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

Published online by Cambridge University Press:  03 June 2021

Fouad A. Sakr ,
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]
Fouad A. Sakr
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, Lebanon 1107 2020, E-mail: melsayed@aub.edu.lb
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Abstract

Introduction:

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

Study Objective:

This study examines the association between the survival rate of blunt trauma patients and the transport modality (police versus ground ambulance).

Methods:

A retrospective, matched cohort study was conducted using the National Trauma Data Bank (NTDB). All blunt trauma patients transported by police to trauma centers were identified and matched (one-to-four) to patients transported by ground Emergency Medical Services (EMS) for analysis. Descriptive analysis was carried out. This was followed by comparing all patients’ characteristics and their survival rates in terms of the mode of transportation.

Results:

Out of the 2,469 patients with blunt injuries, EMS transported 1,846 patients and police transported 623 patients. Most patients were 16-64 years of age (86.2%) with a male predominance (82.5%). Fall (38.4%) was the most common mechanism of injury with majority of injuries involving the head and neck body part (64.8%). Fractures were the most common nature of injury (62.1%). The overall survival rate of adult blunt trauma patients was similar for both methods of transportation (99.2%; P = 1.000).

Conclusion:

In this study, adult blunt trauma patients transported by police had similar outcomes to those transported by EMS. As such, PT in trauma should be encouraged and protocolized to improve resource utilization and outcomes further.

Keywords

blunt traumaground ambulancepolice transportsurvival
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 36 , Issue 4 , August 2021 , pp. 431 - 439
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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References

Centers for Disease Control and Prevention. Injury Prevention and Control. Leading Causes of Death and Injury. https://www.cdc.gov/injury/wisqars/LeadingCauses.html. Accessed October 3, 2020.Google Scholar
US Department of Health and Human Services. Centers for Disease Control and Prevention. National Center for Health Statistics. National hospital ambulatory medical care survey: 2016 emergency department summary tables. https://www.cdc.gov/nchs/data/nhamcs/web_tables/2016_ed_web_tables.pdf. Accessed September 15, 2020.Google Scholar
Martin, JG, Shah, J, Robinson, C, Dariushnia, S. Evaluation and management of blunt solid organ trauma. Tech Vasc Interv Radiol. 2017;20(4):230–236.CrossRefGoogle ScholarPubMed
World Health Organization. The Global Burden of Disease 2004 Update. World Health Organization; 2008. https://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf. Accessed July 12, 2020.Google Scholar
World Health Organization. Road Traffic Injuries. https://www.who.int/news-room/fact-sheets/detail/road-traffic-injuries. Accessed November 1, 2020.Google Scholar
Dakessian, A, Bachir, R, El Sayed, MJ. Association between trauma center designation levels and survival of patients with motor vehicular transport injuries in the United States. J Emerg Med. 2020;58(3):398–406.CrossRefGoogle ScholarPubMed
Mackenzie, EJ, Rivara, FP, Jurkovich, GJ, et al. A national evaluation of the effect of trauma-center care on mortality. N Engl J Med. 2006;354(4):366–378.CrossRefGoogle ScholarPubMed
Colnaric, J, Bachir, R, El Sayed, MJ. Association between mode of transportation and outcomes of adult trauma patients with blunt injury across different prehospital time intervals in the United States: a matched cohort study. J Emerg Med. 2020;59(6):884–893.CrossRefGoogle ScholarPubMed
Harmsen, A, Giannakopoulos, G, Moerbeek, P, Jansma, E, Bonjer, H, Bloemers, F. The influence of prehospital time on trauma patients’ outcome: a systematic review. Injury. 2015;46(4):602–609.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
Philadelphia Police Department. Directive 4.19. Subject: Tourniquet Program. Updated: 05-04-2017. https://www.phillypolice.com/assets/directives/D4.19-TourniquetProgram.pdf. Accessed August 15, 2020.Google Scholar
Husain, S, Eisenberg, M. Police AED programs: a systematic review and meta-analysis. Resuscitation. 2013;84(9):1184–1191.CrossRefGoogle ScholarPubMed
Jacobs, LM; Joint Committee to Create a National Policy to Enhance Survivability from Intentional Mass-Casualty and Active Shooter Events. The Hartford Consensus III: implementation of bleeding control—if you see something do something. Bull Am Coll Surg. 2015;100(1 Suppl):40–46.Google Scholar
Cornwell, EE, Belzberg, H, Hennigan, K, et al. Emergency Medical Services (EMS) vs non-EMS transport of critically injured patients. Arch Surg. 2000;135(3):315–319.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
Wilkinson, P. The bullet and the damage done. Rolling Stone. 2003. https://www.rollingstone.com/culture/culture-news/the-bullet-and-the-damage-done-78649/. Accessed November 14, 2020.Google Scholar
Philadelphia Police Department. Directive 63. Philadelphia, Pennsylvania USA: Philadelphia Police Department;1996.Google Scholar
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.CrossRefGoogle ScholarPubMed
Holena, DN, Jacoby, SF, Reilly, PM. Towards a broader view of police prehospital transport. J Trauma Acute Care Surg. 2017;82(4):821.CrossRefGoogle ScholarPubMed
Band, R, Pryor, J, Gaieski, D, Dickinson, E, Cummings, D, Carr, B. Injury-adjusted mortality of patients transported by police following penetrating trauma. Acad Emerg Med. 2010;18(1):32–37.CrossRefGoogle ScholarPubMed
Wandling, M, Nathens, A, Shapiro, M, Haut, E. Police transport versus ground EMS. J Trauma Acute Care Surg. 2016;81(5):931–935.CrossRefGoogle 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
American College of Surgeons. Inspiring Quality: Highest Standards, Better Outcomes. Annual Call for Data: National Trauma Data Bank (NTDB). https://www.facs.org/quality-programs/trauma/tqp/center-programs/ntdb. Accessed November 14, 2020.Google Scholar
American College of Surgeons. Inspiring Quality: Highest Standards, Better Outcomes. Trauma Quality Programs Participant Use File (PUF). https://www.facs.org/quality-programs/trauma/tqp/center-programs/ntdb/datasets. Accessed June 5, 2020.Google Scholar
American College of Surgeons. Inspiring Quality: Highest Standards, Better Outcomes. National Trauma Data Standard (NTDS). https://www.facs.org/quality-programs/trauma/tqp/center-programs/ntdb/ntds. Accessed June 5, 2020.Google Scholar
Stratton, SJ. Using pre-existing databases for prehospital and disaster research. Prehosp Disaster Med. 2015;30(1):1–3.CrossRefGoogle ScholarPubMed
Chicago Police Department. Special Order S03-06. Squadrol Operating Procedures. November 15, 2017. http://directives.chicagopolice.org/directives/data/a7a57be2-12b53b0f-33812-b53e-d78b693bdacbb396.html. Accessed November 27, 2020.Google Scholar
Diaz, A. Seattle Police Department Manual. 16.130 - Providing Medical Aid. January 1, 2020. http://www.seattle.gov/police-manual/title-16---patrol-operations/16130---providing-medical-aid. Accessed November 10, 2020.Google Scholar
Stockton Police Department. General Orders Manual. Revised December 9, 2019. http://ww1.stocktonca.gov/-/media/Stockton-Website/Departments/Police-Homepage/About-the-Police-Department/General-Orders/Files/2019-Updates/12-9-19-Update/2-GO-CODE-INDEX.pdf?la=en&hash=2B5E639FC7D32D85D8BB7FB39674A9CC45EFD1C4. Accessed November 5, 2020.Google Scholar
Taylor, BN, Rasnake, N, McNutt, K, Mcknight, CL, Daley, BJ. Rapid ground transport of trauma patients: a moderate distance from trauma center improves survival. J Surg Res. 2018;232:318–324.CrossRefGoogle ScholarPubMed
Clements, TW, Vogt, K, Hameed, SM, et al. Does increased prehospital time lead to a “trial of life” effect for patients with blunt trauma? J Surg Res. 2017;216:103–108.CrossRefGoogle ScholarPubMed