Abstract:

Aim: The study aimed to evaluate the determining role of the shock index (SI) in initiating fluid therapy in trauma patients with active bleeding in out-of-hospital emergency care. Method: Trauma patients aged 18 years and older with active bleeding who were brought to the emergency department of a university hospital between 01.07.2010 and 01.07.2020 were scanned. A total of 3367 patients’ files were scanned, and 587 of them who met the inclusion criteria were included in the study. The patients' shock indexes (SI) were calculated based on the first measured vital signs in the EMS ambulance. The SPSS was used for statistical analysis. The chi-square test was used to determine the relationship between the independent and dependent variables. The results were evaluated at a confidence interval of 95%, and p <0.05 was accepted as statistically significant Results: It was found that >500 mL IV crystalloid fluid was administered to 76.7% of the patients at out-of-hospital, 66.4% (n=390) had hemorrhagic shock according to the out-of-hospital SI, 60.3% had a systolic blood pressure of >90 mmHg at the first measurement. Out-of-hospital SI averages of those who died in the hospital were higher than those who were discharged. It was found that among the patients who did not have shock according to the SI, those who received out-of-hospital IV fluids had a higher hospital death rate. Conclusion: SI can be used as a tool for out-of-hospital trauma patient identification and mortality assessment. SI can be used as a predictive tool in determining the need for out-of-hospital fluid therapy.

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