| Popis: |
Objective: The objective of this scoping review is to identify the extent and type of evidence available to clinicians and prehospital services to assist decisions regarding the appropriate prehospital regimens for the maintenance of anaesthesia following intubation of trauma patients. Introduction: The provision of prehospital emergency anaesthesia (PHEA) is a complex intervention, which if conducted safely can have significant potential benefits to the trauma patient. While techniques and anaesthetic regimens for the induction of PHEA are dealt with extensively in the published literature, there is little evidence to guide clinicians on the appropriate choice of anaesthetic regimens for the maintenance of PHEA. Inclusion criteria: The primary review will identify publications addressing the prehospital anaesthetic maintenance regimens for trauma patients post-intubation. A secondary review of the same literature search will identify publications that address post-intubation anaesthetic maintenance regimens in similar clinical scenarios that may allow for reasonable comparisons of practice – namely medical patients in the prehospital setting and trauma patients undergoing interhospital transfer. Methods: Ovid will be used to search the MEDLINE and EMBASE databases and EBSCOhost to search the CINHAL database. The search will be limited to articles published in the English language between January 1990 and September 2022. Two independent reviewers will screen collated articles by title and abstract, then undertake full text review of remaining articles, against the inclusion and exclusion criteria. Any relevant references from the reviewed articles be added for full text review. Data extracted from the final articles meeting criteria will be collated independently in tabular form, and a narrative synthesis will accompany the results, assessing anaesthetic regimens against the pharmacokinetic properties of the described drugs. If practical, the reported regimens will be further illustrated using pharmacokinetic modelling. |
