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Comment & Response
February 26, 2020

Prehospital Severe Trauma Management in Tactical Medicine—Reply

Author Affiliations
  • 1Department of Anaesthesia and Critical Care, Hôpital Beaujon, HUPNVS, AP-HP, Clichy, France
  • 2Trauma System of the Northern French Alps Emergency Network, Hospital Annecy Genevois, Annecy, France
  • 3Department Anesthesia and Critical Care, University Hospital, Grenoble, France
JAMA Surg. 2020;155(5):452-453. doi:10.1001/jamasurg.2019.6039

In Reply We thank Vivien et al for their interest in our study1 and thank the editor for the opportunity to reply. Indeed, it would have been preferable to analyze the complete time frame including time on scene and dispatch. However, only the total prehospital time was consistently available for this study. Any further steps to evaluate all steps involved is an indispensable future avenue of research and cooperation. Nevertheless, we would like to reiterate it is the total prehospital time that ultimately determines the arrival time. Transport times vary owing to numerous variables and do not necessarily depend on geographic distance to a given center. To modelize transport times, a precise scene localization would be tremendously helpful, but such information is currently not reliably available in both participating trauma systems. According to the available data, prolonged entrapment has become actually relatively rare in this cohort at 8%.

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