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Sydney COAST registry: trauma shock first year
Prospective Observational Study Assessing Patient Characteristics, Management and Early Outcomes of Major Trauma Patients With Prehospital Shock. A preliminary report of the Sydney COAST study
Emergency Medicine Australasia · 2026-11-09 · Added 11 November 2026
An Australian prospective multicentre registry enrolled 257 adults with prehospital trauma shock over 12 months in Sydney, finding hypotension drove 90% of shock definitions, 53% received prehospital blood, and mortality was 4.7% at 4 hours and 21% at 30 days.
- Study type
- Registry
- Design
- Prospective multicentre registry, first 12 months (prehospital medical teams)
- Participants
- 257 adults with prehospital trauma shock
- Main finding
- Hypotension was the shock criterion in 90%; 53% received prehospital blood, 31% needed interventional haemorrhage control, 74% in-hospital transfusion; median ISS 27; mortality 4.7% at 4 hours, 9% at 24 hours, 21% at 30 days
- Caveat
- Preliminary descriptive report — no outcome comparisons, and not all shocked patients had haemorrhage
- Bottom line
- Context only
Why it matters in Australia (Medium relevance). Australian data, but the prehospital blood that half these patients got is limited to a few Australian services — the shock epidemiology travels nationally, the blood component doesn't yet
Learning goal
Strengthen my recognition of occult shock in major trauma patients who are not yet hypotensive.
More
- Topic: Trauma
- Daily scan: 11 November 2026
- Podcast: Paramedic Papers Daily, 11 November 2026
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