Outcomes in severely ill patients transported without prehospital ALS

Sheng Chuan Hu, Wei Fong Kao

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


Because of the debate regarding the impact of advanced life support (ALS) care on the outcome of prehospital patients, we monitored the influence of lack of sophisticated prehospital treatment in cases of severe illness arriving by ambulance to the emergency department (ED). A prospective cohort study to examine and compare the outcome of trauma- and nontrauma-induced 'ALS-eligible' cases in the setting of no prehospital care was carried out from August 1, 1993 through May 31, 1994. On arriving at the ED, patients meeting the criteria for ALS cases and sent by EMS public prehospital personnel were assessed for subjective and objective status and change in severity by triage nurses as well as being followed up for neurological status until discharged from the hospital. Chi-Square method was used to compare the data between two groups and P < .05 was considered statistically significant. Of 667 studied ALS cases (159 trauma and 912 nontrauma), <20% had their condition change subjectively and <10% had their condition change objectively; 68% of medical patients and 60% of trauma cases were discharged from the hospital (neurologically intact). However, subgroup analysis showed that objective measures worsened in transit in nearly 18% of trauma victims, a rate nearly 3 times greater than that of medical cases. Moreover, neurological outcome was particularly poor in trauma cases. These results suggest that ALS care may be valuable for severely ill trauma victims.

Original languageEnglish
Pages (from-to)86-88
Number of pages3
JournalAmerican Journal of Emergency Medicine
Issue number1
Publication statusPublished - 1996
Externally publishedYes


  • Emergency medical services (EMS)
  • outcome
  • prehospital care
  • trauma

ASJC Scopus subject areas

  • Emergency Medicine


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