Skip to main content

Table 3 Trial interventions and comparators by group

From: Randomised controlled trials in pre-hospital trauma: a systematic mapping review

Intervention category Total number of participants (median) Interventions Comparator HCP delivering intervention Transport mechanism
Fluid therapy (n = 7) 4202 (229) - 500 mL of intravenous crystalloids and colloids (n = 1) - Delayed or no infusion of intravenous fluids - Paramedics - Land based services
- 250 mL intravenous infusion of 7.5% hypertonic saline and standard intravenous resuscitation fluids (crystalloids, Ringer’s lactate solution or colloids) (n = 1) - 250 mL Ringer’s lactate solution and standard intravenous resuscitation fluids (crystalloids and colloids) - Advanced life support paramedics - Land based and air medical services
- 250 mL hypertonic saline/colloid (7.5%/6%) or hypertonic saline (7.5%) (n = 2) - Normal saline (0.9%) (n = 2) - EMS personnel (n = 2) - Land based and air medical services (n = 2)
- 250 mL hypertonic saline/colloid (7.5%/6%) followed by Ringer’s lactate solution (non-racemic, L-lactate only) (n = 1) - Conventional resuscitation and 250 mL Ringer’s lactate solution - EMS personnel - Land based and air medical services
- 300 mL hypertonic saline 7.5% (n = 1) - Conventional resuscitation (crystalloids and/or colloids) - Emergency physicians - Air medical services
- 250 cc normal saline and 500 cc bottle of water (n = 1) - 1000 cc normal saline and 2 l of fluid - Advanced life support EMS - Land based and air medical services
Analgesia (n = 7) 630 (101) - 100 mg tramadol, more if required (up to 200 mg) (n = 1) - 5 or 10 mg morphine, more if required - Emergency physician - Land based services
- True acupressure; points Di4 (Hegu), KS9 (Schongchong), KS6 (Neiguan), BL60 (Kunlun), and LG20 (Baihui) (n = 1) - False or no acupressure (n = 1) - Paramedics - Land based services
- Diclofenac-ratiopharm Gel (1, 3% or 5%) 2-4 g twice daily (n = 1) - Placebo gel - Investigator and patient - Land based services
- Opioid titration protocol; intravenous 0.15 g/kg sufentanil followed by 0.075 g/kg until pain relief (n = 1) - Intravenous 0.15 mg/kg morphine followed by 0.075 mg/kg until pain relief - Physician, nurse, and EMT - Land based services
- Ketamine diluted in normal saline solution (10 mg/mL) after initial dose of morphine 5 mg intravenously (n = 1) - Morphine diluted in normal saline solution (10 mg/9 mL) after initial dose of morphine 5 mg intravenously - Paramedics - Land based services
- Pre-mixed 50% N2O and oxygen 9 L/min inhalation (n = 1) - Medical air 9 L/min for 15 min followed by premixed 50% N2O and oxygen - Nurse in Firefighter Emergency Services - Land based services
- Single shot peripheral block proximal to injury location under ultrasound guidance (n = 1) - Intravenous analgesia using standard technique of s-ketamine combined with midazolam, in some cases fentanyl - Emergency physicians - Land based and air medical services
Blood product (n = 3) 1381 (523) - Up to 6 U (50 g haemoglobin/unit) of PolyHeme from scene of injury and during first 12 h post-injury (n = 1) - Crystalloids in the field and red blood cells as needed in hospital - Paramedics - Land based and air medical services
- Thawed plasma (n = 2) - Frozen water and normal saline (0.9%) as per standard care (n = 1)
- Standard care resuscitation defined by local protocol (n = 1)
- Paramedics (n = 1)
- Air medical personnel and physicians (n = 1)
- Land based services (n = 1)
- Air medical services (n = 1)
Temperature management (n = 3) 659 (100) - Resistive heating; carbon-fiber electric heating blanket set to 42 °C (n = 1) - Passive warming - Paramedics - Land based services
- A heating pad reaching 50 °C applied across anterior upper torso (n = 1) - Polyester, woollen and rescue blankets - EMS personnel - Land based and air medical services
- Prophylactic hypothermia by bolus of up to 2000 mL intravenous 4 °C saline (0.9%) and surface-cooling wraps targeting core temperature of 35 °C (n = 1) - Normothermia; no exposure or cold fluids and warmed if required - Emergency physicians - Land based services
Airway management/ventilation (n = 2) 409 (204.5) - Monitor; ventilation adjusted to achieve end-tidal carbon dioxide determined according to clinical condition of each patient, ventilation determined by weight of patients on admission (n = 1) - Monitor-blind; ventilation set by using a tidal-volume of 10 mL kg−1 estimated body weight and age-appropriate ventilatory frequency - Trauma anaesthesiologist and paramedic - Air medical services
- Pre-hospital intubation by paramedics (n = 1) - In hospital intubation - Intensive care paramedics - Land based services
Model of care (n = 1) 3124 N/A - Physician team in addition to standard response team (n = 1) - Standard care by paramedics only - Physicians and paramedics - Air medical services
  1. HCP Health Care Professional, EMS Emergency medical services, EMT Emergency medical technician