Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-23T12:07:01.507Z Has data issue: false hasContentIssue false
  • English
  • Français

Association between Mode of Transportation and Survival in Adult Trauma Patients with Penetrating Injuries: Matched Cohort Study between Police and Ground Ambulance Transport

Published online by Cambridge University Press:  08 March 2022

Samer A. Abou Arbid Open the ORCID record for Samer A. Abou Arbid [Opens in a new window] ,
Rana H. Bachir Open the ORCID record for Rana H. Bachir [Opens in a new window]  and
Mazen J. El Sayed Open the ORCID record for Mazen J. El Sayed [Opens in a new window]
Samer A. Abou Arbid
Affiliation:
Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
Rana H. Bachir
Affiliation:
Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
Mazen J. El Sayed*
Affiliation:
Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon Emergency Medical Services and Prehospital Care Program, American University of Beirut Medical Center, Beirut, Lebanon
*
Correspondence: Mazen J. El Sayed, MD, MPH, FACEP, FAEMS Associate Professor of Clinical Emergency Medicine Director of Emergency Medical Services & Prehospital Care Department of Emergency Medicine American University of Beirut Medical Center P.O. Box - 11-0236 Riad El Solh St. Beirut, Lebanon1107 2020 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Police transport (PT) of penetrating trauma patients has the potential to improve survival rates. There are no well-established guidelines for PT of penetrating trauma patients.

Study Objective:

This study examines the association between survival rate to hospital discharge of adult penetrating trauma patients and mode of transport (PT versus ground ambulance [GA]).

Methods:

A retrospective, matched cohort study was conducted using the United States (US) National Trauma Data Bank (NTDB). All adult penetrating injury patients transported by police to trauma centers were identified and matched (one-to-four) to patients transported by GA for analysis. Descriptive analysis was carried out. The patients’ demographic and clinical characteristics were tabulated and stratified by the transport mode.

Results:

Out of the 733 patients with penetrating injuries, ground Emergency Medical Services (EMS) transported 513 patients and police transported 220 patients. Most patients were 16-64 years of age with a male (95.6%) and Black/African American race (79.0%) predominance. Firearm-related injuries (68.8%) were the most common mechanism of injury with the majority of injuries involving the body extremities (62.9%). Open wounds were the most common nature of injury (75.7%). The overall survival rate to hospital discharge was similar for patients transported by GA and by police (94.5% versus 92.7%; P = .343).

Conclusion:

In this study, patients with penetrating trauma transported by police had similar outcomes to those transported by GA. As such, PT in penetrating trauma appears to be effective. Detailed protocols should be developed to further improve resource utilization and outcomes.

Keywords

Emergency Medical Servicesground ambulancepenetrating traumapolice transportsurvival
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 37 , Issue 2 , April 2022 , pp. 171 - 178
Check for updates
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Center for Disease Control and Prevention. National Center for Health Statistics. Deaths: Final Data for 2017. National Vital Statistics Reports. https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_09_tables-508.pdf. Accessed March 6, 2021.Google Scholar
Center for Disease Control and Prevention. National Center for Health Statistics. National Hospital Ambulatory Medical Care Survey: 2017 emergency department summary tables. https://www.cdc.gov/nchs/data/nhamcs/web_tables/2017_ed_web_tables-508.pdf. Accessed March 6, 2021.Google Scholar
Eisenberg, MS, Bergner, L, Hallstrom, A. Cardiac resuscitation in the community. Importance of rapid provision and implications for program planning. JAMA. 1979;241(18):1905–1907.10.1001/jama.1979.03290440027022CrossRefGoogle ScholarPubMed
Stiell, IG, Spaite, DW, Field, B, et al; OPALS Study Group. Advanced life support for out-of-hospital respiratory distress. N Engl J Med. 2007;356(21):2156–2164.CrossRefGoogle Scholar
Ruelas, OS, Tschautscher, CF, Lohse, CM, Sztajnkrycer, MD. Analysis of prehospital scene times and interventions on mortality outcomes in a national cohort of penetrating and blunt trauma patients. Prehosp Emerg Care. 2018;22(6):691–697.10.1080/10903127.2018.1448494CrossRefGoogle Scholar
Liberman, M, Mulder, D, Lavoie, A, Denis, R, Sampalis, JS. Multicenter Canadian study of prehospital trauma care. Ann Surg. 2003;237(2):153–160.10.1097/01.SLA.0000048374.46952.10CrossRefGoogle ScholarPubMed
Bieler, D, Paffrath, T, Schmidt, A, et al. Why do some trauma patients die while others survive? A matched-pair analysis based on data from Trauma Register DGU R. Chin J Traumatol. 2020;23(4):224–232.10.1016/j.cjtee.2020.05.001CrossRefGoogle ScholarPubMed
Soreide, K. Epidemiology of major trauma. Br J Surg. 2009;96(7):697–698.CrossRefGoogle ScholarPubMed
Band, RA, Salhi, RA, Holena, DN, Powell, E, Branas, CC, Carr, BG. Severity-adjusted mortality in trauma patients transported by police. Ann Emerg Med 2014;63(5):608–614.CrossRefGoogle ScholarPubMed
Zafar, SN, Haider, AH, Stevens, KA, et al. Increased mortality associated with EMS transport of gunshot wound victims when compared to private vehicle transport. Injury. 2014;45(9):1320–1326.10.1016/j.injury.2014.05.032CrossRefGoogle ScholarPubMed
Wandling, MW, Nathens, AB, Shapiro, MB, Haut, ER. Police transport versus ground EMS: a trauma system-level evaluation of prehospital care policies and their effect on clinical outcomes. J Trauma Acute Care Surg. 2016;81(5):931–935.CrossRefGoogle ScholarPubMed
Cornwell, EE III, Belzberg, H, Hennigan, K, et al. Emergency Medical Services (EMS) vs non-EMS transport of critically injured patients: a prospective evaluation. Arch Surg. 2000;135(3):315–319.CrossRefGoogle ScholarPubMed
Colnaric, JM, Bachir, RH, El Sayed, MJ. Factors associated with survival in adult trauma patients transported to US trauma centers by police. Prehosp Disaster Med. 2021;36(1):58–66.10.1017/S1049023X20001314CrossRefGoogle ScholarPubMed
Band, RA, Pryor, JP, Gaieski, DF, Dickinson, ET, Cummings, D, Carr, BG. Injury-adjusted mortality of patients transported by police following penetrating trauma. Acad Emerg Med. 2011;18(1):32–37.10.1111/j.1553-2712.2010.00948.xCrossRefGoogle ScholarPubMed
Branas, CC, Sing, RF, Davidson, SJ. Urban trauma transport of assaulted patients using nonmedical personnel. Acad Emerg Med. 1995;2(6):486–493.CrossRefGoogle ScholarPubMed
Kaufman, EJ, Jacoby, SF, Sharoky, CE, et al. Patient characteristics and temporal trends in police transport of blunt trauma patients: a multicenter retrospective cohort study. Prehosp Emerg Care. 2017;21(6):715–721.10.1080/10903127.2017.1332127CrossRefGoogle ScholarPubMed
Associated Press. Law Enforcement and Violence: The Divide between Black and White Americans. https://apnorc.org/wp-content/uploads/2020/02/Issue-Brief_PoliceFinal.pdf. Accessed March 10, 2015.Google Scholar
Jacoby, SF, Branas, CC, Holena, DN, et al. Beyond survival: the broader consequences of prehospital transport by police for penetrating trauma. Trauma Surg Acute Care Open. 2020;5(1):e000541.CrossRefGoogle ScholarPubMed
Jacoby, SF, Reeping, P, Branas, CC. Police-to-hospital transport for violently injured individuals: a way to save lives? Annals Acad Political Social Science. 2020;687(1):186–201.CrossRefGoogle Scholar
Sakr, FA, Bachir, RH, El Sayed, MJ. Association between mode of transportation and survival in adult trauma patients with blunt injuries: matched cohort study between police and ground ambulance transport. Prehosp Disaster Med. 2021;36(4):431–439.10.1017/S1049023X21000510CrossRefGoogle ScholarPubMed