Severe traumatic brain injury- physician provided pre-hospital care and early neurosurgical treatment are associated with improved survival

Method A 6-year period observational data on pre-hospital TBI management in physician versus paramedic staffed EMS systems were retrospectively analysed. Inclusion criteria were isolated TBI with Glasgow coma scale (GCS) ≤ 8 on-scene or during transportation. Patients with lifethreatening multiple trauma, secondary transfers and patients deceased on-scene were excluded. Evaluation was based on patient records one year after the incident. For assessment of neurological outcome, modified Glasgow Outcome Score (GOS) was used. The time and cause of death were recorded.