Advanced Versus Basic Life Support in the Pre‐Hospital Setting – The Controversy between the ‘Scoop and Run’ and the ‘Stay and Play’ Approach to the Care of the Injured Patient

Abstract

Pre‐hospital care for trauma patients is provided by emergency medical personnel using either basic life support (BLS) or advanced life support (ALS) techniques. BLS for the seriously injured trauma patient most notably involves ‘scoop and run’ in which medical interventions are performed while en route to an appropriate hospital. These interventions are non‐invasive and include wound dressing, immobilization, fracture splinting, oxygen administration and non‐invasive cardiopulmonary resuscitation. ALS encompasses all of the previously mentioned BLS techniques in addition to minimally invasive procedures such as endotracheal intubation, intravenous access for fluid replacement and administration of medications. System protocols often dictate that ALS providers ‘stay and play’ at the scene of a serious trauma in order to carry out these more advanced procedures. The rationale for the use of on‐site ALS in trauma is that these interventions will reduce the rate of physiological and haemodynamic deterioratio...