Clinical effectiveness and cost-effectiveness of prehospital intravenous fluids in trauma patients
Dretzke J, Sandercock J, Bayliss S, Burls A
Record ID 32004000328
English
Authors' objectives:
The focus of this report was to determine whether prehospital intravenous (IV) fluid replacement, compared with no IV fluid replacement or delayed fluid replacement, should be undertaken in trauma patients who have haemorrhage-induced hypotension due to trauma. The evidence surrounding the effects of a potential delay in definitive treatment and the choice of fluid was also considered. Trauma patients with head injuries were not included.
Authors' recommendations:
This review found no evidence to suggest that prehospital IV fluid resuscitation is beneficial. There is some evidence that it may be harmful and that patients do comparatively well when fluids are withheld. However, this evidence is not conclusive (particularly for blunt trauma) and is not sufficient to contradict the Consensus Statement and Joint Royal Colleges Ambulance Liaison Committee (JRCALC) guidelines, which recommend hypotensive resuscitation.
The Consensus Statement, and to a lesser extent the JRCALC guidelines, represent a more cautious approach to fluid management than previously advocated, and are therefore in line with the findings of the limited evidence base, which has been systematically reviewed.
Authors' methods:
Systematic review
Details
Project Status:
Completed
URL for project:
http://www.hta.ac.uk/1354
Year Published:
2004
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
England, United Kingdom
MeSH Terms
- Costs and Cost Analysis
- Emergency Medical Services
- Fluid Therapy
- Hemorrhage
- Hypotension
- Infusions, Intravenous
- Wounds and Injuries
Contact
Organisation Name:
NIHR Health Technology Assessment programme
Contact Address:
NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name:
journals.library@nihr.ac.uk
Contact Email:
journals.library@nihr.ac.uk
Copyright:
2009 Queen's Printer and Controller of HMSO
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.