, T.; Gall, C.; Schmidt, J. The prehospital intravenous access assessment: A prospective study on intravenous access failure and access delay in prehospital emergency medicine. Eur. J. Emerg. Med. 2016, 23, 442–447.
  3. Zhang, G.X.; Chen, K.J.; Zhu, H.T.; Lin, A.L.; Liu, Z.H.; Liu, L.C.; Ji, R.; Chan, F.S.; Fan, J.K. Preventable Deaths in Multiple Trauma Patients: The Importance of Auditing and Continuous Quality Improvement. World J. Surg. 2020, 44, 1835–1843.
  4. Wada, D.; Maruyama, S.; Yoshihara, T.; Saito, F.; Yoshiya, K.; Nakamori, Y. Hybrid emergency room: Installation, establishment, and innovation in the emergency department. Acute Med. Surg. 2023, 10, e856.
  5. Ratnayake, A.; Nakahara, S.; Bagaria, D.; De Silva, S.; De Silva, S.L.; Llaneta, A.; Pattanarattanamolee, R.; Li, Y.; Hoang, B.H. Focused research in emergency medical systems in Asia: A necessity for trauma system advancement. Emerg. Crit. Care Med. 2022, 2, 87–93.
  6. Crombie, N.; Doughty, H.A.; Bishop, J.R.B.; Desai, A.; Dixon, E.F.; Hancox, J.M.; Herbert, M.J.; Leech, C.; Lewis, S.J.; Nash, M.R.; et al. Resuscitation with blood products in patients with trauma-related hemorrhagic shock receiving prehospital care (RePHILL): A multicentre, open-label, randomised, controlled, phase 3 trial. Lancet Haematol. 2022, 9, e250–e261.
  7. Peyravi, M.R.; Carlström, E.; Örtenwall, P.; Khorram-Manesh, A. Prehospital Assessment of Non-Traumatic Abdominal Pain. Iran. Red. Cresc. Med. J. 2021, 23, e660.
  8. Haner, A.; Örninge, P.; Khorram-Manesh, A. The role of physician-staffed ambulances: The outcome of a pilot study. J. Acute Dis. 2015, 4, 63–67.
  9. von Vopelius-Feldt, J.; Benger, J. Who does what in prehospital critical care? An analysis of competencies of paramedics, critical care paramedics, and prehospital physicians. Emerg. Med. J. 2014, 31, 1009–1013.
  10. Khorram-Manesh, A.; Wennman, I.; Andersson, B.; Dahlén Holmqvist, L.; Carlson, T.; Carlström, E. Reasons for longer LOS at the emergency departments: Practical, patient-centered, medical, or cultural? Int. J. Health Plann. Manag. 2019, 34, e1586–e1596.
  11. Raidla, A.; Darro, K.; Carlson, T.; Khorram-Manesh, A.; Berlin, J.; Carlström, E. Outcomes of Establishing an Urgent Care Centre in the Same Location as an Emergency Department. Sustainability 2020, 12, 8190.
  12. Deakin, C.D.; King, P.; Thompson, F. Prehospital advanced airway management by ambulance technicians and paramedics: Is clinical practice sufficient to maintain skills? Emerg. Med. J. 2009, 26, 888–891.
  13. Findlay, G.; Martin, I.; Smith, M. Trauma: Who Cares? A Report of the National Confidential Enquiry into Patient Outcome and Death. 2007. Available online: http://www.ncepod.org.uk/2007report2/Downloads/SIP_summary.pdf (accessed on 29 May 2012).
  14. Tran, T.T.; Lee, J.; Sleigh, A.; Banwell, C. Putting Culture into Prehospital Emergency Care: A Systematic Narrative Review of Literature from Lower Middle-Income Countries. Prehosp. Disaster. Med. 2019, 34, 510–520.
  15. Hyde, P.; Mackenzie, R.; Ng, G.; Reid, C.; Pearson, G. Availability and utilization of physician-based pre-hospital critical care support to the NHS ambulance service in England, Wales, and Northern Ireland. Emerg. Med. J. 2012, 29, 177–181.
  16. Nakahara, S.; Hoang, B.H.; Mayxay, M.; Pattanarattanamolee, R.; Jayatilleke, A.U.; Ichikawa, M.; Sakamoto, T. Development of an emergency medical system model for resource-constrained settings. Trop. Med. Int. Health 2019, 24, 1140–1150.
  17. Callese, T.E.; Richards, C.T.; Shaw, P.; Schuetz, S.J.; Paladino, L.; Issa, N.; Swaroop, M. Trauma system development in low- and middle-income countries: A review. J. Surg. Res. 2015, 193, 300–307.
  18. Wisborg, T.; Murad, M.K.; Edvardsen, O.; Husum, H. Prehospital trauma system in a low-income country: System maturation and adaptation during 8 years. J. Trauma 2008, 64, 1342–1348.
  19. Crewdson, K.; Heywoth, A.; Rehn, M.; Sadek, S.; Lockey, D. Apnoeic oxygenation for emergency anaesthesia of pre-hospital trauma patients. Scand. J. Trauma Resusc. Emerg. Med. 2021, 29, 10.
  20. Heschl, S.; Meadley, B.; Andrew, E.; Butt, W.; Bernard, S.; Smith, K. Efficacy of pre-hospital rapid sequence intubation in paediatric traumatic brain injury: A 9-year observational study. Injury 2018, 49, 916–920.
  21. Meadley, B.; Heschl, S.; Andrew, E.; De Wit, A.; Bernard, S.A.; Smith, K. A paramedic-staffed helicopter emergency medical service’s response to winch missions in Victoria, Australia. Prehospital Emerg. Care 2016, 20, 106–110.
  22. Heschl, S.; Andrew, E.; de Wit, A.; Bernard, S.; Kennedy, M.; Smith, K.; Study Investigators. Prehospital transfusion of red cell concentrates in a paramedic-staffed helicopter emergency medical service. Emerg. Med. Australas. 2018, 30, 236–241.
  23. Otsuka, H.; Sato, T.; Morita, S.; Nakagawa, Y.; Inokuchi, S. A case of blunt traumatic cardiac tamponade successfully treated by out-of-hospital pericardial drainage in a “doctor-helicopter” ambulance staffed by skilled emergency physicians. Tokai J. Exp. Clin. Med. 2016, 41, 1–3.
  24. Andruszkow, H.; Schweigkofler, U.; Lefering, R.; Frey, M.; Horst, K.; Pfeifer, R.; Beckers, S.K.; Pape, H.C.; Hildebrand, F. Impact of helicopter emergency medical service in traumatized patients: Which patient benefits most? PLoS ONE 2016, 11, e0146897.
  25. Partyka, C.; Miller, M.; Johnson, T.; Burns, B.; Fogg, T.; Sarrami, P.; Singh, H.; Dee, K.; Dinh, M. Prehospital activation of a coordinated multidisciplinary hospital response in preparation for patients with severe hemorrhage: A statewide data linkage study of the New South Wales “Code Crimson” pathway. J. Trauma Acute Care Surg. 2022, 93, 521–529.
  26. Hansen, P.M.; Jepsen, S.B.; Mikkelsen, S.; Rehn, M. The Great Belt train accident: The emergency medical services response. Scand. J. Trauma Resusc. Emerg. Med. 2021, 29, 140.
  27. Tissier, C.; Bonithon-Kopp, C.; Freysz, M. French Intensive care Recorded in Severe Trauma (FIRST) study group. Statement of severe trauma management in France: Teachings of the FIRST study. In Annales Françaises D’anesthésie et de Réanimation; Elsevier Masson: Amsterdam, The Netherlands, 2013; Volume 32, pp. 465–471.
  28. Mikkelsen, S.; Schaffalitzky de Muckadell, C.; Binderup, L.G.; Lossius, H.M.; Toft, P.; Lassen, A.T. Termination of prehospital resuscitative efforts: A study of documentation on ethical considerations at the scene. Scand. J. Trauma Resusc. Emerg. Med. 2017, 25, 35.
  29. Mikkelsen, S.; Krüger, A.J.; Zwisler, S.T.; Brøchner, A.C. Outcome following physician supervised prehospital resuscitation: A retrospective study. BMJ Open 2015, 5, e006167.
  30. Nielsen, K.; Hansen, C.M.; Rasmussen, L.S. Airway management in unconscious non-trauma patients. Emerg. Med. J. 2012, 29, 887–889.
  31. Brown, E.; Williams, T.A.; Tohira, H.; Bailey, P.; Finn, J. Epidemiology of trauma patients attended by ambulance paramedics in Perth, Western Australia. Emerg. Med. Australas. 2018, 30, 827–833.
  32. Ouzzani, M.; Hammady, H.; Fedorowicz, Z.; Elmagarmid, A. Rayyan—A web and mobile app for systematic reviews. Syst. Rev. 2016, 5, 210.
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Contributors MDPI registered users' name will be linked to their SciProfiles pages. To register with us, please refer to https://encyclopedia.pub/register :
Abdullah Alruwaili
,
Amir Khorram-Manesh
,
Amila Ratnayake
,
Yohan Robinson
,
Krzysztof Goniewicz
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Update Date: 14 Nov 2023
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