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dc.contributor.authorFouche, Pieter F
dc.contributor.authorJennings, Paul A
dc.contributor.authorBoyle, Malcolm
dc.contributor.authorBernard, Stephen
dc.contributor.authorSmith, Karen
dc.date.accessioned2020-08-12T01:47:39Z
dc.date.available2020-08-12T01:47:39Z
dc.date.issued2020
dc.identifier.issn1742-6731
dc.identifier.doi10.1111/1742-6723.13594
dc.identifier.urihttp://hdl.handle.net/10072/396438
dc.description.abstractOBJECTIVE: Rapid sequence intubation (RSI) is used to secure the airway of some patients with stroke. Recent observational studies suggest that RSI is associated with poorer survival, and that decreases in systolic blood pressure (BP) following RSI could be a cause of worse survival. The present study aims to find if decreased systolic BP after paramedic RSI is associated with poorer survival in stroke patients transported by ambulance. METHODS: The present study was a retrospective analysis of all stroke patients who received paramedic RSI attended by Ambulance Victoria, Australia. Logistic regression predicted the survival for strokes that had received RSI. The change in systolic BP during paramedic care was the main predictor. RESULTS: Of 43 831 patients with stroke, 882 (2%) received RSI. Almost 48% of RSI had a decline in systolic BP of more than 20% from baseline, and the decline in systolic BP after RSI was largest for intra-cerebral haemorrhage (-22.7 mmHg) compared to ischaemic strokes (-10.1 mmHg) or subarachnoid haemorrhage (-15.6 mmHg) (P = 0.001). Sixteen percent of the RSI group had an episode of hypotension anytime during the out-of-hospital care. For each 10 mmHg decrease in systolic BP with RSI for intra-cerebral haemorrhage an increase of 11% in the odds of survival is apparent (P = 0.04); for subarachnoid haemorrhage an increase of 17% (P = 0.02) and for ischaemic strokes a non-significant decrease of 7% (P = 0.26). CONCLUSIONS: Paramedic RSI-related decrease in systolic BP is associated with improved survival in those with intra-cerebral or subarachnoid haemorrhage but not ischaemic stroke.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherWiley
dc.relation.ispartofjournalEmergency Medicine Australasia
dc.subject.fieldofresearchClinical sciences
dc.subject.fieldofresearchHealth services and systems
dc.subject.fieldofresearchPublic health
dc.subject.fieldofresearchcode3202
dc.subject.fieldofresearchcode4203
dc.subject.fieldofresearchcode4206
dc.subject.keywordsinteraction
dc.subject.keywordsparamedic
dc.subject.keywordsrapid sequence intubation
dc.subject.keywordsstroke
dc.titleAssociation of blood pressure changes with survival after paramedic rapid sequence intubation in out-of-hospital patients with stroke
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationFouche, PF; Jennings, PA; Boyle, M; Bernard, S; Smith, K, Association of blood pressure changes with survival after paramedic rapid sequence intubation in out-of-hospital patients with stroke, Emergency Medicine Australasia, 2020
dcterms.dateAccepted2020-07-05
dc.date.updated2020-08-12T01:27:11Z
gro.description.notepublicThis publication has been entered in Griffith Research Online as an advanced online version.
gro.hasfulltextNo Full Text
gro.griffith.authorBoyle, Malcolm


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