UMEM Educational Pearls

Category: Trauma

Title: Abnormal pre-hospital SI is a poor predictor even with a normal arrival SI

Keywords: shock index, trauma, pre-hospital (PubMed Search)

Posted: 7/2/2023 by Robert Flint, MD (Updated: 5/29/2024)
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Shock index (heart rate/systolic blood pressure) has been used to predict trauma outcomes. This study from American Journal of Emergency Medicine looked at 89,000 pre-hospital patients who had a normal shock index on arrival at an emergency department. They then looked for those with abnormal pre-hospital shock index vs. those without an abnormal shock index and compared outcomes. Those with an abnormal pre-hospital shock index had worse outcomes than those with normal pre-hospital shock index.

Bottom line: A good handoff from pre-hospital to emergency department staff is critical because any abnormal shock index predicts a worse outcome than those with a normal shock index.


Yoshie Yamada  Sayaka Shimizu, et al  Prehospital shock index predicts 24-h mortality in trauma patients with a normal shock index upon emergency department arrival Am J Emerg Med 2023 May 10;70:101-108  doi: 10.1016/j.ajem.2023.05.008.