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The Non-Use of 9-1-1: Private Transport of Trauma Patients to a Trauma Center

Published online by Cambridge University Press:  28 June 2012

Jeffrey Hammond ,
Gerardo A. Gomez ,
Ellen Fine ,
Jeanne Eckes  and
Monica Castro
Jeffrey Hammond*
Affiliation:
Section of Trauma/ Surgical Critical Care, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ.
Gerardo A. Gomez
Affiliation:
Division of Trauma, University of Indiana School of Medicine, Indianapolis, Ind.
Ellen Fine
Affiliation:
Division of Trauma Services, University of Miami School of Medicine and Jackson Memorial Hospital, Miami, Fla.
Jeanne Eckes
Affiliation:
Division of Trauma Services, University of Miami School of Medicine and Jackson Memorial Hospital, Miami, Fla.
Monica Castro
Affiliation:
Division of Trauma Services, University of Miami School of Medicine and Jackson Memorial Hospital, Miami, Fla.
*
UMDNJ-Robert Wood Johnson Medical School. Department of Surgery, One Robert Wood Johnson Place, CN-19 New Brunswick, NJ 08903-0019USA
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Abstract

Hypothesis:

Privately transported, major trauma patients made up approximately 4% of the total trauma patients population at a major, regional trauma center which treats over 90% of all major trauma victims in the geographic area. This study was undertaken to evaluate the patient profile of those individuals who did not access 9-1-1 for transport to a trauma center, including their reasons for such non-use.

Methods:

Data on all major trauma occurring within Dade County, Florida, were collected by the county trauma registry.

Results:

In the last six months of 1989, 1,672 patients were entered into the trauma registry. One-thousand-six-hundred-thirteen (1,613) were transported by professional ground or air services, 59 by private vehicle. For those patients transported directly from the Emergency Department to the Operating Room, only 35% of private vehicle patients entered surgery within 90 minutes of presentation compared to 57% of those who gained access to the 9-1-1 system and used emergency medical services (EMS). One-half of those patients who did not use 9-1-1 did not have telephone access. Patient acuity was similar for those transported by private vehicle compared to those transported by basic or advanced life support units. Private vehicle transport often delayed patient triage and assessment. Thus, for a number of lower income patients, 9-1-1 access was difficult.

Conclusion:

Underestimation of the severity of the injury or fear of delay in rescue response were prominent reasons for non-use of 9-1-1. While educational efforts should concentrate on decreasing inappropriate 9-1-1 use for nonemergencies, the causes of underutilization should not be ignored.

Keywords

accessacuityair-medical emergency departmentdelayEMS9-1-1patient transportprivate vehiclesseverity of injurytrauma centertrauma registrytrauma victims
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 8 , Issue 1 , March 1993 , pp. 35 - 38
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1993

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Footnotes

*

Presented in part to the 18th Annual Assembly of the American College of Emergency Physicians, 18 September 1990, San Francisco, Calif.

References

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