Prevalence of Prehospital Hypoxemia and Oxygen Use in Trauma Patients

ABSTRACTObjective: This study estimates the prevalence of injured patients requiring prehospital supplemental oxygen based on existing recommendations, and determines whether actual use exceeds those recommendations. Patients and Methods: Prehospital oxygen use and continuous peripheral oxygen saturation measurements were prospectively collected on a purposive sample of injured civilians transported to an urban level 1 trauma center by paramedics. Structured chart review determined injury characteristics and outcomes. Supplemental oxygen administration indications were hypoxemia (peripheral oxygen saturation ≤ 90%), hemorrhagic shock (systolic blood pressure < 100 mmHg), or paramedic suspicion of traumatic brain injury. Results: Paramedics enrolled 224/290 screened subjects. Median (range) age was 34 (18–84) years, 48.7% were nonwhite, 75.4% were male, and Injury Severity Score was 5 (1–75). Half (54.5%) were admitted; 36.2% sustained a penetrating injury. None underwent prehospital endotracheal intubatio...