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Neurotrauma Management for the Severely Injured Polytrauma Patient pp 29–44Cite as

Prehospital Care and EMS Considerations in the Polytrauma Patient with CNS Injuries

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Abstract

Emergency Medical Services (EMS) personnel are often the first medical providers to care for the polytrauma patient with traumatic brain injury. The prehospital environment brings with it unique technical and logistical challenges, as well as safety risks to providers, rarely encountered in hospital medicine. This chapter begins by describing the origins and structure of emergency medical services in the United States, followed by an outline of some of the inherent operational challenges of trauma care in the prehospital environment. The current tenets of EMS trauma care are discussed broadly, followed by a focused discussion on the management of polytrauma patients with traumatic brain injury. Controversies and areas for further research, including rapid sequence intubation, the utility of the prehospital GCS score, resuscitation endpoints, and the diagnosis and management of herniation syndromes, are explored in detail. The chapter ends with a discussion of best practices in EMS-hospital handoff and multidisciplinary quality improvement.

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Authors and Affiliations

  1. Dept. of Emergency Medicine, Inova Fairfax Hospital, Falls Church, USA

    Dan B. Avstreih & Scott D. Weir

  2. The George Washington University School of Medicine, Washington, USA

    Dan B. Avstreih & Scott D. Weir

  3. Fairfax County Fire & Rescue Department, Inova Health System, Fairfax, VA, USA

    Dan B. Avstreih & Scott D. Weir

  4. Virginia Commonwealth University School of Medicine, Richmond, USA

    Dan B. Avstreih

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  1. Dan B. Avstreih
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Correspondence to Dan B. Avstreih .

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Editors and Affiliations

  1. Neuroscience Department, Inova Neuroscience Institute Inova Fairfax Medical Campus, Falls Church, Virginia, USA

    James M. Ecklund

  2. Pediatric Neurosciences, Inova Neuroscience Institute, Falls Church, Virginia, USA

    Leon E. Moores

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Avstreih, D.B., Weir, S.D. (2017). Prehospital Care and EMS Considerations in the Polytrauma Patient with CNS Injuries. In: Ecklund, J., Moores, L. (eds) Neurotrauma Management for the Severely Injured Polytrauma Patient. Springer, Cham. https://doi.org/10.1007/978-3-319-40208-6_5

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