Wednesday, November 29, 2017

Should you call an ambulance or drive a gunshot victim to the hospital?

Let’s start off with a theoretical problem: 

You come out of a restaurant just as a man you do not know gets shot right in front of you. The gunman runs off and the gunshot victim and you lock eyes.
The victim is bleeding from the center of his body, you find yourself taking your shirt off, putting it to the man’s abdomen, and applying pressure. You can’t believe what is happening, as you yell, “Call a doctor! Call a doctor!”
Your thoughts are racing. “What if he bleeds out before the ambulance arrives?”
You think to yourself, “My car is right there, should I drive him to the hospital? It’s not far, but I’m not an ambulance driver. I have no idea what to do! I have no emergency medical training.” 

Should you transport a gunshot victim, or should you wait on emergency medical services?
Before you read on, take a minute to play the thought game. You desperately want to save this person’s life, what should you do? Wait for help, or get your patient to the ER?

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A study in JAMA Surgery found…
Do whatever gets the patient to the Emergency Room the fastest. For most injuries, the prehospital support of an ambulance was often best. But when it came to gunshot or knife wounds, the evidence showed that time was the most important factor. The faster the victim got to the hospital the better. 
The senior researcher, Elliott Haut, at Johns Hopkins University School of Medicine says:
Typically, protocols for prehospital interventions are established at a regional or statewide level, which allows first responders to determine what, if any, medical procedures should be performed prior to and during transport to the hospital, Haut says. But research studies have rarely, if ever, evaluated or compared all of the effects of system-driven pre-hospitalization policies, leaving ideal prehospital care strategies undefined, he adds.

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