viernes, 20 de abril de 2018

Physiologic Predictors of Severe Injury: Systematic Review | Effective Health Care Program

Physiologic Predictors of Severe Injury: Systematic Review | Effective Health Care Program

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Evidence Review Now Available

Physiologic Predictors of Severe Injury: Systematic Review (Systematic Review, released on April 13, 2018)
Selected Key Messages:
Studies examined individual measures and combinations for trauma triage, including systolic blood pressure, heart rate, shock index, lactate, base deficit, respiratory rate, oxygen saturation, and need for airway support.
Included measures have:
  • Low sensitivities, so normal values on the physiologic measure (a negative test) cannot be used with confidence to determine that patients are not seriously injured.
  • High specificities, meaning abnormal values on the physiologic measure (positive test) are unlikely in patients not seriously injured.
Combinations of physiologic measures with measures of consciousness may perform better than physiologic measures alone, but feasibility and reliability of performance in the field are significant challenges.
Measures perform less well in children and older people. Changes in cut-points for these age groups may improve performance but have not yet been rigorously evaluated.
Research is needed on the feasibility of combination measures and how precisely physiologic parameters are measured, including use of technology.
Researchers should use standard definitions of serious injury to permit comparisons across studies and measures.
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