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Fortunately, there is growing evidence that the management of<jats:styled-content style=\"fixed-case\">TBI<\/jats:styled-content>in the early minutes after injury may significantly reduce morbidity and mortality. In response, evidence\u2010based prehospital and in\u2010hospital<jats:styled-content style=\"fixed-case\">TBI<\/jats:styled-content>treatment guidelines have been established by authoritative bodies. However, no large studies have yet evaluated the effectiveness of implementing these guidelines in the prehospital setting. This article describes the background, design, implementation, emergency medical services (<jats:styled-content style=\"fixed-case\">EMS<\/jats:styled-content>) treatment protocols, and statistical analysis of a prospective, controlled (before\/after), statewide study designed to evaluate the effect of implementing the<jats:styled-content style=\"fixed-case\">EMS TBI<\/jats:styled-content>guidelines\u2014the Excellence in Prehospital Injury Care (<jats:styled-content style=\"fixed-case\">EPIC<\/jats:styled-content>) study (<jats:styled-content style=\"fixed-case\">NIH<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">NINDS<\/jats:styled-content>R01<jats:styled-content style=\"fixed-case\">NS<\/jats:styled-content>071049, \u201c<jats:styled-content style=\"fixed-case\">EPIC<\/jats:styled-content>\u201d; and 3R01<jats:styled-content style=\"fixed-case\">NS<\/jats:styled-content>071049\u2010S1, \u201c<jats:styled-content style=\"fixed-case\">EPIC<\/jats:styled-content>4Kids\u201d).<\/jats:p><jats:p>The specific aim of the study is to test the hypothesis that statewide implementation of the international adult and pediatric<jats:styled-content style=\"fixed-case\">EMS TBI<\/jats:styled-content>guidelines will significantly reduce mortality and improve nonmortality outcomes in patients with moderate or severe<jats:styled-content style=\"fixed-case\">TBI<\/jats:styled-content>. Furthermore, it will specifically evaluate the effect of guideline implementation on outcomes in the subgroup of patients who are intubated in the field. Over the course of the entire study (~9 years), it is estimated that approximately 25,000 patients will be enrolled.<\/jats:p>","DOI":"10.1111\/acem.12411","type":"journal-article","created":{"date-parts":[[2014,8,11]],"date-time":"2014-08-11T21:57:35Z","timestamp":1407794255000},"page":"818-830","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Evaluation of the Impact of Implementing the Emergency Medical Services Traumatic Brain Injury Guidelines in Arizona: The Excellence in Prehospital Injury Care (EPIC) Study Methodology"],"prefix":"10.1111","volume":"21","author":[{"given":"Daniel W.","family":"Spaite","sequence":"first","affiliation":[{"name":"The Arizona Emergency Medicine Research Center College of Medicine The University of Arizona Tucson AZ"},{"name":"The Department of Emergency Medicine College of Medicine The University of Arizona Tucson AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bentley J.","family":"Bobrow","sequence":"additional","affiliation":[{"name":"The Arizona Emergency Medicine Research Center College of Medicine The University of Arizona Tucson AZ"},{"name":"The Arizona Department of Health Services Phoenix AZ"},{"name":"The Maricopa Integrated Health System Phoenix AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe","family":"Stolz","sequence":"additional","affiliation":[{"name":"The Arizona Emergency Medicine Research Center College of Medicine The University of Arizona Tucson AZ"},{"name":"The Department of Emergency Medicine College of Medicine The University of Arizona Tucson AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duane","family":"Sherrill","sequence":"additional","affiliation":[{"name":"The College of Public Health University of Arizona Tucson AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vatsal","family":"Chikani","sequence":"additional","affiliation":[{"name":"The Arizona Emergency Medicine Research Center College of Medicine The University of Arizona Tucson AZ"},{"name":"The Arizona Department of Health Services Phoenix AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Barnhart","sequence":"additional","affiliation":[{"name":"The Arizona Emergency Medicine Research Center College of Medicine The University of Arizona Tucson AZ"},{"name":"The Department of Emergency Medicine College of Medicine The University of Arizona Tucson AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Sotelo","sequence":"additional","affiliation":[{"name":"The Arizona Emergency Medicine Research Center College of Medicine The University of Arizona Tucson AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua B.","family":"Gaither","sequence":"additional","affiliation":[{"name":"The Arizona Emergency Medicine Research Center College of Medicine The University of Arizona Tucson AZ"},{"name":"The Department of Emergency Medicine College of Medicine The University of Arizona Tucson AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chad","family":"Viscusi","sequence":"additional","affiliation":[{"name":"The Arizona Emergency Medicine Research Center College of Medicine The University of Arizona Tucson AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. 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