Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
University of Ljubljana, Ljubljana, Slovenia.
Prehosp Disaster Med. 2021 Feb;36(1):58-66. doi: 10.1017/S1049023X20001314. Epub 2020 Nov 3.
INTRODUCTION: Police units often reach the trauma scene before Emergency Medical Services (EMS). Initiatives aiming at delivering early basic trauma care by non-medical providers including police personnel are on the rise. This study describes characteristics of trauma patients transported by police to US hospitals and identifies factors associated with survival in this patient population. METHODS: Using the 2015 National Trauma Data Bank (NTDB), an observational study was conducted of adult trauma patients who were transported by police. After describing the study population, the factors associated with survival to hospital discharge were evaluated using a multivariate analysis. RESULTS: A total of 2,394 patients were included in the study. Patients had a median age of 34.0 years (interquartile range [IQR]: 25-48) and most were males (84.5%). Blunt trauma mechanism (59.4%) was more common than penetrating trauma (29.4%). Factors associated with improved survival included: comorbidity (odds ratio [OR] = 2.92; 95% CI, 1.33-6.40); use of drugs (OR = 2.91; 95% CI, 1.07-7.92); cut/pierce (OR = 11.07; 95% CI, 2.10-58.43); motor vehicle traffic (MVT) mechanism (OR = 6.56; 95% CI, 1.60-26.98); trauma resulting in fractures (OR = 3.03; 95% CI, 1.38-6.64); and private/commercial insurance (OR = 3.41; 95% CI, 1.10-10.55). CONCLUSION: In this study population, a relatively high survival rate was noted (93.5%). Police transport of patients with blunt trauma was unexpectedly more common. Factors associated with survival to hospital discharge were identified. These factors can be used to implement more standardized and protocol-driven risk stratification tools of trauma patients on scene to improve police involvement in trauma patient transport.
简介:警察单位通常在紧急医疗服务(EMS)之前到达创伤现场。旨在通过包括警察在内的非医疗提供者提供早期基本创伤护理的举措正在增加。本研究描述了由警察送往美国医院的创伤患者的特征,并确定了与该患者人群生存相关的因素。 方法:使用 2015 年国家创伤数据库(NTDB),对由警察运送的成年创伤患者进行了一项观察性研究。在描述研究人群后,使用多变量分析评估了与存活至出院相关的因素。 结果:共有 2394 名患者纳入研究。患者的中位年龄为 34.0 岁(四分位距 [IQR]:25-48),大多数为男性(84.5%)。钝性创伤机制(59.4%)比穿透性创伤更常见(29.4%)。与生存改善相关的因素包括:合并症(优势比 [OR] = 2.92;95%置信区间,1.33-6.40);使用药物(OR = 2.91;95%置信区间,1.07-7.92);切割/刺穿(OR = 11.07;95%置信区间,2.10-58.43);机动车交通(MVT)机制(OR = 6.56;95%置信区间,1.60-26.98);创伤导致骨折(OR = 3.03;95%置信区间,1.38-6.64);以及私人/商业保险(OR = 3.41;95%置信区间,1.10-10.55)。 结论:在本研究人群中,观察到较高的生存率(93.5%)。警察运送钝性创伤患者的情况出乎意料地更为常见。确定了与存活至出院相关的因素。这些因素可用于现场实施更标准化和基于协议的创伤患者风险分层工具,以改善警察对创伤患者转运的参与。
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