Emergency Medical Service (EMS) systems in developed and developing countries

被引:107
作者
Roudsari, Bahman S. [1 ]
Nathens, Avery B.
Arreola-Risa, Carlos
Cameron, Peter
Civil, Ian
Grigoriou, Giouli
Gruen, Russet L.
Koepsell, Thomas D.
Lecky, Fiona E.
Lefering, Rolf L.
Liberman, Moishe
Mock, Charles N.
Oestern, Hans-Joerg
Petridou, Elenie
Schildhauer, Thomas A.
Waydhas, Christian
Zargar, Moosa
Rivara, Frederick P.
机构
[1] Univ Texas, Sch Publ Hlth, Dept Epidemiol, Dallas, TX 75230 USA
[2] St Michaels Hosp, Toronto, ON M5B 1W8, Canada
[3] Sistema Estadal Atenc Emergencias Med, Secretaria Salud, Monterrey, Nuevo Leon, Mexico
[4] Alfred Hosp, Monash Sch Publ Hlth, Dept Epidemiol & Prevent Med, Melbourne, Vic, Australia
[5] Univ Auckland, Auckland Hosp, Auckland 1, New Zealand
[6] Univ Athens, Sch Med, Ctr Res Prevent Injuries, GR-11527 Athens, Greece
[7] Menzies Sch Hlth Res, Dept Hlth Serv Res & Policy, Darwin, NT, Australia
[8] Univ Washington, Dept Epidemiol, Harborview Injury Prevent & Res Ctr, Seattle, WA 98195 USA
[9] Univ Washington, Dept Hlth Serv, Harborview Injury Prevent & Res Ctr, Seattle, WA 98195 USA
[10] Univ Manchester, Dept Emergency Med, Manchester, Lancs, England
[11] Univ Cologne, Biochem & Expt Div, Cologne, Germany
[12] McGill Univ, Montreal Gen Hosp, Ctr Hlth, Div Surg & Clin Epidemiol, Montreal, PQ, Canada
[13] Univ Washington, Dept Surg, Harborview Injury Prevent & Res Ctr, Seattle, WA 98195 USA
来源
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED | 2007年 / 38卷 / 09期
关键词
pre-hospital trauma care; emergency medical service (EMS) systems; developed and developing countries; advanced life support; basic life support; intravenous fluid therapy; endotracheal intubation;
D O I
10.1016/j.injury.2007.04.008
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
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.
引用
收藏
页码:1001 / 1013
页数:13
相关论文
共 45 条
[11]   Developing a prognostic model in the presence of missing data: an ovarian cancer case study [J].
Clark, TG ;
Altman, DG .
JOURNAL OF CLINICAL EPIDEMIOLOGY, 2003, 56 (01) :28-37
[12]   Trauma deaths in a mature urban trauma system: Is "trimodal" distribution a valid concept? [J].
Demetriades, D ;
Kimbrell, B ;
Salim, A ;
Velmahos, G ;
Rhee, P ;
Preston, C ;
Gruzinski, G ;
Chan, L .
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2005, 201 (03) :343-348
[13]   PREHOSPITAL CARE BY EMTS AND EMT-IS IN A RURAL SETTING - PROLONGATION OF SCENE TIMES BY ALS PROCEDURES [J].
DONOVAN, PJ ;
CLINE, DM ;
WHITLEY, TW ;
FOSTER, C ;
OUTLAW, M .
ANNALS OF EMERGENCY MEDICINE, 1989, 18 (05) :495-500
[14]   Fall-related injuries in the elderly in Tehran [J].
Ghodsi, SM ;
Roudsari, BS ;
Abdollahi, M ;
Shadman, M .
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 2003, 34 (11) :809-814
[15]   FACTORS CONTRIBUTING TO PARAMEDIC ONSCENE TIME DURING EVALUATION AND MANAGEMENT OF BLUNT TRAUMA [J].
HEDGES, JR ;
FEERO, S ;
MOORE, B ;
SHULTZ, B ;
HAVER, DW .
AMERICAN JOURNAL OF EMERGENCY MEDICINE, 1988, 6 (05) :443-448
[16]  
HEITJAN DF, 1991, APPL STAT-J ROY ST C, V40, P13
[17]   The association between trauma system and trauma center components and outcome in a mature regionalized trauma system [J].
Liberman, M ;
Mulder, DS ;
Jurkovich, GJ ;
Sampalis, AS .
SURGERY, 2005, 137 (06) :647-658
[18]   Multicenter Canadian study of prehospital trauma care [J].
Liberman, M ;
Mulder, D ;
Lavoie, A ;
Denis, R ;
Sampalis, JS .
ANNALS OF SURGERY, 2003, 237 (02) :153-160
[19]   Advanced or basic life support for trauma: Meta-analysis and critical review of the literature [J].
Liberman, M ;
Mulder, D ;
Sampalis, J .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2000, 49 (04) :584-599
[20]  
LIBERMAN M, 2004, INT J DISASTER MED, V2, P1