Addressing prehospital patient safety using the science of injury prevention and control.

There is inadequate information about the scope and character of adverse events in prehospital care. However, there is ample evidence to suggest that prehospital patient safety hazards are often unique and underrecognized. We first summarize what is currently understood about prehospital patient safety and identify the specific aspects of emergency medical services (EMS) care that may make conventional approaches to the evaluation and improvement of patient safety more difficult. Next we introduce the concept of using injury prevention and control science to analyze prehospital adverse events and to help develop EMS patient safety solutions. Injury prevention and control is a proven public health approach for the study and reduction of both intentional and unintentional injuries. It includes the use of a Haddon phase-factor matrix to identify possible interventions, especially environmental modifications that provide automatic protection. We demonstrate how this method can be used as a complementary approach in efforts to prevent injuries caused by prehospital adverse medical events.