The study protocol for the Head Injury Retrieval Trial (HIRT): a single centre randomised
controlled trial of physician prehospital management of severe blunt head injury compared with
management by paramedics
Engelsk titel: The study protocol for the Head Injury Retrieval Trial (HIRT): a single centre randomised
controlled trial of physician prehospital management of severe blunt head injury compared with
management by paramedics.
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Författare:
Garner, Alan A
;
Fearnside, Michael
;
Gebski, Val
Email: alang@careflight.org
Språk: Eng
Antal referenser: 17
Dokumenttyp:
RCT
UI-nummer: 14099025
Sammanfattning
Background
The utility of advanced prehospital interventions for severe blunt traumatic brain injury (BTI) remains
controversial. Of all trauma patient subgroups it has been anticipated that this patient group would
most benefit from advanced prehospital interventions as hypoxia and hypotension have been
demonstrated to be associated with poor outcomes and these factors may be amenable to
prehospital intervention. Supporting evidence is largely lacking however. In particular the efficacy of
early anaesthesia/muscle relaxant assisted intubation has proved difficult to substantiate.
Methods
This article describes the design and protocol of the Head Injury Retrieval Trial (HIRT) which is a
randomised controlled single centre trial of physician prehospital care (delivering advanced
interventions such as rapid sequence intubation and blood transfusion) in addition to paramedic care
for severe blunt TBI compared with paramedic care alone.
Results
Primary endpoint is Glasgow Outcome Scale score at six months post injury. Issues with trial
integrity resulting from drop ins from standard care to the treatment arm as the result of policy
changes by the local ambulance system are discussed.
Conclusion
This randomised controlled trial will contribute to the evaluation of the efficacy of advance
prehospital interventions in severe blunt TBI.