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<< Ballistic Injuries In The Emergency Department (Trauma CME)

Prehospital Care

Prehospital management of gunshot wounds varies somewhat based on the location of the injury, but almost all ballistic injury patients require immediate transport to a trauma center. Two large retrospective Canadian studies have suggested that direct transport to a Level I trauma center instead of a closer, non-trauma center results in better outcomes.23,24 Emergency medical services (EMS) providers should follow common ATLS® prehospital guidelines to control the airway, provide oxygen as needed, and control bleeding with direct pressure as well as obtain vital signs and intravenous (IV) access as soon as possible. Although EMS protocols will vary from region to region and each crew has varying capabilities, the EMS crew should perform lifesaving procedures as indicated but should primarily do their best to minimize transport time to the nearest trauma center.

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