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Trauma Incidents Attended by Emergency Medical Services in Victoria, Australia

Published online by Cambridge University Press:  28 June 2012

Malcolm J. Boyle ,
M ClinEpi ,
Erin C. Smith  and
Frank L. Archer
Malcolm J. Boyle*
Affiliation:
Monash University, Department of Community Emergency Health and Paramedic Practice, Victoria, Australia
M ClinEpi
Affiliation:
Monash University, Department of Community Emergency Health and Paramedic Practice, Victoria, Australia
Erin C. Smith
Affiliation:
Monash University, Department of Community Emergency Health and Paramedic Practice, Victoria, Australia
Frank L. Archer
Affiliation:
Monash University, Department of Community Emergency Health and Paramedic Practice, Victoria, Australia
*
Monash University Department of Community Emergency Health and Paramedic Practice PO Box 527 Frankston 3199 Victoria, Australia E-mail: [email protected]
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Abstract

Introduction:

International literature describing the profile of trauma patients attended by a statewide emergency medical services (EMS) system is lacking. Most literature is limited to descriptions of trauma responses for a single emergency medical service, or to patients transported to a specific Level-1 trauma hospital. There is no Victorian or Australian literature describing the type of trauma patients transported by a state emergency medical service.

Purpose:

The purpose of this study was to define a profile of all trauma incidents attended by statewide EMS.

Methods:

A retrospective cohort study of all patient care records (PCR) for trauma responses attended by Victorian Ambulance Services for 2002 was conducted. Criteria for trauma categories were defined previously, and data were extracted from the PCRs and entered into a secure data repository for descriptive analysis to determine the trauma profile. Ethics committee approval was obtained.

Results:

There were 53,039 trauma incidents attended by emergency ambulances during the 12-month period. Of these, 1,566 patients were in physiological distress, 11,086 had a significant pattern of injury, and a further 8,931 had an identifiable mechanism of injury. The profile includes minor trauma (n = 9,342), standing falls (n = 20,511), no patient transported (n = 3,687), and deceased patients (n = 459).

Conclusions:

This is a unique analysis of prehospital trauma. It provides a baseline dataset that may be utilized in future studies of prehospital trauma care. Additionally, this dataset identifies a ten-fold difference in major trauma between the prehospital and the hospital assessments.

Keywords

air ambulancesambulancesemergency medical systemsemergency medical techniciansout-of-hospitalparamedicprehospitaltrauma
Type
Research Article
Information
Prehospital and Disaster Medicine , Volume 23 , Issue 1 , February 2008 , pp. 20 - 28
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2008

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References

1. Walker, PJ, Cass, DT: Paediatric trauma: Urban epidemiology and an analy-sis of methods for assessing the severity of trauma in 598 injured children. Aust N Z J Surg 1987;57(10):715–722.CrossRefGoogle Scholar
2. Lowe, DK, Oh, GR, Neely, KW, Peterson, CG: Evaluation of injury mecha-nism as a criterion in trauma triage. Am J Surg 1986;152(1):6–10.CrossRefGoogle Scholar
3. Simmons, E, Hedges, J, Irwin, L, et al. : Paramedic injury severity perception can aid trauma triage. Ann Emerg Med 1995;26(4):461–468.CrossRefGoogle ScholarPubMed
4. Cottington, EM, Young, JC, Shufflebarger, CM, et al. : The utility of physio-logical status, injury site, and injury mechanism in identifying patients with major trauma. J Trauma 1988;28(3):305–311.CrossRefGoogle Scholar
5. Knopp, R, Yanagi, A, Kallsen, G, et al. : Mechanism of injury and anatomic injury as criteria for prehospital trauma triage. Ann Emerg Med 1988;17(9):895–902.CrossRefGoogle ScholarPubMed
6. Engum, SA, Mitchell, MK, Scherer, LR, et al. : Prehospital triage in the injured pediatric patient. J Pediatr Surg 2000;35(1):82–87.CrossRefGoogle ScholarPubMed
7. Cooper, ME, Yarbrough, DR, Zone-Smith, L, et al. : Application of field triage guidelines by pre-hospital personnel: Is mechanism of injury a valid guide-line for patient triage? Am Surg 1995;61(4):363–367.Google Scholar
8. Shatney, CH, Sensaki, K: Trauma team activation for “mechanism of injury” blunt trauma victims: Time for a change? J Trauma 1994;37(2):275–281.CrossRefGoogle ScholarPubMed
9. Ma, MH, MacKenzie, EJ, Alcorta, R, Kelen, GD: Compliance with prehospi-tal triage protocols for major trauma patients. J Trauma 1999;46(1):168–175.Google ScholarPubMed
10. Long, WB, Bachulis, BL, Hynes, GD: Accuracy and relationship of mecha- nisms of injury, trauma score, and injury severity score in identifying major trauma. Am J Surg 1986;151(5):581–584.CrossRefGoogle Scholar
11. Knudson, P, Frecceri, CA, DeLateur, SA: Improving the field triage of major trauma victims. J Trauma 1988;28(5):602–606.CrossRefGoogle ScholarPubMed
12. Simon, BJ, Legere, P, Emhoff, T, et al. : Vehicular trauma triage by mechanism: Avoidance of the unproductive evaluation. J Trauma 1994;37(4):645–649.CrossRefGoogle ScholarPubMed
13. Bond, RJ, Kortbeek, JB, Preshaw, RM: Field trauma triage: Combining mech- anism of injury with the prehospital index for an improved trauma triage tool. J Trauma 1997;43(2):283–287.CrossRefGoogle Scholar
14. Qazi, K, Wright, MS, Kippes, C: Stable pediatric blunt trauma patients: Is trauma team activation always necessary? J Trauma 1998;45(3):562–564.CrossRefGoogle ScholarPubMed
15. Morrisey, MA, Ohsfeldt, RL, Johnson, V, Treat, R: Trauma patients: An analy-sis of rural ambulance trip reports. J Trauma 1996;41(4):741–746.CrossRefGoogle Scholar
16. Brennan, PW, Everest, ER, Griggs, WM, et al. : Risk of death among cases attending south Australian major trauma services after severe trauma: The first 4 years of operation of a state trauma system. J Trauma 2002;53(2):333–339.CrossRefGoogle ScholarPubMed
17. Cameron, P, Dziukas, L, Hadj, A: The Victorian major trauma study. Patterns of injury from major trauma in Victoria. Aust NZ J Surg 1995;65:848–852.CrossRefGoogle ScholarPubMed
18. Cameron, P, Dziukas, L, Hadj, A, et al. : Major trauma in Australia: A region-al analysis. J Trauma 1995;39(3):545–552.CrossRefGoogle Scholar
19. Gabbe, BJ, Cameron, PA, Hannaford, AP, et al. : Routine follow up of major trauma patients from trauma registries: What are the outcomes? J Trauma 2006;61(6):1393–1399.CrossRefGoogle ScholarPubMed
20. Macken, L, Manovel, A: Trauma bypass in south-eastern Sydney: An 8-year review. Emerg Med Australas 2005;17(2):137–142.Google ScholarPubMed
21. McMonagle, MP, Flabouris, A, Parr, MJA, Sugrue, M: Reducing time to urgent surgery by transporting resources to the trauma patient. ANZ J Surg 2007;77(4):241–246.CrossRefGoogle Scholar
22. Mitra, B, Cameron, P, Butt, W: Population-based study of paediatric head injury. J Paediatr Child Health 2007;43(3):154–159.CrossRefGoogle ScholarPubMed
23. Palanca, S, Taylor, DM, Bailey, M, Cameron, PA: Mechanisms of motor vehi-cle accidents that predict major injury. Emerg Med (Fremantle) 2003;15(5–6):423–428.CrossRefGoogle ScholarPubMed
24. Wong, K, Petchell, J: Severe trauma caused by stabbing and firearms in metro-politan Sydney, New South Wales, Australia. ANZ J Surg 2005;75(4):225–230.CrossRefGoogle ScholarPubMed
25. Yee, WY, Cameron, PA, Bailey, MJ: Road traffic injuries in the elderly. Emerg Med J 2006;23(1):42–46.CrossRefGoogle Scholar
26. Department of Human Services: Review of Trauma and Emergency Services in Victoria—1999. Melbourne: Department of Human Services; 1999.Google Scholar
27. Australian Bureau of Statistics: Basic community profiles and snapshots. Available at: http://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/6adf95a7dda3173eca256bbf0000542f!OpenDocument.Accessed 21 October 2003.Google Scholar
28. Smith, E, Boyle, M, MacPherson, J: The development of a quality assessment tool for ambulance patient care records. HIM J 2004;33(4):112–120.Google ScholarPubMed
29. Danne, P, Brazenor, G, Kade, R: The major trauma management study: An analysis of the efficacy of current trauma care. Aust NZ J Surg 1998;68:50–57.CrossRefGoogle ScholarPubMed
30. McDermott, F, Cordner, S, Tremayne, A: Evaluation of the Emergency and Clinical Management of Road Traffic Fatalities in Victoria 1992–1993. Melbourne: Consultative Committee on Road Traffic Fatalities in Victoria; 1994.Google Scholar
31. McDermott, F, Cordner, S, Tremayne, A: Evaluation of the Emergency and Clinical Management of Road Traffic Fatalities in Victoria 1993–1994. Melbourne: Consultative Committee on Road Traffic Fatalities in Victoria; 1995.Google Scholar
32. McDermott, F, Cordner, S, Tremayne, A: Evaluation of the Emergency and Clinical Management of Road Traffic Fatalities in Victoria January–March 1996. Melbourne: Consultative Committee on Road Traffic Fatalities in Victoria; 1996.Google Scholar
33. McDermott, F, Cordner, S, Tremayne, A: Evaluation of the Emergency and Clinical Management of Road Traffic Fatalities in Victoria 1996–1997. Melbourne: Consultative Committee on Road Traffic Fatalities in Victoria; 1997.Google Scholar
34. McDermott, F, Cordner, S, Tremayne, A: Evaluation of the Emergency and Clinical Management of Road Traffic Fatalities in Victoria 1997. Melbourne: Consultative Committee on Road Traffic Fatalities in Victoria, 1998.Google Scholar
35. McDermott, F, Cordner, S, Tremayne, A: Evaluation of the Emergency and Clinical Management of Road Traffic Fatalities in Victoria 1998. Melbourne: Consultative Committee on Road Traffic Fatalities in Victoria, 1999.Google Scholar
36. McDermott, F, Cordner, S, Tremayne, A: A “Before and After” Assessment of the Influence of the New Victorian Trauma Care System (1997–1998.vs 2001–2003. on the Emergency and Clinical Management of Road Traffic Fatalities in Victoria. Melbourne: Consultative Committee on Road Traffic Fatalities in Victoria, 2003.Google Scholar
37. Sampalis, JS, Tamim, H, Nikolis, A, et al. : Predictive validity and internal con-sistency of the pre-hospital index measured on-site by physicians. Accid Anal Prev 1996;28(6):675–684.CrossRefGoogle Scholar
38. Kreis, D, Fine, E, Gomez, G, et al. : A prospective evaluation of field catego-rization of trauma. J Trauma 1988;28(7):995–1000.CrossRefGoogle ScholarPubMed
39. Esposito, TJ, Offner, PJ, Jurkovich, GJ, et al. : Do prehospital trauma center triage criteria identify major trauma victims? Arch Surg 1995;130(2):171–176.CrossRefGoogle ScholarPubMed
40. Sampalis, JS, Denis, R, Lavoie, A, et al. : Trauma care regionalization: A process-outcome evaluation. J Trauma 1999;46(4):565–579.CrossRefGoogle ScholarPubMed
41. Mullins, RJ, Hedges, JR, Rowland, DJ, et al. : Survival of seriously injured patients first treated in rural hospitals. J Trauma 2002;52(6):1019–1029.CrossRefGoogle ScholarPubMed
42. Karsteadt, LL, Larsen, CL, Farmer, PD: Analysis of a rural trauma program using the TRISS methodology: A three-year retrospective study. J Trauma 1994;36(3):395–400.CrossRefGoogle ScholarPubMed
43. Ali, J, Adam, RU, Gana, TJ, Williams, JI: Trauma patient outcome after the prehospital trauma life support program. J Trauma 1997;42(6):1018–1021.CrossRefGoogle ScholarPubMed
44. Templeton, J, Oakley, PA, MacKenzie, G, et al. : A comparison of patient characteristics and survival in two trauma centres located in different countries. Injury 2000;31:493–501.CrossRefGoogle ScholarPubMed
45. Champion, HR, Copes, WS, Sacco, WJ, et al. : The major trauma outcome study: Establishing national norms for trauma care. JTrauma 1990;30(11):1356–1365.Google ScholarPubMed
46. Mostafa, G, Huynh, T, Sing, RF, et al. : Gender-related outcomes in trauma. J Trauma 2002;53(3):430–434.CrossRefGoogle ScholarPubMed
47. Phillips, S, Rond, P, Kelly, S, Swartz, P: The failure of triage criteria to identify geriatric patients with trauma: Results from the Florida trauma triage study. J Trauma 1996;40(2):278–283.CrossRefGoogle ScholarPubMed
48. Phillips, S, Rond, PC, Kelly, SM, Swartz, PD: The need for pediatric-specific triage criteria: Results from the Florida trauma triage study. Pediatr Emerg Care 1996;12(6):394–399.CrossRefGoogle ScholarPubMed