Characteristics and Outcomes of Patients Injured in Road Traffic Crashes and Transported by Emergency Medical Services

ABSTRACT BACKGROUND & OBJECTIVE: Road traffic accidents are the ninth leading cause of death worldwide, contributing significantly to global disease burden. Emergency Medical services(EMS) play a role in minimizing the morbidity and mortality. Our objective was to determine the characteristics of injury pattern and causes encountered in Road Traffic crashes (RTCs) managed by 1122 in Faisalabad Pakistan andto access the outcome of these accidents. METHODOLOGY: All Road Traffic crashes and victims in Faisalabad city of Pakistan which were initially managed by Rescue 1122 between 2016 to 2019 were included in the study. Total sample size was 101995. It is descriptive cross-sectional study which includes patients of different ages, sex and motor-vehicles accidents having different injury sites. RESULTS: During the study period there were total 101995 RTCs victims to whom emergency medical services (EMS) were provided. Gender wise 80.73% male victims and 19.27% female victims. Major age groups were between 21-30 years (25.917%). The major risk factors of accidents were over-speeding (56.8%) followed by carelessness (18.32%), wrong turn (8.69%) , u-turn(5.84%) , one wheeling(0.008%), tyre burst (0.117%) and others(10.14%). The injuries frequently encountered are minor which accounts for (44.68%), Single fracture (23.25%), Multiple fracture (16.62%), Head injury (12.40%) and Spinal injury(3.03%). Outcome of RTCs in our study was alive & unstable (54.47%), alive & stable (44.7%) and dead (0.83%). CONCLUSION: This study showed that Road Traffic Accident are the major public health problem in our society and contributes markedly to high morbidity and mortality. Urgent Preventive measures including community education should be established to reduce the risk of their outcome.

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Strengthening the Capacity of Emergency Medical Services in Low and Middle Income Countries using Dispatcher-Coordinated Taxis

Transportation Research Record Journal of the Transportation Research Board ◽

10.1177/0361198120929024 ◽

2020 ◽

Vol 2674 (9) ◽

pp. 338-345

Author(s):

Vipul Mishra ◽

Richa Ahuja ◽

N. Nezamuddin ◽

Geetam Tiwari ◽

Kavi Bhalla

Keyword(s):

Response Time ◽

Emergency Medical Services ◽

Road Traffic ◽

International Standards ◽

Medical Services ◽

Road Traffic Crash ◽

Middle Income ◽

Middle Income Countries ◽

Emergency Medical ◽

Low And Middle Income

International standards recommend provision of one ambulance for every 50,000 people to fulfill demand for transporting patients to definitive care facilities in low and middle income countries (LMICs). Governments’ consistent attempt to build capacity of emergency medical services (EMS) in LMICs has been financially demanding. This study is an attempt to assess the feasibility of capacity building of existing EMS in Delhi, India by using taxis as an alternative mode of transport for emergency transportation of road traffic crash victims to enable improvement in response time for road traffic crashes where time criticality is deemed important. Performance of the proposed system is evaluated based on response time, coverage and distance. The system models the performance and quantifies the taxi–ambulance configuration for achieving EMS performance within international standards.

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Helicopter and ground emergency medical services transportation to hospital after major trauma in England: a comparative cohort study

Trauma Surgery & Acute Care Open ◽

10.1136/tsaco-2020-000508 ◽

2020 ◽

Vol 5 (1) ◽

pp. e000508 ◽

Cited By ~ 1

Author(s):

Oliver Beaumont ◽

Fiona Lecky ◽

Omar Bouamra ◽

Dhushy Surendra Kumar ◽

Tim Coats ◽

...

Keyword(s):

Logistic Regression ◽

Emergency Medical Services ◽

Major Trauma ◽

Road Traffic ◽

Cohort Analysis ◽

Primary Outcome Measure ◽

Research Network ◽

Medical Services ◽

Emergency Medical ◽

The Uk

BackgroundThe utilization of helicopter emergency medical services (HEMS) in modern trauma systems has been a source of debate for many years. This study set to establish the true impact of HEMS in England on survival for patients with major trauma.MethodsA comparative cohort design using prospectively recorded data from the UK Trauma Audit and Research Network registry. 279 107 patients were identified between January 2012 and March 2017. The primary outcome measure was risk adjusted in-hospital mortality within propensity score matched cohorts using logistic regression analysis. Subset analyses were performed for subjects with prehospital Glasgow Coma Scale <8, respiratory rate <10 or >29 and systolic blood pressure <90.ResultsThe analysis was based on 61 733 adult patients directly admitted to major trauma centers: 54 185 ground emergency medical services (GEMS) and 7548 HEMS. HEMS patients were more likely male, younger, more severely injured, more likely to be victims of road traffic collisions and intubated at scene. Crude mortality was higher for HEMS patients. Logistic regression demonstrated a 15% reduction in the risk adjusted odds of death (OR=0.846; 95% CI 0.684 to 1.046) in favor of HEMS. When analyzed for patients previously noted to benefit most from HEMS, the odds of death were reduced further but remained statistically consistent with no effect. Sensitivity analysis on 5685 patients attended by a doctor on scene but transported by GEMS demonstrated a protective effect on mortality versus the standard GEMS response (OR 0.77; 95% CI 0.62 to 0.95).DiscussionThis prospective, level 3 cohort analysis demonstrates a non-significant survival advantage for patients transported by HEMS versus GEMS. Despite the large size of the cohort, the intrinsic mismatch in patient demographics limits the ability to statistically assess HEMS true benefit. It does, however, demonstrate an improved survival for patients attended by doctors on scene in addition to the GEMS response. Improvements in prehospital data and increased trauma unit reporting are required to accurately assess HEMS clinical and cost-effectiveness.

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Dispatch accuracy of physician-staffed emergency medical services in trauma care in south-east Norway: a retrospective observational study

Scandinavian Journal of Trauma Resuscitation and Emergency Medicine ◽

10.1186/s13049-021-00982-3 ◽

2021 ◽

Vol 29 (1) ◽

Author(s):

Martin Samdal ◽

Kjetil Thorsen ◽

Ola Græsli ◽

Mårten Sandberg ◽

Marius Rehn

Keyword(s):

Emergency Medical Services ◽

Trauma Care ◽

Injury Severity ◽

Road Traffic ◽

Medical Services ◽

Data Systems ◽

Hospital Data ◽

Accurate Identification ◽

Emergency Medical ◽

Patient Pathways

Abstract Background Selection of incidents and accurate identification of patients that require assistance from physician-staffed emergency medical services (P-EMS) remain essential. We aimed to evaluate P-EMS availability, the underlying criteria for dispatch, and the corresponding dispatch accuracy of trauma care in south-east Norway in 2015, to identify areas for improvement. Methods Pre-hospital data from emergency medical coordination centres and P-EMS medical databases were linked with data from the Norwegian Trauma Registry (NTR). Based on a set of conditions (injury severity, interventions performed, level of consciousness, incident category), trauma incidents were defined as complex, warranting P-EMS assistance, or non-complex. Incident complexity and P-EMS involvement were the main determinants when assessing the triage accuracy. Undertriage was adjusted for P-EMS availability and response and transport times. Results Among 19,028 trauma incidents, P-EMS were involved in 2506 (13.2%). The range of overtriage was 74–80% and the range of undertriage was 20–32%. P-EMS readiness in the event of complex incidents ranged from 58 to 70%. The most frequent dispatch criterion was “Police/fire brigade request immediate response” recorded in 4321 (22.7%) of the incidents. Criteria from the groups “Accidents” and “Road traffic accidents” were recorded in 10,875 (57.2%) incidents, and criteria from the groups “Transport reservations” and “Unidentified problem” in 6025 (31,7%) incidents. Among 4916 patient pathways in the NTR, 681 (13.9%) could not be matched with pre-hospital data records. Conclusions Both P-EMS availability and dispatch accuracy remain suboptimal in trauma care in south-east Norway. Dispatch criteria are too vague to facilitate accurate P-EMS dispatch, and pre-hospital data is inconsistent and insufficient to provide basic data for scientific research. Future dispatch criteria should focus on the care aspect of P-EMS. Better tools for both dispatch and incident handling for the emergency medical coordination centres are essential. In general, coordination, standardisation, and integration of existing data systems should enhance the quality of trauma care and increase patient safety.

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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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Implementation of Ambulance Hotspot Strategy in Reducing Ambulance Response Time

Borneo Journal of Medical Sciences (BJMS) ◽

10.51200/bjms.vi.2315 ◽

2020 ◽

pp. 3

Author(s):

Su Na Chin ◽

Phee Kheng Cheah ◽

Muhamad Yaakub Arifin ◽

Hui Shan Kang ◽

Zaturrawiah A Omar ◽

...

Keyword(s):

Response Time ◽

Emergency Medical Services ◽

Traffic Congestion ◽

Road Traffic ◽

Mortality Rates ◽

Medical Services ◽

Congested Traffic ◽

Emergency Medical ◽

Road Traffic Congestion

Introduction: Ambulance response time (ART) has an inseparable relationship with mortality rates and therefore is important to be reduced. However, an unprecedented increase in road traffic congestion has led to longer ART, especially during peak hours. To reduce ART despite congested traffic, a pre-dispatched ambulance is deployed at hotspot locations during peak hours. This study aims to determine if the hotspot strategy is able to reduce ART in an Urban Emergency Medical Services system.

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Risk Mapping of Road Traffic Incidents in Greater Kampala Metropolitan Area for Planning of Emergency Medical Services

Prehospital and Disaster Medicine ◽

10.1017/s1049023x19003765 ◽

2019 ◽

Vol 34 (s1) ◽

pp. s165-s165

Author(s):

Joseph Kimuli Balikuddembe

Keyword(s):

Emergency Medical Services ◽

Metropolitan Area ◽

Road Traffic ◽

Methodological Approach ◽

Risk Mapping ◽

Medical Services ◽

Delphi Panel ◽

Cross Sectional ◽

Traffic Incidents ◽

Emergency Medical

Introduction:Compared to high-income countries, low and middle-income countries (LMICs) bear the heaviest brunt of road traffic incidents (RTIs), which is a serious public health and development burden. Like other LMICs, Uganda has been experiencing a worryingly high burden of RTIs and their associated impacts with the highest number of all the total registered RTIs in Uganda registered in the Greater Kampala Metropolitan Area (GKMA). This places a tremendous demand on the few existing emergency medical services (EMS) to adequately respond to those affected.Aim:To aid in better planning of EMS for the victims of RTIs by using risk mapping of RTIs in the GKMA.Methods:A mixed methodological approach involving a systematic review, Delphi panel technique, retrospective data analysis, and a cross-sectional method.Results:With Uganda progressing forward as envisaged in its “Vision 2040,” the GKMA, which is the country’s political and socioeconomic epicenter, is experiencing significant changes in terms of population growth. This has significantly increased RTIs, which puts pressure on the pre-hospital emergency care for those affected unless necessary actions are taken.Discussion:Therefore, the road safety vis-à-vis injury prevention measures, which are needed to reduce the burden of RTIs, should be multifaceted in nature so that they closely correlate with the ongoing dynamics that cause them, particularly in the GKMA which experiences the highest number of RTIs and Uganda as a whole. The WHO “Safe System Approach” is desirable for this purpose as it represents the most appropriate approach because it is broad enough to comprehensively manage any of the ongoing dynamics (political, socio-cultural or economical) that are known to contribute to RTIs.

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