Emergency Medical Services Out-of-Hospital Scene and Transport Times and Their Association With Mortality in Trauma Patients Presenting to an Urban Level I Trauma Center

Abstract Background The time from injury to treatment is considered as one of the major determinants for patient outcome after trauma. Previous studies already attempted to investigate the correlation between prehospital time and trauma patient outcome. However, the outcome for severely injured patients is not clear yet, as little data is available from prehospital systems with both Emergency Medical Services (EMS) and physician staffed Helicopter Emergency Medical Services (HEMS). Therefore, the aim was to investigate the association between prehospital time and mortality in polytrauma patients in a Dutch level I trauma center. Methods A retrospective study was performed using data derived from the Dutch trauma registry of the National Network for Acute Care from Amsterdam UMC location VUmc over a 2-year period. Severely injured polytrauma patients (Injury Severity Score (ISS) ≥ 16), who were treated on-scene by EMS or both EMS and HEMS and transported to our level I trauma center, were included. Patient characteristics, prehospital time, comorbidity, mechanism of injury, type of injury, HEMS assistance, prehospital Glasgow Coma Score and ISS were analyzed using logistic regression analysis. The outcome measure was in-hospital mortality. Results In total, 342 polytrauma patients were included in the analysis. The total mortality rate was 25.7% (n = 88). Similar mean prehospital times were found between the surviving and non-surviving patient groups, 45.3 min (SD 14.4) and 44.9 min (SD 13.2) respectively (p = 0.819). The confounder-adjusted analysis revealed no significant association between prehospital time and mortality (p = 0.156). Conclusion This analysis found no association between prehospital time and mortality in polytrauma patients. Future research is recommended to explore factors of influence on prehospital time and mortality.

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Study on patient satisfaction among patients with trauma admitted to trauma centre and emergency medical services ward

International Surgery Journal ◽

10.18203/2349-2902.isj20191070 ◽

2019 ◽

Vol 6 (4) ◽

pp. 1219

Author(s):

Mrutyunjay I. Uppin ◽

Kapildev K. Hannurkar ◽

Archana M. Uppin

Keyword(s):

Patient Satisfaction ◽

Emergency Medical Services ◽

Trauma Center ◽

Road Traffic ◽

Trauma Centre ◽

Medical Services ◽

Research Centre ◽

Trauma Patients ◽

Quality Health Care ◽

Emergency Medical

Background: Patient satisfaction is an important key factor for determining the quality health care and services offered by the emergency departments in the hospital. The objectives of the study were to assess the satisfaction of the trauma patients attending the trauma center with the services provided by the KLES Dr. Prabhakar Kore Hospital and Research Centre, Belagavi, Karnataka.Methods: Fifty trauma patients admitted and treated in trauma center and emergency medical services ward (TCEMS) at KLES Dr. Prabhakar Kore Hospital and Research Centre, Belagavi, over a period of 3 months (from November 2014 till January 2015) were interviewed. After obtaining an informed consent, the required data was collected using a pre-designed and pre-tested questionnaire.Results: Out of the 50 patients interviewed, 86% were males and 14% were females. Out of them 74% were road traffic accident victims. 67.5% of these victims were between the age group of 21 and 50 yrs. The overall satisfaction was good with all the services provided at the center. 80% were satisfied with the care provided by the doctors, 80% with communication by doctors, more than 75% with accessory services, more than 65% with the wait times at various levels and more than 85% satisfaction with amenities in the ward.Conclusions: In conclusion our study revealed that the availability of consultant in triage area, improvements in communication, quick service at the Casualty Pharmacy, reducing the perceived waiting times at various levels and improvement in the ambience of the unit would further enhance the patient satisfaction with TCEMS.

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Medical command physician triage of trauma patients to level I versus level II trauma centers in helicopter emergency medical services (HEMS)

Air Medical Journal ◽

10.1016/1067-991x(95)90519-7 ◽

1995 ◽

Vol 14 (3) ◽

pp. 156

Author(s):

J.T. Sambol ◽

R.F. Lavery ◽

B.J. Tortella ◽

J.H. Siegel

Keyword(s):

Emergency Medical Services ◽

Medical Services ◽

Trauma Patients ◽

Trauma Centers ◽

Helicopter Emergency Medical Services ◽

Emergency Medical ◽

Level Ii ◽

Versus Level ◽

Level I

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Assessment of helicopter versus ground emergency medical services in reducing mortality rate and the length of stay in adult trauma patients between 2002 and 2014 recorded in King Abdulaziz Medical City trauma registry

Saudi Journal of Emergency Medicine ◽

10.24911/sjemed/72-1576150683 ◽

2020 ◽

pp. 15-19

Author(s):

Shahad Aldelaijan ◽

Mona Alsanae ◽

Maysan almegbel ◽

Nouf Alsadoun ◽

Shahad Altoyan ◽

...

Keyword(s):

Mortality Rate ◽

Length Of Stay ◽

Emergency Medical Services ◽

Trauma Registry ◽

Medical Services ◽

Trauma Patients ◽

Emergency Medical ◽

Medical City

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Usefulness of Pelvic Radiographs in the Initial Trauma Evaluation with Concurrent CT: Is Additional Radiation Exposure Necessary?

International Journal of Pediatrics ◽

10.1155/2018/6260954 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Anne K. Misiura ◽

Autumn D. Nanassy ◽

Jacqueline Urbine

Keyword(s):

Trauma Center ◽

Pediatric Trauma ◽

Trauma Patients ◽

Additional Information ◽

Pelvic Radiographs ◽

Pelvic Radiograph ◽

Digital Radiograph ◽

Urban Level ◽

Level I ◽

Pediatric Trauma Center

Trauma patients in a Level I Pediatric Trauma Center may undergo CT of the abdomen and pelvis with concurrent radiograph during initial evaluation in an attempt to diagnose injury. To determine if plain digital radiograph of the pelvis adds additional information in the initial trauma evaluation when CT of the abdomen and pelvis is also performed, trauma patients who presented to an urban Level I Pediatric Trauma Center between 1 January 2010 and 7 February 2017 in whom pelvic radiograph and CT of the abdomen and pelvis were performed within 24 hours of each other were analyzed. A total of 172 trauma patients had pelvic radiograph and CT exams performed within 24 hours of each other. There were 12 cases in which the radiograph missed pelvic fractures seen on CT and 2 cases in which the radiograph suspected a fracture that was not present on subsequent CT. Furthermore, fractures in the pelvis were missed on pelvic radiographs in 12 of 35 cases identified on CT. Sensitivity of pelvic radiograph in detecting fractures seen on CT was 65.7% with a 95% confidence interval of 47.79-80.87%. Results suggest that there is no added diagnostic information gained from a pelvic radiograph when concurrent CT is also obtained, a practice which exposes the pediatric trauma patient to unnecessary radiation.

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