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Current guidelines for prehospital care of traumatic brain injury (TBI) focus on avoiding or treating hypoxemia, hypotension, and hyperventilation (Prehosp Emerg Care 2008;12 Suppl 1:S1). Unfortunately, these guidelines are largely based on observational data and, more than a decade after publication, have not been prospectively evaluated. Although the recommendations have face validity, we have not known if systematic implementation translates into better outcomes.
To address this, researchers compared survival before and after implementation of the guidelines in patients with suspected TBI who were transported to trauma centers by emergency medical services (EMS) agencies in Arizona. The study included roughly 15,000 patients in the preimp…