@article{3117903,
    title = "Emergency Medical Service (EMS) systems in developed and developing
countries",
    author = "Roudsari, Bahman S. and Nathens, Avery B. and Arreola-Risa, Carlos and and Cameron, Peter and Civil, Ian and Grigoriou, Giouli and Gruen, Russet L. and and Koepsell, Thomas D. and Lecky, Fiona E. and Lefering, Rolf L. and and Liberman, Moishe and Mock, Charles N. and Oestern, Hans-Joerg and and Petridou, Elenie and Schildhauer, Thomas A. and Waydhas, Christian and and Zargar, Moosa and Rivara, Frederick P.",
    journal = "INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED",
    year = "2007",
    volume = "38",
    number = "9",
    pages = "1001-1013",
    publisher = "Elsevier Sci Ltd, Exeter, United Kingdom",
    doi = "10.1016/j.injury.2007.04.008",
    keywords = "pre-hospital trauma care; emergency medical service (EMS) systems;
developed and developing countries; advanced life support; basic life
support; intravenous fluid therapy; endotracheal intubation",
    abstract = "Objectives: To compare patient- and injury-retated characteristics of
trauma victims and pre-hospital trauma care systems among different
developed and developing countries.
Method: We collated de-identified patient-level data from national or
local trauma registries in Australia, Austria, Canada, Greece, Germany,
Iran, Mexico, New Zealand, the Netherlands, the United Kingdom and the
United States. Patient and injury-related characteristics of trauma
victims with injury severity score (ISS) > 15 and the pre-hospital
trauma care provided to these patients were compared among different
countries.
Results: A total of 30,339 subjects from one or several regions in 11
countries were included in this analysis. Austria (51%), Germany (41%)
and Australia (30%) reported the highest proportion of air ambulance
use. Monterrey, Mexico (median 10.1 min) and Montreal, Canada (median
16.1 min) reported the shortest and Germany (median: 30 min) and Austria
(median: 26 min) reported the longest scene time. Use of intravenous
fluid therapy among advanced EMS systems without physicians as
prehospital care providers, varied from 30% (in the Netherlands) to
55% (in the US). The corresponding percentages in advanced EMS systems
with physicians actively involved in pre-hospital trauma care, excluding
Montreal in Canada, ranged from 63% (in London, in the UK) to 75% in
Germany and Austria. Austria and Germany also reported the highest
percentage of pre-hospital intubation (61% and 56%, respectively).
Conclusion: This study provides an early took at international
variability in patient mix, process of care, and performance of
different pre-hospital trauma care systems worldwide. International
efforts should be devoted to developing a minimum standard data set for
trauma patients. (C) 2007 Elsevier Ltd. All rights reserved."
}