Impact of Prehospital Care Provided by Emergency Medical Services on Patient Survival in Trauma Cases
DOI:
https://doi.org/10.22399/ijcesen.4296Keywords:
Prehospital care, Emergency Medical Services, patient survival, trauma cases, advanced airway managementAbstract
The impact of prehospital care provided by Emergency Medical Services (EMS) on patient survival in trauma cases is a critical area of study in emergency medicine. Research has consistently shown that timely and effective prehospital interventions—such as advanced airway management, hemorrhage control, and rapid transport to trauma centers—significantly improve survival rates among trauma patients. The golden hour concept highlights the importance of early medical intervention, where rapid and appropriate treatment in the field can stabilize patients and improve outcomes. Effective communication between EMS and receiving hospitals is also vital, enabling trauma teams to prepare for incoming patients and streamline the transition to definitive care. In addition to immediate medical interventions, the training and experience of EMS providers play a pivotal role in influencing patient outcomes. The implementation of evidence-based protocols and continuous education ensures that EMS personnel are equipped to handle a variety of traumatic injuries effectively. Moreover, system factors such as response times, resource availability, and regional trauma care systems further affect the quality of prehospital care. Understanding these dynamics is essential for developing strategies to enhance prehospital trauma care, ultimately leading to improved patient survival rates in emergency situations.
References
1. Pepe PE, Wyatt CH, Bickell WH, et al. The relationship between total prehospital time and outcome in hypotensive victims of penetrating injuries. Ann Emerg Med. 1987;16:293–297.
2. Lerner EB, Billittier AJ, Dorn JM, et al. Is total out-of-hospital time a significant predictor of trauma patient mortality? Acad Emerg Med. 2003;10:949–954.
3. Norcross ED, Ford DW, Cooper ME, et al. Application of American College of Surgeons’ field triage guidelines by pre-hospital personnel. J Am Coll Surg. 1995;181:539–544.
4. Pracht EE, Tepas JJ, Celso BG, et al. Survival advantage associated with treatment of injury at designated trauma centers: a bivariate probit model with instrumental variables. Med Care Res Rev. 2007;64:83–97.
5. Sampalis JS, Denis R, Lavoie A, et al. Trauma care regionalization: a process-outcome evaluation. J Trauma. 1999;46:565–581.
6. Di Bartolomeo S, Valent F, Rosolen V, et al. Are pre-hospital time and emergency department disposition time useful process indicators for trauma care in Italy? Injury. 2007;38:305–311.
7. Becker LR, Zaloshnja E, Levick N, et al. Relative risk of injury and death in ambulances and other emergency vehicles. Accid Anal Prev. 2003;35:941–948.
8. Davis DP, Garberson LA, Andrusiekc D, et al. A descriptive analysis of emergency medical service systems participating in a large, out-of-hospital resuscitation research network. Prehosp Emerg Care. 2007;11:369–382.
9. Esposito TJ, Offner PJ, Jurkovich GJ, et al. Do prehospital trauma center triage criteria identify major trauma victims? Arch Surg. 1995;130:171–176.
10. 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;354:366–378.
11. Petri RW, Dyer A, Lumpkin J. The effect of prehospital transport time on the mortality from traumatic injury. Prehosp Disaster Med. 1995;10:24–29.
12. Kane G, Engelhardt R, Celentano J, et al. Empirical development and evaluation of out of hospital trauma triage instruments. J Trauma. 1985;25:482–489.
13. Spaite DW, Tse DJ, Valenzuela TD, et al. The impact of injury severity and prehospital procedures on scene time in victims of major trauma. Ann Emerg Med. 1991;20:1299–1305.
14. Lerner EB, Moscati RM. The golden hour: scientific fact or medical “urban legend”? Acad Emerg Med. 2001;8:758–760.
15. Blackwell TH, Kaufman JS. Response time effectiveness: comparison of response time and survival in an urban EMS system. Acad Emerg Med. 2002;9:288–295.
16. Ivatury RR, Nallathambi MN, Roberge RJ, et al. Penetrating thoracic injuries: in-field stabilization versus prompt transport. J Trauma. 1987;27:1066–1072.
17. Hannan EL, Farrell LS, Cooper A, et al. Physiologic trauma triage criteria in adult trauma patients: are they effective in saving lives by transporting patients to trauma centers? J Am Coll Surg. 2005;200:584–592.
18. Pons PT, Haukoos JS, Bludworth W, et al. Paramedic response time: does is affect patient survival? Acad Emerg Med. 2005;12:594–600.
19. Carr BG, Caplan JM, Pryor JP, et al. A meta-analysis of prehospital care times for trauma. Prehosp Emerg Care. 2006;10:198–206.
20. Gervin AS, Fischer RP. The importance of prompt transport in salvage of patients with penetrating heart wounds. J Trauma. 1982;22:443–446.
21. Pons PT, Markovchick VJ. Eight minutes or less: does the ambulance response time guideline impact trauma patient outcome? J Emerg Med. 2002;23:43–48.
22. Mullins RJ, Veum-Stone J, Helfand M, et al. Outcome of hospitalized injured patients after institution of a trauma system in an urban area. JAMA. 1994;271:1919–1924.
23. Stiell IG, Nesbitt LP, Pickett W, et al. The OPALS major trauma outcome study: impact of advanced life-support on survival and morbidity. CMAJ. 2008;178:1141–1152.
24. Wears RL. Advanced statistics: statistical methods for analyzing cluster and cluster-randomized data. Acad Emerg Med. 2002;9:330–341.
25. Feero S, Hedges JR, Simmons E, et al. Does out-of-hospital EMS time affect trauma survival? Am J Emerg Med. 1995;13:133–135.
26. Committee on Trauma. Resources for Optimal Care of the Injured Patient. American College of Surgeons; Chicago, IL: 2006.
27. Osterwalder JJ. Can the “golden hour of shock” safely be extended in blunt polytrauma patients? Prehosp Disaster Med. 2002;17:75–80.
28. McClellan M, McNeil BJ, Newhouse JP. Does more intensive treatment of acute myocardial infarction in the elderly reduce mortality? JAMA. 1994;272:859–866.
29. Clevenger FW, Yarborough DR, Reines HD. Resuscitative thoracotomy: the effect of field time on outcome. J Trauma. 1988;28:441–445.
30. Newgard CD, Sears GK, Rea TD, et al. The Resuscitation Outcomes Consortium Epistry-Trauma: design, development, and implementation of a North American epidemiologic out-of-hospital trauma registry. Resuscitation. 2008;78:170–178.
31. Samplais JS, Lavoie A, Williams JI, et al. Impact of on-site care, prehospital time, and level of in-hospital care on survival in severely injured patients. J Trauma. 1993;34:252–261.
32. Demetriades D, Martin M, Salim A, et al. The effect of trauma center designation and trauma volume on outcome in specific severe injuries. Ann Surg. 2005;242:512–519.
33. Eisenberg MS, Bergner L, Hallstrom A. Cardiac resuscitation in the community: importance of rapid provision and implications for program planning. JAMA. 1979;241:1905–1907.
34. Stock JH, Wright JH, Yogo M. A survey of weak instruments and weak identification in generalized methods of moments. J Business Econ Stat. 2002;20:518–529.
35. Mullins RJ, Veum-Stone J, Hedges JR, et al. Influence of a statewide trauma system on location of hospitalization and outcome of injured patients. J Trauma. 1996;40:536–545.
36. Baxt WG, Jones G, Fortlage D. The Trauma Triage Rule: a new, resource-based approach to the out-of-hospital identification of major trauma victims. Ann Emerg Med. 1990;19:1401–1406.
37. Kahn CA, Pirrallo RG, Kuhn EM. Characteristics of fatal ambulance crashes in the United States: an 11-year retrospective analysis. Prehosp Emerg Care. 2001;5:261–269.
38. Lerner EB. Studies evaluating current field triage: 1966-2005. Prehosp Emerg Care. 2006;10:303–306.
39. Henry MC, Hollander JE, Alicandro JM, et al. Incremental benefit of individual American College of Surgeons trauma triage criteria. Acad Emerg Med. 1996;3:992–1000.
40. Liberman M, Mulder D, Samplais J. Advanced or basic life support for trauma: meta-analysis and critical review of the literature. J Trauma. 2000;49:584–599.
41. Cottington EM, Young JC, Shufflebarger CM, et al. The utility of physiologic status, injury site, and injury mechanism in identifying patients with major trauma. J Trauma. 1988;28:305–311.
42. Grossman DC, Kim A, MacDonald SC, et al. Urban-rural differences in prehospital care of major trauma. J Trauma. 1997;42:723–729.
43. Zechnich AD, Hedges JR, Spackman K, et al. Applying the trauma triage rule to blunt trauma patients. Acad Emerg Med. 1995;2:1043–1052.
44. McConnell J, Newgard CD, Mullins RJ, et al. Mortality benefit of transfer to level I versus level II trauma centers for head-injured patients: analysis using instrumental variables. Health Serv Res. 2005;40:435–457.
45. Ambulance crash-related injuries among emergency medical services workers—Unites States, 1991-2002. MMWR Morb Mortal Wkly Rep. 2003;52:154–156.
46. Brasel KJ, Bulger E, Cook AJ, et al. Hypertonic resuscitation: design and implementation of a prehospital intervention trial. J Am Coll Surg. 2008;206:220–232.
47. De Maio VJ, Stiell IG, Wells GA, et al. Optimal defibrillation response intervals for maximum out-of-hospital cardiac arrest survival rates. Ann Emerg Med. 2003;42:242–250.
48. Spaite DW, Valenzuela TD, Meislin HW, et al. Prospective validation of a new model for evaluating emergency medical services systems by in-field observation of specific time intervals in prehospital care. Ann Emerg Med. 1993;22:638–645.
49. Mullins RJ, Mann NC, Hedges JR, et al. Preferential benefit of implementation of a statewide trauma system in one of two adjacent states. J Trauma. 1998;44:609–617.
50. Martens EP, Pestman WR, de Boer A, et al. Instrumental variables applications and limitations. Epidemiology. 2006;17:260–267.
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