TY - JOUR
TI - Emergency Medical Service (EMS) systems in developed and developing
countries
AU - Roudsari, Bahman S.
AU - Nathens, Avery B.
AU - Arreola-Risa, Carlos and
AU - Cameron, Peter
AU - Civil, Ian
AU - Grigoriou, Giouli
AU - Gruen, Russet L.
AU - and Koepsell, Thomas D.
AU - Lecky, Fiona E.
AU - Lefering, Rolf L. and
AU - Liberman, Moishe
AU - Mock, Charles N.
AU - Oestern, Hans-Joerg and
AU - Petridou, Elenie
AU - Schildhauer, Thomas A.
AU - Waydhas, Christian and
AU - Zargar, Moosa
AU - Rivara, Frederick P.
JO - INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED
PY - 2007
VL - 38
TODO - 9
SP - 1001-1013
PB - Elsevier Sci Ltd, Exeter, United Kingdom
SN - null
TODO - 10.1016/j.injury.2007.04.008
TODO - pre-hospital trauma care; emergency medical service (EMS) systems;
developed and developing countries; advanced life support; basic life
support; intravenous fluid therapy; endotracheal intubation
TODO - 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.
ER -