Faculty Collaboration Database

Patient Characteristics and Temporal Trends in Police Transport of Blunt Trauma Patients: A Multicenter Retrospective Cohort Study. Prehosp Emerg Care 2017;21(6):715-721

Date

07/01/2017

Pubmed ID

28661715

Pubmed Central ID

PMC5849474

DOI

10.1080/10903127.2017.1332127

Scopus ID

2-s2.0-85021632065 (requires institutional sign-in at Scopus site)   16 Citations

Abstract

BACKGROUND: Police transport (PT) of penetrating trauma patients has the potential to decrease prehospital times for patients with life-threatening hemorrhage and is part of official policy in Philadelphia, Pennsylvania. We hypothesized that rates of PT of bluntly injured patients have increased over the past decade.

METHODS: We used Pennsylvania Trauma Outcomes Study registry data from 2006-15 to identify bluntly injured adult patients transported to all 8 trauma centers in Philadelphia. PT was compared to ambulance transport, excluding transfers, burn patients, and private transport. We compared demographics, mechanism, and injury outcomes between PT and ambulance transport patients and used multivariable logistic regression to identify independent predictors of PT. We also identified physiological indicators and injury patterns that might have benefitted from prehospital intervention by EMS.

RESULTS: Of 28 897 bluntly injured patients, 339 (1.2%) were transported by police and 28 558 (98.8%) by ambulance. Blunt trauma accounted for 11% of PT and penetrating trauma for 89%. PT patients were younger, more likely to be male, and more likely to be African American or Asian and were more often injured by assault or motor vehicle crash. There were no significant differences presenting physiology between PT and EMS patients. In multivariable logistic regression analysis, male sex (OR 1.89, 95%CI 1.40-2.55), African American race (OR 1.71 95%CI 1.34-2.18), and Asian race (OR 2.25, 95%CI 1.22-4.14) were independently associated with PT. Controlling for injury severity and physiology, there was no significant difference in mortality between PT and EMS. Overall, 64% of PT patients had a condition that might have benefited from prehospital intervention such as supplemental oxygen for brain injury or spine stabilization for vertebral fractures.

CONCLUSIONS: PT affects a small minority of blunt trauma patients, and did not appear associated with higher mortality. However, PT patients included many who might have benefited from proven, prehospital intervention. Clinicians, EMS providers, and law enforcement should collaborate to optimize use of PT within the trauma system.

Author List

Kaufman EJ, Jacoby SF, Sharoky CE, Carr BG, Delgado MK, Reilly PM, Holena DN

Author

Daniel N. Holena MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Accidents, Traffic
Adult
Aged
Ambulances
Female
Humans
Logistic Models
Male
Middle Aged
Philadelphia
Police
Registries
Retrospective Studies
Transportation of Patients
Trauma Centers
Wounds, Nonpenetrating
Wounds, Penetrating