TS06
HEAD INJURY AND OUTCOME – WHAT INFLUENCE DOES PREHOSPITAL INTUBATION HAVE?

Mortality of severe traumatic brain injury (STBI) varies in literature between 23 and 81% depending on pre‐hospital use of neuromuscular blocking agents (NBA) for endotracheal intubation (ETI) (1, 2). In NSW paramedics are not equipped with NBA. Aim of this study was to determine mortality of STBI patients in a NSW Trauma Centre and compare to intentional standards as an initial step to evaluate potential applicability of NBA for ETI in NSW. Methods: A four‐year retrospective study ending December 2008 on consecutive trauma patients admitted to a NSW Level‐1 Trauma Centre with a pre‐hospital Glasgow Coma Score (GCS) < 9 and STBI [Abbreviated Injury Scale (AIS) > 2]. Patients were identified from trauma registry and focused chart review was performed. Primary outcome was mortality. Results are presented as mean ± SD or percentages. Statistical significance was determined at p < 0.05 based on univariate analysis. Results: A total of 124 patients were identified (age 36.4 ± 20, pre‐hospital GCS 4.8 ± 2, ISS 30.6 ± 13, head AIS 4.2 ± 0.7, 28% had systolic blood pressure (SBP) < 90 mmHg). The overall mortality was 34.6%. 27 patients had pre‐hospital ETI with 74.0% mortality. In 5 patients pre‐hospital ETT failed (mortality 20%). 92 patients had ETT on arrival to hospital (mortality 24.4%). Survivors differed from those who died (age