Spaite DW, et al. - Through the Excellence in Prehospital Injury Care Study, a cohort study with 21,852 patients with moderate, severe, or critical traumatic brain injury (15,228 pre-implementation and 6,624 postimplementation), researchers assessed the correlation of implementing nationally vetted, evidence-based, prehospital treatment guidelines with outcomes in moderate, severe, and critical traumatic brain injury (TBI). The adjusted odds ratio (aOR) for survival to hospital discharge was 1.06. For survival to hospital admission, the aOR was 1.70. Guideline implementation was significantly correlated with survival to discharge in severe injury cohorts (but not moderate or critical); this was true among severe, intubated subgroups. In overall survival to hospital discharge across the entire critical injury spectrum, statewide implementation of the prehospital TBI guidelines had no correlation with significant improvement. Nevertheless, among patients with severe TBI and among the subjects in the severe, intubated cohort, adjusted survival doubled and tripled, respectively. Guideline implementation had a notable relationship with survival to hospital admission. Thus, these findings strengthened the widespread implementation of the prehospital TBI treatment guidelines.