quality:correction
Pre-hospital

The pre-hospital use of stabilization techniques improves the chances of a person surviving the journey to the nearest trauma-equipped hospital. Emergency medicine services determines which people need treatment at a trauma center as well as provide primary stabilization by checking and treating airway, breathing, and circulation as well as assessing for disability and gaining exposure to check for other injuries.

Spinal motion restriction by securing the neck with a cervical collar and placing the person on a long spine board was of high importance in the pre-hospital setting, but due to lack of evidence to support its use, the practice is losing favor. Instead, it is recommended that more exclusive criteria be met such as age and neurological deficits to indicate the need of these adjuncts. This may be accomplished with other medical transport devices, such as a Kendrick extrication device, before moving the person. It is important to quickly control severe bleeding with direct pressure to the wound and consider the use of hemostatic agents or tourniquets if the bleeding continues. Conditions such as impending airway obstruction, enlargening neck hematoma, or unconsciousness require intubation. It is unclear, however, if this is best performed before reaching hospital or in the hospital.

Rapid transportation of severely injured patients improves the outcome in trauma. Helicopter EMS transport reduces mortality compared to ground-based transport in adult trauma patients. Before arrival at the hospital, the availability of advanced life support does not greatly improve the outcome for major trauma when compared to the administration of basic life support. Evidence is inconclusive in determining support for pre-hospital intravenous fluid resuscitation while some evidence has found it may be harmful. Hospitals with designated trauma centers have improved outcomes when compared to hospitals without them, and outcomes may improve when persons who have experienced trauma are transferred directly to a trauma center.

Improvements in pre-hospital care have led to "unexpected survivors", where patients survive trauma when they would have previously been expected to die. However these patients may struggle to rehabilitate.