Abdullah Naseef, Rose Jaydon, Brown Egnall, Geduld Heike
Western Cape Government Health and Wellness, Emergency Medical Services, Cape Town, South Africa.
Department of Emergency Medical Care & Rescue, Faculty of Health Sciences, Durban University of Technology, South Africa.
Afr J Emerg Med. 2025 Jun;15(2):621-627. doi: 10.1016/j.afjem.2025.04.003. Epub 2025 May 7.
Road Traffic Crashes (RTCs) represent a significant global health challenge, with a disproportionate burden on low- and middle-income countries. Vehicle extrication is a critical Emergency Medical Service (EMS) intervention enabling early assessment and treatment of entrapped patients but remains understudied in resource-limited settings despite its potential impact on patient outcomes. This study describes the RTC extrication burden managed by a public sector EMS in the Western Cape, South Africa.
We conducted a retrospective review of Computer-Aided-Dispatch (CAD) and a paper-based rescue case record data related to the extrication practises of 97 Advanced Medical Rescuers stationed across 25 rescue stations throughout the Western Cape of South Africa. Standard descriptive statistical procedures were applied to all variables.
Of 2,587,979 EMS activations during the study period, 23,899 (0.9 %) required specialised medical rescue activations, and 11,699 (0.5 %) were for transport-related emergencies. Of these, 719 (6.1 %) cases necessitated vehicle extrication. Light motor vehicles accounted for most extrications (78.2 %, = 562), while heavy motor vehicles showed higher proportional extrication rates (127.5 vs. 75.8 extrications per 1,000 RTCs). Peak rescue activations occurred between 08h00 and 20h00 (11.9 %, = 1,388). The predominant extrication techniques were vehicle stabilisation (24.9 %, = 501), third-door conversion (23.9 %, = 482 ), and dashboard lift (13.9 %, = 282). Most patients (83.1 %, = 24,588) presented with routine (green) or non-urgent (yellow) acuity, though rural areas exhibited a higher proportion of high-acuity cases.
This first comprehensive analysis of the RTC extrication burden in a South African province reveals significant spatial and temporal variations in rescue needs and techniques. Our findings provide valuable extrication-related data to inform targeted training programs, standardised extrication protocols, and strategic resource allocation to enhance EMS capabilities in resource-limited settings. These insights provide a foundation for workforce planning and specialised training to improve outcomes for entrapped RTC patients in similar contexts.
道路交通事故（RTCs）是一项重大的全球健康挑战，在低收入和中等收入国家造成了不成比例的负担。车辆解救是紧急医疗服务（EMS）的一项关键干预措施，能够对被困患者进行早期评估和治疗，但尽管其对患者预后有潜在影响，在资源有限的环境中仍未得到充分研究。本研究描述了南非西开普省公共部门EMS管理的道路交通事故解救负担。
我们对计算机辅助调度（CAD）以及与驻扎在南非西开普省25个救援站的97名高级医疗救援人员的解救实践相关的纸质救援病例记录数据进行了回顾性审查。对所有变量应用标准描述性统计程序。
在研究期间的2587979次EMS出动中，23899次（0.9%）需要专门的医疗救援出动，11699次（0.5%）是与运输相关的紧急情况。其中，719次（6.1%）病例需要车辆解救。轻型机动车占大多数解救情况（78.2%，n = 562），而重型机动车的解救比例较高（每1000起道路交通事故中有127.5次解救，而轻型机动车为75.8次）。救援出动高峰出现在08:00至20:00之间（11.9%，n = 1388）。主要的解救技术是车辆稳定（24.9%，n = 501）、第三车门转换（23.9%，n = 482）和仪表板提升（13.9%，n = 282）。大多数患者（83.1%，n = 24588）表现为常规（绿色）或非紧急（黄色） acuity，尽管农村地区高 acuity 病例的比例较高。
对南非一个省份的道路交通事故解救负担进行的首次全面分析揭示了解救需求和技术在空间和时间上的显著差异。我们的研究结果提供了有价值的与解救相关的数据，为有针对性的培训计划、标准化的解救方案和战略资源分配提供信息，以增强资源有限环境中的EMS能力。这些见解为劳动力规划和专门培训提供了基础，以改善类似情况下被困道路交通事故患者的预后。
