Joey P Johnson, Bryant W Oliphant, Jimm Dodd, Rommie L Duckworth, Jeffrey M Goodloe, John W Lyng, Scott G Sagraves, Peter E Fischer
{"title":"Prehospital Antibiotic Administration for Suspected Open Fractures: Joint COT/OTA/ACEP/NAEMSP/NAEMT Position Statement.","authors":"Joey P Johnson, Bryant W Oliphant, Jimm Dodd, Rommie L Duckworth, Jeffrey M Goodloe, John W Lyng, Scott G Sagraves, Peter E Fischer","doi":"10.1080/10903127.2024.2409380","DOIUrl":null,"url":null,"abstract":"<p><p>One of the primary concerns associated with open fractures is the development of a fracture-related infection (FRI). To minimize the risk of developing an FRI and subsequent morbidity, prophylactic antibiotics should be administered to patients with open fractures as soon as possible. While the antibiotic recommendations for severe open fractures are somewhat debatable, the use of a cephalosporin remains a mainstay of prophylactic treatment. Though administration of prehospital antibiotics does represent an expansion of EMS responsibilities, there have been several other treatment expansions in the prehospital setting, such as the administration of tranexamic acid and the application of pelvic binders. The administration of antibiotics, specifically cefazolin, is inexpensive, technically simple, and does not require special storage. The following recommendations are supported by and represent consensus of the COT, OTA, ACEP, NAEMSP and NAEMT with regards to prehospital antibiotic prophylaxis for suspected fractures:In a responsive patient with no history of penicillin or cephalosporin allergy, the administration by EMS of a 1<sup>st</sup> generation cephalosporin should be performed after the management of life threats. This intervention should not delay transport.In an obtunded patient, the administration by EMS of a 1<sup>st</sup> generation cephalosporin should be performed after the management of life-threats. This intervention should not delay transport.In a responsive patient with a documented penicillin allergy, the administration by EMS of a 1<sup>st</sup> generation cephalosporin should be performed with close monitoring after the management of life-threats. This intervention should not delay transport.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Prehospital Emergency Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/10903127.2024.2409380","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
One of the primary concerns associated with open fractures is the development of a fracture-related infection (FRI). To minimize the risk of developing an FRI and subsequent morbidity, prophylactic antibiotics should be administered to patients with open fractures as soon as possible. While the antibiotic recommendations for severe open fractures are somewhat debatable, the use of a cephalosporin remains a mainstay of prophylactic treatment. Though administration of prehospital antibiotics does represent an expansion of EMS responsibilities, there have been several other treatment expansions in the prehospital setting, such as the administration of tranexamic acid and the application of pelvic binders. The administration of antibiotics, specifically cefazolin, is inexpensive, technically simple, and does not require special storage. The following recommendations are supported by and represent consensus of the COT, OTA, ACEP, NAEMSP and NAEMT with regards to prehospital antibiotic prophylaxis for suspected fractures:In a responsive patient with no history of penicillin or cephalosporin allergy, the administration by EMS of a 1st generation cephalosporin should be performed after the management of life threats. This intervention should not delay transport.In an obtunded patient, the administration by EMS of a 1st generation cephalosporin should be performed after the management of life-threats. This intervention should not delay transport.In a responsive patient with a documented penicillin allergy, the administration by EMS of a 1st generation cephalosporin should be performed with close monitoring after the management of life-threats. This intervention should not delay transport.
期刊介绍:
Prehospital Emergency Care publishes peer-reviewed information relevant to the practice, educational advancement, and investigation of prehospital emergency care, including the following types of articles: Special Contributions - Original Articles - Education and Practice - Preliminary Reports - Case Conferences - Position Papers - Collective Reviews - Editorials - Letters to the Editor - Media Reviews.