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Advanced airway management for pre-hospital trauma patients

Crewdson, Kate; (2021) Advanced airway management for pre-hospital trauma patients. Doctoral thesis (Ph.D), UCL (University College London). Green open access

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Abstract

Poor airway management in severely injured patients is a source of significant morbidity and mortality and frequently identified as a cause of preventable death in this group of patients. Traditionally the majority of patients have not received definitive airway management until arrival at hospital and those patients who were sufficiently obtunded on scene to tolerate tracheal intubation without the use of drugs had a universally poor outcome. Pre-hospital Emergency Medicine (PHEM) is now a recognised medical subspecialty and is usually delivered by doctors and paramedics with specific training in this field. The development of this subspecialty has increased the practice of Pre-Hospital Emergency Anaesthesia (PHEA). Despite improvements in the delivery of PHEM and consequently of PHEA, controversy surrounding this intervention exists and it has failed to demonstrate an obvious survival benefit. This thesis sets out to further examine the practice of PHEA and attempt to establish why this intervention does not appear to be reducing mortality in patients who have sustained major trauma. I designed and developed studies to address a number of key questions including whether there is a requirement for PHEA, the potential benefit of it, and to identify areas of practice that can be improved. Through studies conducted at a local and national level I have been able to provide evidence that not only is PHEA an essential and beneficial intervention for a subset of major trauma patients, but also that there is a demand for this intervention which is not met by the current prehospital practice and infrastructure in the UK.

Type: Thesis (Doctoral)
Qualification: Ph.D
Title: Advanced airway management for pre-hospital trauma patients
Event: UCL
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Copyright © The Author 2021. Original content in this thesis is licensed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10138789
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