Comparison of the Pre-hospital Trauma Life Support (PHTLS) Recommendations and the German National Guideline on Treatment of Patients with Severe and Multiple Injuries.

Background: The Pre-hospital Trauma Life Support (PHTLS) concept is well established throughout the world. The aim is to improve pre-hospital care for patients suffering from major trauma. In 2011, a German level 3 (S3) evidence- and consensus-based guideline on the treatment of patients with severe and multiple injuries was published. The scope of this study was the systematic comparison between the educational content of the worldwide PHTLS concept and the German S3-guideline. Methods: A total of 62 key recommendations of the German S3-guideline were compared with the content of the English PHTLS manual (8th edition). Depending on the level of agreement, the recommendations were categorized in: (1) Agreement, (2) Minor variation, or (3) Major variation. Comparison was done via a rating system by a number of international experts in the field of out-of-hospital trauma care. The Delphi-method was used to get the final statements by indistinct or board-ranged ratings. Results: Overall, there was no conformity in 12%. In 68% a total agreement and in 88% conformity with slight differences of minor variations was found between the key recommendations of the guideline and the PHTLS manual. The PHTLS primary assessment has a large conformity for the following individual priorities: airway 92%, breathing 92%, circulation 63%, disability 100%, exposure 89%. Conclusions: According to our comparison, the PHTLS manual is largely compatible with the German S3-guideline from 2011. The 12% divergent statements concern mainly fluid resuscitation. Minor deviations in the pre-hospital care are due to a national guideline with an emergency medical service with emergency physicians (S3-guideline) and a global PHTLS concept. (C) 2016 Lippincott Williams & Wilkins, Inc.

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