Philadelphia Immediate Transport in Penetrating Trauma Trial (PIPT)
Hemorrhagic Shock, Peritonitis
About this trial
This is an interventional health services research trial for Hemorrhagic Shock
Eligibility Criteria
Inclusion Criteria:
The investigators will include all penetrating trauma patients with shock over the age of 18.
- Penetrating injury (required)
- Combined torso and distal extremity injury
- Combined penetrating and blunt injury
- Heart rate greater than 100, systolic blood pressure less than 100 or mental status change (evidence of shock)
Exclusion Criteria:
Patients with any injuries above the clavicle or head injuries will be excluded. If known at the time of randomization the investigator will exclude all known minors under the age of 18, known pregnant women, and known prisoners. Patients with isolated blunt mechanism of injury such as motor vehicle accidents will be excluded. However, patients with combined blunt and penetrating torso injury will be included.
- Injury above the clavicle
- Isolated injury distal to the elbows or knees
- Known age <18, pregnant, or prisoner
Sites / Locations
- Temple University Hospital
Arms of the Study
Arm 1
Arm 2
Other
No Intervention
Advanced Life Support
Basic Life Support
ALS providers are trained and able to perform certain procedures such as intubation with endotracheal tubes and placement of intravenous catheters. Endotracheal intubation is often performed by pre-hospital providers in critically ill trauma patients because it is believed that it allows for protection of the airway and better delivery of oxygen. However, most studies actually show that intubation does not provide a survival advantage to this patient population and actually could result in worse outcomes. Intravenous catheter placement and administration of intravenous fluids is also routinely performed however, studies have shown that it is also not helpful.
Subjects randomized to the study group will receive basic life support (BLS) level care. This means that pre-hospital procedures such as endotracheal intubation and intravenous fluid administration will not be carried out. However, passive oxygen and needle thoracostomy, if required for tension pneumothorax, will be permitted if medically necessary.