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BMC Emergency Medicine
Published in: BMC Emergency Medicine 1/2023

Open Access 01-12-2023 | Care | Research

Prehospital clinical practice guidelines for unintentional injuries: a scoping review and prioritisation process

Authors: Desmond Kuupiel, Nasreen S. Jessani, Jody Boffa, Celeste Naude, Emmy De Buck, Philippe Vandekerckhove, Michael McCaul

Published in: BMC Emergency Medicine | Issue 1/2023

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Abstract

Background

Globally, millions of people die and many more develop disabilities resulting from injuries each year. Most people who die from injuries do so before they are transported to hospital. Thus, reliable, pragmatic, and evidence-based prehospital guidance for various injuries is essential. We systematically mapped and described prehospital clinical practice guidelines (CPGs) for injuries in the global context, as well as prioritised injury topics for guidance development and adolopment.

Methods

This study was sequentially conducted in three phases: a scoping review for CPGs (Phase I), identification and refinement of gaps in CPGs (Phase II), and ranking and prioritisation of gaps in CPGs (Phase III). For Phase I, we searched PubMed, SCOPUS, and Trip Database; guideline repositories and websites up to 23rd May 2021. Two authors in duplicate independently screened titles and abstract, and full-text as well as extracted data of eligible CPGs. Guidelines had to meet 60% minimum methodological quality according to rigour of development domain in AGREE II. The second and third phases involved 17 participants from 9 African countries and 1 from Europe who participated in a virtual stakeholder engagement workshop held on 5 April 2022, and followed by an online ranking process.

Results

Fifty-eight CPGs were included out of 3,427 guidance documents obtained and screened. 39/58 (67%) were developed de novo compared to 19 that were developed using alternative approaches. Twenty-five out of 58 guidelines (43%) were developed by bodies in countries within the WHO European Region, while only one guideline was targeted to the African context. Twenty-five (43%) CPGs targeted emergency medical service providers, while 13 (22%) targeted first aid providers (laypeople). Forty-three CPGs (74%) targeted people of all ages. The 58 guidance documents contained 32 injury topics. Injuries linked to road traffic accidents such as traumatic brain injuries and chest injuries were among the top prioritised topics for future guideline development by the workshop participants.

Conclusion

This study highlights the availability, gaps and priority injury topics for future guideline development/adolopment, especially for the African context. Further research is needed to evaluate the recommendations in the 58 included CPGs for possible adaptation to the African context.
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Literature
1.
2.
3.
Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard M, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204–22.
4.
5.
Gopalakrishnan S. A public health perspective of road traffic accidents. J Fam Med Prim Care. 2012;1(2):144–50.CrossRef
6.
Bakke HK, Steinvik T, Eidissen SI, Gilbert M, Wisborg T. Bystander first aid in trauma - prevalence and quality: a prospective observational study. Acta Anaesthesiol Scand. 2015;59(9):1187–93.CrossRefPubMedPubMedCentral
7.
8.
Thind A, Hsia R, Mabweijano J, Hicks ER, Zakariah A, Mock CN. Prehospital and emergency care. 2015.
9.
Wibring K, Magnusson C, Axelsson C, Lundgren P, Herlitz J, Andersson HM. Towards definitions of time-sensitive conditions in prehospital care. Scand J Trauma Resuscitation  Emerg Med. 2020;28(1):7.CrossRef
10.
Mould-Millman NK, Naidoo R, de Vries S, Stein C, Wallis LA. AFEM Consensus Conference, 2013. AFEM Out-of-Hospital Emergency Care Workgroup Consensus Paper: Advancing Out-of-Hospital Emergency Care in Africa-Advocacy and Development. African J Emerg Med. 2014;4(2):90–5.
11.
Vandvik PO, Brandt L, Alonso-Coello P, Treweek S, Akl EA, Kristiansen A, et al. Creating clinical practice guidelines we can trust, use, and share: a new era is imminent. Chest. 2013;144(2):381–9.
12.
13.
Schünemann HJ, Wiercioch W, Etxeandia I, Falavigna M, Santesso N, Mustafa R, et al. Guidelines 2.0: systematic development of a comprehensive checklist for a successful guideline enterprise. Can Med Assoc J. 2014;186(3):E123.
14.
Schünemann HJ, Wiercioch W, Brozek J, Etxeandia-Ikobaltzeta I, Mustafa RA, Manja V, et al. GRADE Evidence to Decision (EtD) frameworks for adoption, adaptation, and de novo development of trustworthy recommendations: GRADE-ADOLOPMENT. J Clin Epidemiol. 2017;81:101–10.CrossRefPubMed
15.
McCaul M, Young T, Clarke M. Strengthening prehospital clinical practice guideline development in South Africa: Reflections from guideline experts. African J Emerg Med. 2021;11(1):132–9.CrossRef
16.
Peters MD, Godfrey CM, Khalil H, McInerney P, Parker D, Soares CB. Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc. 2015;13(3):141–6.CrossRefPubMed
17.
Malherbe P, Smit P, Sharma K, McCaul M. Guidance we can trust? The status and quality of prehospital clinical guidance in sub-Saharan Africa: A scoping review. Afr J Emerg Med. 2020;11(1):79–86.CrossRefPubMedPubMedCentral
18.
19.
Glandon D, Meghani A, Jessani N, Qiu M, Bennett S. Identifying health policy and systems research priorities on multisectoral collaboration for health in low-income and middle-income countries. BMJ Glob Health. 2018;3(Suppl 4): e000970.CrossRefPubMedPubMedCentral
20.
Qiu M, Jessani N, Bennett S. Identifying health policy and systems research priorities for the sustainable development goals: social protection for health. Int J Equity Health. 2018;17(1):155.CrossRefPubMedPubMedCentral
21.
Scott K, Jessani N, Qiu M, Bennett S. Developing more participatory and accountable institutions for health: identifying health system research priorities for the Sustainable Development Goal-era. Health Policy Plan. 2018;33(9):975–87.CrossRefPubMedPubMedCentral
22.
Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32.
23.
Levac D, Colquhoun H, O’Brien KK. Scoping studies: advancing the methodology. Implement Sci. 2010;5(1):69.
24.
Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467–73.
25.
Brouwers MC, Kho ME, Browman GP, Burgers JS, Cluzeau F, Feder G, et al. AGREE II: advancing guideline development, reporting and evaluation in health care. 2010;182(18):E839-E42.
26.
Adisesh A, Lee C, Porter K. Harness suspension and first aid management: development of an evidence-based guideline. Emerg Med J. 2011;28(4):265–8.CrossRefPubMed
27.
Van de Velde S, De Buck E, Vandekerckhove P, Volmink J. Evidence-based African first aid guidelines and training materials. PLoS Med. 2011;8(7): e1001059.CrossRefPubMedPubMedCentral
28.
Fox N, Rajani RR, Bokhari F, Chiu WC, Kerwin A, Seamon MJ, et al. Evaluation and management of penetrating lower extremity arterial trauma: an Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg. 2012;73(5 Suppl 4):S315–20.CrossRefPubMed
29.
Mayglothling J, Duane TM, Gibbs M, McCunn M, Legome E, Eastman AL, et al. Emergency tracheal intubation immediately following traumatic injury: an Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg. 2012;73(5 Suppl 4):S333–40.CrossRefPubMed
30.
Sasser SM, Hunt RC, Faul M, Sugerman D, Pearson WS, Dulski T, et al. Guidelines for field triage of injured patients: recommendations of the National Expert Panel on Field Triage, 2011. MMWR Recomm Reports. 2012;61(RR-1):1–20.
31.
American College of Surgeons Committee on T, American College of Emergency Physicians Pediatric Emergency Medicine C, National Association of EMSP, American Academy of Pediatrics Committee on Pediatric Emergency M, Fallat ME. Withholding or termination of resuscitation in pediatric out-of-hospital traumatic cardiopulmonary arrest. Ann Emerg Med. 2014;63(4):504–15.
32.
Bulger EM, Snyder D, Schoelles K, Gotschall C, Dawson D, Lang E, et al. An evidence-based prehospital guideline for external hemorrhage control: American College of Surgeons Committee on Trauma. Prehosp Emerg Care. 2014;18(2):163–73.CrossRefPubMed
33.
Gausche-Hill M, Brown KM, Oliver ZJ, Sasson C, Dayan PS, Eschmann NM, et al. An Evidence-based Guideline for prehospital analgesia in trauma. Prehosp Emerg Care. 2014;18(Suppl 1):25–34.CrossRefPubMed
34.
Muraro A, Roberts G, Worm M, Bilo MB, Brockow K, Fernandez Rivas M, et al. Anaphylaxis: guidelines from the European Academy of Allergy and Clinical Immunology. Allergy. 2014;69(8):1026–45.CrossRefPubMed
35.
Thomas SH, Brown KM, Oliver ZJ, Spaite DW, Lawner BJ, Sahni R, et al. An Evidence-based Guideline for the air medical transportation of prehospital trauma patients. Prehosp Emerg Care. 2014;18(Suppl 1):35–44.CrossRefPubMed
36.
Zafren K, Giesbrecht GG, Danzl DF, Brugger H, Sagalyn EB, Walpoth B, et al. Wilderness Medical Society practice guidelines for the out-of-hospital evaluation and treatment of accidental hypothermia. Wilderness  Environ Med. 2014;25(4):425–45.CrossRefPubMed
37.
38.
Rehn M, Hyldmo PK, Magnusson V, Kurola J, Kongstad P, Rognas L, et al. Scandinavian SSAI clinical practice guideline on pre-hospital airway management. Acta Anaesthesiol Scand. 2016;60(7):852–64.CrossRefPubMedPubMedCentral
39.
Battaloglu E, Porter K. Management of pregnancy and obstetric complications in prehospital trauma care: prehospital resuscitative hysterotomy/perimortem caesarean section. Emerg Med J. 2017;34(5):326–30.CrossRefPubMed
40.
Battaloglu E, Porter K. Management of pregnancy and obstetric complications in prehospital trauma care: faculty of prehospital care consensus guidelines. Emerg Med J. 2017;34(5):318–25.CrossRefPubMed
41.
Bouzat P, Raux M, David JS, Tazarourte K, Galinski M, Desmettre T, et al. Chest trauma: First 48hours management. Anaesthes Critical Care Pain Med. 2017;36(2):135–45.CrossRef
42.
Kornhall DK, Jorgensen JJ, Brommeland T, Hyldmo PK, Asbjornsen H, Dolven T, et al. The Norwegian guidelines for the prehospital management of adult trauma patients with potential spinal injury. Scandinavian journal of trauma, resuscitation and emergency medicine. 2017;25(1):2.CrossRefPubMedPubMedCentral
43.
De Buck E, Borra V, Van Remoortel H, Laermans J, VanDe VA, Vandekerckhove P. First aid for everyone: First aid guideline for laypeople. Tijdschrift voor Geneeskunde. 2018;74(1):15–29.
44.
Geeraerts T, Velly L, Abdennour L, Asehnoune K, Audibert G, Bouzat P, et al. Management of severe traumatic brain injury (first 24hours). Anaesthes Critical Care Pain Med. 2018;37(2):171–86.CrossRef
45.
Polytrauma Guideline Update G. Level 3 guideline on the treatment of patients with severe/multiple injuries. European Journal of Trauma & Emergency Surgery. 2018;44:3–271.
46.
Strapazzon G, Reisten O, Argenone F, Zafren K, Zen-Ruffinen G, Larsen GL, et al. International commission for mountain emergency medicine consensus guidelines for on-site management and transport of patients in canyoning incidents. Wilderness Environ Med. 2018;29(2):252–65.CrossRefPubMed
47.
Velopulos CG, Shihab HM, Lottenberg L, Feinman M, Raja A, Salomone J, et al. Prehospital spine immobilization/spinal motion restriction in penetrating trauma: A practice management guideline from the Eastern Association for the Surgery of Trauma (EAST). J Trauma Acute Care Surg. 2018;84(5):736–44.CrossRefPubMed
48.
Maschmann C, Jeppesen E, Rubin MA, Barfod C. New clinical guidelines on the spinal stabilisation of adult trauma patients - consensus and evidence based. Scand J Trauma Resusc Emerg Med. 2019;27(1):77.CrossRefPubMedPubMedCentral
49.
Schmidt AC, Sempsrott JR, Hawkins SC, Arastu AS, Cushing TA, Auerbach PS. Wilderness medical society clinical practice guidelines for the treatment and prevention of drowning: 2019 update. Wild Environ Med. 2019;30(4S):S70–86.CrossRef
50.
Spahn DR, Bouillon B, Cerny V, Duranteau J, Filipescu D, Hunt BJ, et al. The European guideline on management of major bleeding and coagulopathy following trauma: fifth edition. Critical Care. 2019;23(1):N.PAG-N.PAG.
51.
Bouzat P, Valdenaire G, Gauss T, Charbit J, Arvieux C, Balandraud P, et al. Early management of severe abdominal trauma. Anaesth Crit Care Pain Med. 2020;39(2):269–77.CrossRefPubMed
52.
Roquilly A, Vigué B, Boutonnet M, Bouzat P, Buffenoir K, Cesareo E, et al. French recommendations for the management of patients with spinal cord injury or at risk of spinal cord injury. Anaesth Crit Care Pain Med. 2020;39(2):279–89.CrossRefPubMed
53.
Singletary EM, Zideman DA, Bendall JC, Berry DA, Borra V, Carlson JN, et al. 2020 International Consensus on First Aid Science With Treatment Recommendations. Resuscitation. 2020;156:A240–82.CrossRefPubMed
54.
Zideman DA, Singletary EM, Borra V, Cassan P, Cimpoesu CD, De Buck E, et al. European Resuscitation Council Guidelines 2021: First aid. Resuscitation. 2021;161:270–90.CrossRefPubMed
55.
56.
57.
58.
59.
60.
Panchal AR, Bartos JA, Cabañas JG, Donnino MW, Drennan IR, Hirsch KG, et al. Part 3: adult basic and advanced life support: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2020;142(16_Suppl_2):S366-S468.
61.
62.
63.
64.
65.
Australia and New Zealand Resuscitation Council (ANZCOR). ANZCOR Guideline 7 – Automated External Defibrillation in Basic Life Support Australia: ANZCOR; 2021 [cited 28 Jan 2022]. Available from: https://​resus.​org.​au/​guidelines/​. Accessed 25 Jan 2022.
66.
Australia and New Zealand Resuscitation Council (ANZCOR). ANZCOR Guideline 8 – Cardiopulmonary Resuscitation (CPR) Australia: ANZCOR; 2021 [cited 28 Jan 2022]. Available from: https://​resus.​org.​au/​guidelines/​. Accessed 25 Jan 2022.
67.
Australia and New Zealand Resuscitation Council (ANZCOR). ANZCOR Guideline 9.1.1 – First Aid for Management of Bleeding Australia: ANZCOR; 2021 [cited 28 Jan 2022]. Available from: https://​resus.​org.​au/​guidelines/​. Accessed 25 Jan 2022.
68.
Australia and New Zealand Resuscitation Council (ANZCOR). ANZCOR Guideline 9.1.5 – First Aid Management of Harness Suspension Trauma Australia: ANZCOR; 2021 [cited 28 Jan 2022]. Available from: https://​resus.​org.​au/​guidelines/​. Accessed 25 Jan 2022.
69.
Australia and New Zealand Resuscitation Council (ANZCOR). ANZCOR Guideline 9.1.7 - First Aid Management of a Crushed Victim Australia: ANZCOR; 2021 [cited 28 Jan 2022]. Available from: https://​resus.​org.​au/​guidelines/​. Accessed 25 Jan 2022.
70.
Australia and New Zealand Resuscitation Council (ANZCOR). ANZCOR Guideline 9.2.3 – Shock: First Aid Management of the Seriously Injured Person Australia: ANZCOR; 2021 [cited 28 Jan 2022]. Available from: https://​resus.​org.​au/​guidelines/​. Accessed 25 Jan 2022.
71.
Australia and New Zealand Resuscitation Council (ANZCOR). ANZCOR Guideline 9.4.1 – First Aid Management of Australian Snake Bite Australia: ANZCOR; 2021 [cited 28 Jan 2022]. Available from: https://​resus.​org.​au/​guidelines/​. Accessed 25 Jan 2022.
72.
Australia and New Zealand Resuscitation Council (ANZCOR). ANZCOR Guideline 9.4.2 - First Aid Management of Spider Bite Australia: ANZCOR; 2021 [cited  28 Jan 2022]. Available from: https://​resus.​org.​au/​guidelines/​. Accessed 25 Jan 2022.
73.
74.
Australia and New Zealand Resuscitation Council (ANZCOR). ANZCOR Guideline 9.2.10 - The Use of Oxygen in Emergencies Australia: ANZCOR; 2021 [cited 28 Jan 2022]. Available from: https://​resus.​org.​au/​guidelines/​. Accessed 25 Jan 2022.
75.
Australia and New Zealand Resuscitation Council (ANZCOR). ANZCOR Guideline 9.3.3 - First Aid Management of Hypothermia and Cold-Related Injuries Australia: ANZCOR; 2021 [cited 28 Jan 2022]. Available from: https://​resus.​org.​au/​guidelines/​. Accessed 25 Jan 2022.
76.
Australia and New Zealand Resuscitation Council (ANZCOR). ANZCOR Guideline 9.3.4 – Heat Induced Illness (Hyperthermia) Australia: ANZCOR; 2021 [cited 28 Jan 2022]. Available from: https://​resus.​org.​au/​guidelines/​. Accessed 25 Jan 2022.
77.
Australia and New Zealand Resuscitation Council (ANZCOR). ANZCOR Guideline 12.1 – Paediatric Basic Life Support (PBLS) for health professionals Australia: ANZCOR; 2021 [cited 28 Jan 2022]. Available from: https://​resus.​org.​au/​guidelines/​. Accessed 25 Jan 2022.
78.
Australia and New Zealand Resuscitation Council (ANZCOR). ANZCOR Guideline 12.5 – Management after Return of Spontaneous Circulation Australia: ANZCOR; 2021 [cited 28 Jan 2022]. Available from: https://​resus.​org.​au/​guidelines/​. Accessed 15 Jan 2022.
79.
Australia and New Zealand Resuscitation Council (ANZCOR). ANZCOR Guideline 12.2 – Paediatric Advanced Life Support Australia: ANZCOR; 2021 [cited 28 Jan 2022]. Available from: https://​resus.​org.​au/​guidelines/​. Accessed 25 Jan 2022.
80.
Australia and New Zealand Resuscitation Council (ANZCOR). ANZCOR Guideline 12.4 – Paediatric resuscitation in special circumstances Australia: ANZCOR; 2021 [cited 2022 28  Jan 2022]. Available from: https://​resus.​org.​au/​guidelines/​. Accessed 25 Jan 2022.
81.
Olasveengen TM, Semeraro F, Ristagno G, Castren M, Handley A, Kuzovlev A, et al. European Resuscitation Council guidelines 2021: basic life support. Resuscitation. 2021;161:98–114.CrossRefPubMed
82.
Soar J, Böttiger BW, Carli P, Couper K, Deakin CD, Djärv T, et al. European Resuscitation Council guidelines 2021: adult advanced life support. Resuscitation. 2021;161:115–51.CrossRefPubMed
83.
Lott C, Truhlář A, Alfonzo A, Barelli A, González-Salvado V, Hinkelbein J, et al. European Resuscitation Council Guidelines 2021: cardiac arrest in special circumstances. Resuscitation. 2021;161:152–219.CrossRefPubMed
84.
85.
Fervers B, Burgers JS, Haugh MC, Latreille J, Mlika-Cabanne N, Paquet L, et al. Adaptation of clinical guidelines: literature review and proposition for a framework and procedure. Int J Qual Health Care. 2006;18(3):167–76.CrossRefPubMed
Metadata
Title
Prehospital clinical practice guidelines for unintentional injuries: a scoping review and prioritisation process
Authors
Desmond Kuupiel
Nasreen S. Jessani
Jody Boffa
Celeste Naude
Emmy De Buck
Philippe Vandekerckhove
Michael McCaul
Publication date
01-12-2023
Publisher
BioMed Central
Keyword
Care
Published in
BMC Emergency Medicine / Issue 1/2023
Electronic ISSN: 1471-227X
DOI
https://doi.org/10.1186/s12873-023-00794-x

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