Skip to main content
Sister Publication Links
  • ESG: THE IMPLEMENTATION IMPERATIVE
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • Providers
    • Insurance
    • Digital Health
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Transformation
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Unwell in America
  • Opinion
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Diversity in Healthcare
      • - Luminaries
      • - Top 25 Diversity Leaders
      • - Leaders to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Digital Health Transformation Summit
    • ESG: The Implementation Imperative Summit
    • Leadership Symposium
    • Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Diversity Leaders Gala
    • Top 25 Women Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Hospital at Home
    • - Workplace of the Future
    • - Digital Health
    • - Future of Staffing
    • - Hospital of the Future (Fall)
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
  • Data Center
    • Data Center Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • MORE+
    • Contact Us
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Safety & Quality
July 14, 2016 01:00 AM

Basic or advanced life support? Philadelphia researchers test conventions of trauma care

Elizabeth Whitman
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print
    emergency sign

    Convention suggests that a person who is shot or stabbed has a better chance of surviving if he receives a certain amount and type of care before reaching the hospital. A group of researchers in Philadelphia suspects that such assumptions could be flawed, and so for the next several years, they intend to test them out in a major citywide study.

    The study, Philadelphia Immediate Transport in Penetrating Trauma Trial, will examine whether two procedures—placing breathing tubes or administering IV fluids—actually confer survival advantages on patients with penetrating injuries, defined as “gunshot, shotgun or stab wounds to the chest, abdomen or upper arms or legs.”

    The study is designed to compare the benefits of IVs and breathing tubes of advanced life support with those of basic life support, where no such instruments are used but oxygen is administered through a face mask. Researchers hypothesize that patients brought immediately to the hospital without advanced life support will have a greater survival rate than those who do receive such care.

    “For many people, including medical people, it's counterintuitive and scary,” said Dr. Zoe Maher, the study's principal investigator and a trauma surgeon and assistant professor of surgery at the Lewis Katz School of Medicine at Temple University. Still, the study's results could have local, national and even international implications for the way trauma care is practiced, she added.

    Patients eligible for the study are limited to those in Philadelphia, with gunshot, shotgun or stab wounds with evidence of bleeding and brought to the hospital by an ambulance. One group of patients will receive advanced life support; the other will not. Both would receive the same care upon arriving at the hospital.

    Researchers hope the study, led by Temple University Hospital and including six hospitals and all of Philadelphia's Level 1 and Level 2 trauma centers, will begin this year. They initially hoped to start in 2015, Maher said, but the researchers first must inform the community.

    “This process of community consultation and our desire to really educate the Philadelphia community has taken longer than we initially anticipated," Maher said. Outreach has targeted at-risk and high-interest communities to educate them about the study, which includes an exception from informed consent, she added.

    Those wishing to opt out of the study can fill out a form online. They then receive a wristband that they must wear for five years. “If you do not wear the wristband and are injured by gunshot, shotgun or stab wound you may be included in the trial,” the announcement added.

    The study excludes patients injured in the head or neck. Prisoners, pregnant women and those under the age of 18 are also ineligible. It is designed to require a total of 1,036 patients, in order to detect whether basic life support confers a survival advantage over advanced life support.

    “If there's harm to patients in either arm, the trial will also be stopped early,” Maher said.

    Still, viewed by some as gambling with people's lives, the study has stirred some controversy. But if its results do determine that less care is better, even if only for certain types or degrees of injuries, it could help revamp trauma care to save more lives.

    One school of thought in medicine posits that trauma victims fare better if they are rushed rapidly to the hospital instead of receiving advanced care along the way, in what could be a lengthier wait before arriving in the ER.

    In rural areas far from hospitals, such advanced practices can be beneficial to patients, the Philadelphia study announcement noted. But in urban areas, “the advantage of these field procedures ... is less convincing,” it added.

    “In fact, studies have shown that pre-hospital intubation clearly does not confer a survival advantage to penetrating trauma patients in urban locations,” the study's detailed description reads. “Yet pre-hospital procedures continue to be performed in urban Philadelphia on a regular basis.”

    In 1994, the New England Journal of Medicine published the findings of a similar, three-year study in Houston that compared survival rates of trauma patients with penetrating torso injuries. It found that those who received delayed intravascular fluid resuscitation had a higher rate of survival, 70%, than those who received immediate resuscitation (62%).

    A University of Pennsylvania study published in 2014 found that gunshot and stab wound patients who were brought to hospitals by police in Philadelphia were not any more or less likely to survive than those brought via ambulance. And among severely injured gunshot victims, those transported by police were more likely to survive, the study showed.

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    Ecri kids main mental health STATIC
    Pediatric mental health, workplace violence are top 2023 safety concerns: ECRI
    A patient safety student with the Texas College of Osteopathic Medicine vaccinates a patient.
    Patient safety courses a tough sell at medical schools
    Most Popular
    1
    More healthcare organizations at risk of credit default, Moody's says
    2
    Centene fills out senior executive team with new president, COO
    3
    SCAN, CareOregon plan to merge into the HealthRight Group
    4
    Blue Cross Blue Shield of Michigan unveils big push that lets physicians take on risk, reap rewards
    5
    Bright Health weighs reverse stock split as delisting looms
    Sponsored Content
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2023. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • Providers
      • Insurance
      • Digital Health
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Unwell in America
    • Opinion
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Hospital at Home
        • - Workplace of the Future
        • - Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • Data Center
      • Data Center Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • MORE+
      • Contact Us
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing