TY - JOUR
T1 - A meta-analysis of prehospital care times for trauma
AU - Carr, Brendan G.
AU - Caplan, Joel M.
AU - Pryor, John P.
AU - Branas, Charles C.
N1 - Funding Information:
Address correspondence and requests for reprints to: Brendan G. Carr, MD, MA, Division of Trauma & Surgical Critical Care, Department of Surgery, Department of Emergency Medicine, The Trauma Center at Penn, Dulles Building, 2nd Floor, Hospital of the University of Pennsylvania, 34th and Spruce Street, Philadelphia, PA 19104. e-mail: <[email protected].> This work was supported in part by the American Trauma Society Trauma Information and Exchange Program, grant R01HS010914 from the Agency for Healthcare Research and Quality, and grant H28CCH319122 from the Centers for Disease Control and Prevention’s Center for Injury Prevention and Control.
PY - 2006/4
Y1 - 2006/4
N2 - Background. Time to definitive care is a major determinant of trauma patient outcomes yet little is empirically known about prehospital times at the national level. We sought to determine national averages for prehospital times based on a systematic review of published literature. Methods. We performed a systematic literature search for all articles reporting prehospital times for trauma patients transported by helicopter and ground ambulance over a 30-year period. Forty-nine articles were included in a final meta-analysis. Activation time, response time, on-scene time, and transport time were abstracted from these articles. Prehospital times were also divided into urban, suburban, rural, and air transports. Statistical tests were computed using weighted arithmetic means and standard deviations. Results. The data were drawn from 20 states in all four U.S. Census Regions and represent the prehospital experience of 155,179 patients. Average duration in minutes for urban, suburban, and rural ground ambulances for the total prehospital interval were 30.96, 30.97, and 43.17; for the response interval were 5.25, 5.21, and 7.72; for the on-scene interval were 13.40, 13.39, and 14.59; and for the transport interval were 10.77, 10.86, and 17.28. Average helicopter ambulance times were response 23.25, on-scene 20.43, and transport 29.80 minutes. Conclusions. Despite the emphasis on time in the prehospital and trauma literature there has been no national effort to empirically define average prehospital time intervals for trauma patients. We provide points of reference for prehospital intervals so that policymakers can compare individual emergency medical systems to national norms.
AB - Background. Time to definitive care is a major determinant of trauma patient outcomes yet little is empirically known about prehospital times at the national level. We sought to determine national averages for prehospital times based on a systematic review of published literature. Methods. We performed a systematic literature search for all articles reporting prehospital times for trauma patients transported by helicopter and ground ambulance over a 30-year period. Forty-nine articles were included in a final meta-analysis. Activation time, response time, on-scene time, and transport time were abstracted from these articles. Prehospital times were also divided into urban, suburban, rural, and air transports. Statistical tests were computed using weighted arithmetic means and standard deviations. Results. The data were drawn from 20 states in all four U.S. Census Regions and represent the prehospital experience of 155,179 patients. Average duration in minutes for urban, suburban, and rural ground ambulances for the total prehospital interval were 30.96, 30.97, and 43.17; for the response interval were 5.25, 5.21, and 7.72; for the on-scene interval were 13.40, 13.39, and 14.59; and for the transport interval were 10.77, 10.86, and 17.28. Average helicopter ambulance times were response 23.25, on-scene 20.43, and transport 29.80 minutes. Conclusions. Despite the emphasis on time in the prehospital and trauma literature there has been no national effort to empirically define average prehospital time intervals for trauma patients. We provide points of reference for prehospital intervals so that policymakers can compare individual emergency medical systems to national norms.
KW - Aircraft
KW - Ambulances
KW - Emergency medical services
KW - Injuries
KW - Time
KW - Trauma
UR - http://www.scopus.com/inward/record.url?scp=33644966977&partnerID=8YFLogxK
U2 - 10.1080/10903120500541324
DO - 10.1080/10903120500541324
M3 - Review article
C2 - 16531377
AN - SCOPUS:33644966977
SN - 1090-3127
VL - 10
SP - 198
EP - 206
JO - Prehospital Emergency Care
JF - Prehospital Emergency Care
IS - 2
ER -