Open access article just released online via Emergency Medicine Journal!

The Head Injury Retrieval Trial (HIRT): a single-centre randomised controlled trial of physician prehospital management of severe blunt head injury compared with management by paramedics only

PHARM comments :

• very challenging topic to study in RCT manner as HIRT suffered from noncompliance and crossover issues
• For severe head injury, in a predominantly urban setting, the benefit of a prehospital HEMS physician response vs advanced  ground paramedic response remains unproven and appears to be marginal.
• Case in point of Senator Gabrielle Giffords and 2011 Tuscon shooting incident in which she was shot in head at point blank range. HEMS units were on standby to respond but she was treated and transported by ground medic unit and under surgery within 38 minutes of the shooting. She has made a remarkable recovery to this date.